Many people spend their working lives helping to fund Medicare through their payroll tax contributions. A new study, though, shows that a growing number of people won’t live long enough to reap these benefits, which are for those 65 and older.
Health declines and premature deaths were particularly prevalent for Black individuals, researchers at Brown and Harvard universities said. According to their study, published in JAMA Friday, the mean life expectancy in the U.S. was 77.5 years in 2022, a decrease from 78.9 years in 2014.
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“These are people who contribute to Medicare their entire lives yet never live long enough to use it,” lead author Irene Papanicolas, a professor of health services, policy and practice at the Brown University School of Public Health, said in a statement. “When you look through the lens of race, it’s clear that one group is increasingly dying before they ever see the benefits of the system they helped fund.”
Deaths among all adults aged 18 to 64 increased by 27% between 2012-2022. For Black adults, that increase was 38%, while white adults saw a 28% rise.
Across America, premature deaths went up from 243 per 100,000 adults in 2012 to 309 in 2022. Black adults saw 309 deaths per 100,000 in 2012, and 427 per 100,000 in 2022. White adults had 247 premature deaths per 100,000 in 2012 and 316 per 100,000 in 2022.
Researchers determined this by analyzing Medicare enrollment files and death records from the U.S. Centers for Disease Control and Prevention.
Analysis was limited to Black and white populations because the way race and ethnicity were coded across data sources was inconsistent and unreliable.
“Because premature mortality disproportionately affects Black Americans, the current design of the Medicare program effectively bakes structural inequity into a system that was meant to be universal,” Jose Figueroa, co-author of the study and an associate professor of health policy at Harvard University, said. “What’s most troubling is that these inequities aren’t shrinking — they’re deepening across nearly every state.”
West Virginia had the highest rate of premature deaths in 2022. Massachusetts had the lowest. All states saw racial disparities except for Mexico, Rhode Island and Utah.
As a whole, U.S. life expectancy has been falling for most of the decade, and researchers note there’s also been more preventable deaths.
“What we’re increasingly seeing is that Americans have increased health needs during midlife,” Papanicolas said. “Which raises the question for policymakers: Does the system still work if more people are getting sick and dying before the age of 65?”
