The observation that downward mortality trends have reversed in recent years for some groups of Americans is not new. Economists Ann Case and Angus Deaton helped start the discussion with their 2015 paper on rising mortality among middle-aged, non-Hispanic White Americans, and subsequently gave the phenomenon a resonant name: “deaths of despair.” Research has also identified those without college degrees and rural Americans as especially troubled.
In March, a National Academies of Sciences, Engineering, and Medicine committee summed up the current state of knowledge in a 475-page report on “High and Rising Mortality Rates Among Working-Age Adults.” Advances in overall life expectancy stalled in the U.S. after 2010 even while continuing in other wealthy countries, the committee summed up, attributing this mainly to (1) rising mortality due to external causes such as drugs, alcohol and suicide among those aged 25 through 64 and (2) a slowing in declines in deaths from internal causes, chiefly cardiovascular diseases.
Looking at the NYT article “Which Groups Are Still Dying of Covid in the U.S.?” — online interactive data visualization related to COVID deaths and demographic groups in the U.S. I thought one key graph was misleading
“Previously, at the start of the pandemic, we were seeing people who were over the age of 60, who have numerous comorbidities,” said Dr. Krutika Kuppalli, an infectious disease expert at the Medical University of South Carolina. “I’m not seeing that as much anymore.” Instead, she said, hospitalizations have lately been skewing toward “people who are younger, people who have not been vaccinated.”
More than 80 percent of those 65 and older have received at least one dose of a Covid-19 vaccine, compared with about half of those aged 25 to 64 who have received one dose. Data collected by the C.D.C. on so-called breakthrough infections — those that happen to vaccinated people — suggest an exceedingly low rate of death among people who had received a Covid-19 vaccine.
In the United States, an estimated 28.7% of adults aged 65 years or older fell in 2014.1 Falls result in increased morbidity, mortality, and health care costs.1,2 Risk factors for falls include age, medication use, poor balance, and chronic conditions (ie, depression, diabetes).1 Fall prevention strategies are typically recommended for adults older than 65 years. In several European countries, an increase in mortality from falls has been observed since 2000, particularly among adults older than 75 years.3,4 This age group has the highest fall risk and potential for cost-effective interventions. We report trends in mortality from falls for the US population aged 75 years or older from 2000 to 2016.
Author(s): Klaas A. Hartholt, MD, PhD1; Robin Lee, PhD, MPH2; Elizabeth R. Burns, MPH2; et al
The overall age-adjusted mortality rate for 2020 was 828.7 deaths per 100,000 of population. This rate was 15.9% greater than the 2019 overall age-adjusted mortality rate. This high level of mortality has not been experienced in the U.S. since 2003.
If deaths coded as COVID (COVID deaths)3 were excluded, the overall age-adjusted 2020 mortality rate would have been 737.2 per 100,000 or 3.1% higher than the 2019 rate. This increase excluding COVID deaths is also noteworthy because it reverses the two previous calendar years of decreasing mortality; however, some or all of this may be due to the misclassification of CODs as discussed in Section 6.
2020 mortality rates increased in both sexes, with the male rates increasing more than the female rates. The differences in the increases between males and females were about 3% when all causes of death (CODs) are included and about 1% when COVID deaths are excluded.
The slope of the 2020 COVID mortality curve by age group is not as steep as the slope of the non-COVID deaths, indicating that COVID impacts younger ages more evenly across age groups that all other non-COVID CODs combined.
In the review of the 2020 mortality rates by age group, it is interesting to see that the highest percentage increases were in the younger adult ages, not at the very old ages. When COVID deaths were removed, ages 15-44 saw the largest increases in mortality rates.
Female life expectancy exceeds male life expectancy. Males at ages 15 to 40 die at rates that are often three times female levels, but this excess mortality is not the main cause of the life expectancy gap. Few deaths occur at younger adult ages compared with mortality after age 60 or, historically, among newborns. Our demographic analysis shows that, up through the early decades of the 20th century, the life expectancy gap largely resulted from excess deaths of infant boys. Afterward, higher mortality among men 60+ became crucial. The higher mortality of males at ages 15 to 40 has played a modest role.
Author(s): Virginia Zarulli, Ilya Kashnitsky, James W. Vaupel
According to estimates from the Centers for Disease Control and Prevention, the infection fatality rate for Americans who are 70 or older is something like 5.4 percent, compared to 0.5 percent for 50-to-69-year-olds, 0.02 percent for 20-to-49-year-olds, and 0.003 percent for people younger than 20. In other words, the risk for the oldest age group is 11 times the risk for the next oldest, 270 times the risk for 20-to-49-year-olds, and 1,800 times the risk for the youngest cohort.
Yet Los Angeles Times reporters Soumya Karlamanga and Rong-Gong Lin II, citing University of Florida epidemiologist Cindy Prins, write that “Florida’s older population might have, perhaps counterintuitively, prevented the virus from spreading as quickly as it did in California.” How so? “Young adults who socialize and mingle, either at work or in social settings, tend to spread the virus the most while older people are more cautious and stay home.”
Florida, of course, is a mecca for college students on spring break, whose socializing and mingling provided ammunition for critics of DeSantis’ alleged recklessness. And despite the relative timidity of elderly Americans, they account for more than four-fifths of COVID-19 deaths in the United States. Nursing homes alone account for more than a quarter of the total death toll.
But the state has its terms for success defined backward, said Saad Omer, Yale School of Public Health epidemiologist and the director of the Yale Institute for Global Health. “That’s a process metric,” he said. “It’s not an outcome metric.”
How important is speed in the COVID-19 vaccine rollout? To Connecticut, it’s an important enough consideration to partially justify bucking CDC guidance on prioritizing people with co-morbidities, though experts suggest that it is the best way to prevent deaths in younger populations.
But by rolling out vaccine through an age-based process, the state will effectively de-prioritize younger adults with co-morbidities that put them at higher risk of dying from COVID-19, Omer said, because in those younger age groups, those with existing health issues will be part of a much larger crowd of eligible residents.
Age. Minimum wage workers tend to be young. Although workers under age 25 represented just under one-fifth of hourly paid workers, they made up 48 percent of those paid the federal minimum wage or less. Among employed teenagers (ages 16 to 19) paid by the hour, about 5 percent earned the minimum wage or less, compared with 1 percent of workers age 25 and older. (See tables 1 and 7.)
Deaths from coronavirus have fallen by 62% among over-80s since 24 January, the point at which a third of that age group had some level of immunity against coronavirus, having received their first vaccine dose at least two weeks earlier, data analysis by the Guardian showed.
This drop was larger than among groups with a lower level of vaccination. Among people aged between 20 and 64 the drop in deaths was 47%, while the drop among those aged 65 to 79 was 51%.
Author(s): Anna Leach, Ashley Kirk, and Pamela Duncan
But the governor’s announcement Monday — which ironically was made the same day the national Food Industry Association celebrated “Supermarket Employee Day” — shifted to a priority system that is strictly age-based, with one exception: school employees and child care providers. The next round of shots will open March 1 to people who are between ages 55 and 64, teachers and others who work in schools, and day care workers.
Besides grocery story workers, the administration also had been considering giving priority in this next phase to transportation workers, as well as people 16 and older who have underlying health conditions like heart disease and diabetes, and teachers and other school staff. Only the last group is being given priority in Lamont’s new plan.