A million US deaths could be averted each year if mortality rates in America were on par with those in other rich countries, a damning report has found.
Researchers looked at the rate of all-cause mortality per population size since the 1930s in nearly two dozen peer nations, including the UK, Canada, Japan, Australia and 17 European countries.
They found that despite the US being the richest, it has suffered more deaths per capita than any of the 21 other nations since around 1980, which have reached ‘unprecedented levels’ in recent years.
The study noted the opioid and fentanyl epidemic, gun violence, and obesity-related deaths, which have all been exacerbated by the Covid pandemic, are the reason America is an outlier.
The graph shows how each country of the G7, an informal grouping of seven of the world’s advanced economies, fared in international life expectancy rankings each year from 1950 to 2020. The US plummeted from 13th place to 53rd place
The above graph shows the number of excess deaths in the United States relative to other nations over the time period researchers analyzed, 1933 to 2021. During World War II and thereafter, America had a lower mortality rate than peer countries. In the 1960s and 70s, the rate was similar to other wealthy countries. However, in the 1980s, the number of excess deaths began to rise
The above graph shows the number of years, in millions, of life lost due to excess deaths in the US relative to other countries
The study, published in Proceedings of the National Academy of Sciences Nexus, found that by 2019, around 600,000 deaths could have been prevented if the US had similar mortality rates to its peer nations.
But in 2020 and 2021, this rose to 1.1million.
Steffie Woolhandler, senior author and professor at the School of Urban Public Health at Hunter College, blamed America’s healthcare system, insurers, corporate greed and politicians for the avoidable deaths the country has seen.
‘We waste hundreds of billions each year on health insurers’ profits and paperwork, while tens of millions can’t afford medical care, healthy food, or a decent place to live,’ Woolhandler said.
‘Americans die younger than their counterparts elsewhere because when corporate profits conflict with health, our politicians side with the corporations,’ she added.
The United States was only one of a handful of countries on the list that does not provide universal healthcare coverage to its residents.
Despite the number of excess deaths peaking in 2020 and 2021, the team from Boston University School of Public Health, University of Pennsylvania, Harvard Chan School of Public Health and Hunter College found America’s excess death rate had been worsening since the 1980s.
During World War II and thereafter, America had a lower mortality rate than peer countries.
In the 1960s and 70s, the rate was similar to other wealthy countries.
However, in the 1980s, the number of excess deaths began to rise, climbing to approximately 622,500 in 2019.
Deaths then spiked in 2020 and 2021 during the pandemic. Those years saw approximately one million excess deaths.
In the years between 1980 and 2021, there were 13.1 million ‘missing Americans’.
Study lead and corresponding author Jacob Bor, an associate professor of global health and epidemiology at Boston University, called the number of missing Americans ‘unprecedented in modern times.’
Nearly half of the missing Americans died prior to age 65 in 2020 and 2021, a level of excess deaths Bor said was particularly stark.
‘Think of people you know who have passed away before reaching age 65. Statistically, half of them would still be alive if the US had the mortality rates of our peers. The US is experiencing a crisis of early death that is unique among wealthy nations,’ Bor said.
The Centers for Disease Control and Prevention (CDC) reported life expectancy in 2020 was 77 years old, a decline of nearly two years from 2019. In 2021, life expectancy declined again to 76.4 years.
In 2020, nine of the 10 leading causes of death were the same as in 2019, though five causes switched ranks.
However, heart disease and cancer remained the top two, while Covid was newly added and took the third slot.
Unintentional injuries moved to fourth place and stroke moved to fifth place.
In 2021, nine of the 10 leading causes of death remained unchanged from the year prior and heart disease, cancer and Covid were the top three again.
Unintentional injury and stroke remained the fourth and fifth top causes of death in 2021, respectively.
During both 2020 and 2021, deaths among all ages increased year-over-year, except those among one- to four-year-olds, which declined slightly only in 2020.
‘Living in the US is a risk factor for early death that is common across many US racial and ethnic groups,’ Bor said.
‘Whereas most health disparities studies assess differences between US racial/ethnic groups, such an approach renders the poor health of Whites invisible and grossly underestimates the health shortfall of minoritized groups.
‘By using an international benchmark, we show that Americans of all races and ethnicities are adversely affected by the US policy environment, which places a low priority on public health and social protections, particularly for low-income people.’
During both 2020 and 2021, deaths among all ages increased year-over-year, except those among one- to four-year-olds, which declined slightly only in 2020
During both 2020 and 2021, deaths among all ages increased year-over-year, except those among one- to four-year-olds, which declined slightly only in 2020
Accounting for the future years lost due to someone dying prematurely, researchers estimate that in 2021, excess deaths translated to 26.4 million years of life lost when compared to peer countries.
Based on the study results and the trend of excess deaths in the US, Mr Bor is not optimistic mortality rates will rebound in the near future, even as Covid deaths fall to some of their lowest numbers.
‘The US was already experiencing more than 600,000 missing Americans annually before the pandemic began, and that number was increasing each year. There have been no significant policy changes since then to change this trajectory.
‘While COVID-19 brought new attention to public health, the backlash unleashed during the pandemic has undermined trust in government and support for expansive policies to improve population health.
‘This could be the most harmful long-term impact of the pandemic, because expansion of public policy to support health is exactly how our peer countries have attained higher life expectancy and better health outcomes.’