Much has been made of America’s life expectancy deficit, but focusing on a statistic which is an average for the whole population masks truly staggering disparities at the extremes. For men at the bottom of the US economic ladder, it’s even worse. My calculations suggest the average age of death in that group is just 36 years old, compared with 55 in the Netherlands and 57 in Sweden.
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In most wealthy countries, if you’re desperately unlucky in the longevity stakes, you succumb to cancer before you reach 60. But if you’re unlucky in the US, you die from a drug overdose or gunshot wound by 40. Which brings us again to the most shocking statistic: among the least fortunate 10 per cent of American men, the average age at death is 36.
Looking at different regions within the US paints a similar picture. Conditions such as obesity shorten the lives of rich and poor alike, but the most uniquely American afflictions have steep socio-economic gradients. Wealthy Americans who live in the parts of the country with high opioid use and gun violence live just as long as those who live where fentanyl addiction and gunshot incidents are relatively rare. But poor Americans live far shorter lives if they grow up surrounded by guns and drugs than if they don’t.
In the 1970s, American lifeexpectancy grew by about four months each year. By the 1980s, it was similar to lifeexpectancy in other rich countries. Since then, other countries have continued to progress, with life spans increasing by more than two and a half months a year.
But the United States has slowly, gradually and then precipitously fallen behind.
These ever-widening gaps have long troubled demographers and prompted three reports from the National Academy of Sciences. The gaps grew wider during the pandemic.
But even before, not only was lifeexpectancy in the United States far from that of the best-performing countries (Japan and Switzerland), but it was also more than two years lower than that of the worst performers (Germany and Britain) among 22 other rich countries.
Public health authorities in the United States record educational qualifications at death so that, after 1992, we can calculate lifeexpectancy by college degree, starting at age 25, when most people have completed their education. In new research using these individual death records, we have found startling results.
Lifeexpectancy at age 25 (adult lifeexpectancy) for those with four-year college degrees rose to 59 years on the eve of the pandemic — so an average individual would live to 84 — up from 54 years (or 79 years old) in 1992. During the pandemic, by 2021, the expectation slipped a year.
But we were staggered to discover that for those without college degrees, lifeexpectancy reached its peak around 2010 and has been falling since, an unfolding disaster that has attracted little attention in the media or among elected officials.
Adult lifeexpectancy for this group started out two and a half years lower, at 51.6, in 1992 — so an average individual would live to nearly 77 years old. But by 2021, it was 49.8 years (or almost 75 years old), roughly eight and a half years less than people with college degrees, and those without had lost 3.3 years during the pandemic.
The divergence of lifeexpectancies on either side of the college divide — one going up, one going down — is both shocking and rare. We have found reference to only one other case in modern history, in the former Communist countries of Eastern Europe after the collapse of the Soviet Union. Like those countries, the United States is failing its less-educated people, an awful condemnation of where the country is today.
The estimated number of suicide deaths in the United States rose to nearly 50,000 in 2022, according to provisional data released on Thursday from the Centers for Disease Control and Prevention. The total would be an increase of approximately 2.6 percent since 2021.
The C.D.C. estimates the overall number of deaths to be 49,449 but has not yet calculated the suicide rates for 2022. Given that the U.S. population grew by about 0.4 percent in 2022, a 2.6 percent increase in deaths indicates that suicide rates are continuing to rise, although not universally among all groups.
Suicide deaths have fluctuated somewhat over the years and declined in 2019 and 2020. But the overall suicide rate, or the number of suicides per 100,000 people, has increased by about 35 percent over the last two decades. People 65 and older had the highest increase in the number of deaths by suicide in 2022 among the various age groups.
Korea’s fertility rate dropped to a new low of 0.78, the lowest among countries in the Organization for Economic Cooperation and Development, and possibly the world.
Korea would need to triple its annual births to 700,000 per year to maintain and stabilize its population.
Statistics Korea expected people aged 65 and above will take up 20 percent of the population in 2025, marking a sharp rise from 18.4 percent estimated for this year.
The Korean government sees the next five years as critical to increasing fertility and salvaging the country.
Korea’s government is considering easing the burden of gift taxes exclusively for newlywed couples, by raising the minimum amount of cash they can receive from parents without being taxed to either 100 million won ($76,000) or 150 million won.
Several municipalities have also introduced similar programs. Seongnam, Gyeonggi Province, held two couple matchmaking events in July for unmarried men and women who either live or work in the region. As a result, 39 couples found a match.
The average life expectancy fell for both Japanese men and women for the second consecutive year in 2022, a health ministry survey showed Friday.
The average life expectancy last declined for both sexes two years in a row in 2010 and 2011.
In 2022, the average life expectancy for men fell 0.42 years from 2021 to 81.05 years, and that for women dropped 0.49 years to 87.09 years. The drops were “largely due to the COVID-19 pandemic,” a ministry official said.
According to the ministry, the reported number of people who died after getting infected with the coronavirus rose to 47,635 in 2022 from 16,766 in 2021.
The pandemic is seen to have shortened the average life expectancy in 2022 by 0.12 years for men and 0.13 years for women, larger than 0.10 years and 0.07 years, respectively, in 2021.
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In 2022, Japanese women had the highest average life expectancy in the world.
Japanese men ranked fourth, down by one place from the preceding year. Switzerland ranked first, followed by Sweden and Australia.
Of Japanese men born in 2022, 75.3% are expected to live until 75, 25.5% until 90 and 8.7% until 95. The proportion of Japanese women who are expected to live until 75, 90 and 95 stands at 87.9%, 49.8% and 25%, respectively.
Specialty Utilization Specialty utilization by a total of 1802 patients evaluated at the Comprehensive COVID Center (CCC) during the first 21 months in a total of 2361 initial visits in 12 specialty clinics. The mean number of specialty clinics visited by CCC patients was 1.3 (range 1-6) and multiple clinic consultations accounted for 405 visits.
Excerpt:
Background
Persistent multi-organ symptoms after COVID-19 have been termed “long COVID” or “post-acute sequelae of SARS-CoV-2 infection” (PASC). The complexity of these clinical manifestations posed challenges early in the pandemic as different ambulatory models formed out of necessity to manage the influx of patients. Little is known about the characteristics and outcomes of patients seeking care at multidisciplinary post-COVID centers.
Methods
We performed a retrospective cohort study of patients evaluated at our multidisciplinary Comprehensive COVID-19 Center (CCC) in Chicago, IL, between May 2020 and February 2022. We analyzed specialty clinic utilization and clinical test results according to severity of acute COVID-19.
Results
We evaluated 1802 patients a median of 8 months from acute COVID-19 onset, including 350 post-hospitalization and 1452 non-hospitalized patients. Patients were seen in 2361 initial visits in 12 specialty clinics, with 1151 (48.8%) in neurology, 591 (25%) in pulmonology, and 284 (12%) in cardiology. Among patients tested, 742/878(85%) reported decreased quality of life, 284/553(51%) had cognitive impairment, 195/434(44.9%) had alteration of lung function, 249/299(83.3%) had abnormal CT chest scans, and 14/116(12.1%) had elevated heart rate on rhythm monitoring. Frequency of cognitive impairment and pulmonary dysfunction was associated with severity of acute COVID-19. Non-hospitalized patients with positive SARS-CoV-2 testing had similar findings than those with negative or no test results.
Conclusions
The CCC experience shows common utilization of multiple specialists by long COVID patients, who harbor frequent neurologic, pulmonary, and cardiologic abnormalities. Differences in post-hospitalization and non-hospitalized groups suggest distinct pathogenic mechanisms of long COVID in these populations.
Keywords: Long COVID, Post-Acute Sequelae of SARS-CoV-2 Infection, PASC, Multidisciplinary Care, Health Service Delivery
Author(s): Joseph Bailey, M.D.,a,⁎ Bianca Lavelle, M.D.,b Janet Miller, B.S.,a Millenia Jimenez, B.S.,c Patrick H. Lim, M.S.,c Zachary S. Orban, B.S.,c Jeffrey R. Clark, B.A.,c Ria Tomar, B.S.,a Amy Ludwig, M.D.,a Sareen T. Ali, B.S.,c Grace K. Lank, B.S.,c Allison Zielinski, M.D.,d Ruben Mylvaganam, M.D.,a Ravi Kalhan, M.D.,a Malek El Muayed, M.D.,e R. Kannan Mutharasan, M.D.,d Eric M. Liotta, M.D. M.S.,c Jacob I Sznajder, M.D.,a Charles Davidson, M.D.,d Igor J. Koralnik, M.D.,c,1 and Marc A. Sala, M.D.a,1, for the Northwestern Medicine Comprehensive COVID Center Investigators
Long COVID occurs in approximately a third of COVID survivors and is now the third leading neurologic disorder in the United States. In May 2020, during the height of the pandemic, Northwestern Medicine physicians noticed this growing trend and established one of the first Comprehensive COVID-19 Centers in the United States to treat patients suffering from lingering impacts of the virus such as brain fog, shortness of breath and chest pain. Three years later, a new study published in the American Journal of Medicine reports key findings from more than 1,800 patients who were evaluated during the first 21 months at the Northwestern Medicine Comprehensive COVID-19 Center (CCC) with neurology, pulmonology and cardiology being the most commonly accessed specialties and still in high-demand today.
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The team evaluated 1,802 patients (350 post-hospitalization and 1,452 non-hospitalized) via telehealth or in-person at the CCC between May 2020 and February 2022. Patients were seen in 2,361 initial visits in 12 specialty clinics including neurology, pulmonology, cardiology, otolaryngology, gastroenterology, infectious diseases, endocrinology, nephrology, hematology, dermatology, psychiatry and rheumatology. Patients most commonly sought treatment from neurology (49%), pulmonology (25%) and cardiology (12%) specialists.
Among patients tested:
– 85% of patients reported decreased quality of life
– 51% had cognitive impairment
– 45% had altered lung function
– 83% had abnormal CT chest scans
– 12% had elevated heart rate on rhythm monitoring
– Frequency of cognitive impairment and pulmonary dysfunction was associated with severity of acute COVID-19
– Non-hospitalized patients with positive COVID-19 testing had similar findings than those with negative or no test results
DEMOGRAPHICS
– 65% of patients identified as female
– Average age at first clinic visit was 47 years old
– 72% were White, 10% were Black, 4% were Asian and 13% were Hispanic
First, the 1983 Amendments were an interim solution to the well-understood changing of the age distribution due to the drop in birth rate after 1965. These Amendments were expected to extend the ability to pay scheduled benefits from 1982 to the mid-2050s, with the clear understanding that further changes would be needed by then.
Second, the redistribution of earned income to the highest earners was not anticipated in 1983. This shift resulted in about 8 percent less payroll tax revenue by 2000 than had been expected, with this reduced level continuing thereafter. The severity of the 2007-09 recession was also not anticipated.
Third, with the passage of 40 years since 1983, we clearly see the shortcomings of the 1983 Amendments in achieving “sustainable solvency” for Social Security. We are now in a position to formulate further changes needed, building on the start made in 1983.
Fourth, the long-known and understood shift in the age distribution of the US population will continue to increase the aged dependency ratio until about 2040, and in turn increase the cost of the OASDI program as a percentage of taxable payroll and GDP. Once this shift, which reflects the drop in the birth rate after 1965, is complete, the cost of the program will be relatively stable at around 6 percent of GDP. The unfunded obligation for the OASDI program over the next 75 years represents 1.2 percent of GDP over the period as a whole.
Author(s): Stephen C. Goss, Chief Actuary, Social Security Administration
Researchers in Japan have found a significant increase in the number of suicides among women and girls between the ages of 10 and 24 during the pandemic, while there was no significant change in the suicide rate for boys and men in the same age group.
The research team analyzed data on suicides by gender across three age groups — 10 to 14, 15 to 19 and 20 to 24 — comparing the number of suicides after July 2020 with the number of suicides before the pandemic began.
According to the health ministry, the number of suicides among women and girls age between 10 and 24 in 2022 was 745, an increase of 233 compared with the 2019 figure. The data also showed that the number of boys and men in that age range who committed suicide was 1,278, an increase of 100 cases from 2019.
The research was led by Nobuyuki Horita from Yokohama City University Hospital and Sho Moriguchi from the Department of Neuroscience at Keio University using data on deaths by suicide from July 2012 to June 2022 provided by the health ministry.
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Over the past 10 years, a total of 13,263 young people age 10 to 24 — 9,428 male and 3,835 female — died by suicide.
In the previous Weekly Chart, Elliot brought the data to confirm a commonsense impression: people these days are waiting later than their parents and grandparents did to get married and have children. The average age of a newlywed in the U.K. is 30.6 for women and 32.1 for men — about five years older than they would have been 1995, and nine years older than in 1964.
When we’re looking back in history, three generations is about as far as common sense can usually go. Those are the people whose lives we know firsthand. Many of us might have a general impression that women, especially, married young in the past, but we don’t actually have any 19th century friends or family to compare that impression against. Reading last week’s post, I was curious to see the older data that could fill in that gap.
Things are changing more rapidly. Smaller hospitals are under an attack of high costs and less revenue. As a result, many are closing leaving the small town and rural residents without medical care or having to drive long distances in emergencies. As reported by Healthcare Quality and Payment Reform:
Many people across the country could not receive hospital care in their community when the pandemic began. Over 150 rural hospitals closed between 2005 and 2019. An additional 19 rural hospitals closed in 2020, more than any year in the previous decade. The closures are not resulting from the pandemic, but by financial losses in previous years. Ten more rural hospitals closed in 2021 and 2022. The closures decreased in 2019 due to the special financial assistance hospitals received during the pandemic. The pandemic aid has ended and closures are likely to increase.
Hundreds of Hospitals are at Risk of Closing
Six hundred rural hospitals or ~ 30% of all rural hospitals in the country are at risk of closing. At risk because of the serious financial problems, they are experiencing:
Author(s): Center for Healthcare Quality and Payment Reform
Publication Date: 7 Jun 2023 on blog, accessed 14 Jun 2023
Where did people move to during the pandemic? It's a common question that's been explored using various sources, but the most accurate & detailed data recently came out from the IRS
