It's Official: Life Expectancy Fell 1.5 Years in 2020

Life expectancy at birth in the United States fell by 1.5 years in 2020, according to the National Center for Health Statistics (NCHS). Covid-19 deaths accounted for most but not all of the decline. From 78.8 years in 2019, life expectancy fell to 77.3 years in 2020. The decline was much greater for some groups than others... 

Change in life expectancy at birth, 2019 to 2020 (in years)

Total: -1.5

Females: -1.2

Males: -1.8

Blacks: -2.9

Hispanics: -3.0

Non-Hispanic whites: -1.2

Hispanic males: -3.7

Black males: -3.3

Black females: -2.4

Hispanic females: -2.0

Non-Hispanic white males: -1.3

Non-Hispanic white females: -1.1

"Mortality due to Covid-19 had, by far, the single greatest effect on the decline in life expectancy at birth between 2019 and 2020," reports the NCHS. Covid accounted for 74 percent of the negative change in life expectancy. More deaths due to unintentional injuries (mostly drug overdoses) contributed another 11 percent, and the rise in homicides contributed 3 percent. 

Fewer deaths from cancer, heart disease, stroke, chronic lower respiratory disease, and Alzheimer's prevented life expectancy from falling even further.

Source: National Center for Health Statistics, Provisional Life Expectancy Estimates for 2020 (PDF)

Life Expectancy in U.S. Falling Further and Further Behind Peer Countries

Life expectancy in the U.S. declined by 1.87 years between 2018 and 2020, according to an Urban Institute study. This decline was 8.5 times greater than the 0.22 average decline of 16 peer (high-income) countries. Not only did the U.S. suffer a disproportionate number of Covid-19 deaths overall, but the higher death rates among Blacks and Hispanics also contributed to our growing disadvantage in life expectancy.

For more than a decade, life expectancy at birth in the United States has been falling further behind life expectancy in peer countries. The difference in life expectancy between the U.S. and the 16 peer countries average was 1.88 years in 2010. The difference had grown to 3.05 years by 2018. In 2020, U.S. life expectancy was an even greater 4.69 years behind life expectancy in the peer countries. 

"A longstanding and widening U.S. health disadvantage, high death rates in 2020, and continued inequitable effects on racial and ethnic minority groups are likely the products of longstanding policy choices and systemic racism," the study concludes. 

Source: Urban Institute, Effect of the Covid-19 Pandemic in 2020 on Life Expectancy across Populations in the USA and other High Income Countries: Simulations of Provisional Mortality Data

First Time Ever: Life Expectancy by State

For the first time ever, the National Center for Health Statistics has released a report estimating life expectancy by state. The estimates are for 2018, with plans to produce the state estimates annually. 

The report reveals big differences by state in life expectancy at birth and at age 65. Hawaii is number one on both measures, with a life expectancy at birth of 81.0 years and at age 65 of 21.1 years. Life expectancy at birth bottoms out in West Virginia, at 74.4 years. Kentucky is last among the states in life expectancy at age 65—just 17.5 years. Here are the top and bottom states for life expectancy at birth...

Top 10		Bottom 10
1. Hawaii	81.0	42. Missouri	76.6
2. California	80.8	43. South Carolina	76.5
3. New York	80.5	44. Arkansas	75.6
4. Minnesota	80.5	45. Oklahoma	75.6
5. Connecticut	80.4	46. Louisiana	75.6
6. Massachusetts	80.1	47. Tennessee	75.5
7. Washington	80.0	48. Kentucky	75.3
8. Colorado	80.0	49. Alabama	75.1
9. New Jersey	79.8	50. Mississippi	74.6
10. Rhode Island	79.8	51. West Virginia	74.4

The life expectancy of males at birth is highest in California, at 78.4 years. Female life expectancy at birth is highest in Hawaii, at 84.0 years. For both males and females, life expectancy at birth is lowest in West Virginia—71.7 and 77.3 years, respectively.

Source: National Center for Health Statistics, U.S. State Life Tables, 2018 (PDF)

1.0 Year Decline in Life Expectancy, January-June 2020

Yep, it happened. As projected by a study in the Proceedings of the National Academy of Sciences, the coronavirus pandemic resulted in a 1.0 year decline in life expectancy in the first six months of 2020. One year may not sound like a lot, but it is the biggest decline since World War II, the New York Times reports.

Life expectancy at birth in the United States fell to 77.8 years in the first half of 2020—one full year below the 78.8 year life expectancy of 2019, according to the National Center for Health Statistics. Here are the declines in life expectancy at birth by sex, race, and Hispanic origin...

Decline in life expectancy at birth, January–June 2020 versus 2019

Black males: -3.0 years

Hispanic males: -2.4 years

Black females: -2.3 years

Hispanic females: -1.1 years

Non-Hispanic white males: -0.8 years

Non-Hispanic white females: -0.7 years

Source: National Center for Health Statistics, Provisional Life Expectancy Estimates for January through June, 2020 (PDF)

Life Expectancy to Drop by More than 1 Year

Whenever life expectancy declines in the United States, it's a big deal. In the past 50 years, the National Center for Health Statistics has measured only four annual declines in life expectancy at birth, all of them small, ranging from a drop of 0.1 years to 0.3 years. 

Brace yourself: Because of Covid-19, life expectancy is projected to drop by 1.13 years in 2020, according to a study in the Proceedings of the National Academy of Sciences (PNAS). This is a very big deal. 

There's more. The PNAS study was undertaken months ago, and its projections are based on the Institute for Health Metrics and Evaluation's (IHME) medium scenario of Covid deaths produced in early October. At that time, the medium scenario forecast a total of 321,000 Covid deaths. In fact, Covid killed 344,000 people in 2020, according to the CDC. This larger number is close to IHME's high scenario estimate of 348,000 deaths by the end of the year. The high scenario means an even larger life expectancy decline in 2020, according to the PNAS study—a drop of 1.22 years.

There's even more. Because of Covid's disproportionate impact on people of color, the life expectancy decline will be much greater for Blacks and Hispanics than for non-Hispanic Whites. Under the medium death scenario, Hispanic life expectancy at birth in 2020 is projected to decline by 3.05 years, Black by 2.10 years, and non-Hispanic white by 0.68 years. 

"One of the many very distressing consequences of the Covid-19 pandemic is an estimated 39% increase in the Black-White life expectancy gap," note the study's authors. The life expectancy decline will also reduce what is called the Hispanic paradox (the longer life expectancy of Hispanics versus non-Hispanic whites) by more than 70 percent, the authors report.

Is the projected 2020 life expectancy decline just a blip or will it be long lasting? The study's authors are doubtful the decline is just a blip. "A rapid return to pre-Covid-19 life expectancy is unlikely," they conclude. Covid-19 deaths are continuing to mount. Also, say the authors, there are "the long-term detrimental health impacts for those who recovered from the virus, deaths from other health conditions that were precipitated by Covid-19, and social and economic losses resulting from the pandemic."

Source: Proceedings of the National Academy of Sciences, Reductions in 2020 US Life Expectancy Due to Covid-19 and the Disproportionate Impact on the Black and Latino Populations

We're Already Behind in Life Expectancy

The good news is that American life expectancy is projected to rise, according to the Census Bureau. The bad news is that our life expectancy has already fallen short of what it should be to achieve the projected gains.

In a report on future trends in life expectancy, the Census Bureau foresees life expectancy rising from the 79.7 years it had projected for 2017 to 85.6 years in 2060, an increase of about 6 years. The trouble is, actual life expectancy in 2017 was only 78.6 years, fully 1.1 year less than the 79.7 projected, which was the starting point for the trends forecast in the report. The lower actual life expectancy of 2017 is a consequence of three years of life expectancy declines during the 2010s. So, we're already behind on making those life expectancy gains.

This disconnect is mentioned in the report. A footnote reads: Official life expectancy measures from the NCHS were lower than the projected life expectancy values for 2017. Despite recently observed decreases in life expectancy, these projections assume continued increases in life expectancy." The researchers also explain that they expect the pattern of broad increases in life expectancy to resume.

Let's hope so, because the potential increases are impressive. Here are the life expectancy projections for 2060, the increase from the projected life expectancy of 2017 (and actual life expectancy in 2017)...

Total population
85.6 years in 2060, 5.9 years more than the 79.7 projected for 2017 (78.6 actual)

Males
83.9 years in 2060, 6.6 years more than the 77.3 projected for 2017 (76.1 actual)

Females
87.3 years in 2060, 5.3 years more than the 82.0 projected for 2017 (81.1 actual)

Non-Hispanic Whites
85.6 years in 2060, 5.6 years more than the 80.0 projected for 2017 (78.5 actual)

Non-Hispanic Blacks 
84.6 in 2060, 8.4 years more than the 76.2 projected for 2017 (74.9 actual)

Hispanics
86.5 years in 2060, 4.3 years more than the 82.2 projected for 2017 (81.8 actual)

Source: Census Bureau, Living Longer: Historical and Projected Life Expectancy in the United States, 1960 to 2060

Life Expectancy Is at a Standstill

Life expectancy in the United States was no higher in 2018 than it was in 2010, which makes the 2010s (so far) the first decade in modern history in which the lives of Americans have not increased. During those eight years, life expectancy at birth succeeded in climbing 0.2 years, reaching a high of 78.9 in 2014. Then, to the consternation of many, it fell by 0.2 years between 2014 and 2015—the first decline since 1993. It fell another 0.1 year between 2016 and 2017, but gained 0.1 year between 2017 and 2018. In 2018, as in 2010, life expectancy at birth in the United States was 78.7 years.

Life expectancy at birth in the United States, 2010 to 2018
2018: 78.7 years
2017: 78.6
2016: 78.7
2015: 78.7
2014: 78.9
2013: 78.8
2012: 78.8
2011: 78.7
2010: 78.7

A study by the National Center for Health Statistics takes a look at the reasons for the 0.3 year decline in life expectancy between 2014 and 2017. Most of the decline was caused by the increase in drug overdose deaths. In 2010, there were 38,329 deaths from drug overdoses. The number grew to 47,055 by 2014. Then things really got bad, with deaths surging to 70,237 by 2017—a 49 percent increase between 2014 and 2017. This surge explains the 51 percent majority of the decline in life expectancy during those years, reports the National Center for Health Statistics. Other causes of death contributing to the decline in life expectancy were Alzheimer's disease, suicide, homicide, and diabetes.

Drug deaths fell slightly in 2018, and life expectancy recovered a bit—but it's only back to where it was nearly a decade ago.

Source: National Center for Health Statistics, Mortality Data, Changes in Life Expectancy at Birth, 2010–2018; and Drug Overdose Deaths in the United States, 1999–2018

Remarkable Increase in Men's Life Expectancy

In recent years, life expectancy trends in the United States have been disappointing. Length of life has increased more slowly in the United States than in other developed countries. Geographic disparities in life expectancy are growing and, in the past few years, overall life expectancy has actually declined. But there's some good news on the life expectancy front. According to a study in Demography, the gains in the life expectancy of American men in a number of large cities have been nothing short of extraordinary.

Examining men's mortality in 25 large U.S. cities over the 25 years from 1990 to 2015, the researchers found above average increases in places such as San Francisco (13.7 years), Washington, D.C. (13.7 ), and New York City (11.8). These increases are far above the overall gain of 4.8 years for all American men during the time period. In most of the 25 cities examined, in fact, men's life expectancy grew far more than the 4.8 year average.

What accounts for this "remarkable" rise in life expectancy, as the researchers describe it? One factor is the decline in deaths due to HIV/AIDS. Another is the decline in homicides. The changing socioeconomic characteristics of city populations also contributed to the rise. Resilience also has a role, the authors suggest. "One potential explanation for the pattern of city improvements involves the long-run strength and character of local institutions," they conclude. "The six top-performing cities—San Francisco, New York City, Los Angeles, Chicago, Boston, and Washington, DC—stand out as international centers of cultural and economic activity and have long histories of strong amenities and commensurate institutional infrastructure."

Source: Demography, Life and Death in the American  City: Men's Life Expectancy in 25 Major American Cities from 1990 to 2015, by Andrew Fenelon and Michel Boudreaux, Volume 56, No. 6,  ($39.95)

Life Expectancy at Birth by Sex, Race, Hispanic Origin

Life expectancy at birth varies by race and Hispanic origin. Non-Hispanic Blacks have a lower life expectancy at birth (74.9 years) than non-Hispanic Whites (78.6 years). Non-Hispanic Whites have a lower life expectancy at birth than Hispanics (81.8 years).

Add sex to the mix and the ranking of life expectancy becomes more complex. Non-Hispanic Black females have a higher life expectancy than non-Hispanic White males. Non-Hispanic White females have a higher life expectancy than Hispanic males. Hispanic females have the highest life expectancy of all.

Life expectancy at birth in 2016
84.3 years: Hispanic females
81.0 years: non-Hispanic White females
79.1 years: Hispanic males
78.0 years: non-Hispanic Black females
76.2 years: non-Hispanic White males
71.6 years: non-Hispanic Black males

Source: National Center for Health Statistics, Mortality Data, United States Life Tables, 2016

10 Questions: An Update (Part 1)

Two years ago Demo Memo presented 10 vital demographic questions and asked how many answers to these questions we would have once we had more data in hand. Two years later, the same questions are still of great importance. We have more data. So how much more do we know? Let's take a look...

1. When will the baby bust end? We now know it might not end. The decline in births since the 2007 peak is as great as the decline in the aftermath of the Great Depression (a 10.7 percent drop). But this may be more than a dip in the road. An analysis by the Center for Retirement Research suggests the fertility decline may be permanent, driven by structural changes in childbearing patterns. The United States appears to be adopting the low-fertility regime common in other developed countries.

2. Why is life expectancy declining? In two of the past three years, life expectancy in the United States has declined. We now know that the declines in 2015 and 2017 were due in large part to rising mortality rates among people under age 65—primarily from drug overdoses and suicides. The biggest increases in drug overdoses and suicide rates have occurred in rural areas—see Question 4, below.

3. Will homeownership make a comeback? The homeownership rate hit a post-Great Recession low of 63.4 percent in 2016, then climbed to 63.9 percent in 2017—the first statistically significant rise in more than a decade. While the increase is encouraging, the homeownership rate is unlikely to return to the highs of the early 2000s. The Millennial generation—now at the age of first-time home buying—is burdened by student loan payments. Student loans delay homeownership by 7 years, according to the National Association of Realtors. Consequently, the age of first-time home buying (the age at which the homeownership rate first surpasses 50 percent) has shifted from the early to the late thirties.

4. What will save small town and rural America? Corporate America will not be coming to the rescue, judging by Amazon's choice to place its second headquarters in two of the largest and richest metropolitan areas in the country. The continuing allure of urban areas makes this question more important than ever—and we don't yet have any answers. But we may know more about why rural areas are falling behind. A statistical concept called "gambler's ruin" explains it, says economist and New York Times columnist Paul Krugman. The gambler (small town or rural area) who starts with the fewest pennies (economic opportunities) is the one most likely to go bankrupt. Small towns and rural America have a shrinking pile of pennies to play with and are increasingly likely to face ruin because of it. We still don't know how to solve this problem or even if we can.

5. When will Millennials marry? The median age at first marriage continues to rise, reaching a new record high in 2017 of 27.8 years for women and 29.8 years for men. Why are Millennials delaying marriage? One reason is that a much larger share of them go to college, which delays marriage and childbearing. Another reason is student loan debt, which not only delays homeownership but also marriage, according to the National Association of Realtors.

To be continued tomorrow...

Another Decline in Life Expectancy

Life expectancy at birth fell to 78.6 years in 2017, according to the National Center for Health Statistics, down from 78.7 years in 2016. Life expectancy also fell in 2015, held steady in 2016 according to revised numbers, then fell again in 2017. "The nation is in the longest period of a generally declining life expectancy since the late 1910s," reports the New York Times about the trend. Behind the decline are rising death rates for 7 of the 10 leading causes of death including unintentional injuries and suicide.

Unintentional injuries: Most drug overdose deaths are included in the "unintentional injuries" cause of death. The number of drug overdose deaths climbed to 70,237 in 2017, up from 63,632 in 2016. The death rate from drug overdoses was 21.7 per 100,000 population in 2017, up from 12.3 in 2010 and 6.2 in 2000.

Suicide: Suicides are also on the rise. Between 1999 and 2017 the suicide rate increased 33 percent, climbing from 10.5 to 14.0 deaths per 100,000 population. Suicide rates are much higher for men than for women. They are much higher in rural than in urban counties, and the gap is growing. The suicide rate in the most rural counties was 36 percent greater than the rate in the most urban counties in 1999. The rural rate was 80 percent higher in 2017.

The decline in life expectancy in 2017 was limited to males and people under age 65. "People are increasingly hopeless," said George Washington University disease prevention expert Dr. William Dietz in the New York Times, "and that leads to drug use, it leads potentially to suicide."

Source: National Center for Health Statistics, Mortality in the United States, 2017 and Drug Overdose Deaths in the United States, 1999–2017 and Suicide Mortality in the United States, 1999–2017

How Long Are the Golden Years?

Just how long are the golden years? If you are nearing retirement, how many years can you and your spouse expect to spend together? This is not an easy calculation. The answer is not simply the shorter life expectancy of the husband. Instead, the calculation of joint life expectancy requires incorporating the probabilities of both husband and wife surviving in each successive year.

It's a tedious job, say economists Janice Compton and Robert A. Pollack, but they did it. Their results are published in a National Bureau of Economic Research working paper, which examines trends in joint life expectancy over time and by race, Hispanic origin, and education. They illustrate their findings throughout the paper by considering a wife aged 60 married to a husband aged 62. "We focus on 60 year old wives and their husbands because these are ages at which many couples make crucial retirement-related decisions such as leaving career employment and claiming social security benefits," the authors explain. Here are some of the findings by race, Hispanic origin, and education based on life expectancy stats in 2010...

Joint life expectancy for wife at 60 and husband at 62 (and probability wife will be survivor)
Blacks: 15.45 years (63%)
Hispanics: 18.79 years (65%)
Non-Hispanic Whites: 17.66 years (63%)

Neither is a college graduate: 15.53 years (65%)
Only wife is a college graduate: 17.17 years (68%)
Only husband is a college graduate: 18.31 years (59%)
Both are college graduates: 18.99 years (63%)

Joint life expectancy has expanded over the decades as individual life expectancy has grown, the researchers find. For non-Hispanic White couples, joint life expectancy has stretched from just 12.06 years in 1950 to the 17.66 years of 2010. Black couples can look forward to 15.45 golden years, up from just 9.99 in 1950.

Source: National Bureau of Economic Research, The Life Expectancy of Older Couples and Surviving Spouses, Working Paper 25009 ($5)

Life Expectancy Gap Grew in 2016

In the United States, women live longer than men. But the female advantage has been shrinking for decades—until now. In 2016 the life expectancy gap between females and males widened for the first time since 1990, according to the National Center for Health Statistics report, Deaths: Final Data for 2016, increasing from 4.8 to 5.0 years between 2015 and 2016. Here is the trend since 1950...

Gap in female-male life expectancy
2016: 5.0 years (first increase since 1989-90)
2015: 4.8 years
2010: 4.8 years
2000: 5.2 years
1990: 7.0 years
1980: 7.4 years
1979: 7.8 years (biggest gap)
1970: 7.6 years
1960: 6.5 years
1950: 5.5 years

Since 1950, the life expectancy of both males and females has increased substantially—rising from 65.6 to 76.1 years (+10.5 years) for males, and from 71.1 to 81.1 years (+10.0 years) for females. During those years, the female-male life expectancy gap grew from 5.5 years in 1950 to a peak of 7.8 years in 1979. The gap then began to shrink, falling to 4.8 years from 2010 through 2015.

Behind the 1950-to-1979 increase in the female-male life expectancy gap were higher rates of smoking and heart disease among men. As smoking rates fell and heart disease was better controlled, the life expectancy gap began to decline. The decline has come to a halt, at least temporarily, as male mortality rates rise faster than female for some causes of death. One of those causes is drug-induced deaths. Between 2015 and 2016, the drug-induced mortality rate of males climbed 26.0 percent. The female rate increased by a smaller 13.6 percent.

Source: National Center for Health Statistics, Mortality Data

Life Expectancy Declines, Again

Big, big news: Life expectancy at birth fell for the second year in a row in 2016, according to the National Center for Health Statistics. This is the first two-year life expectancy decline since flu outbreaks in 1962 and 1963 drove life expectancy down, according to NCHS. Life expectancy at birth in 2016 was 78.6 years, 0.1 year less than in 2015. Life expectancy at birth peaked at 78.9 years in 2014.

Drug overdose deaths are behind the life expectancy decline. There were 63,632 overdose deaths in 2016—21 percent (!) more than in 2015. The increase in drug overdose deaths has managed to rearrange the list of leading causes of death. "Unintentional injuries," which includes most drug overdose deaths, is now the 3rd leading cause of death. It was 4th in 2015.

Drug overdose deaths are highest among 25-to-54-year-olds and uncommon among people aged 65 or older. In fact, life expectancy at age 65 increased by 0.1 years in 2016 to 19.4 years as death rates from heart disease and cancer declined.

Source: National Center for Health Statistics, Mortality in the United States, 2016 and Drug Overdose Deaths in the United States, 1999–2016

Work Life Expectancy at Age 50

How many years of work life remain for men and women at age 50? That depends on their educational attainment, according to a study published in Demography. Those with a college degree have a significantly longer work life expectancy than those with no more than a high school diploma, the researchers found. For Black men, having a college degree more than doubles their work life expectancy at age 50. Here are the results by highest level of education...

Black men
High school diploma: 8.2 years
College degree: 17.6 years

Black women
High school diploma: 9.9 years
College degree: 10.3 years

Hispanic men
High school diploma: 11.0 years
College degree: 14.3 years

Hispanic women
High school diploma: 11.2 years
College degree: 12.9 years

Non-Hispanic white men
High school diploma: 13.2 years
College degree: 16.3 years

Non-Hispanic white women
High school diploma: 11.5 years
College degree: 14.4 years

Some of the difference in work life expectancy by education is due to higher mortality rates among the less educated, say the researchers. But most is "attributable to weaker labor force attachment among the less-educated."

Source: Demography, Working Life Expectancy at Age 50 in the United States and the Impact of the Great Recession

Years of Healthy Grandparenthood Are Expanding

With Millennials delaying marriage and childbearing longer than any previous generation, many wannabe grandparents are experiencing FOMO—fear of missing out. Will they still be around—and able to enjoy—their grandchildren when they finally arrive? A study in Demography should help ease their fear. Despite delayed childbearing, expected years of healthy grandparenthood are rising.

Using data from several surveys including the Health and Retirement Study, researchers Rachel Margolis and Laura Wright examined grandparenthood and health status over time. They wanted to determine whether the years of healthy grandparenthood, "one of the most satisfying parts of older age," are expanding or contracting as the dueling forces of later childbearing and longer life expectancy interact.

The answer: the best part of old age is expanding. Expected years of healthy grandparenthood for Americans at age 50 grew significantly between 1992–94 and 2010. For men, years of healthy grandparenthood grew from 13.2 to 15.8 (a gain of 2.6 years). For women they climbed from 15.9 to 18.9 (a gain of 3.0 years). The proportion of grandparenthood spent healthy also increased during the time period, rising from 71 to 73 percent for men and from 69 to 74 percent for women.

Healthy grandparenthood is a big deal not just because it's fun. It is a time when elders provide important transfers to younger family members, the researchers note—such as providing child care. In contrast, "unhealthy grandparenthood represents a period when the middle generation may be more likely to provide care upward," say the researchers.

Source: Demography, Healthy Grandparenthood: How Long Is It, and How Has It Changed?

Is Life Expectancy Falling among the Least Educated?

Not according to a study by the Center for Retirement Research. The least-educated Americans are not who they used to be, say CRR researchers, and that must be taken into account when determining trends in life expectancy.

Back when dropping out of high school was practically the norm, the least educated were part of the economic mainstream. Today, they are an increasingly disadvantaged economic minority. That's why comparing the life expectancy of high school dropouts over time is like comparing apples and oranges. To solve this problem, CRR researchers took a different approach. They examined life expectancy trends between 1979 and 2011 by dividing the population in each year into educational attainment quartiles. By defining educational attainment relatively rather than absolutely, the decline in life expectancy among the least educated disappears.

In fact, the life expectancy of the least educated increased between 1979 and 2011, as did the life expectancy of every other educational attainment quartile. But the gains were bigger for the better-educated groups and biggest among the most highly educated. Life expectancy is increasing for all, conclude the researchers. But "mortality inequality is worsening over time."

Source: Center for Retirement Research, Rising Inequality in Life Expectancy by Socioeconomic Status

"Deaths of Despair"—Economists Document Rising Mortality among Less-Educated Non-Hispanic Whites

Death rates are rising for middle-aged non-Hispanic Whites with a high school diploma or less education, report Princeton economists Ann Case and Angus Deaton in a stunning analysis of this troubled segment of the American population. The rise in mortality rates is due to what Case and Deaton call "deaths of despair"—deaths due to drug use, alcohol abuse, and suicide.

Among non-Hispanic Whites with no more than a high school diploma, mortality rates in 2015 were higher than in 1999. During those years, mortality rates fell for other segments of the population—better educated non-Hispanic Whites, Blacks, and Hispanics. The mortality rates of non-Hispanic Whites with a high school diploma or less education were 30 percent lower than the mortality rates of Blacks in 1999. By 2015, they were 30 percent higher.

Case and Deaton see globalization and automation as the possible deep underlying causes of what they call the collapse of the white working class. The long-run stagnation of the wages of this group has led to a decline in marriage, greater social isolation, withdrawal from the labor force, a sense of hopelessness, and more deaths of despair.

Source: Brookings Institution, Brookings Papers on Economic Activity, Mortality and Morbidity in the 21st Century

10 Questions for 2017 (Part 1)

As demographic trends unfold, questions arise. This is the first of a two-part post with 10 vital questions about ongoing demographic trends. The fresh data to be released in 2017 may answer these questions. (Click here for Part 2.)

1. When will the baby bust end? Population growth in the U.S. has slowed to a crawl because of the ongoing baby bust. The annual number of births fell 8 percent between 2007 (the peak year) and 2015. The fertility rate is at an all-time low, and most childless women say they don't expect to have children anytime soon. How long will they wait?

2. Why is life expectancy declining? Life expectancy fell in 2015 for the first time since 1993, and death rates rose for 8 of the 10 leading causes of death. The experts are wondering what's going on. With so many focused on this troubling trend, we might get some answers in 2017.

3. Will homeownership make a comeback? The homeownership rate fell to 63.7 percent in 2015, the lowest since 1967 and 5.3 percentage points below the 2004 peak. Among 30-to-44-year-olds, the decline exceeded 10 percentage points. After waiting more than a decade for home buying to stage a comeback, will 2017 be the year we throw in the towel and declare lower rates to be the new normal?

4. What will save small town and rural America? We're in the midst of an urban renaissance. The population of the nation's most urban counties grew faster than others between 2010 and 2015, while rural counties lost population. Economic growth, too, is occurring disproportionately in large metro centers. Outside these hubs of activity, there's a male employment crisis. What can small town and rural residents do to get back in the game?

5. When will Millennials marry? The median age at first marriage is at a record high for both men and women as Millennials remain single longer than any other generation in history. The economic consequences are huge and include the urban renaissance, the baby bust, and the decline of homeownership. The Millennial generation, more than any other, will determine what we will be talking about this year.

Life Expectancy Falls in 2015

Life expectancy at birth in the United States fell by 0.1 year in 2015—to 78.8 years. This seemingly small decline is a big deal and troubling for two reasons. One, a decline in life expectancy does not happen very often. The 2015 decline was the first since 1993, and the 1993 decline was the first since 1980. Two, unlike the 1993 decline in life expectancy—a consequence of HIV's rapid rise to become the 8th leading cause of death—the reason for the 2015 decline is not clear.

That's because there are many reasons. The age-adjusted death rate increased significantly in 2015 for fully 8 of the top 10 causes of death: heart disease, chronic lower respiratory disease, unintentional injuries, stroke, Alzheimer's disease, diabetes, kidney disease, and suicide. The death rate increased for non-Hispanic Whites (males and females) and non-Hispanic Black males. The death rate was unchanged for non-Hispanic Black females and for Hispanics (males and females).

While the National Center for Health Statistics' report does not shed much light on the significance of the life expectancy decline, a New York Times story does, quoting  professor of health policy and management at Columbia University, Dr. Peter Muennig, who tells the Times, "a 0.1 decrease is huge."

Source: National Center for Health Statistics, Mortality in the United States, 2015