“Missing Americans” – Increase in early deaths in the United States, and not just from COVID-19

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More than 2 million Americans died in 2020 and 2021 might still be alive today if the United States had death rates equal to those of other developed nations.

A new study looked at how many deaths could have been prevented, based on averages of age-specific death rates from 21 other wealthy countries. Researchers have found that excess deaths have “increased” during the COVID-19 pandemic, but the death rate in the United States has diverged from that of other countries for decades.

The authors said the number of “missing Americans” rose to more than one million in 2020 and nearly 1.1 million in 2021. Analyzing numbers dating back to 1933, the number of excess deaths n has never been more important in the United States.

“The number of Americans missing in recent years is unprecedented in modern times,” said corresponding author Jacob Bor, ScD, in a Press release. Bor is an associate professor of global health and epidemiology at the Boston University School of Public Health.

In 2020 and 2021, nearly half of all missing Americans died before age 65, the study found.

“Think of the people you know who died before they reached age 65. Statistically, half of them would still be alive if the United States had the death rates of our peers,” said Bor. “The United States is experiencing an early death crisis unique among wealthy countries.”

20th century history

The researchers used figures from the Human Mortality Database and the US Centers for Disease Control and Prevention.

The United States had lower death rates than peer countries from the 1930s through the 1950s. World War II had a “disproportionate mortality shock” on younger age groups in many European countries and in Japan. In the mid-twentieth century, young Americans had high death rates compared to other countries, while older Americans enjoyed a lower death rate. This pattern began to change in the late 1970s.

“Death rates in the United States began to diverge in the 1980s, and this divergence has accelerated in the 21st century,” the study says. Researchers estimated that there were 622,534 additional deaths in 2019, capping a four-decade period with 11 million additional deaths from 1980 to 2019.

Root causes

Americans were already dying at higher rates than other countries when the COVID-19 pandemic emerged in 2020, while other countries were better positioned to weather the emergency phase of the pandemic and protect the health of the population in the future. In 2021, nearly 1.1 million missing Americans would have enjoyed an estimated 26.4 million additional years of life if they had lived. “High levels of excess mortality in the United States are expected to continue even if COVID mortality declines,” the study said.

Mortality is not limited to any ethnic or racial group. According to the study, black and Native Americans have endured decades of structural racism that has resulted in disparities in wealth, education, housing and health care.

But the United States has a larger population of white people who made up about 2/3 of the Americans missing. People of all races and ethnicities live with government policies that fail to address issues such as the opioid epidemic, gun violence, pollution, poverty, hunger, and workplace safety.

“We waste hundreds of billions each year on profits and health insurer paperwork, while tens of millions of people cannot afford medical care, healthy food or decent housing,” the author said. Study principal Steffie Woolhandler, MD, MPH, in the press release. Woolhandler is Distinguished Professor in the School of Urban Public Health at Hunter College, City University of New York. “Americans are dying younger than their counterparts elsewhere because when corporate profits collide with health care, our politicians side with the corporations.”

The authors acknowledged that the estimate of the number of missing Americans is a statistical construct and that there is no way of knowing which deaths could have been prevented. But examining other countries shows what is achievable in high-income countries, setting a benchmark for judging the United States.

Comparator countries were: Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Iceland, Ireland, Italy, Japan, Luxembourg , the Netherlands, New Zealand, Norway, Portugal, Spain, Sweden, Switzerland and the United States. Kingdom.

The study, “Missing Americans: Early death in the United States – 1933-2021,” was published in PNAS Nexus.