More than one million US deaths per year—including many young people could be avoided
[July 27, 2023: Staff Writer, The Brighter Side of News]
A new study found that more than one million US deaths a year—including many young and working-age adults—could be avoided. (CREDIT: Creative Commons)
In a groundbreaking study that's making waves internationally, Boston University School of Public Health (BUSPH) researchers unveiled a grim reality: if the United States matched the mortality rates of other affluent nations, a staggering 1.1 million lives would have been spared in 2021 alone.
This landmark research, proudly showcased in the reputable journal PNAS Nexus, introduces the term “Missing Americans”. These are the individuals who might still be with us if the United States' mortality statistics aligned with those of its global peers.
Delving into age-specific death rates from 1933 to 2021, the team meticulously compared the U.S. statistics against 21 other affluent nations. Their verdict? The U.S. stands out with significantly elevated death rates, with the sheer number of excess deaths reaching an all-time high.
Dr. Jacob Bor, the study's lead and associate professor of global health and epidemiology at BUSPH, made the gravity of the situation clear. "The number of Missing Americans in recent years is unprecedented in modern times," he stated.
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These numbers become even more daunting upon realization that nearly half of all Missing Americans during 2020 and 2021 were under the age of 65. Dr. Bor accentuated the crisis, stating, “Statistically, half of them would still be alive if the US had the mortality rates of our peers. The US is grappling with an early death crisis unparalleled among wealthy nations.”
The shadow of the COVID-19 pandemic looms large over these statistics, undoubtedly contributing to the U.S.'s exacerbated mortality rates. Yet, the research suggests an alarming trend: the rate of excess deaths in the U.S. had been on an upward trajectory for the last four decades, much before the pandemic’s onset.
Through a rigorous analysis of death trends from 1933 to 2021, including COVID-19’s profound impact, the study juxtaposed U.S. mortality rates against countries like Canada, Japan, Australia, and several European nations. Historically, the U.S. showcased lower mortality rates during WWII and its aftermath.
Age-standardized mortality trends in the United States and other wealthy nations. Figure shows deaths per 100,000 person-years: A) 1933–2021 and B) 1980–2021. The solid thick red line is the United States, the dashed thick grey line is the population-weighted average of 21 other wealthy nations, and the thin grey lines are country-specific trends for each of the other nations. Total mortality was age-standardized to the 2000 US population age distribution. (CREDIT: PNAS Nexus)
However, as the 1980s approached, a haunting pattern emerged. The Missing Americans statistic began its upward climb, peaking with 622,534 annual excess deaths by 2019, and exceeding a million in the pandemic-ridden years of 2020 and 2021. The total count of Missing Americans from 1980 to 2021 stands at a harrowing 13.1 million.
But who are these Missing Americans? Contrary to common perception, this mortality crisis isn't exclusive to any specific racial or ethnic group. Black and Native Americans have indeed been disproportionately affected, with mortality rates in early adulthood that are alarmingly higher than other affluent nations. The team’s research further identifies structural racism, manifested in policies like slavery and redlining, as significant contributors to these disparities, impacting access to fundamental resources like education, housing, and healthcare.
Age-standardized mortality trends in the United States and other wealthy nations. Figure shows deaths per 100,000 person-years: 1980–2021. The solid thick red line is the United States, the dashed thick grey line is the population-weighted average of 21 other wealthy nations, and the thin grey lines are country-specific trends for each of the other nations. Total mortality was age-standardized to the 2000 US population age distribution. (CREDIT: PNAS Nexus)
However, the majority, around two-thirds of the Missing Americans, are White. As Dr. Bor notes, "By using an international benchmark, we showcase that Americans across all racial and ethnic backgrounds bear the brunt of the U.S. policy environment that has consistently overlooked public health and social protections, especially for its economically disadvantaged."
These lives lost before their time in 2021 correspond to an estimated 26.4 million years of life, a number that further underscores the severity of the crisis. The root causes? A series of overlooked public health issues ranging from the opioid epidemic, gun violence, environmental pollution, to economic inequality, food scarcity, and workplace hazards. COVID-19, while certainly a major player, only heightened existing disparities, especially among lower-income and minority groups.
Excess deaths and YLL in the United States relative to other wealthy nations, 1933–2021. (CREDIT: Human Mortality Database)
Dr. Steffie Woolhandler, the study’s senior author and Distinguished Professor at the School of Urban Public Health at Hunter College, City University of New York, brings forth the contrast between the U.S. and its peers. “Americans die younger because when corporate profits conflict with health, our politicians side with the corporations,” she opines. The aftermath of the Omicron wave further solidified this difference, as other nations displayed higher vaccination rates and stricter mask policies, correlating with fewer COVID-19 cases.
Dr. Andrew Stokes, assistant professor of global health at BUSPH and a coauthor of the study, highlighted the pressing questions that emerge from their findings, urging further research to pinpoint the specific geographic areas and causes of death responsible for the excess mortality.
Dr. Bor, although appreciative of the attention COVID-19 brought to public health, remains skeptical about a swift change in the U.S. mortality trajectory. The ongoing mistrust in government and declining support for expansive public health policies, he notes, might be the most enduring and damaging impact of the pandemic.
In a country hailed for its prowess in various sectors, this research unveils a dire health landscape. As Dr. Bor emphasizes, the solutions lie in robust public health policies, something other affluent nations have embraced for a better quality of life and longevity for their citizens.
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