US Life Expectancy Stagnation Linked to Generational Shifts and Cardiovascular Disease

Recent research published in the Proceedings of the National Academy of Sciences reveals a concerning trend: stagnation in US life expectancy, a crisis that predates the COVID-19 pandemic and continues to be influenced by chronic diseases and emerging cancers. A comprehensive analysis of four decades of mortality data points to cardiovascular disease, external causes of death, and generational health patterns as key factors reshaping longevity in the United States.

Life Expectancy Slowdown: A Broader Trend

While the US has experienced a slowdown in life expectancy gains, this isn’t an isolated phenomenon. Many high-income countries are facing similar challenges. However, the deceleration in the US is more pronounced than in other nations. Between 2010-2019, US life expectancy improved by only 0.26 years, a significant drop compared to the average of 1.78 years per decade observed in the preceding five decades. Understanding these changes requires a detailed examination of age-specific mortality rates and underlying causes of death.

Cohort-Based Analysis Reveals Key Patterns

Researchers utilized Lexis diagrams and regression models to analyze mortality data from 1979 to 2019, extending their analysis to 2023 to assess the impact of the COVID-19 pandemic. Data from the National Vital Statistics System and the Human Mortality Database, encompassing cohorts born between the 1890s and the 1980s, were evaluated to track all-cause mortality, cancer deaths, cardiovascular disease (CVD) mortality, and deaths from external causes.

The 1950s Cohort: A Turning Point

The study identified the 1950-1959 birth cohorts as a pivotal turning point. Individuals born during this period exhibited higher mortality rates than their predecessors across nearly all adult ages. Improvements in mortality rates that began around 2000 for those aged 55 and older began to decline around 2010. Alarmingly, the 1970-1980 cohorts showed a significant increase in mortality between the ages of 30 and 45 in the 2010s.

Cardiovascular Disease: A Major Driver

A broad deterioration in mortality began around 2010, affecting most adults and largely driven by changes in cardiovascular disease mortality. While the 1950s cohorts initially saw favorable trends in CVD mortality in their 50s (between 2000-2009), this progress was reversed after 2010. Individuals born before 1915 (males) and 1925 (females) experienced worsening cancer mortality compared to earlier generations.

Cancer and External Causes of Death

While overall cancer mortality generally improved after the cohorts most exposed to smoking, the 1950-1959 cohorts showed either higher mortality or stagnating declines, particularly among women. Younger cohorts born around 1970-1985 also exhibited adverse cancer patterns at younger adult ages.

Mortality from external causes, including drug overdoses, suicides, and accidents, declined from 1980 to 1995 but increased thereafter. The 1950 and 1959 cohorts experienced higher mortality from external causes at ages 40 and 69 compared to previous generations. Subsequent cohorts showed progressively higher rates, with a substantial increase in drug overdose deaths beginning in the late 1990s. Suicide rates among women worsened after 2000, impacting all cohorts by 2010. Traffic accidents and homicides also saw stark increases in the 2010s.

COVID-19 Pandemic Exacerbates Existing Trends

The COVID-19 pandemic (2019-2023) further worsened mortality trends across most cohorts, increasing deaths from all causes, external causes, cancer, and CVD. CVD mortality increased from 2019 to 2022, with some recovery observed in 2023, while external deaths continued to rise and cancer mortality showed some improvement during these years.

Implications for the Future

The study highlights the complex and multifaceted nature of the US life expectancy stagnation crisis. The findings suggest that this stagnation isn’t attributable to a single cause but rather a combination of factors. The 1950s birth cohort represents a transition, marking a shift from improving mortality trends to worsening ones. If current cohort trends persist, the US may face prolonged stagnation or even sustained declines in life expectancy.

Source: Abrams L, Bramajo O, van Raalte A, Myrskylä M, Mehta NK (2026). Insights into US life expectancy stagnation from birth cohort mortality dynamics. Proceedings of the National Academy of Sciences, 123(11), e2519356123. DOI: 10.1073/pnas.2519356123