Excess mortality among younger Americans — who represent most of the commercially insured market — is increasing. Between Q1 2020 and Q4 2022, non-COVID excess mortality for Americans aged 35-44 increased by 28 percentage points, peaking in Q3 2021 with a 35%-point increase above the baseline.
Note: PP denotes percentage point.
Source: Society of Actuaries Research Institute Group Life COVID-19 Mortality Survey Report.
Between 2018 and 2022, the mortality rate for Americans under age 40 increased in 42 states. These spikes are largely attributable to a marked increase in overdose deaths – the primary cause of death in 37 states for this age cohort in 2022.
Note: State counts are inclusive of all 50 states and DC.
Source: Centers for Disease Control and Prevention WONDER database.
In 2020, a greater share of consumers deferred care due to concerns about the pandemic than cost. However, in 2022, this trend reversed, and the share of consumers who deferred care due to COVID-19 fell by 11 percentage points. Cost — both of overall living and of healthcare services — has returned as the primary reason for deferring care.
Source: QualtricsXM, Rising Costs Replace Pandemic Concerns As Top Reason Americans Defer Healthcare.
From 2019 to 2022, primary care volumes (-8.4%) declined, while women’s health volumes (+5.0%) and behavioral health volumes (+20.1%) increased. The reduction in preventive care compounded by the increase in behavioral health demand and constrained behavioral health provider supply will inevitably result in greater morbidity and mortality, as already evidenced by increasing mortality in younger adults.
Source: All-Payer Claims Databases, Agency for Healthcare Research and Quality.
Excess mortality among younger Americans — who represent most of the commercially insured market — is increasing. Between Q1 2020 and Q4 2022, non-COVID excess mortality for Americans aged 35-44 increased by 28 percentage points, peaking in Q3 2021 with a 35%-point increase above the baseline.
Note: PP denotes percentage point.
Source: Society of Actuaries Research Institute Group Life COVID-19 Mortality Survey Report.
While e-prescribing of antidepressants (-4.5%), stimulants (7.4%) and opioids (-24.3%) changed in 2022 from 2021, the share of total prescribing was higher for antidepressants (1.3%) and stimulants (11.2%) but lower for opioids (-3.6%).
Source: All-Payer Claims Databases, Agency for Healthcare Research and Quality.
Primary care utilization declined from 2021 to 2022, ranging from -7.8% (Miami, Chicago) to -4.1% (Washington, DC). This trend persists despite large metropolitan markets having a larger footprint of new entrants (e.g., CVS) offering access to select primary care services. Conversely, behavioral health utilization increased in nine of the ten markets, ranging from -1.9% (Miami) to 8.0% (Los Angeles).
Source: All-Payer Claims Databases, Agency for Healthcare Research and Quality.
Rates of early-onset cancers are growing, especially for adults ages 30-39, for whom incidence increased by almost 20% between 2010 and 2019. Given that primary care volumes declined by 6.3% from 2021 to 2022, the likelihood of diagnosing early-onset cancer has dropped and will likely manifest in later stage diagnosis and increased mortality.
Source: All-Payer Claims Databases, Agency for Healthcare Research and Quality.
While national cancer mortality rates have been declining for many years, the variation in rate by age has changed in more recent years. From 2018 to 2022, malignant neoplasm deaths were up 5.0% for ages 35-44 — an age cohort that historically is less affected by many cancers as reflected in current screening guidelines. Conversely, malignant neoplasm deaths have declined year-over-year for older age groups — ages 45-54 and 55-64
Source: All-Payer Claims Databases, Agency for Healthcare Research and Quality.
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