Much has been made of America’s life expectancy deficit, but focusing on a statistic which is an average for the whole population masks truly staggering disparities at the extremes. For men at the bottom of the US economic ladder, it’s even worse. My calculations suggest the average age of death in that group is just 36 years old, compared with 55 in the Netherlands and 57 in Sweden.
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In most wealthy countries, if you’re desperately unlucky in the longevity stakes, you succumb to cancer before you reach 60. But if you’re unlucky in the US, you die from a drug overdose or gunshot wound by 40. Which brings us again to the most shocking statistic: among the least fortunate 10 per cent of American men, the average age at death is 36.
Looking at different regions within the US paints a similar picture. Conditions such as obesity shorten the lives of rich and poor alike, but the most uniquely American afflictions have steep socio-economic gradients. Wealthy Americans who live in the parts of the country with high opioid use and gun violence live just as long as those who live where fentanyl addiction and gunshot incidents are relatively rare. But poor Americans live far shorter lives if they grow up surrounded by guns and drugs than if they don’t.
The attack on opioid prescriptions for non-cancer chronic pain began to advance around 2010, and intensified thereafter. The crackdown coincided with—and perhaps caused—a rapid growth in heroin overdose deaths, and later, an explosion in illegal synthetic opioid deaths, primarily fentanyl, an illicitly manufactured substance added to or substituted for heroin to meet the increasing demand for illegal opiates. This pattern of events is illustrated in a graphic put out by the Centers for Disease Control (CDC).
Indeed, overdose deaths from commonly prescribed opiates increased rapidly from 1999 to 2010, but the chart doesn’t tell us how many of the victims legally obtained the opiates. The chosen scale also omits the fact that drug overdose deaths have been increasing at a fairly steady rate since 1979, with no obvious changes associated with the rise and fall of opioid prescriptions for chronic pain. The chart does show how overdose death rates from commonly prescribed opiates did not decline much after 2010, although legal prescriptions went down dramatically. This suggests that these deaths may have involved individuals who bought illegally manufactured opiates, or that the people who lost pain medication as a result of official actions were not the ones liable to overdose.
The increase in deaths of despair obviously merits some policy attention, but labeling it an “opioid crisis,” as is common nowadays, profoundly misstates its nature, timing, and likely causes and solutions. To justify restricting opioids for non-cancer chronic pain patients requires specific evidence that people prescribed opioids for pain are the ones dying of overdoses. There’s quite a bit of negative evidence on this score, but public health officials have seized on a few positive studies to support their claims.
One influential and heavily cited 2011 study published in the Journal of the American Medical Association, “Association Between Opioid Prescribing Patterns and Opioid Overdose-Related Deaths,” uses a classic prohibitionist tactic. The authors use a sample of 750 Veterans Health Administration (VHA) patients who received opioid prescriptions for pain and later died of opioid overdoses, and compare them to a random sample of 155,000 other VHA patients who received opioid prescriptions and did not die of overdoses.
In the 1970s, American lifeexpectancy grew by about four months each year. By the 1980s, it was similar to lifeexpectancy in other rich countries. Since then, other countries have continued to progress, with life spans increasing by more than two and a half months a year.
But the United States has slowly, gradually and then precipitously fallen behind.
These ever-widening gaps have long troubled demographers and prompted three reports from the National Academy of Sciences. The gaps grew wider during the pandemic.
But even before, not only was lifeexpectancy in the United States far from that of the best-performing countries (Japan and Switzerland), but it was also more than two years lower than that of the worst performers (Germany and Britain) among 22 other rich countries.
Public health authorities in the United States record educational qualifications at death so that, after 1992, we can calculate lifeexpectancy by college degree, starting at age 25, when most people have completed their education. In new research using these individual death records, we have found startling results.
Lifeexpectancy at age 25 (adult lifeexpectancy) for those with four-year college degrees rose to 59 years on the eve of the pandemic — so an average individual would live to 84 — up from 54 years (or 79 years old) in 1992. During the pandemic, by 2021, the expectation slipped a year.
But we were staggered to discover that for those without college degrees, lifeexpectancy reached its peak around 2010 and has been falling since, an unfolding disaster that has attracted little attention in the media or among elected officials.
Adult lifeexpectancy for this group started out two and a half years lower, at 51.6, in 1992 — so an average individual would live to nearly 77 years old. But by 2021, it was 49.8 years (or almost 75 years old), roughly eight and a half years less than people with college degrees, and those without had lost 3.3 years during the pandemic.
The divergence of lifeexpectancies on either side of the college divide — one going up, one going down — is both shocking and rare. We have found reference to only one other case in modern history, in the former Communist countries of Eastern Europe after the collapse of the Soviet Union. Like those countries, the United States is failing its less-educated people, an awful condemnation of where the country is today.
Samuel’s death is part of a growing trend in America, where pedestrian and cyclist fatalities are up 60% since 2011 to more than 8,000 last year.
In the past 25 years, the percentage of people who died in road crashes — while inside a vehicle — dropped from 80% of all road deaths to 66%. At the same time, the share of pedestrian and bicyclist deaths climbed sharply – making up 20% of all road deaths in 1997, to now accounting for 34% of all road deaths.
“If you’re somebody in a car, the street is designed perfect for you,” Brunet said. “The ideal street is balanced: A street that’s built for a pedestrian and a bicyclist, somebody that has mobility issues. We need to think about the most vulnerable user of the road.”
The number of prescription opioid pain pills shipped in the United States plummeted nearly 45 percent between 2011 and 2019, new federal data shows, even as fatal overdoses rose to record levels as users increasingly used heroin, and then illegal fentanyl.
The data confirms what’s long been known about the arc of the nation’s addiction crisis: Users first got hooked by pain pills saturating the nation, then turned to cheaper and more readily available street drugs after law enforcement crackdowns, public outcry and changes in how the medical community views prescribing opioids to treat pain.
The drug industry transaction data, collected by the Drug Enforcement Administration and released Tuesday by attorneys involved in the massive litigation against opioid industry players, reveals that the number of prescription hydrocodone and oxycodone pills peaked in 2011 at 12.8 billion pills, and dropped to fewer than 7.1 billion by 2019. Shipments of potent 80-milligram oxycodone pills dropped 92 percent in 2019 from their peak a decade earlier.
Many of the counties with the highest fentanyl death rates — in hard-hit states such as West Virginia, Kentucky and Ohio — started out with alarmingly high doses of prescription pills per capita, according to a Washington Post analysis of the DEA data and federal death records.
Counties with the highest average doses of legal pain pills per person from 2006 to 2013 suffered the highest death rates in the nation over the subsequent six years.
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Annual overall overdose deaths reached a grim milestone in 2021, surpassing 100,000 for the first time in U.S. history. More than 110,000 people died of drug overdoses in 2022, two-thirds of whom succumbed to synthetic opioids such as fentanyl, according to estimates by the Centers for Disease Control and Prevention.
The SOA Research Institute’s Mortality and Longevity Strategic Research Program is pleased to make available a research report that quantifies differences in mortality and disease prevalence by health status. Additionally, period life tables by health status, sex, and age are available in Appendix D.
Author(s):
Natalia S. Gavrilova, Ph.D. Leonid A. Gavrilov, Ph.D.
This page provides data on work-related fatalities that occurred under Federal OSHA and State Plan jurisdiction for cases that have been closed or citations issued on or after January 1, 2017.
Employers must report worker fatalities to OSHA within eight hours. OSHA investigates all work-related fatalities in all covered workplaces. The agency has up to six months to complete an investigation and determine whether citations will be issued.
The table below can be modified or searched by inserting additional information in the boxes above each column.
COVID-19-related fatalities are provided in the “COVID-19” tab below, and are not included in the CY 2017-22 list.
The estimated number of suicide deaths in the United States rose to nearly 50,000 in 2022, according to provisional data released on Thursday from the Centers for Disease Control and Prevention. The total would be an increase of approximately 2.6 percent since 2021.
The C.D.C. estimates the overall number of deaths to be 49,449 but has not yet calculated the suicide rates for 2022. Given that the U.S. population grew by about 0.4 percent in 2022, a 2.6 percent increase in deaths indicates that suicide rates are continuing to rise, although not universally among all groups.
Suicide deaths have fluctuated somewhat over the years and declined in 2019 and 2020. But the overall suicide rate, or the number of suicides per 100,000 people, has increased by about 35 percent over the last two decades. People 65 and older had the highest increase in the number of deaths by suicide in 2022 among the various age groups.
Question Was political party affiliation a risk factor associated with excess mortality during the COVID-19 pandemic in Florida and Ohio?
Findings In this cohort study evaluating 538 159 deaths in individuals aged 25 years and older in Florida and Ohio between March 2020 and December 2021, excess mortality was significantly higher for Republican voters than Democratic voters after COVID-19 vaccines were available to all adults, but not before. These differences were concentrated in counties with lower vaccination rates, and primarily noted in voters residing in Ohio.
Meaning The differences in excess mortality by political party affiliation after COVID-19 vaccines were available to all adults suggest that differences in vaccination attitudes and reported uptake between Republican and Democratic voters may have been a factor in the severity and trajectory of the pandemic in the US.
Abstract
Importance There is evidence that Republican-leaning counties have had higher COVID-19 death rates than Democratic-leaning counties and similar evidence of an association between political party affiliation and attitudes regarding COVID-19 vaccination; further data on these rates may be useful.
Objective To assess political party affiliation and mortality rates for individuals during the initial 22 months of the COVID-19 pandemic.
Design, Setting, and Participants A cross-sectional comparison of excess mortality between registered Republican and Democratic voters between March 2020 and December 2021 adjusted for age and state of voter registration was conducted. Voter and mortality data from Florida and Ohio in 2017 linked to mortality records for January 1, 2018, to December 31, 2021, were used in data analysis.
Exposures Political party affiliation.
Main Outcomes and Measures Excess weekly deaths during the COVID-19 pandemic adjusted for age, county, party affiliation, and seasonality.
Results Between January 1, 2018, and December 31, 2021, there were 538 159 individuals in Ohio and Florida who died at age 25 years or older in the study sample. The median age at death was 78 years (IQR, 71-89 years). Overall, the excess death rate for Republican voters was 2.8 percentage points, or 15%, higher than the excess death rate for Democratic voters (95% prediction interval [PI], 1.6-3.7 percentage points). After May 1, 2021, when vaccines were available to all adults, the excess death rate gap between Republican and Democratic voters widened from −0.9 percentage point (95% PI, −2.5 to 0.3 percentage points) to 7.7 percentage points (95% PI, 6.0-9.3 percentage points) in the adjusted analysis; the excess death rate among Republican voters was 43% higher than the excess death rate among Democratic voters. The gap in excess death rates between Republican and Democratic voters was larger in counties with lower vaccination rates and was primarily noted in voters residing in Ohio.
Conclusions and Relevance In this cross-sectional study, an association was observed between political party affiliation and excess deaths in Ohio and Florida after COVID-19 vaccines were available to all adults. These findings suggest that differences in vaccination attitudes and reported uptake between Republican and Democratic voters may have been factors in the severity and trajectory of the pandemic in the US.
Author(s): Jacob Wallace, PhD1; Paul Goldsmith-Pinkham, PhD2; Jason L. Schwartz, PhD1
The average life expectancy fell for both Japanese men and women for the second consecutive year in 2022, a health ministry survey showed Friday.
The average life expectancy last declined for both sexes two years in a row in 2010 and 2011.
In 2022, the average life expectancy for men fell 0.42 years from 2021 to 81.05 years, and that for women dropped 0.49 years to 87.09 years. The drops were “largely due to the COVID-19 pandemic,” a ministry official said.
According to the ministry, the reported number of people who died after getting infected with the coronavirus rose to 47,635 in 2022 from 16,766 in 2021.
The pandemic is seen to have shortened the average life expectancy in 2022 by 0.12 years for men and 0.13 years for women, larger than 0.10 years and 0.07 years, respectively, in 2021.
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In 2022, Japanese women had the highest average life expectancy in the world.
Japanese men ranked fourth, down by one place from the preceding year. Switzerland ranked first, followed by Sweden and Australia.
Of Japanese men born in 2022, 75.3% are expected to live until 75, 25.5% until 90 and 8.7% until 95. The proportion of Japanese women who are expected to live until 75, 90 and 95 stands at 87.9%, 49.8% and 25%, respectively.
Improving diagnosis in health care is a moral, professional and public health imperative, according to the U.S. National Academy of Medicine. However, little is known about the full scope of harms related to medical misdiagnosis — current estimates range widely. Using novel methods, a team from the Johns Hopkins Armstrong Institute Center for Diagnostic Excellence and partners from the Risk Management Foundation of the Harvard Medical Institutions sought to derive what is believed to be the first rigorous national estimate of permanent disability and death from diagnostic error.
The original research article was published July 17 by BMJ Quality & Safety. Results of the new analysis of national data found that across all clinical settings, including hospital and clinic-based care, an estimated 795,000 Americans die or are permanently disabled by diagnostic error each year, confirming the pressing nature of the public health problem.
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To identify their findings, researchers multiplied national measures of disease incidence by the disease-specific proportion of patients with that illness who experience errors or harms. Researchers repeated this method for the 15 diseases causing the most harms, then extrapolated to the grand total across all dangerous diseases. To assess the accuracy of the final estimates, the study’s authors ran the analyses under different sets of assumptions to measure the impact of methodological choices and then tested the validity of findings by comparing them with independent data sources and expert review. The resulting national estimate of 371,000 deaths and 424,000 permanent disabilities reflects serious harms widely across care settings, and it matches data produced from multiple prior studies that focused on diagnostic errors in ambulatory clinics and emergency departments and during inpatient care.
Vascular events, infections and cancers, dubbed the Big Three, account for 75% of the serious harms. The study found that 15 diseases account for 50.7% of the total serious harms. Five conditions causing the most frequent serious harms account for 38.7% of total serious harms: stroke, sepsis, pneumonia, venous thromboembolism and lung cancer. The overall average error rate across diseases was estimated at 11.1%, but the rate ranges widely from 1.5% for heart attack to 62% for spinal abscess. The top cause of serious harm from misdiagnosis was stroke, which was found to be missed in 17.5% of cases.
Researchers in Japan have found a significant increase in the number of suicides among women and girls between the ages of 10 and 24 during the pandemic, while there was no significant change in the suicide rate for boys and men in the same age group.
The research team analyzed data on suicides by gender across three age groups — 10 to 14, 15 to 19 and 20 to 24 — comparing the number of suicides after July 2020 with the number of suicides before the pandemic began.
According to the health ministry, the number of suicides among women and girls age between 10 and 24 in 2022 was 745, an increase of 233 compared with the 2019 figure. The data also showed that the number of boys and men in that age range who committed suicide was 1,278, an increase of 100 cases from 2019.
The research was led by Nobuyuki Horita from Yokohama City University Hospital and Sho Moriguchi from the Department of Neuroscience at Keio University using data on deaths by suicide from July 2012 to June 2022 provided by the health ministry.
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Over the past 10 years, a total of 13,263 young people age 10 to 24 — 9,428 male and 3,835 female — died by suicide.
