U.S. Mortality Down 6% in 2023, but Up 5-7% compared to 2019
Plus other preliminary CDC results: heart disease and cancer still on top, COVID down to #10
First, the filtered-through-press-release version:
CNN: US death rate dropped 6% in 2023, with Covid-19 falling to 10th leading cause of death, CDC says
A steep drop in Covid-19 deaths helped the overall death rate in the United States fall 6% in 2023, according to provisional data published Thursday by the US Centers for Disease Control and Prevention.
There were about 3.1 million deaths in the US last year, for an age-adjusted rate of 750 deaths for every 100,000 people. In 2022, there were 799 deaths for every 100,000 people.
The US death rate has been dropping quickly since reaching a pandemic-high of about 880 deaths for every 100,000 people in 2021, but this provisional data suggests the death rate is still well above pre-pandemic years. In 2019, there were 715 deaths per 100,000 people, CDC data shows.
As in previous years, heart disease, cancer and unintentional injury – which includes drug overdoses – were the leading causes of death. These top three causes accounted for about half of all deaths last year. Cancer deaths ticked up in 2023 compared with 2022, while deaths from heart disease declined.
I have been updating my spreadsheets with the recent data, but first, I will link the CDC’s report & graphs, then my own graphs. You can tell me which you prefer.
CDC’s Provisional Data for 2023: Report
Mortality in the United States — Provisional Data, 2023
Abstract (edited for readability)
Final annual mortality data from the National Vital Statistics System for a given year are typically released 11 months after the end of the calendar year. Provisional data, which are based on preliminary death certificate data, provide an early estimate of deaths before the release of final data.
In 2023, a provisional total of 3,090,582 deaths occurred in the United States. The age-adjusted death rate per 100,000 population was 884.2 among males and 632.8 among females; the overall rate, 750.4, was 6.1% lower than in 2022 (798.8). The overall rate decreased for all age groups.
Overall age-adjusted death rates in 2023 were lowest among non-Hispanic multiracial (352.1) and highest among non-Hispanic Black or African American persons (924.3). The leading causes of death were heart disease, cancer, and unintentional injury. The number of deaths from COVID-19 (76,446) was 68.9% lower than in 2022 (245,614).
Provisional death estimates provide an early signal about shifts in mortality trends. Timely and actionable data can guide public health policies and interventions for populations experiencing higher mortality.
For the record, this is somewhat the motivation behind the group I’m involved with, the Insurance Collaboration to Save Lives.
Please see this piece by my fellow volunteer Nate Worrell: Throwing Starfish: The Quest to Save a Million Lives
In “The Star Thrower,” by Loren Eisley, we find a coastline strewn with starfish on the brink of succumbing to various fates: consumed by gulls, drying out in the sun, or being collected and boiled by a collector.
Like the battered beach, current trends in U.S mortality and many other global regions present a dire scene.
Excess deaths became news headlines throughout the various Covid pandemic surges, but more recently, other causes of death seem to be driving inflated mortality. Most troubling is that this trend appears to be driven by the younger, working ages between 15 and 45….
More on that last point below.
Back to the CDC’s graphs:
FIGURE 1. Provisional* number of COVID-19–associated deaths† and other deaths and percentage of deaths associated with COVID-19, by week of death — National Vital Statistics System, United States, 2023
FIGURE 2. Leading underlying causes of death* — National Vital Statistics System, United States, 2023
Putting 2023 Mortality in Context: 1968 — 2023
While 2023 is 6% lower in death rate compared to 2022, whether by crude rate or age-adjusted rate, it’s still higher than 2019, the last pre-pandemic year.
Let me show you the graph I just updated:
The crude rate and age-adjusted rate in 2023 are both 6% less than that seen in 2022.
However, they’re both higher than the rates in 2019:
The crude rate is 7% higher in 2023 than in 2019
The age-adjusted rate is 5% higher
You may wonder how significant that is. This brings 2023 back to the level, at these metrics, to about 2009 for the age-adjusted rate.
The crude rate is highly affected by the age structure of the U.S. and is now seeing levels last seen in the early 1970s, but that’s not meaningful. In 1973, when the crude rate was about the same, that was a much younger population dying at much higher rates — thus, the higher age-adjusted death rates.
That said, we do need to look at what age groups are most contributing to the “hangover” of heightened mortality of 2023.
Age-group effects: 2018-2023
If we compare age group by age group, we see that there are quite different effects:
I will put up a simpler graph in a moment, but I want to show you that yes, 2023 (in black) wasn’t as bad as 2020-2022. The worst year was 2021, in red (and de-emphasized).
For each age group, the percentage graphed is how much that year’s death rate differed from 2019. This is a relative measure.
Of course, there are more deaths at older ages (except for infant mortality, which is a spike compared to childhood mortality).
Let’s look at the 2023 results alone:
You may wonder how, with such large percentage increases for ages 15 - 44 (with an interesting carve-out for ages 20-24), the overall increases in both crude rate and age-adjusted death rate were only 5 - 7%.
It’s because most deaths are in the senior range, and those increased only 3 - 8%.
Weighted averages will do that to you.
The number of deaths in the “prime working ages” under age 45 for these 5-year age groups is in the thousands or tens of thousands, versus over a million for those age 85+.
The cause(s) of death creating this havoc at younger ages, mind you, is not COVID.
Spreadsheet for the above
Cause of death ranking tables, updated, 2018-2023
This did not change much from my July post. I have updated the numbers, and there were some minor shifts in rankings and counts, but the rates didn’t budge much.
Top Ten Overall By Count, 2018-2023
Top Ten Overall By Rate, 2018-2023
I did not re-rank these by rate, for what it’s worth, which is why liver disease is below kidney disease for 2023.
Top Ten by Age Group By Count, 2023
Top Ten by Age Group By Rate, 2023
Spreadsheet for Ranking Tables
Upcoming: Changes By Age Groups By Cause of Death
As in prior years, I will look at where changes in death rates for the age groups are coming from. Examples from last year:
Children — Age 1-17:
Young Adults — Age 18-39: approximately the Millennials in 2020-2022
Middle Agers — Age 40-59: approximately Gen X
Young Seniors — Age 60-79: approximately Boomers
Old Seniors — Age 80+: mainly Silent Generation (as older generations are mostly dead at this point)
The sources of increased mortality compared to 2019 have differed among the age groups, and we have seen this with the different percentage changes as well.
COVID had a large effect on the oldest age groups, but now that effect has waned, the persistency of other causes, or even worsening trends, is something to investigate more.