Life Expectancy Ticks Up in 2022

Mike Stobbe at AP:

U.S. life expectancy rose last year — by more than a year — but still isn’t close to what it was before the COVID-19 pandemic.

The 2022 rise was mainly due to the waning pandemic, Centers for Disease Control and Prevention researchers said Wednesday. But even with the large increase, U.S. life expectancy is only back to 77 years, 6 months — about what it was two decades ago.

Life expectancy is an estimate of the average number of years a baby born in a given year might expect to live, assuming the death rates at that time hold constant. The snapshot statistic is considered one of the most important measures of the health of the U.S. population. The 2022 calculations released Wednesday are provisional, and could change a little as the math is finalized.

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

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.

 

Party and Health

 Hamamsy, T., Danziger, M., Nagler, J., & Bonneau, R. (2021). Viewing the US presidential electoral map through the lens of public health. PLOS ONE, 16(7), e0254001. https://doi.org/10.1371/journal.pone.0254001

Health, disease, and mortality vary greatly at the county level, and there are strong geographical trends of disease in the United States. Healthcare is and has been a top priority for voters in the U.S., and an important political issue. Consequently, it is important to determine what relationship voting patterns have with health, disease, and mortality, as doing so may help guide appropriate policy. We performed a comprehensive analysis of the relationship between voting patterns and over 150 different public health and wellbeing variables at the county level, comparing all states, including counties in 2016 battleground states, and counties in states that flipped from majority Democrat to majority Republican from 2012 to 2016. We also investigated county-level health trends over the last 30+ years and find statistically significant relationships between a number of health measures and the voting patterns of counties in presidential elections. Collectively, these data exhibit a strong pattern: counties that voted Republican in the 2016 election had overall worse health outcomes than those that voted Democrat. We hope that this strong relationship can guide improvements in healthcare policy legislation at the county level.

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

US Has Fallen Behind in Life Expectancy

American Journal of Public Health, "Falling Behind: The Growing Gap in Life Expectancy Between the United States and Other Countries, 1933–2021,"   by Steven H. Woolf MD, MPH.

Objectives. To document the evolution of the US life expectancy disadvantage and regional variation across the US states.

Methods. I obtained life expectancy estimates in 2022 from the United Nations, the Human Mortality Database, and the US Mortality Database, and calculated changes in growth rates, US global position (rank), and state-level trends.

Results. Increases in US life expectancy slowed from 1950 to 1954 (0.21 years/annum) and 1955 to 1973 (0.10 years/annum), accelerated from 1974 to 1982 (0.34 years/annum), and progressively deteriorated from 1983 to 2009 (0.15 years/annum), 2010 to 2019 (0.06 years/annum), and 2020 to 2021 (–0.97 years/annum). Other countries experienced faster growth in each phase except 1974 to 1982. During 1933 to 2021, 56 countries on 6 continents surpassed US life expectancy. Growth in US life expectancy was slowest in Midwest and South Central states.

Conclusions. The US life expectancy disadvantage began in the 1950s and has steadily worsened over the past 4 decades. Dozens of globally diverse countries have outperformed the United States. Causal factors appear to have been concentrated in the Midwest and South.

Public Health Implications. Policies that differentiate the United States from other countries and circumstances associated with the Midwest and South may have contributed. (Am J Public Health. 2023;113(9):970–980. https://doi.org/10.2105/AJPH.2023.307310)

I consider this chart to be the clearest indictment of our country’s path over the last several decades: In 1980, the U.S. had a typical life expectancy for an affluent country. Today, the U.S. has the lowest life expectancy of any affluent country: pic.twitter.com/GhUIn9fzdb

— David Leonhardt (@DLeonhardt) August 22, 2023

Opioid Abuse and Deaths of Despir

National Institute on Drug Abuse:

In 2021, an estimated 2.5 million people aged 18 years or older in the U.S. had opioid use disorder in the past year, yet only 1 in 5 of them (22%) received medications to treat it, according to a new study Some groups were substantially less likely to receive medication for opioid use disorder, including Black adults, women, those who were unemployed, and those in nonmetropolitan areas.

 Chun-Tung Kuo, and Ichiro Kawachi at JAMA Network: "County-Level Income Inequality, Social Mobility, and Deaths of Despair in the US, 2000-2019."

Question  Is the interaction between income inequality and social mobility associated with an increased risk of deaths of despair (deaths from suicide, drug overdose, and alcoholic liver disease) among the working-age population in the US?

Findings  In this cross-sectional study, higher income inequality and lower social mobility were associated with a higher burden of deaths of despair for Black, Hispanic, and White populations. In addition, the joint exposure of unequal income distribution and lack of social mobility was associated with additional risks of deaths of despair on both the additive and multiplicative scales.

Meaning  The findings of this study suggest that policy responses to the epidemic of deaths of despair must address the underlying social and economic conditions associated with these deaths.

Life Expectancy Drops in 2021

Many posts have dealt with health policy, disease, mortality, and life expectancy.

Lenny Bernstein at WP:

U.S. life expectancy continued its steady, alarming decline in 2021, as covid-19 and illegal drugs took the lives of hundreds of thousands of Americans, according to final government data released Thursday.

Even as some peer nations began to bounce back from the toll of the pandemic, life expectancy in the U.S. dropped to 76.4 years at birth, down from 77 in 2020, according to data from the National Center for Health Statistics. That means Americans can expect to live as long as they did in 1996 — a dismal benchmark for a reliable measure of health that should rise steadily in an affluent, developed nation. (In August, using preliminary data, the agency had pegged life expectancy in 2021 at 76.1 years.)

...
The data reinforces a trend line of American longevity declining relative to that of its peer nations. A child born in the United States in 2019, for instance, could expect to live to 78.5, according to the World Health Organization, while a Japanese child born that year had a life expectancy of 84.5, Belgians lived to 81.4 and Swedes lived to 82.4.

...

The 2021 decline was the second consecutive drop for the United States and the continuation of a trend that began in the middle of the last decade, when “deaths of despair” — those caused by drug oerdoses, suicide and alcoholism — rose markedly.

It also contrasted with rebounding life expectancy rates in some other nations as they brought the covid pandemic under greater control with vaccines and masking. A study of 29 countries published in August in the journal Nature Human Behavior found that eight experienced significant life expectancy “bounce backs” in 2021.

Mortality in the United States, 2021 NCHS Data Brief No. 456, December 2022 Jiaquan Xu, M.D., Sherry L. Murphy, B.S., Kenneth D. Kochanek, M.A., and Elizabeth Arias, Ph.D.

In 2021, a total of 3,464,231 resident deaths were registered in the United States—80,502 more deaths than in 2020. The number of deaths for which COVID-19 was the underlying cause of death increased 18.8% from 350,831 in 2020 to 416,893 in 2021. The age-adjusted death rate for the total population increased 5.3% in 2021 from 2020 after an increase of 16.8% from 2019 to 2020 (1). The decrease in life expectancy for the total population of 0.6 year from 2020 to 2021 was lower than the decline of 1.8 years from 2019 to 2020 (2). Age-specific death rates from 2020 to 2021 increased for each age group 1 year and over. Age-adjusted death rates decreased in 2021 from 2020 for Hispanic males and non-Hispanic Black males, remained unchanged statistically for non-Hispanic Asian males and non-Hispanic Asian females, and increased for all other race and ethnicity groups for both males and females.

Of the 10 leading causes of death in 2021, 9 remained the same as in 2020. Heart disease was the leading cause of death, followed by cancer and COVID-19. Age-adjusted death rates increased for 8 leading causes and decreased for 2. Life expectancy at birth decreased 0.6 year from 77.0 in 2020 to 76.4 in 2021, largely because of increases in mortality due to COVID-19, unintentional injuries, chronic liver disease and cirrhosis, suicide, and homicide.

In 2021, 19,920 deaths occurred in children under age 1 year, which was 338 more infant deaths than in 2020. The change in the IMR from 2020 to 2021 was not statistically significant. Among the 10 leading causes of infant death, the decrease in IMR for one cause (low birth weight) was significant.

Data and findings in this report are based on final mortality data and may differ from provisional data and findings previously published.

Smoking Is Down

 Jeffrey M. Jones at Gallup:

As the percentage of U.S. adults who smoke cigarettes has reached a new low of 11% this year, much of the decline is tied to sharply lower smoking rates among young adults. From 2001 to 2003, an average of 35% of U.S. adults between the ages of 18 and 29 said they smoked cigarettes, compared with 12% in the latest estimate.

This 23-percentage-point decline among young adults is more than double that of any other age group over that time. As a result of these changes, young adults have moved from the group most likely to smoke cigarettes to the second-least likely, with a rate higher than only the oldest Americans.

Alone

 Dana Goldstein and Robert Gebeloff at NYT:

In 1960, just 13 percent of American households had a single occupant. But that figure has risen steadily, and today it is approaching 30 percent. For households headed by someone 50 or older, that figure is 36 percent.

Nearly 26 million Americans 50 or older now live alone, up from 15 million in 2000. Older people have always been more likely than others to live by themselves, and now that age group — baby boomers and Gen Xers — makes up a bigger share of the population than at any time in the nation’s history.

The trend has also been driven by deep changes in attitudes surrounding gender and marriage. People 50-plus today are more likely than earlier generations to be divorced, separated or never married.
...
But while many people in their 50s and 60s thrive living solo, research is unequivocal that people aging alone experience worse physical and mental health outcomes and shorter life spans.
...
Compounding the challenge of living solo, a growing share of older adults — about 1 in 6 Americans 55 and older — do not have children, raising questions about how elder care will be managed in the coming decades.

Bryce Ward at WP:

According to the Census Bureau’s American Time Use Survey, the amount of time the average American spent with friends was stable, at 6½ hours per week, between 2010 and 2013. Then, in 2014, time spent with friends began to decline.

By 2019, the average American was spending only four hours per week with friends (a sharp, 37 percent decline from five years before). Social media, political polarization and new technologies all played a role in the drop. (It is notable that market penetration for smartphones crossed 50 percent in 2014.)

Covid then deepened this trend. During the pandemic, time with friends fell further — in 2021, the average American spent only two hours and 45 minutes a week with close friends (a 58 percent decline relative to 2010-2013).

Similar declines can be seen even when the definition of “friends” is expanded to include neighbors, co-workers and clients. The average American spent 15 hours per week with this broader group of friends a decade ago, 12 hours per week in 2019 and only 10 hours a week in 2021.

 

One Million COVID Deaths in the US

 Carla K. Johnson at AP:

The U.S. death toll from COVID-19 reached 1 million Monday, a once-unimaginable figure that only hints at the multitudes of loved ones and friends staggered by grief and frustration.

The number of dead, as tallied by the Centers for Disease Control and Prevention’s National Center for Health Statistics, is equivalent to that of a 9/11 attack every day for 336 days. It is roughly equal to how many Americans died in the Civil War and World War II combined. It’s as if Boston and Pittsburgh were wiped out.

“It is hard to imagine a million people plucked from this Earth,” said Jennifer Nuzzo, who leads a new pandemic center at the Brown University School of Public Health in Providence, R.I. “It’s still happening and we are letting it happen.”

Three out of every four deaths were people 65 and older. More men died than women. White people made up most of the deaths overall, but Black, Latino and Native American people have been roughly twice as likely to die from COVID-19 as their white counterparts.

Australia's death rate is only one-tenth as great.  Damien Cave at NYT:

In global surveys, Australians were more likely than Americans to agree that “most people can be trusted” — a major factor, researchers found, in getting people to change their behavior for the common good to combat Covid, by reducing their movements, wearing masks and getting vaccinated. Partly because of that compliance, which kept the virus more in check, Australia’s economy has grown faster than America’s through the pandemic.

But of greater import, interpersonal trust — a belief that others would do what was right not just for the individual but for the community — saved lives. Trust mattered more than smoking prevalence, health spending or form of government, a study of 177 countries in The Lancet recently found. And in Australia, the process of turning trust into action began early.

...

During the toughest of Covid times, Australians showed that the national trait of “mateship” — defined as the bond between equal partners or close friends — was still alive and well. They saw Covid spiral out of control in the United States and Britain, and chose a different path.

Compliance rates with social distancing guidelines, along with Covid testing, contact tracing and isolation, held steady at around 90 percent during the worst early outbreaks, according to modeling from the University of Sydney. In the United States, reductions in mobility — a key measure of social distancing — were less stark, shorter and more inconsistent, based in part on location, political identity or wealth.

In Australia, rule-following was the social norm. It was Mick Fanning, a surfing superstar, who did not question the need to stay with his American wife and infant in a small hotel room for 14 days of quarantine after a trip to California. It was border officials canceling the visa of Novak Djokovic, the top male tennis player in the world, for failing to follow a Covid vaccine mandate, leading to his eventual deportation.

It was also all the Australians who lined up to get tested, who wore masks without question, who turned their phones into virus trackers with check-in apps, who set up food services for the old, infirm or poor in lockdowns, or who offered a place to stay to women who had been trapped in their homes with abusive husbands.

COVID Has Infected 60% of Americans

Andrew Joseph  and Elizabeth Cooney at STAT:

Nearly 60% of people in the United States, including 3 in 4 children, have now been infected with Omicron or another coronavirus variant, data released Tuesday show.

The new findings, which go through February 2022, highlight just how widely the Omicron variant of the SARS-CoV-2 virus spread in the country. On Tuesday, the virus even reached into the White House, with Vice President Kamala Harris reporting that she had tested positive. She has shown no symptoms, a spokesperson said, and would work outside the White House, at her official residence, until she tested negative.

Before the Omicron variant took off in the United States in December, the portion of the population that had been infected was about 1 in 3, the Centers for Disease Control and Prevention reported.

The updated figures come from a study that has been measuring the so-called seroprevalence of the coronavirus at various points throughout the pandemic. The study relies on testing blood samples from participants for particular antibodies that are generated only by an infection; they are different from the antibodies that Covid-19 vaccines elicit. This is the first time that the population seroprevalence is over 50%.

The F in FDA

 Helena Bottemiller Evich at Politico:

Food is not a high priority at the Food and Drug Administration.

A monthslong POLITICO investigation — based on more than 50 interviews — found that drugs and other medical products dominate food at the agency, both in budget and bandwidth. Over the years, the food side of FDA has been so ignored and grown so dysfunctional that even former FDA commissioners readily acknowledged problems. There’s a long running joke among officials: The “F” in FDA is silent.

The dynamic has only been exacerbated during the pandemic. The FDA regulates nearly 80 percent of the American food supply, and each year — according to estimates from the Centers for Disease Control and Prevention — more than 128,000 people are hospitalized and 3,000 people die from foodborne illnesses.

We published a deep dive into the agency’s structural failures, lack of action to prevent major produce outbreaks and slowness to try to make food healthier. We encourage you to bookmark it and read it in full.

In the meantime, here are four top-level takeaways. 

1. The food division has structural and leadership problems
2. Congress asked FDA to regulate water to keep deadly pathogens out of produce. 11 years later, it still hasn’t.
3. FDA made little progress on keeping toxic elements out of baby foods.
4. FDA has not taken timely action to help cut sodium consumption

Life Expectancy Dropped in 2021

 A release from Virginia Commonwealth University:

Life expectancy in the United States decreased during 2020 as a result of the pandemic. Now, a new study shows for the first time that life expectancy continued to decline even further in 2021.

“We already knew that the U.S. experienced historic losses in life expectancy in 2020 due to the COVID-19 pandemic. What wasn’t clear is what happened in 2021. To our knowledge this is the first study to report data for 2021, and the news isn’t good,” said corresponding author Steven Woolf, M.D., director emeritus of the Center on Society and Health at Virginia Commonwealth University.

U.S. life expectancy decreased from 78.86 years in 2019 to 76.99 years in 2020 and 76.60 years in 2021, a net loss of 2.26 years, according to the study, “Changes in Life Expectancy Between 2019 and 2021: United States and 19 Peer Countries,” which was published online Thursday but has not yet been peer reviewed.

The decline in U.S. life expectancy between 2019 and 2021 reflects the biggest drop since 1943, the deadliest year for Americans in World War II, the researchers wrote.

The study investigated mortality data for not only the U.S., but also 19 other high-income countries. In contrast to the U.S., the 19 peer countries experienced a smaller decline in life expectancy between 2019 and 2021 (an average of 0.57 years) and an average 0.28-year increase between 2020 and 2021 — widening the gap in life expectancy between the United States and peer countries to more than five years.

“While other high-income countries saw their life expectancy increase in 2021, recovering about half of their losses, U.S. life expectancy continued to fall,” Woolf said. “This speaks volumes about the life consequences of how the U.S. handled the pandemic, and in a country where the U.S. Constitution and 10th Amendment grant public health authority to the states, I believe the U.S. catastrophe speaks volumes about the policies and behaviors of U.S. governors — at least some of them. A highly effective vaccine was available in 2021 that made COVID-19 deaths almost completely preventable.”

The enormous loss of life documented by the study was caused in part by COVID-19 variants, delta and omicron, but those same variants swept through other countries where life expectancy actually increased, Woolf said.

“Deaths from these variants occurred almost entirely among unvaccinated people,” said Woolf, a professor in the Department of Family Medicine and Population Health at the VCU School of Medicine. “What happened in the U.S. is less about the variants than the levels of resistance to vaccination and the public’s rejection of practices, such as masking and mandates, to reduce viral transmission.”

Lead author Ryan Masters, Ph.D., an assistant professor of sociology at University of Colorado Boulder and an affiliate with the CU Population Center, said high rates of obesity and heart disease, along with inequities in access to health care, were already leading the U.S. to lose ground with respect to health and survival before the pandemic.

“Those same factors made the US more vulnerable than other countries to the mortality consequences of COVID-19,” Masters said.

The decrease in U.S. life expectancy was highly racialized, with Hispanic and Black populations experiencing the largest losses in life expectancy between 2019 and 2021. The disproportionate impact on communities of color, the researchers wrote, reflect “the legacy of systemic racism and inadequacies in the U.S. handling of the pandemic.”

In 2020, the largest decreases in life expectancy occurred among Black and Hispanic populations. In 2021, however, life expectancy plateaued in the Hispanic population and increased among the Black population. Only the white population saw a decline in life expectancy, the study reported.

...

In addition to Woolf and Masters, the study was co-authored by Laudan Y. Aron, a senior fellow in the Health 

Infant Formula

 Helena Bottemiller Evich at Politico:

A sweeping recall of some of the biggest names in baby formula — including Similac — has been tied to a handful of hospitalizations, including two infant deaths. As POLITICO first reported, FDA, CDC and formula-maker Abbott were told in September about the first baby who got sick from Cronobacter sakazakii, a rare bacteria — several months before the massive product recall in mid-February. Lawmakers have begun to ask questions about the timeline of the recall.
...

In more than a decade covering food policy, I have covered countless outbreaks. I have never seen so many anecdotal and unconfirmed reports of illness that are not officially tied to the outbreak come out of the woodwork. It’s incredibly puzzling. Are parents wrongly blaming formula because they saw the recall? Or is the public health system missing cases? I am continuing to press health officials for answers.

It’s important to note that Abbott Nutrition, the formula maker, has maintained that its product has not been found to contain this rare bacteria as part of this outbreak: “The cases are under investigation and at this time the cause of the infants’ infections have not been determined,” the company said in a statement to POLITICO last week. “All infant formula products are tested for Cronobacter sakazakii, Salmonella and other pathogens and they must test negative before any product is released.” (FDA did find the bacteria in the Sturgis plant, however.)

This whole ordeal has me and a whole bunch of researchers revisiting a policy question that’s been kicked around in food safety circles for a long time: Should the government use social media as a tool to help detect or even solve foodborne illness outbreaks like this? Currently, CDC doesn’t, a spokesperson confirmed, but some local health departments have dabbled with using Yelp reviews, for example, to help detect outbreaks.

Political Geography of COVID

Bradley Jones at Pew:

During the fourth wave of the pandemic, death rates in the most pro-Trump counties were about four times what they were in the most pro-Biden counties. When the highly transmissible omicron variant began to spread in the U.S. in late 2021, these differences narrowed substantially. However, death rates in the most pro-Trump counties were still about 180% of what they were in the most pro-Biden counties throughout late 2021 and early 2022.

The cumulative impact of these divergent death rates is a wide difference in total deaths from COVID-19 between the most pro-Trump and most pro-Biden parts of the country. Since the pandemic began, counties representing the 20% of the population where Trump ran up his highest margins in 2020 have experienced nearly 70,000 more deaths from COVID-19 than have the counties representing the 20% of population where Biden performed best. Overall, the COVID-19 death rate in all counties Trump won in 2020 is substantially higher than it is in counties Biden won (as of the end of February 2022, 326 per 100,000 in Trump counties and 258 per 100,000 in Biden counties).

Partisan differences in COVID-19 death rates expanded dramatically after the availability of vaccines increased. Unvaccinated people are at far higher risk of death and hospitalization from COVID-19, according to the Centers for Disease Control and Prevention, and vaccination decisions are strongly associated with partisanship. Among the large majority of counties for which reliable vaccination data exists, counties that supported Trump at higher margins have substantially lower vaccination rates than those that supported Biden at higher margins.

Deaths: COVID and Overdose

The U.S. faces other steep disadvantages, ones that experts worry could cause additional problems. For example, many Americans have health problems like obesity and diabetes that increase the risk of severe Covid. https://t.co/Ie4YT3jLlI

— The New York Times (@nytimes) February 2, 2022

Jon Kamp, Jennifer Levitz, Brianna Abbott and Paul Overberg at WSJ:

Two years into the Covid-19 pandemic, America’s death toll is closing in on one million.

Federal authorities estimate that 987,456 more people have died since early 2020 than would have otherwise been expected, based on long-term trends. People killed by coronavirus infections account for the overwhelming majority of cases. Thousands more died from derivative causes, like disruptions in their healthcare and a spike in overdoses.


Covid-19 has left the same proportion of the population dead—about 0.3%—as did World War II, and in less time.

Unlike the 1918 flu pandemic or major wars, which hit younger people, Covid-19 has been particularly hard on vulnerable seniors. It has also killed thousands of front-line workers and disproportionately affected minority populations.

It robbed society of grandparents, parents, spouses, sons and daughters, best friends, mentors, loyal employees and bosses. Those lost include a 55-year-old Rhode Island correctional officer; a 46-year-old Texas dental-office receptionist who helped care for her granddaughter; a 30-year-old Iowan who fatally overdosed; and an active 72-year-old and grandmother of 15 who was Nashville’s first female city bus driver.

“It’s catastrophic,” said Steven Woolf, director emeritus at the Center on Society and Health at Virginia Commonwealth University. “This is an enormous loss of life.”

O. Trent Hall and colleagues have an article at JAMA Pediatrics titled "Unintentional Drug Overdose Mortality in Years of Life Lost Among Adolescents and Young People in the US From 2015 to 2019."

 Over the 5-year period of this cross-sectional study, adolescents experienced nearly 200 000 YLL, and young people amassed greater than 1.25 million YLL [years of life lost]. Male adolescents and young people accounted for substantially greater unintentional drug overdose mortality (YLL and incident deaths) than female adolescents and young people. Although limited by death records potentially undercounting overdoses and a cross-sectional design insensitive to temporal relations between risk factors and deaths, our findings represent an unacceptable preventable mortality burden for adolescents and young people in the US. Prior research has identified polysubstance use, psychiatric comorbidity, and unstable housing as relevant risk factors for unintentional drug overdose in this age cohort.6 Our findings suggest that further resources are needed to mitigate these factors. The present study should inform future mortality reviews among adolescents and young people, as well as ecologic interventions involving family, school, and community, in unintentional drug overdose prevention and substance use treatment.

Unhappy Americans

The latest data on happiness from the General Social Survey is truly something else. Nothing remotely like it in the past five decades of polling. https://t.co/JZBj8H6KpR pic.twitter.com/CALnfzMV9h

— Christopher Ingraham (@_cingraham) January 28, 2022

The survey is not an outlier. Other data suggest increasing despair among many Americans.

Lois M. Collins at The Deseret News:

About one-third of respondents to the American Family Survey said their feelings of sadness or depression increased. Just 9% said they felt less sad or depressed between March 2020 and when the survey was fielded in late June and early July 2021. The survey questioned roughly 3,000 adults.

Nearly 1 in 4 said members of their family hadn’t gotten needed mental health care, while 20% said they didn’t get the physical care they needed.

Additionally, more than a third said they gained weight, compared to 17% who lost weight and 49% whose weight stayed the same, the survey found.

COVID and Deaths of Despair

At STAT, David Introcaso writes of deaths of despair:

The term deaths of despair comes from Princeton economists Anne Case and Angus Deaton, who set out to understand what accounted for falling U.S. life expectancies. They learned that the fastest rising death rates among Americans were from drug overdoses, suicide, and alcoholic liver disease. Deaths from these causes have increased between 56% and 387%, depending on the age cohort, over the past two decades, averaging 70,000 per year.

...

This psychological state is largely the result of economic hardship or the loss of work or wages, something that today is disproportionately experienced by approximately 66 million white workers without college degrees between the ages of 25 and 64 years, or 38% of working-age people. As Case and Deaton showed, this population has seen the purchasing power of their wages decline by 13% since 1979 while per capita income increased 85% over the same period.

The resulting health effects are altogether predictable. Insecurity, deprivation, the loss of possibilities, the lack of belonging, hopelessness, and social maladjustment lead to negative emotions including loneliness, unhappiness, worry, and stress that in turn lead individuals to, in part, experience more pain and pain sensitivity both physical and psychological. Over approximately the past three decades, survey data show that Americans, particularly middle-aged white people, report more pain than respondents in 30 other wealthy countries. Pain, especially chronic pain, can become a gateway to opioid use and addiction.

Factor in the Covid-19 pandemic, and it’s no wonder that 911 calls for opioid-related use increased 250% between 2019 and early 2020.

Echoing Durkheim, Case and Deaton concluded, “Jobs are not just the source of money; they are the basis for the rituals, customs, and routines of working-class life. Destroy work and, in the end, working-class life cannot survive. It is the loss of meaning, of dignity, of price, and of self-respect that comes with the loss of marriage and of community that brings on despair.”