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hubie writes:

A new study found that more than one million US deaths per year—including many young and working-age adults—could be avoided if the US had mortality rates similar to its peer nations:

In 2021, 1.1 million deaths would have been averted in the United States if the US had mortality rates similar to other wealthy nations, according to a new study led by a School of Public Health researcher.

Published in the journal PNAS Nexus, the study refers to these excess deaths as "Missing Americans," because these deaths reflect people who would still be alive if the US mortality rates were equal to its peer countries.

Comparing age-specific death rates in the U.S. and 21 other wealthy nations from 1933 through 2021, the authors find that current death rates in the US are much higher than other wealthy nations, and the number of excess U.S. deaths has never been larger.

"The number of Missing Americans in recent years is unprecedented in modern times," says study lead and corresponding author Jacob Bor, associate professor of global health and epidemiology.

Nearly 50 percent of all Missing Americans died before age 65 in 2020 and 2021. According to Bor, the level of excess mortality among working age adults is particularly stark. "Think of people you know who have passed away before reaching age 65. Statistically, half of them would still be alive if the US had the mortality rates of our peers. The US is experiencing a crisis of early death that is unique among wealthy nations."

The COVID-19 pandemic contributed to a sharp spike in mortality in the US—more so than in other countries—but the new findings show that the number of excess US deaths has been accelerating over the last four decades. Bor and colleagues analyzed trends in US deaths from 1933 to 2021, including the impact of COVID-19, and then compared these trends with age-specific mortality rates in Canada, Japan, Australia, and 18 European nations.

The US had lower mortality rates than peer countries during World War II and its aftermath. During the 1960's and 1970's, the US had mortality rates similar to other wealthy nations, but the number of Missing Americans began to increase year by year starting in the 1980's, reaching 622,534 annual excess U.S. deaths by 2019. Deaths then spiked to 1,009,467 in 2020 and 1,090,103 in 2021 during the pandemic. From 1980 to 2021, there were a total of 13.1 million Missing Americans.

[...] "We waste hundreds of billions each year on health insurers' profits and paperwork, while tens of millions can't afford medical care, healthy food, or a decent place to live," says study senior author Steffie Woolhandler, Distinguished Professor at the School of Urban Public Health at Hunter College, City University of New York. "Americans die younger than their counterparts elsewhere because when corporate profits conflict with health, our politicians side with the corporations."

[...] "The US was already experiencing more than 600,000 Missing Americans annually before the pandemic began, and that number was increasing each year. There have been no significant policy changes since then to change this trajectory," he says.

"While COVID-19 brought new attention to public health, the backlash unleashed during the pandemic has undermined trust in government and support for expansive policies to improve population health," said Bor. "This could be the most harmful long-term impact of the pandemic, because expansion of public policy to support health is exactly how our peer countries have attained higher life expectancy and better health outcomes."

Journal Reference:
Jacob Bor, Andrew C Stokes, Julia Raifman, et al., Missing Americans: Early death in the United States—1933–2021, PNAS Nexus, Volume 2, Issue 6, June 2023, pgad173, https://doi.org/10.1093/pnasnexus/pgad173

Original Submission