Kaiser Family Foundation —
Since the early days of the pandemic, COVID-19 has taken its greatest toll among older adults in the US in terms of cases, hospitalizations and deaths. Months into the pandemic, older adults continue to be one of the populations most at risk of becoming seriously ill and dying from COVID-19. Adults 65 and older account for 16% of the US population but 80% of COVID-19 deaths in the US, somewhat higher than their share of deaths from all causes (75%) over the same period. Around the country, however, states have put in place a variety of policies regarding COVID-19, and on different timetables, which have contributed to different case trajectories and could result in variations across states in the proportion of COVID-19 deaths among older people. Other factors that may contribute to these differences include the prevalence of underlying medical conditions and racial composition of each state’s population.
To examine the extent of state-level variation in the share of COVID-19 deaths accounted for by older adults, we analyze the distribution of COVID-19 deaths by age group at the state level, based on data from the Centers for Disease Control and Prevention (CDC) as of July 22, 2020, for the week ending July 11. The data are provisional and reflect a time lag due to differences in how states report data.
Of the 41 states and District of Columbia included in this analysis, the share of people 65 and older who have died of COVID-19 varies considerably by state (Figure 1).
The percent of COVID-19 deaths accounted for by people 65 and older is consistently high and ranges from a high of 94% in Idaho to a low of 70% in the District of Columbia.
In most states, the share of adults 65 and older who have died due to COVID-19 is higher than their share of deaths from all causes (Figure 2).
For example, in Idaho, a substantially higher share of COVID-19 deaths were 65 and older (94%) compared to deaths from all causes (76%). Similarly, in West Virginia, the share of people 65 and older who have died of COVID-19 was much higher than for all causes (90% vs 73%). This was true for almost all states included in the analysis except for Arizona, Arkansas, Kansas, New Mexico, New York and Texas, where the share of COVID-19 deaths and deaths from all causes were the same, and Nebraska where the share of COVID-19 deaths was lower than for all causes.
COVID-19 Deaths tied to Nursing Home Performance
States that have reported a larger share of adults 65 and older who have died of COVID-19 tend to be those states that have had a disproportionate number of deaths in long-term care facilities. These include Idaho, with 94% of COVID-19 deaths among those 65 and older, as well as New Hampshire (92%), Massachusetts (90%), Rhode Island (90%), Minnesota (89%), Connecticut (89%), Pennsylvania (87%), Ohio (86%), Kentucky (84%), and Delaware (83%).
Many of the states that have reported a smaller share of adults 65 and older in COVID-19 deaths compared to the national average are in the South and the Sun Belt, including Alabama (76%), Tennessee (76%), Nevada (75%), Arizona (74%), Mississippi (74%), Arkansas (71%), New Mexico (71%), and Texas (70%). With the exception of Texas, these states have a population age distribution similar to the US average, which suggests that this finding is not a function of having a younger population. In these states, the pandemic is peaking later than in states that were hit earlier, which may contribute to a lag in deaths among older adults.
States that have experienced a large percentage of COVID-19 deaths at long-term care facilities also are more likely to have a larger share of COVID-19 deaths in the oldest age cohort, those 85 and older (Figure 3).
In the US overall, 33% of people who have died from COVID-19 were age 85 and older, compared to 31% of people who died from all causes over the same period who were 85 and older. In states with a relatively large share of deaths in long-term care facilities, the percentage is higher, e.g., 48% in New Hampshire and Massachusetts, 46% in Rhode Island, 45% in Minnesota and Connecticut, 43% in Pennsylvania, 39% in Idaho, 37% in Kentucky, Delaware, and Ohio.
The number of adults 65 and older who have died of COVID-19 is considerably higher in some states than others, with 61% of all adults 65 and older who died of COVID-19 as of July 15, residing in just 7 states: New York, New Jersey, Massachusetts, Pennsylvania, Illinois, California, and Michigan (Figure 4).1
By comparison, only 36% of deaths among people 65 and older from all causes were among older adults residing in those 7 states.
The majority of COVID-19 deaths are among people 65 and older nationwide; however, there is a fair amount of variation across states. These differences may reflect a number of factors, including underlying demographic characteristics, other state-specific factors, and the timing of outbreaks. In states that were affected earlier, older adults tend to account for a higher share of deaths. This may be attributable to the relatively large number of deaths in long-term care facilities. States that have experienced more recent outbreaks have a somewhat smaller share of deaths accounted for by people 65 and older, but as the pandemic progresses, the share of deaths among older people in these states may rise, especially in states that are now experiencing a sharp rise in coronavirus cases in long-term care facilities.
Endnotes
- The Centers of Disease Control and Prevention dataset used in this analysis produces slightly different counts of deaths for July 11 than other sources producing these estimates, such as the Johns Hopkins University Coronavirus Resource Center or the COVID Tracking project.
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