Category: Mortality

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

The future of excess mortality after COVID-19

Mary Pat Campbell

Link: https://www.swissre.com/institute/research/topics-and-risk-dialogues/health-and-longevity/covid-19-pandemic-synonymous-excess-mortality.html?utm_campaign=CPN-2181_mortality-2024_Group_GLOBAL_2024&utm_medium=Other_Organic&utm_source=LinkedIn&utm_content=Health_N/A_Publication_EN&utm_term=excessmortality

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Excerpt:

Four years on from the outbreak of the pandemic in 2020, many countries worldwide still report elevated deaths in their populations. This impact appears generally independent of healthcare systems and population health. This trend is evident even after accounting for shifting population sizes, and the range of reporting mechanisms and death classifications that make inter-country comparisons complex. There is also likely a degree of excess mortality under-reporting.

Quantifying excess mortality has been an acute challenge since 2020 due to the exceptional mortality rates of the pandemic. Excess mortality refers to the number of deaths over and above an assumed “expected” number of deaths. The different methods of estimating expected mortality can generate very different excess mortality rates.

This represents a potential challenge for Life and Health (L&H) insurance, with potentially several years of elevated mortality claims ahead, depending on how general population trends translate into the insured population. Ongoing excess mortality can have implications for L&H insurance claims and reserves. Excess mortality that continues to exceed current expectations may affect the long-term performance of in-force life portfolios as well as the pricing of new life policies.

Author(s): By Daniel Meier, Life & Health R&D Manager, CUO L&H Reinsurance & Prachi Patkee, Life & Health R&D Analyst, CUO L&H Reinsurance & Adam Strange, Life & Health R&D Manager, CUO L&H Reinsurance

Publication Date: 16 Sept 2024

Publication Site: Swiss Re Institute

The Mortality After Release from Incarceration Consortium (MARIC): Protocol for a multi-national, individual participant data meta-analysis

Mary Pat Campbell

Link: https://ijpds.org/article/view/1145

doi: 10.23889/ijpds.v5i1.1145

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Abstract

Introduction
More than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance.

Objectives
To comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from prison.

Methods
We created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology.

Results
The combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up.

Conclusions
The consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalized population.

Author(s): Borschmann, R., Tibble, H., Spittal, M. J., Preen, D., Pirkis, J., Larney, S., Rosen, D. L., Young, J. T., Love, A. D., Altice, F. L., Binswanger, I. A., Bukten, A., Butler, T., Chang, Z., Chen, C.-Y., Clausen, T., Christensen, P. B., Culbert, G. J., Degenhardt, L., Dirkzwager, A. J., Dolan, K., Fazel, S., Fischbacher, C., Giles, M., Graham, L., Harding, D., Huang, Y.-F., Huber, F., Karaminia, A., Kouyoumdjian, F. G., Lim, S., Møller, L., Moniruzzaman, A., Morenoff, J., O’Moore, E., Pizzicato, L. N., Pratt, D., Proescholdbell, S. F., Ranapurwala, S. I., Shanahan, M. E., Shaw, J., Slaunwhite, A., Somers, J. M., Spaulding, A. C., Stern, M. F., Viner, K. M., Wang, N., Willoughby, M., Zhao, B. and Kinner, S. A. 

Publication Date: February 2020

Publication Site: International Journal of Population Data Science

U.S. Deaths Still 7% Over Pre-COVID Norm in Q2

Mary Pat Campbell

Link:https://www.thinkadvisor.com/2024/08/12/u-s-deaths-still-7-over-pre-covid-norm-in-q2/

Excerpt:

What You Need to Know

  • General-population mortality trends may differ from trends for people with life insurance and annuities.
  • The total number of first-half deaths was about 110,000 higher than the first six months of 2019.
  • One group would like to see life insurers use voluntary screening tests to learn more about mortality trends.

Author(s): Allison Bell

Publication Date: 12 Aug 2024

Publication Site: Think Advisor

Trends of Heat-Related Deaths in the US, 1999-2023

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jama/fullarticle/2822854?guestAccessKey=53b50a89-0945-4117-a662-5e1e1484ebce&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=082624

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We analyzed all deaths from 1999 to 2023 in which the International Statistical Classification of Diseases and Related Health Problems, 10th Revision code was P81 (environmental hyperthermia of newborn), T67 (effects of heat and light), or X30 (exposure to excessive natural heat) as either the underlying cause or as a contributing cause of death, as recorded in the Multiple Cause of Death file. Data were accessed through the Centers for Disease Control and Prevention’s WONDER platform,5 which combines death counts with population estimates produced by the US Census Bureau to calculate mortality rates. For each year, we extracted age-adjusted mortality rates (AAMRs) per 100 000 person-years for heat-related deaths. The AAMR accounts for differences due to age structures, allowing direct comparisons across time. The approach of analyzing cause-specific mortality rates rather than excess mortality is warranted because the excess mortality methodology is subject to confounding from the COVID-19 pandemic from 2020 to 2023. This study used publicly available, deidentified aggregate data; thus, it was not considered human subjects research.

Joinpoint version 5.2.0 (National Cancer Institute) regression6 was used to analyze AAMRs to assess trends and determine elbow points where the trend began to shift to a new trajectory. Results of joinpoint analyses are reported as average annual percentage change (AAPC) in rates with 95% CIs. Statistical significance was defined as 2-sided P < .05. Data were visualized with R version 4.2.2 (R Foundation for Statistical Computing).

Results

From 1999 to 2023, 21 518 deaths were recorded as heat-related underlying or contributing cause of death, with an AAMR of 0.26 per 100 000 person-years (95% CI, 0.24-0.27) (Table). The number of heat-related deaths increased from 1069 (AAMR = 0.38; 95% CI, 0.36-0.40) in 1999 to 2325 (AAMR = 0.62; 95% CI, 0.60-0.65) in 2023, a 117% increase in the number of heat-related deaths and a 63% increase in the AAMR. The lowest number of heat-related deaths in the study period was 311 in 2004, whereas the highest, 2325, was in 2023.

Results of the joinpoint trend analysis showed that during the entire period, the AAMR increased by 3.6% per year (AAPC = 3.6%; 95% CI, 0.1%-7.2%; P = .04) from 1999 to 2023 (Figure). The number of heat-related deaths and AAMR showed year-to-year variability, with spikes in 2006 and 2011, before showing steady increases after 2016. Joinpoint results showed a nonsignificant decrease of 1.4% per year from 1999 to 2016 (AAPC = −1.4%; 95% CI, −4.7% to 2.1%; P = .42), followed by a significant increase of 16.8% per year in the AAMR from 2016 to 2023 (AAPC = 16.8%; 95% CI, 6.4%-28.2%; P = .002).

Author(s): Jeffrey T. Howard, PhD1; Nicole Androne, MS1; Karl C. Alcover, PhD2; et al

Publication Date:  Published online August 26, 2024
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Publication Site: JAMA Network

doi:10.1001/jama.2024.16386

Heat killed a record number of Americans last year

Mary Pat Campbell

Link: https://www.usatoday.com/story/news/health/2024/08/26/2023-heat-deaths-record-number/74937063007/

Excerpt:

More Americans died from heat in 2023 than any year in over two decades of records, according to the findings published Monday. Last year was also the globe’s hottest year on record, the latest grim milestone in a warming trend fueled by climate change.

The study, published in the American Medical Association journal JAMA, found that 2,325 people died from heat in 2023. Researchers admit that number is likely an undercount. The research adjusted for a growing and aging U.S. population, and found the death toll was still staggering.

….

Howard – along with researchers from the Uniformed Services University of the Health Sciences, in Maryland, and Pennsylvania State University – examined death certificate data between 1999 and 2023. Deaths were counted if heat was listed as an underlying or contributing cause of death.

Reported deaths remained relatively flat until around 2016, when the number of people dying began increasing, in what Howard, who studies health effects from extreme weather, calls a “hockey stick.” The hockey stick analogy has been used to describe warming global temperatures caused by climate change, where temperatures have swooped upward at alarming rates in recent years. 

Howard’s study suggests the human toll follows the same outline. An important indicator is age-adjusted deaths per 100,000 people. That heat-related death rate has increased dramatically compared to the early 2000s, regardless of age or population size.

The upward trajectory appears to be sharpening recently. In 2022, 1,722 people died at an adjusted rate of 0.47. But 2023 saw 603 more deaths than the previous year, with an adjusted rate of 0.63, the highest on record.

Deaths weren’t evenly spread nationally. In an interview, Howard said deaths were overwhelmingly concentrated in traditionally hot regions: Arizona, California, Nevada and Texas.

The study is limited in how local governments classify heat-related deaths, which could mean the actual number of deaths is an undercount. It’s also potentially skewed as more people become aware of the fatal risks of heat. The study didn’t break down vulnerable groups. For example, people without air conditioning, those who live or work outdoors, and people with underlying health conditions, are all at greater risk of serious illness or death from heat.

Author(s): Eduardo Cuevas and Dinah Voyles Pulver

Publication Date: 26 Aug 2024

Publication Site: USA Today

Mortality in the United States — Provisional Data, 2023

Mary Pat Campbell

Link: https://www.cdc.gov/mmwr/volumes/73/wr/mm7331a1.htm?s_cid=mm7331a1_w

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FIGURE 1. Provisional* number of COVID-19–associated deaths† and other deaths and percentage of deaths associated with COVID-19, by week of death — National Vital Statistics System, United States, 2023

* National Vital Statistics System provisional data for 2023 are incomplete. Data from December 2023 are less complete because of reporting lags. These data exclude deaths that occurred in the United States among residents of U.S. territories and foreign countries.

† Deaths with confirmed or presumed COVID-19 as an underlying or contributing cause of death, with International Classification of Diseases, Tenth Revision code U07.1.

Excerpt:

Abstract

Final annual mortality data from the National Vital Statistics System for a given year are typically released 11 months after the end of the calendar year. Provisional data, which are based on preliminary death certificate data, provide an early estimate of deaths before the release of final data. In 2023, a provisional total of 3,090,582 deaths occurred in the United States. The age-adjusted death rate per 100,000 population was 884.2 among males and 632.8 among females; the overall rate, 750.4, was 6.1% lower than in 2022 (798.8). The overall rate decreased for all age groups. Overall age-adjusted death rates in 2023 were lowest among non-Hispanic multiracial (352.1) and highest among non-Hispanic Black or African American persons (924.3). The leading causes of death were heart disease, cancer, and unintentional injury. The number of deaths from COVID-19 (76,446) was 68.9% lower than in 2022 (245,614). Provisional death estimates provide an early signal about shifts in mortality trends. Timely and actionable data can guide public health policies and interventions for populations experiencing higher mortality.

Author(s): Farida B. Ahmad, MPH1; Jodi A. Cisewski, MPH1; Robert N. Anderson, PhD

Publication Date: 8 Aug 2024

Publication Site: CDC, MMWR Morbidity/Mortality Weekly Report

Suggested citation for this article: Ahmad FB, Cisewski JA, Anderson RN. Mortality in the United States — Provisional Data, 2023. MMWR Morb Mortal Wkly Rep 2024;73:677–681. DOI: http://dx.doi.org/10.15585/mmwr.mm7331a1

Mortality Stays Slightly Elevated: Globe Life Exec

Mary Pat Campbell

Link:https://www.thinkadvisor.com/2024/07/30/mortality-stays-slightly-elevated-globe-life-exec/

Excerpt:

Since the COVID-19 pandemic began, in early 2020, Globe Life has been one of the life insurers that’s been quickest to give analysts candid assessments of U.S. mortality.

Mortality is much lower than it was when pandemic-related mortality was peaking, and mortality trends are now helping, not, hurting, Globe Life’s earnings, Kalmbach said.

“Mortality has been fairly consistent over the last few quarters, which has been good,” he said.

He sees the mortality rate from accidents and other nonmedical causes improving.

….

“Heart disease and cancer, although improved, are still a little bit higher,” he said. “Another one that remains elevated as a cause of death is neurological disorders, which would be stroke and Alzheimer’s. We’re keeping an eye on that.”

Author(s): Allison Bell

Publication Date: 30 July 2024

Publication Site: think Advisor

How COVID-19 has Affected Mortality in 2020 to 2023 [Australia]

Mary Pat Campbell

Link: https://www.actuaries.asn.au/public-policy-and-media/our-thought-leadership/reports/how-covid-19-has-affected-mortality-in-2020-to-2023?utm_medium=email&utm_campaign=240722-PPP-How%20COVID-19%20has%20Affected%20Mortality%20in%202020%20to%202023-Members&utm_content=240722-PPP-How%20COVID-19%20has%20Affected%20Mortality%20in%202020%20to%202023-Members+CID_aedad499bf553276132939b99d7a0215&utm_source=Campaign%20Monitor&utm_term=How%20COVID-19%20Affected%20Mortality%20in%20Australia%20from%202020%20to%202023

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Excerpt:

There were 8,400 more deaths in Australia in 2023 than predicted had the pandemic not occurred – less than half of the almost 20,000 excess deaths estimated for 2022.

The new Research Paper from the Mortality Working Group explores how COVID-19 affected mortality in Australia from 2020 to 2023 and how Australia’s experience compares with the rest of the world.  

In brief: 

  • The steep decline in excess deaths in 2023 was primarily due to the number of people dying from COVID-19 falling to 4,600 in 2023 from 10,300 in 2022.  
  • While Australia’s excess mortality rate had dropped substantially, it remains significantly higher than the 1-2% excess observed in years of high flu deaths prior to the pandemic.  
  • When analysing the excess mortality of 40 countries from 2020 to 2023, Australia’s excess mortality over the four-year period (5%) was low by global standards (11%).  

Author(s): Mortality Working Group. Members Karen Cutter, Ronald Lai, Jennifer Lang, Han Li, Richard
Lyon, Matt Ralph, Amitoze Singh, Michael Seymour, Zhan Wang.

Publication Date: July 2024

Publication Site: Actuaries Institute

Work Longer, Die Sooner! America’s Dire Need to Expand Social Security and Medicare

Mary Pat Campbell

Link: https://www.ineteconomics.org/perspectives/blog/work-longer-die-sooner-americas-dire-need-to-expand-social-security-and-medicare

Excerpt:

Are we all really living longer? Let’s first point out that Princeton economists Anne Case and Angus Deaton, noted for their research in health and economics, recently showed that many Americans are not, in fact, enjoying extended lives. As they stated in their own New York Times op-ed, those without college degrees are “scarred by death and a staggeringly shorter life span.” According to their investigation, the expected lifespan for this group has been falling since 2010. By 2021, people without college degrees were expected to live to about 75, nearly 8.5 years shorter than their college-educated counterparts.

Overall life expectancy in America dropped in 2020 and 2021, with increases in mortality across the leading causes of death and among all ages, not just due to COVID-19. In August 2022, data confirmed that Americans are dying younger across all demographics. Again, the U.S. is an outlier. It was one of two developed countries where life expectancy did not bounce back in the second year of the pandemic.

So the argument that everyone is living longer greatly stretches the truth—unless, of course, you happen to be rich: A Harvard study revealed that the wealthiest Americans enjoy a life expectancy over a decade longer than their poorest counterparts.

Could the idea that working into our seventies and beyond boosts our health and well-being hold true? Obviously, for those in physically demanding roles, such as construction or mining, prolonged work is likely to lead to a higher risk of injury, accidents, and wearing down health-wise. But what about everybody else? What if you have a desk job? Wouldn’t it be great to get out there, do something meaningful, and interact with people, too?

Perhaps it’s easy for people like Steuerle and Kramon to imagine older people working in secure, dignified positions that might offer health benefits into old age – after all, those are the types of positions they know best.

But the reality is different. Economist Teresa Ghilarducci, a professor at the New School for Social Research, focuses on the economic security of older workers and flaws in U.S. retirement systems in her new book, Work, Retire, Repeat: The Uncertainty of Retirement in the New Economy. She calls those praising the health perks of working longer “oddballs” – those fortunate folks in cushy positions who have a lot of autonomy and purpose. Like lawmakers or tenured professors, for example.

Author(s): Lynn Parramore

Publication Date: 8 May 2024

Publication Site: Institute for New Economic Thinking

The Hartford Sees High Mortality for the Next Few Years

Mary Pat Campbell

Link:https://www.thinkadvisor.com/2024/04/26/hartford-sees-high-mortality-for-next-few-years/

Excerpt:

Chris Swift, the chief executive officer of Hartford Financial, on Friday confirmed what government statistics seem to be showing: The U.S. death rate continues to be noticeably higher than it was before early 2020, when the COVID-19 pandemic came to light.

Swift talked about the effects of the higher U.S. mortality rate on the company’s group life insurance business Friday during a conference call with securities analysts.

He noted that mortality was much lower in the first quarter than in the first quarter of 2023, but that it was still somewhat higher than the pre-pandemic average.

“The trends are downward,” Swift said. “But we believe that we’re still operating in an endemic state of mortality, which means it’s going to be higher than normal, and we think that will continue for at least the next the next couple of years. We’ve been pricing our product with that view.”

Author(s): Allison Bell

Publication Date: 26 April 2024

Publication Site: Think Advisor

An Iowa farm county seeks answers amid cancer rates 50% higher than national average

Mary Pat Campbell

Link: https://www.thenewlede.org/2024/05/an-iowa-farm-county-seeks-answers-amid-cancer-rates-50-higher-than-national-average/

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Excerpt:

Palo Alto’s [County, Iowa] 2022 tally of 842 farms generates nearly $800 million in annual market value. But nearly 400 small farms have been absorbed into bigger operations or otherwise stopped operating over recent decades, and Palo Alto’s population has dropped by 4,200 people since 1970.

Today’s Iowa farms are largely focused on raising hogs and growing corn, both of which are linked to numerous environmental problems. Farmers growing corn, for example, often rely heavily on applications of toxic pesticides and fertilizers, while livestock operations generate millions of tons of manure annually. The chemicals and manure pollute food and water consumed by people even far from farm fields.

When nitrogen from fertilizer and manure combine with oxygen they create nitrates, which routinely drain from farm fields into groundwater, streams, and rivers, contaminating water sources. Babies can suffer severe health problems when consuming nitrates in drinking water, and a growing body of literature indicates potential associations that include an increased risk of cancer. Exposure to elevated levels of nitrates in drinking water has been linked by researchers to cancers of the blood, brain, breast, bladder and ovaries.

As well, there are years of research showing that many herbicides and other pesticides applied to farm fields are linked to cancers and other diseases. The National Cancer Institute and the National Institute of Environmental Health Sciences have been funding research to investigate the links between disease and farming for more than 30 years, focusing their work on people in Iowa and North Carolina. Among the findings are links between pesticides and malignant brain tumors, multiple myeloma, pancreatic cancer and certain breast cancers.

Concerns about connections between the farm pollutants and cancer have been mounting, particularly in Palo Alto County, which had the highest incidence of cancer of any county in the state and the second-highest incidence of cancer among all US counties, with 83 new cases of cancer on average each year, in a population of 8,996, according to a 2023 report by US News.

Author(s): Keith Schneider

Publication Date: 7 May 2024

Publication Site: The New Lede