INTRODUCTION – The five-year interval between 2013 and 2018 represents the first episode in almost one hundred years when life expectancy at birth in the US experienced a sustained decline. In 2020, according to UN population projections made prior to the Covid-19 pandemic, US life expectancy was anticipated to return roughly to the level observed seven years before, in 2013. This would have marked a seven-year interval, without any major exogenous event, with null gains in life expectancy, an unprecedented case worldwide in modern times. With the arrival of the Covid-19, the picture is obviously much bleaker and large reductions in life expectancy are now expected in 2020 (Andrasfay and Goldman, 2020).

The recent increases in mortality have brought life expectancy back to the forefront of the US public health debate. Though unprecedented, these reductions in life expectancy come after an equally surprising but, within economics and the broader public debate, largely overlooked phenomenon: a decades long deterioration in the country’s relative performance in life expectancy, after which the US has fallen considerably behind the rest of the developed world. Today, life expectancy in the US is substantially lower than in every single Western European country, including those with income per capita below half of its own, such as Greece and Portugal, both of which have life expectancy numbers more than 2.5 years above that of the US. In fact, life expectancy at birth in the US is now slightly below that of Chile and only slightly above that of Uruguay, two of Latin America’s top performers (2016 data from the World Bank’s World Development Indicators).

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