Mortality Rates and Excess Death Rates for the Seriously Mentally Ill

Objectives.—To compute mortality rates and excess death rates for patients with serious mental illness, specific to categories of gender, age and race/ethnicity. Background.—People with serious mental illness are known to be at greatly increased risk of mortality across the lifespan. However, the measures of mortality reported for this high-risk population are typically only summary measures, which do not provide either the mortality rates or excess death rates needed to construct life tables for individuals with serious mental illness. Methods.—Mortality rates were computed by dividing the number of deaths by the amount of life-years lived in strata specific to gender, age and race/ethnicity. Age-specific excess death rates were determined as the difference between the study population rate and the corresponding general population rate in each stratum. To compute excess death rates beyond observed ages in the cohort, a method with documented reliability and validity for chronic medical conditions was used. Results.—For the cohort with mental illness, mortality rates for Black and White females were mostly equal, and consistently greater than those for Hispanic females; excess death rates for females displayed a similar pattern. Among males, mortality rates were highest for Whites, with Hispanics and Blacks close in magnitude at all ages. Excess death rates for males showed more divergence between the categories of race/ethnicity across the age range. Conclusions.—Mortality rates specific to categories of gender, age and race/ethnicity show sufficient differences as to make them the preferred way to construct life tables. This is especially true in contrast to broader summary measures such as risk ratios, standardized incidence rates, or life expectancy.

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Geospatial Variability in Excess Death Rates during the COVID-19 Pandemic in Mexico: Examining Socio Demographic and Population Health Characteristics

10.1101/2021.08.11.21261930 ◽

2021 ◽

Author(s):

Sushma Dahal ◽

Ruiyan Luo ◽

Monica H Swahn ◽

Gerardo Chowell

Keyword(s):

Population Health ◽

Excess Mortality ◽

Health Indicators ◽

Mortality Rates ◽

Household Size ◽

P Value ◽

Death Rates ◽

Excess Death ◽

Average Household Size ◽

Aging Index

Background: Mexico has suffered one of the highest COVID-19 mortality rates in the world. In this study we examined how socio-demographic and population health characteristics shape the geospatial variability in excess mortality patterns during the COVID-19 pandemic in Mexico. Methods: Weekly all-cause mortality time series for all 32 Mexican states, from January 4, 2015 to April 10, 2021, were analyzed to estimate the excess mortality rates using Serfling regression models. The association between socio-demographic, health indicators and excess mortality rates were determined using multiple linear regression analyses. Finally, we used functional data analysis to characterize clusters of states with distinct mortality growth rate curves. Results: The overall all-cause excess deaths rate during the COVID-19 pandemic in Mexico until April 10, 2021 was estimated at 39.66 per 10 000 population. The lowest excess death rates were observed in southeastern states including Chiapas (12.72), Oaxaca (13.42) and Quintana Roo (19.41) whereas Mexico City had the highest excess death rate (106.17), followed by Tlaxcala (51.99) and Morelos (45.90). We found a positive association of excess mortality rates with aging index (P value<.0001), marginalization index (P value<.0001), and average household size (P value=0.0003) in the final adjusted model (Model R2=76%). We identified four distinct clusters with qualitatively similar excess mortality curves. Conclusion: Central states exhibited the highest excess mortality rates whereas the distribution of aging index, marginalization index, and average household size explained the variability in excess mortality rates across Mexico. Our findings can help tailor interventions to mitigate the mortality impact of the pandemic.

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EXCESS MORTALITY FROM COVID-19. WEEKLY EXCESS DEATH RATES BY AGE AND SEX FOR SWEDEN AND ITS MOST AFFECTED REGION

European Journal of Public Health ◽

10.1093/eurpub/ckaa218 ◽

2020 ◽

Author(s):

Karin Modig ◽

Anders Ahlbom ◽

Marcus Ebeling

Keyword(s):

Causes Of Death ◽

Excess Mortality ◽

National Level ◽

Mortality Rates ◽

Regional Level ◽

Death Rates ◽

Excess Death ◽

All Cause Mortality ◽

Specific Mortality ◽

Age And Sex

Abstract Background Sweden has one of the highest numbers of COVID-19 deaths per inhabitant globally. However, absolute death counts can be misleading. Estimating age- and sex-specific mortality rates is necessary in order to account for the underlying population structure. Furthermore, given the difficulty of assigning causes of death, excess all-cause mortality should be estimated to assess the overall burden of the pandemic. Methods By estimating weekly age- and sex-specific death rates during 2020 and during the preceding five years, our aim is to get more accurate estimates of the excess mortality attributed to COVID-19 in Sweden, and in the most affected region Stockholm. Results Eight weeks after Sweden’s first confirmed case, the death rates at all ages above 60 were higher than for previous years. Persons above age 80 were disproportionally more affected, and men suffered greater excess mortality than women in ages up to 75 years. At older ages, the excess mortality was similar for men and women, with up to 1.5 times higher death rates for Sweden and up to 3 times higher for Stockholm. Life expectancy at age 50 declined by less than 1 year for Sweden and 1.5 years for Stockholm compared to 2019. Conclusions The excess mortality has been high in older ages during the pandemic, but it remains to be answered if this is because of age itself being a prognostic factor or a proxy for comorbidity. Only monitoring deaths at a national level may hide the effect of the pandemic on the regional level.

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Serious Mental Illness and Mortality Rates

Psychiatric Services ◽

10.1176/ps.45.6.604 ◽

1994 ◽

Vol 45 (6) ◽

pp. 604-605 ◽

Cited By ~ 7

Author(s):

Michael R. Berren ◽

Kimberly R. Hill ◽

Elizabeth Merikle ◽

Noel Gonzalez ◽

José Santiago

Keyword(s):

Mental Illness ◽

Serious Mental Illness ◽

Mortality Rates

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Excess mortality from COVID and non-COVID causes in minority populations

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.2101386118 ◽

2021 ◽

Vol 118 (39) ◽

pp. e2101386118 ◽

Cited By ~ 1

Author(s):

Christopher J. Cronin ◽

William N. Evans

Keyword(s):

Excess Mortality ◽

Time Interval ◽

Hispanic Males ◽

Excess Death ◽

Life Years ◽

Life Years Lost ◽

Race Ethnicity ◽

And Gender ◽

Death Count ◽

Excess Deaths

The 2020 US mortality totaled 2.8 million after early March, which is 17.3% higher than age-population–weighted mortality over the same time interval in 2017 to 2019, for a total excess death count of 413,592. We use data on weekly death counts by cause, as well as life tables, to quantify excess mortality and life years lost from both COVID-19 and non–COVID-19 causes by race/ethnicity, age, and gender/sex. Excess mortality from non–COVID-19 causes is substantial and much more heavily concentrated among males and minorities, especially Black, non-Hispanic males, than COVID-19 deaths. Thirty-four percent of the excess life years lost for males is from non–COVID-19 causes. While minorities represent 36% of COVID-19 deaths, they represent 70% of non–COVID-19 related excess deaths and 58% of non–COVID-19 excess life years lost. Black, non-Hispanic males represent only 6.9% of the population, but they are responsible for 8.9% of COVID-19 deaths and 28% of 2020 excess deaths from non–COVID-19 causes. For this group, nearly half of the excess life years lost in 2020 are due to non–COVID-19 causes.

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Do women in Europe live longer and happier lives than men?

European Journal of Public Health ◽

10.1093/eurpub/cky070 ◽

2018 ◽

Vol 28 (5) ◽

pp. 847-852 ◽

Cited By ~ 9

Author(s):

Aïda Solé-Auró ◽

Domantas Jasilionis ◽

Peng Li ◽

Anna Oksuzyan

Keyword(s):

Gender Differences ◽

Life Satisfaction ◽

Gender Gap ◽

Life Tables ◽

Death Rates ◽

Happy Life ◽

Female Advantage ◽

Life Years ◽

The One ◽

Single Question

Abstract Background The article examines gender differences in happy life expectancy at age 50 (LE50) and computes the age-specific contributions of mortality and happiness effects to gender differences in happy LE50 in 16 European countries. Methods Abridged life tables and happy LE50 were calculated using conventional life tables and Sullivan’s method. Age-specific death rates were calculated from deaths and population exposures in the Human Mortality Database. Happiness prevalence was estimated using the 2010–11 Survey of Health, Ageing and Retirement in Europe. Happiness was defined using a single question about life satisfaction on a scale of 0–10. A decomposition algorithm was applied to estimate the exact contributions of the differences in mortality and happiness to the overall gender gap in happy LE50. Results Gender differences in happy LE50 favour women in all countries except Portugal (0.43 years in Italy and 3.55 years in Slovenia). Generally, the contribution of the gender gap in happiness prevalence is smaller than the one in mortality. The male advantage in the prevalence of happiness partially offsets the effects of the female advantage in mortality on the total gender gap in happy LE50. Gender differences in unhappy life years make up the greatest share of the gender gap in total LE50 in all countries except Denmark, Germany, Netherlands, Slovenia and Sweden. Conclusion Countries with the largest gender gap in LE are not necessarily the countries with larger differences in happy LE50. The remaining years of life of women are expected to be spent not only in unhealthy but also in unhappy state.

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Introduction:Cardiovascular Disease and Metabolic Risk Factors in Patients with Mental Illness

CNS Spectrums ◽

10.1017/s1092852900003084 ◽

2008 ◽

Vol 13 (S10) ◽

pp. 3-4 ◽

Cited By ~ 3

Author(s):

John W. Newcomer

Keyword(s):

Mental Illness ◽

General Population ◽

Life Expectancy ◽

Serious Mental Illness ◽

The United States ◽

Persistent Mental Illness ◽

Life Years ◽

The Us ◽

Common Causes ◽

National Comorbidity Study

According to the National Comorbidity Study Replication, >25% of people in the United States have some type of mental illness. The prevalence of serious mental illness has been estimated at 6.2%. Patients with severe and persistent mental illness have significantly reduced life expectancy relative to the general population. On average, pooled populations of public sector inpatients and outpatients die 25–30 years earlier than unaffected individuals in the general population, according to recent data from multiple states in the US. Schizophrenia and bipolar disorder together account for ∼23,000 deaths and >20 million life-years of disability worldwide each year. The most common cause of mortality in these individuals is cardiovascular disease (CVD), not, as might be assumed, suicide (Figure 1). Heart disease and stroke are the most common causes of death in patients with serious mental illness, accounting for ∼40% of deaths, underlying the dramatically decreased life expectancy in these patients.

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