For over a century, New York City’s efforts to improve public health have been a major success story, with the city’s death rate consistently dropping or plateauing year over year—until now. According to analysis by The New York Times, New York’s death rate soared during the pandemic, increasing by about 50% in 2020 from 6 deaths per 1,000 residents to 9. At the same time, life expectancy across the city plummeted by an average of 4.6 years, with the pandemic creating a cascading series of crises from mental health to drug abuse. “When you see this spike, there is a sense of ‘Have we gone backwards?’” the city’s health commissioner told The New York Times, calling the declining health conditions something “from a different era.”