The following was written by Public Health Insider, the blog for Public Health — Seattle & King County:
The year 2020 will be remembered for many things – and pain and loss will be high on the list. One way to give proper attention to the grief and hardship is by keeping track of the lives lost.
A new report from Public Health—Seattle & King County finds that death rates increased in 2020 for common causes of death in King County, and not only those due to COVID-19. Death rates were higher for cardiovascular disease, diabetes, unintentional injury, drowning, and homicide.
Key findings include increased mortality rates among adults ages 18-44 (which saw increases of 23-31 percent) and among communities of color (which all saw increases ranging from 14 percent to 38 percent).
The report examines causes of death due to any reason, except COVID-19, from Jan. 1 through Dec. 31, 2020. It looks at common causes of death, as well as some less common causes that could be indirectly impacted by the COVID-19 pandemic.
“A full year into this pandemic, we can see how much pain and suffering it has caused, reflected in this data – and especially for our communities of color who continue to feel disproportionate impacts. We need to remember and honor those who have passed away. And we must strengthen our efforts to reduce illness, suffering and death,” said Patty Hayes, Director of Public Health—Seattle & King County.
WHAT DOES THIS REPORT TELL US?
In 2020, there were 14,893 deaths, compared to an annual average of 13,137 deaths over the previous three years. When adjusted for age and other demographics, that represents a 12 percent increase in the death rate.
Residents in all racial/ethnic groups across King County were affected. But death rates increased most significantly among American Indian/Alaska Native (38 percent increase) and Hispanic/Latinx residents (37 percent increase in death rates). American Indian/Alaska Native residents saw increased deaths from cardiovascular disease, while Hispanic/Latinx residents saw increased deaths from cardiovascular disease, diabetes, and overdoses. All communities of color saw at least a 14 percent increase in death rates, reinforcing findings from other national data.
These outcomes reinforce why, last June, King County declared racism is a public health crisis. The increased death rates reflect the combined impacts from long-standing racist systems that put people of color at additional risk for disease. For example, they reflect how communities of color have endured higher unemployment and deeper impacts across many areas. In response, King County launched new investments, policies and partnerships aimed at changing systems that are the root causes of health disparities.
Among age groups, people ages 18-24 had the highest percent (31 percent) increase in death rates, with adults ages 25-44 experiencing a 23 percent increase. Increases were observed for unintentional injuries and overdoses (a continuation of pre-pandemic trends) for both age groups, as well as increased homicides for adults ages 25-44.
Of particular note, the report finds:
• 7 percent increase in cardiovascular deaths (5,387 deaths in 2020, an increase of 429 deaths)
• 23 percent increase in diabetes-related death rates (440 deaths, an increase of 109 deaths)
• 19 percent increase in unintentional injury death rates (1,004 deaths in 2020, an increase of 178 deaths)
•23 percent increase in overdose deaths (452 deaths, an increase of 90 deaths)
• 61 percent increase in drowning (54 deaths in 2020, an increase of 21 deaths)
• 36 percent increase in homicide (114 deaths in 2020, an increase of 32 deaths)
While there have been concerns about potential increases in suicide related to the COVID-19 pandemic, overall suicide rates in King County in 2020 were stable compared with the 2017-2019 time period. Public Health continues to monitor rates among youth under 18, who had an average of 10 suicide deaths per year in 2017-2019 versus 15 deaths in 2020. That increase is important to note (although it is not statistically significant), as youth suicide rates have been steadily increasing in prior years. It remains unclear whether 2020 rates reflect an existing trend or may be due to impacts of COVID-19.
WHY ARE WE SEEING THESE INCREASES IN SO MANY CAUSES OF DEATH?
Much is still unknown about the causes of these increases. Economic stressors, impacts of isolation, lack of access to health care, and delays or avoidance of medical care due to the pandemic may be playing a role. This analysis did not control for underlying health conditions (e.g. heart disease, diabetes) or COVID-19 status. Both of these have disproportionately impacted the health and wellbeing of communities of color for many years, due to systemic racism. Many communities of color were less likely to have health insurance pre-pandemic. And some supports like unemployment or stimulus payments were not available to many families.
HOW DOES COVID-19 FIT INTO THESE FINDINGS?
This report did not analyze deaths due to COVID-19, which are discussed separately in the Summary Report on Deaths Associated with COVID-19 for 2020. The increase in rates of death remains true even when deaths due to COVID-19 are excluded. In 2020, 1,126 King County residents died from COVID-19.
WHAT WILL PUBLIC HEALTH DO WITH THIS INFORMATION?
Public Health is focused on limiting the spread of COVID-19 and the harms it is causing. The agency continues to monitor causes of death in order to identify trends and provide factual information to inform community discussions and decisions, and ultimately prevent deaths. Public Health also designs programs and policies, and works in partnership with others in the community, to improve the overall health of King County.
Current programs are critical to limiting harm from diseases and injuries discussed in the report. For example, programs encourage everyone to eat healthy and stay active and prevent injuries (including preventing gun violence).
Other programs also address underlying causes of death:
- Public Health’s Access & Outreach program assists people with enrolling in health insurance through Washington Healthplanfinder and Apple Health, including a special enrollment period that starts Feb. 15, 2021.
- In response to the increase in firearm related homicides, Zero Youth Detention (ZYD) convened 40+ system and community partners to develop a comprehensive “Regional Safety and Wellbeing Plan.” ZYD’s goal is to implement long-term, sustainable community-based intervention, prevention, and restoration strategies, while also meeting the immediate needs of youth and families disproportionately impacted by violence in King County.
- Public Health works with partners to prevent overdoses, increase access to treatment, and provide harm reduction services that reduce the health impacts for people with substance use disorder.
- During the pandemic, new services help people find health food resources at a location near them, and Public Health is connecting essential workers with mental health support services.
Policies that limit the spread of COVID-19 and maintain health care resources may be indirectly contributing to some of these health impacts. For example, increasing food insecurity and economic stressors like job loss can lead to emotional distress. We see this reflected in other data sources Public Health is monitoring. A forecast by the Washington State Department of Health highlights concern for a mental health crisis that still may come – because after the great recession and other pandemics, the rates of suicide and other ‘deaths of despair’ tended to increase after a delayed period of time.
By being aware of these impacts and potential impacts, Public Health and the community can bolster supports and add services that prevent or limit the harm.
- This work is funded by Public Health—Seattle & King County, the Washington State Department of Health, and the Centers for Disease Control and Prevention. Public Health will continue to monitor these data for emerging trends, sharing regular updates at kingcounty.gov/covid/impacts.
- Explore detailed data about King County deaths through the online dashboard
- For the an overview of COVID-19 deaths in 2020, see Public Health’s “Summary Report on Deaths Associated with COVID-19”