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How Many People in America Have Lost a Loved One?

Sep 6, 2022 | COVID, Data Collection, Federal Government, Grief, Research

Just How Many People In America Have Lost A Loved One?

The Centers for Disease Control and Prevention (CDC) is one of the nation’s most-trusted, science-based sources of data on public health in the United States. For more than 70 years, this government agency has been monitoring the nation’s health landscape and providing guidance to the public on how to prevent and respond to health threats. It collects myraids of data on national health trends, including mortality rates related to homicide, suicide, substance misuse, maternal mortality, accidents, and more. Yet, while it collects how we die, it does not collect who survives these deaths and what the implications are.

With concurrent mortality epidemics touching every neighborhood in America, millions of people have experienced the death of a family or friend, but exactly how many people are impacted? We don’t know. What adverse outcomes do people experience in the aftermath of death? We have to look to academia or to other international registries to better understand the ramifications of losing someone meaningful.

“We all know the saying, ‘what gets measured, gets done,’” says Evermore founder Joyal Mulheron. “Bereavement is a public health concern hiding in plain sight simply because we are not measuring the scale or impact that losing loved ones has on our society.”

For example, to understand how many people have been impacted by COVID-19, we can look at the findings from a research study conducted by Ashton Verdery of Pennsylvania State University, Emily Smith-Greenaway of the University of California at Los Angeles, and Rachel Margolis of the University of Western Ontario. They find that for every one COVID-19 death, approximately nine survivors were impacted by the loss of a grandparent, parent, sibling, spouse, or child. But the study’s authors suggest that this is actually a significant underestimate, and likely more individuals are impacted, on average, by a single death. We also know that family survivors are more at risk for poor physical health outcomes, premature death, and other adverse consequences that can alter their life course.

For COVID-19 alone, more than 9 million individuals lost a loved one to COVID-19, including an estimated 78,000 children who lost a parent. This indicates that a significant portion of the population has been impacted by not only loss and grief, but in many cases by the loss of income and health care benefits (if the deceased individual contributed to household earnings and held a job with insurance). This is why we need sound data collection — to provide a clear picture of the impact in order to shape a federal response.

In order to develop sound policies and practices for supporting loved ones after a death event, our nation requires consistent and reliable data on the prevalence and consequences of death and bereavement. We need to know how many people are impacted by different types of death epidemics so we can see a more accurate picture of the true impact.

“When we lose someone meaningful in our life, it can irrevocably alter our health and our social and economic stability for years, decades, and in some cases, impact our well-being for the rest of our lives,” says Mulheron. “The more we know, the more we can help children and families.”

Collecting statistics on bereaved children, parents, siblings, and spouses could help Americans better understand the associated outcomes and impacts, such as housing and food insecurity, health care coverage loss, educational hardship, incarceration, substance use, suicide attempts, and premature death. These statistics are also crucial in helping us better understand what can be done to support bereaved people.

TONI P. MILES, MD, PHD

In 2021, Evermore made legislative strides, using the U.S. budget process as a vehicle to advance CDC data collection. Using work piloted by Toni Miles, M.D., PhD, formerly of the University of Georgia, Evermore advocated for the inclusion of bereavement epidemiology in CDC’s Behavioral Risk Factor Surveillance Survey (BRFSS). BRFSS is the nation’s premier survey tool to collect data from 400,000 adults living in the 50 states, the District of Columbia, and three U.S. territories. It is the largest continuously conducted health survey in the world.

Dr. Miles’ work preceded the COVID-19 pandemic, but found that 45 percent of Georgians — or 3.7 million Georgian residents — were bereaved in the last two years. She found that bereavement disproportionately impacts African American families with 58 percent reporting a recent loss.

“Dr. Miles’ work is very important because it enables policymakers to narrow and focus solutions to help bereaved families,” says Mulheron. “For example, Dr. Miles’ preliminary evidence found that 53 percent of those with a recent loss were out of work. This demonstrates the need for more compassionate employer policies, but also the need for Congress to add death of a loved one as a qualifying event to the Family Medical Leave Act.”

Ultimately, the budget provision passed Congress, but with no funding for CDC to include bereavement as a measurement on BRFSS. In budgetary legislative language, Congress is encouraging CDC to collect bereavement data, but it is an unfunded mandate that CDC is not obligated to follow.

“Still, this is a legislative victory and CDC is beginning to pay attention to bereavement and its impact,” says Mulheron. “As a nation we are beginning to recognize that death is not simply a mental health issue. It creates vast uncertainty for an individual’s health, social, and economic well-being. We will continue to fight for America’s families. It’ll take time, but we will get there.”

Additional resources

Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States, Ashton Verdery, PhD, Emily Smith-Greenaway, PhD, Rachel Margolis, PhD

Estimates and Projections of COVID-19 and Parental Death in the US, Rachel Kidman, PhD, Rachel Margolis, PhD, Ashton Verdery, PhD, Emily Smith-Greenaway, PhD

Evermore’s Bereavement Facts & Figures

Concentric Circles of Grief: DC Exhibit Honors COVID-19 Victims

Sep 29, 2021 | Advocacy, COVID, Family, Grief

For 25 years, visual artist Suzanne Brennan Firstenberg has comforted families in mourning as a hospice volunteer. And with each new family she’s consoled came lessons about the scope of grief, its impact, and the lack of spaces for people to express their deep sorrow.

Firstenberg brings those experiences to her latest work — a sprawling public art exhibition that honors the 684,400 people and counting who have died from COVID-19 in the United States. “In America: Remember” opened on Sept. 17 and runs through Oct. 3 on the National Mall in Washington, DC.

The display features lines of white flags, evocative of the white headstones in Arlington National Cemetery. Each flag represents an individual who has died from COVID during the pandemic. Visitors are encouraged to dedicate flags to friends and family who died from the illness. People who can’t visit Washington, DC., can share details about their loved one online through InAmericaFlags.org, and volunteers will inscribe the flag and plant it in the exhibit.

Since its opening, Firstenberg has seen middle-aged men break down for the first time. One woman told her she finally realized, after seeing the exhibit, that she wasn’t alone in her grief. And those reactions point to a bigger problem, Firstenberg said in an interview with Evermore.

“We need to stop and realize that America is hurting badly,” she said. “We have to stop and find a way to heal America. And we have to find a way to learn how to deal with death and loss in our community.”

Amazing acts of caring’

For Firstenberg, it all started last year with outrage after some were discounting the deaths of older adults and people of color, who face higher rates of serious health impacts and death from COVID. In fall 2020, as the total number of COVID deaths climbed into the 200,000s, she opened a similar exhibit, called “In America: How Could This Happen,” outside RFK Stadium in Washington.

“I realized that the number of people who we had lost in this pandemic had become so large that it became easy to ignore,” she said.

“I had to, as a visual artist, use my art to help people identify the enormity of our loss.

“I knew I wanted to do art that would help people visually translate the cumulative death toll into something physical and something they could experience.”

But outrage hasn’t sustained her; the deep expressions of care and emotion from the people who visited the original exhibit did. She remembers a director from the Centers for Disease Control and Prevention who traveled from Georgia to snap a picture of the display and share it with their team. And there was an ER doctor who wrote out the names of a dozen patients he had lost to COVID on flags and pushed them into the ground before he went on to his next shift.

“I began last fall with a great deal of outrage,” she said. “But when I did that art installation, so many people brought their caring and their grief and their respect and love for those they have lost, and I saw such amazing acts of caring.”

Grief on ‘America’s stage’

This time, the exhibit extends beyond DC in two important ways. People who can’t travel to the nation’s capital can share details online about their loved one, who will then be honored with a flag in the exhibit. The placement along the National Mall, Firstenberg said, is another critical difference when considering the pandemic’s reach across the country.

“This is America’s stage,” she said of the National Mall. “We have brought America’s lost to its most important space.”

Just like the original exhibit, “In America” encourages participation. It’s designed that way, Firstenberg said, because she knows from her work with hospice that action supports the grieving process. Planting flags in the ground for loved ones is a public way for people to express their grief. The action of walking through the immense field of flags is another way to trigger understanding, she said.

As visitors glance down to read the names and stories of COVID’s victims, no longer is the death toll a number, but a representation of individuals — like the 99-year-old man who eschewed a ventilator to save somebody younger, as one flag notes, and the people who loved him.

“Each individual flag represents concentric circles of grief — the family, friends, the neighbors, the co-workers, the members of their faith community, and those medical workers who fought so hard to save that life,” she said. “They grieve too.”

Finding hope

Until the exhibit closes, each day at noon, Firstenberg will push more flags into the National Mall as the COVID death count ticks higher. But, despite being surrounded by this sprawling representation of death and grief, Firstenberg is hopeful.

“I am hopeful because I see people walking through these flags and looking down at names and that means they care,” she said. “I really do believe that humanity is going to win out. We just have to highlight it, celebrate it and come to expect it. … And I’m hopeful that this will make people realize that we need to have a better relationship with death and dying. We have to incorporate grief into our understanding of daily life.”