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Three major Supreme Court decisions in 2022 have each been widely criticized by health experts as threats to public health, but a study published Thursday in JAMA Network Open modeled their collective toll. The study found that, according to conservative estimates, the decisions will result in thousands of deaths in the coming years, and tens of thousands more in damage.
The three decisions include: one of January 13, 2022, which invalidated some COVID-19 workplace protections (National Federation of Independent Business v Department of Labor, Occupational Safety and Health Administration (OSHA)); one on June 23, 2022, which invalidated a number of state laws restricting the carrying of handguns (New York State Rifle and Pistol Association Inc v Superintendent of the New York State Police (Bruen)); and one on June 24, 2022, which revoked the constitutional right to abortion (Dobbs v Jackson Women’s Health Organization).
A group of health researchers, led by Adam Gaffney at Harvard University, modeled how these decisions would affect the morbidity and mortality of Americans in the near future.
COVID deaths and damage
For the OSHA decision, the researchers relied on OSHA’s estimates of how many workers would have been vaccinated under the agency’s Temporary Emergency Standard (ETS), which would have required large employers to vaccinate workers or take precautions such as masking and testing. OSHA estimated that implementation of the ETC would have resulted in an additional 18.9 million people being vaccinated at the time, coinciding with the first omic wave.
The study authors modeled three scenarios, ranging from when implementation took effect amid the infection wave in January and February 2022, using data from the Centers for Disease Control and Prevention to assess deaths by vaccination status, age and calendar week in the execution period. They also modeled the rate of hospital admissions, intensive care unit admissions, and the use of mechanical ventilation.
Between January and May 2022, the invalidation of the OSHA ETS was estimated to have resulted in between 980 and 2,940 deaths, with an average estimate of 1,402. In addition, estimates of hospitalizations ranged from nearly 16,000 to 48,000, with a middle scenario of just under 23,000. Estimated cases requiring intensive care and mechanical ventilation were nearly 4,000 and 1,500, respectively.
Deaths and injuries from firearms
For the Brown the authors reviewed seven recent studies estimating the increased rate of firearm-related homicides associated with the dropping of “may-issue” concealed carry handgun permits. The Supreme Court ruling overturned such laws in six states (California, Hawaii, Maryland, Massachusetts, New York and New Jersey) and the District of Columbia. Based on the literature review, Gaffney and colleagues estimate the increase in homicides to be between 3 percent and 9 percent. That set up modeling for three scenarios, with an average increase of 6 percent, based on CDC data on firearm-related homicide rates in the affected states and DC. They also modeled three scenarios in which states offset the effects of invalidating the laws with new policies, in whole, in part, or not at all.
Overall, the middle scenario estimated an increase of 152 additional firearm deaths per year, with 377 additional non-fatal firearm injuries.
