Years of life lost associated with COVID-19 deaths in the USA during the first 2 years of the pandemic.

BACKGROUND: Prior estimates of the years of life lost (YLLs) in the USA associated with coronavirus disease 2019 (COVID-19) were 1.2 million through 11 July 2020 and 3.9 million through 31 January 2021 (which roughly coincides with the first full year of the pandemic). The aim of this study is to update YLL estimates through the first 2 years of the pandemic. METHODS: We employed data regarding COVID-19 deaths through 5 February 2022 by jurisdiction, gender and age group. We used actuarial life expectancy tables by gender and age to estimate YLLs. RESULTS: We estimated roughly 9.7 million YLLs due to COVID-19 deaths. The number of YLLs per 10 000 capita was 297.5, with the highest rate in Mississippi (482.7) and the lowest in Vermont (61.4). There was substantial interstate variation in the timing of YLLs and differences in YLLs by gender. YLLs per death increased from 9.2 in the first year of the pandemic to 10.8 through the first 2 years. CONCLUSIONS: Our findings improve our understanding of how the mortality effects of COVID-19 have evolved. This insight can be valuable to public health officials as the disease moves to an endemic phase.

Behavioral Health Diagnoses and Health Care Use Before and During the COVID-19 Pandemic.

OBJECTIVE: Emerging evidence has suggested a population-wide worsening of psychiatric symptoms during the COVID-19 pandemic, particularly among individuals with preexisting mental health conditions. The authors investigated whether reported behavioral health problems are being identified and treated. METHODS: This observational cohort study retrospectively compared Medicaid data of patients from the first year of the pandemic (2020) in the United States (N=1,589,111 patients) with the corresponding data from the year before (2019; N=1,715,872 patients). Outcome measures included several behavioral health diagnoses and health care utilization. RESULTS: During the pandemic period examined, the numbers of patients served, adults receiving a new diagnosis of anxiety, and children receiving a new diagnosis of depression all increased. Across all age groups, nonbehavioral health emergency department visits significantly decreased. CONCLUSIONS: These findings support reports of increases in psychiatric morbidity but do not provide evidence for increased demand for health care services.

Who Volunteers? Results from a Regular Cognitive Monitoring Study

Previous research indicates volunteering promotes well-being of individuals and communities. Volunteering in later-life may buffer some of the negative health effects experienced during retirement, facilitating opportunities for older adults to engage in meaningful activities and stay active. The current study examined characteristics of older adults who volunteered outside of participation in a regular cognitive monitoring study. All 124 members (M= 76.87, SD= 7.47;80 volunteers, 44 non-volunteers) of a regular cognitive monitoring study, requiring completion of a 15-minute cognitive online test once a month, with complete data on personal characteristics, volunteer activities, as well as study adherence and dropout rates were included. ANCOVA and logistic regression analyses adjusted for sociodemographic characteristics were used to assess differences between volunteers and non-volunteers. Results indicated that volunteers were less educated (p<.05), and slightly more likely to be younger and women compared to non-volunteers. There were no differences in cognitive performance (ps>.05). Volunteers had lower scores for neuroticism (p=.02) and were marginally higher agreeable and extraverted (ps<.09). Volunteers needed more reminders to complete the monthly test (ps<.01) but had lower dropout rates (p=.001). The most frequent type of volunteer activity reported was religious. Volunteers were motivated mainly by altruism, although most reported multiple reasons such as building social relationships and feeling important. Findings provide information about characteristics that can help identify older adults who are likely to volunteer. Results regarding study adherence may have implications for promoting recruitment and retention among older adult volunteers.

Excess Mortality Associated With COVID-19 by Demographic Group: Evidence From Florida and Ohio.

OBJECTIVE: COVID-19 mortality varies across demographic groups at the national level, but little is known about potential differences in COVID-19 mortality across states. The objective of this study was to estimate the number of all-cause excess deaths associated with COVID-19 in Florida and Ohio overall and by sex, age, and race. METHODS: We calculated the number of weekly and cumulative excess deaths among adults aged ≥20 from March 15 through December 5, 2020, in Florida and Ohio as the observed number of deaths less the expected number of deaths, adjusted for population, secular trends, and seasonality. We based our estimates on death certificate data from the previous 10 years. RESULTS: The results were based on ratios of observed-to-expected deaths. The ratios were 1.17 (95% prediction interval, 1.14-1.21) in Florida and 1.15 (95% prediction interval, 1.11-1.19) in Ohio. Although the largest number of excess deaths occurred in the oldest age groups, in both states the ratios of observed-to-expected deaths were highest among adults aged 20-49 (1.21; 95% prediction interval, 1.11-1.32). The ratio of observed-to-expected deaths for the Black population was especially elevated in Florida. CONCLUSIONS: Although excess deaths were largely concentrated among older cohorts, the high ratios of observed-to-expected deaths among younger age groups indicate widespread effects of COVID-19. The high levels of observed-to-expected deaths among Black adults may reflect in part disparities in infection rates, preexisting conditions, and access to care. The finding of high excess deaths among Black adults deserves further attention.

Years of life lost associated with COVID-19 deaths in the USA during the first year of the pandemic.

BACKGROUND: Years of Life Lost (YLLs) measure the shortfall in life expectancy due to a medical condition and have been used in multiple contexts. Previously it was estimated that there were 1.2 million YLLs associated with coronavirus disease 2019 (COVID-19) deaths in the USA through 11 July 2020. The aim of this study is to update YLL estimates for the first full year of the pandemic. METHODS: We employed data regarding COVID-19 deaths in the USA through 31 January 2021 by jurisdiction, gender and age group. We used actuarial life expectancy tables by gender and age to estimate YLLs. RESULTS: We estimated roughly 3.9 million YLLs due to COVID-19 deaths, which correspond to roughly 9.2 YLLs per death. We observed a large range across states in YLLs per 10 000 capita, with New York City at 298 and Vermont at 12. Nationally, the YLLs per 10 000 capita were greater for males than females (136.3 versus 102.3), but there was significant variation in the differences across states. CONCLUSIONS: Our estimates provide further insight into the mortality effects of COVID-19. The observed differences across states and genders demonstrate the need for disaggregated analyses of the pandemic's effects.

Association Between Exposure to Hurricane Irma and Mortality and Hospitalization in Florida Nursing Home Residents.

Importance: Nursing home residents are at heightened risk for morbidity and mortality following an exposure to a disaster such as a hurricane or the COVID19 pandemic. Previous research has shown that nursing home resident mortality related to disasters is frequently underreported. There is a need to better understand the consequences of disasters on nursing home residents and to differentiate vulnerability based on patient characteristics. Objective: To evaluate mortality and morbidity associated with exposure to Hurricane Irma, a Category 4 storm that made landfall on September 10, 2017, in Cudjoe Key, Florida, among short-stay (<90-day residence) and long-stay (≥90-day residence) residents of nursing homes. Design, Setting, and Participants: Cohort study of Florida nursing home residents comparing residents exposed to Hurricane Irma in September 2017 to a control group of residents residing at the same nursing homes over the same time period in calendar year 2015. Data were analyzed from August 28, 2019, to July 22, 2020. Exposure: Residents who experienced Hurricane Irma were considered exposed; those who did not were considered unexposed. Main Outcome and Measures: Outcome variables included 30-day and 90-day mortality and first hospitalizations after the storm in both the short term and the long term. Results: A total of 61 564 residents who were present in 640 Florida nursing home facilities on September 7, 2017, were identified. A comparison cohort of 61 813 residents was evaluated in 2015. Both cohorts were mostly female (2015, 68%; 2017, 67%), mostly White (2015, 79%; 2017, 78%), and approximately 40% of the residents in each group were over the age of 85 years. Compared with the control group in 2015, an additional 262 more nursing home deaths were identified at 30 days and 433 more deaths at 90 days. The odds of a first hospitalization for those exposed (vs nonexposed) were 1.09 (95% CI, 1.05-1.13) within the first 30 days after the storm and 1.05 (95% CI, 1.02-1.08) at 90 days; the odds of mortality were 1.12 (95% CI, 1.05-1.18) at 30 days and 1.07 (95% CI, 1.03-1.11) at 90 days. Among long-stay residents, the odds of mortality for those exposed to Hurricane Irma were 1.18 (95% CI, 1.08-1.29) times those unexposed and the odds of hospitalization were 1.11 (95% CI, 1.04-1.18) times those unexposed in the post 30-day period. Conclusions and Relevance: The findings of this study suggest that nursing home residents are at considerable risk to the consequences of disasters. These risks may be underreported by state and federal agencies. Long-stay residents, those who have resided in a nursing home for 90 days or more, may be most vulnerable to the consequences of hurricane disasters.

Years of life lost associated with COVID-19 deaths in the United States.

BACKGROUND: The mortality effects of COVID-19 are a critical aspect of the disease's impact. Years of life lost (YLLs) can provide greater insight than the number of deaths by conveying the shortfall in life expectancy and thus the age profile of the decedents. METHODS: We employed data regarding COVID-19 deaths in the USA by jurisdiction, gender and age group for the period 1 February 2020 through 11 July 2020. We used actuarial life expectancy tables by gender and age to estimate YLLs. RESULTS: We estimated roughly 1.2 million YLLs due to COVID-19 deaths. The YLLs for the top six jurisdictions exceeded those for the remaining 43. On a per-capita basis, female YLLs were generally higher than male YLLs throughout the country. CONCLUSIONS: Our estimates offer new insight into the effects of COVID-19. Our findings of heterogenous rates of YLLs by geography and gender highlight variation in the magnitude of the pandemic's effects that may inform effective policy responses.