US Face Unprecedented Crisis of 1.1 million Early Deaths

A groundbreaking study led by researchers at the Boston University School of Public Health (BUSPH) revealed that the United States has been experiencing an alarming surge in excess mortality rates compared to other wealthy nations. Termed “Missing Americans,” the study highlights the shocking reality that approximately 1.1 million deaths in 2021 could have been prevented if the US had mortality rates similar to its peer countries.

The research, published in the journal PNAS Nexus, delves into the trends of age-specific death rates in the US and 21 other wealthy nations from 1933 to 2021. The findings indicate that the US currently suffers from substantially higher death rates than its counterparts, and the number of excess deaths has reached an unprecedented level, making it a crisis of early deaths unparalleled among wealthy nations. 

Dr. Jacob Bor, the study’s lead author and associate professor of global health and epidemiology at BUSPH, expressed his concern over the severity of the issue. He pointed out that nearly 50 percent of Missing Americans died before age 65 in 2020 and 2021.

The situation is particularly alarming among working-age adults, with statistics suggesting that half of those who passed away before 65 would have survived if the US had the same mortality rates as its peer nations. This crisis extends across racial and ethnic lines, with Black and Native Americans disproportionately affected, experiencing mortality rates that were five and eight times higher than the average of other wealthy nations in early adulthood (ages 15-44). 

The study also highlighted a worrying historical trend: the US had lower mortality rates than its peer countries during World War II and its aftermath. However, starting in the 1980s, the number of Missing Americans escalated, reaching 622,534 annual excess deaths by 2019. The situation was further exacerbated the COVID-19 pandemic, leading to 1,009,467 excess deaths in 2020 and 1,090,103 in 2021. 

While the pandemic contributed to a sharp spike in mortality, the research indicates that the problem of excess US deaths has steadily increased over the past four decades. Structural racism in the US, which includes historical policies like slavery and redlining, has contributed to racial and ethnic disparities in wealth, education, housing, and healthcare. These disparities, in turn, drive the leading causes of worse mortality rates, especially among young adults. 

The researchers argue that the mortality crisis is not limited to specific minority groups but affects all Americans across racial and ethnic backgrounds. Although Black and Native Americans are disproportionately impacted, most Missing Americans are White due to their larger population, older age distribution, and significantly higher death rates than wealthy nations. 

The study connects the enormous excess mortality burden to US policies’ failure to address major public health issues. The key factors contributing to early deaths are the opioid epidemic, gun violence, environmental pollution, economic inequality, food insecurity, and workplace safety. Moreover, the COVID-19 pandemic exposed vulnerabilities, particularly among lower-income and minority groups, and the expiration of safety-net policies created during the pandemic left these vulnerable groups without crucial support. 

Dr. Steffie Woolhandler, the senior author of the study and Distinguished Professor at the School of Urban Public Health at Hunter College, City University of New York, laments the focus on corporate profits over public health in the US. The researchers believe politicians should prioritize public health and social protections to address these alarming mortality rates effectively. 

In contrast to other countries, the US had higher vaccination uptake and mask policies during the Omicron wave, contributing to fewer COVID-19 cases. However, the overall mortality crisis requires comprehensive and systemic solutions. The study raises critical questions requiring further investigation and research to identify specific geographic areas disproportionately responsible for the Missing Americans and the causes of death in those regions. This information could help guide targeted policy solutions. 

Despite the attention brought to public health by the COVID-19 pandemic, Dr. Bor is not optimistic about an immediate reversal of mortality rates. He expresses concern that there have been no significant policy changes to address this trajectory, and the lack of trust in government and support for expansive health policies could be a detrimental long-term impact of the pandemic. 

The “Missing Americans” crisis indicates a severe disparity in mortality rates between the US and other wealthy nations. The research underscores the urgent need for comprehensive policy changes and prioritization of public health to reduce early deaths in the United States. Addressing the root causes of excess mortality, such as economic inequality, structural racism, and inadequate healthcare access, is crucial to ensure Americans’ healthier and longer life expectancy.