“A surprising pandemic side effect: People have become more engaged with their health” is the headline of an engaging essay, highlighting positive outcomes from people becoming self-sufficient when traditional services were in short supply.
People learned and practiced effective behaviors to stop the transmission of infectious diseases this past year. Influenza declined to 1% of what would have been typical due to physical distancing, hand washing, mask wearing, and other effective measures. Digital connections modernized traditional, paternalistic healthcare practices overnight with increased and less expensive accessibility. People and communities who were healthier at the start of the pandemic, not unexpectedly, proved to be more resilient.
Understanding and navigating the healthcare system became a learning experience as COVID-19 diagnosis, testing, treatment, and vaccines matured. Medical science, epidemiology, clinical trials, vaccine development, and even proficiency with digital connectivity all became topics of daily conversation. Social determinants of health and public health interventions rose in awareness.
The above is the good news. In sharp contradistinction, a May 2021 British Medical Journal article demonstrated just the opposite conclusion.
“The U.S. had a much larger decrease in life expectancy between 2018 and 2020 than other high income nation nations, with pronounced losses among the Hispanic and non-Hispanic Black populations. 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.”
Average life expectancy in 2018 was 78.7 years; that number dropped to 76.9 at the end of 2020, the greatest fall since WWII. Equally unnerving, the U.S. has fallen much more than any of the other high-income nations in this metric. Other nations went into the pandemic with both a longer life expectancy and greater increases year-over-year in life expectancy than the U.S. Prior to COVID-19, diseases of despair—alcohol abuse, drug addiction, and suicide—were responsible for flattening and then decreasing life expectancy in America.
The two paradoxes created by the stress of COVID-19 are explainable but are not the important “take home” message. Effectively addressing the social determinants of health for all populations across the socio-economic spectrum should become the rallying cry not only for improving health and enhancing wellness but also for promoting economic success and maintaining civil tranquility.
