EXCESS MORTALITY IS AN UNUSUAL MORTALITY INCREASE during a specific period in a given population. We have an excess death problem in America. Today, we explore this American health disaster.
Every day, individuals die of many causes: Accidents, diseases, or old age. Generally, each country’s death numbers are relatively unchanged from one year to the next. We can estimate how many people are likely to die next year.
Factors such as the economy or demographic changes can alter mortality rates, but such chances are typically slow to have an impact. Their impact is revealed over the years.
On the other hand, natural or manufactured catastrophes (think wars) can lead to more folks dying than expected. Such happenings lead to excess mortality. It’s the number of deaths beyond what would normally expect.
The calculation of excess mortality is complex. For example, war can kill individuals via combat. Alternatively, food shortages or unmet health needs may contribute less visibly. Watching hospitals destroyed in Ukraine reminds me of this phenomenon.
Since Russia’sinvasion, nearly one in ten hospitals in Ukraine has been damaged by attacks. Counting only combat casualties would lead us to underestimate the war’s impact. To better understand the conflict’s impact, we can compare how many died during wartime (versus how many typically died in peacetime).
CNN Report: Since Russia’sinvasion, nearly one in every ten hospitals in Ukraine has been damaged by attacks.
www.cnn.com
We have an excess death problem in America. Why?
First, the obvious: There are several contributors to the American excess mortality problem, including the COVID-19 pandemic. While we see excess mortality in many countries, the mortality incidence has been higher in the United States than elsewhere. Here are the global numbers, according to The Economist.
Factors making the American excess mortality greater than elsewhere include our population size, extraordinary comorbidities (including being overweight or obese), and delays in implementing and following effective COVID virus control measures.
American health disaster – Excessive mortality issues
Here are three of the issues:
- Substance Abuse and Overdose. Substance abuse and overdose deaths have significantly contributed to excess mortality in the USA, particularly in recent years. According to the US Centers for Disease Control, there were over 107,000 drug overdose deaths in the United States in 2021, an increase of nearly 15% from the 93,655 deaths estimated in 2020. The 2021 increase was half of what it was a year ago when overdose deaths rose 30% from 2019 to 2020. The opioid epidemic, in particular, has led to a sharp increase in overdose deaths. The COVID-19 pandemic has compounded the problem, which has made it more challenging for people to access treatment.
- Other Health Issues. Other health issues, such as heart disease, cancer, and diabetes, have also contributed to excess mortality in the USA. Poor diet, lack of exercise, and inadequate healthcare access for certain population segments have exacerbated the problem.
- Social and Economic Factors. Social and economic factors, such as poverty, inequality, and unemployment, have also contributed to excess mortality in America. These factors can lead to poor health outcomes, including higher rates of chronic disease, substance abuse, and mental health issues.
In summary, excess mortality in the USA is a complex issue influenced by various factors, including the COVID-19 pandemic, substance abuse and overdose, other health issues, and social and economic factors.
Excessive mortality — a new research report
A new article calculates The United States’ excess deaths (by comparing US mortality rates with the five largest Western European countries, including the United Kingdom, France, Germany, Italy, and Spain).
After study author Patrick Heuveline controlled for the differences in the demographics of the Europeans, he offered the expected death numbers in the USA over the last five years:
“The mortality gap between the United States and other high-income nations substantially expanded during the first two decades of the 21st century.”
The mortality gap has widened in the COVID-19 pandemic era. The increase is disturbing: This mortality gap analysis shows that the mortality gap increased the number of American deaths by more than one-third (35 percent) in 2021, causing nearly 900,000 “excess deaths that year.
It’s worse than you think: After researchers accounted for population size, they discovered that the yearly number of excess deaths nearly doubled between 2019 and 2021 (up 85 percent).
Here is a graphic illustration of the number of US deaths attributed to COVID-19 and the proportion of COVID-19 deaths that are excess deaths:
The author notes that diverging trends in virus-related mortality contributed to this rise in excess deaths. This trend became particularly evident by the end of 2021 as American vaccination rates plateaued lower than our European counterparts.
As you can see in the chart above, the number of excess American deaths involving COVID-19 reached over 223,000. This number represented one in four of all excess deaths that year.
But, 46 percent of the increase in excess deaths between 2019 and 2021 is secondary to other causes. While the COVID contribution to excess mortality may be transient, we see divergent trends in mortality from other countries persistently separating the United States and West European countries, according to Heuveline.
The excess mortality is especially high between ages 15 and 64. In 2021, nearly half (48 percent) of all US deaths in this age range are excess deaths.
American health disaster — We must do better.
Even pre-pandemic, the United States had an excess mortality problem. Yale School of Medicine’s (USA) F. Perry Wilson, MD, MSCE, reminds us that this is not entirely surprising. Commenting in Medscape, here’s his take:
“First, you can see that even before the pandemic, the United States had an excess mortality problem. This is not entirely a surprise; we’ve known that so-called ‘deaths of despair,’ those due to alcohol abuse, drug overdoses, and suicide, are at an all-time high and tend to affect a ‘prime of life’ population that would not otherwise be expected to die. Half of US excess deaths occur in those between the ages of 15 and 64.”
Alas, the differences in mortality from other causes continue to grow. While there has been a substantial reduction in deaths from other causes in the five European countries (partially compensating for the additional deaths directly attributable to Covid-19), the United States has had an increase in deaths from other causes.
Unintentional injuries in the United States are rising, especially those involving alcohol or artificial opioids. Look at this disturbing chart of the drug problem in my country:
We have a chronic, not acute, problem in the United States. Nearly half of the American deaths between ages 15 and 64 were secondary to this excess mortality. For those over 50, deaths attributable to smoking in 2003 were lower (24 percent). We have a crisis. The numbers are even worse for underrepresented minorities.
Covid and more
Covid plays a large role in excessive mortality calculations but accounts for only about one-half of the excess deaths.
This analysis pulls back the curtain on social conditions in the United States and some unfortunate health choices. It also demonstrates our flawed health system. I don’t have any quick answers, but I was shaken enough by the excess death problem in America to write to you.
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The information I provided in this blog is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider for medical advice, diagnoses, or treatment. I am not liable for risks or issues associated with using or acting upon the information in this blog.
Thank you for reading “American Health Disaster.”
