High deaths in middle age

Dr. John Campbell
4 Jan 202414:40
EducationalLearning
32 Likes 10 Comments

TLDRThe transcript discusses the concerning issue of excess mortality in England following the COVID-19 pandemic, with a 7.2% increase in deaths in 2022 and continued excess deaths in 2023. The Lancet Regional Health Europe article highlights that the majority of these deaths are not directly related to COVID-19 but may be due to acute pressures on NHS services and disruptions in chronic disease management. The data reveals a significant increase in deaths among younger and middle-aged adults, with higher rates seen in those aged 50 to 64. The transcript calls for a more granular analysis to identify the underlying causes of these excess deaths and to inform prevention and disease management efforts.

Takeaways
  • 📚 The Lancet Regional Health Europe published an article discussing excess mortality in England post-COVID-19 pandemic, highlighting implications for secondary prevention.
  • 💷 There is a £4,000 fee for publishing an article with open access in the Lancet Regional Health Europe, which may limit the accessibility of research to those without sufficient funding.
  • 📉 Excess deaths have persisted in the UK and globally, with 7.2% more deaths in the UK in 2022, and 8.86% more in the first half of 2023, compared to expected numbers.
  • 🏥 Acute pressures on the NHS and disruptions to chronic disease management are cited as causes for the excess deaths, but the script suggests there may be other contributing factors that warrant investigation.
  • 👨‍👩‍👧‍👦 Excess deaths are most prominent among middle-aged and younger adults, not just the elderly, which is concerning as it's not typically the age group most affected by COVID-19.
  • 📈 There are significant increases in deaths from various diseases such as cardiovascular disease, heart failure, liver disease, and diabetes, with diabetes showing a particularly sharp increase of 133%.
  • 🤔 The script calls for a granular analysis to understand not just the proximal (immediate) causes of death, but also the distal (underlying) causes to inform prevention and disease management.
  • 👴 Middle-aged adults (50 to 64 years old) are experiencing a higher rate of excess deaths, with some diseases showing a 33-44% increase compared to expected numbers.
  • 🌍 The phenomenon of excess deaths is not limited to the UK but is an international issue, affecting multiple countries around the world.
  • ⏳ The article concludes with a declaration of interest by the lead author, noting personal fees from pharmaceutical companies, which may influence the interpretation of the findings.
  • 📉 There is a clear need for timely and granular analysis to describe the trends of excess deaths and to inform prevention and disease management efforts, which are currently lacking.
Q & A

  • What is the main topic of the discussed journal article?

    -The main topic of the journal article is the issue of excess mortality in England post-COVID-19 pandemic and its implications for secondary prevention.

  • What is the publication name where the discussed article was published?

    -The discussed article was published in 'The Lancet Regional Health Europe'.

  • What is the Open Access publishing charge for articles in 'The Lancet Regional Health Europe'?

    -The Open Access publishing charge for articles in 'The Lancet Regional Health Europe' is £4,000.

  • According to the UK Office for National Statistics, what was the percentage of excess deaths in the UK in 2022?

    -The UK Office for National Statistics calculated that there were 7.2% more deaths registered in the UK in 2022.

  • What is the percentage of excess deaths for the first 44 weeks of 2023 according to the OECD data?

    -According to the OECD data, there were 99.44% excess deaths in the first 44 weeks of 2023.

  • What are the potential causes of the excess deaths as mentioned in the article?

    -The potential causes of excess deaths mentioned in the article include direct effects of COVID-19 infection, acute pressure on NHS services, and disruption to chronic disease detection and management.

  • Which age group experienced the highest relative excess deaths according to the article?

    -The age group 50 to 64 years old experienced the highest relative excess deaths, with a 15% higher rate than expected.

  • What is the increase in percentage for diabetes-related deaths in the discussed time period?

    -There was a 133% increase in diabetes-related deaths in the discussed time period.

  • What is the main concern expressed about the current understanding of the causes of excess deaths?

    -The main concern expressed is that while the proximal (immediate) causes of death are identified, the distal (underlying) causes are not being adequately explored or addressed.

  • What type of analysis is suggested to better understand the trends of excess deaths?

    -A longitudinal, granular analysis that considers variables such as age, sex, smoking status, medication history, and other relevant factors is suggested to better understand the trends of excess deaths.

  • What is the significance of the Declaration of Interest mentioned at the end of the article?

    -The Declaration of Interest indicates that the lead author of the study has received personal fees from pharmaceutical companies, which is important to disclose to maintain transparency and avoid potential conflicts of interest.

  • What is the current trend of excess deaths worldwide as discussed in the video?

    -The current trend of excess deaths is persistent, with a significant number of excess deaths continuing to occur worldwide, particularly among middle-aged and younger adults.

Outlines
00:00
📚 Excess Mortality Post-COVID-19: Journal Article Insights

The first paragraph discusses an article from 'The Lancet Regional Health, Europe' on excess mortality in England following the COVID-19 pandemic. The speaker expresses concerns about the publishing fees for open access articles in the journal and shares statistics on the increase in deaths in the UK for 2022 and the first half of 2023. The speaker also mentions discrepancies in data from different sources and raises questions about the direct and indirect causes of these excess deaths, including the impact of acute pressures on the NHS and chronic disease management.

05:04
🤔 Investigating the Causes of Excess Deaths

The second paragraph delves into the potential causes of the observed excess deaths, beyond the direct effects of COVID-19. It highlights the impact of acute pressures on the NHS services and the disruption to chronic disease detection and management. The speaker ponders if there are other factors at play that might have changed between 2015 and 2019 that could explain the excess mortality. The paragraph also provides data on the age groups most affected by excess deaths, noting a significant increase in deaths among younger and middle-aged adults, and discusses the rise in specific diseases such as cardiovascular disease, heart failure, liver disease, and diabetes.

10:06
📉 The Tragedy of Persistent Excess Deaths: A Call for Detailed Analysis

The third paragraph emphasizes the ongoing issue of persistent excess deaths, particularly among middle-aged and younger adults. It stresses the need for a granular, longitudinal study to understand the proximal and distal causes of these deaths. The speaker criticizes the lack of focus on the underlying causes of the diseases leading to excess deaths and calls for a comprehensive analysis that considers various factors, including age, sex, smoking status, and medication history. The paragraph concludes with a declaration of interest from the lead author of the article, mentioning personal fees from pharmaceutical companies, and ends with a reflection on the frustration surrounding the continued excess mortality rates.

Mindmap
Keywords
💡Excess mortality
Excess mortality refers to the number of deaths that exceed the expected number in a specific period. In the video, it is discussed in the context of England post-COVID-19 pandemic, where there has been a significant increase in deaths beyond what would normally be anticipated. This is a central theme of the video as it sets the stage for discussing the various implications and causes behind this phenomenon.
💡The Lancet Regional Health Europe
The Lancet Regional Health Europe is a medical journal where the article on excess mortality post-COVID-19 pandemic in England was published. The journal is mentioned as a reputable source, although there is a discussion about the £4,000 fee for open access publishing, which raises questions about accessibility and financial barriers to disseminating research findings.
💡COVID-19 pandemic
The COVID-19 pandemic is the global health crisis caused by the SARS-CoV-2 virus. The video discusses how the pandemic has led to an excess of deaths even after the peak periods of 2020 and 2021. It is a key concept as it is the starting point for understanding the subsequent analysis of death rates and their causes.
💡Acute pressures on the NHS
Acute pressures on the NHS (National Health Service) refer to the sudden and intense demands placed on the healthcare system, likely due to the pandemic. The video suggests that these pressures may have contributed to poor outcomes from acute illnesses and are considered a factor in the excess mortality rates. This is an important aspect of the discussion as it highlights the strain on healthcare services and its impact on public health.
💡Chronic disease management
Chronic disease management involves the ongoing care and treatment of health conditions that persist over a long period of time. The video mentions that disruption to chronic disease detection and management could be a contributing factor to the excess mortality rates. This is significant as it points to the broader impacts of the pandemic on healthcare beyond the direct effects of COVID-19.
💡Open Access publishing
Open Access publishing is a model where research findings are made freely available to the public, rather than being restricted behind paywalls. The video discusses the £4,000 fee for open access in The Lancet Regional Health Europe, which may limit the accessibility of important research to those who cannot afford it. This concept is important as it touches on issues of equity and the dissemination of knowledge.
💡Excess deaths by age group
The video provides statistics on excess deaths among different age groups, particularly noting that those aged 50 to 64 experienced a 15% higher death rate than expected. This information is crucial as it highlights the demographic groups most affected by the excess mortality and suggests that the issue is not confined to older adults typically more vulnerable to COVID-19.
💡Cardiovascular disease
Cardiovascular disease refers to conditions affecting the heart and blood vessels, such as heart attacks and strokes. The video mentions a 12% increase in cardiovascular disease as a cause of death, indicating that it is a significant contributor to the excess mortality rates. This underscores the need to understand the broader health impacts beyond the direct effects of the pandemic.
💡Diabetes
Diabetes is a chronic metabolic disorder that is highlighted in the video as having a 133% increase in death rates during the observed period. This dramatic rise underscores the impact of pre-existing health conditions on mortality rates and the potential strain on healthcare systems when these conditions are exacerbated or not managed effectively.
💡
💡Proximal and distal causes
Proximal and distal causes refer to the immediate (proximal) and underlying (distal) factors leading to a disease or death. The video calls for a deeper investigation into the distal causes of the observed excess mortality, suggesting that there may be factors beyond the immediate health conditions that need to be examined. This concept is pivotal as it shifts the focus towards a more comprehensive understanding of the situation.
💡Office for Health Improvement and Disparities
The Office for Health Improvement and Disparities is mentioned as the source of data on excess deaths and various health conditions. The video discusses the data's significance in understanding the scope and nature of the health crisis. This keyword is important as it identifies the authoritative source of the health statistics discussed throughout the video.
Highlights

Excess mortality in England post-COVID-19 pandemic has continued long after the peaks associated with the pandemic in 2020 and 2021.

The UK Office for National Statistics calculated that there were 7.2% or 44,255 more deaths registered in the UK in 2022.

The first six months of 2023 saw 8.88% or 28,000 more deaths registered than expected.

The causes of excess deaths are likely to be multiple, including direct effects of COVID-19 infection and acute pressures on the NHS.

Disruption to chronic disease detection and management is also cited as a contributing factor to the excess deaths.

Excess deaths for all causes were relatively greatest for those aged 50 to 64 years, at 15% higher than expected.

Young adults aged 25 to 49 and under 25 are also experiencing higher death rates, at 11% and 11% respectively.

Cardiovascular disease, heart failure, liver disease, and diabetes have seen significant increases in death rates.

The immediate causes of death are identified, but the underlying or 'distal' causes are not, indicating a need for further investigation.

There is a call for a granular, longitudinal study to analyze variables such as age, sex, smoking status, and medication history to understand the trends.

The article in The Lancet Regional Health Europe discusses the need for timely and granular analysis to inform prevention and disease management efforts.

The article's lead author declares personal fees from pharmaceutical companies, including Novo Nordisk and Pfizer.

The pattern of persistent excess deaths is most prominent in middle-aged and younger adults, indicating an unfolding tragedy.

The article suggests that young, fit adults are dying at accelerated rates, with identified proximal causes but undetermined distal causes.

The discussion highlights the need for a national curiosity to investigate the causes behind the increased rates of heart and other diseases.

The transcript raises concerns about the £4,000 fee for Open Access publishing in The Lancet Regional Health Europe, potentially limiting access to research.

The speaker expresses frustration with the ongoing excess deaths and calls for more in-depth analysis to understand and address the situation.

The article concludes by emphasizing the importance of understanding the proximal and distal causes of the observed health trends.

Transcripts

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Excess MortalityPost-COVIDEnglandPandemic ImpactSecondary PreventionHealth AnalysisNHS PressuresChronic DiseaseAcute IllnessLancet JournalOpen AccessHealth DisparitiesMortality TrendsDisease ManagementYoung AdultsCardiovascular DiseaseDiabetesHealthcare CostsPharmaceutical Interests