The Covid Toll: 2021 Worse than 2020

The Covid death toll was greater in 2021 than in 2020 despite the roll-out of vaccines. Why? In part, because pandemic mitigation efforts became politicized, creating an anti-vax movement whose consequences can be seen in the numbers. 

Total number of deaths due to Covid

2021: 460,513

2020: 384,536

Number of Covid deaths per 100,000 population

2021: 111.4

2020:   93.2

Change in death rate from Covid, 2020-21 by age

Aged 15-24:    +179%

Aged 25-34:    +167%

Aged 35-44:    +154%

Aged 45-54:    +117%

Aged 55-64:      +75%

Aged 65-74:      +31%

Aged 75-84:        +1%

Aged 85-plus:    -24%

Change in death rate from Covid, 2020-21 by race and Hispanic origin

Asians: -5%

Blacks: -5%

Hispanics: -4%

Non-Hispanic whites: +36%

Between 2020 and 2021, the Covid death rate among adults under age 55 more than doubled. Among non-Hispanic whites in 2021, the Covid death rate climbed 36 percent while falling for Asians, Blacks, and Hispanics.

According to the Peterson-KFF Health System Tracker, an estimated 161,900 Covid deaths in 2021 could have been prevented by vaccination—more than one-third of all Covid deaths last year. Many of those deaths were the consequence of the anti-vax movement.

Source: CDC, Provisional Mortality Data—United States, 2021 

Born in 1970? Have We Got News for You

Who is the longest-lived human being on record? Her name was Jeanne Calment. She was born in Arles, France in 1875. She died 122 years and 164 days later in 1997. She currently holds the record for what is called the "maximum reported age at death."

How long will her record stand? That's what a study published in Demographic Research wanted to determine. Researchers Michael Pearce and Adrian E. Raftery of the University of Washington calculated the probabilities that the record would be broken by 2100. The chances are very good that Jeanne Calment's record will be broken by then. In fact, there's a 99 percent probability that someone will have lived more than 122 years 164 days by 2100, the researchers report. 

Pearce and Raftery also calculated the probability that the record would rise to 126, 128, and 130 years by 2100. There is an excellent (89 percent) chance that someone will live to be at least age 126 by 2100, they calculate. The probability is pretty good (44 percent) that someone will live to be at least age 128 by 2100. 

The probability is a smaller but still significant 13 percent that someone will live to be at least 130 by 2100. If you were born in 1970, we're looking at you. You might be the one who is still around in 2100 to celebrate your 130th birthday.

Source: Demographic Research, Probabilistic Forecasting of Maximum Human Lifespan by 2100 Using Bayesian Population Projections 

75% of White Evangelicals Favor the Death Penalty

Support for the death penalty varies by religious affiliation, according to a Pew Research Center survey. Overall, 60 percent of Americans aged 18 or older support the death penalty for people convicted of murder. Only 35 percent of those who identify themselves as atheists support the death penalty—the lowest level of support by religious affiliation. The highest level of support is among white evangelical Protestants, 75 percent of whom support the death penalty.

Percent who favor the death penalty for people convicted of murder

75% of white Evangelical Protestants

73% of white Protestants, not evangelical

61% of Hispanic Catholics

56% of white Catholics

50% of Black Protestants

43% of Agnostics

35% of Atheists

Source: Pew Research Center, Unlike Other U.S. Religious Groups, Most Atheists and Agnostics Oppose the Death Penalty

60% of Americans Favor the Death Penalty

The 60 percent majority of Americans support the death penalty for people convicted of murder, according to a Pew Research Center survey. Pew documents large partisan differences in support for the death penalty, with 77 percent of Republicans versus 46 percent of Democrats in favor. 

The partisan gap in attitudes towards the death penalty explains why executions are much more likely to occur in red states than blue states. Of the 22 prisoners executed by the states in 2019, Texas executed 9 (41 percent), according to the Bureau of Justice Statistics (BJS). Alabama, Georgia, and Tennessee each executed three prisoners, Florida executed two, and Missouri and South Dakota each executed one. 

Overall, 2,570 prisoners were under sentence of death in the United States at the end of 2019. Nearly all (98 percent) are men. The 56 percent majority are white, 41 percent Black, and 15 percent Hispanic (who may be of any race). Their median age is 51 and median level of education is 12th grade. Most have never been married. They have been on death row for an average of 18.7 years. 

In a preview of 2020 capital punishment statistics included in the 2019 report, the BJS notes a decline in executions to 17. "Sixteen of the executions in 2020 were by lethal injection," says BJS, "while 1 (in Tennessee) was by electrocution. Ten of those executed were white, 5 were black, 1 was Hispanic, and 1 was American Indian. No females were executed during this period."

Source: Bureau of Justice Statistics, Capital Punishment, 2019—Statistical Tables

Blacks Are More than Twice as Likely as Whites to Know Someone Who Died from Covid-19

Twenty-two percent of all Americans know someone who died from Covid-19, according to PRRI's 2020 American Values Survey. Blacks are more than twice as likely as non-Hispanic whites to know someone who died...

Percent who know someone who died from Covid-19

38% of Blacks

29% of Hispanics

16% of non-Hispanic whites

Source: PRRI, 2020 American Values Survey

Death Rate Much Lower for Married People

Married people have strikingly lower death rate than the never-married, divorced, or widowed, according to a report by the National Center for Health Statistics. Take a look at the number of deaths per 100,000 population in 2017 by marital status...

Age-adjusted death rate by marital status in 2017
   779.6 for the married
1,368.8 for the divorced
1,443.6 for the never married
1,656.9 for the widowed

The age-adjusted death rate of married people was 43 percent lower than the death rate of the divorced in 2017. It was 46 percent lower than the death rate of the never married, and 53 percent lower than the death rate of the widowed.

One factor that leads to the lower death rate for the married is self-selection, with healthier people more likely than the less healthy to be married. Another factor is the benefit of living with someone who has your back, urging you to go to doctor appointments, take your pills, and eat right. A third factor leading to higher death rates for the single, divorced, widowed, is the stress surrounding the single life, marital breakups, and the death of a spouse.

Source: National Center for Health Statistics, Mortality among Adults Aged 25 and over by Marital Status: United States, 2010–2017

Profiles of Violent Death

There were 65,000 violent deaths in the United States in 2016, according to the CDC. The 62 percent majority were suicides, followed by homicides (25 percent), deaths of undetermined intent (11 percent),  legal intervention (1 percent), and unintentional firearm deaths (fewer than 1 percent). The legal intervention category is defined as "deaths caused by law enforcement and other persons with legal authority to use deadly force in the line of duty, excluding legal executions."

The CDC analyzed the circumstances surrounding the violent deaths that occurred in 32 states in 2016. In those states, there were 23,630 suicides, 10,336 homicides, 515 legal interventions, and 295 unintentional firearm deaths. The CDC examined the demographics of the victims  (age, sex, race), the method of death (firearm, sharp instrument, drowning, etc.), the location of death (house/apartment, street, etc.), and precipitating circumstances (depression, intimate partner problem, job problem, crime in progress, and so on).

Looking at the most likely scenario for each type of violent death, here are their profiles...

Suicide: A non-Hispanic White (83 percent) man (77 percent) aged 35 to 64 (52 percent) shot (49 percent) or hung (28 percent) himself in his house/apartment (74 percent) because he was depressed (74 percent). He did not leave a suicide note (66 percent), nor did he disclose to others his suicide intent (76.5 percent).

Homicide: A Black (56 percent) man (79 percent) aged 20 to 34 (46 percent) was shot (74 percent) in his house/apartment (47 percent) by an acquaintance/friend (27 percent) during an argument (32 percent).

Legal intervention death: A non-Hispanic White (50 percent) man (96 percent) aged 25 to 44 (59 percent) was shot (96 percent) in a house/apartment (38 percent) or on the street (28 percent). He had a drug problem (26 percent) or mental illness (21 percent). He had a weapon (73 percent).

Unintentional firearm death: A non-Hispanic White (59 percent) man (86 percent) aged 15 to 24 (35 percent) was in his house/apartment (74 percent), playing (35 percent) with a handgun (63 percent) when he unintentionally pulled the trigger (23.5 percent).

Source: CDC, Surveillance for Violent Deaths—National Violent Death Reporting System, 32 States, 2016

States with the Highest Death Rates

Your chances of dying are much higher in some states than in others, according to a National Center for Health Statistics' report analyzing the five states with the highest and lowest death rates in 2017.

Highest death rates: Alabama, Kentucky, Mississippi, Oklahoma, and West Virginia
Lowest death rates: California, Connecticut, Hawaii, Minnesota, and New York

The difference is not trivial. The annual number of deaths per 100,000 age-adjusted population is 926.8 in the five states with the highest death rate (the High Five) compared with 624.0 deaths per 100,000 age-adjusted population in the five states with the lowest rate (the Low Five). So, the death rate in the High Five is an astounding 49 percent higher than the death rate in the Low Five. These differences "persist when stratifying by gender, age, and race and Hispanic origin," according to the NCHS analysis.

The death rate in the High Five exceeds the death rate in the Low Five in every age group. The biggest difference occurs in the 25-to-34 and 35-to-44 age groups, where the death rate in the High Five is more than double the death rate in the Low Five.

The death rate in the High Five exceeds the death rate in the Low Five for both non-Hispanic Blacks (32 percent higher) and non-Hispanic Whites (39 percent higher). Hispanics are the only exception. The Hispanic death rate in the High Five is 27 percent lower than the Hispanic death rate in the Low Five.

The High Five has a higher death rate than the Low Five for each of the top five causes of death. The heart disease death rate is 46 percent higher, cancer 29 percent, chronic lower respiratory disease 100 percent, unintentional injuries 83 percent, and stroke 39 percent.

Source: National Center for Health Statistics, Mortality Patterns between Five States with Highest Death Rates and Five States with Lowest Death Rates: United States, 2017

The Hispanic Paradox Grows

Hispanics have lower death rates and a longer life expectancy than non-Hispanic Whites. This is true despite the fact that Hispanics are poorer than non-Hispanic Whites and less likely to have health insurance. Their mortality advantage is known as the "Hispanic paradox" because demographers cannot explain it.

The Hispanic paradox is growing, according to a National Center for Health Statistics' analysis of trends in mortality rates. For Hispanics aged 25 or older in 2017, the age-adjusted death rate per 100,000 population was 31 percent lower than the rate for non-Hispanic Whites. In 2000, the Hispanic death rate was only 23 percent lower than the non-Hispanic White rate.

Death rate per 100,000 population aged 25 or older, 2017 (and 2000)
Hispanics: 784.4 (995.1)
Non-Hispanic Whites: 1,137.4 (1,288.1)

Between 2000 and 2017, the age-adjusted death rate for Hispanics aged 25 or older fell 21 percent. The non-Hispanic White death rate fell by only 12 percent. "The mortality advantage for Hispanic adults has endured through 2017," concludes the NCHS report, "and has been increasing with respect to non-Hispanic white adults."

Source: National Center for Health Statistics, Mortality Trends by Race and Ethnicity among Adults Aged 25 and Over: United States, 2000–2017

The Age When We Lose Our Parents

"The loss of one or both parents can profoundly affect a person's life," say Census Bureau researchers Zachary Scherer and Rose M. Kreider in an analysis of the age at which people lose their parents. Parents provide financial, emotional, and practical support to their children throughout life, note Scherer and Kreider. Consequently, the age at which one loses a parent can affect quality of life and standard of living.

Little has been known about the age at which Americans experience the loss of their parents—until now. The 2014 Survey of Income and Program Participation asked respondents whether their parents were still alive. Scherer and Kreider analyzed the data and found that the loss of one or more parents becomes the norm in the 45-to-54 age group...

Percent with one or more deceased parents
Total, 18-plus: 42.2%
Under age 18: 2.8%
Aged 18 to 24: 7.7%
Aged 25 to 34: 16.4%
Aged 35 to 44: 33.9%
Aged 45 to 54: 63.0%
Aged 55 to 64: 88.4%
Aged 65-plus: 99.1%

People lose their father before their mother, according to the analysis. Most 45-to-54-year-olds have lost Dad, while only one-third of the age group has lost Mom. Among 55-to-64-year-olds, the 54 percent majority has lost both parents. Among people aged 65 or older, a nearly universal 91 percent has lost both parents.

The age at which people lose a parent differs by socioeconomic factors. The higher the income and education, the smaller the percentage who have lost a parent in every age group until 65-plus, when nearly everyone has experienced the loss. By race and Hispanic origin, Blacks experience the loss of a parent at an earlier age than other race and Hispanic origin groups. Among 25-to-34-year-olds, for example, one in four Blacks has experienced the death of a parent. The figure is 15 percent among non-Hispanic Whites and Asians and 17 percent among Hispanics.

Because parents potentially provide their children with financial, emotional, and practical support throughout life, the earlier loss of parents may lower their children's standard of living. "Ostensibly, individuals with lower income, lower educational attainment, and those from communities that experience lower life expectancy would benefit most from parental support. However, our findings indicate that these same groups are the ones that experience parental loss earlier in life," the researchers conclude.

Source: Census Bureau, The Link Between Socioeconomic Factors and Parental Mortality

Dementia: the 3rd Leading Cause of Death?

Dementia is a major cause of death. We know that. The government's mortality reports show Alzheimer's disease to be the 6th leading cause of death in the United States. In 2017, Alzheimer's disease killed 121,000 Americans.

But Alzheimer's disease accounts for only a portion of dementia deaths. A much larger 262,000 people died of dementia in 2017, according to a report by the National Center for Health Statistics. If all types of dementias were considered a single cause of death (as they are in some countries), then dementia would be the third leading cause of death in the United States, following heart disease and cancer.

The NCHS report provides a detailed look at dementia deaths by type. Alzheimer's disease is most common, accounting for 46 percent of dementia deaths in 2017. Vascular dementia deaths are another 6 percent, and other types or unspecified dementias account for the rest. Regardless of the type, all dementias have one thing in common—they are debilitating for the individual and devastating for the family. One table in the report reveals the debilitation and devastation: place of death. Most dementia deaths occur in a nursing home, long-term care facility, or hospice. In other words, most patients and families are unable to deal with the consequences of dementia on their own or at home. Among all deaths in the U.S., just 27 percent occur in a nursing home, long-term care facility, or hospice. Among dementia deaths, the figure is 60 percent.

Source: National Center for Health Statistics, Mortality Data, Dementia Mortality in the United States, 2000–2017

Home Is the Most Likely Place of Death

For the first time in a long time, home is the most likely place of death. Among people who died in 2016, the 30.5 percent plurality died at home—slightly larger than the 29.4 percent who died in a hospital...

Place of death, all ages, 2016
30.5% died at home
29.4% died in a hospital
19.3% died in a nursing home or long-term care facility
7.7% died in a hospice facility
13.1% died in all other places, including dead on arrival at hospitals

Among people under age 65 who died in 2016, the percentages who died at home or in a hospital were identical, at 33.4 percent. Not so for decedents aged 65 or older....

Place of death, aged 65-plus, 2016
29.4% died at home
27.9% died in a hospital
24.7% died in a nursing home or long-term care facility
8.5% died in a hospice facility
9.5% died in all other places, including dead on arrival at hospitals

Ten years earlier in 2006, the home ranked third as a place of death for people aged 65 or older. Only 23.5 percent died at home, 28.2 percent in a nursing home/long-term care facility, and 35.9 percent in a hospital.

Source: National Center for Health Statistics, Health, United States, 2017 

Is Your Father Still Alive?

Many Americans celebrated Father's Day yesterday by remembering their father rather than spending time with him. Only 45 percent of adults still have Dad in their life, and the 55 percent majority do not. The percentage of adults whose father is no longer alive becomes the majority in the 45-to-54 age group...

Father is no longer alive
Total 18-plus:   54.8%
Aged 18 to 29:   7.3%
Aged 30 to 44: 32.7%
Aged 45 to 54: 64.2%
Aged 55 to 64: 89.0%
Aged 65-plus:  99.1%

Note: Click here for how many have living mothers.
Source: Demo Memo analysis of the General Social Survey

CDC Investigates Rise in Suicides

The CDC's report on the rising number of suicides in the United States was released on June 8,  just days after Kate Spade committed suicide and the same day Anthony Bourdain took his own life. The government's in-depth analysis of suicide's potential causal factors sheds light on just how difficult it will be to stem the rising tide.

In 2016, nearly 45,000 Americans killed themselves, making suicide the 10th leading cause of death. The annual number of suicides has grown by almost 30 percent since 1999, the CDC reports. The suicide rate has increased in every age group under age 75 and has grown in most states. Confronted with these facts, this timely CDC report examines 2015 data from the National Violent Death Reporting System, in which 27 states participated. Information from friends and family, reported to law enforcement at the time of death, are part of the database. The findings are not encouraging...

• Among those who committed suicide in the 27 reporting states, the 54 percent majority did not have a known mental health condition. 
• Among those without a mental health condition, only 22.4 percent had disclosed their intention to commit suicide. Even among those with a known mental health condition, only 23.5 percent had disclosed their intention to commit suicide. 
• Only 28 percent of those who committed suicide had problematic substance abuse problems—a possible indicator of suicide risk.
• Among suicide victims with known mental health problems, more than half were in treatment at the time of death.

What can be done to save lives? In an attempt to answer that question, the CDC examined the problems of suicide victims, with information provided by friends and family about troubles in the victim's life. The most commonly reported issues were intimate partner problems (27 percent), physical health problems (22 percent), school problems (20 percent), and job/financial problems (16 percent). These troubles are not unique to suicide victims, of course, which is why one of the CDC's recommendations is the suggestion that we teach better "coping and problem-solving skills to manage everyday stressors and prevent future relationship problems, especially early in life."

Most of the family and friends of suicide victims may never know why their loved one chose to take his or her own life. Only one-third of suicide victims leave a note, the CDC reports.

Source: CDC, Vital Signs: Trends in State Suicide Rates—United States, 1999–2016 and Circumstances Contributing to Suicide—27 States, 2015

Big Increase in Death by Falling

Older Americans are increasingly likely to die from a fall, the CDC reports. The annual number of people aged 65 or older who die because of falling climbed from 18,000 in 2007 to 30,000 in 2016. Even more telling, the death rate from falls grew steeply during those years—from 47 deaths per 100,000 people aged 65 or older in 2007 to 62 deaths per 100,000 in 2016, a 31 percent increase. The rise in the death rate from falls among older Americans is not a new phenomenon, according to the CDC. Between 2000 and 2006, the rate climbed 42 percent.

Why is falling a growing problem for older Americans? The increase in the 85-plus population may be one factor, says the CDC, since the death rate from falls is highest in the oldest age group. But even among the oldest old, the death rate from falls has surged—up 41 percent between 2007 and 2016. How to explain this? "Nationally, the rate of deaths from falls might be increasing because of longer survival after the onset of common diseases such as heart disease, cancer, and stroke," the CDC speculates.

One possible factor behind the increase, not mentioned in the CDC report, is obesity. Older Americans are increasingly likely to be obese, and the obese may find it more difficult to maintain their balance as they age. Among men aged 75 or older, the prevalence of obesity grew from 18 to 27 percent between 1999–2002 and 2011–14, according to the National Center for Health Statistics. Among their female counterparts, obesity increased from 24 to 31 percent.

If the death rate from falls cannot be reduced, the CDC warns, many more older people will die from falls in the years ahead. "If the current rate remains stable," it reports, "an estimated 43,000 U.S. residents aged ≥ 65 years will die because of a fall in 2030, and if the rate continues to increase, 59,000 fall-related deaths could result."

Source: CDC, Deaths from Fall among Persons Aged ≥ 65 Years—United States, 2007–2016

Cold Is A Bigger Killer

Among weather-related deaths, cold is a bigger killer than heat, flood, storm, or lightning, according to an analysis by the CDC. In the 2006–2010 time period, cold-weather deaths accounted for 62 percent of the 10,649 weather-related deaths in the United States.

During the time period under analysis, the cold-related death rate was 4.2 deaths per million population, the CDC reports. The rate was below average among people under age 45. It was slightly above average among those aged 45 to 74. The death rate climbs steeply in the 75-plus age groups. The rate was nearly four times the average among people aged 75 to 84 (15.5) and more than nine times the average among those aged 85 or older (39.6).

Source: National Center for Health Statistics, National Health Statistics Reports, Deaths Attributed to Heat, Cold, and Other Weather Events in the United States, 2006–2010

Why Do the Educated Live Longer?

The better educated you are, the longer you are likely to live. What are the reasons for the educational disparity in mortality? A study published in the journal Demographic Research investigated the contribution of one factor: the greater prevalence of obesity among the less educated.

Previous studies have shown obesity to have little effect on differences in life expectancy by educational attainment, but researcher Yana C. Vierboom takes issue with those studies because their measure of obesity is body mass index (BMI) at the time of the survey. This introduces bias into the results, says Vierboom, "given that less educated people are more likely to contract illnesses that induce weight loss." Instead, lifetime maximum BMI is a better measure of obesity.

Using lifetime maximum BMI, Vierboom finds obesity to be an important contributor to the educational disparity in mortality. "Differences in maximum BMI were associated with between 10.3% and 12% of mortality differences between college graduates and all others," she says. Among nonsmokers, between 18.4% and 27.6% of mortality differences between college graduates and all others were associated with differences in maximum BMI."

Source: Demographic Research, The Contribution of Differences in Adiposity to Educational Disparities in Mortality in the United States

Nearly 1/3 of Accidental Deaths are Poisonings

More than 146,000 Americans died from "accidents (unintentional injuries)" in 2015, according to the National Center for Health Statistics, making it the 4th leading cause of death in the United States. Nearly one-third of accidental deaths are due to unintentional poisoning—mostly drug overdoses. Unintentional poisoning has been the leading mechanism of accidental death since 2011, reports NCHS.

Number (and percent distribution) of accidental deaths by mechanism in 2015
Total accidental deaths: 146,571
Deaths from poisoning: 47,478 (32%)
Deaths from motor vehicles: 36,161 (25%)
Deaths from falls: 33,381 (23%)
Deaths due to other mechanisms: 29,551 (20%)

If unintentional poisoning were a separate cause of death, it would rank 10th among the leading causes of death in the United States.

Source: National Center for Health Statistics, Deaths: Final Data for 2015

Dying Slowly from Serious Health Conditions

Dying has changed. It has become a slow process rather than a sudden event, according to the Kaiser Family Foundation. "Due to medical advances and the ability to manage chronic conditions in older adults, more people are living longer and, rather than dying from acute episodes of illness, they are dying after long periods of sickness and declining health," says Kaiser. After surveying a nationally representative sample of adults aged 18 or older, Kaiser finds most Americans (74 percent) are aware of this fact.

What are the primary conditions that cause this slow death? The Kaiser survey probed a large subset of its survey sample—respondents aged 65 or older who are experiencing a serious illness that has resulted in functional limitations or who have been diagnosed with specific conditions such as diabetes, lung disease, heart disease, cancer, or dementia. Also included in this subset were family members whose loved ones aged 65 or older are (or were) experiencing serious illness (prior to their death). For the seriously ill, these were the most commonly diagnosed conditions (many had more than one)...

52% had dementia
47% had heart problems/stroke
35% had diabetes
28% had mental health problems (anxiety, depression)
26% had lung problems (asthma, emphysema, COPD)
24% had cancer
14% had chronic kidney disease or kidney failure

The prolonged process of dying places great demands on the health care system. Most Americans think the system comes up short. The 52 percent majority of the public says the health care provided to older people with serious health conditions is only fair or poor. To track the evolution of attitudes and policies to cope with serious illness in late life, Kaiser plans more surveys in the future.

Source: Kaiser Family Foundation, Serious Illness in Late Life: The Public's Views and Experience

Analyzing 10,000 Murders

Homicide is one of the leading causes of death for women under age 45, reports the CDC. What are the characteristics of women who become homicide victims? To find out, the CDC analyzed 10,018 murders of women aged 18 or older occurring from 2003 to 2014 and reported to the National Violent Death Reporting System, which includes data from 18 states. These are some of their characteristics...

Age of homicide victim
18 to 29: 29%
30 to 39: 22%
40 to 49: 21%
50-plus: 28%

Marital status of homicide victim
Married/partner: 32%
Never married: 38%
Separated/divorced: 30%

Education of homicide victim
Less than high school: 25%
High school graduate: 41%
Some college or more: 34%

Women who die by homicide are young and old, from all educational backgrounds, and about evenly split by marital status. What they have in common is that most were murdered by a current or former intimate partner (55 percent) and most were killed by guns (54 percent).

Source: CDC, Racial and Ethnic Differences in Homicides of Adult Women and the Role of Intimate Partner Violence—United States, 2003–2014