Links Between Early Retirement and Mortality

Link: https://www.ssa.gov/policy/docs/workingpapers/wp93.html#:~:text=Relative%20to%20those%20retiring%20at,odds%20of%20dying%20by%200.1089

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In this paper I use the 1973 cross-sectional Current Population Survey (CPS) matched to longitudinal Social Security administrative data (through 1998) to examine the relationship between retirement age and mortality for men who have lived to at least age 65 by year 1997 or earlier.1 Logistic regression results indicate that controlling for current age, year of birth, education, marital status in 1973, and race, men who retire early die sooner than men who retire at age 65 or older. A positive correlation between age of retirement and life expectancy may suggest that retirement age is correlated with health in the 1973 CPS; however, the 1973 CPS data do not provide the ability to test that hypothesis directly.

Regression results also indicate that the composition of the early retirement variable matters. I represent early retirees by four dummy variables representing age of entitlement to Social Security benefits—exactly age 62 to less than 62 years and 3 months (referred to as exactly age 62 in this paper), age 62 and 3 months to 62 and 11 months, age 63, and age 64. The reference variable is men taking benefits at age 65 or older. I find that men taking benefits at exactly age 62 have higher mortality risk than men taking benefits in any of the other four age groups. I also find that men taking benefits at age 62 and 3 months to 62 and 11 months, age 63, and age 64 have higher mortality risk than men taking benefits at age 65 or older. Estimates of mortality risk for “early” retirees are lowered when higher-risk age 62 retirees are combined with age 63 and age 64 retirees and when age 62 retirees are compared with a reference variable of age 63 and older retirees. Econometric models may benefit by classifying early retirees by single year of retirement age—or at least separating age 62 retirees from age 63 and age 64 retirees and age 63 and age 64 retirees from age 65 and older retirees—if single-year breakdowns are not possible.

The differential mortality literature clearly indicates that mortality risk is higher for low-educated males relative to high-educated males. If low-educated males tend to retire early in relatively greater numbers than high-educated males, higher mortality risk for such individuals due to low educational attainment would be added to the higher mortality risk I find for early retirees relative to that for normal retirees. Descriptive statistics for the 1973 CPS show that a greater proportion of age 65 retirees are college educated than age 62 retirees. In addition, a greater proportion of age 64 retirees are college educated than age 62 retirees, and a lesser proportion of age 64 retirees are college educated than age 65 or older retirees. Age 63 retirees are only slightly more educated than age 62 retirees.

Despite a trend toward early retirement over the birth cohorts in the 1973 CPS, I do not find a change in retirement age differentials over time. However, I do find a change in mortality risk by education over time. Such a change may result from the changing proportion of individuals in each education category over time, a trend toward increasing mortality differentials by socioeconomic status, or a combination of the two.

This paper does not directly explore why a positive correlation between retirement age and survival probability exists. One possibility is that men who retire early are relatively less healthy than men who retire later and that these poorer health characteristics lead to earlier deaths. One can interpret this hypothesis with a “quasidisability” explanation and a benefit optimization explanation. Links between these interpretations and my analysis of the 1973 CPS are fairly speculative because I do not have the appropriate variables needed to test these interpretations.

A quasi-disability explanation, following Kingson (1982), Packard (1985), and Leonesio, Vaughan, and Wixon (2000), could be that a subgroup of workers who choose to take retired-worker benefits at age 62 is significantly less healthy than other workers but unable to qualify for disabled-worker benefits. An econometric model with a mix of both these borderline individuals and healthy individuals retiring at age 62 and with almost no borderline individuals retiring at age 65 could lead to a positive correlation between retirement and mortality, even if a greater percentage of individuals who retire at age 62 are healthy than unhealthy. Evidence for this hypothesis can be inferred from the finding that retiring at exactly age 62 increases the odds of dying in a unit age interval by 12 percent relative to men retiring at 62 and 3 months to 62 and 11 months for men in the 1973 CPS. In addition, retiring exactly at age 62 increases the odds of dying by 23 percent relative to men retiring at age 63 and by 24 percent relative to men retiring at age 64. A group with relatively severe health problems waiting for their 62nd birthday to take benefits could create this result.

An explanation based on benefit optimization follows Hurd and McGarry’s research (1995, 1997) in which they find that individuals’ subjective survival probabilities roughly predict actual survival. If men in the 1973 CPS choose age of benefit receipt based on expectations of their own life expectancy, then perhaps a positive correlation between age of retirement and life expectancy implies that their expectations are correct on average. If actuarial reductions for retirement before the normal retirement age are linked to average life expectancy and an individual’s life expectancy is below average, it may be rational for that individual to retire before the normal retirement age. Evidence for this hypothesis can be inferred from the fact that men retiring at age 62 and 3 months to age 62 and 11 months, age 63, and age 64 all experience greater mortality risk than men retiring at age 65 or older. If only men with severe health problems who are unable to qualify for disability benefits are driving the results, we probably would not expect to see this result. We might expect most of these individuals to retire at the earliest opportunity (exactly age 62).2

Author(s): Hilary Waldron

Publication Date: August 2001

Publication Site: Social Security Office of Policy, ORES Working Paper No 93

Mounting research shows that COVID-19 leaves its mark on the brain, including with significant drops in IQ scores

Link:https://theconversation.com/mounting-research-shows-that-covid-19-leaves-its-mark-on-the-brain-including-with-significant-drops-in-iq-scores-224216

Excerpt:

From the very early days of the pandemic, brain fog emerged as a significant health condition that many experience after COVID-19.

Brain fog is a colloquial term that describes a state of mental sluggishness or lack of clarity and haziness that makes it difficult to concentrate, remember things and think clearly.

Fast-forward four years and there is now abundant evidence that being infected with SARS-CoV-2 – the virus that causes COVID-19 – can affect brain health in many ways.

In addition to brain fog, COVID-19 can lead to an array of problems, including headaches, seizure disorders, strokes, sleep problems, and tingling and paralysis of the nerves, as well as several mental health disorders.

Author(s): Ziyad Al-Aly

Publication Date: 28 Feb 2024

Publication Site: The Conversation

Adele vs. Taylor Swift, Covid, and Entertainment Industry Pandemic Insurance

Link: https://www.nakedcapitalism.com/2024/02/adele-vs-taylor-swift-covid-and-entertainment-industry-pandemic-insurance.html

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Making those timelines — 2020, 2021, 2022, 2023, 2024 — really brought home to me how long this pandemic has been going on; I lost track in the daily grind (though the daily grind is also my form of coping). And it’s a bit discouraging to see the most solidarity our society seems capable of fizzle out after 2020, followed by a struggle to return to business as usual, a struggle that failed by 2024, in that a once-essential part of touring — contact with the fans — has now gone missing.

We can, of course, moralize about what how these artists have gone about their business:

To be fair, though, when CDC Director Mandy Cohen is swanning about with no mask, modeling how to infect everybody she breathes on, what’s a poor celebrity to do? Restoring social norms that support non-pharmaceutical interventions will probably take a whole-of-society approach (which could happen when those Tiktokers start doing their research).

Here, however, are two small steps artists like Adele and Taylor Swift could do to improve the Covid pandemic situation.

First, big acts could really help out smaller acts by supporting organizations like this one: [Clean Air Club]

Second, sell N95s at your concerts and on your websites as branded merch. K-Pop powerhouse Twice already does this (though KN94s, not N95s):

And if, by some happy chance, some intern from either organization reads this post, please champion these ideas!

Oh, and champion clean air, too. Who could be against that? Miasma delenda est!

Author(s): Lambert Strether

Publication Date: 28 Feb 2024

Publication Site: naked capitalism

Lessons Learned During the Pandemic Can Help Improve Care in Nursing Homes

Link: https://oig.hhs.gov/documents/evaluation/9808/OEI-02-20-00492.pdf

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OIG recommends that the Centers for Medicare & Medicaid Services (CMS):

1. Implement and expand upon its policies and programs to strengthen the nursing home workforce.

2. Reassess nurse aide training and certification requirements.

3. Update the nursing home requirements for infection control to incorporate lessons learned from the pandemic.

4. Provide effective guidance and assistance to nursing homes on how to comply with updated infection control requirements.

5. Facilitate sharing of strategies and information to help nursing homes overcome challenges and improve care.

CMS did not explicitly state its concurrence or nonconcurrence for the five recommendations.

Author: Christi A. Grimm

Publication Date: February 2024

Publication Site: Office of the Inspector General, HHS

Staffing shortages, poor infection control plague nursing homes

Link: https://www.upi.com/Health_News/2024/03/01/nursing-home-staffing-shortage/8751709302182/

Excerpt:

Although the pandemic has ended, staffing shortages and employee burnout still plague U.S. nursing homes, a new government report finds.

But the problems didn’t end there: The report, issued Thursday by the Inspector General’s Office at the U.S. Department of Health and Human Services, showed that infection-control procedures were still sorely lacking at many facilities.

Not only that, COVID-19 booster vaccination rates remain far lower than they should be, with only 38% of residents and 15% of staff up-to-date on their shots, according to a recent KFF report.

Author(s): Robin Foster

Publication Date: 1 Mae 2024

Publication Site: UPI

Cognitive impairment after long COVID-19: current evidence and perspectives

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423939/

Published online 2023 Jul 31. doi: 10.3389/fneur.2023.1239182

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Abstract:

COVID-19, caused by the SARS-CoV-2 virus, is a respiratory infectious disease. While most patients recover after treatment, there is growing evidence that COVID-19 may result in cognitive impairment. Recent studies reveal that some individuals experience cognitive deficits, such as diminished memory and attention, as well as sleep disturbances, suggesting that COVID-19 could have long-term effects on cognitive function. Research indicates that COVID-19 may contribute to cognitive decline by damaging crucial brain regions, including the hippocampus and anterior cingulate cortex. Additionally, studies have identified active neuroinflammation, mitochondrial dysfunction, and microglial activation in COVID-19 patients, implying that these factors may be potential mechanisms leading to cognitive impairment. Given these findings, the possibility of cognitive impairment following COVID-19 treatment warrants careful consideration. Large-scale follow-up studies are needed to investigate the impact of COVID-19 on cognitive function and offer evidence to support clinical treatment and rehabilitation practices. In-depth neuropathological and biological studies can elucidate precise mechanisms and provide a theoretical basis for prevention, treatment, and intervention research. Considering the risks of the long-term effects of COVID-19 and the possibility of reinfection, it is imperative to integrate basic and clinical research data to optimize the preservation of patients’ cognitive function and quality of life. This integration will also offer valuable insights for responding to similar public health events in the future. This perspective article synthesizes clinical and basic evidence of cognitive impairment following COVID-19, discussing potential mechanisms and outlining future research directions.

Author(s):Zhitao Li,# 1 , 2 , † Zhen Zhang,# 3 , † Zhuoya Zhang,# 4 , † Zhiyong Wang, 3 , * and Hao Li

Publication Date: 2023 Jul 31

Publication Site: Frontiers in Neurology

‘Fourth Wave’ of Opioid Epidemic Crashes Ashore, Propelled by Fentanyl and Meth

Link:https://kffhealthnews.org/news/article/fourth-wave-opioid-epidemic-fentanyl-millennium-health-report/

Excerpt:

The United States is knee-deep in what some experts call the opioid epidemic’s “fourth wave,” which is not only placing drug users at greater risk but is also complicating efforts to address the nation’s drug problem.

These waves, according to a report out today from Millennium Health, began with the crisis in prescription opioid use, followed by a significant jump in heroin use, then an increase in the use of synthetic opioids like fentanyl.

The latest wave involves using multiple substances at the same time, combining fentanyl mainly with either methamphetamine or cocaine, the report found. “And I’ve yet to see a peak,” said one of the co-authors, Eric Dawson, vice president of clinical affairs at Millennium Health, a specialty laboratory that provides drug testing services to monitor use of prescription medications and illicit drugs.

The report, which takes a deep dive into the nation’s drug trends and breaks usage patterns down by region, is based on 4.1 million urine samples collected from January 2013 to December 2023 from people receiving some kind of drug addiction care.

Its findings offer staggering statistics and insights. Its major finding: how common polysubstance use has become. According to the report, an overwhelming majority of fentanyl-positive urine samples — nearly 93% — contained additional substances. “And that is huge,” said Nora Volkow, director of the National Institute on Drug Abuse at the National Institutes of Health.

Author(s): Colleen DeGuzman

Publication Date: 21 Feb 2024

Publication Site: KFF Health News

Disparities Grow as Smoking Rates Rise Again

Link: https://americaninequality.substack.com/p/smoking-and-inequality?utm_source=post-email-title&publication_id=267573&post_id=138207076&utm_campaign=email-post-title&isFreemail=true&r=15zk5&utm_medium=email

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South Dakota is home to 3 of the 5 counties with the highest percent of cigarette smokers. We’ve written about one of those counties, Oglala Lakota County, several times before as it has the lowest life expectancy of any county in the US (residents die at 67 on average), and median income is $30,347. Meanwhile, Utah is home to 6 of the 10 counties with the lowest percent of cigarette smokers. American Inequality has covered several of these counties before. For example, Summit County has the highest life expectancy of any county in the US (residents die at 87 on average), and median income is 2.5x higher than in Oglala. 

Cigarette smoking is 50% higher than in the following 12 states compared to the rest of the nation: Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio, Oklahoma, Tennessee and West Virginia. An average smoker in these 12 states goes through about 53 packs in one year, compared with an average of 29 packs in the rest of the US. Life expectancy is 3 years lower in these states compared to the national average. 

In 1998, California became the first state to implement a smoke free law prohibiting smoking in all indoor areas of bars and restaurants, as well as in most indoor workplaces. As we can see from the map above, California now has one of the lowest percent of adults smoking in the country. 

Author(s): Jeremy Ney

Publication Date: 25 October 2023

Publication Site: American Inequality

CDC Downplayed News of Vax Myocarditis

Link: https://checkyourwork.kelleykga.com/p/cdc-downplayed-news-of-vax-myocarditis

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With the recent discovery that the CDC drafted — but never sent — a Health Alert in May 2021 about myocarditis after mRNA vaccination, I put together this timeline about vaccine myocarditis news and updates from government officials. I include a combination of documents from CDC and FDA, as well as what was covered in the mainstream media.

I think this timeline shows a pattern in which CDC & FDA failed to adequately investigate and inform the public about the risks of myocarditis early in the vaccine rollout. However, there was public acknowledgement by the CDC, as early as May 20, 2021, about a potential pattern of myocarditis after the 2nd dose of mRNA vaccines, particularly in young men.

On June 1, 2021, the CDC confirmed that they had identified a higher than expected signal of myocarditis for young men after mRNA vaccination, but that they still recommended Covid vaccination for everyone in this age group. Despite a lot more analysis and discussion of myocarditis after that, and a changing landscape with widespread natural immunity, the CDC & FDA position has changed very little since that time.

Author(s): Kelley in Georgia

Publication Date: 19 Jan 2024

Publication Site: Check your Work on substack

I Am Afraid of Early Cancer Detection

Link: https://www.sensible-med.com/p/i-am-afraid-of-early-cancer-detection?utm_source=post-email-title&publication_id=1000397&post_id=141592311&utm_campaign=email-post-title&isFreemail=true&r=15zk5&utm_medium=email

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Looking a bit more closely you see why Grail’s test is actually useless, or dangerous, or both. Let’s start with the sensitivity of the test. For a cancer screening test to work, it must find disease before it has caused symptoms — when it is in an early or premalignant stage. Say what you want about lung cancer screening, mammography, PSA, and colonoscopy (I’m talking to you Drs. M and P) but at least they look for, and succeed at finding, early stage/premalignant disease. Here is the sensitivity of the Galleri test by stage: stage 1, 16.8%; stage 2, 40.4%; stage 3, 77%; stage 4, 90.1%.

The test is nearly worthless at finding stage 1 disease, the stage we would like to find with screening. The type of disease that is usually cured with surgery alone.

How about specificity? Let’s consider a fictional, 64-year-old male patient who presents to his internist worried about pancreatic cancer. I pick pancreatic not only because it is a scary cancer: we can’t screen for it, our treatments stink, and it seems to kill half the people in NYT obituary section. I also chose it because it is the anecdotal disease in the WSJ article.

….

Working through the math (prevalence 0.03%, sensitivity 61.9%, specificity 99.5%), this means our patient’s likelihood of having pancreatic cancer after a positive test is only 3.58%. For our patient, we have caused anxiety and the need for an MRI. You almost hope to find pancreatic cancer at this point to be able to say, “Well, it was all worth it.” If the MRI or ERCP is negative, the patient will live with fear and constant monitoring. (You will have to wait until next week to consider with me the impact of this test if we were to deploy it widely).

If the evaluation is positive, and you have managed to diagnose asymptomatic, pancreatic cancer, the likelihood of survival is probably, at best, 50%.

Let’s end this week with two thoughts. First the data for the Galleri test is not good, yet. The test characteristics are certainly not those we would like to see for a screening test. Even more importantly, good test characteristics are just the start. To know that a test is worthwhile, you would like to know that it does more good than harm. This has not even been tested. The WSJ article scoffs at the idea that we would want this data.5

Author(s): Adam Cifu, MD

Publication Date: 15 Feb 2024

Publication Site: Sensible Medicine, substack

How methadone, other meds are helping to lower CT opioid deaths

Link: https://ctmirror.org/2023/12/03/ct-opioid-epidemic-methadone-buprenorphine/

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Even more, the health professionals who administer methadone — and another commonly used treatment drug called buprenorphine — say the medications enable people to find new jobs, to regain custody of their children and to more easily recover from the mind-altering effects of opioids.

Lugo is just one of the tens of thousands of people who benefitted from a methadone treatment program in Connecticut in recent years, but state officials want to see that number increase even more to combat the state’s ongoing epidemic.

special advisory committee, set up to manage roughly $600 million in opioid settlement funds for Connecticut, published a report earlier this year that laid out several key strategies for curtailing opioid overdoes in the state, and it argued that increasing the accessibility and use of methadone and buprenorphine would be the most effective approach to stemming the mounting death toll.

….

Sharfstein, who also cowrote a book titled “The Opioid Epidemic: What Everyone Needs to Know,” said treatment programs that incorporate methadone and buprenorphine meet both of those principles.

The effectiveness of medication-assisted treatment, Sharfstein said, has been reviewed by the American Medical Association, the American Psychiatric Association and the National Academies of Sciences, Engineering, and Medicine.

And research has suggested that the use of methadone and buprenorphine in treating opioid use disorders can substantially reduce people’s chances of fatally overdosing — some studies suggest by up to 50%.

“For a disease that is killing many Americans, that is a significant reduction in mortality that you can get with appropriate treatment that includes medications,”  Sharfstein said. “And that I think is just an incredibly important point to keep in mind as officials are thinking about expanding access to treatment.” 

Author(s): Andrew Brown

Publication Date: 3 Dec 2023

Publication Site: CT Mirror

Combating the black maternal and infant mortality crisis

Link: https://cbs6albany.com/news/local/combating-the-black-maternal-and-infant-mortality-crisis

Excerpt:

She’s not alone, according to the CDC black women of all backgrounds are three times more likely to die from a pregnancy related cause than white woman. Black infants are also three times more likely to die than white babies.

Many black women report feeling silenced or ignored by healthcare providers during their pregnancy journey.

“It is 2023 almost 2024, and in this time, we should not be dying in birth. Period. You may be the medical professional, and you may have great textbook knowledge and you may have many degrees, but nobody is in my body but me, and nobody can tell me that this pain that I’m feeling is not there,” King said.

….

This month New York Governor Kathy Hochul called the issue a crisis and a disgrace. Hochul announced more than $4 million in funding for regional perinatal centers and said doula services will now be covered for all Medicaid enrollees beginning January first.

In a statement, Governor Hochul said, “as the first mom and grandma to serve as Governor of New York, I’m committed to doing everything in my power to tackle the disturbing rise in infant mortality.”

Esther is hopeful the attacks on this issue from all fronts will lead to better outcomes for women and babies in the future.

….

For more information about BirthNet visit this link.

Author(s): Emani Payne

Publication Date: 21 Nov 2023

Publication Site: CBS 6 Albany