Which Factors Most Strongly Predict Mortality Risk For Older Adults?

Things that make life suck in general, significantly increase one's probability of dying for adults. 

A history of divorce is the second highest risk factor after being a current smoker and ahead of a history of smoking. Recent financial difficulties and a history of unemployment adds more to your risk than being male.

In the current investigation, we compare 57 factors within a multidisciplinary framework. These include (i) adverse socioeconomic and psychosocial experiences during childhood and (ii) socioeconomic conditions, (iii) health behaviors, (iv) social connections, (v) psychological characteristics, and (vi) adverse experiences during adulthood. 

The current prospective cohort investigation with 13,611 adults from 52 to 104 y of age (mean age 69.3 y) from the nationally representative Health and Retirement Study used weighted traditional (i.e., multivariate Cox regressions) and machine-learning (i.e., lasso, random forest analysis) statistical approaches to identify the leading predictors of mortality over 6 y of follow-up time. 

We demonstrate that, in addition to the well-established behavioral risk factors of smoking, alcohol abuse, and lack of physical activity, economic (e.g., recent financial difficulties, unemployment history), social (e.g., childhood adversity, divorce history), and psychological (e.g., negative affectivity) factors were also among the strongest predictors of mortality among older American adults.

From PNAS.

The money chart:

Variable -- HR -- 95% CI

Current smoker1.91--1.70, 2.14
History of divorce1.45--1.31, 1.60
Alcohol abuse1.36--1.15, 1.61
Recent financial difficulties1.32--1.22, 1.44
History of unemployment1.32--1.10, 1.59
History of smoking1.32--1.22, 1.43
Lower life satisfaction1.31--1.19, 1.45
Never married1.30--1.03, 1.63
History of food stamps1.28--1.09, 1.49
Negative affectivity1.23--1.14, 1.33
Negative interactions with family1.23--1.12, 1.35
Negative interactions with children1.22--1.12, 1.34
Daily discrimination1.22--1.12, 1.32
Trait anxiety1.21--1.12, 1.31
Lower positive interactions with children1.21--1.11, 1.31
Childhood psychosocial adversities1.20--1.11, 1.31
Anger out1.18--1.08, 1.28
Major discrimination1.17--1.07, 1.29
Negative Interactions with friends1.17--1.08, 1.27
Cynical hostility1.16--1.07, 1.26
Pessimism1.16--1.07, 1.25
Low/no vigorous activity1.15--1.03, 1.28
History of food insecurity1.14--1.02, 1.27
Hopelessness1.14--1.06, 1.23
Lower positive affectivity1.14--1.05, 1.23
Lower optimism1.13--1.05, 1.22
Lower occupational status1.13--1.03, 1.25
Lower wealth1.13--0.98, 1.30
History of Medicaid1.13--1.01, 1.26
Lower neighborhood safety1.13--1.04, 1.23
Anger in1.13--1.04, 1.22
Loneliness1.12--1.04, 1.21
Lower neighborhood cohesion1.12--1.04, 1.20
Low/no moderate activity1.12--1.04, 1.20
Lower purpose in life1.12--1.03, 1.21
Neighborhood disorder1.11--1.03, 1.20
Sleep problems1.11--1.02, 1.20
Lower positive interactions with family1.11--1.03, 1.20
Lower conscientiousness1.10--1.03, 1.17
Perceptions of obstacles1.09--1.02, 1.17
Lower neuroticism1.09--1.02, 1.16
Lower extroversion1.09--1.01, 1.17
Lower income1.07--0.88, 1.30
Lower education1.07--0.99, 1.16
Family received financial help in childhood1.07--0.96, 1.19
Lower sense of mastery1.06--0.99, 1.14
Lower father occupational status1.06--0.98, 1.14
History of renting1.04--0.96, 1.14
Relocated homes in childhood1.03--0.95, 1.13
Lower openness to experiences1.02--0.95, 1.10
Lower religiosity1.00--0.92, 1.08
Lower education father 0.98--0.87, 1.10
Father was unemployed in childhood 0.97--0.89, 1.05
Lower positive interactions with friends 0.96--0.89, 1.04
Lower agreeableness 0.94--0.88, 1.02
Adulthood psychosocial adversity 0.93--0.86, 1.01
Lower education mother 0.86--0.77, 0.97

Sadly, I Know What This Means

U.S. Senate, U.S. House and Governor's Race Polling And Punditry In A Nutshell

State Governor's Races In 2020

There are 11 seats for state governor facing voters in 2020. 

Real Clear politics rates 2 of the 4 seats currently held by Democrats (Delaware and Washington State) as safe, and four of the seven seats currently held by Republicans (Utah, North Dakota, Indiana and West Virginia) as safe.

Two of the seats currently held by Democrats (Montana and North Carolina) are listed as "toss ups".

Two of the seats currently held by Republicans (Missouri and New Hampshire) are rated as "leans GOP", and one of the seats currently held by a Republican (Vermont) is rated as "likely GOP".

The U.S. Senate Races In 2020

Democrats need 50 seats to control the U.S. Senate if Biden wins the Presidential race (a net gain of three seats), and 51 if Trump wins the Presidential race (a net gain of four seats). It is likely that Democrats will regain control of the U.S. Senate. (Biden has a clear lead over Trump in Presidential polling at the moment.)

If the election were held today, the Democrats would have a U.S. Senate majority, gaining six seats (Arizona, Colorado, Iowa, Maine, Montana and North Carolina), and losing Alabama.

From here.

Michigan, Minnesota, New Hampshire and New Mexico have Democrats running for re-election in the U.S. Senate this year, all of whom are likely to win re-election.

The winner of the GOP primary in Alabama, Tommy Tuberville, led incumbent Democrat Doug Jones, by eight percentage points in the only head to head poll available at Real Clear Politics in this race, taken in in February 2020. I am certain that the race is tighter today than it was then (I've seen polls touting it as a toss up), but it is still the most likely seat for the Democrats to lose in the U.S. Senate.

Cory Gardner of Colorado is considered the most likely incumbent Republican to lose his seat in his race against John Hickenlooper.

Incumbent Republicans in Arizona, in two separate races (one for a full term and one to fill a vacancy) in Georgia (GA1, GA2), in Iowa, in Maine, in Montana, in North Carolina and even in Texas Texas, as well as the open seat in Kansas now held by a Republican, are considered vulnerable to Democratic upsets.

It is a long shot, but some polling has shown top GOP Senator Mitch McConnell of Kentucky in a toss up race with his Democratic challenger.

The U.S. House Races In 2020

A majority of the U.S. House is 218 seats. 

Real Clear Politics rates 180 U.S. House seats held by Democrats as "safe" for the Democrats, 20 as "likely Dem" and 14 as "leans Dem" for a total of 214 seats currently held by Democrats and leaning towards ending up that way again in November.

It rates 159 U.S. House seats held by Republicans as "safe" for Republicans, 17 as "likely GOP" and 14 as "leans GOP" for a total of 190 seats currently held by Republicans and leaning towards ending up that way again in November.

The leaves 31 seats rates as "toss ups" currently held by 19 Democrats and 12 Republicans. Democrats can lose all twelve of the "toss up" seats currently held by Republicans and 15 out of 19 of the "toss up" seats currently held by Democrats and retain control of the U.S. House.

The fourth Congressional District in Colorado (Western Slope and Southern Colorado) is currently listed as a safe GOP seat, but now that the incumbent Republican Congressman was ousted in a primary to a radical right newcomer, this seat could be in play as well.

In practice, the odds of the Democrats losing control of the U.S. House in November are low. 

Given the way that the political winds are blowing this year, it seems more likely that the Democrats will pick up seats in the U.S. House than it is that they will lose any net seats there. In "generic vote" polling, Democrats are preferred over Republicans for the U.S. House by 8.6 percentage points.

The seats it rates at "toss up" are:

CA21	CA25	CA39
GA6	GA7	IA1
IA2	IA3	IL13
IL14	ME2	MI3
MN7	NE2	NJ3
NM2	NY2	NY11
NY22	OK5	PA1
PA8	PA10	SC1
TX10	TX22	TX23
TX24	UT4	VA2
VA7

U.S. Army Rebids Bradley Replacement

The Army has been trying to replace the Bradley infantry fighting vehicle, a heavily armored personnel carrier, second only to a main battle tank in the current U.S. arsenal for levels of armor and armament in ground vehicles, for a long time. But, previous efforts were too ambitious to be possible and the last effort secured only one bid. So, it is trying again with a somewhat less ambitious request for proposal. 

The U.S. Army has restarted its effort to replace the Cold War-era Bradley fighting vehicle with a new Optionally Manned Fighting Vehicle (OMFV), a key priority in the service's modernization strategy. 

Program officials released a draft request for proposal (RFP) for the OMFV's Preliminary Digital Design phase, aimed at gathering additional industry feedback prior to the final RFP release for this phase later this year, according to a July 17 Army news release.

In January, the service announced its plan to restart the high-priority effort after it received only one valid bid from General Dynamics for the $45 billion program. A competing bid from Raytheon and Germany's Rheinmetall was disqualified when Rheinmetall failed to ship a prototype of its Lynx KF41 Infantry Fighting Vehicle to the U.S. by the service's deadline. 

Army acquisition officials told lawmakers in March that they may have rushed the prototyping effort, which discouraged many companies from competing.

From Defense Tech. 

A July 13, 2020 report from the Congressional Research Service explains that:

The M-2 Bradley, which has been in service since 1981, is an Infantry Fighting Vehicle (IFV) used to transport infantry on the battlefield and provide fire support to dismounted troops and suppress or destroy enemy fighting vehicles. Updated numerous times since its introduction, the M-2 Bradley is widely considered to have reached the technological limits of its capacity to accommodate new electronics, armor, and defense systems. Two past efforts to replace the M-2 Bradley—the Future Combat System (FCS) Program and the Ground Combat Vehicle (GCV) Program—were cancelled for programmatic and cost-associated reasons. . . .  

The Army’s Optionally Manned Fighting Vehicle (OMFV) is the Army’s third attempt to replace the M-2 Bradley Infantry Fighting Vehicle (IFV) which has been in service since the early 1980s. Despite numerous upgrades since its introduction, the Army contends the M-2 is near the end of its useful life and can no longer accommodate the types of upgrades needed for it to be effective on the modern battlefield.  

Because the OMFV would be an important weapon system in the Army’s Armored Brigade Combat Teams (ABCTs), Congress may be concerned with how the OMFV would impact the effectiveness of ground forces over the full spectrum of military operations. Moreover, Congress might also be concerned with how much more capable the OMFV is projected to be over the M-2 Bradley to ensure that it is not just a costly marginal improvement over the current system. A number of past unsuccessful Army acquisition programs have served to heighten congressional oversight of Army programs, and the OMFV may be subject to a high degree of congressional interest.  

In June 2018, the Army established the Next Generation Combat Vehicle (NGCV) program to replace the M-2 Bradley Infantry Fighting Vehicle (IFV), which has been in service since the early 1980s. In October 2018, Army leadership reportedly decided to redesignate the NGCV as the Optionally Manned Fighting Vehicle (OMFV) and add additional vehicle programs to what would be called the NGCV Program.1 Under the new NGCV Program, the following systems are planned for development:  

 The Optionally Manned Fighting Vehicle (OMFV): the M-2 Bradley IFV replacement. 

 The Armored Multi-Purpose Vehicle (AMPV):  the M-113 vehicle replacement. 

 Mobile Protected Firepower (MPF):  a light tank for Infantry Brigade Combat Teams (IBCTs).  

 Robotic Combat Vehicles (RCVs): three versions, Light, Medium, and Heavy. 

 The Decisive Lethality Platform (DLP): the M-1 Abrams tank replacement. . . . 

The Army’s preliminary basic operational requirements for the OMFV included the following:  

 Optionally manned. It must have the ability to conduct remotely controlled operations while the crew is off-platform.  

 Capacity. It should eventually operate with no more than two crewmen and possess sufficient volume under armor to carry at least six soldiers.  

 Transportability. Two OMFVs should be transportable by one C-17 and be ready for combat within 15 minutes.  

 Dense urban terrain operations and mobility. Platforms should include the ability to super elevate weapons and simultaneously engage threats using main gun and an independent weapons system.  

 Protection. It must possess requisite protection to survive on the contemporary and future battlefield.  

 Growth. It should possess sufficient size, weight, architecture, power, and cooling for automotive and electrical purposes to meet all platform needs and allow for preplanned product improvements. 

 Lethality. It should apply immediate, precise, and decisively lethal extended range medium-caliber, directed energy, and missile fires in day/night/all-weather conditions, while moving and/or stationary against moving and/or stationary targets. The platform should allow for mounted, dismounted, and unmanned system target handover.  

 Embedded platform training. It should have embedded training systems that have interoperability with the Synthetic Training Environment.  

 Sustainability. Industry should demonstrate innovations that achieve breakthroughs in power generation and management to obtain increased operational range and fuel efficiency, increased silent watch, part and component reliability, and significantly reduced sustainment burden.  

Additional requirements included the capacity to accommodate  

 reactive armor,  

 an Active Protection System (APS), 

 artificial intelligence,  and 

 directed-energy weapons and advanced target sensors. . .

Background  

The Army’s Current Infantry Fighting Vehicle (IFV)  

The M-2 Bradley is an Infantry Fighting Vehicle (IFV) used to transport infantry on the battlefield and provide fire support to dismounted troops and suppress or destroy enemy fighting vehicles. The M-2 has a crew of three—commander, gunner, and driver—and carries seven fully equipped infantry soldiers. M-2 Bradley IFVs are primarily found in the Army’s Armored Brigade Combat Teams (ABCT). The first M-2 prototypes were delivered to the Army in December 1978, and the first delivery of M-2s to units started in May 1981. The M-2 Bradley has been upgraded often since 1981.9 M-2  

Limitations and the Need for a Replacement  

Despite numerous upgrades over its lifetime, the M-2 Bradley has what some consider a notable limitation. Although the M-2 Bradley can accommodate seven fully equipped infantry soldiers, infantry squads consist of nine soldiers. As a result, “each mechanized [ABCT] infantry platoon has to divide three squads between four Bradleys, meaning that all the members of a squad are not able to ride in the same vehicle.” This limitation raises both command and control and employment challenges for Bradley-mounted infantry squads and platoons. The M-2 Bradley first saw combat in 1991 in Operation Desert Storm, where its crews were generally satisfied with its performance. The M-2’s service in 2003’s Operation Iraqi Freedom (OIF) was also considered satisfactory. However, reports of vehicle and crew losses attributed to mines, improvised explosive devices (IEDs), and anti-tank rockets—despite the addition of reactive armor to the M-2—raised concerns about the survivability of the Bradley. Furthermore, the M-2 Bradley is reportedly reaching the technological limits of its capacity to accommodate new electronics, armor, and defense systems. By some accounts, M-2 Bradleys  

Why the FCS and GCV Programs Were Cancelled 

FCS  

Introduced in 1999 by Army Chief of Staff General Eric Shinseki, FCS was envisioned as a family of networked manned and unmanned vehicles and aircraft for the future battlefield. The Army believed that advanced sensor technology would result in total battlefield awareness, permitting the development of lesser-armored combat vehicles and the ability to engage and destroy targets beyond the line-of-sight. However, a variety of factors led to the program’s cancellation, including a complicated, industry-led management approach; the failure of a number of critical technologies to perform as envisioned; and frequently changing requirements from Army leadership—all of which resulted in program costs increasing by 25%.19 After $21.4 billion already spent and the program only in the preproduction phase, then Secretary Gates restructured the program in 2009, effectively cancelling it. 

GCV  

Recognizing the need to replace the M-2 Bradley, as part of the FCS “restructuring,” the Army was directed by the Secretary of Defense in 2009 to develop a ground combat vehicle (GCV) that would be relevant across the entire spectrum of Army operations, incorporating combat lessons learned in Iraq and Afghanistan. In 2010, the Army, in conjunction with the Pentagon’s acquisition office, conducted a review of the GCV program to “review GCV core elements including acquisition strategy, vehicle capabilities, operational needs, program schedule, cost performance, and technological specifications.” This review found that the GCV relied on too many immature technologies, had too many performance requirements, and was required by Army leadership to have too many capabilities to make it affordable. In February 2014, the Army recommended terminating the GCV program and redirecting the funds toward developing a next generation platform. The cost of GCV cancellation was estimated at $1.5 billion. 

After the Ground Combat Vehicle (GCV): The Next Generation Combat Vehicle (NGCV) Program  

In the aftermath of the GCV program, the Army embarked on a Future Fighting Vehicle (FFV) effort in 2015. Army officials—described as “cautious” and “in no hurry to initiate an infantry fighting vehicle program”—instead initiated industry studies to “understand the trade space before leaping into a new program.” In general, Army combat vehicle modernization efforts post-FCS were characterized as upgrading existing platforms as opposed to developing new systems. This was due in part to reluctance of senior Army leadership, but also to significant budgetary restrictions imposed on the Army during this period. Some in Congress, however, were not pleased with the pace of Army modernization, reportedly noting the Army was “woefully behind on modernization” and was “essentially organized and equipped as it was in the 1980s.” In June 2018, in part due to congressional concerns, the Army announced a new modernization strategy and designated the NGCV as the second of its six modernization priorities. Originally, the NGCV was considered the program to replace the M-2 Bradley. Development of the NGCV would be managed by the Program Executive Officer (PEO) Ground Combat Systems, under the Assistant Secretary of the Army (ASA), Acquisition, Logistics, and Technology (ALT). . . .  

Army Restarts OMFV Program  

Reportedly, on February 7, 2020, the Army reopened the OMFV competition by releasing a new market survey with a minimally prescriptive wish list and an acquisition strategy that shifted most of the initial cost burden to the Army, in what was described as “a bid to regain industry’s trust after a faulty start.”  As part of the new acquisition strategy, the Army asked potential vendors to first submit a “rough digital prototype” and stated that the Army would not initially seek a target fielding date of FY2026. Also, the Army suggested the requirement to fit two OMFVs on a C-17 aircraft was not part of this new “wish list.” Reportedly, it is hoped this new acquisition approach will bring companies who initially bowed out of the previous competition back into the new competition.  

New OMFV Program Guidance  

On April 9, 2020, the Army released new OMFV program guidance to industry. Of note, the Army stated it now plans to “reduce foreign barriers to competition,” and “identify a pathway to integrate relevant but immature technologies” for the OMFV program. The Army currently plans for a five-phased approach to OMFV acquisition:  

 development and refinement OMFV acquisition and contracting strategies;  

 preliminary design;  

 detailed design;  

 prototype building and testing; and  

 production and fielding.  

The Army now plans to award the first contract in the fourth quarter of FY2021, with a second award planned for the second quarter of FY2023 and down-select to a single vendor in the second quarter of FY2027. The new program guidance also calls for a full-rate production decision in the third quarter of FY2029. The Army now plans for the first unit to be equipped in the fourth quarter of FY2028.

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