We assessed how many US deaths would have been averted each year, 1933–2021, if US age-specific mortality rates had equaled the average of 21 other wealthy nations. We refer to these excess US deaths as “missing Americans.” The United States had lower mortality rates than peer countries in the 1930s–1950s and similar mortality in the 1960s and 1970s. Beginning in the 1980s, however, the United States began experiencing a steady increase in the number of missing Americans, reaching 622,534 in 2019 alone. Excess US deaths surged during the COVID-19 pandemic, reaching 1,009,467 in 2020 and 1,090,103 in 2021. Excess US mortality was particularly pronounced for persons under 65 years. In 2020 and 2021, half of all US deaths under 65 years and 90% of the increase in under-65 mortality from 2019 to 2021 would have been avoided if the United States had the mortality rates of its peers. In 2021, there were 26.4 million years of life lost due to excess US mortality relative to peer nations, and 49% of all missing Americans died before age 65. Black and Native Americans made up a disproportionate share of excess US deaths, although the majority of missing Americans were White. [end quote]
Deaths of despair – drug use, alcoholism and suicide. Gun violence. Chronic and acute disease.
According to the Institute for Health Metrics and Evaluation, there are 22 times as many gun-related homicides in the United States as in the countries of the European Union. Between 2019 and 2021, total U.S. gun deaths — including suicides and accidents — [grew 23 percent] to 48,830 such deaths in 2021.
In 2019, the “Missing Americans” authors calculate, the United States had almost twice as many deaths among those under the age of 15 than in its peer countries. And instead of approximately 70,000 deaths among those aged 15 to 44, as would be implied by peer-average mortality rates, there were more than 170,000.
During the Covid pandemic, across the other wealthy nations, age-standardized mortality among those under the age of 65 increased by six deaths per 100,000 between 2019 and 2021. In the United States, those rates grew by 254 deaths per 100,000 among Native Americans, 143 deaths per 100,000 among Black Americans, 108 deaths per 100,000 among Hispanic Americans, 72 deaths per 100,000 among white Americans and 36 deaths per 100,000 among Asian Americans.
Mortality rate ratios relative to other nations increased over time for all race/ethnicities, indicating worsening position relative to other wealthy nations. Mortality rate ratios were largest among younger adults, indicating that the pattern of elevated early- and mid-life US mortality is not limited to one specific race or ethnicity.
In 2020 and 2021, more than half of all US deaths under 65 years would have been averted if the United States had experienced the mortality rates of its peers. During the first two years of the COVID-19 pandemic, there were nearly 1 million excess US deaths under 65 years. The 1.1 million missing Americans in 2021 would have enjoyed an estimated 26.4 million additional years of life had they survived.
The authors chose to compare the U.S. to other countries of similar economic status (mostly in Europe) rather than the usual excess mortality compared with the U.S. in earlier years. This is because the U.S. has had growing excess mortality compared with these other countries since 1980 so self-comparison hides a lot of excess deaths. The study showed that even before the pandemic, the United States experienced more than 600,000 excess US deaths each year, with most occurring among Americans under 65 years.
In an aging population, Macroeconomic trends require a healthy, young work force to maintain the promised level of benefits. Aside from the tragic suffering of the missing Americans, our economy is weakened by their loss.
The article ends with a long list of research-documented ways to decrease excess mortality, especially among the young and poor, based on the results of peer countries with much lower mortality. The article doesn’t mention the rise in obesity due to the Standard American Diet of processed food. They do mention many potential government programs, all of which would engender serious political opposition.
Sad to say, I don’t see this situation changing. There will probably be many more missing Americans in future years.