Tag: cause of death

The Mortality After Release from Incarceration Consortium (MARIC): Protocol for a multi-national, individual participant data meta-analysis

Mary Pat Campbell

Link: https://ijpds.org/article/view/1145

doi: 10.23889/ijpds.v5i1.1145

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Abstract

Introduction
More than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance.

Objectives
To comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from prison.

Methods
We created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology.

Results
The combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up.

Conclusions
The consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalized population.

Author(s): Borschmann, R., Tibble, H., Spittal, M. J., Preen, D., Pirkis, J., Larney, S., Rosen, D. L., Young, J. T., Love, A. D., Altice, F. L., Binswanger, I. A., Bukten, A., Butler, T., Chang, Z., Chen, C.-Y., Clausen, T., Christensen, P. B., Culbert, G. J., Degenhardt, L., Dirkzwager, A. J., Dolan, K., Fazel, S., Fischbacher, C., Giles, M., Graham, L., Harding, D., Huang, Y.-F., Huber, F., Karaminia, A., Kouyoumdjian, F. G., Lim, S., Møller, L., Moniruzzaman, A., Morenoff, J., O’Moore, E., Pizzicato, L. N., Pratt, D., Proescholdbell, S. F., Ranapurwala, S. I., Shanahan, M. E., Shaw, J., Slaunwhite, A., Somers, J. M., Spaulding, A. C., Stern, M. F., Viner, K. M., Wang, N., Willoughby, M., Zhao, B. and Kinner, S. A. 

Publication Date: February 2020

Publication Site: International Journal of Population Data Science

Mortality in the United States — Provisional Data, 2023

Mary Pat Campbell

Link: https://www.cdc.gov/mmwr/volumes/73/wr/mm7331a1.htm?s_cid=mm7331a1_w

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FIGURE 1. Provisional* number of COVID-19–associated deaths† and other deaths and percentage of deaths associated with COVID-19, by week of death — National Vital Statistics System, United States, 2023

* National Vital Statistics System provisional data for 2023 are incomplete. Data from December 2023 are less complete because of reporting lags. These data exclude deaths that occurred in the United States among residents of U.S. territories and foreign countries.

† Deaths with confirmed or presumed COVID-19 as an underlying or contributing cause of death, with International Classification of Diseases, Tenth Revision code U07.1.

Excerpt:

Abstract

Final annual mortality data from the National Vital Statistics System for a given year are typically released 11 months after the end of the calendar year. Provisional data, which are based on preliminary death certificate data, provide an early estimate of deaths before the release of final data. In 2023, a provisional total of 3,090,582 deaths occurred in the United States. The age-adjusted death rate per 100,000 population was 884.2 among males and 632.8 among females; the overall rate, 750.4, was 6.1% lower than in 2022 (798.8). The overall rate decreased for all age groups. Overall age-adjusted death rates in 2023 were lowest among non-Hispanic multiracial (352.1) and highest among non-Hispanic Black or African American persons (924.3). The leading causes of death were heart disease, cancer, and unintentional injury. The number of deaths from COVID-19 (76,446) was 68.9% lower than in 2022 (245,614). Provisional death estimates provide an early signal about shifts in mortality trends. Timely and actionable data can guide public health policies and interventions for populations experiencing higher mortality.

Author(s): Farida B. Ahmad, MPH1; Jodi A. Cisewski, MPH1; Robert N. Anderson, PhD

Publication Date: 8 Aug 2024

Publication Site: CDC, MMWR Morbidity/Mortality Weekly Report

Suggested citation for this article: Ahmad FB, Cisewski JA, Anderson RN. Mortality in the United States — Provisional Data, 2023. MMWR Morb Mortal Wkly Rep 2024;73:677–681. DOI: http://dx.doi.org/10.15585/mmwr.mm7331a1

Mortality Stays Slightly Elevated: Globe Life Exec

Mary Pat Campbell

Link:https://www.thinkadvisor.com/2024/07/30/mortality-stays-slightly-elevated-globe-life-exec/

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Since the COVID-19 pandemic began, in early 2020, Globe Life has been one of the life insurers that’s been quickest to give analysts candid assessments of U.S. mortality.

Mortality is much lower than it was when pandemic-related mortality was peaking, and mortality trends are now helping, not, hurting, Globe Life’s earnings, Kalmbach said.

“Mortality has been fairly consistent over the last few quarters, which has been good,” he said.

He sees the mortality rate from accidents and other nonmedical causes improving.

….

“Heart disease and cancer, although improved, are still a little bit higher,” he said. “Another one that remains elevated as a cause of death is neurological disorders, which would be stroke and Alzheimer’s. We’re keeping an eye on that.”

Author(s): Allison Bell

Publication Date: 30 July 2024

Publication Site: think Advisor

#20: Many great things you missed this year

Mary Pat Campbell

Link: https://www.scientificdiscovery.dev/p/20-so-many-great-things-you-missed

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You can see that, in childhood, in the US, the most common causes of death are ‘external causes’. This is a broad category that includes accidents, falls, violence, and overdoses, and is shown in red. But there’s also a notable contribution from birth disorders (in muted green), childhood cancers (in blue), and respiratory diseases (in cyan).

The share of deaths in childhood from cancers stood out to me. We’ve seen lots of progress against many childhood cancers over the last 50 years — notably in treating leukemia, brain cancers, kidney cancers, lymphomas, and retinoblastoma — but this is a reminder that there’s still further to go.

From adolescence until middle-age, ‘external causes’ are now the overwhelming cause of death. Around 80% of deaths at the age of 20 in the US are due to external causes. These result from causes such as accidents, violence, and overdoses.

At older ages, diseases rise in importance. Causes of death also become more varied, although cardiovascular diseases and cancers are the most common.

You might also be wondering about the brown category at the bottom, called ‘special ICD codes’. That’s a placeholder category in the system for deaths caused by new diseases — predominantly Covid-19, since the data spans 2018 to 2021.3

Author(s): SALONI DATTANI

Publication Date: 16 Mar 2022

Publication Site: Scientific Discovery on substack

Guidance for Certifying Deaths Due to Coronavirus Disease 2019 (COVID-19)

Mary Pat Campbell

Link: https://www.cdc.gov/nchs/data/nvss/vsrg/vsrg03-508.pdf

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Certifying deaths due to post-acute sequelae of
COVID-19
In the acute phase, clinical manifestations and complications
of COVID-19 of varying degrees have been documented,
including death. However, patients who recover from the acute
phase of the infection can still suffer long-term effects (8).
Post-acute sequelae of COVID-19 (PASC), commonly referred
to as “long COVID,” refers to the long-term symptoms, signs,
and complications experienced by some patients who have
recovered from the acute phase of COVID-19 (8–10). Emerging
evidence suggests that severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19,
can have lasting effects on nearly every organ and organ system
of the body weeks, months, and potentially years after infection
(11,12). Documented serious post-COVID-19 conditions include
cardiovascular, pulmonary, neurological, renal, endocrine,
hematological, and gastrointestinal complications (8), as well as
death (13).

Consequently, when completing the death certificate, certifiers
should carefully review and consider the decedent’s medical
history and records, laboratory test results, and autopsy report,
if one is available. For decedents who had a previous SARSCoV-2 infection and were diagnosed with a post-COVID-19
condition, the certifier may consider the possibility that the death
was due to long-term complications of COVID-19, even if the
original infection occurred months or years before death. If it is
determined that PASC was the UCOD, it should be reported on
the lowest line used in Part I with the condition(s) it led to on the
line(s) above in a logical sequence in terms of time and etiology.
If it is determined that PASC was not the UCOD but was still a
significant condition that contributed to death, then it should be
reported in Part II. Certifiers should use standard terminology,
that is, “Post-acute sequelae of COVID-19.” See Scenario IV in
the Appendix for an example certification. In accordance with
all death certification guidance, if the certifier determines that
PASC did not cause or contribute to death, then they should not
report it anywhere on the death certificate.

Author(s): National Vital Statistics System, National Center for Health Statistics

Publication Date: updated 27 Feb 2023

Publication Site: CDC

Two Key Takeaways From The New CDC Life Expectancy Data

Mary Pat Campbell

Link: https://www.forbes.com/sites/ebauer/2022/09/02/two-key-takeaways-from-the-new-cdc-life-expectancy-data/?sh=6ce149f31cfc

Excerpt:

To what extent, are these drops of life expectancy due to Covid-19, rather than other causes?

From 2019 to 2020, the CDC reports that 90% of the drop in Hispanic life expectancy was attributable to Covid; the corresponding rates were 68% for whites and 59% for blacks. (No breakdown was provided for the AIAN or Asian categories.) However, the CDC data splits its breakdowns into “contributions to decreases” and “contributions to increases” rather than overall net effect. Those readers who are used to looking at data and charts will expect a “waterfall” style chart; the CDC version is not this, and is not particularly helpful.

In any event, relative to the 2020 baseline, the further decreases in life expectancy during 2021 had multiple causes. Only among the White demographic group was Covid the cause of over half of the decline; unintentional injury (including overdoses) was the second-largest contributing factor and for the AIAN demographic group, worsening rates of death due to chronic liver disease and cirrhosis played almost as substantial a role.

And, finally, it is important to understand that the CDC data shows a continued improvement in life expectancy due to reductions in death due to such causes as influenza/pneumonia, COPD/emphysema, Alzheimer disease, diabetes, and perinatal conditions (infant deaths). In fact, strikingly, in 2021, heart disease was a contributor to increased life expectancy in the Black, Hispanic, and Asian demographic groups, but a contributor to decreased life expectancy for the White and AIAN groups.

Again, though, the way the CDC provides its information means that, when it comes down to it, there is much that is simply missing; we do not know the magnitude of the improvements in life expectancy due to these causes, just that it exists. It even seems likely, or at least possible, that some of the apparent improvement in mortality due to these factors was actually because deaths were actually recorded as Covid deaths instead (whether due to multiple causes of death or other reasons).

Author(s): Elizabeth Bauer

Publication Date: 2 Sept 2022

Publication Site: Forbes

Excess mortality in England

Mary Pat Campbell

Link: https://app.powerbi.com/view?r=eyJrIjoiYmUwNmFhMjYtNGZhYS00NDk2LWFlMTAtOTg0OGNhNmFiNGM0IiwidCI6ImVlNGUxNDk5LTRhMzUtNGIyZS1hZDQ3LTVmM2NmOWRlODY2NiIsImMiOjh9

Data download:

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The numbers of expected deaths are estimated using statistical models and based on previous 5 years’ (2015 to 2019) mortality rates. Weekly monitoring of excess mortality from all causes throughout the COVID-19 pandemic provides an objective and comparable measure of the scale of the pandemic [reference 1]. Measuring excess mortality from all causes, instead of focusing solely on mortality from COVID-19, overcomes the issues of variation in testing and differential coding of cause of death between individuals and over time [reference 1].


In the weekly reports, estimates of excess deaths are presented by week of registration at national and subnational level, for subgroups of the population (age groups, sex, deprivation groups, ethnic groups) and by cause of death and place of death.

Author(s): Office for Health Improvement and Disparities

Publication Date: accessed 10 Aug 2022

Publication Site: Public PowerBI dashboard

Mortality Monday: DEATH TO GEESE

Mary Pat Campbell

Link: https://stump.marypat.org/article/766/mortality-monday-death-to-geese

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ANIMAL ENCOUNTER DIAGNOSES

Going back to the mortality database from the U.S. in 2014, I needed to figure out what the relevant ICD-10 codes were.

….

That’s a total of 384 deaths, and it looks like the primary cause is being attacked by some non-dog mammal. I would assume the second cause is primarily people being thrown from or falling off horses. Alas, most of the vehicular accident codes do not distinguish between hitting a person and hitting an animal.

Author(s): Mary Pat Campbell

Publication Date: 3 July 2017

Publication Site: STUMP

Mortality Nuggets: Videos on Suicide Rate Trends, Society of Actuaries Report, and Fixing Their Graph

Mary Pat Campbell

Link:https://marypatcampbell.substack.com/p/mortality-nuggets-videos-on-suicide

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  • I highlighted a few of the cause-of-death trends. In particular, COVID (which, obviously, is biased more towards the old), and external causes of death: homicide, suicide, and accidents (which includes drug overdoses and motor vehicle accidents).
  • There are basically too many things going on in this graph, so there aren’t a lot of good choices for either me or the SOA. What I did was to pick four of the data series to highlight with data labels, as noted above (and I also slapped one data label on dementia for the oldest age group, just because). I am in the middle of a series going through how that external causes of death changed in 2020 — in particular, accidents and homicides went up, and really affected mortality for adults under age 45, plus male teens.
  • Yeah, check out heart disease and cancer (bottom of the graph). Ain’t old age great?

Author(s): Mary Pat Campbell

Publication Date: 6 Feb 2022

Publication Site: STUMP at substack

U.S. Population Mortality Observations – Updated with 2020 Experience

Mary Pat Campbell

Link:https://www.soa.org/resources/research-reports/2022/us-population-mortality/

pdf: https://www.soa.org/globalassets/assets/files/resources/research-report/2022/population-mortality-observation.pdf

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The overall age-adjusted mortality rate (both sexes) from all causes of death recorded the historically highest increase of published records dating back to 1900 of 16.8% in 2020, following a 1.2% decrease in 2019. The increase eclipsed the size of recent years’ annual volatility and exceeded the 11.7% increase in
1918 that occurred during the Spanish influenza pandemic. When COVID deaths are removed, all other
CODs’ (Cause of Death) combined mortality increased by 4.9%, which was last exceeded by a 5.6% increase in 1936.

All other CODs featured in this report had increased 2020 mortality. In many instances, the single year
mortality increases were the largest for the span of this report. Heart disease and Alzheimer’s/Dementia
had 4.7% and 7.8% increases, respectively. Other physiological CODs with lower death rates had double-digit increases. Diabetes, liver and hypertension had increases of 14.9%, 16.0% and 13.3%, respectively.
The external CODs of assaults and opioid overdoses had extreme increases at ages 15-24 of 35.9% and
61.2%, respectively.

Author(s):

Jerome Holman, FSA, MAAA, RJH Integrated Solutions, LLC
Cynthia S. MacDonald, FSA, MAAA, Society of Actuaries Research Institute

Publication Date: Jan 2022

Publication Site: SOA

2021 U.S. January-June Cause-of-Death Ranking Table

Mary Pat Campbell

Link:https://marypatcampbell.substack.com/p/2021-us-january-june-cause-of-death

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I don’t recommend simply doubling the numbers from the ranking table and comparing them to the 2020 table, especially for the COVID numbers. I know that won’t work, because of the overall 2021 mortality trend we saw:

….

However, I have been making estimates and projections, and I see some really worrying numbers for the ages 15-44 grouping, especially for external causes of death: suicide, homicide, and accidents. The worrying trend is that these may extend past the time COVID mortality wanes. It looks worse for 2021 than for 2020.

I will be doing posts looking at these three large categories, starting with suicide, in upcoming posts, by more detailed demographics than just age. Some of these trends have geographic components to consider as well.

Author(s): Mary Pat Campbell

Publication Date: 27 Jan 2022

Publication Site: STUMP at substack

Top Causes of Death by Age Group, 2020: Raw Numbers

Mary Pat Campbell

Link: https://marypatcampbell.substack.com/p/top-causes-of-death-by-age-group

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The numbers below each cause are the total number of finalized deaths in CDC Wonder as of 11 January 2022 for the completed calendar year 2020.

COVID deaths for under age 15 weren’t in the top 10 causes for those age groups, which is why they aren’t seen in the table. But you may be interested in those numbers:
at #12 for ages 5-14, with 49 deaths
at #12 for ages 1-4, with 19 deaths
at #13 for infant mortality (<1 year), at 35 deaths

In general, other than the new cause of COVID, most of the causes of death were in the same rank order as in 2019, with a few switches for causes that tend to be close in numbers.

Author(s): Mary Pat Campbell

Publication Date: 12 Jan 2022

Publication Site: STUMP at substack