Failing health of the United States

Woolf, Steven H.; Aron, Laudan

doi:10.1136/bmj.k496

Cited by 22 publications

(19 citation statements)

References 4 publications

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“…Life expectancy in the United States has not kept pace with progress in other industrialized nations and is now decreasing. 37 This study, like others, reports that mortality rates have increased since the 1990s, but the problem has older roots. According to a 2013 report by the National Research Council and Institute of Medicine, the “US health disadvantage” began decades ago and has grown more pervasive with time.…”

Section: Discussionsupporting

confidence: 55%

Changes in midlife death rates across racial and ethnic groups in the United States: systematic analysis of vital statistics

Woolf

Chapman

Buchanich

et al. 2018

BMJ

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134

135

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ObjectiveTo systematically compare midlife mortality patterns in the United States across racial and ethnic groups during 1999-2016, documenting causes of death and their relative contribution to excess deaths.DesignTrend analysis of US vital statistics among racial and ethnic groups.SettingUnited States, 1999-2016.PopulationUS adults aged 25-64 years (midlife).Main outcome measuresAbsolute changes in mortality measured as average year-to-year change during 1999-2016 and 2012-16; excess deaths attributable to increasing mortality; and relative changes in mortality measured as relative difference between mortality in 1999 versus 2016 and the nadir year versus 2016, and the slope of modeled mortality trends for 1999-2016 and for intervals between joinpoints.ResultsDuring 1999-2016, all cause mortality in midlife increased not only among non-Hispanic (NH) whites but also among NH American Indians and Alaskan Natives. Although all cause mortality initially decreased among NH blacks, Hispanics, and NH Asians and Pacific Islanders, this trend ended in 2009-11. Drug overdoses were the leading cause of increased mortality in midlife in each population, but mortality also increased for alcohol related conditions, suicides, and organ diseases involving multiple body systems. Although midlife mortality among NH whites increased across a multitude of conditions, a similar trend affected non-white populations. Absolute (year-to-year) increases in midlife mortality among non-white populationsoften matched or exceeded those of NH whites, especially in 2012-16, when the rate of increase intensified for many causes of death. During 1999-2016, NH American Indians and Alaskan Natives experienced large increases in midlife mortality from 12 causes, not only drug overdoses (411.4%) but also hypertensive diseases (269.3%), liver cancer (115.1%), viral hepatitis (112.1%), and diseases of the nervous system (99.8%). NH blacks experienced increased midlife mortality from 17 causes, including drug overdoses (149.6%), homicides (21.4%), hypertensive diseases (15.5%), obesity (120.7%), and liver cancer (49.5%). NH blacks also experienced retrogression: after a period of stable or declining midlife mortality early in 1999-2016, death rates increased for alcohol related liver disease, chronic lower respiratory tract disease, suicides, diabetes, and pancreatic cancer. Among Hispanics, midlife mortality increased across 12 causes, including drug overdoses (80.0%), hypertensive diseases (40.6%), liver cancer (41.8%), suicides (21.9%), obesity (106.6%), and metabolic disorders (60.0%). Retrogression also occurred in this population; after a period of declining mortality, death rates increased for alcohol related liver disease, mental and behavioral disorders involving psychoactive substances, and homicides. NH Asians and Pacific Islanders were least affected by this trend but also experienced increases in midlife mortality from drug overdoses (300.6%), alcohol related liver disease (62.9%), hypertensive diseases (28.3%), and brain cancer ...

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Section: Discussionsupporting

confidence: 55%

Changes in midlife death rates across racial and ethnic groups in the United States: systematic analysis of vital statistics

Woolf

Chapman

Buchanich

et al. 2018

BMJ

Self Cite

134

135

View full text Add to dashboard Cite

show abstract

“…The reasons of this increment have not been clarified, but the opioid epidemic among the non-Hispanic White population could have at least partly contributed to the upward trend in the US middle-aged population. However, other factors are likely to be involved, including the collapse of some local rural economies and increased distress among the middle-aged ''working class Whites'' who experienced hopelessness and disillusion as they entered the labour market with poor prospects, low-paid job, and less opportunities than the previous generation (Stein et al 2017;Woolf and Aron 2018).…”

Section: Interpretation Of Findingsmentioning

confidence: 99%

Worldwide trends in suicide mortality from 1990 to 2015 with a focus on the global recession time frame

Alicandro

Malvezzi

Gallus

et al. 2019

Int J Public Health

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Objectives To report worldwide trends in suicide mortality during a period that covers 7 years after the 2008 global crisis. Methods We performed a time trend analysis with joinpoint regression. Results Over the 2000s, suicide mortality decreased with the largest declines observed in some Eastern European countries. The downward trends were followed by an increase in concomitance with the 2008 global crisis in some countries, including Greece (annual percentage change = ? 6 in men and ? 11.8 in women), the Netherlands (? 4.2 in men and ? 4.0 in women), and the UK (? 1.6 in men), while the pre-crisis downward trends stopped in Germany, Italy, and Spain. The joinpoint analysis also revealed long-term rises in

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“…The etiology of the opioid epidemic is multifactorial, with contributing factors arrayed along with every level of the socioecological model of health—from individual biopsychosocial characteristics including childhood adversity and smoking status to global economic phenomena such as income inequality and job insecurity wrought by fading rural economies . Injuries in the workplace have been identified as a factor in the rise of opioid dependence and OROD .…”

Section: Introductionmentioning

confidence: 99%

Opioid‐related overdose deaths by industry and occupation—Massachusetts, 2011‐2015

Hawkins

Roelofs

Laing

et al. 2019

American J Industrial Med

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Background: Thousands of people in the United States continue to die from opioid overdoses every year. Work-related injuries and other factors associated with work may increase exposure to opioids and, subsequently, opioid-related overdose deaths (OROD).This study sought to determine whether OROD rates differed by industry and occupation and explored work-related factors that might contribute to these differences. Methods:We coded industry and occupation information on death certificates for all OROD among Massachusetts residents from 2011 to 2015. We estimated rates of OROD by industry and occupation using Massachusetts employment data. National survey data were used to explore whether work-related factors known to vary by occupation (occupational injury and illness, job insecurity, and paid sick leave) correlate to observed differences in OROD.Results: Several industries and occupation groups had rates of OROD that were significantly higher than the rates for other workers. Construction workers and fishing workers stood out for having OROD rates many times higher than the average for all workers. Occupation groups with high rates of occupational injuries and illnesses, high job insecurity, and low availability of paid sick leave had higher rates of OROD.Conclusions: These findings underscore the need for policy and educational interventions to reduce OROD tailored to the needs of high rate worker populations. Interventions should address workplace hazards that cause injuries for which opioids are prescribed, as well as best practices in medical management and return to work following injury, safer prescribing, enhanced access to treatment for opioid use disorders, and overdose prevention education.

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Failing health of the United States

Abstract: The role of challenging life conditions and the policies behind them

Cited by 22 publications

References 4 publications

Changes in midlife death rates across racial and ethnic groups in the United States: systematic analysis of vital statistics

Changes in midlife death rates across racial and ethnic groups in the United States: systematic analysis of vital statistics

Worldwide trends in suicide mortality from 1990 to 2015 with a focus on the global recession time frame

Opioid‐related overdose deaths by industry and occupation—Massachusetts, 2011‐2015

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