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

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

During the height of 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Today, however, the virus has been replaced by drug overdoses and cardiovascular disease as the main causes driving down average lifespans.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 the medical journal JAMA by researchers from UCLA, Northwestern, Princeton and Virginia Commonwealth University finds that the average life expectancy for Californians in 2024 was nearly a year less than in 2019. The shortfall of 0.86 year 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.

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Although 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 with 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 year, 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 although 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 with 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 prepandemic 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-emergency 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 year) to the life expectancy deficit for Black Californians and over half a year (0.52) for residents of low-income areas.

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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 year in 2024 while it declined to 0.26 year for residents in low-income areas; in the same time frame, the statewide number dropped from 0.4 year to 0.17 year.

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 year of the gap for the wealthiest quartile, more than COVID-19 did at 0.10 year. The authors note this is consistent with statewide rising rates of obesity, which may be playing a role.

Dr. Tyler Evans, chief medical officer and chief executive 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 such as 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.

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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 the 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.

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A push to end a fractured approach to post-fire contamination removal

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A push to end a fractured approach to post-fire contamination removal

The patchwork efforts to identify and safely remove contamination left by the 2025 Eaton and Palisades fires has been akin to the Wild West.

Experts have given conflicting guidance on best practices. Shortly after the fires, the federal government suddenly refused to adhere to California’s decades-old post-fire soil-testing policy; California later considered following suit.

Meanwhile, insurance companies have resisted remediation practices widely recommended by scientists for still-standing homes.

A new bill introduced this week by state Assemblymember John Harabedian (D-Pasadena) aims to change that by creating statewide science-based standards for the testing and removal of contamination deposited by wildfires — specifically within still-standing homes, workplaces and schools, and in the soil around those structures.

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“In a state where we’ve had a number of different wildfires that have happened in urban and suburban areas, I was shocked that we didn’t have a black-and-white standard and protocol that would lay out a uniform post-fire safety standard for when a home is habitable again,” Harabedian said.

The bill, AB 1642, would task the state’s Department of Toxic Substances Control with creating standards by July 1, 2027. The standards would only serve as guidance — not requirements — but even that would be helpful, advocates say.

“Guidance, advisories — those are extremely helpful for families that are trying to return home safely,” said Nicole Maccalla, who leads data science efforts with Eaton Fire Residents United, a grassroots organization addressing contamination in still-standing homes. “Right now, there’s nothing … which means that insurance companies are the decision-makers. And they don’t necessarily prioritize human health. They’re running a business.”

Maccalla supports tasking DTSC with determining what levels of contamination pose an unacceptable health risk, though she does want the state to convene independent experts including physicians, exposure scientists and remediation professionals to address the best testing procedures and cleanup techniques.

Harabedian said the details are still being worked out.

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“What’s clear from my standpoint, is, let’s let the public health experts and the science and the scientists actually dictate what the proper standards and protocol is,” Harabedian said. “Not bureaucrats and definitely not insurance companies.”

For many residents with still-standing homes that were blanketed in toxic soot and ash, clear guidance on how to restore their homes to safe conditions would be a much welcome relief.

Insurance companies, environmental health academics, and professionals focused on addressing indoor environmental hazards have all disagreed on the necessary steps to restore homes, creating confusion for survivors.

Insurance companies and survivors have routinely fought over who is responsible for the costs of contamination testing. Residents have also said their insurers have pushed back on paying for the replacement of assets like mattresses that can absorb contamination, and any restoration work beyond a deep clean, such as replacing contaminated wall insulation.

Scientists and remediation professionals have clashed over which contaminants homeowners ought to test for after a fire. Just last week, researchers hotly debated the thoroughness of the contamination testing at Palisades Charter High School’s campus. The school district decided it was safe for students to return; in-person classes began Tuesday.

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Harabedian hopes the new guidelines could solidify the state’s long-standing policy to conduct comprehensive, post-fire soil testing.

Not long after the federal government refused to adhere to the state’s soil testing policy, Nancy Ward, the former director of the California Governor’s Office of Emergency Services, had privately contemplated ending state funding for post-fire soil testing as well, according to an internal memo obtained by The Times.

“That debate, internally, should have never happened,” Harabedian said. “Obviously, if we have statewide standards that say, ‘This is what you do in this situation,’ then there is no debate.”

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Expiration of federal health insurance subsidies: What to know in California

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Expiration of federal health insurance subsidies: What to know in California

Thousands of middle-class Californians who depend on the state-run health insurance marketplace face premiums that are thousands of dollars higher than last year because enhanced federal subsidies that began during the COVID-19 pandemic have expired.

Despite fears that more people would go without coverage with the end of the extra benefits, the number enrolling in Covered California has held steady so far, according to state data.

But that may change.

Jessica Altman, executive director of Covered California, said that she believes the number of people dropping their coverage could increase as they receive bills with their new higher premiums in the mail this month. She said better data on enrollment will be available in the spring.

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Altman said that even though the extra benefits ended Dec. 31, 92% of enrollees continue to receive government subsidies to help pay for their health insurance. Nearly half qualify for health insurance that costs $10 or less per month. And 17% of Californians renewing their Covered California policies will pay nothing for premiums if they keep their current plan.

The deadline to sign up for 2026 benefits is Saturday.

Here’s help in sorting out what the expiration of the enhanced subsidies for insurance provided under the Affordable Care Act, often called Obamacare, means in the Golden State.

What expired?

In 2021, Congress voted to temporarily to boost the amount of subsidies Americans could receive for an ACA plan. The law also expanded the program to families who had more money. Before the vote, only Americans with incomes below 400% of the federal poverty level — currently $62,600 a year for a single person or $128,600 for a family of four — were eligible for ACA subsidies. The 2021 vote eliminated the income cap and limited the cost of premiums for those higher-earning families to no more than 8.5% of their income.

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How could costs change this year for those enrolled in Covered California?

Anyone with income above 400% of the federal poverty level no longer receives subsidies. And many below that level won’t receive as much assistance as they had been receiving since 2021. At the same time, fast-rising health costs boosted the average Covered California premium this year by more than 10.3%, deepening the burden on families.

How much would the net monthly premium for a Los Angeles couple with two children and a household income of $90,000 rise?

The family’s net premium for the benchmark Silver plan would jump to $699 a month this year from $414 a month last year, according to Covered California. That’s an increase of 69%, costing the family an additional $3,420 this year.

Who else could face substantially higher health bills?

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People who retired before the Medicare-qualifying age of 65, believing that the enhanced subsidies were permanent, will be especially hit hard. Those with incomes above 400% of the federal poverty level could now be facing thousands of dollars in additional health insurance costs.

How did enrollment in Covered California change after the enhanced subsidies expired on Dec. 31?

As of Jan. 17, 1,906,033 Californians had enrolled for 2026 insurance. That’s less than 1% lower than the 1,921,840 who had enrolled by this time last year.

Who depends on Covered California?

Enrollees are mostly those who don’t have access to an employer’s health insurance plan and don’t qualify for Medi-Cal, the government-paid insurance for lower-income people and those who are disabled.

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An analysis by KFF, a nonprofit that provides health policy information, found that nearly half the adults enrolled in an ACA plan are small-business owners or their employees, or are self-employed. Occupations using the health insurance exchanges where they can buy an ACA plan include realtors, farmers, chiropractors and musicians, the analysis found.

What is the underlying problem?

Healthcare spending has been increasing faster than overall inflation for years. The nation now spends more than $15,000 per person on healthcare each year. Medical spending today represents about 18% of the U.S. economy, which means that almost one out of every five dollars spent in the U.S. goes toward healthcare. In 1960, health spending was just 5% of the economy.

What has California done to help people who are paying more?

The state government allocated $190 million this year to provide subsidies for those earning up to 165% of the federal poverty level. This money will help keep monthly premiums consistent with 2025 levels for those with an annual income of up to $23,475 for an individual or $48,225 for a family of four, according to Covered California.

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Where can I sign up?

People can find out whether they qualify for financial help and see their coverage options at the website CoveredCA.com.

What if I decide to go without health insurance?

People without insurance could face medical bills of tens of thousands of dollars if they become sick or get injured. And under California state law, those without coverage face an annual penalty of at least $900 for each adult and $450 for each child.

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Department of Education finds San Jose State violated Title IX regarding transgender volleyball player

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Department of Education finds San Jose State violated Title IX regarding transgender volleyball player

The U.S. Department of Education has given San José State 10 days to comply with a list of demands after finding that the university violated Title IX concerning a transgender volleyball player in 2024.

A federal investigation was launched into San José State a year ago after controversy over a transgender player marred the 2024 volleyball season. Four Mountain West Conference teams — Boise State, Wyoming, Utah State and Nevada-Reno — each chose to forfeit or cancel two conference matches to San José State. Boise State also forfeited its conference tournament semifinal match to the Spartans.

The transgender player, Blaire Fleming, was on the San José State roster for three seasons after transferring from Coastal Carolina, although opponents protested the player’s participation only in 2024.

In a news release Wednesday, the Education Department warned that San José State risks “imminent enforcement action” if it doesn’t voluntarily resolve the violations by taking the following actions, not all of which pertain solely to sports:

1) Issue a public statement that SJSU will adopt biology-based definitions of the words “male” and “female” and acknowledge that the sex of a human — male or female — is unchangeable.

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2) Specify that SJSU will follow Title IX by separating sports and intimate facilities based on biological sex.

3) State that SJSU will not delegate its obligation to comply with Title IX to any external association or entity and will not contract with any entity that discriminates on the basis of sex.

4) Restore to female athletes all individual athletic records and titles misappropriated by male athletes competing in women’s categories, and issue a personalized letter of apology on behalf of SJSU to each female athlete for allowing her participation in athletics to be marred by sex discrimination.

5) Send a personalized apology to every woman who played in SJSU’s women’s indoor volleyball from 2022 to 2024, beach volleyball in 2023, and to any woman on a team that forfeited rather than compete against SJSU while a male student was on the roster — expressing sincere regret for placing female athletes in that position.

“SJSU caused significant harm to female athletes by allowing a male to compete on the women’s volleyball team — creating unfairness in competition, compromising safety, and denying women equal opportunities in athletics, including scholarships and playing time,” Kimberly Richey, Education Department assistant secretary for civil rights, said.

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“Even worse, when female athletes spoke out, SJSU retaliated — ignoring sex-discrimination claims while subjecting one female SJSU athlete to a Title IX complaint for allegedly ‘misgendering’ the male athlete competing on a women’s team. This is unacceptable.”

San José State responded with a statement acknowledging that the Education Department had informed the university of its investigation and findings.

“The University is in the process of reviewing the Department’s findings and proposed resolution agreement,” the statement said. “We remain committed to providing a safe, respectful, and inclusive educational environment for all students while complying with applicable laws and regulations.”

In a New York Times profile, Fleming said she learned about transgender identity when she was in eighth grade. “It was a lightbulb moment,” she said. “I felt this huge relief and a weight off my shoulders. It made so much sense.”

With the support of her mother and stepfather, Fleming worked with a therapist and a doctor and started to socially and medically transition, according to the Times. When she joined the high school girls’ volleyball team, her coaches and teammates knew she was transgender and accepted her.

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Fleming’s first two years at San José State were uneventful, but in 2024 co-captain Brooke Slusser joined lawsuits against the NCAA, the Mountain West Conference and representatives of San José State after alleging she shared hotel rooms and locker rooms with Fleming without being told she is transgender.

The Education Department also determined that Fleming and a Colorado State player conspired to spike Slusser in the face, although a Mountain West investigation found “insufficient evidence to corroborate the allegations of misconduct.” Slusser was not spiked in the face during the match.

President Trump signed an executive order a year ago designed to ban transgender athletes from competing on girls’ and women’s sports teams. The order stated that educational institutions and athletic associations may not ignore “fundamental biological truths between the two sexes.” The NCAA responded by banning transgender athletes.

The order, titled “Keeping Men Out of Women’s Sports,” gives federal agencies, including the Justice and Education departments, wide latitude to ensure entities that receive federal funding abide by Title IX in alignment with the Trump administration’s view, which interprets a person’s sex as the gender they were assigned at birth.

San José State has been in the federal government’s crosshairs ever since. If the university does not comply voluntarily to the actions listed by the government, it could face a Justice Department lawsuit and risk losing federal funding.

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“We will not relent until SJSU is held to account for these abuses and commits to upholding Title IX to protect future athletes from the same indignities,” Richey said.

San José State was found in violation of Title IX in an unrelated case in 2021 and paid $1.6 million to more than a dozen female athletes after the Department of Justice found that the university failed to properly handle the students’ allegations of sexual abuse by a former athletic trainer.

The federal investigation found that San José State did not take adequate action in response to the athletes’ reports and retaliated against two employees who raised repeated concerns about Scott Shaw, the former director of sports medicine. Shaw was sentenced to 24 months in prison for unlawfully touching female student-athletes under the guise of providing medical treatment.

The current findings against San José State came two weeks after federal investigators announced that the California Community College Athletic Assn. and four other state colleges and school districts are the targets of a probe over whether their transgender participation policies violate Title IX.

The investigation targets a California Community College Athletic Assn. rule that allows transgender and nonbinary students to participate on women’s sports teams if the students have completed “at least one calendar year of testosterone suppression.”

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Also, the Education Department’s Office of Civil Rights has launched 18 Title IX investigations into school districts across the United States on the heels of the Supreme Court hearing oral arguments on efforts to protect women’s and girls’ sports.

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