Americans excess death data caused by lack of access to health care

Excess death gap widens between US and Europe
By Patrick Heuveline published in Plos One- Abstract follows article:

US has an increasingly high proportion of excess deaths compared to five European countries.

A new health status analysis shows that, compared to similarly high-income European countries, the US continues to have substantially higher death rates at all but the oldest ages, resulting in more “excess deaths,” and this gap widened during the Covid-19 pandemic. Patrick Heuveline, of the University of California, Los Angeles (UCLA), presents these findings in the open-access journal PLOS ONE on March 29, 2023.

Calculating excess death rates can be useful for comparing mortality between different countries or sub-populations, as well as before and after the onset of a health crisis. 

Prior research has documented a substantial widening of the mortality gap between the US and five high-income European countries between 2000, and 2017. Mounting evidence suggests that, compared to those countries, the US has experienced even higher Covid-19 mortality during the pandemic.

Building on those earlier studies, Heuveline calculated excess death rates in the US relative to the same five countries—England & Wales, France, Germany, Italy, and Spain—for 2017 through 2021. The calculations account for different population sizes between the countries.

Heuveline found that the number of excess deaths between the US and the five European countries did indeed increase between 2017 and 2021, and that Covid-19 mortality contributed to this increase. Between 2019 and 2021, the annual number of excess deaths in the US nearly doubled, however, 45 percent of this rise was due to causes other than Covid-19. In 2021, 25 percent of all excess deaths in the US were attributed to Covid-19, representing 223,266 deaths out of 892,491 total excess deaths from any cause.

Further research will be needed to identify specific underlying reasons for how, exactly, the Covid-19 pandemic helped to drive the widening excess deaths gap between the US and Europe. For instance, Heuveline suggests, such research could explore differences in vaccination rates or social conditions that place a disproportionate impact on minority populations.

Heuveline adds: “The mortality gap widened during the pandemic, but not just due to the US handling of the crisis mortality from Covid-19. The chronic toll of excess deaths due to causes other than Covid-19 continued to increase as well, further demonstrating the US health policy failure to integrate the social, psychological and economic dimensions of health, from a weak social security net and lack of health care access for all to poor health behaviors.”

Abstract:  The mortality gap between the United States and other high-income nations substantially expanded during the first two decades of the 21st century. International comparisons of Covid-19 mortality suggest this gap might have grown during the Covid-19 pandemic. Applying population-weighted average mortality rates of the five largest West European countries to the US population reveals that this mortality gap increased the number of US deaths by 34.8% in 2021, causing 892,491 “excess deaths” that year. Controlling for population size, the annual number of excess deaths has nearly doubled between 2019 and 2021 (+84.9%). Diverging trends in Covid-19 mortality contributed to this increase in excess deaths, especially towards the end of 2021 as US vaccination rates plateaued at lower levels than in European countries. In 2021, the number of excess deaths involving Covid-19 in the United States reached 223,266 deaths, representing 25.0% of all excess deaths that year. However, 45.5% of the population-standardized increase in excess deaths between 2019 and 2021 is due to other causes of deaths. While the contribution of Covid-19 to excess mortality might be transient, divergent trends in mortality from other causes persistently separates the United States from West European countries. Excess mortality is particularly high between ages 15 and 64. In 2021, nearly half of all US deaths in this age range are excess deaths (48.0%).

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