Boston A recent study revealed the dire state of public health in the United States. Compared to other rich countries, the US has a much higher death rate – leading researchers to say the country is “in fact experiencing an early death crisis”.
Researchers from Boston University School of Public Health (BUSPH) found that more than 1 million deaths in the United States annually—including many young adults and working-age adults—could be avoided if the country’s death rates were comparable to other high-income nations.
And in 2021, 1.1 million deaths could have been avoided if death rates in the United States were comparable to those in other rich countries. The study refers to these excess deaths as “missing Americans,” because these deaths reflect the people who would still be alive if the death rate in the United States was equal to that of other countries.
“The number of Americans missing in recent years has been unprecedented in modern times,” says Dr. Jacob Burr, lead author of the study and associate professor of global health and epidemiology at BUSPH, in an article. Media release.
Nearly 50% of all missing Americans died before the age of 65 in 2020 and 2021. Particularly stark is the level of excess mortality among working-age adults, the study found.
“Think about the people you know who died before they reached the age of 65,” Dr. Burr said. “Statistically, half of them would still be alive if the United States had mortality rates comparable to our peers.” “The United States is experiencing an early death crisis, which is unique among rich countries.”
The COVID-19 pandemic has contributed to a sharp rise in the death rate in the United States – more so than in other countries – but the new findings show that the number of excess deaths in the United States has been accelerating over the past four decades. Dr. Bohr and the team analyzed mortality trends in the United States from 1933 to 2021, including the impact of COVID-19, and then compared these trends to age-specific death rates in Canada, Japan, Australia and 18 European countries.
Death rates in the United States were lower than during World War II and its aftermath. During the 1960s and 1970s, death rates in the United States were comparable to other rich countries, but the number of missing Americans began to increase year by year starting in the 1980s, reaching 622,534 annual excess deaths in the United States by 2019. Deaths then rose to 1,009,467 in 2020. and 1,090,103 in 2021 during a pandemic. From 1980 to 2021, there were a total of 13.1 million Americans missing.
The researchers stress that this mortality crisis is a multi-ethnic phenomenon and is not confined to minorities. Black and Native Americans are overrepresented in these measures, with mortality rates in early adulthood (ages 15 to 44) five to eight times higher than the average for other affluent nations.
The team also says that the history of structural racism in the United States, including policies such as slavery and redlines, has contributed to racial and ethnic disparities in wealth and access to education, housing and health care that are leading causes of worse death rates. , especially at young ages.
However, the missing two-thirds of Americans are white, as a result of the larger population of white Americans, their older age distribution, and death rates that are much higher than in other rich nations.
“Living in the United States is a risk factor for premature death and is common among many racial and ethnic groups in the United States. While most studies of health disparities evaluate differences between racial/ethnic groups in the United States, such an approach It makes the poor health of whites invisible and greatly reduces health deficiencies in minority groups.”
“By using an international benchmark, we show that Americans of all races and ethnicities are negatively impacted by a US policy environment that places low priority on public health and social protection, especially for people with low incomes.”
When calculating future years of life lost when a person dies prematurely, the team estimates that in 2021, excess mortality in the United States translates to 26.4 million years of life lost compared to mortality rates in peer countries. They link the significant death overburden to the failure of US policy to adequately address major public health issues, including the opioid epidemic, gun violence, environmental pollution, economic inequality, food insecurity, and workplace safety.
The COVID-19 pandemic has exacerbated many of these issues, particularly among low-income groups and minorities, and now that most of the safety net policies created during COVID-19 have expired, vulnerable groups have lost vital support.
“We waste hundreds of billions each year on health insurance earnings and paperwork, while tens of millions cannot afford medical care, healthy food, or a decent place to live,” says Dr. Stevie Wallhandler, lead study author and Distinguished Professor. in the School of Urban Public Health at Hunter College in New York. “Americans are dying younger than their counterparts elsewhere, because when corporate profits conflict with health, our politicians side with corporations.”
Compared to the United States, other countries also had higher uptake policies for vaccination and masks during the Omicron wave, and this layer easing was associated with fewer COVID-19 cases.
The findings raise a number of pressing questions that will be important to address in future research, says study co-author Dr. Andrew Stokes, assistant professor of global health at Boston University.
“Which geographic regions are disproportionately responsible for missing Americans, and what are the causes of their deaths?” Dr. Stokes explains that answers to these questions may help inform policy solutions.
For now, Dr. Burr says he’s not optimistic that death rates will reverse in the near future, even as Covid-related deaths continue to decline from their peak in 2021.
“The US was already seeing more than 600,000 Americans missing annually before the pandemic began, and that number has been growing every year. There have been no major policy changes since then to alter that course,” adds Dr. Burr.
“While the COVID-19 virus has brought new public health concerns, the backlash that has erupted during the pandemic has undermined confidence in government and support for expanded policies to improve the health of the population,” Burr concludes. “This may be the most damaging long-term impact of the pandemic, because expanding public policy to support health is exactly how peer countries have achieved higher life expectancy and better health outcomes.”
The study was published in the journal PNAS Association.