Objective To estimate changes in life expectancy in 2010-18 and during the covid-19 pandemic in 2020 across population groups in the United States and to compare outcomes with peer nations. Design Simulations of provisional mortality data. Setting US and 16 other high income countries in 2010-18 and 2020, by sex, including an analysis of US outcomes by race and ethnicity. Population Data for the US and for 16 other high income countries from the National Center for Health Statistics and the Human Mortality Database, respectively. Main outcome measures Life expectancy at birth, and at ages 25 and 65, by sex, and, in the US only, by race and ethnicity. Analysis excluded 2019 because life table data were not available for many peer countries. Life expectancy in 2020 was estimated by simulating life tables from estimated age specific mortality rates in 2020 and allowing for 10% random error. Estimates for 2020 are reported as medians with fifth and 95th centiles. Results Between 2010 and 2018, the gap in life expectancy between the US and the peer country average increased from 1.88 years (78.66 v 80.54 years, respectively) to 3.05 years (78.74 v 81.78 years). Between 2018 and 2020, life expectancy in the US decreased by 1.87 years (to 76.87 years), 8.5 times the average decrease in peer countries (0.22 years), widening the gap to 4.69 years. Life expectancy in the US decreased disproportionately among racial and ethnic minority groups between 2018 and 2020, declining by 3.88, 3.25, and 1.36 years in Hispanic, non-Hispanic Black, and non-Hispanic White populations, respectively. In Hispanic and non-Hispanic Black populations, reductions in life expectancy were 18 and 15 times the average in peer countries, respectively. Progress since 2010 in reducing the gap in life expectancy in the US between Black and White people was erased in 2018-20; life expectancy in Black men reached its lowest level since 1998 (67.73 years), and the longstanding Hispanic life expectancy advantage almost disappeared. Conclusions The US had a much larger decrease in life expectancy between 2018 and 2020 than other high income nations, with pronounced losses among the Hispanic and non-Hispanic Black populations. A longstanding and widening US 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. Data sharing: Requests for additional data and analytic scripts used in this study should be emailed to RKM (Ryan.Masters@colorado.edu).

中文翻译：

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2020 年 covid-19 大流行对美国和其他高收入国家人口预期寿命的影响：临时死亡率数据的模拟

目标 估计 2010-18 年和 2020 年 covid-19 大流行期间美国各人群预期寿命的变化，并将结果与​​同类国家进行比较。临时死亡率数据的设计模拟。按性别设定 2010-18 年和 2020 年美国和其他 16 个高收入国家的情况，包括按种族和民族对美国结果进行分析。美国和其他 16 个高收入国家的人口数据分别来自国家卫生统计中心和人类死亡率数据库。主要结果按性别衡量出生时以及 25 岁和 65 岁时的预期寿命，仅在美国，按种族和民族划分。分析排除了 2019 年，因为许多同等国家没有生命表数据。2020 年的预期寿命是通过根据 2020 年估计的年龄特定死亡率模拟生命表并允许 10% 的随机误差来估计的。2020 年的估计值以 5 和 95 百分位数的中位数报告。结果 2010年至2018年间，美国与其他国家的平均预期寿命差距从1.88岁（分别为78.66岁和80.54岁）扩大到3.05岁（分别为78.74岁和81.78岁）。2018年至2020年间，美国的预期寿命下降了1.87岁（至76.87岁），是同类国家平均下降幅度（0.22岁）的8.5倍，差距扩大至4.69岁。2018 年至 2020 年间，美国少数种族和族裔群体的预期寿命出现了不成比例的下降，西班牙裔、非西班牙裔黑人和非西班牙裔白人的预期寿命分别下降了 3.88 岁、3.25 岁和 1.36 岁。在西班牙裔和非西班牙裔黑人人口中，预期寿命的缩短分别是同类国家平均水平的 18 倍和 15 倍。自 2010 年以来在缩小美国黑人和白人预期寿命差距方面取得的进展在 2018-20 年度被抹去；黑人男性的预期寿命达到1998年以来的最低水平（67.73岁），西班牙裔长期以来的预期寿命优势几乎消失。结论 2018 年至 2020 年间，美国的预期寿命下降幅度比其他高收入国家要大得多，其中西班牙裔和非西班牙裔黑人人口的预期寿命下降明显。美国长期存在且不断扩大的健康劣势、2020年的高死亡率以及对少数种族和族裔群体持续的不平等影响可能是长期政策选择和系统性种族主义的产物。数据共享：如需本研究中使用的其他数据和分析脚本，请通过电子邮件发送至 RKM (Ryan.Masters@colorado.edu)。