Post-pandemic surge in excess US deaths exposes public health decline

Editor's Note

The United States recorded more than 1.5 million excess deaths in 2022 and 2023 alone—avoidable fatalities that would not have occurred if US death rates matched those of other wealthy nations, according to a May 23 article in CIDRAP reporting on a Boston University–led study published in JAMA Health Forum. The findings underscore a long-term mortality crisis in the US, driven by drug overdoses, gun violence, car accidents, and preventable chronic conditions. 

As detailed in the article, researchers examined all-cause mortality data from the US and 21 other high-income countries (HICs) between 1980 and 2023. Over that period, US death rates consistently declined more slowly than in peer nations. This lag resulted in 14.7 million excess US deaths—fatalities that would likely have been avoided if the country had kept pace with the age-specific death rates of comparable nations.

While excess deaths spiked during the COVID-19 pandemic, they remained high in its aftermath. In 2023, excess deaths totaled over 705,000, accounting for nearly 23% of all US deaths and 46% of deaths among those under age 65. Notably, US adults aged 25 to 44 were 2.6 times more likely to die than their counterparts in other high-income countries.

The outlet reports that although death rates narrowed slightly in 2022 and 2023, the long-term trend remains alarming. The researchers emphasized that the majority of these deaths were not due to COVID-19 but to persistent crises in violence, addiction, and chronic disease. 

The authors argue that other countries’ successes in reducing mortality—through universal healthcare, robust social safety nets, and consistent public health policies—illustrate a path the US has so far failed to follow. They also warn that recent cuts to public health, science funding, and federal health programs may further deepen the disparity.