There is no good time for a pandemic, but COVID-19 has hit the United States since the public health crisis was underway.
A new report concludes that the new coronavirus has exacerbated mortality rates that are already rising among Americans at the best time of their lives. Racially minorities and people of all races with low incomes and with secondary education or less are especially affected.
The report, released March 2 by the National Academies of Science, Engineering, and Medicine, provides the most comprehensive view of premature deaths in the United States to date. An image emerges of how the interaction of known and often preventable risk factors, including rising rates of opioid overdose and obesity, is contributing to declining U.S. life expectancy (SN: 21/12/17).
Since the 1990s, drug overdoses, alcohol abuse, suicides, and obesity-related conditions have killed nearly 6.7 million American adults between the ages of 25 and 64, according to a 12-member committee. Mortality rates from these causes tended to accelerate in the 2010s. The regime suggests that the aftershocks of the severe economic recession of 2008 contributed to that development.
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“This is a public health crisis that is not improving and somehow getting worse,” said Kathleen Mullan Harris, a sociologist at the University of North Carolina at Chapel Hill and chair of the committee, during a March 2 webinar. to discuss the report.
The report shows that declining life expectancy among racial minorities and working-class whites before the pandemic "set the stage for the challenges we saw during COVID-19," says epidemiologist Sandro Galea, dean of Boston University School of Public Health. Galea assisted in the peer review of the committee’s analyzes.
People with underlying health conditions – often the very conditions that drive the trend of premature deaths – were especially vulnerable during the pandemic. For example, studies have found that obesity creates a substantial risk of hospitalization and death after a coronavirus infection (SN: 22/04/20). And the federal data cited in the report reinforces that the virus did not affect all groups equally. From January 1, 2020 to January 9, 2021, 4.3 percent of all deaths among working-age white residents involved COVID-19. That figure reached 10 percent for black residents, 21.4 percent for Hispanics, 14.2 percent for Native American groups, 13 percent for Asians, and 16.1 percent for Hispanics. Hawaiians and other Pacific islands.
Although COVID-19 is currently the leading cause of death, what prompted the new report was the fact that U.S. life expectancy had fallen for three years in a row starting in 2015. Harris ’team analyzed data on mortality of people of working age in the United States. States from 1990 to 2017, as well as reviewing research on social trends related to illness and death.
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Cardiometabolic diseases, including diabetes, high cholesterol, obesity, high blood pressure caused by heart disease, narrowed heart arteries and stroke, have caused more than 4.8 million premature deaths, a trend that accelerated after 2010 While the mortality rate from these causes for black people varied during the study period, sometimes falling, it remained consistently double that of white and Hispanic people, the report found.
Many cardiometabolic deaths have resulted from obesity-related illnesses, Harris said. Young adults, especially in the south and rural areas, have shown the largest increase in obesity-related deaths. Research suggests those people typically had unhealthy diets and lacked free and safe spaces to exercise throughout their lives, Harris said.
Drug overdose and alcohol-related conditions caused more than 1.3 million deaths among people of working age from 1990 to 2017. Drug overdose mortality has steadily increased in all states, especially in Appalachia, New England and parts of the Midwest ravaged by the loss of industrial employment.
This drug overdose epidemic has resulted in the increasing availability of prescribed and illegal opioids combined with a growing demand for drugs to relieve physical and mental pain, according to the report. Many overdoses may reflect despair and hopelessness among people who have lost their jobs and have little education (SN: 02/11/20). But little research has explored that possibility, Harris' group adds.
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Deaths of working age by suicide amounted to 569,099 between 1990 and 2017. Suicide rates increased mainly among white people, especially white men, and in rural areas. Financial unrest, increased foreclosures, and loss of support from community and religious institutions likely contributed to these trends, the report concludes.
Harris and colleagues recommend a number of policies to counteract these mortality trends. Suggestions include youth-led obesity prevention programs, improved access to treatment for substance abuse and mental health problems, and exploring ways to reduce racial disparities in health and mortality.
In the short term, policymakers should prioritize efforts to restrict harmful access to prescribed opiates and to stop the flow of fentanyl and other illegal opioids into the country, says Johns Hopkins University sociologist Andrew Cherlin, who also assisted in the peer review. of the new report. “In the long run, the best political implication is to revive the economies of rural America,” Cherlin says.