Missing Americans: Early Death in the United States, 1933-2021

Bor, Jacob; Stokes, Andrew; Raifman, Julia; Venkataramani, Atheendar S.; Bassett, Mary T.; Himmelstein, David U.; Woolhandler, Steffie

doi:10.1101/2022.06.29.22277065

Cited by 10 publications

(17 citation statements)

References 61 publications

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“…Several studies have identified higher baseline mortality rates in the USA relative to peer nations prior to and during the pandemic 24 – 27 . Consistent with these findings, Supplementary Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Prior research has reported that in 2017, the USA would have seen approximately 400,000 fewer deaths if the age- and sex-specific mortality rates matched those of five large European countries; a gap that has widened substantially since 2000 27 . Another recent study found that if the USA had the same age-specific mortality rates as other wealthy nations in 2019, there would have been 626,353 fewer deaths, with over half of these deaths occurring in people under 65 years of age 24 . These differences have grown during the pandemic 24 , 26 , with one recent analysis finding that approximately 1.1 million deaths in the USA, including half of deaths in people under 65 years, could have been averted in 2021 had age-specific mortality rates matched those of other wealthy countries 24 .…”

Section: Discussionmentioning

confidence: 99%

“…Another recent study found that if the USA had the same age-specific mortality rates as other wealthy nations in 2019, there would have been 626,353 fewer deaths, with over half of these deaths occurring in people under 65 years of age 24 . These differences have grown during the pandemic 24 , 26 , with one recent analysis finding that approximately 1.1 million deaths in the USA, including half of deaths in people under 65 years, could have been averted in 2021 had age-specific mortality rates matched those of other wealthy countries 24 . The drivers of these long-standing differences in baseline mortality rates between the USA and other wealthy countries are complex, but include factors such as increasing drug overdose and suicide mortality as well as a plateau in heart disease mortality among other causes of death, with widening educational inequalities in mortality seen in the USA over the past several decades relative to other peer nations 25 .…”

Section: Discussionmentioning

confidence: 99%

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Excess all-cause mortality in the USA and Europe during the COVID-19 pandemic, 2020 and 2021

Rossen

Nørgaard

Sutton

et al. 2022

Sci Rep

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Both the USA and Europe experienced substantial excess mortality in 2020 and 2021 related to the COVID-19 pandemic. Methods used to estimate excess mortality vary, making comparisons difficult. This retrospective observational study included data on deaths from all causes occurring in the USA and 25 European countries or subnational areas participating in the network for European monitoring of excess mortality for public health action (EuroMOMO). We applied the EuroMOMO algorithm to estimate excess all-cause mortality in the USA and Europe during the first two years of the COVID-19 pandemic, 2020–2021, and compared excess mortality by age group and time periods reflecting three primary waves. During 2020–2021, the USA experienced 154.5 (95% Uncertainty Interval [UI]: 154.2–154.9) cumulative age-standardized excess all-cause deaths per 100,000 person years, compared with 110.4 (95% UI: 109.9–111.0) for the European countries. Excess all-cause mortality in the USA was higher than in Europe for nearly all age groups, with an additional 44.1 excess deaths per 100,000 person years overall from 2020–2021. If the USA had experienced an excess mortality rate similar to Europe, there would have been approximately 391 thousand (36%) fewer excess deaths in the USA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Excess all-cause mortality in the USA and Europe during the COVID-19 pandemic, 2020 and 2021

Rossen

Nørgaard

Sutton

et al. 2022

Sci Rep

View full text Add to dashboard Cite

show abstract

“…64 In fact, the U.S. overall has experienced significantly more Covid-19 deaths than other peer countries who have more progressive national and local health policies. 65 Some of these policies, such as no paid sick leave, may have directly contributed to increased Covid-19 mortality during the pandemic. While the increases in mortality were largest among non-Hispanic white residents in nonmetro areas, other racial/ethnic groups, including non-Hispanic Black, Hispanic, and non-Hispanic AIAN populations, also had elevated mortality rates in nonmetro areas, indicating that most racial/ethnic groups faced substantial health challenges during the pandemic in rural areas and are impacted by the health polices and structural factors affecting rural communities.…”

Section: Discussionmentioning

confidence: 99%

Geographic and Temporal Patterns in Covid-19 Mortality by Race and Ethnicity in the United States from March 2020 to February 2022

Lundberg

Cho

Raquib

et al. 2022

Preprint

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Prior research has established that American Indian, Alaska Native, Black, Hispanic, and Pacific Islander populations in the United States have experienced substantially higher mortality rates from Covid-19 compared to non-Hispanic white residents during the first year of the pandemic. What remains less clear is how mortality rates have changed for each of these racial/ethnic groups during 2021, given the increasing prevalence of vaccination. In particular, it is unknown how these changes in mortality have varied geographically. In this study, we used provisional data from the National Center for Health Statistics (NCHS) to produce age-standardized estimates of Covid-19 mortality by race/ethnicity in the United States from March 2020 to February 2022 in each metro-nonmetro category, Census region, and Census division. We calculated changes in mortality rates between the first and second years of the pandemic and examined mortality changes by month. We found that when Covid-19 first affected a geographic area, non-Hispanic Black and Hispanic populations experienced extremely high levels of Covid-19 mortality and racial/ethnic inequity that were not repeated at any other time during the pandemic. Between the first and second year of the pandemic, racial/ethnic inequities in Covid-19 mortality decreased—but were not eliminated—for Hispanic, non-Hispanic Black, and non-Hispanic AIAN residents. These inequities decreased due to reductions in mortality for these populations alongside increases in non-Hispanic white mortality. Though racial/ethnic inequities in Covid-19 mortality decreased, substantial inequities still existed in most geographic areas during the pandemic’s second year: Non-Hispanic Black, non-Hispanic AIAN, and Hispanic residents reported higher Covid-19 death rates in rural areas than in urban areas, indicating that these communities are facing serious public health challenges. At the same time, the non-Hispanic white mortality rate worsened in rural areas during the second year of the pandemic, suggesting there may be unique factors driving mortality in this population. Finally, vaccination rates were associated with reductions in Covid-19 mortality for Hispanic, non-Hispanic Black, and non-Hispanic white residents, and increased vaccination may have contributed to the decreases in racial/ethnic inequities in Covid-19 mortality observed during the second year of the pandemic. Despite reductions in mortality, Covid-19 mortality remained elevated in nonmetro areas and increased for some racial/ethnic groups, highlighting the need for increased vaccination delivery and equitable public health measures especially in rural communities. Taken together, these findings highlight the continued need to prioritize health equity in the pandemic response and to modify the structures and policies through which systemic racism operates and has generated racial health inequities.

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“…4 Recent research emphasizes the exceptionally young age distribution of COVID-19 deaths in the U.S. relative to the distribution in other countries. 5 , 6 , 7 Because deaths at midlife ages drove this phenomenon 7 and because such deaths exhibited substantial racial/ethnic inequality before vaccines were available, 8 this study focuses on vaccination and mortality at these key ages.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Vaccination and Racial/Ethnic Inequities in Mortality at Midlife in Minnesota

Wrigley-Field¹,

Berry²,

Stokes³

et al. 2023

American Journal of Preventive Medicine

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Missing Americans: Early Death in the United States, 1933-2021

Cited by 10 publications

References 61 publications

Excess all-cause mortality in the USA and Europe during the COVID-19 pandemic, 2020 and 2021

Excess all-cause mortality in the USA and Europe during the COVID-19 pandemic, 2020 and 2021

Geographic and Temporal Patterns in Covid-19 Mortality by Race and Ethnicity in the United States from March 2020 to February 2022

COVID-19 Vaccination and Racial/Ethnic Inequities in Mortality at Midlife in Minnesota

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