13.1 million missing Americans since 1980. Where’s the outrage?

Americans die younger than people living in other wealthy nations. A lot younger. That’s been the case since the early 1980s, and it’s getting worse. A lot worse. Since 1980, 13.1 million American lives have been lost relative to other wealthy nations.

Did we even see this in the news? The entire population of the Los Angeles metropolitan statistical area lost in a little over 40 years. Over 2 million were in 2020 and 2021. 2022 and what’s passed in 2023 are not included, so there’s probably another 1.5 million or so lost.

Excess deaths are far higher in younger populations. Nearly 50 percent of the 2.1 million excess deaths in 2020 and 2021 were under age 65. If you know two people who died before age 65, one would still be alive if they both lived in New Zealand or Germany instead of the U.S. Someone in their 20s in the U.S. is now almost 4 times as likely to die comparatively.

The comparisons are made to other wealthy nations: Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Iceland, Ireland, Italy, Japan, Luxembourg, Netherlands, New Zealand, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom.

All this is getting worse, not better. In 2019, there were 622,534 excess deaths in the U.S. That number rose to 1,009,467 in 2020 and was topped in 2021 at 1,090,103.

Where is our outrage? Seriously, 2.1 million Missing Americans in just 2 years. We’re so focused on getting the 270,000 deaths from sepsis each year down to 250,000. Clearly, I’m not saying we should not strive to identify and treat sepsis well. I’m a hospitalist, and I treat sepsis and teach on it. But think about the vast differences. If we just got to average death rates for wealthy nations, we’d be saving over a million lives a year.

Why? How are these people dying? And what can we do about it?

The primary drivers appear to include the opioid crisis, a higher mortality rate due to COVID-19, mental health issues, socioeconomic disparities, and a health care system that simply does not embrace prevention. There are lots of other factors, including pollution and violence. We need solutions, but they will not be easy to find and harder to implement.

Steve Burgess is a hospitalist and creator, CME Vacations, designed to give participants the ultimate CME “working vacation.”

Hospital Medicine Update and Outpatient Medicine Update are available online or in great vacation destinations, including Florida, the BahamasSan DiegoSan Antonio, and cruises.

To meet the DEA requirement, an online 8-hour course is available, Diagnosing and Treating Opioid and Other Substance Use Disorders.

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