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  #411  
Old 02-10-2020, 02:19 PM
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this is not only mortality, but here goes:

https://twitter.com/trevornoren/stat...85086990249989

Quote:
"Starting work in a recession affects people for their whole lives...Downturns linked to deaths and divorces long after the economy has recovered" https://economist.com/graphic-detail...ir-whole-lives


https://www.economist.com/graphic-de...ir-whole-lives
Quote:
Starting work in a recession affects people for their whole lives
Downturns are linked to deaths and divorces long after the economy has recovered


Spoiler:
TIMING IS EVERYTHING. This is especially true in the labour market. Workers who start looking for a job during a recession earn significantly less than their timelier counterparts. This wage penalty can last for years—a phenomenon economists call wage “scarring”. Until now, it has been assumed that such scars are mainly economic, affecting workers’ employment, income and wealth. But new research by Hannes Schwandt of Northwestern University and Till von Wachter of the University of California, Los Angeles suggests that economic downturns can have other long-lasting effects.

Using data on the roughly 4m Americans who entered the workforce shortly before, during and after the 1982 recession—when unemployment reached almost 11%—the authors measured how the downturn affected those people’s health and mortality many years later. On joining the labour force, they faced a national unemployment rate 3.9 percentage points higher than that before the onset of recession. That was associated, the authors found, with a cut in their life expectancy of six to nine months. The additional deaths were from causes linked to unhealthy behaviour, including heart disease, lung cancer, liver disease and drug poisoning.


wotking paper:
https://www.ipr.northwestern.edu/our...inkId=81059191

press release:
https://news.northwestern.edu/storie...arch-suggests/

excerpt:
Quote:
Schwandt and von Wachter analyzed outcomes for people who entered the job market during the historic economic downturn of 1981 and 1982. Prior to 2007, the recession of the early 1980s was the worst economic downturn in the U.S. since the Great Depression. But the Great Recession triggered by the bursting of the housing bubble and the subprime mortgage crisis has since eclipsed the 1980s recession in terms of length and GDP.

In middle age, unlucky labor market entrants earn less and work more while receiving less welfare support. They are also less likely to be married, more likely to be divorced, and less likely to be cohabitating with own children, the study found.

A related 2014 study by Schwandt and Janet Currie of Princeton University showed that recession exposure in early adulthood reduces lifetime fertility for women. There is also evidence that male college graduates from the 1982 recession experience worsening self-reported health in middle age.

The new study makes use of several large cross-sectional data sources, and a novel approach to estimate midlife effects of entering the labor market in a recession on mortality by cause and various measures of socioeconomic status.

To analyze effects in middle age, the researchers focused on cohorts entering the labor market in different U.S. states before, during, and after the 1982 recession. They used Vital Statistics data from 1979 to 2016 and population estimates from the Census and the American Communities Survey (ACS) to construct mortality rates, which are regressed on the state-level unemployment rate that a cohort faced at the time of graduation. Information on socioeconomic outcomes, including earnings, labor supply, marital status, divorce, and cohabitation was derived from the Decennial Census (Census), the ACS, and the Current Population Survey (CPS).

This looks like the final paper:
https://papers.ssrn.com/sol3/papers....act_id=3518251
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  #412  
Old 02-20-2020, 01:53 PM
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https://www.bloomberg.com/opinion/ar...uce-fatalities

Quote:
More Older Americans Are on the Job — And Dying There Too
The best way to reduce occupational deaths among workers 65 and older might be retirement.


Spoiler:
U.S. workplaces have gotten a lot safer over the course of the past century. In 1913, the Bureau of Labor Statistics estimated that there were 23,000 “industrial deaths,” or 61 for every 100,000 workers. In 2018, the number of what are now called “occupational fatalities” was 5,250, according to a BLS survey much more exhaustive than its 1913 precursor, or 3.5 for every 100,000 full-time equivalent workers.

But those 5,250 deaths were an increase over 2017’s 5,147, and workplace fatalities have been up for six of the last nine years (the chart starts in 1992 because that’s when the BLS started its more-complete Census of Fatal Occupational Injuries).

Recessions tend to reduce the number of workplace injuries and deaths, because there are fewer workers to get hurt and because high-risk industries such as construction and trucking are often hit hardest by job losses. Some increase in fatalities was thus to be expected as the economy recovered in recent years, and the current number and rate of fatalities remain below the levels that prevailed before the last recession. (The BLS changed how it calculated the rates in 2006, which is why this chart only goes back that far.)

The Fatality Rate Has Flatlined
Occupational fatalities per 100,000 full-time-equivalent workers


Source: U.S. Bureau of Labor Statistics

There was, however, something unusual going on in 2006 — a housing bubble that pushed the fatality-prone construction sector to its highest share of nonfarm employment since 1956 — that makes the drop afterward less impressive and the subsequent failure of the fatality rate to keep falling the bigger story. It is also possible to identify a major force that has been keeping the rate from falling. This force is not necessarily evil, but as a 56-year-old I do find it kind of creepy: More people older than 55 are working, and people over 55 are more likely to die on the job than younger workers.

First, the statistics on 55-plussers in the workplace:

The Workplace Is Skewing Older
Percentage of U.S. employed persons ages 55 and older


Source: U.S. Bureau of Labor Statistics

This rise of the older worker is partly just demographics — the giant baby boom generation, as defined by the Census Bureau, ranges in age from 55 to 74. But it’s also because older Americans, especially much-older Americans, are far more likely to be part of the labor force now than they were in the 1970s through 1990s. Among those 65 and older, the labor force participation rate has risen from a low of 10.4% in 1985 to 20.3% now. Among those 75 and older it has gone from 4% to 9.7% percent.

Older Americans are likelier to be working now for a variety of reasons. Some seem entirely positive — despite the recent stall in life expectancy, Americans are living significantly longer than they did a few decades ago, and once-common mandatory-retirement rules have largely disappeared since Congress banned most of them in 1986. A more complicated issue is the changing nature of retirement income: Some Americans work into their 70s because they have no retirement savings, while others have savings but work longer because the defined-contribution plans that now predominate reward delayed retirement in ways that most traditional pensions do not.

In any case, as the share of older workers has grown, the share of workplace deaths that they account for has grown, too.

Workplace Deaths Are Skewing Older Too
Percentage of U.S. occupational fatalities


Source: U.S. Bureau of Labor Statistics

It’s not that the workplace has been getting more dangerous over time for older workers. Every age group has seen declines in workplace fatality rates since 2006, and the decline for those 65 and older has been the biggest. But 65-plussers’ share of the workforce has grown by three percentage points just since 2006, and their occupational fatality rate remains much, much higher than anybody else’s: 10.3 in 2018 versus 3.5 for the workforce overall and 4.6 for those ages 55 through 64.

Workplace Deaths by Age Group
Occupational fatalities per 100,000 full-time-equivalent workers


Source: U.S. Bureau of Labor Statistics

Being older obviously does make one more prone to keel over, but the occupational fatality statistics don’t include on-the-job deaths due to natural causes. So what explains the higher death rates of older workers? In an analysis published last month that was the inspiration for this column, BLS economists Sean M. Smith and Stephen M. Pegula sliced and diced the numbers in several ways in an attempt to answer that question. (To get statistically meaningful results, they generally focused on the entire 55-plus age group, not the smaller but much-higher-risk group of workers 65 and older, and combined data for a number of years.)

One thing that they found was that those 55 and older were more likely than younger workers to die of lingering injuries days, weeks, months or even years after a workplace incident. Older people are more fragile than younger ones, so they have more trouble recovering from workplace injuries than their younger peers, and are more likely to suffer certain injuries (hip fractures, for example).

When it comes kinds of accidents, the biggest cause of workplace fatalities for both older and younger workers is roadway incidents involving motorized land vehicles, aka traffic accidents, which Smith and Pegula found were responsible for about a quarter of deaths from 2011 through 2017 among those under 55 and among those 55 and older — so no disparity there. Fatalities among those 55 and older were significantly less likely to be caused by electrocution, homicide and suicide than among younger workers, while deaths from being struck by an object or equipment, falling to a lower level and being hit by a vehicle as a pedestrian made up a moderately larger share of workplace deaths for older workers than younger ones. The cause of death for which the age difference was the biggest was nonroadway noncollision incidents, which accounted for 6% of workplace deaths for those 55 and older and 3% for those 54 and younger.

What could these nonroadway noncollision incidents possibly involve? Think tractors. Agriculture, forestry, fishing and hunting had the second-highest fatality rate in 2018 of any industry whose fatality rate was estimated by the BLS, after truck transportation (23 deaths per 100,000 full-time equivalent workers versus 28). Smith and Pegula found that, from 2003 through 2017, farmers, ranchers and other agricultural managers suffered 14% of the occupational fatalities among those 55 and older, versus a bit more than 2% among those 54 and younger.

For a variety of reasons, farmers have been finding it harder and harder to retire — or easier and easier not to retire, as modern farm equipment allows them to do more on their own. Farmers and ranchers have the highest median age among occupations for which the BLS calculates that figure, 1 at 56.1 years, and a remarkable 30.8% of them are 65 and older. Most of the fatal nonroadway noncollision incidents mentioned above involved jack-knifed or overturned vehicles, so basically, a not-insignificant number of elderly farmers are dying when their tractors or pickup trucks tip over. But hey, they’re out in the fields, amid the amber waves of grain. There are worse ways to go.

Which brings us to the bigger question of whether anything should be done about this rise in older-worker fatalities. Smith and Pegula conclude their study with the hope that it will help safety and health experts “tailor their efforts to best meet the needs of older workers and to keep them safe during their careers,” which sounds like a good plan but not exactly a game-changer. Technological advances have played a big role in reducing workplace risks in the past, and one can easily see how self-driving technology could make truck driving, farming and other occupations much safer — albeit at the same time destroying lots of jobs. In the meantime, the most powerful policy lever seems to be retirement-system design.

In countries where old-style pensions still prevail, 65-plussers are much less likely to have jobs than in the U.S.

Over 65 and in the Workforce
Employment-population ratio in 2018 for ages 65 through 69


Source: Organization for Economic Cooperation and Development

Data from the International Labor Organization also indicate that the U.S. has a much higher occupational fatality rate than most other affluent countries, but national standards for reporting and calculating these rates seem to vary so much that I suspect the numbers aren’t really comparable. So no chart of that! But it does seem clear that if we paid people to leave their jobs at 65, there would be fewer occupational fatalities in this country.

This would also, of course, be very expensive, and the funding shortfalls that loom in some of those countries with old-style pensions dwarf what is in store for Social Security (which is basically an old-style pension, too, but is relatively small and doesn’t require that you retire to receive it). What’s more, there’s a growing body of evidence indicating that working past 65 actually prolongs people’s lives. That is, you may be more likely to die on the job, but you’re less likely to die, period. Which seems like an OK trade-off.

The agency doesn't calculate a median age for legislators, but from the information it does provide it is clear that this would be even higher than that of farmers.


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  #413  
Old 02-20-2020, 03:18 PM
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https://www.census.gov/library/publi...ce=govdelivery

Quote:
Living Longer: Historical and Projected Life Expectancy in the United States, 1960 to 2060
FEBRUARY 2020
REPORT NUMBER P25-1145
LAUREN MEDINA, SHANNON SABO, AND JONATHAN VESPA
Introduction

Download Living Longer: Historical and Projected Life Expectancy in the United States, 1960 to 2060 [PDF - <1.0 MB]
This report uses the U.S. Census Bureau’s 2017 National Population Projections to examine potential mortality and life expectancy changes in the coming decades. To provide historical context, we draw extensively on life expectancy data from the National Center for Health Statistics (NCHS). The report includes projections of life expectancy from 2017 to 2060 and explores projected differences in mortality for men and women and for different race and Hispanic origin groups in the United States. The report also focuses on projected life expectancy differences between the native and foreign-born populations. The mortality projections covered in this report are based on the first nativity-specific life tables and life expectancies to be published by the U.S. Census Bureau.

Full paper: https://www.census.gov/content/dam/C...o/p25-1145.pdf
Quote:
REPORT HIGHLIGHTS

• Americans are projected to have longer life expectancies in coming decades. By 2060, life expectancy for the total population is projected to increase by about six years, from 79.7 in 2017 to 85.6 in 2060.2

• Increases in life expectancy are projected to be larger for men than women, although women are still projected to live longer than men do, on average, in 2060.

• All racial and ethnic groups are projected to have longer life expectancies in coming decades, but the greatest gains will be to native-born men who
are non-Hispanic Black alone and non-Hispanic American Indian or Alaska Native alone.

• Among the native-born population, Hispanic women had the longest life expectancy, 83.3 years, of any race or Hispanic origin group in the United States in 2017. They are projected to continue to have the longest life expectancy, 87.8 years, in 2060.

• In 2060, foreign-born men and women are projected to continue having longer life expectancies than their native-born peers, regardless of race or Hispanic origin.
Supplemental tables: https://www.census.gov/content/dam/C...tal-tables.pdf
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  #414  
Old 03-02-2020, 10:44 AM
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https://nypost.com/2020/02/27/us-ped...nes-weed-suvs/

Quote:
US pedestrian deaths spike — researchers blame phones, weed, SUVs

Spoiler:
Pedestrian fatalities in the US reached a 30-year high in 2019, according to a new study — and the researchers believe smartphones, an increase in SUVs and marijuana legalization are behind the spike.

An estimated 6,590 pedestrians died in car crashes across the country last year, according to the study released Thursday by the non-profit Governors Highway Safety Association — a 5 percent increase from 2018, and 60 percent spike since the number began to rise in 2009.

The last time pedestrian deaths were that high was 1988.

The man behind the report thinks increased smartphone use is the primary culprit.

“For 30 years, pedestrian deaths were declining. Something changed in 2009,” said researcher Richard Retting of the Sam Schwartz Engineering firm, who wrote the study. “What happened in 2009 that reversed that trend? I don’t see any other factor.”

Both pedestrian and driver distraction may be at play, but the extent to which one or the other is a greater problem is not clear, he said.

“Drivers have gone way beyond just texting, but have cellphones mounted on their windows and dashboards. They’re watching movies and baseball games,” Retting told The Post. “We were basically creating an environment where people who are taking their eyes off the road for seconds at a time are traveling hundreds of feet in that time.”

Retting’s conclusions are based on preliminary data from the first six months of 2019, which he extrapolated to make an estimate for the rest of the year.

Among the other possible explanations for the surge in deaths offered by the researchers — the growing popularity of SUVs and warmer temperatures drawing more pedestrians out after dark, when fatality rates are significantly higher.

The report also suggests “changing patterns in drug use, including decriminalization of marijuana” as a possible cause, though provides no evidence.

A whopping 47 percent of the pedestrians deaths occurred in either Florida, Georgia, Arizona, California or Texas — all states whose suburban populations are booming, putting more and more people in areas prone to faster driving.

“It’s a national crisis, and the fact that 300 more deaths occurred last year than the year before is a shame on this country,” Retting said. “We are in crisis mode.”


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  #415  
Old 03-04-2020, 12:37 PM
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Really nice interactive visualization from the SOA:

https://www.soa.org/resources/resear...-observations/
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  #416  
Old 03-04-2020, 12:46 PM
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hmmm, doesn't seem to be very interactive in my current browser
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Old 03-05-2020, 11:52 AM
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https://www.upi.com/Science_News/202...3161583337967/

Quote:
Sex chromosomes explain shorter lifespans of male mammals

Spoiler:
March 4 (UPI) -- According to a new study, male mammals live shorter lives than their female peers as a result of sex chromosomes, not because of their risky behavior.

When an international team of researchers surveyed the scientific literature for links between sex chromosomes and lifespan across the animal kingdom, they found evidence supporting the "unguarded X hypothesis."


The unguarded X hypothesis supposes that males, because they have an X and Y chromosome, are less able to avoid harmful genes expressed on the X chromosome. Because the Y chromosome is often smaller than the X, it can's hide the flaws in the X chromosome.

Having two X chromosomes is beneficial because the homogametic chromosomes can be interchanged, with a healthy X chromosome taking the place of an X that has damaging genes.

Researchers found broad support for the hypothesis in available scientific literature. They published findings Wednesday in the journal Biology Letters.

"We looked at lifespan data in not just primates, other mammals and birds, but also reptiles, fish, amphibians, arachnids, cockroaches, grasshoppers, beetles, butterflies and moths among others," lead study author Zoe Xirocostas, doctoral student at the University of New South Wales, said in a news release. "And we found that across that broad range of species, the heterogametic sex does tend to die earlier than the homogametic sex, and it's 17.6 percent earlier on average."

Male animals don't always carry heterogametic sex chromosomes. Female birds, butterflies and moths carry ZW chromosomes, while the males carry homogametic ZZ sex chromosomes. Data analyzed by Xirocostas and her colleagues showed female birds, butterflies and moths tend to die sooner than their male counterparts.

The difference in lifespans between the carriers of ZW and ZZ chromosomes wasn't as great, however.

"We found a smaller difference in lifespan between the males and females in the female heterogametic species compared to males and females in the male heterogametic species," Xirocostas said. "In species where males are heterogametic (XY), females live almost 21 percent longer than males. But in the species of birds, butterflies and moths, where females are heterogametic (ZW), males only outlive females by 7 percent."

The findings suggest chromosomal differences help explain some of differences in lifespan between male and female mammals, but it's possible that differences in behavior further shrink the male mammal's already shorter lifespan.


https://royalsocietypublishing.org/d...rsbl.2019.0867
Quote:
The sex with the reduced sex chromosome dies earlier: a comparison across the tree of life

Abstract
Many taxa show substantial differences in lifespan between the sexes. However, these differences are not always in the same direction. In mammals, females tend to live longer than males, while in birds, males tend to live longer than females. One possible explanation for these differences in lifespan is the unguarded X hypothesis, which suggests that the reduced or absent chromosome in the heterogametic sex (e.g. the Y chromosome in mammals and the W chromosome in birds) exposes recessive deleterious mutations on the other sex chromosome. While the unguarded X hypothesis is intuitively appealing, it had never been subject to a broad test. We compiled male and female longevity data for 229 species spanning 99 families, 38 orders and eight classes across the tree of life. Consistent with the unguarded X hypothesis, a meta-analysis showed that the homogametic sex, on average, lives 17.6% longer than the heterogametic sex. Surprisingly, we found substantial differences in lifespan dimorphism between female heterogametic species (in which the homogametic sex lives 7.1% longer) and male heterogametic species (in which the homogametic sex lives 20.9% longer). Our findings demonstrate the importance of considering chromosome morphology in addition to sexual selection and environment as potential drivers of sexual dimorphism, and advance our fundamental understanding of the mechanisms that shape an organism's lifespan.

Spoiler:



https://twitter.com/HeatherEHeying/s...94878111092736
Quote:
Lifespan differences between the sexes cannot be explained wholly by sex chromosomes, however. In species where females are homogametic, they live ~21% longer than males; when males are homogametic, they only live ~7% longer.
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  #418  
Old 03-09-2020, 08:50 PM
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UNITED KINGDOM

http://www.instituteofhealthequity.o...ew-10-years-on

Quote:
Marmot Review 10 Years On

Summary
Ten years since the publication of The Marmot Review, for the first time in more than 100 years life expectancy has failed to increase across the country, and for the poorest 10% of women it has actually declined. Over the last decade health inequalities have widened overall, and the amount of time people spend in poor health has increased since 2010.

#Marmot2020 confirms an increase in the north/south health gap, where the largest decreases were seen in the most deprived 10% of neighbourhoods in the North East, and the largest increases in the least deprived 10% of neighbourhoods in London.



Key Points:

The more deprived the area, the shorter the life expectancy. This social gradient has become steeper over the last decade, and it is women in the most deprived 10% of areas for whom life expectancy fell from 2010-12 and 2016-18.
There are marked regional differences in life expectancy, particularly among people living in more deprived areas.
Mortality rates are increasing for men and women aged 45-49 – perhaps related to so-called ‘deaths of despair’ (suicide, drugs and alcohol abuse) as seen in the USA.
Child poverty has increased (22% compared to Europe’s lowest of 10% in Norway, Iceland and The Netherlands); children’s and youth centres have closed; funding for education is down.
There is a housing crisis and a rise in homelessness; people have insufficient money to lead a healthy life; and there are more ignored communities with poor conditions and little reason for hope.



https://finance.yahoo.com/news/why-e...093740369.html

Quote:
Why England's women life expectancy data should prompt pensions rethink
Spoiler:
Life expectancy in England has stalled over the last decade but women who come from the most deprived areas of the country are suffering the most.

According to the Marmot Review report, the stagnation in life expectancy has not happened since at least 1900 and “if health has stopped improving it is a sign that society has stopped improving. When a society is flourishing health tends to flourish.”

Financiers have warned that this will prompt calls for the government to allow people earlier access to state pension funds.

“Life expectancy stalling overall and reversing for some, in particular women from more deprived areas brings huge challenges,” said Nathan Long, senior analyst at financial services firm Hargreaves Lansdown.

“A widening gap between rich and poor, and across regions of the UK adds additional pressure to the pension system. Raising State Pension Age has so far been a simple, but rather blunt, way of containing the cost of helping people meet their outgoings after they’ve finished work, but it does cause issues and could prompt more calls for early access to state pension for some.”

What is the life expectancy?
Healthy life expectancy has fallen on average for women but those in the poorest 10% of areas, saw life expectancy fall between 2010-12 and 2016-18.

Source: ONS, 2019 (20) Chart: Marmot ReviewView photos
Source: ONS, 2019 (20) Chart: Marmot Review
More
People, in general, from the poorest areas spend more of their lives in ill health than those in affluent areas, said the report.

Source: ONS, 2020 (23). Chart: Marmot ReviewView photos
Source: ONS, 2020 (23). Chart: Marmot Review
More
The report, led by Sir Michael Marmot is one of the country's leading experts on health inequalities. Over a decade ago, he published a major review into the growing gap between the rich and poor and looked at regional inequalities from the north and south of England.

Read more: How to save for a pension

“The national government has not prioritised health inequalities, despite the concerning trends and there has been no national health inequalities strategy since 2010,” said the report.

“We see this as an essential first step in leading the necessary national endeavour to reduce health inequalities. We set out a clear agenda for national government to tackle health inequalities, building on evidence of experience in other countries and local areas since 2010. We establish how the government must take action in England as a matter of urgency.

“The goal should be to bring the level of health of deprived areas in the North up to the level of good health enjoyed by people living in affluent areas in London and the South.”

UK health secretary Matt Hancock said in a statement on Tuesday: "There is still much more to do, and our bold prevention agenda, record 33.9bn [$43.9] a year investment in the NHS, and world-leading plans to improve children's health will help ensure every person can lead a long and healthy life."

On Tuesday, the government also announced that it has confirmed a multi-billion pound spending increase for councils. It said the settlement is “the biggest real-terms increase in spending power in a decade and includes an extra 1.5bn for social care.”

UK state pension concerns
Both men and women can claim their state pension at the age of 65 but this will increase to 66 by October 2020.

There are currently proposals for the age to claim a state pension rising to 67 between 2026 and 2028 with further increases to 68 between 2037 and 2039 — this has yet to be confirmed.

The state pension will rise by 3.9%, or over 6 a week, from 6 April this year. This is the equivalent to 175.20 a week, or to 9,110.40 a year.

People are living for longer than they were even just a few decades ago and due to the 1960s baby boom, this means that there are more people entering retirement than worker borns since then to pay for their pensions.

Read more: The UK town where men would work until they die if the pension age hits 75

For some baby boomers, it could mean they spend a third of their lives in retirement.

However, as the age continues to increase to claim a state pension although data showing the life expectancy is stagnating or declining for certain areas of society, it has prompted some to say that the government should look to allowing early access to cash.

This is especially pertinent to those who come from deprived areas and struggle for a large proportion of their lives from ill health and live for a shorter amount of time.

In the meantime, Long from Hargreaves Lansdown said that “the best way to prepare yourself is to take control of your financial future. Squirreling just a few extra pounds away each month can make all the difference when it comes to finishing work, particularly if you find you cannot continue due to ill health.”

Watch the latest videos from Yahoo Finance UK

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  #419  
Old 06-01-2020, 08:17 AM
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SEX GAP

[not only about disparity in COVID deaths]

https://www.wsj.com/articles/the-ove...en-11590775292

Quote:
The Overlooked Disparity: Coronavirus Kills Mostly Men
In the U.S., 54% of those killed by the virus are male. For younger patients the disparity is greater.

Spoiler:
The United Nations wants you to know that coronavirus is a particular problem for women. So does Politico ("Covid's war on women"). An article in the feminist magazine Ms. says women are shouldering the brunt of Covid-induced "emotional labor," which is "all-consuming."

The virus, unenlightened by this outpouring, persists in killing mostly men. The U.S. male-to-female ratio of confirmed Covid-19 deaths is running about 54 to 46, but the imbalance is much greater among younger people, meaning men are losing many more years of life. Global Health 50/50, a group devoted to equality of the sexes in health, finds that "in most countries, available data indicates that men have been upwards of 50% more likely to die following diagnosis than women." The disparity probably has several causes. In the U.S., men have more health problems to begin with but get less medical care. And women appear to have stronger immune systems.

Pandemics tend to change the world. One overdue change is a greater focus on men's health. Even before Covid-19, U.S. women outlived men by about five years. Most people take the difference for granted, as they once took for granted that women couldn't do all kinds of things men can do.

Women have a tough life in much of the world, but the global longevity gap is even larger than it is in America. America's gap was also bigger in the mid-20th century, when more men smoked, worked as coal miners or lumberjacks, and went to war. But after shrinking for a while, there are signs the gap is growing again.

Remember the opioid epidemic? Men accounted for 69% of its U.S. deaths. And 3.5 times as many American men as women die by suicide. Violence against women is the focus of much-needed attention lately. But around three quarters of U.S. homicide victims are men.

Men bear the greater lifelong burden of illness, too. They have a 20% higher chance of developing cancer, for example, but they are less likely to have health insurance or go to the doctor. In 2017, American men between 18 and 64 accounted on average for $3,979 in health-care spending, compared with $5,447 for women in the same age range.

Yet the focus -- culturally, politically and medically -- is unrelentingly on women's health. Searching "men's health center," I got 3.8 million hits on Google. "Women's health center" yielded 24 million. Celebrities and progressive CEOs like Twitter's Jack Dorsey direct their donations to women's health causes. The federal Health and Human Services Department has an Office on Women's Health but no equivalent for men.

During the pandemic, news articles and polemics have decried the burden of coronavirus on women, how they are more likely to be interrupted on Zoom, how they are publishing fewer scientific papers, and how they may face additional domestic violence -- all real concerns. The burden of fatality, unfortunately, falls quite a bit more on men.

Like so many differences between men and women, the difference in lifespans is partly biological. Females outlive males in most places and in most mammal species.

But one reason to believe we can help American men live longer is that the longevity gap is smaller in some other affluent countries -- three years in the Netherlands and four in Sweden. In both those countries, men and women alike outlive their American counterparts.

"The diversity in worldwide longevity alone indicates that the difference in mortality between the sexes is not purely biological and that there are intervening social factors," the demographic researcher Bertrand Desjardins wrote in 2004. "Women most probably have a biological advantage that allows them to live longer, but in the past -- and in several places, still today -- the status and life conditions of women nullified this benefit. Today, given the general progress in female life conditions, women have not only regained their biological advantage, but have gone much beyond it."

Surely if women died five years younger than men, or if coronavirus were killing far more women than men, it would prompt an outcry. Perhaps the time has come to acknowledge the problem of men's health -- everything from declining sperm counts to suicide -- and do something about it.

I regularly see public-service commercials and other advertisements aimed at improving women's health and well-being, but I don't see many aimed at men. That ought to change. We need to get guys to eat healthier, exercise more, smoke less and moderate their drinking. And they need to hear this message from other guys.

Men need to see the doctor more, too. That's true for Covid-19, for which women are more likely to get tested, as well as other diseases. It might help if there were more outfits like NYU Langone's Preston Robert Tisch Center for Men's Health. There aren't any bearskin rugs, brandy snifters or cigars. But most of the doctors are men and the name is inviting, even if patient forms ask about pregnancy (some patients are women who followed doctors to the center or simply find it convenient).

For too long, men's deficits in health and well-being have mostly been ignored, at least compared with such sins as "mansplaining." Perhaps the pandemic can serve as a useful reminder that men's health, like women's, is a matter of life and death.


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Overdose Deaths Have Skyrocketed in Chicago, and the Coronavirus Pandemic May Be Making It Worse
Opioid-related deaths in Cook County have doubled since this time last year, and similar increases are happening across the country. “If you’re alone, there’s nobody to give you the Narcan,” said one coroner.


Spoiler:
As COVID-19 kills thousands in Chicago and across Illinois, the opioid epidemic has intensified its own deadly siege away from the spotlight, engulfing one public health crisis inside another.

More than twice as many people have died or are suspected to have died of opioid overdoses in the first five months of the year in Cook County, when compared with the same period last year, according to a ProPublica Illinois analysis of medical examiner’s office death records. There have been at least 924 confirmed or suspected overdose deaths so far in 2020; there were 461 at this time last year. And much like the coronavirus outbreak, the opioid epidemic has disproportionately affected African Americans on Chicago’s West and South Sides.

Statewide, opioid deaths also are outpacing 2019 numbers, largely due to the increase in Cook County.

The deadly surge comes at what was supposed to be a turning point for Illinois. A 2017 state action plan from then-Gov. Bruce Rauner vowed to halt the “explosive growth” of opioid deaths and reduce the projected number of opioid-related deaths this year by a third.

Based on the number of overdose deaths so far in Cook County alone, it’s highly unlikely the state can meet that goal.


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While the spike in deaths began several months before the first known case of the coronavirus appeared in Illinois, COVID-19 appears to be exacerbating the crisis.

“This is going to make it so much worse,” said Kathleen Kane-Willis, a researcher with the Chicago Urban League who has studied the opioid epidemic for more than a decade, adding that the true impact of the pandemic on drug overdoses likely won’t be known for some time.

“It’s going to wear on people. It’s going to make them more anxious and depressed,” she said. “Being thrust into poverty is such a stressor, and people do turn to substances to get through that stress.”

The rise in opioid-related deaths in Cook County echoes a pattern seen in other areas of the country, from Milwaukee to Memphis and in Virginia and western New York. The American Medical Association recently sounded an alarm, noting news reports from 28 states on increases in opioid-induced overdoses and issuing a series of recommendations to state governments.

Coroners in at least nine Illinois counties — ranging from Lake County north of Chicago to Peoria County in central Illinois and Madison County near St. Louis — have noted increases, though the number of overdose deaths is far lower than in Cook County. DuPage County Coroner Dr. Richard Jorgensen said he was so startled this month to see 22 overdose deaths in three weeks that he called local rehabilitation clinics and advocates to see if they could explain what was happening.

“They’ve been seeing the same thing — a lot of people calling with problems, having trouble staying sober, having relapses,” said Jorgensen, who worries that more people are using drugs alone because of the state’s stay-at-home order. “If you’re alone, there’s nobody to give you the Narcan,” he said, referring to the drug that can reverse overdoses. “That’s a problem.”

A Complicating Factor
Even before the pandemic hit, state officials, medical experts and drug recovery workers began to notice an increase in overdoses. State officials said they issued an alert in January warning the public about an increase in opioid-related overdoses.

A sustained climb in the number of opioid-related deaths over the previous year began in November, according to a ProPublica Illinois analysis of data from the Cook County Medical Examiner’s Office.

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An increase in more dangerous blends of opioids hitting Cook County, including drugs laced with fentanyl and other synthetic additives, is likely partially to blame, several experts and city and state officials said.

“One thing we know for sure: The violent drug cartels and distributors have not stopped trafficking deadly fentanyl,” Robert Bell, the special agent in charge of the Chicago Field Division of the Drug Enforcement Administration, said in a statement. “The recent spike of overdose deaths emphasizes that the opioid and fentanyl epidemic has not paused — in fact, it has intensified in many places.”

In Cook County, fentanyl is listed as one of the primary causes of death in 81% of the confirmed opioid-related fatalities this year, up from 74% last year, according to ProPublica Illinois’ analysis. The majority of the cases involve fentanyl combined with other substances, such as heroin.

Still, the sheer number of opioid-related fatalities in Cook County this year has left some experts disheartened. As of Friday, the medical examiner’s office had confirmed nearly 500 deaths involving opioids. An additional 614 deaths are still under investigation, typically pending toxicology results. Of those, some 70% to 80% are expected to come back positive for opioids, according to the county’s chief medical examiner, Dr. Ponni Arunkumar. (Pathologists often ask for toxicology screenings when there is evidence of an overdose, such as white powder near the body or a needle in the arm, a spokeswoman for the medical examiner’s office said.)

That projection would put the year’s total at at least 924, more than double the number in the first five months of 2019.

Read More

COVID-19 Took Black Lives First. It Didn’t Have To.
In Chicago, 70 of the city’s 100 first recorded victims of COVID-19 were black. Their lives were rich, and their deaths cannot be dismissed as inevitable. Immediate factors could — and should — have been addressed.

“Oh, goodness. That’s insane,” said Dr. Steven Aks, an emergency room physician at John H. Stroger Jr. Hospital of Cook County and chief of toxicology for Cook County Health, when told about the increase. “This is something that we were very nervous about when the pandemic hit.”

In addition to the rise in deaths, state officials say there have been increases in nonfatal overdoses involving opioids in the first four months of this year. In February, the numbers jumped by more two-thirds, to 2,047 when compared with the average over the previous three Februaries. In Chicago, emergency calls related to overdoses were up by more than a third from January through mid-April this year compared with the same period in 2019, according to an analysis of police and fire department call data.

Dani Kirby, director of the division of substance use prevention and recovery for the state’s Department of Human Services, said in a statement that COVID-19 has complicated both the state’s response to the overdose crisis and the lives of those who use drugs.

“The stress of unemployment, isolation, and general uncertainty are all risk factors for a return to substance use or an escalation of existing patterns of use,” Kirby said. “There is an additional concern that, due to the risk of exposure to COVID-19, people may be more reluctant to call 911 or go to a hospital when an overdose occurs.”

Some overdose prevention strategies “directly contradict” strategies that are meant to prevent the spread of COVID-19, she added.

“We know that human connection is a fundamental element of service delivery — whether a program is linking someone to harm reduction supplies (clean syringes, naloxone, safer smoking supplies, etc) or providing treatment and recovery services — and COVID-19 makes it more difficult for people to access these services,” Kirby said in the statement. Naloxone is an overdose-reversal drug.

Matthew Richards, deputy commissioner of behavioral health for the Chicago Department of Public Health, echoed those challenges. “Sometimes persons that are at highest risk for overdoses, part of the effort is really meeting people where they are in community with peer services or community health educators and building rapport,” he said. “What that looks like right now in terms of social distancing and whatnot is really complicated.”

Read More

In Chicago, Urban Density May Not Be to Blame for the Spread of the Coronavirus
The communities hardest hit by the coronavirus in Chicago are low-density black and Hispanic neighborhoods, including ones where economic decline and population loss have caused more people to live in the same household.

Some Chicago-based programs that serve people who use drugs have had to scale back or shutter services in the wake of the pandemic, in part to protect older workers who may be more vulnerable to the coronavirus. Officials at other programs, on the other hand, said they have been able to meet an increase in demands for some services, such as naloxone, or medical outreach.

The pandemic has also meant that many people who rely on panhandling to make money and buy drugs are unable to do so now, because so many downtown office workers are now working from home, said Andrew Wojda, who works on a street medicine outreach team for The Night Ministry, a Chicago-based organization that works with the homeless.

This decreases their drug tolerance, making them more vulnerable to an overdose when they use again. “When they do get some cash, then they’re going back to using however much they were using a few days ago,” Wojda said. “But within three days, their tolerance can go down. It doesn’t really take much time at all for that to start being a much riskier game they’re playing.”

A Statewide Problem
Researchers and advocates said they are worried about the spread of the coronavirus among drug users and whether deaths involving both opioids and COVID-19 are being adequately tracked. Drug users often have comorbidities — underlying medical conditions — that make them more vulnerable to contracting the coronavirus. It might be hard to distinguish virus-like symptoms from those of withdrawal, researchers said.

So far only four people whose deaths were related to opioids also tested positive for the coronavirus, according to data from the Cook County Medical Examiner’s Office. The office said it has not found a direct correlation between opioids and the coronavirus.

A spokeswoman for the office said they do not test every body for COVID-19. Instead, the body is tested if the person is suspected to have contracted the virus but was not tested at a hospital or if the office’s investigators find out the person displayed symptoms or was exposed to someone who had contracted the virus.

In suburban Lake County, where the coroner, Dr. Howard Cooper, said all bodies are tested for COVID-19 as a safety measure and to let families know if their loved one had the disease, only one of the 43 confirmed or suspected overdose deaths so far this year has also tested positive for the coronavirus. The county also has experienced a rise in fatal overdoses, which Cooper said totaled 23 this time last year.

Even in counties that haven’t seen a rise or are seeing modest increases of one or two deaths, coroners remain concerned. With 14 confirmed or suspected overdose deaths this year, Kane County is up by only two compared with the same time last year, but COVID-19 may upend things, said Coroner Rob Russell.

“Maybe we haven’t seen it yet,” he added. “Maybe it’s coming.”

In Peoria County, Coroner Jamie Harwood said it has been tough to witness a rise in overdoses because it represents a reverse of hard-won progress. From January to April of 2018, the county saw 31 overdose deaths. In 2019, that number dropped to six, which he attributes to increased naloxone distribution, offering fentanyl test strips and providing clean needles for exchange. But now, with this latest spike, the county is almost double 2019’s numbers for the same time with 11 overdose deaths this year.

“It’s really hard to see it go up because you know that there’s a kid left without a parent, a mom left without a daughter or a son,” Harwood said.

A Hopeful Goal
This was the year that opioid-related deaths were supposed to drop significantly in Illinois. A 2017 state action plan developed under Rauner outlined steps to reduce the estimated death toll by one-third, from a projected 2,700 to about 1,800 in 2020.

Statewide opioid-related deaths had been on the decline, from 2,202 in 2017 to 2,167 in 2018. It was the first decrease in overdose deaths among Illinois residents in five years. The numbers fell again last year to 2,107, state officials said.

Read More

Early Data Shows Black People Are Being Disproportionally Arrested for Social Distancing Violations
Crowds of mostly white protesters have defied Ohio’s stay-at-home order without arrest, while in several of the state’s biggest jurisdictions, police departments have primarily arrested black people for violating the order.

The drop in 2018 was largely due to a decrease in opioid-related deaths for white residents. But those deaths rose for African Americans, who saw a 9% increase, and to a lesser extent for Latino residents, who saw a 4% increase, state figures show, resulting in what a 2019 state report called a “persistent disparity.”

The data on the most recent deaths in Cook County magnify the disparities. African Americans make up more than half the confirmed opioid-related deaths so far this year, even though they make up less than a quarter of county residents.

This trend is also happening nationally: One recent study showed that whites were the only group that saw a decline in drug-induced deaths in 2018.

Kane-Willis, who co-authored a 2017 report on the impact of the opioid epidemic on African Americans and is preparing to publish a follow-up paper, said black drug users have higher overdose mortality rates for many of the same reasons they’re more likely to die from COVID-19: poverty, less access to effective medical treatment and more health problems.

A spokeswoman for Gov. J.B. Pritzker’s office said the administration is “continuing to work toward” the action plan’s goals and highlighted initiatives this year to combat the overdose crisis with an emphasis on social and racial equity.

In January, Pritzker issued an executive order to promote equitable prevention and treatment access, as well as earmarking $4.1 million to expand opioid-related services across the state. Some of that money is going to a state Rapid Deployment Project that teams with local health departments to target specific communities that have seen spikes in overdoses, officials said.

In response to the coronavirus pandemic, Illinois has eased up regulations to allow patients to take home longer-lasting supplies of methadone, residential facilities are taking extra measures to protect residents and staff, and community organizations are ensuring patients have better access to naloxone, Kirby said.

The city of Chicago, meanwhile, said it’s studying data on overdoses to identify demographic and geographic patterns and determine which neighborhoods need the most resources, including naloxone, syringe exchanges and community health education, Richards said. The city has already increased funding for naloxone distribution, he said, and in June plans to start issuing monthly reports showing year-to-date trends.

The goal, he said, is to create a robust response to the epidemic.

“I don’t want to underestimate the challenge, but I also don’t want to underestimate the power of using data to fund things that work,” he said. “Our goal is to get the biggest impacts that we can possibly get. We’re talking about saving lives.”


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