Over the last decade, mean income rose in the US while life expectancy fell for three years prior to the arrival of COVID-19, and fell further during the pandemic. The typical household in the US has often done much worse than typical households in other wealthy countries. Those with a college degree are a minority of the US population. Life expectancy for Americans with at least a BA looks like life expectancy for the best performing countries in the world, while the US is the only case where life expectancy is falling for the less-educated group. Within the US, the gap in adult life expectancy between those with and without a BA rose from 2.6 years in 1992 to 6.3 years in 2019, the eve of the pandemic, with a further rise to 8.5 years in 2021. The causes of “deaths of despair” were and are more common among those without a four-year college degree, with mortality differences between the education groups ever increasing. The links between health and education have been relatively underexplored, and the lifetime health differences between those with and without a four-year college degree will reward much more research and thought.