The Silence Doctors Are Keeping About Millennial Deaths

Link: https://www.theatlantic.com/health/archive/2024/07/millennials-cancer-death/678896/

Excerpt:

Several years ago, in my work as a palliative-care doctor, I cared for a man in his 60s who had been mostly healthy before he was diagnosed with stomach cancer. After three different treatments had failed him, his oncologist and I told him that a fourth treatment might buy him a few weeks at best. “Send me back to Boston,” he said immediately. He wanted to smell the Atlantic, see his childhood home. He made it there, dying a week later.

My patient died on his own terms: He was comfortable, fully informed about his worsening cancer, and able to decide where he wanted to die, whom he wanted to be with. This is the type of proverbial “good death” that our medical system is slowly learning to strive for—but not necessarily for younger people.

In the hospital room next to this man was a young mother who, like me, was in her 30s. We bonded over our love of ’90s music and the Southern California beaches where we’d built sandcastles as children and stayed out late as teenagers. She, too, was dying of Stage 4 stomach cancer; I first met her when her oncology team asked if I could help manage her pain and nausea. She would rest her hands on her protruding belly, swollen with fluid and gas because cancer blocked her bowels; she couldn’t eat, so medications and liquid nutrition dripped through a large catheter threaded up a blood vessel in her arm and into her heart.

Author(s): Sunita Puri

Publication Date: 5 July 2024

Publication Site: The Atlantic

Racial Disparities in Mortality by Sex, Age, and Cause of Death

Link: https://www.nber.org/papers/w33905

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Abstract:

Racial differences in mortality are large, persistent and likely caused, at least in part, by racism. While the causal pathways linking racism to mortality are conceptually well defined, empirical evidence to support causal claims related to its effect on health is incomplete. In this study, we provide a unique set of facts about racial disparities in mortality that all theories of racism and health need to confront to be convincing. We measure racial disparities in mortality between ages 40 and 80 for both males and females and for several causes of death and, measure how those disparities change with age. Estimates indicate that racial disparities in mortality grow with age but at a decreasing rate. Estimates also indicate that the source of racial disparities in mortality changes with age, sex and cause of death. For men in their fifties, racial disparities in mortality are primarily caused by disparities in deaths due to external causes. For both sexes, it is racial disparities in death from healthcare amenable causes that are the main cause of racial disparities in mortality between ages 55 and 75. Notably, racial disparities in cancer and other causes of death are relatively small even though these causes of death account for over half of all deaths. Adjusting for economic resources and health largely eliminate racial disparities in mortality at all ages and the mediating effect of these factors grows with age. The pattern of results suggests that, to the extent that racism influences health, it is primarily through racism’s effect on investments to treat healthcare amenable diseases that cause racial disparities in mortality.

Author(s): Robert KaestnerAnuj Gangopadhyaya & Cuiping Schiman

Publication Date: June 2025

Publication Site: NBER Working Papers

Denmark is first in Europe to raise retirement age to 70

Link: https://www.thetimes.com/world/europe/article/denmark-retirement-age-70-2tgr5rvv7

Excerpt:

Workers born after 1970 have been told they need to keep going for another three years — and many are not happy

Denmark has raised its retirement age to 70 for everyone born after 1970, becoming the first European country to reach the symbolic threshold.

While other nations are bogged down in seemingly intractable political battles over increasing the state pension age, the Danes are following a long-established principle that it should go up broadly in line with life expectancy. The average for Danes is 81.7 years. The legislation was passed with an overwhelming majority in the Danish parliament.

However, there is a good deal of public unease at the plan to oblige many people to keep working until the end of their seventh decade. Some MPs look aghast at projections that the retirement age could rise as high as 77.

Author(s): Oliver Moody

Publication Date: 22 May 2025

Publication Site: The Times

State and Local Government Employees Without Social Security Coverage: What Percentage Will Earn Pension Benefits That Fall Short of Social Security Equivalence?

Link: https://www.ssa.gov/policy/docs/ssb/v82n3/v82n3p1.html

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Excerpt:

Analysis based on a synthetic population of noncovered state and local government workers confirms earlier results based on a sample of retirement plan benefit formulas: Workers with medium-length government tenures are at risk of receiving lifetime retirement income that falls short of Social Security equivalence. Given the distributions of the synthetic population of noncovered workers by occupation, retirement-plan benefit formula, and tenure in government employment, this translates to about 16 percent of all noncovered workers at risk of receiving less retirement income than they would have received from Social Security alone had they spent their whole careers in covered employment.

Although the share of workers with projected retirement benefits that fall short of Social Security equivalence is not large, the problem is serious. Social Security is intended to provide a minimum level of retirement income for all Americans. Covered public-sector workers and many private-sector workers augment their Social Security benefits with employer-sponsored retirement plans. The concern is that pension benefits ultimately will not meet that minimum level for 750,000 to 1 million noncovered workers annually who cannot augment those benefits with Social Security income.

Author(s):  Jean-Pierre Aubry, Siyan Liu, Alicia H. Munnell, Laura D. Quinby, and Glenn R. Springstead

Social Security Bulletin, Vol. 82 No. 3, 2022 (released August 2022)

Publication Date: August 2022

Publication Site: Social Security Administration

Modifiable risk factors for stroke, dementia and late-life depression: a systematic review and DALY-weighted risk factors for a composite outcome

Link: https://jnnp.bmj.com/content/early/2025/03/21/jnnp-2024-334925.long

Excerpt:

Abstract

Background At least 60% of stroke, 40% of dementia and 35% of late-life depression (LLD) are attributable to modifiable risk factors, with great overlap due to shared pathophysiology. This study aims to systematically identify overlapping risk factors for these diseases and calculate their relative impact on a composite outcome.

Methods A systematic literature review was performed in PubMed, Embase and PsycInfo, between January 2000 and September 2023. We included meta-analyses reporting effect sizes of modifiable risk factors on the incidence of stroke, dementia and/or LLD. The most relevant meta-analyses were selected, and disability-adjusted life year (DALY) weighted beta (β)-coefficients were calculated for a composite outcome. The β-coefficients were normalised to assess relative impact.

Results Our search yielded 182 meta-analyses meeting the inclusion criteria, of which 59 were selected to calculate DALY-weighted risk factors for a composite outcome. Identified risk factors included alcohol (normalised β-coefficient highest category: −34), blood pressure (130), body mass index (70), fasting plasma glucose (94), total cholesterol (22), leisure time cognitive activity (−91), depressive symptoms (57), diet (51), hearing loss (60), kidney function (101), pain (42), physical activity (−56), purpose in life (−50), sleep (76), smoking (91), social engagement (53) and stress (55).

Conclusions This study identified overlapping modifiable risk factors and calculated the relative impact of these factors on the risk of a composite outcome of stroke, dementia and LLD. These findings could guide preventative strategies and serve as an empirical foundation for future development of tools that can empower people to reduce their risk of these diseases.

Author(s): http://orcid.org/0009-0002-6540-480XJasper Senff1,2,3,4,5, http://orcid.org/0000-0003-3204-0309Reinier Willem Pieter Tack1,2,3,4,5, Akashleena Mallick1,2,3,4, Leidys Gutierrez-Martinez1,2,3,4, Jonathan Duskin1,2,3,4, Tamara N Kimball1,2,3,4,6, Benjamin Y Q Tan1,2,3,4,7, Zeina N Chemali1,2,8, Amy Newhouse1,9, Christina Kourkoulis1,2,3,4, Cyprien Rivier10,11, Guido J Falcone10,11, Kevin N Sheth10,11, Ronald M Lazar12, Sarah Ibrahim13,14,15,16,17, Aleksandra Pikula14,15,16,17, Rudolph E Tanzi1, Gregory L Fricchione8, Hens Bart Brouwers5, Gabriel J E Rinkel5, Nirupama Yechoor1,2,3,4, Jonathan Rosand1,2,3,4, Christopher D Anderson1,2,3,4,6, Sanjula D Singh1,2,3,4

https://doi.org/10.1136/jnnp-2024-334925

Publication Date: April 2025

Publication Site: Journal of Neurology, Neurosurgery, & Psychiatry

17 Ways to Cut Your Risk of Stroke, Dementia and Depression All at Once

Link: https://www.nytimes.com/2025/04/23/well/dementia-stroke-depression-prevention.html?smid=url-share

Graphic:

Excerpt:

New research has identified 17 overlapping factors that affect your risk of stroke, dementia and late-life depression, suggesting that a number of lifestyle changes could simultaneously lower the risk of all three.

Though they may appear unrelated, people who have dementia or depression or who experience a stroke also often end up having one or both of the other conditions, said Dr. Sanjula Singh, a principal investigator at the Brain Care Labs at Massachusetts General Hospital and the lead author of the study. That’s because they may share underlying damage to small blood vessels in the brain, experts said.

….

The study, which looked at data from 59 meta-analyses, identified six factors that lower your risk of brain diseases:

  • Low to moderate alcohol intake (Consuming one to three drinks a day had a smaller benefit than consuming less than one drink a day.)
  • Cognitive activity, meaning regular engagement in mentally stimulating tasks like reading or doing puzzles
  • A diet high in vegetables, fruit, dairy, fish and nuts
  • Moderate or high levels of physical activity
  • A sense of purpose in life
  • A large social network

The study also identified 13 health characteristics and habits that make you more likely to develop dementia, a stroke or late-life depression. (Altogether, the protective and harmful factors add up to 19 factors because two of them, diet and social connections, can increase or decrease risk, depending on their type and quality.)

  • High blood pressure
  • High body mass index
  • High blood sugar
  • High total cholesterol
  • Depressive symptoms
  • A diet high in red meat, sugar-sweetened beverages, sweets and sodium
  • Hearing loss
  • Kidney disease
  • Pain, particularly forms that interfere with activity
  • Sleep disturbances (for example, insomnia or poor sleep quality) or sleep periods longer than eight hours
  • Smoking history
  • Loneliness or isolation
  • General stress or stressful life events (as reported by study subjects)

Author(s): Nina Agrawal

Publication Date: 23 Apr 2025

Publication Site: NYT