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Life expectancy drops by 1.6 years in Wisconsin; doctors urge screenings

The life expectancy of Wisconsin residents dropped by 1.6 years in 2020, likely because of COVID-19 and a rise in unintentional injuries like drug overdoses, according to new data released by the Centers for Disease Control and Prevention.

The life expectancy in 2020 was 77.7 — 80.3 years for women and 71.9 years for men — which was down from 79.3 the previous year. There was a decrease in life expectancy in every state, with Hawaii at the highest at 80.7 and Mississippi at the lowest at 71.9.

The death rate in Wisconsin, which had fallen slightly from an eight-year high in 2018, went from 847 per 100,000 male residents to 989 per 100,000 in 2020. For women, that rate jumped from 611 to 697.

That concerns doctors, who worry in part about an already stressed health care system. They emphasize the need for preventive care, health screenings and ensuring access to health care for the state’s most vulnerable residents.

“As the system gets stressed, it’s easier to miss things and be overloaded,” said Dr. Mark Wegner of the Wisconsin Department of Health Services Chronic Disease Program. “We want people to continue to do those basic things, those regular screenings that can … help the medical system in the future.”

The Wisconsin State Journal looked into the leading causes of death in south-central Wisconsin from 2020, using CDC data from Dane and its surrounding counties (Columbia, Dodge, Green, Jefferson, Iowa, Lafayette, Rock and Sauk).

Here’s what we found.

1. Cancer

Cancer was the leading cause of death in south-central Wisconsin in 2020, as well as from 2006 to 2009. In every other year since 1999, it was the second-leading cause.

Of the many types of cancer, lung cancer led to the most deaths in south-central Wisconsin and nationally. In 2020, 443 people in the area died from lung cancer. The second most deadly cancer, pancreas cancer, killed 184 people.

While treatments have consistently improved, the critical issue is detection, said Molly Collins, a spokesperson for the American Lung Association in Wisconsin.

Last year, U.S. Preventive Service Task Force recommended that anyone 50 or older who smoked at least 20 packs a year, including those who quit in the last 15 years, be screened with a low-dose computed tomography scan, a process that gives off a very low dose of radiation to make detailed pictures of the lungs. The previous guidelines were age 55 and older and 30 packs per year. The changes were designed, in part, to include more Black residents and women in screening and opened up eligibility for screening to Black women nationally by 50 percent, according to a Boston University study.

CT Scan 1-09012022104753

Cancer was the leading cause of death in South Central Wisconsin in 2020, with lung cancer the most prevalent followed by pancreatic cancer. While treatments have improved, experts say, early detection is critical.

But few in Wisconsin are aware of the new screening guidelines, Collins said. If patients receive an earlier diagnosis, their five-year survival rate goes up, she said.

Cigarettes and smoking are the leading causes of lung cancer, according to the CDC.

“There’s a stigma around it that people who have it deserve it because they smoked,” she said. “It’s just not fair. We don’t deserve our negative health outcomes.”

Lung cancer also disproportionately affects Black Wisconsinites, Collins said. Black residents face a rate of new lung cancer cases of 92.5 per 100,000,compared to a rate of 59.2 for the state as a whole, according to the American Lung Association. Racial health care disparities — less access, or fewer conversations with a primary care provider who might recommend a screening — can prevent early treatment, Collins said.

Other factors, like exposure to radon, can also cause lung cancer. The Environmental Protection Agency considers Southern Wisconsin as an area with potential elevated risk for indoor radon exposure.

Exposure to the natural, invisible and odorless gas that can seep into homes has led people who are “extremely healthy and never smoked” to develop lung cancer, Collins said. Home testing kits cost around $20 to $25 and are available from hardware stores, as well as from Public Health Madison and Dane County.

CT Scan 2-09012022104753

Low-dose computed tomography scans, like this one being administered to a patient at UW’s Digestive Health Center in Madison, can provide detailed pictures of the lung, enabling doctors to spot and treat cancer early and improve survival rates.

2. Heart disease

From 2010 to 2019, heart disease led to the most deaths in south-central Wisconsin.

“Unfortunately, it’s been at that spot for a long time,” said Liz Jirschele, a spokesperson for the American Heart Association in Wisconsin.

In the Madison area, coronary heart disease — a buildup of fats in the coronary arteries — led to the most deaths of any form of heart disease in 2020, killing 744. It causes more deaths than any other form of cardiovascular disease, according to the American Heart Association.

That number has risen since 2009, when coronary heart disease killed 577.

The incidence of deaths from heart attacks has dropped steadily over the last two decades, from 751 in 1999 to 274 in 2020 – though recent studies show an increased risk of cardiovascular problems following a COVID-19 infection.

But deaths from other forms of heart disease have increased in the region, helping drive the overall uptick since 2009.

Pinpointing an exact cause — and whether the rise is a trend — presents a challenge, said Dr. Ryan Kipp, an electrophysiologist at UW Health.

Increasing deaths from heart disease stem from a number of risk factors that have become more prevalent, Wegner said, such as obesity, poor diets and hypertension.

“We want to focus on the prevention aspect,” he said. “Making the healthy choice the default choice or the easy choice.” That includes making the state more walkable and bike friendly and increasing access to cheap, healthy food.

Another key measure for reducing heart disease, quitting smoking and vaping, could prove more difficult. In 2017, the state had the fewest smokers attempting to quit, a Surgeon General’s report said. The state in 2020 had a smoking rate among adults of 15.5%, the same as the national average.

3. Accidents

Accidental death is a broad term, but two major causes of death are falls and poisoning, often accidental drug overdoses.

Wisconsin has long had the nation’s highest rate of deadly falls among older adults. More people died from falls than breast and prostate cancer combined in 2019.

Experts speculate that icy winters, higher rates of alcohol use and an older-than-average population led to an elevated rate of deaths from falls.

Local organizations are working to prevent an increasing number of falls in Dane County and around the state. At Safe Communities of Madison and Dane County, a nonprofit that tackles the leading causes of injury-related deaths, staff have implemented a program called Stepping On, which is a 7-week program to teach people how to prevent falls.

“Awareness is essential,” Ashley Hillman, falls prevention program manager at Safe Communities, said. “Most people don’t think it could happen to them. These falls can be prevented. Learning that can make people surprised but hopeful: It could happen to them, but it doesn’t have to.’”

The program has struggled to reach a broad cross-section of Wisconsinites, Hillman said. Minorities and rural Wisconsin residents often have a harder time accessing care, Wegner said.

Safe Communities also hosts a drug poisoning prevention program that receives more than $500,000 in county funding.

In 2020, the Wisconsin Department of Health Services reported 1,227 deaths in the state related to opioids. While around 18.5% of accident-related deaths are caused by falls, 16.5% are caused by poisoning. Most of these deaths are related to fentanyl and opioid use.

Earlier this year, the State Journal reported that the preliminary total of opioid deaths in Wisconsin in 2021 surpassed 2020’s numbers. The 1,227 deaths from overdoses that Wisconsin saw in 2020 were 32% more than the numbers in any other year.

The state has been working to address falls and poisonings in Wisconsin. Wisconsin’s Injury and Violence Prevention Program helps fund interventions for both fall and overdose related injuries, while overdoses remain at an all-time high.

“Unfortunately we continue to see record rates of overdoses and overdose deaths, many attributable to opioids,” Paul Krupski, director of opioid initiatives at the Wisconsin Department of Health Services said. “The highest rates and highest number of people overdosing ever is happening. We need to save lives. That’s the number one goal right now. We need to save lives.”

4. COVID-19

In 2020, 673 people died of COVID in south-central Wisconsin.

Throughout the pandemic, south-central Wisconsin sustained lower rates of deaths from COVID-19 compared to much of the state. But the 216 deaths in Dane County during 2020 were still far too many, Public Health Madison and Dane County spokesperson Morgan Finke said, although it’s difficult to say why the area took less of a hit, she said.

“It speaks to the unpredictability of the virus,” Finke said.

Strong compliance with mask mandates, accessible testing and, later on, “robust access” to vaccines may have contributed to preventing more COVID-19 deaths, she said.

“There was a lot of compliance,” Finke said. “And a lot of people stepping up to ... help themselves and help each other stay healthy.”

5. Strokes

Medical advancements led to more people who survived strokes in south-central Wisconsin. In 2010, mortality rates due to strokes were roughly 40.8 per 100,000. But the pandemic turned that progress around.

By 2020, they were back up at 45.4 per 100,000 in the region. There was a high rate of stroke complications among COVID-19 patients. And isolation during the pandemic meant many stroke patients did not receive timely care in emergency rooms because family members were often not around their loved ones to witness warning signs and get help.

“Delayed care is a large reason why stroke outcomes have been worse in the past couple of years,” John Bowser, Wisconsin Coverdell Stroke Program director, said. “In the time of COVID, a stroke symptom may not have been enough to send someone into the hospital.”

A study by the American Heart Association found that emergency room visits for stroke patients declined significantly after COVID-19 was declared a national emergency in March of 2020.

“COVID scared a lot of people from the ER,” Kerry Ahrens, an emergency medicine doctor at UW Health, said. “They said: ‘I don’t care if I have a stroke or a heart attack, I’m not going.”

In 2001, Congress created the Paul Coverdell National Acute Stroke Program to support states as they built systems to connect residents to better stroke care.

“The Coverdell program allows us to connect all over the state with all of the stroke coordinators from hospitals that participate,” Ahrens said. “It also helped hospitals in the state adopt a system which helps people who are experiencing more severe strokes access hospitals that can better support them.”

For some doctors, stroke-related funding and programs have helped them access medicine like tenecteplase. The medication targets blood clots and is effective in reducing stroke complications when provided in a 4.5 hour time window after a stroke, according to the AMA Journal.

Funding has also helped doctors further surgical procedures, like thrombectomies, that can halt or ease strokes. Thrombectomies remove a blood clot from an artery or vein and restore blood flow. Over time, medical initiatives have allowed doctors to complete thrombectomies in a shorter amount of time.

“We have the tools to address it,” Ahrens said. “Now we have to be looking at how COVID encouraged the increased rates of stroke.”

No time to lose: Finding rare diseases in infants

Wisconsin doesn't screen newborns for some disorders other states include, which can delay treatment that could prevent death or disability.

As parents urge state officials to expand the program to catch more ailments early, doctors are increasingly turning to genome sequencing to diagnose some critical conditions.

This three-day series explores the promise and limits of the state's newborn screening and testing.

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The state started testing babies for severe combined immunodeficiency disorder in 2008. 

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Amy and Adan Medina’s children, Mateo, 10, Javier, 5, and Amelia, 3, were all born with SMA or spinal muscular atrophy

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At University Research Park, San Diego-based Illumina makes enzymes used in its DNA sequencers.

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Rikki and Joshua Gutzdorf’s son, Theo, 3, was born with Stuve-Wiedemann syndrome that was diagnosed three weeks after birth through genome seq…

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