Dataset Information

The US Midlife Mortality Crisis Continues: Excess Cause-Specific Mortality During 2020.

ABSTRACT: Whether monthly excess mortality in the United States during 2020 varied by age and cause of death is investigated in this analysis. Based on national-level death counts and population estimates for 1999-2020, sex-specific negative binomial regression models were used to estimate monthly cause-specific excess mortality by age group during 2020. Among men, 71% non-COVID excess deaths occurred at working ages (25-64 years), but those ages accounted for only 36% of non-COVID excess deaths among women. Many excess deaths resulted from external causes (particularly among men), heart disease, diabetes, Alzheimer disease (particularly among women), and cerebrovascular disease. For men, the largest share of non-COVID excess deaths resulted from external causes, nearly 80% of which occurred at working ages. Although incorrectly classified COVID-19 deaths may explain some excess non-COVID mortality, misclassification is unlikely to explain the increase in external causes of death. Auxiliary analyses suggested that drug-related deaths may be driving the increase in external mortality, but drug overdoses were already increasing for a full year before the pandemic. The oldest Americans bore the brunt of COVID-19 deaths, but working-age Americans, particularly men, suffered substantial numbers of excess non-COVID deaths, most commonly from external causes and heart disease.

SUBMITTER: Glei DA

PROVIDER: S-EPMC9767865 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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The US Midlife Mortality Crisis Continues: Excess Cause-Specific Mortality During 2020.

Glei Dana A DA

American journal of epidemiology 20220901 10

Whether monthly excess mortality in the United States during 2020 varied by age and cause of death is investigated in this analysis. Based on national-level death counts and population estimates for 1999-2020, sex-specific negative binomial regression models were used to estimate monthly cause-specific excess mortality by age group during 2020. Among men, 71% non-COVID excess deaths occurred at working ages (25-64 years), but those ages accounted for only 36% of non-COVID excess deaths among wom ...[more]

PMID: 35333293

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Project description:Official COVID-19 mortality statistics are strongly influenced by local diagnostic capacity, strength of the healthcare and vital registration systems, and death certification criteria and capacity, often resulting in significant undercounting of COVID-19 attributable deaths. Excess mortality, which is defined as the increase in observed death counts compared to a baseline expectation, provides an alternate measure of the mortality shock-both direct and indirect-of the COVID-19 pandemic. Here, we use data from civil death registers from a convenience sample of 90 (of 162) municipalities across the state of Gujarat, India, to estimate the impact of the COVID-19 pandemic on all-cause mortality. Using a model fit to weekly data from January 2019 to February 2020, we estimated excess mortality over the course of the pandemic from March 2020 to April 2021. During this period, the official government data reported 10,098 deaths attributable to COVID-19 for the entire state of Gujarat. We estimated 21,300 [95% CI: 20, 700, 22, 000] excess deaths across these 90 municipalities in this period, representing a 44% [95% CI: 43%, 45%] increase over the expected baseline. The sharpest increase in deaths in our sample was observed in late April 2021, with an estimated 678% [95% CI: 649%, 707%] increase in mortality from expected counts. The 40 to 65 age group experienced the highest increase in mortality relative to the other age groups. We found substantial increases in mortality for males and females. Our excess mortality estimate for these 90 municipalities, representing approximately at least 8% of the population, based on the 2011 census, exceeds the official COVID-19 death count for the entire state of Gujarat, even before the delta wave of the pandemic in India peaked in May 2021. Prior studies have concluded that true pandemic-related mortality in India greatly exceeds official counts. This study, using data directly from the first point of official death registration data recording, provides incontrovertible evidence of the high excess mortality in Gujarat from March 2020 to April 2021.

Dataset Information

The US Midlife Mortality Crisis Continues: Excess Cause-Specific Mortality During 2020.

Publications

The US Midlife Mortality Crisis Continues: Excess Cause-Specific Mortality During 2020.

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