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Covid-19 and drug overdoses led to a second straight year of worsening life expectancy in the US - its lowest in 25 years, according to the latest data from the Centers for Disease Control.
As per the 2021 data, Americans are expected to live 76.4 years, down from a peak of 78.8 years in 2019.
It also shows the US continues to rank lowest among countries with large economies.
Heart disease remains the leading cause of death, followed by cancer and Covid.
The data is outlined in two reports released by the CDC on Thursday: one on 2021 mortality in the US, and the second on drug deaths in the US from 2001 to 2021.
The finalised numbers confirm preliminary ones released by the CDC in August, in which the health agency predicted the worst two-year decline of life expectancy on record in the US since 1923.
"The declines in life expectancy since 2019 are largely driven by the pandemic," the agency said in an August news release.
"Covid-19 deaths contributed to nearly three-fourths, or 74%, of the decline from 2019 to 2020, and 50% of the decline from 2020 to 2021."
Drug overdose deaths are also a factor. They now account for more than a third of all accidental deaths in the US, the data shows. Overall, overdose deaths have risen by 16% from 2020.
This includes deaths involving fentanyl, which increased by 22% in 2021.
Life expectancy in the US remains lower than the UK, where the average is 80.8 years. It is also lower than neighbouring Canada, where life expectancy as of 2020 is 81.75 years.
Of both countries, the US spends the highest amount of money on healthcare. Per capita, the US pays $12,318 (£10,217), while the UK spends $5,387. Canada's healthcare spending, in comparison, sits at $5,511 per capita. (BBC)