Male-Female Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: A State-by-State Analysis

doi:10.1101/2021.05.02.21256495

This is a preprint.

It has not yet been peer reviewed by a journal.

The National Library of Medicine is running a pilot to include preprints that result from research funded by NIH in PMC and PubMed.

[Preprint]. 2021 May 5:2021.05.02.21256495.

doi: 10.1101/2021.05.02.21256495.

Male-Female Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: A State-by-State Analysis

Jay J Xu¹, Jarvis T Chen², Thomas R Belin^{1

3}, Ronald S Brookmeyer¹, Marc A Suchard^{1

4

5}, Christina M Ramirez¹

Affiliations

¹ Department of Biostatistics, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, USA.
² Department of Social and Behavioral Sciences, Harvard T.H. Chan School Of Public Health, Harvard University, Cambridge, MA 02115, USA.
³ Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA.
⁴ Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA.
⁵ Department of Computational Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA.

PMID: 33972951
PMCID: PMC8109188
DOI: 10.1101/2021.05.02.21256495

Male-Female Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: A State-by-State Analysis

Jay J Xu et al. medRxiv. 2021.

[Preprint]. 2021 May 5:2021.05.02.21256495.

doi: 10.1101/2021.05.02.21256495.

Authors

Jay J Xu¹, Jarvis T Chen², Thomas R Belin^{1

3}, Ronald S Brookmeyer¹, Marc A Suchard^{1

4

5}, Christina M Ramirez¹

Affiliations

¹ Department of Biostatistics, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, USA.
² Department of Social and Behavioral Sciences, Harvard T.H. Chan School Of Public Health, Harvard University, Cambridge, MA 02115, USA.
³ Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA.
⁴ Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA.
⁵ Department of Computational Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA.

PMID: 33972951
PMCID: PMC8109188
DOI: 10.1101/2021.05.02.21256495

Update in

This article has been published with doi: 10.3390/app11167403

Abstract

Males are at higher risk relative to females of severe outcomes following COVID-19 infection. Focusing on COVID-19-attributable mortality in the United States (U.S.), we quantify and contrast years of potential life lost (YPLL) attributable to COVID-19 by sex based on data from the U.S. National Center for Health Statistics as of 31 March 2021, specifically by contrasting male and female percentages of total YPLL with their respective percent population shares and calculating age-adjusted male-to-female YPLL rate ratios both nationally and for each of the 50 states and the District of Columbia. Using YPLL before age 75 to anchor comparisons between males and females and a novel Monte Carlo simulation procedure to perform estimation and uncertainty quantification, our results reveal a near-universal pattern across states of higher COVID-19-attributable YPLL among males compared to females. Furthermore, the disproportionately high COVID-19 mortality burden among males is generally more pronounced when measuring mortality in terms of YPLL compared to age-irrespective death counts, reflecting dual phenomena of males dying from COVID-19 at higher rates and at systematically younger ages relative to females. The U.S. COVID-19 epidemic also offers lessons underscoring the importance of a public health environment that recognizes sex-specific needs as well as different patterns in risk factors, health behaviors, and responses to interventions between men and women. Public health strategies incorporating focused efforts to increase COVID-19 vaccinations among men are particularly urged.

Keywords: COVID-19; Monte Carlo simulation; SARS-CoV-2; United States; coronavirus; epidemiology; public health; sex disparities; vaccine hesitancy; years of potential life lost.

PubMed Disclaimer

Figures

**Figure 1.**
Conservative 95% interval estimates of the percentage of total COVID-19-attributable YPLL before age 75, the percentage of total COVID-19 deaths, and the percent population shares for males in the U.S. and in each of the 50 states and D.C. with respect to cumulative COVID-19 deaths according to data from the National Center for Health Statistics as of 31 March 2021.

**Figure 2.**
Conservative 95% interval estimates of the percentage of total COVID-19-attributable YPLL before age 75, the percentage of total COVID-19 deaths, and the percent population shares for females in the U.S. and in each of the 50 states and D.C. with respect to cumulative COVID-19 deaths according to data from the National Center for Health Statistics as of 31 March 2021.

**Figure 3.**
Conservative 95% interval estimates of the age-adjusted male-to-female YPLL and mortality RR’s in the U.S. and in each of the 50 states and D.C. with respect to cumulative COVID-19 deaths according to data from the National Center for Health Statistics as of 31 March 2021. States are ordered from top to bottom in descending order of the signed difference between the lower limit of the YPLL RR interval and the upper limit of the mortality RR interval.

See this image and copyright information in PMC

References

1. Cevik M.; Kuppalli K.; Kindrachuk J.; Peiris M. Virology, transmission, and pathogenesis of SARS-CoV-2. BMJ 2020, 371. - PubMed
1. Cucinotta D.; Vanelli M. WHO declares COVID-19 a pandemic. Acta Bio Medica 2020, 91, 157–160. - PMC - PubMed
1. Rabin R.C. First Patient With Wuhan Coronavirus Is Identified in the U.S., Accessed 31 March 2021. https://www.nytimes.com/2020/01/21/health/cdc-coronavirus.html.
1. Holshue M.L.; DeBolt C.; Lindquist S.; Lofy K.H.; Wiesman J.; Bruce H.; Spitters C.; Ericson K.; Wilkerson S.; Tural A.; Diaz G.; Cohn A.; Fox L.; Patel A.; Gerber S.I.; Kim L.; Tong S.; Lu X.; Lindstrom S.; Pallansch M.A.; Weldon W.C.; Biggs H.M.; Uyeki T.M.; Pillai S.K. First Case of 2019 Novel Coronavirus in the United States. New England Journal of Medicine 2020, 382, 929–936. - PMC - PubMed
1. Elmore J.G.; Wang P.C.; Kerr K.F.; Schriger D.L.; Morrison D.E.; Brookmeyer R.S.; Pfeffer M.A.; Payne T.H.; Currier J.S. Excess Patient Visits for Cough and Pulmonary Disease at a Large US Health System in the Months Prior to the COVID-19 Pandemic: Time-Series Analysis. Journal of Medical Internet Research 2020, 22, e21562. - PMC - PubMed

Publication types

Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Miscellaneous
- NCI CPTAC Assay Portal

[1] Cevik M.; Kuppalli K.; Kindrachuk J.; Peiris M. Virology, transmission, and pathogenesis of SARS-CoV-2. BMJ 2020, 371. - PubMed

[2] Cevik M.; Kuppalli K.; Kindrachuk J.; Peiris M. Virology, transmission, and pathogenesis of SARS-CoV-2. BMJ 2020, 371. - PubMed

[3] Cucinotta D.; Vanelli M. WHO declares COVID-19 a pandemic. Acta Bio Medica 2020, 91, 157–160. - PMC - PubMed

[4] Cucinotta D.; Vanelli M. WHO declares COVID-19 a pandemic. Acta Bio Medica 2020, 91, 157–160. - PMC - PubMed

[5] Rabin R.C. First Patient With Wuhan Coronavirus Is Identified in the U.S., Accessed 31 March 2021. https://www.nytimes.com/2020/01/21/health/cdc-coronavirus.html.

[6] Rabin R.C. First Patient With Wuhan Coronavirus Is Identified in the U.S., Accessed 31 March 2021. https://www.nytimes.com/2020/01/21/health/cdc-coronavirus.html.

[7] Holshue M.L.; DeBolt C.; Lindquist S.; Lofy K.H.; Wiesman J.; Bruce H.; Spitters C.; Ericson K.; Wilkerson S.; Tural A.; Diaz G.; Cohn A.; Fox L.; Patel A.; Gerber S.I.; Kim L.; Tong S.; Lu X.; Lindstrom S.; Pallansch M.A.; Weldon W.C.; Biggs H.M.; Uyeki T.M.; Pillai S.K. First Case of 2019 Novel Coronavirus in the United States. New England Journal of Medicine 2020, 382, 929–936. - PMC - PubMed

[8] Holshue M.L.; DeBolt C.; Lindquist S.; Lofy K.H.; Wiesman J.; Bruce H.; Spitters C.; Ericson K.; Wilkerson S.; Tural A.; Diaz G.; Cohn A.; Fox L.; Patel A.; Gerber S.I.; Kim L.; Tong S.; Lu X.; Lindstrom S.; Pallansch M.A.; Weldon W.C.; Biggs H.M.; Uyeki T.M.; Pillai S.K. First Case of 2019 Novel Coronavirus in the United States. New England Journal of Medicine 2020, 382, 929–936. - PMC - PubMed

[9] Elmore J.G.; Wang P.C.; Kerr K.F.; Schriger D.L.; Morrison D.E.; Brookmeyer R.S.; Pfeffer M.A.; Payne T.H.; Currier J.S. Excess Patient Visits for Cough and Pulmonary Disease at a Large US Health System in the Months Prior to the COVID-19 Pandemic: Time-Series Analysis. Journal of Medical Internet Research 2020, 22, e21562. - PMC - PubMed

[10] Elmore J.G.; Wang P.C.; Kerr K.F.; Schriger D.L.; Morrison D.E.; Brookmeyer R.S.; Pfeffer M.A.; Payne T.H.; Currier J.S. Excess Patient Visits for Cough and Pulmonary Disease at a Large US Health System in the Months Prior to the COVID-19 Pandemic: Time-Series Analysis. Journal of Medical Internet Research 2020, 22, e21562. - PMC - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

This is a preprint.

Male-Female Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: A State-by-State Analysis

Affiliations

Male-Female Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: A State-by-State Analysis

Authors

Affiliations

Update in

Abstract

Figures

Similar articles

References

Publication types

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Miscellaneous