According to a report released Wednesday by the Centers for Disease Control and Prevention, death rates for Americans aged 15 and older rose sharply in 2020, with Black and Hispanic Americans bearing the brunt of the burden.

The report, which contains the agency’s finalized data on 2020 death rates, confirmed that life expectancy in the United States fell by nearly two years last year, the largest one-year drop since World War II.

“We don’t normally see such large drops in life expectancy,” said Bob Anderson, chief of the mortality statistics branch at the CDC’s National Center for Health Statistics. “Normally, when we see fluctuations in life expectancy, it’s only for a few months out of the year, so this is quite significant.”

Overall life expectancy fell from 78.8 years in 2019 to 77 years in 2020. Male life expectancy fell by 2.1 years, from 76.3 in 2019 to 74.2 in 2020. The average decrease for women was 1.5 years, from 81.4 in 2019 to 79.9 in 2020.

“One of the most startling findings in the report is the racial disparities,” said Dr. Steven Woolf, emeritus director of Virginia Commonwealth University’s Center on Society and Health.

From 715.2 deaths per 100,000 people in 2019 to 835.4 deaths per 100,000 people in 2020, the average age-adjusted death rate increased by nearly 17 percent. However, the increase was far greater for Black and Hispanic Americans.

Hispanic male death rates increased by nearly 43 percent, while Hispanic female death rates increased by more than 32 percent. Death rates for Black males increased by 28 percent, while death rates for Black females increased by nearly 25 percent, compared to roughly 13 percent for white males and 12 percent for white females. “That just shouldn’t be happening,” Woolf said. “There is this deeply embedded health consequence of systemic racism.”

Nine of the top ten long-standing causes of death in the United States remained the same, with Covid appearing on the list for the first time. Heart disease was still the leading cause of death, followed by cancer, Covid-19, unintentional injuries (including drug overdoses), stroke, chronic lower respiratory disease, Alzheimer’s disease, influenza and pneumonia, and kidney disease. The greatest increases in deaths were due to heart disease, unintentional injury, and diabetes.

According to experts, the increase in deaths from these other causes demonstrates the impact of the pandemic on all aspects of health in America.

“What these increases in non-Covid causes tell us is that, in addition to people dying directly from Covid, there was also an adverse effect on people’s health for conditions unrelated to the virus,” Woolf explained. He attributed the rise in non-Covid deaths to a lack of access to care and medication, as well as the stress of the pandemic itself.

Dr. Elizabeth Seaquist, director of the University of Minnesota’s Division of Diabetes, Endocrinology, and Metabolism, agreed.

In the absence of routine screening, early warning signs of illnesses such as heart disease and cancer may go unnoticed.

Keeping blood sugar levels under control may be difficult for people with diabetes, which requires multiple aspects of management and treatment, according to Seaquist. “You can die of acute problems if your diabetes is not well controlled,” she said.

Diabetes deaths increased sixteen-fold from 2019 to 2020, surpassing 100,000 for the first time, according to the report.

Access to insulin remained a problem for many Americans in 2020. In addition to missed appointments during the pandemic, which could cause a prescription to expire, the drug has become unaffordable for many patients in recent years, according to Seaquist.

From 2002 to 2013, the average list price for insulin in the United States tripled, then doubled from 2012 to 2016. In the last two years, states such as Maine, Minnesota, and Texas have passed legislation limiting out-of-pocket insulin costs, though even with the caps, costs can still reach the hundreds of dollars per month.

Despite the sobering increases in overall death rates, there were significant decreases in one area: infant mortality. According to the report, infant mortality fell by nearly 3% in 2020, reaching a new low of 541.9 infant deaths per 100,000 live births.