Announcements
: US Excess Deaths Continued to Rise Even After the COVID-19 Pandemic
In 2022 and 2023, the United States saw over 1.5 million more deaths than expected. Excess US deaths have been increasing for decades, with working-age adults disproportionately affected. This trend continued during and after the pandemic.
The study published in JAMA Health Forum by Minnesota Population Center researchers and collaborators at Boston University, refers to these excess deaths as “missing Americans” because these deaths reflect people who would still be alive if US mortality rates were equal to the average mortality rate in other high-income countries.
The study found:
- U.S. death rates were one-third higher than death rates in 21 other wealthy nations, including Canada, Finland, Iceland and Portugal.
- In 2023, a staggering 45.9% of U.S. deaths under 65 years old would have been prevented if we had the death rate of other wealthy nations.
- Adults aged 25-44 in the U.S. are 2.5 times more likely to die than international peers.
- Excess deaths, meaning the number of deaths above the expected death rate, spiked during the COVID-19 pandemic and remain higher than peer nations in 2023, particularly for adults aged 25-44.
The findings reveal a continuing and worrying trend in worsening US mortality compared to other wealthy nations over the last four decades.
“The 700,000 excess American deaths in 2023 is exactly what you’d predict based on prior rising trends, even if there had never been a pandemic,” said study coauthor Elizabeth Wrigley-Field, associate professor of sociology at the University of Minnesota. “These deaths are driven by long-running crises in drug overdose, gun violence, car collisions, and preventable cardiometabolic deaths.”
“The US has been in a protracted health crisis for decades, with health outcomes far worse than other high-income countries,” says lead author Jacob Bor, associate professor of global health and epidemiology at Boston University School of Public Health. “This longer-run tragedy continued to unfold in the shadows of the COVID-19 pandemic.”
Excess mortality is a nationwide problem, but the study revealed another staggering, yet persistent, statistic about younger and working-age Americans: 46 percent of all US deaths among people under 65 years old would not have occurred if the US had the age-specific death rates of its peers. This age-related disparity was evident before, during, and after the pandemic, and the 2023 excess death rate was only slightly lower than it was in 2021, at 50 percent, a finding detailed in a previous study by the researchers.
“Imagine the lives saved, the grief and trauma averted, if the US simply performed at the average of our peers,” says lead author Jacob Bor, associate professor of global health and epidemiology at Boston University School of Public Health. “One out of every 2 US deaths under 65 years is likely avoidable. Our failure to address this is a national scandal.”
“These deaths reflect not individual choices, but policy neglect and deep-rooted social and health system failures,” says senior author Andrew Stokes, associate professor of global health at Boston University. “The COVID-19 pandemic exposed structural weaknesses—including gaps in healthcare access and social supports—that have continued to fuel premature deaths even after the acute phase of the pandemic ended.”
Stokes coauthored a separate study earlier this year that found that drug-related deaths were the single largest cause of mortality among adults ages 25-44.
Future research is needed to pinpoint specific causes of the US’ disparity in mortality rates, but the researchers say the nation should look to the policies of its peer countries for insight into reducing health inequities and improving population health outcomes.
“Other countries show that investing in universal healthcare, strong safety nets, and evidence-based public health policies leads to longer, healthier lives,” says Stokes. “Unfortunately, the US faces unique challenges; public distrust of government and growing political polarization have made it harder to implement policies that have proven successful elsewhere.”
“Deep cuts to public health, scientific research, safety net programs, environmental regulations, and federal health data could lead to a further widening of health disparities between the US and other wealthy nations, and growing numbers of excess—and utterly preventable—deaths to Americans,” cautions Dr. Bor.
The study was also coauthored by Rafeya Raquib, research fellow in the Department of Global Health at SPH; Steffie Woolhandler, Distinguished Professor at the School of Urban Public Health at Hunter College; and David Himmelstein, lecturer in medicine at Cambridge Health Alliance/Harvard Medical School and Distinguished Professor at Hunter College.
See the original write up of this research by Jillian McKoy on the Boston University School of Public Health website.
: Stability and change in the academic qualifications of recent men and women college entrants
Research in Social Stratification and Mobility | MPC Member: Tom VanHeuvelen
Policy makers, commentators, and some scholars have become increasingly concerned that men are falling further behind women in college attendance rates. There has been concern about which men and women, in terms of academic qualifications, attend colleges in the U.S. —particularly elite colleges that are associated with the greatest economic and social returns. MPC member Tom VanHeuvelen and co-author Natasha Quadlin set out to examine these questions in this era of heightened competitiveness using data from the Education Longitudinal Study of 2002 and the High School Longitudinal Study of 2009.
The research found:
- Given equal qualifications, men and women had roughly equal chances of attending top colleges
- The largest changes were concentrated among less-prepared students attending less-selective institutions
- Less prepared men increasingly opt into two-year colleges, while less prepared women’s enrollment has stayed more or less constant, weakening women’s advantages at this level of education
- Gender imbalances continue to favor of men at some top STEM-oriented institutions
- The study only look at actual enrollment rates, not admission applications
While commentary continues to focus on elite institutions, this research shows the recent changes at non-elite institutions are much more consequential for broader education trends.
: Orphan discipline and child neglect: An analysis from 48 countries
Child Abuse & Neglect | MPC Authors: Anna Bolgrien, Elizabeth Heger Boyle, Mehr Munir, Miriam L. King
Orphan exposure to violent discipline is poorly understood, as research on parents' disciplinary practices largely focuses on biological families. The little research that exists has found that orphans are at reduced risk of harsh discipline but fails to explain why. This analysis from over 48 countries finds the lower odds of physical discipline are a result, largely, of neglect.
Highlights
- Orphans are defined as children with one or no living parent.
- Orphans have lower odds of receiving physical, psychological, and nonviolent discipline.
- Lower odds of physical discipline are driven largely by caregiver neglect.
- Education on healthy disciplinary practices should be accompanied with caregiver support.
Learn more in this engaging story map of the research.
: Consequences of undocumented residents in the census—study shows trivial political impact
by PNAS Nexus
In recent years, some public figures have argued that undocumented residents in the United States should not be included in census data used for congressional apportionment because their inclusion unfairly benefits Democratic-leaning states.
MPC Member John Robert Warren and Robert E. Warren analyzed data from every census from 1980 through 2020 and used high quality state-level estimates of the size of the undocumented resident population at each time point. The authors then calculated how many House seats and how many Electoral College votes would have changed had undocumented residents been excluded from the data after each census. The study is published in the journal PNAS Nexus.
Previous efforts to address this question used projected rather than actual estimates and only considered the 2020 census. Using actual data from 1980–2020, the authors find that no more than five House seats or Electoral College votes would have switched states in any year if undocumented residents were removed and there were no years in which party control of the House or the outcome of a presidential election would have meaningfully changed.
In general, removing undocumented residents from census data used for apportionment would have had a trivial impact on party representation in the House or the outcome of presidential elections and is unlikely to have an increased impact in the future.
: Rising early adult mortality in the US
New research from the University of Minnesota shows that death rates for early adults, or adults aged 25-44, rose sharply during the COVID-19 pandemic and remain higher than expected post-pandemic.
Heightened death rates during the COVID-19 pandemic intensified an already negative trend for early adults, which began around 2010. As a result, early adult death rates in 2023 were about 70% higher than they might have been if death rates had not begun to rise about a decade before the pandemic.
Researchers from the University of Minnesota and Boston University analyzed death rates between 1999-2023. The study, published in JAMA Network Open, found:
- For early adults, there was a large jump in the death rate between 2019 and 2021, which are considered the core pandemic years. In 2023, the death rate remained nearly 20% higher than in 2019.
- Drug-related deaths are the single largest cause of 2023 excess mortality, compared with the mortality that would have been expected had earlier trends continued.
- Other important contributing causes were a variety of natural causes, including cardiometabolic and nutritional causes, and a variety of other external causes, including transport deaths.
"The rise in opiate deaths has been devastating for Americans in early and middle adulthood,” said Elizabeth Wrigley-Field, lead author and an associate professor in the University of Minnesota College of Liberal Arts and Associate Director at the Minnesota Population Center. “What we didn't expect is how many different causes of death have really grown for these early adults. It's drug and alcohol deaths, but it's also car collisions, it's circulatory and metabolic diseases — causes that are very different from each other. That tells us this isn't one simple problem to fix, but something broader."
"Our findings underscore the urgent need for comprehensive policies to address the structural factors driving worsening health among recent generations of young adults,” said author Andrew Stokes of Boston University. “Solutions may include expanding access to nutritious foods, strengthening social services and increasing regulation of industries that affect public health.”
Future research will explore ongoing consequences of the COVID-19 pandemic and the trends that were already in place when it began.
Funding was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the Robert Wood Johnson Foundation, the National Institute on Aging, the W.K. Kellogg Foundation and the Minnesota Population Center. Original post of this article can be found on the UMN News website.