Category: Mortality

MBTA retirement fund is headed for a financial reckoning

Mary Pat Campbell

Link: https://www.bostonglobe.com/2023/06/19/opinion/mbta-retirement-fund-finances/

Excerpt:

The MBTA Retirement Fund is going over a cliff, and the reasons why are well known. But neither the T nor its unions are in a hurry to do anything about it.

The new MBTA Retirement Fund Actuarial Valuation Report shows the fund’s balance as of Dec. 31, 2022, was $1.62 billion — about $300 million less than what it was just 12 months earlier. Its liability — the amount it will owe current and future T retirees — is over $3.1 billion, meaning the fund is about 51 percent funded. In 2006, it was 94 percent funded. A “death spiral” generally accelerates when retirement system funding dips below 50 percent.

In April, the Pioneer Public Interest Law Center got the MBTA to hand over an August 2022 arbitration decision regarding a pension dispute between the T and its biggest union. It contained a critical win for the authority: Arbitrator Elizabeth Neumeier decided that most employees would have to work until age 65 to earn a full pension, saving the MBTA at least $12 million annually.

But the Carmen’s Union sued to invalidate that portion of the decision, and the parties returned to the bargaining table. The new pension agreement they hammered out doesn’t include the historic retirement age victory; T management negotiated it away.

….

As of Dec. 31, 2022, 5,555 active employees paid into the fund, but 6,783 retirees collected from it. The biggest reason for the mismatch is the age at which T employees retire. Those hired before December 2012 can retire with a full pension after 23 years of service, regardless of age. Those hired after December 2012 can retire with a full pension at age 55 after 25 years.

The arbitrator finally gave the MBTA the win it so desperately needed, and T management promptly gave it back. Many MBTA managers have long opposed changing the age at which employees can earn a full pension, fearing the reaction of T unions.

….

Hard as it may be to believe, the T retirement fund’s financial outlook is even worse than it appears. Financial projections assume the fund’s assets will earn 7.25 percent annually. Over time, actual returns have been more like 4 percent to 7 percent.

These misleading projections are based on other faulty assumptions. In her 2022 decision, Neumeier refused the MBTA’s request to use newer actuarial tables, ruling that changing would be costly and that there was no compelling reason to update the tables. The ones in place are from 1989 — so old that they assume all T employees are men. Since women tend to live longer, the tables materially understate the retirement fund liability.

Author(s): Mark T. Williams, Charles Chieppo 

Publication Date: 19 Jun 2023

Publication Site: Boston Globe

$50 Billion in Opioid Settlement Cash Is on the Way. We’re Tracking How It’s Spent.

Mary Pat Campbell

Link: https://kffhealthnews.org/news/article/opioid-drugmakers-settlement-funds-50-billion-dollars-khn-investigation-payback/

Graphic:

Excerpt:

More than $50 billion in settlement funds is being delivered to thousands of state and local governments from companies accused of flooding their communities with opioid painkillers that have left millions addicted or dead.

….

Most of the settlements stipulate that states must spend at least 85% of the money they will receive over the next 15 years on addiction treatment and prevention. But defining those concepts depends on stakeholders’ views — and state politics. To some, it might mean opening more treatment sites. To others, buying police cruisers.

….

What’s more, many states are not being transparent about where the funds are going and who will benefit. An investigation by KHN and Christine Minhee, founder of OpioidSettlementTracker.com, concluded only 12 states have committed to detailed public reporting of all their spending.

The analysis involved scouring hundreds of legal documents, laws, and public statements to determine how each state is divvying up its settlement money among state agencies, city and county governments, and councils that oversee dedicated trusts. The next step was to determine the level and detail of public reporting required. The finding: Few states promise to report in ways that are accessible to the average person, and many are silent on the issue of transparency altogether.

More than $3 billion has gone out to state and local governments so far. KHN will be following how that cash — and the billions set to arrive in coming years — is used.

Author(s): Aneri Pattani

Publication Date: 30 March 2023

Publication Site: Kaiser Health News

Suicide Mortality in the United States, 2001–2021

Mary Pat Campbell

Link: https://www.cdc.gov/nchs/products/databriefs/db464.htm

Graphic:

Excerpt:

  • The total age-adjusted suicide rate increased from 10.7 deaths per 100,000 standard population in 2001 to a recent peak of 14.2 in 2018, and then declined to 13.5 in 2020. In 2021, the rate increased 4% to 14.1, the largest 1-year increase during the period (Figure 1).
  • The suicide rate for males did not change significantly from 2001 (18.2) through 2006 (18.1), and then increased to 22.8 in 2018. Rates declined in 2019 (22.4) and 2020 (22.0) but then increased 4% in 2021 (22.8).
  • The suicide rate for females increased from 2001 (4.1) through 2015 (6.0) and then did not change significantly through 2018 (6.2). Following a 2-year decline to 5.5 in 2020, the rate increased 4% in 2021 (5.7).
  • The suicide rate for males was three to four and one-half times the rate for females during the 2001–2021 period.

Author(s): Matthew F. Garnett, M.P.H., and Sally C. Curtin, M.A.

Publication Date: April 2023

Publication Site: National Center for Health Statistics, CDC

The American Addiction to Speeding

Mary Pat Campbell

Link: https://slate.com/business/2021/12/speed-limit-americas-most-broken-law-history.html

Excerpt:

Speeding is a national health problem and a big reason why this country is increasingly an outlier on traffic safety in the developed world. More than 1 in 4 fatal crashes in the United States involve at least one speeding driver, making speeding a factor in nearly 10,000 deaths each year, in addition to an unknowable number of injuries. Thousands of car crash victims are on foot, and speed is an even more crucial determinant of whether they live or die: The odds of a pedestrian being killed in a collision rise from 10 percent at 23 mph to 75 percent at 50 mph. And we’re now in a moment of particular urgency. Last year, when the pandemic shutdowns lowered total miles traveled by 13 percent, the per-mile death rate rose by 24 percent—the greatest increase in a century, thanks to drivers hitting high velocities on empty roads. “COVID,” Roberts said, “was midnight on the day shift.”

In the first six months of 2021, projected traffic fatalities in the U.S. rose by 18 percent, the largest increase since the U.S. Department of Transportation started counting and double the rate of the previous year’s surge. “We cannot and should not accept these fatalities as simply a part of everyday life in America,” said Transportation Secretary Pete Buttigieg in a press release.

….

It is as strange as cigarettes on airplanes or dating ads in newspapers to think that between 1974 and 1995, the United States maintained a national speed limit of 55 miles per hour in the name of saving lives. It was one of those moments, like the end of the Concorde’s supersonic passenger jet service or the collapse of the Arecibo Telescope, when technology lurched backward.

The 50-state slowdown known as the “double nickel” began in 1973, with President Richard Nixon’s appeal for collective sacrifice. In retaliation for America’s support of Israel in the Yom Kippur War, the coalition of Middle Eastern states known as OPEC decided that fall to stop selling oil to the United States. Prices quadrupled. The president wanted Americans to change their ways: He asked gas stations to close on Sundays and businesses to turn off lighted advertisements. Mayors and department stores dimmed Christmas bulbs nationwide. Daylight saving time went year-round in an effort to use less electric light. Thanks to the lowered thermostat, women were permitted to wear pants in the White House.

….

But that did not come to pass. The number of annual auto deaths dropped below 44,000 in 1990 and has not passed that number since; instead, it fell to a 40-year low in 2014, despite enormous growth in the number of cars on the road. Every state has raised the speed limit over the past few decades, with parts of Texas now topping out at 80 mph.

….

Given all this, speeding enforcement could use a tighter focus. Relatively few motorists drive at what the National Highway Traffic Safety Administration calls “extreme speeds” of more than 20 mph over the limit. In the District of Columbia, it was just 6 percent of speeders in 2019. (One of them was going 132 mph in a 50 mph zone.) For a police-based enforcement system to be able to find and stop those drivers would be remarkably good luck. But those are exactly the drivers most likely to hurt themselves or others in a crash.

….

Speed cameras and speed traps have something in common: They both rely on the wisdom of speed limits, which are not very wise. The conventional wisdom in the field of traffic engineering is that the speed limit should be set according to the 85th percentile rule—at the speed of the 15th-fastest of 100 drivers on the road. City transportation officials do not like this method: The fastest 15 percent of drivers, they argue, are not always the most rational appraisers of what constitutes a safe speed. Nor should drivers’ interests determine the character of a street for its other users. In an essay in the Harvard Law Review, Greg Shill and Sara Bronin write, “The 85th Percentile Rule is perhaps unique in American law in empowering lawbreakers to activate a rewrite of the law to legalize their own unlawful conduct.”

Author(s): Henry Grabar

Publication Date: 15 Dec 2021

Publication Site: Slate

State Variation in Underreporting of Alcohol Involvement on Death Certificates: Motor Vehicle Traffic Crash Fatalities as an Example

Mary Pat Campbell

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3965684/

Graphic:

Abstract:

Abstract

Objective:

We used motor vehicle traffic (MVT) crash fatalities as an example to examine the extent of underreporting of alcohol involvement on death certificates and state variations.

Method:

We compared MVT-related death certificates identified from national mortality data (Multiple Cause of Death [MCoD] data) with deaths in national traffic census data from the Fatality Analysis Reporting System (FARS). Because MCoD data were not individually linked to FARS data, the comparisons were at the aggregate level. Reporting ratio of alcohol involvement on death certificates was thus computed as the prevalence of any mention of alcohol-related conditions among MVT deaths in MCoD, divided by the prevalence of decedents with blood alcohol concentration (BAC) test results (not imputed) of .08% or greater in FARS. Through bivariate analysis and multiple regression, we explored state characteristics correlated with state reporting ratios.

Results:

Both MCoD and FARS identified about 450,000 MVT deaths in 1999–2009. Reporting ratio was only 0.16 for all traffic deaths and 0.18 for driver deaths nationally, reflecting that death certificates captured only a small percentage of MVT deaths involving BAC of .08% or more. Reporting ratio did not improve over time, even though FARS indicated that the prevalence of BAC of at least .08% in MVT deaths increased from 19.9% in 1999 to 24.2% in 2009. State reporting ratios varied widely, from 0.02 (Nevada and New Jersey) to 0.81 (Delaware).

Conclusions:

The comparison of MCoD with FARS revealed a large discrepancy in reporting alcohol involvement in MVT deaths and considerable state variation in the magnitude of underreporting. We suspect similar underreporting and state variations in alcohol involvement in other types of injury deaths.

Author(s): I-Jen P Castle, Ph.D.,a,* Hsiao-Ye Yi, Ph.D.,a Ralph W Hingson, Sc.D.,b and Aaron M White, Ph.D.b

Publication Date: March 2014

Publication Site: Journal of Studies on Alcohol and Drugs, National Library of Medicine

Excess mortality and life expectancy

Mary Pat Campbell

Link: https://ulflorr.substack.com/p/excess-mortality-and-life-expectancy

Graphic:

Fig. 1: Annual values of life expectancy in Germany with fit (blue). The fit did not respect the values for 2021 and 2022.

Excerpt:

Life expectancy is relatively difficult to calculate. The mortality risk has to be determined from death and population figures for each individual year of life. A hurdle is that data are often only available in age cohorts. So the missing values have to be interpolated. Using the mortality risks, a fictitious newborn cohort is projected forward year by year until all have died. A weighted average value is calculated from those who died each year in this modeled time series, yielding the life expectancy.

Life expectancy in Germany increased for many years until 2020, allthough this trend seemed to be gradually approaching a saturation point, which might be around 82 years (Fig. 1).

Author(s): ULF LORRÉ

Publication Date: 30 Mar 2023

Publication Site: Demographic Data Analysis

Excess Mortality and Years of Potential Life Lost Among the Black Population in the US, 1999-2020

Mary Pat Campbell

Link:https://jamanetwork.com/journals/jama/article-abstract/2804822/

JAMA. 2023;329(19):1662-1670. doi:10.1001/jama.2023.7022

Excerpt:

Key Points

Question  How many excess deaths and years of potential life lost for the Black population, compared with the White population, occurred in the United States from 1999 through 2020?

Findings  Based on Centers for Disease Control and Prevention data, excess deaths and years of potential life lost persisted throughout the period, with initial progress followed by stagnation of improvement and substantial worsening in 2020. The Black population had 1.63 million excess deaths, representing more than 80 million years of potential life lost over the study period.

Meaning  After initial progress, excess mortality and years of potential life lost among the US Black population stagnated and then worsened, indicating a need for new approaches.

Author(s): César Caraballo, MD1,2; Daisy S. Massey, BA3; Chima D. Ndumele, PhD4; et al

Publication Date: 16 May 2023

Publication Site: JAMA Network

A Striking Gap Between Deaths of Black and White Babies Plagues the South

Mary Pat Campbell

Link: https://kffhealthnews.org/news/article/a-striking-gap-between-deaths-of-black-and-white-babies-plagues-the-south/

Excerpt:

Although the regional hospital in the city of Orangeburg delivers babies, the birth outcomes in the county are awful by any standard. In 2021, nearly 3% of all Black infants in Orangeburg County died before their 1st birthday.

Nationally, the average is about 1% for Black infants and less than 0.5% for white infants.

Meanwhile, Orangeburg County’s infant mortality rate for babies of all races is the highest in South Carolina, according to the latest data published by the South Carolina Department of Health and Environmental Control.

By 2030, the federal government wants infant mortality to fall to 5 or fewer deaths per 1,000 live births. According to annual data compiled by the Centers for Disease Control and Prevention, 16 states have already met or surpassed that goal, including Nevada, New York, and California. But none of those states are in the South, where infant mortality is by far the highest in the country, with Mississippi’s rate of 8.12 deaths per 1,000 live births ranking worst.

Even in those few Southern states where infant mortality rates are inching closer to the national average, the gap between death rates of Black and white babies is vast. In Florida and North Carolina, for example, the Black infant mortality rate is more than twice as high as it is for white babies. A new study published in JAMA found that over two decades Black people in the U.S. experienced more than 1.6 million excess deaths and 80 million years of life lost because of increased mortality risk relative to white Americans. The study also found that infants and older Black Americans bear the brunt of excess deaths and years lost.

….

The state Department of Health and Human Services — which administers Medicaid, the health coverage program for low-income residents, and pays for more than half of all births in South Carolina — claims accidental deaths were the No. 1 reason babies covered by Medicaid died from 2016 to 2020, according to Medicaid spokesperson Jeff Leieritz.

But the state health department, where all infant death data is housed, reported birth defects as the top cause for the past several years. Accidental deaths ranked fifth among all causes in 2021, according to the 2021 health department report. All but one of those accidental infant deaths were attributed to suffocation or strangulation in bed.

Author(s): Lauren Sausser

Publication Date: 22 May 2023

Publication Site: Kaiser Health News

As US Life Expectancy Falls, Experts Cite the Health Impacts of Incarceration

Mary Pat Campbell

Link: https://kffhealthnews.org/news/article/prison-health-impact-american-life-expectancy-aging/

Excerpt:

Thousands of people like Jordan are released from prisons and jails every year with conditions such as cancer, heart disease, and infectious diseases they developed while incarcerated. The issue hits hard in Alabama, Louisiana, and other Southeastern states, which have some of the highest incarceration rates in the nation.

A major reason the U.S. trails other developed countries in life expectancy is because it has more people behind bars and keeps them there far longer, said Chris Wildeman, a Duke University sociology professor who has researched the link between criminal justice and life expectancy.

“It’s a health strain on the population,” Wildeman said. “The worse the prison conditions, the more likely it is incarceration can be tied to excess mortality.”

Mass incarceration has a ripple effect across society.

Author(s): Fred Clasen-Kelly

Publication Date: 27 April 2023

Publication Site: KFF Health News

Long-lived rivals: actuaries say Biden and Trump are not too old for office

Mary Pat Campbell

Link: https://www.ft.com/content/ad3a97fc-6394-471b-95b6-a46576808f4a?accessToken=zwAF-p9xpktIkdOtOpf8Y5RHG9OVtqRldoCPSg.MEUCIDgGL7wEhhf0DcMprg_1VYV0TDGsyWYpn56E-cBhCGWoAiEA_YjdblG4oKzNoagG66jcPOhEtvtht7Du5gnihbZVDfU&sharetype=gift&token=82960010-bfb1-44e4-a677-de6e47ba5545

Graphic:

Excerpt:

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Any predictions are by their nature uncertain, yet a longevity modelling firm has forecasted that both candidates are likely to live well beyond the end of the next presidency in 2029. According to Club Vita, actuarial data suggests both men could have more than another decade ahead of them.

The company, which offers analytical services to insurers, said its US model suggested Biden has a life expectancy of another 11 years, taking him to 91. Trump has 14 more years to look forward to, per the model, meaning he would die at 90.

The model’s inputs include affluence, marital status, and employment. These key demographics for both Biden and Trump put them in the same favourable categories for the main factors, including addresses in the top category for life expectancy: the analysts used Trump’s Palm Beach address and Biden’s Delaware home.

Erik Pickett, a New Jersey-based actuary for Club Vita, said a wide range of factors could prove its model wrong, from whether the candidates “are in significantly different health to the average of someone with the same characteristics” to the fact that presidents have “access to higher quality medical treatments” than the typical American.

Author(s): Ian Smith in London and David Crow in New York

Publication Date: 30 April 2023

Publication Site: FT.com

Heat exposure deaths inspire proposed air conditioning requirements in Illinois

Mary Pat Campbell

Link:https://www.thecentersquare.com/illinois/article_6616e81a-e074-11ed-8a30-8b0b8fc31490.html

Excerpt:

 Two bills in the Illinois legislature this session will require air conditioning, or at least a common room with air conditioning, in buildings housing seniors.

Last May, when a heat wave sent temperatures in Illinois soaring into the high 90s, three older women living in state-subsidized housing died of heat exposure in the Rogers Park neighborhood of Chicago. The three seniors, Delores McNeely, 76, Gwendolyn Osborne, 72, and Janice Reed, 68, were constituents of state Sen. Mike Simmons, D-Chicago. Two separate bills now aim to prevent these types of deaths,

Simmons sponsored a proposal that would require all state-funded affordable housing to have air conditioning. The bill passed the state Senate in March.

….

In March, the National Low Income Housing Coalition and Housing Action Illinois found that Illinois is lacking 300,000 affordable housing units for the 443,746 poorest households in the state. For every 100 extremely low-income renters, there are only 34 affordable and available units, the report found.

The report defines “very low income” in the Chicago area as households that earn less than $31,250 a year for a family of four, and $22,000 a year for a single person. Many seniors on Social Security live on half of that, Palmer said.

Author(s): Zeta Cross

Publication Date: 22 Apr 2023

Publication Site: The Center Square