Many black women report feeling silenced or ignored by healthcare providers during their pregnancy journey.
“It is 2023 almost 2024, and in this time, we should not be dying in birth. Period. You may be the medical professional, and you may have great textbook knowledge and you may have many degrees, but nobody is in my body but me, and nobody can tell me that this pain that I’m feeling is not there,” King said.
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This month New York Governor Kathy Hochul called the issue a crisis and a disgrace. Hochul announced more than $4 million in funding for regional perinatal centers and said doula services will now be covered for all Medicaid enrollees beginning January first.
In a statement, Governor Hochul said, “as the first mom and grandma to serve as Governor of New York, I’m committed to doing everything in my power to tackle the disturbing rise in infant mortality.”
Esther is hopeful the attacks on this issue from all fronts will lead to better outcomes for women and babies in the future.
It’s not the orgy of pink that reminds me of breast cancer. It’s the Nobel Prize in Physiology or Medicine. I have a rooting interest, and so far I’ve been disappointed. I want the prize to go to UCLA cancer researcher Dennis Slamon, who in recent years has been on the Great Mentioner’s short list (an improvement since I started paying attention a decade or so ago).
Slamon’s work did two things: Beginning with HER2+ breast cancer, it demonstrated that cancers could be identified by specific genetic variants, rather than merely where they occur in the body. Then it showed that those variations could be targeted and treated with specific antibodies. The first practical result was the drug Herceptin, which treats the roughly 25 percent of breast cancer patients with an especially aggressive form.
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The usual sources were still not interested in paying for research. But in 1989, Slamon was treating Hollywood honcho Brandon Tartikoff, best known for his stint as president of NBC, for Hodgkin’s lymphoma. Tartikoff’s wife Lilly was grateful for the care and asked Slamon what she might do to help him. He told her about the idea of finding a drug to treat HER2+ breast cancer. Soon thereafter, in a classic Hollywood moment, she ran into Ronald O. Perelman, who owned Revlon, at Wolfgang Puck’s original Spago restaurant. She gave him the pitch: You own Revlon. Revlon sells to women. Women get breast cancer. You and Revlon should support this research. He agreed to let his representative meet with Slamon.
At the meeting, Slamon was accompanied by his colleague John Glaspy, who is a notably blunt-spoken person. Even if they got government funding, Glaspy warned, it would take several years and by then “we’ll have a Rose Bowl full of dead women” from breast cancer. The pitch worked.
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In 1998, the drug was approved for treatment of Stage 4 HER2+ breast cancer and in 2006 it was approved for treating early stage cancers. A year later, it saved my life.
Author(s): Virginia Postrel
Publication Date: 9 Oct 2023
Publication Site: Virginia Postrel’s newsletter at Substack
Her pleas for help were shrugged off, she said, and she was repeatedly sent home from the hospital. Doctors and nurses told her she was suffering from normal contractions, she said, even as her abdominal pain worsened and she began to vomit bile. Angelica said she wasn’t taken seriously until a searing pain rocketed throughout her body and her baby’s heart rate plummeted.
Rushed into the operating room for an emergency cesarean section, months before her due date, she nearly died of an undiagnosed case of sepsis.
Even more disheartening: Angelica worked at the University of Alabama at Birmingham, the university affiliated with the hospital that treated her.
Her experience is a reflection of the medical racism, bias and inattentive care that Black Americans endure. Black women have the highest maternal mortality rate in the United States — 69.9 per 100,000 live births for 2021, almost three times the rate for white women, according to the Centers for Disease Control and Prevention.
Black babies are more likely to die, and also far more likely to be born prematurely, setting the stage for health issues that could follow them through their lives.
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
