All-cause mortality is rising in the U.S., but the reason behind it is difficult to pinpoint, an opinion essay published in JAMA said.
Life expectancy flatlined in 2010, primarily due to rising mortality rates in individuals aged 25-64. Thiswas first observed in middle-aged White adults, but has since been identified in other ages and races.
At the peak of the COVID-19 pandemic in 2021, the mortality rate was 104.12 per 100,000 population and fell to 15 per 100,000 in 2023. However the mortality rate for other diseases and causes has been on the rise for years and continues to grow.
Here are eight factors driving the current mortality growth rate:
- All-cause mortality for pediatrics began increasing in 2020, primarily due to homicide, suicide, transport injuries and drug overdoses.
- Drug overdose deaths have tripled between 2000 and 2019, rising from 4.15 to 19.14 per 100,000, and increased to 30.14 in 2022.
- Alcohol-related mortality climbed from 17.24 per 100,000 in 2000 to 34.9 per 100,000 in 2021.
- Alcoholic liver disease also increased among adults aged 25-44 by 60% between 2010 and 2019, from 2.75 per 100,000 to 4.4 per 100,000, respectively.
- Suicides increased from 13.5 to 19.52 per 100,000 between 2000 and 2019.
- Homicides involving young and middle-aged adults increased by 39.5% between 2019 and 2021.
- Since 2002, women aged 25-44 have died at increasing rates from pregnancy, childbirth and the puerperium.
- Deaths from hypertensive diseases and kidney failure have increased, as have deaths from neurologic diseases such as Alzheimer's, and deaths due to diabetes.
"With mortality rates for some conditions higher than at any time in the past two decades, the search for answers is paramount," the authors wrote. "COVID-19 is only a partial explanation. Surges in mortality during the pandemic could have been fueled by complications of COVID-19 and long COVID, as well as disruptions to the health care system and stresses induced by the economy and lockdowns. … However, for many non-COVID causes, the increases in mortality began years before the pandemic and have remained elevated even as cases of COVID-19 abated."
Some explanations for the increased mortality are tied directly with the cause of death — addiction disorders, obesity and access to firearms — but others may stem from systemic or economic factors, such as inflation, unstable employment, food and housing insecurity, and chronic stress.