Monday, July 17, 2023

Climate change fostered rise and fall of the Tibetan Empire during 600-800 AD

Peer-Reviewed Publication

SCIENCE CHINA PRESS

The varved sediments of JiangCo 

IMAGE: THE VARVES OF JIANGCO ARE ANNUAL VARVES, EACH LAYER DIVIDED INTO COARSE-GRAINED AND FINE-GRAINED SUB-LAYERS view more 

CREDIT: ©SCIENCE CHINA PRESS



This study is led by Dr. Juzhi Hou, Dr. Fahu Chen, and Dr. Kejia Ji (Group of Alpine Paleoecology and Human Adaptation (ALPHA), State Key Laboratory of Tibetan Plateau Earth System, Resources and Environment (TPESRE), Institute of Tibetan Plateau Research, Chinese Academy of Sciences). The research team obtained a high-resolution climate record of the past 2000 years using the varved sediments of Lake JiangCo on the central Tibetan Plateau. The warm and humid climate during the 7th-9th centuries AD and the subsequent cold and aridification are consistent with the rise and fall of the Tibetan Empire. Climate change is one of the possible reasons for the rise and fall of the Tibetan Empire.

During the preliminary field investigation, the researchers found that the varved sediment in JiangCo, a lake on the central Tibetan Plateau, was well-preserved. Through earlier varve counting and other radiometric dating methods, the time range of a gravity core of up to 1 meter covering the past 2000 years was determined. Subsequently, high-resolution XRF elements scanning and carbonate carbon/oxygen isotope analysis were performed on the sediment, and the temperature and precipitation records for the past 2000 years were reconstructed using biomarkers such as alkenones. The results showed that the 7th-9th centuries AD was an unusually warm and humid period. The researchers compared this period with historical literatures and found that it coincided with the only unified local regime, the Tibetan Empire, which existed on the Tibetan Plateau at that time. The changes in warm and humid climate and cold and dry climate were highly correlated with the foreign policy changes of the Tibetan Empire. Combined with the ecological niche model, the researchers simulated the area of highland barley cultivation during the warm and humid period of the 7th-9th centuries AD and the subsequent cold and dry period, which differed by about 10.88 million hectares.

The element titanium is an allothigenic element that reflects changes in precipitation. The dry and wet periods reflected by titanium are highly consistent with the timing of historical events such as the treaties and wars of the Tibetan Empire.

CREDIT

©Science China Press

On the ecologically fragile environment of the Tibetan Plateau, climate change is one of the factors that constrains human activities. This latest research results show that warm and humid climates promote the development of agriculture and animal husbandry on the plateau, while cold and arid conditions have negative effects on agriculture and animal husbandry. Climate change played a important role in the rise and fall of the Tibetan Empire. Today, with the warming and humidification of the Tibetan Plateau, studying the human-environment interactions in the past has important implications for modern responses to climate change.

Heading frequency and risk of cognitive impairment in retired male professional soccer players

JAMA Network Open

Peer-Reviewed Publication

JAMA NETWORK



About The Study: The findings of this study suggest that repetitive heading during a professional soccer career is associated with an increased risk of cognitive impairment in later life. Further study is needed to establish the upper threshold for heading frequency to mitigate this risk. 

Authors: Weiya Zhang, Ph.D., of the University of Nottingham in Nottingham, United Kingdom, is the corresponding author. 

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/ 

(doi:10.1001/jamanetworkopen.2023.23822)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

 http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2023.23822?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=071723

About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Addressing the future challenges of global surface water quality


Sub-Saharan Africa as the key future hotspot


Peer-Reviewed Publication

UNIVERSITEIT UTRECHT FACULTEIT GEOWETENSCHAPPEN




As the world's population continues to grow, ensuring access to clean and safe water has become an increasingly important concern, yet little is known about how surface water quality will change in the future. Recent scientific research has shed light on the potential challenges that surface water quality may face in the coming years, particularly in Sub-Saharan Africa. “While surface water quality is projected to improve in most developed countries, there is an important caveat: the outlook for the poorest nations is bleak”. 

A recent study, published in Nature Water, has projected an increase in surface water pollution in Sub-Saharan Africa. These findings highlight the need for proactive measures to protect surface water resources and safeguard the well-being of communities. The study, led by Utrecht University researcher Edward Jones, emphasizes the importance of equitable and sustainable development, particularly in regions expected to experience the greatest challenges. Using a new global model, he assessed how climate change and societal developments could impact surface water quality until the end of the century.

Key hotspot

“Irrespective of climate change and socio-economic scenario, there will be a strong increase in the number of people living in Sub-Saharan Africa who are exposed to poor surface water quality”, warns Jones. “This pattern is not systematically replicated in any other world region.” Even under the most optimistic future scenario the number of people exposed to pollutant concentrations exceedances in Sub-Saharan Africa will more than double. Alternatively, under pessimistic assumptions, the number of people exposed to poor surface water quality can increase 5-fold. “With the combination of strong water quality degradation and the drastic increases in the number of people exposed to poor surface water quality, our paper concludes that Sub-Saharan Africa will become the key hotspot of surface water pollution in the future.”

Challenges

The challenges are multifold, according to Jones. Waterborne diseases caused by pathogen-contaminated water can pose a significant risk to human populations. With a growing global population, the availability of good quality water for irrigation is of utmost importance. Additionally, energy production, which is key for global development, can be hampered by a combination of both low water levels and high water temperatures. Thus, the study highlights the importance of limiting both climate change and anthropogenic water pollution to safeguard both human livelihoods and ecosystem health in the future.

Article

Edward R. Jones, Marc F.P. Bierkens, Peter J.T.M. van Puijenbroek (...), Michelle T.H. van Vliet, ‘Sub-Saharan Africa will increasingly become the dominant hotspot of surface water pollution’, Nature Waterhttps://doi.org/10.1038/s44221-023-00105-5 (after lift of embargo)

All about the Benjamins: Researchers decipher the secrets of Benjamin Franklin’s paper money


A rare window into the early American monetary history — thanks to techniques from physics

Peer-Reviewed Publication

UNIVERSITY OF NOTRE DAME

Researchers decipher the secrets of Benjamin Franklin’s paper money 

IMAGE: KHACHATUR MANUKYAN AND HIS TEAM EMPLOYED CUTTING-EDGE SPECTROSCOPIC AND IMAGING INSTRUMENTS TO GET A CLOSER LOOK THAN EVER AT THE INKS, PAPER AND FIBERS THAT MADE BENJAMIN FRANKLIN’S BILLS DISTINCTIVE AND HARD TO REPLICATE. view more 

CREDIT: UNIVERSITY OF NOTRE DAME



Benjamin Franklin may be best known as the creator of bifocals and the lightning rod, but a group of University of Notre Dame researchers suggest he should also be known for his innovative ways of making (literal) money.

During his career, Franklin printed nearly 2,500,000 money notes for the American Colonies using what the researchers have identified as highly original techniques, as reported in a study published this week in the Proceedings of the National Academy of Sciences.

The research team, led by Khachatur Manukyan, an associate research professor in the Department of Physics and Astronomy, has spent the past seven years analyzing a trove of nearly 600 notes from the Colonial period, which is part of an extensive collection developed by the Hesburgh Libraries’ Rare Books and Special Collections. The Colonial notes span an 80-year period and include notes printed by Franklin’s network of printing shops and other printers, as well as a series of counterfeit notes.

Manukyan explained that the effort to print money for the fledgling Colonial monetary system was important to Franklin not just as a printer but as a statesman as well.

“Benjamin Franklin saw that the Colonies’ financial independence was necessary for their political independence. Most of the silver and gold coins brought to the British American colonies were rapidly drained away to pay for manufactured goods imported from abroad, leaving the Colonies without sufficient monetary supply to expand their economy,” Manukyan said.

However, one major problem stood in the way of efforts to print paper money: counterfeiting. When Franklin opened his printing house in 1728, paper money was a relatively new concept. Unlike gold and silver, paper money’s lack of intrinsic value meant it was constantly at risk of depreciating. There were no standardized bills in the Colonial period, leaving an opportunity for counterfeiters to pass off fake bills as real ones. In response, Franklin worked to embed a suite of security features that made his bills distinctive.

“To maintain the notes’ dependability, Franklin had to stay a step ahead of counterfeiters,” said Manukyan. “But the ledger where we know he recorded these printing decisions and methods has been lost to history. Using the techniques of physics, we have been able to restore, in part, some of what that record would have shown.”

Manukyan and his team employed cutting-edge spectroscopic and imaging instruments housed in the Nuclear Science Laboratory and four Notre Dame research core facilities: the Center for Environmental Science and Technology, the Integrated Imaging Facility, the Materials Characterization Facility and the Molecular Structure Facility. The tools enabled them to get a closer look than ever at the inks, paper and fibers that made Franklin’s bills distinctive and hard to replicate.

One of the most distinctive features they found was in Franklin’s pigments. Manukyan and his team determined the chemical elements used for each item in Notre Dame’s collection of Colonial notes. The counterfeits, they found, have distinctive high quantities of calcium and phosphorus, but these elements are found only in traces in the genuine bills.

Their analyses revealed that although Franklin used (and sold) “lamp black,” a pigment created by burning vegetable oils, for most printing, Franklin’s printed currency used a special black dye made from graphite found in rock. This pigment is also different from the “bone black” made from burned bone, which was favored both by counterfeiters and by those outside Franklin’s network of printing houses.

Another of Franklin’s innovations was in the paper itself. The invention of including tiny fibers in paper pulp — visible as pigmented squiggles within paper money — has often been credited to paper manufacturer Zenas Marshall Crane, who introduced this practice in 1844. But Manukyan and his team found evidence that Franklin was including colored silks in his paper much earlier.

The team also discovered that notes printed by Franklin’s network have a distinctive look due to the addition of a translucent material they identified as muscovite. The team determined that Franklin began adding muscovite to his papers and the size of this muscovite crystals in his paper increased over time. The team speculates that Franklin initially began adding muscovite to make the printed notes more durable but continued to add it when it proved to be a helpful deterrent to counterfeiters.

Manukyan said that it is unusual for a physics lab to work with rare and archival materials, and this posed special challenges.

“Few scientists are interested in working with materials like these. In some cases, these bills are one-of-a-kind. They must be handled with extreme care, and they cannot be damaged. Those are constraints that would turn many physicists off to a project like this,” he said.

But for him, the project is a testament to the value of interdisciplinary work.

“We were fortunate to have student researchers on this project with interests both in physics as well as in history and art conservation. And the core research facilities as well as the Rare Books and Special Collections team were incredible research partners. Without an uncommon level of collaboration across disciplines, our discoveries would not have been possible.”

In addition to lead investigator Manukyan, the research team for this project included Armenuhi Yeghishyan, a laboratory technician in the Department of Physics and Astronomy; Ani Aprahamian, the Frank M. Freimann Professor of Physics and concurrent professor in the Department of Chemistry and Biochemistry; Louis Jordan, an associate University librarian emeritus for academic services and collections; Michael Kurkowski, a former undergraduate researcher studying physics and mathematics; Mark Raddell, a former undergraduate researcher studying finance and physics who is now a consultant at Deloitte; Laura Richter Le, a former undergraduate researcher who is now a graduate student at the Conservation Center at New York University’s Institute of Fine Arts; Zachary D. Schultz, a former associate professor at Notre Dame who is now a faculty member at the Ohio State University; Liam Spillane, who works at Gatan Inc.; and Michael Wiescher, the Frank M. Freimann Professor of Physics.

This research project was funded by an internal grant from Notre Dame Research. For more information on the Nuclear Science Laboratory’s work investigating historical materials, visit sites.nd.edu/kmanukyan/research/.

COVID-19 vaccines saved dementia patients' lives in nursing homes

Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - SAN FRANCISCO



Deaths among older adults with dementia fell starkly in nursing homes and long-term care centers after COVID-19 vaccinations became available, yet remained high for those living at home, according to a new study led by UC San Francisco.  
 
The nationwide study published July 17, 2023 in JAMA Neurology, is the first to use data from 2019 to 2022 to quantify “excess” deaths – or those above what would have been anticipated had there been no pandemic – taking into account age, sex, racial and ethnic groups, as well as the settings where people died. 

In the first year, there were 509,179 dementia-related deaths in the U.S. among people 65 and older, which the researchers estimated was 94,688 more than would be expected in that population if the pandemic had not occurred. In the second year, the number of excess deaths dropped by 77% to 21,586.  

The decline in mortality shows people with dementia generally benefited from the COVID-19 vaccines that became available in December of 2020, as well as from new treatments. 
 
Dementia deaths declined in every age, sex, racial and ethnic group evaluated among those in long-term care and nursing homes. But deaths did not decline nearly as much for those who remained at home. Among the home-based population, there were 34,487 excess deaths in the first year of the pandemic. That decreased by just 16% to 28,804 in the second year.  

“Older adults with Alzheimer’s Disease and related dementias are very vulnerable to the COVID pandemic,” said Ruijia Chen, ScD, MS, a postdoctoral fellow in epidemiology and biostatistics at UC San Francisco and first author of the paper. “What we were trying to understand with this paper is whether the excess deaths actually declined after the vaccines became available.”  
 
Nursing homes were an early epicenter of the COVID-19 pandemic. Older people with dementia were especially susceptible to contracting the virus and dying from it due to comorbidities, difficulties adhering to infection control protocols, disruptions in care and isolation from family members and caregivers.  
 
The pandemic also saw significant disparities in excess deaths among ethnic groups, with higher rates of infection, hospitalization and death among Black, Latino and Asian patients, compared to non-Hispanic white people.  
 
Researchers analyzed data from the National Center for Health Statistics (NCHS) to compare deaths from the first year of the pandemic (March 2020 to February 2021) to the second (March 2021 to February 2022).  

Many of the oldest, frailest nursing home residents were lost in the first year of the pandemic, although that doesn’t fully explain the trend.
 
The researchers said other factors could have played a role. Nursing home residents were among the first to receive the vaccines, while their delivery was not as well coordinated for those at home. Loneliness and social isolation also likely played a role for those remaining in the community, along with deferred medical care and the shift to virtual care, which is difficult for this population to access.  
 
“The declining mortality in long-term care settings when vaccines became available show how lives can be saved when systems are in place to achieve comprehensive access to vaccinations,” said Maria Glymour, ScD, MS, senior author of the paper. Now chair of the Department of Epidemiology at Boston University, Glymour conducted the research when she was at UCSF. “Our findings suggest critical resources to make COVID-19 a survivable infection – most importantly vaccinations for themselves and those around them – are not reaching older adults living at home.”
   
Authors:  In addition to Glymour and Chen, UCSF authors include Kirsten Bibbons-Domingo, MD, PhD, Jingxuan Wang, MS, Erika Meza, MPH, Hélène E. Aschmann, PhD, Michelle A. DeVost, MPH, and Yea-Hung Chen, PhD. For other authors, please see the study. 

Funding: This work was supported by the National Institute on Aging (K00AG068431 and F31AG079651), the SNSF Postdoc Fellowship, the National Institute on Drug Abuse (K99DA051534) and the Robert Wood Johnson Foundation.  

 

About UCSF: The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. UCSF Health, which serves as UCSF's primary academic medical center, includes top-ranked specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area. UCSF School of Medicine also has a regional campus in Fresno. Learn more at https://ucsf.edu, or see our Fact Sheet.

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World-first clinical trial to help millions with penicillin allergies


Peer-Reviewed Publication

VANDERBILT UNIVERSITY MEDICAL CENTER

Dr. Elizabeth Phillips 

IMAGE: VANDERBILT UNIVERSITY MEDICAL CENTER PRINCIPAL INVESTIGATOR ELIZABETH PHILLIPS, MD, THE JOHN OATES PROFESSOR OF CLINICAL RESEARCH. view more 

CREDIT: VANDERBILT UNIVERSITY MEDICAL CENTER



Penicillin allergy affects more than 25 million people in the United States (up to 1 in 10 Americans) and has been shown to lead to particularly poor health outcomes in pregnant women and surgical patients. It is also a public health threat, leading to antibiotic resistance and infections in hospitalized patients that can be life threatening.

Seventy-five% or more penicillin allergy labels come on by age 3 due to, for example, confusion with a viral rash. The majority of these rashes were never allergic, but the labels ‘stick’ into adulthood and carry many adverse consequences.”

 

Many low-risk patients with a penicillin allergy were able to have their penicillin allergy label removed through a simple procedure known as “direct oral challenge” as part of a world-first multicenter randomized control trial known as the Penicillin Allergy Clinical Decision Rule (PALACE) study.

 

In the PALACE study, investigators randomized low-risk penicillin allergic patients to two different approaches to remove their allergy label. They either underwent the current standard of care to have skin testing followed if negative by oral challenge with a penicillin or they went straight to oral challenge (“direct oral challenge”) without preceding skin testing.   

 

“The majority of patients labeled as penicillin allergic, more than 90%, have low-risk histories, meaning they did not have a history to suggest a severe or more recent reaction to a penicillin,” said PALACE study protocol member and Vanderbilt University Medical Center principal investigator Elizabeth Phillips, MD, the John Oates Professor of Clinical Research. “We would expect more than 95% of these patients to have negative testing and be able to take penicillin in the future.”

 

The study, undertaken by a team of researchers from specialized centers in North America and Australia, enrolled 382 adults who were assessed using a specialized risk assessment tool called PEN-FAST. Participants were randomly assigned to receive either a direct oral penicillin challenge or the standard approach (penicillin skin testing followed by an oral challenge). The primary goal was to determine if the direct oral penicillin challenge was no worse than the standard method of skin testing followed by oral challenge which needs to be performed in an allergist’s office.

 

Only one patient (0.5%) in each group experienced a positive reaction to the penicillin challenge, demonstrating that the direct oral penicillin challenge performs just as well as the standard method. Importantly, there were no significant differences in adverse events between the two groups, and no serious adverse events were reported.

 

The findings have wide-ranging implications for patients. By accurately identifying low-risk penicillin allergy patients, health care providers can ensure appropriate antibiotic prescriptions. Patients with a documented penicillin allergy are more likely to be prescribed alternative antibiotics, known as second-line antibiotics, which are often not as effective against certain infections and may have more side effects.

 

“Patients with penicillin allergy are more likely to get second-line or broader spectrum antibiotics that lead to risk of antibiotic resistance and serious infections such as antibiotic-associated diarrhea due to Clostridioides difficile, which can spread through hospitals and become a major public health problem.” Phillips said. “In the U.S. increasingly we also have a major problem with other antibiotic-resistant ‘superbugs’ such as multi-resistant gram-negative infections, Candida auris and even a resurgence of syphilis for which penicillin is the best treatment and the only treatment that should be used in pregnancy to prevent transmission to an unborn child.

 

“The evidence provided by the PALACE study will change clinical practice.  Many patients in the United States do not have direct access to an allergist to provide specialized testing such as skin testing.  Therefore, the ability to go to direct oral challenge with a penicillin in low-risk patients which can be carried out in any observed setting will make it easier for patients in the United States to access health care to safely and effectively remove the label of penicillin allergy,” she said.

 

The PALACE study was led by Ana-Maria Copaescu, MD, PhD, McGill University Health Centre, Montréal, and senior author Jason Trubiano. PhD, Center for Antibiotic Allergy and Research, Department of Infectious Diseases at Austin Health. Cosby Stone, MD, assistant professor of Medicine in the Division of Allergy, Pulmonology, and Critical Care Medicine, was a co-investigator for VUMC.

 

 

 

 

 

 

 

The missing Americans: Unprecedented US mortality far exceeds other wealthy nations


A new study found that more than one million US deaths per year—including many young and working-age adults—could be avoided if the US had mortality rates similar to its peer nations.

Peer-Reviewed Publication

BOSTON UNIVERSITY SCHOOL OF PUBLIC HEALTH



A new study found that more than one million US deaths a year—including many young and working-age adults—could be avoided if the US had mortality rates similar to its peer nations.

In 2021, 1.1 million deaths would have been averted in the United States if the US had mortality rates similar to other wealthy nations, according to a new study led by a Boston University School of Public Health (BUSPH) researcher.

Published in the journal PNAS Nexus, the study refers to these excess deaths as "Missing Americans," because these deaths reflect people who would still be alive if the US mortality rates were equal to its peer countries. 

Comparing age-specific death rates in the U.S. and 21 other wealthy nations from 1933 through 2021, the authors find that current death rates in the US are much higher than other wealthy nations, and the number of excess U.S. deaths has never been larger.

“The number of Missing Americans in recent years is unprecedented in modern times,” says study lead and corresponding author Dr. Jacob Bor, associate professor of global health and epidemiology at BUSPH.

Nearly 50 percent of all Missing Americans died before age 65 in 2020 and 2021. According to Dr. Bor, the level of excess mortality among working age adults is particularly stark. “Think of people you know who have passed away before reaching age 65. Statistically, half of them would still be alive if the US had the mortality rates of our peers. The US is experiencing a crisis of early death that is unique among wealthy nations.”

The COVID-19 pandemic contributed to a sharp spike in mortality in the US—more so than in other countries—but the new findings show that the number of excess US deaths has been accelerating over the last four decades. Dr. Bor and colleagues analyzed trends in US deaths from 1933 to 2021, including the impact of COVID-19, and then compared these trends with age-specific mortality rates in Canada, Japan, Australia, and 18 European nations.

The US had lower mortality rates than peer countries during World War II and its aftermath. During the 1960’s and 1970’s, the US had mortality rates similar to other wealthy nations, but the number of Missing Americans began to increase year by year starting in the 1980’s, reaching 622,534 annual excess US deaths by 2019. Deaths then spiked to 1,009,467 in 2020 and 1,090,103 in 2021 during the pandemic. From 1980 to 2021, there were a total of 13.1 million Missing Americans.

The researchers emphasize that this mortality crisis is a multiracial phenomenon and is not specific to minoritized groups. Black and Native Americans are overrepresented in these measures, with mortality rates in early adulthood (ages 15-44) that were five and eight times higher than the average of other wealthy nations. The team also says that the history of structural racism in the US, including policies such as slavery and redlining, has contributed to racial and ethnic disparities in wealth and in access to education, housing, and healthcare that drive leading causes of worse mortality rates, particularly at young ages.

Still, two-thirds of the Missing Americans are White, a result of the larger population of White Americans, their older age distribution, and death rates that are significantly higher than other wealthy nations.

“Living in the US is a risk factor for early death that is common across many US racial and ethnic groups. Whereas most health disparities studies assess differences between US racial/ethnic groups, such an approach renders the poor health of Whites invisible and grossly underestimates the health shortfall of minoritized groups,” Dr. Bor says. “By using an international benchmark, we show that Americans of all races and ethnicities are adversely affected by the US policy environment, which places a low priority on public health and social protections, particularly for low-income people.”

Accounting for future years of life lost due when a person dies prematurely, the team estimates that in 2021, excess U.S. mortality translated to 26.4 million years of life lost relative to the mortality rates of peer nations. They connect the large excess mortality burden to the failure of US policy to adequately address major public health issues, including the opioid epidemic, gun violence, environmental pollution, economic inequality, food insecurity, and workplace safety. The COVID-19 pandemic exacerbated many of these issues, particularly among lower-income and minority groups, and now that most of the safety-net policies created during COVID-19 have expired, vulnerable groups have lost vital support. 

“We waste hundreds of billions each year on health insurers’ profits and paperwork, while tens of millions can’t afford medical care, healthy food, or a decent place to live,” says study senior author Dr. Steffie Woolhandler, Distinguished Professor at the School of Urban Public Health at Hunter College, City University of New York. “Americans die younger than their counterparts elsewhere because when corporate profits conflict with health, our politicians side with the corporations.”

In comparison to the US, other countries also had higher vaccination uptake and mask policies during the Omicron wave, and this layered mitigation was associated with fewer COVID-19 cases.

The findings raise a number of urgent questions that will be critical to address in future research, says study coauthor Dr. Andrew Stokes, assistant professor of global health at BUSPH. For example, he says, "Which geographic areas are disproportionately responsible for the Missing Americans, and what were their causes of death? Answers to these questions may help to clarify policy solutions.” 

At the moment, Dr. Bor says he is not optimistic that mortality rates will reverse in the near future, even as COVID-related deaths continue to wane from their 2021 peak. 

“The US was already experiencing more than 600,000 Missing Americans annually before the pandemic began, and that number was increasing each year. There have been no significant policy changes since then to change this trajectory,” he says.

“While COVID-19 brought new attention to public health, the backlash unleashed during the pandemic has undermined trust in government and support for expansive policies to improve population health,” said Dr. Bor. “This could be the most harmful long-term impact of the pandemic, because expansion of public policy to support health is exactly how our peer countries have attained higher life expectancy and better health outcomes.”

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About Boston University School of Public Health

Founded in 1976, Boston University School of Public Health is one of the top ten ranked schools of public health in the world. It offers master's- and doctoral-level education in public health. The faculty in six departments conduct policy-changing public health research around the world, with the mission of improving the health of populations—especially the disadvantaged, underserved, and vulnerable—locally and globally.