Steady and significant improvements in life expectancy have been a bright spot for human progress for the last century or more. Recently, this success has shown signs of faltering in some high‐income countries, where mortality improvements have slowed or even reversed since the early 2010s. Combined with the large mortality shock of the COVID‐19 pandemic, guaranteed forward progress feels less certain. We review mortality trends in high‐income countries since 2000 through the COVID‐19 pandemic. While deteriorating mortality in the United States has received the most attention, countries including the United Kingdom, Canada, the Netherlands, Greece, and Germany are also seeing slowdowns. Before COVID‐19, these slowdowns largely reflected stalling improvements in cardiovascular disease mortality and increases in deaths from external causes in young and midlife for the worst‐performing countries. We discuss prospects for the future of mortality in high‐income countries, including lingering impacts of the COVID‐19 pandemic, challenges and opportunities related to the obesity epidemic, and emerging reasons for both optimism and pessimism. While biological limits to increased life expectancy may eventually dominate long‐term trends, human‐made social factors are currently holding many countries back from already achievable best‐practice life expectancy and will be key to near‐term improvements.

中文翻译：

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进展停滞不前？高收入国家死亡率的不确定前景


预期寿命的稳步和显著改善一直是上个世纪或更长时间人类进步的亮点。最近，在一些高收入国家，这一成功显示出步履蹒跚的迹象，自 2010 年代初以来，这些国家的死亡率改善已经放缓甚至逆转。再加上 COVID-19 大流行的巨大死亡率冲击，保证向前进展似乎不太确定。我们回顾了自 2000 年以来到 COVID-19 大流行期间高收入国家的死亡率趋势。虽然美国不断恶化的死亡率最受关注，但包括英国、加拿大、荷兰、希腊和德国在内的国家也出现了放缓。在 COVID-19 之前，这些放缓在很大程度上反映了表现最差国家心血管疾病死亡率的停滞改善以及年轻人和中年人因外部原因死亡的增加。我们讨论了高收入国家未来死亡率的前景，包括 COVID-19 大流行的挥之不去的影响、与肥胖流行相关的挑战和机遇，以及乐观和悲观的新原因。虽然预期寿命延长的生物学限制可能最终主导长期趋势，但人为的社会因素目前阻碍了许多国家已经可以实现的最佳实践预期寿命，这将是近期改善的关键。