The world made remarkable progress in child survival in the past three decades, and millions of children have better survival chances than in 1990—1 in 26 children died before reaching age five in 2021, compared to 1 in 11 in 1990. Moreover, progress in reducing child mortality rates has been accelerated in the 2000s period compared with the 1990s, with the annual rate of reduction in the global under-five mortality rate increasing from 1.8 per cent in 1990s to 4.0 per cent for 2000-2009 and 2.7 per cent for 2010-2021.
The under-five mortality rate refers to the probability a newborn would die before reaching exactly 5 years of age, expressed per 1,000 live births. In 2021, 5.0 million children under 5 years of age died. Globally, infectious diseases, including pneumonia, diarrhoea and malaria, remain a leading cause of under-five deaths, along with preterm birth and intrapartum-related complications.
The global under-five mortality rate declined by 59 per cent, from 93 deaths per 1,000 live births in 1990 to 38 in 2021. Despite this considerable progress, improving child survival remains a matter of urgent concern. In 2021 alone, roughly 13,800 under-five deaths occurred every day, an intolerably high number of largely preventable child deaths.
Publication Date: January 2023, accessed 21 March 2023
Table 5.2 shows more detailed industry results for the top ten industry segments by number of COVID claims. Most of these industries were in the top ten for the July 2021 report as well. As we now have more quarters with more complete results, both the A/E ratios for April 2020 through September 2021, as well as the COVID claims as a percentage of baseline claims, showed greater consistency across industries than in the previous report. Public Administration continues to be a key driver of high A/E ratios for the White Collar category. Doctors (Healthcare, also White Collar), Retail Trade (Grey Collar), and Misc. Services (Grey Collar) have the highest COVID claims as a percentage of baseline claims. Heavy Steel Manufacturing (Blue Collar) has a much lower A/E ratio than the other top 10 industries. In the table below, “B,” “W,” and “G” refer to Blue Collar, White Collar, and Grey Collar, respectively.
It should be noted that the high A/E ratios for Public Administration are driven by experience in the Executive, Legislative, and General Government segment (Standard Industry Classification [SIC] codes 9100-9199). This segment does not include police and fire and represents over 85% of claims in the broader Public Administration segment.
Publication Date: January 2022
Publication Site: Society of Actuaries Research Institute
— 1800 to 1950: Gapminder v7 (In some cases this is also used for years after 1950, see below.) This was compiled and documented by Klara Johansson and Mattias Lindgren from many sources but mainly based on www.mortality.org and the series of books called International Historical Statistics by Brian R Mitchell, which often have historic estimates of Infant mortality rate which were converted to Child mortality through regression. See detailed documentation of v7 below.
— 1950 to 2016: UNIGME, is a data collaboration project between UNICEF, WHO, UN Population Division and the World Bank. They released new estimates of child mortality for countries and a global estimate on September 19, 2019, and the data is available at www.childmortality.org. In this dataset, 70% of all countries have estimates between 1970 and 2018, while roughly half the countries also reach back to 1960 and 17% reach back to 1950.
JAMA Health Forum. 2023;4(3):e230010. doi:10.1001/jamahealthforum.2023.0010
Question Do postacute sequelae of SARS-CoV-2 increase risks of 1-year adverse outcomes?
Findings In this case-control study of 13 435 US adults with post–COVID-19 condition (PCC) and 26 870 matched adults without COVID-19, the adults with PCC experienced increased risks for a number of cardiovascular outcomes, such as ischemic stroke. During the 12-month follow-up period, 2.8% of the individuals with PCC vs 1.2% of the individuals without COVID-19 died, implying an excess death rate of 16.4 per 1000 individuals.
Meaning Individuals with PCC may be at increased risk for adverse outcomes in the year following initial infection.
Author(s): Andrea DeVries, PhD1; Sonali Shambhu, BDS, MPH1; Sue Sloop, PhD1; et al
A giant health insurer says health plan enrollees who suffered from long COVID-19 symptoms were more than twice as likely as other enrollees to die during a 12-month follow-up period.
Andrea DeVries, a researcher at Elevance Health, and three colleagues found that, during the year studied, 2.8% of the 13,435 enrollees classified as having “post-COVID-19 condition” died, according to a study published in the JAMA Health Forum, which is affiliated with the Journal of the American Medical Association.
That compares with a death rate of just 1.2% for similar enrollees without COVID-19 during the same period.
Elevance Health is the company formerly known as Anthem. The company provides or administers major medical coverage for about 48 million people.
The DeVries looked at claim records for 249,013 Elevance plan enrollees ages and older who were diagnosed with COVID-19 from April 1, 2020, through July 31, 2020 — before regulators had adopted a long COVID diagnosis code.
The team began by identifying enrollees with COVID-19 who had been enrolled in an Elevance plan for at least five months before being diagnosed with COVID-19 and who had survived for at least two months after the diagnosis date.
Because of the lack of a long COVID-19 diagnosis code, the team used claims for other conditions, such as loss of the sense of smell, brain fog, anxiety and heart rate problems, to come up with a list of enrollees with long COVID.
The report analyses the development of mortality assumptions to build mortality tables to better protect retirement income provision. It first provides an international overview of longevity trends and drivers over the last several decades, including the impact of the COVID-19 pandemic. It then explores considerations and traditional approaches for developing mortality tables, and details the standard mortality tables developed across OECD member countries. It concludes with guidelines to assist regulators and supervisors in assessing whether the mortality assumptions and tables used in the context of retirement income provision are appropriate.
The OECD will provide an overview of the publication, followed by a roundtable discussion with government and industry stakeholders. Topics discussed will include:
Recent mortality trends and drivers
How mortality trends/drivers can inform future expectations, and how to account for that in modelling
The challenge of accounting for COVID in setting mortality assumptions
Trade-offs for different modelling approaches
The usefulness of the guidelines included in the report in practice
How to better communicate around mortality assumptions to non-experts
Demographers and actuaries make the following distinction between life expectancy and longevity: Life expectancy refers to the average number of years someone will live from a given age, whereas longevity refers to how long he or she might live if everything goes well, typically expressed as the probability of living beyond a certain age such as 85, 90 or even 100.
A growing body of evidence shows that many people are ignorant of their so-called longevity risk—the probability of living a very long time—and the complications that presents.
Drs. Hurwitz and Mitchell note that retirement calculators provide information about average life expectancy, but not longevity. They have found that about five times as many Census Bureau publications relate to life expectancy as longevity. Thus, people who have planned appropriately for their life expectancy might miss how likely they are to live longer.
People can look up their longevity risk with an online Longevity Illustrator maintained by the American Academy of Actuaries and Society of Actuaries, based off the latest mortality data from the Social Security Administration.
Understanding the mortality impact of COVID-19 requires not only counting the dead, but analyzing how premature the deaths are. We calculate years of life lost (YLL) across 81 countries due to COVID-19 attributable deaths, and also conduct an analysis based on estimated excess deaths. We find that over 20.5 million years of life have been lost to COVID-19 globally. As of January 6, 2021, YLL in heavily affected countries are 2–9 times the average seasonal influenza; three quarters of the YLL result from deaths in ages below 75 and almost a third from deaths below 55; and men have lost 45% more life years than women. The results confirm the large mortality impact of COVID-19 among the elderly. They also call for heightened awareness in devising policies that protect vulnerable demographics losing the largest number of life-years.
Author(s): Héctor Pifarré i Arolas, Enrique Acosta, Guillem López-Casasnovas, Adeline Lo, Catia Nicodemo, Tim Riffe & Mikko Myrskylä
The CMI has issued its consultation to help shape the next version of its mortality projection model, which is used by the majority of pension scheme trustees and sponsors in setting their funding and accounting assumptions. The consultation focuses on how to respond to the very high mortality rates seen in England & Wales over 2022, to which the model is calibrated.
The CMI believe mortality in 2022 may be indicative of future mortality to some extent, unlike the exceptional mortality seen in 2020 and 2021 during the peak of the pandemic.
The key proposal is to give 25% weight to the 2022 mortality data. In the coming years, the CMI plan to steadily increase the weight on mortality data until around 2025, by which time it expects a clearer indication of mortality trends of the future. The CMI also intend to update the model to use the latest population estimates based on the 2021 Census.
Both of these changes reduce projected life expectancy relative to previous versions of the model.
Chris Tavener, Partner and Head of Life Analytics commented: “If these proposals go ahead then life expectancy assumptions at age 65 are likely to fall by around 6 months, equivalent to 2%, when adopting the new core model, all else being equal. This is a larger fall in life expectancies compared to recent model updates, but we share the concern expressed by the CMI that higher death rates seen in the latter part of 2022, and continuing into January, may be indicative of future mortality.
“We are seeing an increasing number of pension scheme trustees and sponsors look to us to understand how their own members are likely to be affected by the various factors driving recent higher death rates, such as the ramifications of the pandemic and pressures on the healthcare system, which in our view will affect some groups more than others.”
Despite such tragedies, Missouri is one of two states — the other is Montana — that do not prohibit all drivers from text messaging while operating vehicles. (Missouri has such a law for people 21 and under.)
Before this year, Missouri state lawmakers from both parties had proposed more than 80 bills since 2010 with varying levels of restrictions on cellphone use and driving. Similar legislation has been proposed in Montana, too. In both states, such bills have faltered, largely because Republican opponents say they don’t think the laws work and are just another infringement on people’s civil liberties.
Nevertheless, Missouri Republicans and Democrats introduced at least seven bills this session concerning hand-held phone use while driving — and road safety advocates think such legislation has a better chance of passing this year. Montana, meanwhile, has a bill seeking to block localities’ distracted driving laws.
Supporters of hands-free driving laws concede that distracted driving restrictions are not a panacea for all traffic fatalities. And even if Missouri passes additional restrictions on cellphone use, small nuances in wording could influence whether such a law is effective.
Nationwide, about 3,000 people typically die in distracted driving crashes each year, according to National Highway Traffic Safety Administration data, though researchers suggest that’s an undercount. While hands-free options are now standard for new vehicles, the number of distracted driving deaths has stayed relatively steady. They represented at least 1 in 12 traffic fatalities in 2020.
Distracted driving laws reduce fatalities — if, like the ones established in 24 states, they ban all hand-held cellphone use rather than banning only a specific activity such as texting, according to the Governors Highway Safety Association and a study published in 2021 in the journal Epidemiology. Banning texting alone does not make a difference, those researchers found.
Oregon and Washington saw significant reductions in the rates of monthly rear-end crashes when they broadened their laws to prohibit “holding” a cellphone as compared with states that banned only texting, according to a study from the Insurance Institute for Highway Safety. Those two states also prohibited holding a phone when stopped temporarily — say, at a red light.
U.S. public health agencies recorded a total of about 3.2 million deaths in 2022, according to full-year mortality figures from the U.S. Centers for Disease Control and Prevention.
The total number of deaths was down 7% from the preliminary total for 2021 that the CDC reported a year earlier, but it was 15% higher than the preliminary, full-year average — about 2.8 million per year — for the period from 2015 through 2019, before the COVID-19 pandemic began.
A total of 38,824 people died in motor vehicle crashes in the U.S. in 2020, 2,570 (7.1%) more than forecast from models developed using data from 2011 through 2019 (Figure). In April 2020—the first full month of the pandemic—the number of fatalities was much lower than what would have been expected based on pre-pandemic trends. By May 2020, however, the actual number of fatalities was similar to historical levels. The number of fatalities greatly exceeded forecasts based on pre-pandemic trends for the remainder of 2020. In May through December collectively, there were a total of 28,611 traffic fatalities nationwide, which was 3,083 (12.1%) more than expected based on pre-pandemic trends.
The increase in traffic fatalities was not uniform across crash-, vehicle-, and driver-related factors. Scenarios present in greater than expected numbers in fatal crashes in 2020 included evening and late-night hours, speeding drivers, drivers with illegal alcohol levels, drivers without valid licenses, drivers of older vehicles, drivers of vehicles registered to other people, crash involvement and deaths of teens and young adults, and deaths of vehicle occupants not wearing seatbelts. In contrast, several crash types followed pre-pandemic trends (e.g., crashes in the middle of the day; crash involvements of drivers with valid licenses; pedestrian fatalities), and a few decreased (e.g., crashes of elderly drivers; crashes during typical morning commute hours).