Reflecting on Covid

Many posts have discussed COVID and pandemic preparedness.

Stephen Macedo and Frances Lee, In COVID's Wake:  How Our Politics Failed Us (Princeton University Press, 2025), 197, 199, 294.

The central message of this book is that several tenets of basic rationality evaporated under the stress of the Covid onslaught. One of the greatest failures, as we have shown, was the failure to weigh the expected costs of policy against the expected benefits. Such failures were evident in government advising processes, as well as outside government in news media coverage and academic analysis. These failures occurred despite the public health field’s substantial investment in developing pandemic plans before 2020.  These pre-2020 pandemic plans correctly anticipated many of the costs and ethical dilemmas that emerged during the Covid pandemic response. But such considerations played  little role in informing discussion about what to do in 2020. Previously untested, unproven policies were implemented  wholesale across society in earnest hope of benefits, heedless of costs.

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 The pandemic response also raises some other troubling concerns about the quality of democratic deliberation involved. Pandemic policy seems to have been driven by a profound form of short-term bias. Any benefits of the policies in delaying infection and death were top of mind for policymakers. For many months, national newspapers, cable news outlets, and even local news led their daily coverage with the latest num-bers of Covid infections, hospitalizations, and deaths. Meanwhile, in almost all cases, the costs were much less vis i ble and experienced at some delay. Many of  these second-  and third-order costs—for education, mental health, cancer diagnoses, social disorder—unfolded only over lengthy timelines and emerge clearly only in hindsight. Clearly, democracies are likely to struggle with any policies having  these features, as political incentives for elected officials are to attend predominantly to the short term and to discount the long term.

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Experts, including scientific experts, play an important role in the policy  process, but it is also of necessity a  limited role. Experts must stay in their lane, so to speak. We must be more willing to engage in  political deliberation, including or especially with  those on the other side of the political spectrum. American democracy is defined deeply by polariza-tion based on having (or not having) a four-year college degree; educational polarization, in turn, has the unfortunate but unmistakable effect of placing the weight of the experts on one side of the partisan divide. A rebalancing of the role of experts could help address that tendency. At minimum, we have relearned that it is important to listen to more than one kind of expert in formulating policy on complex, society-wide issues. We must also not forget that experts tend to come from well-off positions in society and can be oblivious to their class biases

Pandemic Preparedness

Many posts have discussed COVID and pandemic preparedness.

Britt Lampert and Anemone Franz at  The Hill:

The White House’s pandemic preparedness team has quietly withered to a single part-time employee.

Last month, Dr. Gerald Parker, the top White House pandemic preparedness official, resigned as senior director for the National Security Council’s Biosecurity and Pandemic Response directorate. His exit drew needed, though still scant, attention to a troubling reality: the biosecurity office now has no full-time staff, and the White House Office of Pandemic Preparedness and Response Policy (OPPR), which some headlines mistakenly claimed Parker led, has sat empty since late June.

This collapse comes as pandemic preparedness and public health programs are being dismantled, measles outbreaks in undervaccinated communities reach a 33-year high, and H5N1 bird flu spreads through U.S. farms. The White House offices responsible for coordinating the U.S. government’s response to biological threats have effectively vanished.

Congress established OPPR in 2022 with broad bipartisan support to coordinate and strengthen domestic pandemic preparedness and response. It worked alongside the National Security Council’s Global Health Security and Biodefense directorate (renamed Biosecurity and Pandemic Response, or BPR, in 2025), which focused on global threats to national security.

As OPPR’s first (and so far only) director, Maj. Gen. Paul Friedrichs told Congress the office was meant to build on “the foundation laid by multiple administrations over the past twenty years which have recognized that biological threats are increasing in frequency and impact.

 Jennifer Calfas, Josh Dawsey and  Sabrina Siddiqui at WSJ:

As President Trump sat with top donors at his New Jersey golf club this month, he made a private admission: He believed the coronavirus vaccine was one of the biggest accomplishments of his presidency, but he couldn’t bask in it.

Trump told donors at a dinner—who were paying $1 million to be there—that he wished he could talk more about Operation Warp Speed, the government program he initiated that helped expedite the development of the vaccine, attendees said. The guests included Pfizer Chief Executive Albert Bourla, whose company developed one of the first Covid-19 vaccines.

Trump’s private comments illuminate the fraught politics around vaccines that the White House is confronting, which reached a boiling point Wednesday after the administration fired the head of the Centers for Disease Control and Prevention and other top officials quit their jobs in the midst of disagreements with Health and Human Services Secretary Robert F. Kennedy Jr. over vaccine policy.

The agency is now facing a crisis. Longtime officials there said Kennedy is ignoring scientific findings to pursue an antivaccine agenda, threatening public health as the calendar gets closer to winter and seasonal outbreaks of Covid and other viruses.

The Long Shadow of COVID, continued

Many posts have discussed COVID. Five years later, we are only now starting to grasp its long-term consequences.

Megan Brenan at Gallup:

Looking back on the COVID-19 pandemic’s impact on their school-age children, U.S. parents are more likely to report negative social and emotional issues than academic or physical health troubles.

Gallup’s latest update to its COVID-19 tracking poll finds that 45% of parents of school-age children say the pandemic has had a negative impact on their child’s social skills development. Half of them, 22%, report the social difficulty is ongoing, while the other half, 23%, say it has eased. Similarly, 42% of these parents say their child’s mental health has been negatively affected by the pandemic, including 21% who say the issue persists.

In terms of academics, at least three in 10 parents say the pandemic negatively impacted their child’s skills in math (36%), reading (31%) or science (30%), with roughly half of each group saying the effects are ongoing. Fewer parents (23%) say the pandemic negatively affected their child’s physical health.

Meanwhile, solid majorities of K-12 parents -- ranging from 56% to 69% -- say there was no effect on their child’s physical health or math, reading or science skills. Fewer say the same about their child’s social skills development (47%) and mental health (52%). No more than 10% of parents say their child was positively affected by the pandemic in any of the six areas measured.

 

The Long Shadow of COVID

Many posts have discussed COVID. Five years later, we are only now starting to grasp its long-term consequences.

Erica Pandey and Erin Doherty at Axios:

Covid was a top issue in 2020 exit polls, with 52% of voters saying controlling the virus itself was more important than rebuilding the post-pandemic economy.That mindset shifted over the next four years, as closed schools, inflation and isolation frustrated voters — and changed many of their votes.

"Younger voters are in the process of understanding who they are and what their values are, and that was disproportionately shaped by Covid," says John Della Volpe, director of polling at the Harvard Kennedy School Institute of Politics. "It intensified economic anxiety and created this survivalist mindset.""Democrats helped create this vacuum, which was filled by Trump and Trump-aligned podcasters and influencers."

Case in point: In 2020, voters under 30 broke for Joe Biden by 24 points, but in 2020, Kamala Harris only won the youth vote by 4 points, The Atlantic reports.

And many parents in deep blue cities and towns flipped their politics after seeing the effect of school closures and Covid isolation on their kids.

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Those who experience these events from the ages of 18 to 25 are more likely to develop a lasting lack of trust in political institutions and leaders, according to a study from the Systemic Risk Center at the London School of Economics.

"You can think of epidemics as somewhat of a stress test for governments. Leaders have to respond fast and with the right policies," says Orkun Saka, the study's author. "There is almost no way to get it completely right. When you get it especially wrong, there is a deep scar in the eyes of the young generation."

Kate Cohen at WP: 

Study after study after study has confirmed what everyone I know has expressed: that the pandemic altered our sense of time, which has in turn warped our memory. One study from a year into the pandemic asked participants to describe their experience of time and then sorted their responses into formal-sounding but utterly familiar categories, such as “temporal rift” (“Everything that happened before the pandemic feels like it happened in some distant era, in the ‘Before Times’’’) and “temporal vertigo” (“The pandemic itself seems to be going on for both 10 years, and two weeks”).

The covid-19 pandemic, which to date has killed between 7 million and 20 million people worldwide, including more than 1.2 million Americans, is almost perfectly designed to be forgotten.

For starters, it had two modes, both of which resist memory. One mode was horrific. People saw loved ones die struggling for breath — or couldn’t see them at all because of safety protocols. Front-line health workers risked their lives and witnessed horrors in understaffed, underequipped hospitals. For those who experienced the pandemic as extreme trauma, memories of specific events are often too painful to revisit — and acute stress can make retrieving those memories more difficult.

The other pandemic mode was humdrum. Most of us who were spared life-and-death trauma probably experienced the pandemic as featureless tedium: day after day in the same place with the same people and no present or future events to divide the calendar into little memorable bites. “Gone are the rehearsals that made Sundays Sunday, the town board meetings that made Wednesdays Wednesday,” I wrote at the time, in a column about why my family of nonbelievers decided to hold a Zoom Shabbat (essentially, to make a Friday feel like Friday). “Time stretches out, unmarked, unshaped and, therefore, incomprehensible.”

The Impact of COVID

Many posts have discussed COVID.

Alec Tyson, Michael Lipka and Claudia Deane at Pew:

The most significant pandemic of our lifetime arrived as the United States was experiencing three major societal trends: a growing divide between partisans of the left and right, decreasing trust in many institutions, and a massive splintering of the information environment.

COVID-19 did not cause any of this, but these forces fueled the country’s divided response. Looking back, nearly three-quarters of U.S. adults (72%) say the pandemic did more to drive the country apart than to bring it together.

Fundamental differences arose between Americans over what we expect from our government, how much tolerance we have for health risks, and which groups and sectors to prioritize in a pandemic. Many of these divides continue to play out in the nation’s politics today.

The pandemic left few aspects of daily life in America untouched. Looking back on it nearly five years later, three-quarters of Americans say the COVID-19 pandemic took some sort of toll on their own lives. This includes 27% who say it had a major toll on them and 47% who say it took a minor toll.

The virus itself also had a staggering impact. A large majority of U.S. adults have had COVID-19 at some point, and more than 1 million Americans died from it. Millions continue to struggle with long COVID. And most say they know someone who was hospitalized or died from the virus.

Incumbent Parties Lost Ground Nearly Everywhere

Alexander Smith at NBC:

NBC News reported at the start of 2024 how it would see more elections than any other year on record, with more than 70 nations covering 4 billion people going to the polls.

Now that all the ballots have been cast and tallied, the trend is unmistakable: In almost all the world’s industrialized countries — and in many developing countries, too — governments’ vote shares decreased.

“It has been a remarkably bad year for incumbents,” said Rachel Kleinfeld, a senior fellow at the Carnegie Endowment for International Peace, a think tank in Washington, D.C.

 This was the first year since records began in 1905 that every incumbent party lost vote share in developed countries holding elections, according to data from ParlGov, an independent database run by the University of Bremen in Germany and first analyzed by the Financial Times newspaper.

Even the exceptions came with caveats: June’s victory for Mexico’s governing party came after a string of more than a dozen incumbent defeats in Latin America; and Ireland’s government was re-elected in November despite its support diminishing slightly.

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 The pandemic snarled global supply chains, hiking prices that remain stubbornly high. At the same time, governments pumped money into their limping economies, which some economists say fueled inflation. Hardly helping was the general declining trust and satisfaction with public institutions, and even evidence of a collective growing unhappiness, worldwide.

The Pew Research Center highlighted the “extent of global economic gloom,” with polling this month finding that 64% of adults across 34 countries thought their countries’ finances were in bad shape.

 

Test Scores

Many posts have discussed education.

 Matt Barnum at WSJ:

American students’ math scores took a bigger hit from the pandemic than their peers overseas, according to a closely watched international exam.

U.S. fourth- and eighth-grade students’ math performance on a big worldwide test fell between 2023 and 2019, the last time the test was administered. America’s rankings slipped relative to other countries.

The exam, called the Trends in International Mathematics and Science Study or TIMSS, is a broad math and science assessment of fourth- and eighth-graders from the U.S. and dozens of other countries.

Research has linked school closures to greater learning loss, and the U.S. had a higher duration of at least partial school closures than many other countries, including all of Europe, according to a Unesco analysis. Still, at least one other big exam of high-schoolers, released last year, suggested U.S. learning loss wasn’t worse than its peers.

The stakes are high. Test scores predict economic success both for countries and individual students.

“I would call these declines sharp, steep,” Peggy Carr, commissioner of a statistical agency at the U.S. Department of Education, said in a call with reporters about the test data. The pandemic drops deepen slides that had already started, she said. “Something that we should be concerned about is that this isn’t just the impact of the pandemic.

U.S. scores were no better than when the tests were first given in 1995. In math, the recent declines wiped out years of gains. American science scores have fallen since 2015, although the latest drops from 2019 weren’t statistically significant.

Commuinicating Health Information

Many posts have discussed myths and misinformation -- especially about COVID and vaccines.

Liz Essley Whyte at WSJ:

Health authorities who beat the pandemic worry about losing more trust from the people they worked to save. Doctors, scientists and public-health officials are asking themselves how they can win it back. Among their postelection revelations: Don’t underestimate or talk down to those without a medical degree.
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“We weren’t really considering the consequences in communities that were not New York City,” the places where the virus wasn’t hitting as hard, former National Institutes of Health Director Francis Collins said at an event last year.

Authorities focused on ways to stop the disease and failed to consider “this actually, totally disrupts peoples’ lives, ruins the economy and has many kids kept out of school,” Collins said. The U.S. overall took the right approach, he said, but overlooking long-term consequences was “really unfortunate. That’s another mistake we made.”

Public-health officials wonder if they have sufficient clout for the next national emergency. “Science is losing its place as a source of truth,” said Dr. Paul Offit, an infectious-disease physician at Children’s Hospital of Philadelphia. “It’s becoming just another voice in the room.”

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To counter such views, Jessica Malaty Rivera, an epidemiologist with hundreds of thousands of Instagram followers, shared information on the importance of vaccines and face masks. She dismissed unsupported claims as misinformation and described some of their purveyors as grifters.

Looking back, Rivera said her sometimes scolding messages weren’t helpful. “Everybody has been tempted by the slam dunk,” she said. “It’s not an effective way to communicate science. It’s just not.” She and others say they are dialing back the use of the word misinformation, saying it makes people feel they are being called liars or dumb.

Some Food and Drug Administration staffers have already stopped saying that vaccines are safe and effective, instead advising that the benefits outweigh the risks, a person familiar with the matter said. The change is intended to make clear that all medical interventions have risks, the person said, and to spike the argument that rare side effects mean vaccines aren’t safe.

Virologist Dr. Greg Poland said he advises scientists to communicate with humility and empathy, to speak as a compassionate physician would with a patient. “We’re not dogmatic. We’re not about forcing people,” he said. “We’re about imparting information.”

To build trust in vaccines, Poland, who is also a Presbyterian minister, speaks to conservative churches and civic groups. He tells them he will be truthful and transparent and then explains how vaccines work and how scientists arrive at a consensus.

Poland said he stays until he has answered every last question.

Wealth and Inequality

Many posts have discussed the inequality of wealth in the United States.

 CBO:

In this report, the Congressional Budget Office examines changes in the distribution of family wealth (a family’s assets minus its debts) from 1989 to 2022. Building on earlier work, CBO used an expanded measure of wealth that includes families’ projected Social Security retirement and disability benefits.

• Total Wealth. Adjusted for inflation, the wealth held by families in the United States almost quadrupled between 1989 and 2022, rising from $52 trillion (in 2022 dollars) to $199 trillion, at an average rate of about 4 percent per year. In 2022, retirement assets and accrued Social Security benefits made up about 40 percent of wealth. Nonretirement financial assets, home equity, and other assets made up the rest.
• Concentration of Wealth. Over that 33-year period, family wealth was unevenly distributed, and that inequality increased. In 2022, families in the top 10 percent of the distribution held 60 percent of all wealth, up from 56 percent in 1989, and families in the top 1 percent of the distribution held 27 percent, up from 23 percent in 1989. The share of wealth held by the rest of the families in the top half of the distribution shrank from 37 percent to 33 percent over the same period. Families in the bottom half of the distribution held 6 percent of all wealth in both 1989 and 2022.
• Value of Accrued Social Security Wealth. In 2022, accrued Social Security wealth accounted for 20 percent of families’ total wealth—up from 17 percent in 1989. Together, defined contribution and defined benefit pension plans accounted for a similar share, 21 percent. Throughout the period, Social Security wealth accounted for a larger portion of assets among families who had less wealth.
• Changes in Wealth During the Coronavirus Pandemic. From 2019 to 2022, total family wealth increased by 17 percent, from $170 trillion to $199 trillion (in 2022 dollars), and median family wealth increased by 8 percent, from $466,500 to $504,000. Wealth inequality changed little during the pandemic: Throughout that period, the share of wealth held by families in the top 1 percent of the distribution remained at 27 percent.
• Differences From CBO’s Previous Studies of Family Wealth. In 2016, CBO published a report that defined family wealth as a family’s marketable wealth—that is, its easily tradable assets minus its debts—and in 2022, CBO published a report that defined family wealth as the sum of a family’s marketable wealth and its promised income from defined benefit pension plans. This report updates those prior analyses with more recent data and expands the measure of wealth to account for future streams of income from Social Security benefits.

Vaccine Misinformation

 Many posts have discussed myths and misinformation -- especially about COVID and vaccines.

  Kwasi Gyamfi Asiedu at Poynter:

COVID-19 vaccines were quickly developed, with U.S. patients receiving the first shots in December 2020, 11 months after the first domestic case was detected.

Experts credit the speedy development with helping to save millions of lives and preventing hospitalizations. Researchers at the University of Southern California and Brown University calculated that vaccines saved 2.4 million lives in 141 countries from January 2021 to August 2021 alone. Centers for Disease Control and Prevention data shows there were 574 U.S. deaths attributed to COVID-19 the week of March 2, down from nearly 26,000 at the pandemic’s height in January 2021, as vaccines were just rolling out.

But on social media and in some public officials’ remarks, misinformation about COVID-19 vaccine efficacy and safety is common. U.S. presidential candidate Robert F. Kennedy Jr. built his 2024 campaign on a movement that seeks to legitimize conspiracy theories about the vaccines. We made that our 2023 Lie of the Year.

PolitiFact has seen claims that spike proteins from vaccines are replacing sperm in vaccinated males. (That’s False.) We’ve researched the assertion that vaccines can change your DNA. (That’s misleading and ignores evidence). Social media posts poked fun at Kansas City Chiefs tight end Travis Kelce for encouraging people to get vaccinated, asserting that the vaccine actually shuts off recipients’ hearts. (No, it doesn’t.) And some people pointed to an American Red Cross blood donation questionnaire as evidence that shots are unsafe. (We rated that False.)

Experts say this misinformation has real-world effects.

A Nov. 2023 survey by KFF found that only 57% of Americans “say they are very or somewhat confident” in COVID-19 vaccines. And those who distrust them are more likely to identify as politically conservative: Thirty-six percent of Republicans compared with 84% of Democrats say they are very or somewhat confident in the vaccine.

Immunization rates for routine vaccines for other conditions have also taken a hit. Measles had been eradicated for more than 20 years in the U.S. but there have been recent outbreaks in states including Florida, Maryland and Ohio. Florida’s surgeon general has expressed skepticism about vaccines and rejected guidance from the U.S. Centers for Disease Control and Prevention about how to contain potentially deadly disease spread.

The vaccination rate among kindergarteners has declined from 95% in the 2019-20 school year to 93% in 2022-23, according to the CDC. Public health officials have set a 95% vaccination rate target to prevent and reduce the risk of disease outbreaks. The CDC also found exemptions had risen to 3%, the highest rate ever recorded in the U.S.

Quack Cure Killed

 Many posts have discussed myths and misinformation.

Ramon Antonio Vargas at The Guardian:

People who took an anti-malaria treatment that Donald Trump touted as a cure for Covid-19 in the early days of the pandemic and waning days of his presidency were 11% more likely to die from the virus, according to a new scientific study.

The study’s authors – who published their findings in the peer-reviewed Biomedicine & Pharmacotherapy journal – also estimated that nearly 17,000 people in six different countries, including the US, died after contracting Covid-19 and taking the antimalarial hydroxychloroquine.

Doctors who prescribed hydroxychloroquine to treat Covid-19 at the height of activity restrictions meant to slow the spread of the virus did so off-label and without evidence that there was any clinical benefit, as the authors of the new study noted. The study’s conclusions “illustrate the hazard of drug repurposing with low-level evidence for the management of future pandemics”, its authors added.

 A meta-analysis of randomized trials produced the findings in the study released by Biomedicine & Pharmacotherapy, a 67-year-old journal edited by DM Townsend of the Medical University of South Carolina.

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Pandemic Polarization

Many posts have discussed partisan polarization and aversive or negative partisanship.

 Jay J. Van Bavel have an article at  Perspectives on Psychological Science titled "The Costs of Polarizing a Pandemic: Antecedents, Consequences, and Lessons."

Abstract

Polarization has been rising in the United States of America for the past few decades and now poses a significant—and growing—public-health risk. One of the signature features of the American response to the COVID-19 pandemic has been the degree to which perceptions of risk and willingness to follow public-health recommendations have been politically polarized. Although COVID-19 has proven more lethal than any war or public-health crisis in American history, the deadly consequences of the pandemic were exacerbated by polarization. We review research detailing how every phase of the COVID-19 pandemic has been polarized, including judgments of risk, spatial distancing, mask wearing, and vaccination. We describe the role of political ideology, partisan identity, leadership, misinformation, and mass communication in this public-health crisis. We then assess the overall impact of polarization on infections, illness, and mortality during the pandemic; offer a psychological analysis of key policy questions; and identify a set of future research questions for scholars and policy experts. Our analysis suggests that the catastrophic death toll in the United States was largely preventable and due, in large part, to the polarization of the pandemic. Finally, we discuss implications for public policy to help avoid the same deadly mistakes in future public-health crises.

From the article:

Studies have suggested that partisan identity is the primary driver of affective polarization in the United States and that policy preferences contribute to affective polarization mainly by signaling partisan identity (Dias & Lelkes, 2021; Mason, 2018b). Affective polarization is at its highest point in 40 years, and out-group hate now surpasses in-group love in U.S. politics (Finkel et al., 2020). It is therefore reasonable to expect partisan affiliation to influence voting behavior and attitudes toward specific policies. But why would partisanship affect people’s health-related behaviors—especially in ways that clearly run counter to their own self-interest, such as avoiding disease and death (or infecting their family and friends)? A potential explanation is that political parties not only represent a set of political stances but also fulfill social functions, and these functions can therefore affect beliefs and behavior.

Social groups satisfy basic human needs, such as belonging, distinctiveness, status, and epistemic closure (Baumeister & Leary, 2017; Brewer, 1991; Hogg et al., 2008). According to social-identity theory (Tajfel & Turner, 2004), people’s sense of self is defined not only by their personal traits but also by their group memberships—which can include their political-party affiliation (Iyengar et al., 2019; Mason, 2018a). In a polarized context, such as the United States, partisanship has become a particularly important social identity (Mason, 2018b; Van Bavel & Packer, 2021). The combination of elite cues, partisan news media, hostile rhetoric, social media “echo chambers,” and geographic sorting increases the centrality of partisanship to the self-concepts of citizens (Finkel et al., 2020). Furthermore, partisan identities have become “mega-identities” that are strongly associated with a number of other demographic identities (e.g., gender, race/ethnicity, sexuality, religion, region; Mason, 2018b).

These identities, in turn, shape how people interpret the environment around them (see Xiao et al., 2016). According to the identity-based model of political belief, people tend to believe information that allows them to maintain a positive view of the groups they identify with so that these groups can continue to meet their core social needs (Van Bavel & Pereira, 2018). Partisanship, or identification with a political party, is one way people satisfy these needs (e.g., by attending political rallies and events). As a result, political parties affect not only people’s policy preferences but also other aspects of their beliefs and behavior (see Dimant, 2023; Robbett & Matthews, 2021), including health-related choices. This becomes an issue when party members make unhealthy choices part of their identity—or resist healthy choices because they are associated with a hated out-group.

Social-identity goals can thus outweigh accuracy concerns, making people susceptible to believing misinformation (Van Bavel & Pereira, 2018). For instance, both Democrats and Republicans are more likely to believe and share positive news about the in-group and negative news about the out-group even when the information is false (Pereira et al., 2023). Moreover, one analysis of 2,730,215 social media posts found that out-group animosity was strongly associated with sharing political news (Rathje et al., 2021)—and similar patterns have been found for the spread of misinformation ( Batailler et al., 2022; Borukhson et al., 2022; Osmundsen et al., 2021).1 In the context of the COVID-19 pandemic, many have expressed concern that a misinformation “infodemic” on social media may have harmed public health (Robertson et al., 2022; Van Bavel, Harris, et al., 2021; Zarocostas, 2020). For instance, COVID-19 misinformation has a causal effect on vaccination intentions (Loomba et al., 2021). Moreover, one global study of nearly 50,000 people found that belief in COVID-19 conspiracy theories negatively predicted adherence to public-health behaviors across 67 countries (Pavlović et al., 2022). Thus, partisan differences in vaccination and other public-health behaviors in the United States (Dolman et al., 2023; Liu & Li, 2021; H. A. Roberts et al., 2022; Tram et al., 2022) could be partly explained by an identity-driven motivation to believe misinformation and conspiracy theories.

American Men and Life Expectancy

 A release from the Harvard T.H. Chan School of Public Health

We’ve known for more than a century that women outlive men. But new research led by Harvard T.H. Chan School of Public Health and UC San Francisco shows that, at least in the United States, the gap has been widening for more than a decade. The trend is being driven by the COVID-19 pandemic and the opioid overdose epidemic, among other factors.

In a research paper, to be published online on November 13 in JAMA Internal Medicine, the authors found the difference between how long American men and women live increased to 5.8 years in 2021, the largest it’s been since 1996. This is an increase from 4.8 years in 2010, when the gap was at its smallest in recent history.

The pandemic, which took a disproportionate toll on men, was the biggest contributor to the widening gap from 2019-2021, followed by unintentional injuries and poisonings (mostly drug overdoses), accidents, and suicide.

“There’s been a lot of research into the decline in life expectancy in recent years, but no one has systematically analyzed why the gap between men and women has been widening since 2010,” said first author Brandon Yan, a UCSF internal medicine resident physician and research collaborator at Harvard Chan School.

Life expectancy in the U.S. dropped in 2021 to 76.1 years, falling from 78.8 years in 2019 and 77 years in 2020.

The shortening lifespan of Americans has been attributed in part to so-called “deaths of despair.” The term refers to the increase in deaths from such causes as suicide, drug use disorders, and alcoholic liver disease, which are often connected with economic hardship, depression, and stress.

“While rates of death from drug overdose and homicide have climbed for both men and women, it is clear that men constitute an increasingly disproportionate share of these deaths,” Yan said.

Using data from the National Center for Health Statistics, Yan and fellow researchers from around the country identified the causes of death that were lowering life expectancy the most. Then they estimated the effects on men and women to see how much different causes were contributing to the gap.

Prior to the COVID pandemic, the largest contributors were unintentional injuries, diabetes, suicide, homicide, and heart disease.

But during the pandemic, men were more likely to die of the virus. That was likely due to a number of reasons, including differences in health behaviors, as well as social factors, such as the risk of exposure at work, reluctance to seek medical care, incarceration, and housing instability. Chronic metabolic disorders, mental illness, and gun violence also contributed.

Yan said the results raise questions about whether more specialized care for men, such as in mental health, should be developed to address the growing disparity in life expectancy.

“We have brought insights to a worrisome trend,” Yan said. “Future research ought to help focus public health interventions towards helping reverse this decline in life expectancy.”

Yan and co-authors, including senior author Howard Koh, professor of the practice of public health leadership at Harvard Chan School, also noted that further analysis is needed to see if these trends change after 2021.

“We need to track these trends closely as the pandemic recedes,” Koh said. “And we must make significant investments in prevention and care to ensure that this widening disparity, among many others, do not become entrenched.”

Alan Geller, senior lecturer on social and behavioral sciences at Harvard Chan School, was also a co-author.

“Widening Gender Gap in Life Expectancy in the US, 2010-2021,” Brandon W. Yan, Elizabeth Erias, Alan C. Geller, Donald R. Miller, Kenneth D. Kochanek, Howard K. Koh, JAMA Internal Medicine, online November 13, 2023, doi: 10.1001/jamainternmed.2023.6041

Home Schooling

Many posts have discussed education.

Laura Meckler and Peter Jamison at the  Washington Post:

In March 2020, an involuntary form of home schooling — remote learning — was thrust upon American families everywhere. Millions could not wait to get their kids back to school, but for hundreds of thousands of others, the idea of teaching their kids at home was appealing. A surge in home schooling became one of the lasting impacts of the pandemic.

Yet there has been scant reliable data on the magnitude of the growth or the nature of the new home-schoolers. As part of a year-long series, The Washington Post set out to understand who the new home-schoolers are, where they live, how many there are and why they made these choices.

This research has included more than 100 interviews and two groundbreaking data projects: the collection and analysis of six years of enrollment and home-schooling registration figures in nearly 7,000 school districts, and a national poll of home-school parents.

The results paint a picture of home schooling as the fastest growing part of the U.S. education system, embraced by families more diverse than ever before, who are engaged in new and different ways of home education from the home-schoolers who preceded them.

In the first year of the pandemic, home schooling surged. Although small declines followed in the next two years, the number of children in home schooling remained 45 percent higher in the 2022-23 academic year than it was in 2017-18, based on data collected by the Post.

In 18 states, The Post was able to compare the growth of home schooling to enrollment in public and private schools over six years. In those states, the number of home-school students rose 51 percent between 2017-18 and 2022-23 — far exceeding a 7 percent rise in private school enrollment and a 4 percent decline in public school enrollment. That makes home schooling the fastest growing form of education, by a lot

Behold a Pale Horse

 

Seat belts. Cigarette taxes. Public health investment.

Some lawmakers chose to back these policies. Others don’t.

Those choices along red and blue lines are shaving years off American lives.

w/ @ddiamond @dtkeating https://t.co/QJB3wadyGe

— Lauren Weber (@LaurenWeberHP) October 3, 2023

The mortality crisis has developed over decades, with early deaths an extreme manifestation of an underlying deterioration of health and a failure of the health system to respond.

Covid highlighted this for all the world to see. https://t.co/lHDJyxzH2Z

— The Washington Post (@washingtonpost) October 3, 2023

Life Expectancy and Education

 Anne Case and Angus Deaton:at Brookings:

The widening gap in death rates between Americans with and without a four-year college degree shows the U.S. economy is failing working class people, suggests a paper discussed at the Brookings Papers on Economic Activity (BPEA) conference on September 28.

The U.S. economy, as measured by conventional metrics such as growth in gross domestic product (GDP), has recently outperformed other advanced economies. But mortality data paint a different picture, according to “Accounting for the Widening Mortality Gap between American Adults with and without a BA.”

“GDP may be doing great, but people are dying in increasing numbers, especially less-educated people,” Anne Case, one of the authors, said in an interview with The Brookings Institution. “A lot of the increasing prosperity is going to the well-educated elites. It is not going to typical working people.”

She and co-author Angus Deaton, the winner of the 2015 Nobel Prize in economics, both of Princeton University, analyzed U.S. death certificate information, including the age of death, cause of death, and educational attainment. They found that life expectancy for the college educated in 2021 was eight-and-a-half years longer than for the two-thirds of American adults without a bachelor’s degree. That’s more than triple the 1992 gap of about two-and-a-half years.

... 

 Deaths of despair were the leading driver of the widening mortality gap over the past 30 years, but the gap also widened for most other major causes of death, the paper notes. Cancer mortality, for instance, has declined overall but it has declined more for people with college degrees.

The mortality gap widened explosively during the pandemic, according to the paper. Both COVID-19 deaths and deaths of despair were more common among people without college degrees, who were more likely to work in public-facing jobs, use public transportation, and live in crowded quarters.

“People with BAs have Zoom. People without BAs don’t have Zoom; they have to go to work,” Deaton said.

 

Health Misinformation

 Many posts have discussed myths and misinformation.

 Kaiser Family Foundation:

Overall, health misinformation is widely prevalent in the U.S. with 96% of adults saying they have heard at least one of the ten items of health-related misinformation asked about in the survey. The most widespread misinformation items included in the survey were related to COVID-19 and vaccines, including that the COVID-19 vaccines have caused thousands of deaths in otherwise healthy people (65% say they have heard or read this) and that the MMR vaccines have been proven to cause autism in children (65%).

Regardless of whether they have heard or read specific items of misinformation, the survey also asked people whether they think each claim is definitely true, probably true, probably false, or definitely false. For most of the misinformation items included in the survey, between one-fifth and one-third of the public say they are “definitely” or “probably true.” While the most frequently heard claims are related to COVID-19 and vaccines, the most frequently believed claims were related to guns, including that armed school police guards have been proven to prevent school shootings (60% say this is probably or definitely true), that most gun homicides in the U.S. are gang-related (43%), and that people who have firearms at home are less likely to be killed by a gun than those who do not (42%).

Combining these measures, the share of the public who both have heard each false claim and believe it is probably or definitely true ranges from 14% (for the claim that “more people have died from the COVID-19 vaccine than from the virus”) to 35% (“armed school police guards have been proven to prevent school shootings”).

Health misinformation everywhere, and most uncertain whether true or false @DrewAltman: “The public’s uncertainty leaves them vulnerable to misinformation..."

Reality: ALL DEFINITELY FALSE!

Ivermectin works? No.

Vaccines cause autism? No.

COVID vaccines cause fertility? No.… pic.twitter.com/TP27fHuWBn

— Timothy Caulfield (@CaulfieldTim) August 22, 2023