Life expectancy in California still hasn't rebounded since the pandemic

Los Angeles Times

3 days ago

During the COVID-19 pandemic, the virus caused life expectancy in California to drop significantly. It's now been over two years since officials declared the pandemic-related public health emergency to be over. And yet, life expectancy for Californians has not fully recovered. Today, however, the virus has been replaced by drug overdoses and cardiovascular disease as the main causes driving down average lifespans.
A new study published in JAMA by researchers from UCLA, Northwestern, Princeton and Virginia Commonwealth University finds that Californians lived, on average, nearly a year less in 2024 than they did in 2019. The shortfall of 0.86 years signals that only about two-thirds of the state's pandemic-era losses of 2.92 years have been reversed.
Using mortality data from the California Comprehensive Death Files and population estimates from the American Community Survey, the researchers calculated annual life expectancy from 2019 to 2024, breaking the figures down by race, ethnicity, income and cause of death.
While the COVID-19 virus was the primary factor in life expectancy declines during the pandemic's peak, accounting for 61.6% of the life expectancy gap, its impact has significantly lessened. In 2024, COVID-19 accounted for only 12.8% of the life expectancy gap compared to 2019, while drug overdoses and cardiovascular disease contributed more — 19.8% and 16.3%, respectively.
For Black and Hispanic Californians, recovery has been even slower. Life expectancy for Black residents in 2024 remained 1.48 years below 2019 levels, while for Hispanic residents it was 1.44 years lower. In contrast, the gap for white residents was 0.63 years, and for Asian residents, who have the highest life expectancy in the state at 85.51 years, it was 1.06 years. Overall, the life expectancy for Black Californians in 2024 was under 73.5 years, more than a dozen years lower than that of Asian Californians.
Janet Currie, a co-author of the study and professor at Princeton University, noted that these disparities are especially striking. 'You saw the very big hit that Hispanic people and Black people took during the pandemic,' she said, 'but you also see that Black people in particular are still not caught up.' She added that while Hispanic populations saw a faster rebound, they too remain behind.
Income-based disparities in life expectancy persist in stark form. Californians living in the lowest-income census tracts (the bottom quartile) experienced a 0.99-year gap in 2024 compared to 2019, while those in the highest-income quartile had a slightly smaller 0.85-year gap. However, the overall life expectancy difference between these groups, 5.77 years, was nearly identical to the pre-pandemic gap of 5.63 years, suggesting that income-based health disparities persist even as pandemic impacts recede.
The study highlights drug overdoses as a primary post-pandemic driver of reduced life expectancy. Black Californians and residents of low-income areas were especially affected. In 2023, drug overdoses contributed nearly a full year (0.99 years) to the life expectancy deficit for Black Californians and over half a year (0.52) for residents of low-income areas.
That said, there are signs that state and national efforts to address the overdose crisis may be yielding early results. The number for Black Californians declined to 0.55 years in 2024 while it declined to 0.26 years for residents in low income areas; in the same time frame, the statewide number dropped from 0.4 years to 0.17 years.
Currie attributed the initial surge in overdose deaths in part to the pandemic itself — there were disruptions in access to treatment, and many Californians suffered greater isolation. While she welcomed the recent progress, she cautioned that the share of deaths attributable to overdoses remains high and emphasized that this was 'one of the real bad consequences of the pandemic.'
Meanwhile, cardiovascular disease is now the leading contributor to life expectancy loss among high-income Californians. In 2024, it accounted for 0.22 years of the gap for the wealthiest quartile, more than COVID-19 did at 0.10 years. The authors note this is consistent with statewide rising rates of obesity, which may be playing a role.
Tyler Evans, chief medical officer and CEO of Wellness Equity Alliance as well as the author of the book 'Pandemics, Poverty, and Politics: Decoding the Social and Political Drivers of Pandemics from Plague to COVID-19,' emphasized how the pandemic exacerbated long-standing health inequities. 'These chronic health inequities were further amplified as the result of the pandemic,' he said. While investments in social determinants of health initially helped mitigate some of the worst outcomes, he added, 'the funding dried up,' making recovery harder for communities already at greater risk of poor outcomes.
Evans also pointed to a broader pattern of overlapping health crises that he described as a 'syndemic,' a convergence of epidemics like addiction, chronic disease and poor access to care that interact to worsen outcomes for historically marginalized populations. 'Until we invest in that sort of foundation long term, the numbers will continue to decline,' he said. 'California should be a leader in health improvement outcomes in the country, not a state that continues to have our survival decline.'
Although the findings are limited to California and based on preliminary 2024 data, the study provides an early glimpse into post-pandemic mortality trends ahead of the Centers for Disease Control and Prevention's national life expectancy dataset, expected to be published later this year. California, home to one-eighth of the U.S. population, provides valuable insight into how racial, ethnic and socioeconomic disparities continue to shape public health.
Ultimately, the study highlights how although the most visible impacts of COVID-19 may have faded, their ripple effects, compounded by ongoing structural inequities, continue to shape life and death in California. The pandemic may have accelerated long-standing public health challenges, and post-pandemic recovery, the study makes clear, has been uneven and incomplete.
Currie warned that further cuts to Medicaid and public hospitals could make these gaps even worse. 'We know what to do. We just don't do it,' she said.