Category: Mortality

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

Mary Pat Campbell

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 Kaestner, Anuj Gangopadhyaya & Cuiping Schiman

Publication Date: June 2025

Publication Site: NBER Working Papers

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

Mary Pat Campbell

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

Mary Pat Campbell

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

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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

BRCA1, BRCA2, and Associated Cancer Risks and Management for Male Patients

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jamaoncology/article-abstract/2821594

Excerpt:

Importance  Half of all carriers of inherited cancer-predisposing variants in BRCA1 and BRCA2 are male, but the implications for their health are underrecognized compared to female individuals. Germline variants in BRCA1 and BRCA2 (also known as pathogenic or likely pathogenic variants, referred to here as BRCA1/2 PVs) are well known to significantly increase the risk of breast and ovarian cancers in female carriers, and knowledge of BRCA1/2 PVs informs established cancer screening and options for risk reduction. While risks to male carriers of BRCA1/2 PVs are less characterized, there is convincing evidence of increased risk for prostate cancer, pancreatic cancer, and breast cancer in males. There has also been a rapid expansion of US Food and Drug Administration–approved targeted cancer therapies, including poly ADP ribose polymerase (PARP) inhibitors, for breast, pancreatic, and prostate cancers associated with BRCA1/2 PVs.

Observations  This narrative review summarized the data that inform cancer risks, targeted cancer therapy options, and guidelines for early cancer detection. It also highlighted areas of emerging research and clinical trial opportunities for male BRCA1/2 PV carriers. These developments, along with the continued relevance to family cancer risk and reproductive options, have informed changes to guideline recommendations for genetic testing and strengthened the case for increased genetic testing for males.

Conclusions and Relevance  Despite increasing clinical actionability for male carriers of BRCA1/2 PVs, far fewer males than female individuals undergo cancer genetic testing. Oncologists, internists, and primary care clinicians should be vigilant about offering appropriate genetic testing to males. Identifying more male carriers of BRCA1/2 PVs will maximize opportunities for cancer early detection, targeted risk management, and cancer treatment for males, along with facilitating opportunities for risk reduction and prevention in their family members, thereby decreasing the burden of hereditary cancer.

Author(s): Heather H. Cheng, MD, PhD1,2; Jeffrey W. Shevach, MD3; Elena Castro, MD, PhD4; et al

JAMA Oncol. 2024;10(9):1272-1281.

doi:10.1001/jamaoncol.2024.2185

Publication Date: July 25, 2024

Publication Site: JAMA Oncology

Fecal Immunochemical Test Screening and Risk of Colorectal Cancer Death

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821348

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Excerpt:

Key Points

Question  What is the colorectal cancer mortality benefit of screening with fecal immunochemical tests (FITs)?

Findings  In this nested case control study of 10 711 individuals, completing a FIT to screen for colorectal cancer was associated with a reduction in risk of dying from colorectal cancer of approximately 33% overall, and there was a 42% lower risk for left colon and rectum cancers. FIT screening was also associated with lower risk of colorectal cancer death among non-Hispanic Asian, non-Hispanic Black, and non-Hispanic White people.

Meaning  This study provides US community-based evidence that suggests FIT screening lowers the risk of dying from colorectal cancer and supports the strategy of population-based screening using FIT.

Author(s): Chyke A. Doubeni, MD, MPH1,2; Douglas A. Corley, MD, PhD3; Christopher D. Jensen, PhD3; et al

Publication Date: July 19, 2024

Publication Site: JAMA Netw Open. 

2024;7(7):e2423671.

doi:10.1001/jamanetworkopen.2024.23671

From a Simple Test to Open Heart Surgery: How a Cardiac Screening Saved George’s Life

Mary Pat Campbell

Link: https://www.chestercountyhospital.org/news/health-eliving-blog/2020/february/how-cardiac-screening-saved-georges-life

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Excerpt:

George, who is 51 years old, has been a police officer in Chester County for 31 years. He has lived a life of action — which comes with some feelings of invincibility. “As a police officer, there are times we think we are indestructible,” he explains.

Because of his active lifestyle — and no signs of heart problems whatsoever — heart disease was the furthest thing from George’s mind. “I walked anywhere from 6 to 8 hours a day. I was never winded, never tired, and I had no numbness. All of those telltale signs of heart disease — I never got any of them,” George explains.

Through a collaboration between Chester County Hospital and local police departments, George was offered a free cardiac risk screening for first responders. Despite zero signs of heart disease, he figured he might as well take advantage. Little did he know, he would end up having open-heart surgery just a few months later.

Publication Date: 10 Feb 2020

Publication Site: Chester County Hospital, Penn Medicine blog

The Latest Research on Why So Many Young Adults Are Getting Cancer

Mary Pat Campbell

Link: https://www.mskcc.org/news/why-is-cancer-rising-among-young-adults

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MSK breast oncologist Dr. Shari Goldfarb

Excerpt:

Men and women in the prime of their lives are increasingly being diagnosed with serious cancers, including colorectal, breast, prostate, uterine, stomach (gastric), pancreatic, and more. One forecast predicts cancer for this age group will increase by 30% globally from 2019 to 2030.

“This is serious and worrisome,” says Shari Goldfarb, MD, breast oncologist and Director of MSK’s Young Women With Breast Cancer program.   

“This is not a blip,” explains Andrea Cercek, MD, gastrointestinal oncologist and Co-Director of The Center for Young Onset Colorectal and Gastrointestinal Cancer. “The more data we gather, the clearer this becomes.”

MSK is a pioneer in caring for the specific needs of people facing what are often called early-onset cancers, who confront very different challenges than older adults. The coming surge in cases is a key reason MSK is building a new state-of-the-art hospital, called the MSK Pavilion.

Just as importantly, MSK experts are leading the investigation into why this is happening.

Author(s): Bill Piersol

Publication Date: 3 Sept 2024

Publication Site: Memorial Sloan Kettering News

An Analysis of Motor Vehicle Records and All-Cause Mortality

Mary Pat Campbell

Link: https://www.rgare.com/knowledge-center/article/an-analysis-of-motor-vehicle-records-and-all-cause-mortality

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Excerpt:

This paper analyzes the all-cause mortality experience of a large cohort of applicants linked to the number and severity of their recent driving infractions. The study verifies that significant excess mortality risk exists for applicants with a recent history of either major or frequent driving violations. The extra mortality risk for drivers with adverse MVRs is persistent across ages for both genders. The results from this study also suggest that MVRs likely have positive protective value across a wide spectrum of ages and face amounts.

Author(s): Timothy L. Rozar

Publication Date: April 2012

Publication Site: RGA Re

Longevity Illustrator: Find Out How Long You Might Live

Mary Pat Campbell

Link: https://www.kiplinger.com/retirement/longevity-illustrator-find-out-how-long-you-might-live

Excerpt:

When planning for retirement, it’s important to consider all the risks, and one consideration that individuals often overlook is “longevity risk.” Longevity risk refers to the chance a person could outlive their savings. Understanding longevity and reasonably estimating the probabilities of living to various advanced ages and the risk of outliving resources are important for planning a secure retirement.

As a result of healthy lifestyles, medical advancements and scientific discoveries, it has become much more common for people these days to live into their 80s and 90s — or even their 100s! In fact, Pew Research Center writes that, according to estimates by the U.S. Census Bureau, there are about 101,000 centenarians in the U.S. in 2024, and this population could quadruple to about 422,000 in 2054.

While a long life is something most people desire, it requires planning for a longer retirement than in the past. For example, if a worker retires at 67, planning for a 20-year retirement may not be enough, and if they live to be in their 90s, or even past 100, they could outlive their savings or end up with fewer assets to leave their heirs.

Author(s):  Lisa A. Schilling, FSA, EA, FCA, MAAA

Publication Date: 22 Sept 2024

Publication Site: Kiplinger Personal Finance

Impact of AI on Mortality – Essay Collection

Mary Pat Campbell

Link: https://www.soa.org/resources/research-reports/2024/ai-mortality-essay-collection/

PDF: https://www.soa.org/4a5e85/globalassets/assets/files/resources/research-report/2024/impact-ai-mortality/2024-impact-ai-mort-essays.pdf

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Excerpt:

The Society of Actuaries (SOA) Research Institute’s Mortality and Longevity Strategic Research Program Steering Committee issued a call for essays to explore the application of artificial intelligence (AI) to mortality and longevity. The objective was to gather a variety of perspectives and experiences on the use of AI in mortality modeling, forecasting and prediction to promote discussion and future research around this topic.


The collection includes six essays that were accepted for publication from all submissions. Two essays were chosen for prizes based on their creativity, originality, and likelihood of further thought on the subject matter.

Author(s): multiple

Publication Date: September 2024

Publication Site: Society of Actuaries, SOA Research Institute

Provisional Drug Overdose Death Counts

Mary Pat Campbell

Link: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

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Excerpt:

This data visualization presents provisional counts for drug overdose deaths based on a current flow of mortality data in the National Vital Statistics System. Counts for the most recent final annual data are provided for comparison. National provisional counts include deaths occurring within the 50 states and the District of Columbia as of the date specified and may not include all deaths that occurred during a given time period. Provisional counts are often incomplete and causes of death may be pending investigation (see Technical notes) resulting in an underestimate relative to final counts. To address this, methods were developed to adjust provisional counts for reporting delays by generating a set of predicted provisional counts (see Technical notes).

The provisional data presented in this visualization include: (a) the reported and predicted provisional counts of deaths due to drug overdose occurring nationally and in each jurisdiction; (b) a U.S. map of the percentage changes in provisional drug overdose deaths for the current 12 month-ending period compared with the 12-month period ending in the same month of the previous year, by jurisdiction; and (c) the reported and predicted provisional counts of drug overdose deaths involving specific drugs or drug classes occurring nationally and in selected jurisdictions. The reported and predicted provisional counts represent the numbers of deaths due to drug overdose occurring in the 12-month periods ending in the month indicated. These counts include all seasons of the year and are insensitive to variations by seasonality. Deaths are reported by the jurisdiction in which the death occurred.

Several data quality metrics, including the percent completeness in overall death reporting, percentage of deaths with cause of death pending further investigation, and the percentage of drug overdose deaths with specific drugs or drug classes reported are included to aid in interpretation of provisional data as these measures are related to the accuracy of provisional counts (see Technical notes). Reporting of the specific drugs and drug classes involved in drug overdose deaths varies by jurisdiction, and comparisons of death rates involving specific drugs across selected jurisdictions should not be made (see Technical notes). Provisional data presented in this visualization will be updated on a monthly basis as additional records are received.

Publication Date: Accessed 19 Sept 2024

Publication Site: National Center for Health Statistics, CDC