Connect with us

Company

‘Deaths of despair’ during COVID-19 rose by up to 60% in 2020, new research says

Published

on


Deaths of despair have risen during the coronavirus pandemic, and latest research suggests the increase has been dramatic.

The pandemic and recession were associated with a 10% to 60% increase in deaths of despair above already high pre-pandemic levels, according to a working paper by Casey Mulligan, professor of economics at the University of Chicago. These non-COVID excess deaths are disproportionately experienced by men aged 15-55, including men aged 15-25, he found.

“From March onward, excess deaths are approximately 250,000 of which about 17,000 appear to be a COVID under-count and 30,000 non-COVID. Deaths of despair — drug overdose, suicide, alcohol — in 2017 and 2018 are good predictors of the demographic groups with NCEDs in 2020,” Mulligan wrote in his paper, distributed Monday by the National Bureau of Economic Research.


‘Mortality in 2020 significantly exceeds what would have occurred if official COVID deaths were combined with a normal number of deaths from other causes.’


— Casey Mulligan, professor of economics at the University of Chicago

“Mortality in 2020 significantly exceeds what would have occurred if official COVID deaths were combined with a normal number of deaths from other causes. The demographic and time patterns of the non-COVID excess deaths (NCEDs) point to deaths of despair rather than an under-count of COVID deaths.” They increased steadily from March to June and then plateaued.

They were disproportionately experienced by working aged men, including men as young as aged 15 to 24. “Presumably social isolation is part of the mechanism that turns a pandemic into a wave of deaths of despair,” Mulligan said. However, he did not speculate on how much, if any, comes from government stay-at-home or business closures to encourage social distancing.

Others advise caution on such estimates. “We do not actually know that these deaths are increasing during the COVID-19 pandemic,” according to Megan Ranney, an emergency physician and associate professor of emergency medicine and public health at Brown University, and Jessica Gold, a psychiatrist and assistant professor of psychiatry at Washington University in St. Louis.

In an op-ed for the health site Stat, they said, “Police and crisis hot lines may — or may not — be receiving extra calls for domestic violence and child abuse. Firearm homicide rates are staying steady. Suicides are certainly occurring, but there is no evidence to date that their rate is on the rise (and we may not know the impact of the pandemic on suicide for years to come).”

“Despite ample evidence that anxiety is increasing during the pandemic, anxiety alone is rarely a driver for suicide. It is not even a risk factor for it,” Ranney and Gold added. “Right now it is all too easy to blame every tragedy on COVID-19. Science warns us, however, not to make this fundamental error of attribution.”

People are, of course, suffering economically. At the height of the pandemic in March, more than 30 million Americans were laid off or furloughed when the economy shut down to curb the spread of COVID-19. The unemployment rate at that point was 14.7%; it has since come down to 6.7%. The leisure and hospitality industries have been particularly hit hard by the pandemic.

In April, nearly 12 million low-wage workers were laid off, while some 6 million workers who were earning between $18 to $29 an hour were laid off. By November, all but 400,000 of those workers earning $18 to $29 an hour had returned to work, Raj Chetty, a Harvard economics professor, said. Meanwhile, some 6 million workers who earned less than $13 an hour have yet to return to work.

As of Monday, COVID-19 has infected over 85.2 million people worldwide, which mostly does not account for asymptomatic cases, and killed 1.8 million, including 351,590 in the U.S. The U.S. has the world’s highest number of COVID-19 cases (20.6 million), followed by India (10.3 million), Brazil (7.7 million) and Russia (3.2 million), according to data aggregated by Johns Hopkins University.

Mulligan measured actual deaths from a Centers for Disease Control and Prevention file for 2020 that begins on Jan. 26, and ended his calculations through week 40 — the week ending Oct. 3. COVID-19 deaths and actual total deaths are reported in this file. He defined excess deaths as the difference between actual total deaths and projected deaths, based on previous years.

“The CDC reports 12-month moving sums of deaths from drug overdose,” Mulligan wrote. During the nine months before the pandemic, each new moving figure of none-COVID excess deaths (or NCEDs) averaged 680 deaths more than the previous. In March 2020, however, they totaled 1,511 above the previous total.

“The same CDC data through May 2020 show that synthetic opioids such as fentanyl are driving the increases. Given that men have a larger share of fentanyl-overdose deaths than prescription-opioid-overdose deaths, this suggests that men would be disproportionately represented among 2020 NCEDs,” he concluded.

Some health professionals have warned of a rise in the epidemic of “deaths of despair” in the U.S. In fact, approximately 75,000 more people will likely die from drug or alcohol misuse and suicide as a result, according to predictions released last March by Well Being Trust and the Robert Graham Center for Policy Studies in Family Medicine and Primary Care.


‘A complex constellation of risk factors, only a few of which are directly tied to COVID-19, are known to drive these tragic deaths.’


— Megan Ranney, an emergency physician, and Jessica Gold, a psychiatrist, writing in Stat

Projections of additional “deaths of despair” range from 27,644, assuming a quick economic recovery and the smallest impact from unemployment, to 154,037, assuming a slow recovery and the greatest impact from unemployment. “We can prevent these deaths by taking meaningful and comprehensive action as a nation,” the researchers wrote in the report.

“More Americans could lose their lives to deaths of despair, deaths due to drug, alcohol, and suicide, if we do not do something immediately,” the report said. “Deaths of despair have been on the rise for the last decade, and in the context of COVID-19, deaths of despair should be seen as the epidemic within the pandemic.”

However, Ranney and Gold said those results should be taken with some serious caveats. “These projections are based on data from the Great Recession, meaning the models weren’t able to factor in the unique aspects of what is happening today, such as how new technologies make possible increased virtual social connection and support,” they added.

“A complex constellation of risk factors, only a few of which are directly tied to COVID-19, are known to drive these tragic deaths,” they wrote. “We have evidence-based interventions that can reduce the rates of many of the risk factors for all of these deaths whether or not the country is practicing social distancing, hand-washing, and mask wearing.”


Source: Well Being Trust and the Robert Graham Center for Policy Studies in Family Medicine and Primary Care.

President Donald Trump has repeatedly warned that efforts to stem the rapid spread of COVID-19, the disease caused by severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2, are spiraling the economy into another Great Recession; the impact has sent the Dow Jones Industrial Average
DJIA,
-0.35%

 ricocheting wildly in recent months.

The federal government must fully support and invest in a plan to improve mental-health care, said Benjamin Miller, chief strategy officer at the Well Being Trust. “If we work to put in place healthy community conditions, good health-care coverage, and inclusive policies, we can improve mental health and well-being,” he added.

The Well Being Trust is a national foundation dedicated to advancing the mental, social, and spiritual health of the nation. The Robert Graham Center for Policy Studies in Family Medicine and Primary Care is an independent research unit affiliated with the American Academy of Family Physicians, and works to improve individual and population health by enhancing the delivery of primary care.

Trump has vacillated between heeding the advice of public-health experts and bending to the views of his favored economists.


MarketWatch photo illustration/Getty Images

Don’t miss: New estimates on coronavirus fatalities make for chilling reading as U.S. states ease restrictions on social distancing

Anne Case and Angus Deaton, economists at Princeton University, first chronicled these “deaths of despair” among middle-aged non-Hispanic caucasians since 1999. They include deaths by suicide, alcohol poisoning, overdoses of opioids and other drugs, and cirrhosis of the liver. The CDC estimates they’ve almost doubled since 1999, reaching 150,000 in 2017.

”SARS CoV-2 is having an unprecedented impact on the world. No one alive can recall any infection or worldwide event of such magnitude and scale,” the new report added. “Along with the tens of thousands of deaths in the United States from the virus, COVID-19 overlays the growing epidemic of deaths of despair threatening to make an already significant problem even worse.”

The researchers issued a warning for the months and even years ahead, arguing for additional investment in health care and strategies to deal with the phenomenon. “A preventable surge of avoidable deaths from drugs, alcohol, and suicide is ahead of us if the country does not begin to invest in solutions that can help heal the nation’s isolation, pain, and suffering,” they wrote.

The debate over the ramifications of a months-long shutdown of the American economy has been at times both emotional and sobering. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases for more than three decades and one of the leading experts in the U.S. on infectious diseases, has pleaded with people to “socially distance.”

The debate over the economy’s survival vs. the public health emergency highlights, as well, the chasm between left and right on the American political spectrum. The left generally believes that strong social structures beget a stronger economy for all. The right traditionally follows the idea that a strong economic system begets strong social structures for all.

Ranney and Gold argue that drawing a line between deaths of despair and political policies to reduce social distancing is a crude one. “It is also wrong to imply that reopening the country will, in and of itself, stop deaths of despair. Jobs may or may not rebound when social distancing rules are relaxed. Much of the decline in travel and eating in restaurants predated formal rules about social distancing.”


Source: Well Being Trust and the Robert Graham Center for Policy Studies in Family Medicine and Primary Care.



Source link

Continue Reading
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

Company

‘I could live on my Social Security and still save money’: This 66-year-old left Chicago for ‘calming’ Costa Rica — where he now plans to live indefinitely

Published

on

By


Editor’s note: This article was first published in September 2019.

A school break changed 66-year-old Martin Farber’s life forever.

In 2007, his daughter — who at the time was attending Illinois State University — decided she wanted to spend a college holiday volunteering in Costa Rica and staying with a local family, he explains. She came home raving about the experience, so, in 2008, Farber — who at the time was living in Evanston, Ill., just outside Chicago, and selling cars — took his first trip there.

“It was a big surprise to me — bumpy roads, dogs barking in the streets,” he says. “I wasn’t enamored at first.”

But as his daughter began traveling there more and eventually moved there for a year, he took additional trips to Costa Rica. It quickly grew on him — in particular, the people. “The Costa Rican people are warm, open and friendly. I felt less invisible in a strange country in a strange town where I didn’t speak the language than I did in Evanston.”

And the more time he spent there, the more it impacted him: “On one of my trips there, I thought: My daughter’s life makes more sense than mine,” he says. “There was nothing wrong with my life, but I felt that my life was out of context with who I’d become. … I would have bills and make money to pay them, but that had ceased to be satisfying,” he recalls. “I knew I needed to change my life — there was no more joy in what I was doing.”

What’s more, when he’d return from his Costa Rica trips, people noticed. “I would come back, and my friends and therapist would say: You seem better after you go,” he says with a laugh.

A view from the hot springs near Martin Farber’s home in Costa Rica.


Martin Farber

So in 2014, he packed up and moved to Orosi — a picturesque, lush small town with waterfalls and hot springs a little over an hour’s drive from San Jose — promising himself he’d stay for two years. It’s been five, and he now plans to stay in Costa Rica indefinitely. (Though Farber notes that, to him, “it’s not a retirement; it’s a chance to lead a new and different life.”)

Here’s what his life is like, from costs to health care to residency to everyday life:

The cost: While many expats spend way more living in Costa Rica, Farber says: “I could live on my Social Security and still save money.” He says “a person can live on $1,200 per month, two people on $2,000.” The key, he says, is to live more like he does and as the Costa Ricans do — in a modest home, eating local food and purchasing local goods.

Indeed, Farber himself spends just $300 a month for rent (he rents a home from a friend who moved recently and gave him a good deal), roughly $225 a month on groceries and just $50 a month total on water and electricity (the temperate climate in Orosi means you rarely need heat or air conditioning). The veteran Volkswagen
VOW,
+0.96%

 
VLKAF,
+0.98%

salesman saves money by not owning a car (those over 65 ride municipal buses for free), which can be a significant expense in Costa Rica; for his cellphone, “I pay as I go … roughly $10 may last me a couple weeks or more,” he says, adding that “many people handle there their cellphones this way. You can get them recharged anywhere.”

His major expense is travel: He goes back to the U.S. to visit his mother in Florida several times a year and lately has spent part of the summer in Chicago helping out a friend with a dealership there. He also spends a good amount of money on health care. He says that while flights can be had for as little as $350 roundtrip during offseasons, the cost can be much higher the rest of the year.

In the saddle.


Martin Farber

Health care: Farber, who has permanent resident status in Costa Rica, says he pays about $90 per month to participate in the country’s health-care system — adding that the health care he’s received has been very good. (A 2018 study of health-care quality and access in more than 190 nations ranked Costa Rica No. 62.)

When he developed a detached retina, though, he paid for the procedure out of pocket so that he didn’t have to wait for the required surgery, he says — adding that the entire procedure cost him about $5,000. “I would have had to have waited four days,” he says, if he had not paid to expedite matters. “That might have been fine, but it might not.” And he adds that the quality of care depends on where you get it in the country.

Lifestyle: Though Farber says that he “moved here with no goals and no agenda,” he’s found plenty to do. “I take Spanish lessons two days a week for two hours a day. It’s been great. I never thought I would acquire a usable language in my 60s,” he says. He also rides his bike all around the area, does some writing and belongs to a community group that undertakes projects to improve the area.

And he often simply takes in nature, which he says has been an essential part of why he feels calmer and more relaxed in Costa Rica than in the U.S. “I live at 3,000 feet but in a valley surrounded by coffee fields and lime trees and water. At night, if I open the windows, I can hear the river rushing by,” he says. “It is very calming … hundreds of trees everywhere … you know the Earth is alive.”

The historic Iglesia de San José de Orosi.


iStock

Cons: “I don’t want to overglorify. It’s not without its problems,” Farber says of Costa Rica. “There are social problems and downsides.” He notes that crime and petty theft can be a problem (“I am cautious,” he says of his approach) and seem to have increased since he moved there, and adds that he misses out on some cultural things because of where he lives. And, he says with a laugh, “I can’t order Thai food at 9 at night.” But, he adds: “These are trade-offs — in the afternoon, I get to walk in the coffee fields and see flocks of parrots.”

Residency: To qualify for Costa Rica’s pensionado visa, expats must prove that they have a pension of at least $1,000 coming in each month. (Here are the details of that program.) Once you have lived in Costa Rica for three years, you can apply for permanent residency. Farber used a lawyer to help him figure out the ins and outs of residency options; his entire path to permanent residency took about a year, he says.

The bottom line: “After five years I am still amazed and surprised that I made the decision to lead a life I never thought I would,” he says. And while he may not stay in Orosi forever — “the town doesn’t have an ambulance, [and] I don’t know what it will be like to be 80 there,” he says — he does plan to stay in Costa Rica in no small part because of the people and sense of community. “I have the feeling that life is good here,” he says. “It’s hard sometimes, but we are all in it together.”



Source link

Continue Reading

Company

Mutual Funds Weekly: These money and investing tips can help you read the market’s signs and stay on your path

Published

on

By



These money and investing stories were popular with MarketWatch readers over the past week.





Source link

Continue Reading

Company

Mutual Funds Weekly: These money and investing tips can help you read the market’s signs and stay on your path

Published

on

By



These money and investing stories were popular with MarketWatch readers over the past week.





Source link

Continue Reading

Trending