Life expectancy in the United States dropped last year to its lowest since 1996, extending a downward trend that began in 2020, according to new data from the Centers for Disease Control and Prevention.

The latest figures from the CDC, which leave expected U.S. lifespans well below those in other large, wealthy nations, reflect the federal and local governments’ ongoing struggle to meet the demands of concurrent public health crises.

The Covid-19 pandemic has had “a domino effect,” said Nora Volkow, director of the National Institute on Drug Abuse, by “exacerbating the already very severe problem that we have in overdose deaths.”

The two crises, the Covid-19 pandemic and rising drug addiction and overdoses, are “a wake-up call” for government, added Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “It clearly is what’s cutting into the health of our communities, unlike almost anything we’ve seen before.”

People born in the U.S. in 2021 can now expect to live 76.4 years, wiping out roughly a generation’s worth of gains. In 2019, the figure was 78.8.

It’s a dramatic reversal for the U.S., where life expectancy had been rising since the turn of the 20th century. The upward trajectory was steady for decades, driven by gains in public health and medicine.

That reversed with Covid’s arrival in 2020. The disease pummeled an overstretched U.S. health care system, and the CDC found death rates worsened in the pandemic’s second year. The number of Covid-19 deaths jumped nearly 20 percent from 2020 to 2021 and were once again the third-leading cause of death — behind heart disease and cancer.

Though deaths have declined in 2022, many public health experts believe they could be much lower. The ongoing politicization of the U.S. Covid response has negatively impacted many Americans’ decisions about vaccination and other mitigation measures. Roughly 14 percent of Americans and 36 percent of people 65 and over have received the latest booster, according to the CDC.

At the same time, Volkow believes the pandemic drove social changes that made people more vulnerable to taking drugs as a way of escaping. The pandemic also made it harder to get help. “Resources that were able to support people in the past were no longer available,” she said.

More than 106,000 people died from a drug overdose in 2021, a nearly 16 percent increase from 2020. The rate of deaths from synthetic opioids — including fentanyl — cocaine and psychostimulants, such as methamphetamines, all increased by more than 20 percent.

That comes on top of a 30 percent increase in overdose deaths in 2020.

Fatal drug overdose rates increased among nearly every racial and ethnic group, and were highest among American Indian or Alaska Native and Black individuals.

The Biden administration has struggled to respond as the deadly trafficking of fentanyl and other synthetic opioids has evolved, and to expand access to treatment for substance use disorder.

Overall, there were 3,464,231 deaths registered in the U.S. in 2021 — 80,502 more than in 2020. The other leading causes of death included unintentional injuries, stroke, chronic lower respiratory diseases, Alzheimer’s disease, diabetes, chronic liver disease and cirrhosis, and kidney disease.

After Covid-19, the rate of people dying from unintentional injuries, which include drug overdoses, and liver disease and cirrhosis, most commonly caused by drinking alcohol, hepatitis and complications due to obesity and diabetes, saw the largest increases.

Rates of death have increased the most among American Indian or Alaska Native women, followed by white men.

According to provisional data the CDC released in August, white people’s life expectancy has declined from 78.8 in 2019 to 76.4 in 2021.

American Indian and Alaska Native people now have a life expectancy of 65.2 years, that data shows, down from 71.8 in 2019.