Why is life expectancy falling?
A child born in the UK in 2011 could expect to live longer than a child born in 2010. That had been true, almost without interruption, for more than a century. Clean water, vaccination, antibiotics, and falling infant mortality pushed the average higher decade after decade. The idea that your children would live longer than you felt like a law of progress.
It is not a law. It is a statistical result that can reverse.
Since 2014, US life expectancy has stalled and then fallen. UK life expectancy growth slowed to a near-flat line before 2020. Then COVID-19 arrived. The pandemic did not cause the stalling. It made a hidden condition visible.
How much did COVID-19 cut?
COVID-19 caused the largest single-year drop in life expectancy since the Second World War in both the UK and the US. In 2020, US life expectancy at birth fell by about 1.8 years. The UK saw a fall of roughly 1.0 years. Those are not rounding errors. In a metric that usually changes by a few tenths of a year, a drop of over a year is a shock.
By 2022 and 2023, some recovery appeared. But the recovery has been uneven. In the US, life expectancy in 2023 remained below the 2019 level. In the UK, it recovered partially but did not return to the pre-pandemic trend line. If you had projected the 2010-2019 trend forward, actual life expectancy in 2025 is meaningfully lower than expected.
The pandemic removed the people who died early from the average. It also exposed deep underlying weaknesses in population health that had been growing for years.
Why did US life expectancy fall before the pandemic?
The US life expectancy decline started before anyone had heard of SARS-CoV-2. Between 2014 and 2019, US life expectancy fell or flatlined in three separate years. The driver was not influenza. It was not heart disease. It was opioids.
Deaths from drug overdose rose from under 20,000 in 1999 to over 100,000 by 2021. The majority were people in their 20s, 30s, and 40s. When a 30-year-old dies of an overdose, the effect on life expectancy at birth is large because that death removes decades of expected life from the average. The same death at age 80 has a much smaller effect.
The term "deaths of despair" emerged to describe this pattern: drug overdoses, alcohol-related liver disease, and suicide. All three rose in the US between 2000 and 2020. The causes are debated. Economic decline in manufacturing regions. Reduced social connection. Inadequate mental health care. The aggressive marketing of prescription opioids. What is not debated is the arithmetic: when middle-aged adults die at rising rates, life expectancy falls.
The opioid crisis alone explains roughly half of the US life expectancy slowdown between 2014 and 2019. COVID-19 then added another layer.
What stalled UK life expectancy after 2011?
The UK story is different. There was no opioid crisis on the American scale. UK drug overdose rates are lower by a factor of four. Yet UK life expectancy growth stalled around 2011 and has never recovered.
The UK's Office for National Statistics data shows that between 2011 and 2019, life expectancy for men rose by only about 0.1 years per year. For women in some regions, it did not rise at all. Before 2011, the typical increase was 0.2 to 0.3 years per year. The gap between the pre-2011 trend and the post-2011 reality represents thousands of "missing" years of life improvement.
Researchers point to austerity: the programme of public spending cuts introduced after the 2008 financial crisis. Spending on social care, public health, and local services was reduced. Mortality rates for people over 65 continued to improve. Mortality rates for working-age adults stopped improving and, for some groups, worsened. Deaths from heart disease and cancer fell more slowly than in comparable European countries.
Health inequalities widened. People in the poorest 10% of areas in England have life expectancy about 9 years lower than those in the richest 10%. That gap has grown since 2010, not shrunk.
The UK's stalling is quieter than the US decline. It does not appear in dramatic headlines about opioid epidemics. But it means that a 40-year-old in the UK today has a lower life expectancy at that age than a 40-year-old in 2010 would have had, if you applied the pre-2011 trend.
Has life expectancy fallen this fast before?
The US and UK are not the first countries to see life expectancy fall in modern times. Russia in the 1990s provides the starkest example.
Between 1990 and 1994, life expectancy at birth for Russian men fell from about 64 to 57 years. A drop of seven years. In four years. The cause was the collapse of the Soviet Union. Economic shock, mass unemployment, and a breakdown of the healthcare system led to a surge in deaths from heart disease, accidents, violence, and alcohol poisoning. Alcohol consumption, particularly of cheap, strong spirits, drove a large share of the excess deaths.
Russian male life expectancy did not return to the 1990 level until about 2010. A whole generation lived shorter lives than the generation before them.
The Russian example is a warning. Life expectancy can fall fast when social and economic systems break down. The US and UK have not experienced that scale of collapse. But the Russian case proves that the assumption of continuous improvement is fragile.
Is the long-term rise over?
No. But the trend is not guaranteed.
The long-term upward trend in life expectancy is driven by medical advances, reduced infectious disease, and lower infant mortality. Those forces have not reversed. Cancer survival rates continue to improve. Cardiovascular death rates, while slowing in some groups, are still far below 1970 levels. Infant mortality in both the UK and US is low by historical standards.
What has changed is the rate of improvement for adults. For working-age people, mortality has stopped falling in the UK and has risen in the US. That is a new phenomenon. If it continues, life expectancy will not return to the pre-2010 trend line for decades, if ever.
The COVID-19 pandemic was a one-time shock. The opioid crisis and the slowing of health improvement for working-age adults are ongoing structural problems. They will not solve themselves.
What a falling life expectancy means for your planning
A falling or slowing life expectancy changes the numbers you use for personal planning.
If you are using a life clock that assumes a life expectancy of 80 or 85, you may be using a figure that no longer applies to your demographic. For a man in the poorest areas of England, life expectancy at birth is about 74. For a woman in the highest-income areas, it is about 86. The gap is twelve years. That is the difference between retiring at 65 with a 20-year horizon or a 30-year horizon.
For retirement planning, the relevant figure is not life expectancy at birth. It is remaining life expectancy at your current age. If you are 60, your remaining life expectancy is higher than the at-birth figure minus 60. You have already survived the high-risk years of infancy, adolescence, and young adulthood. But the slowing of improvement for working-age adults means that a 60-year-old today may have a lower remaining life expectancy than a 60-year-old in 2010 would have had.
The practical advice: do not assume the future will be better. Use the most recent data from your own country and demographic. How accurate is life expectancy depends on which figure you use and for whom. The national average hides wide variation.
The person who should change their planning is someone in their 40s or 50s who assumed they would live to 90. If you are in a demographic where life expectancy has stalled or fallen, your planning horizon may be five to ten years shorter than you thought. Less time to save. Less time to work. Less time to do what matters. The life clock is not a prediction. It is a prompt.