Mortality rates for US residents 15 years or older increased sharply in 2020, fueled by nearly 351鈥�000 deaths attributed to COVID-19 during the year. As a result, average US life expectancy at birth declined by nearly 2 years from that in 2019, according to a from the Centers for Disease Control and Prevention鈥檚 National Center for Health Statistics (NCHS).
The NCHS report, an analysis of finalized data collected from the nation鈥檚 death certificates, noted that 3鈥�383鈥�729 resident deaths were registered in the US, nearly 529鈥�000 more deaths than in 2019. The analysis showed that the average life expectancy for the US population in 2020 was 77.0 years, a decrease of 1.8 years from 2019 and the largest 1-year decline in .
Average life expectancy for males fell 2.1 years in 2020鈥攂efore COVID-19 vaccines became widely available鈥攆rom 76.3 years in 2019 to 74.2 years in 2020. For females, the average decrease was 1.5 years, from 81.4 years in 2019 to 79.9 years in 2020.
The drop in life expectancy was 鈥渓argely because of increases in mortality due to COVID-19, unintentional injuries, heart disease, homicide, and diabetes,鈥� the report said.
The age-adjusted death rate increased by nearly 17%, from 715.2 deaths per 100鈥�000 standard population in 2019 to 835.4 in 2020. However, the increases in death rates for non-Hispanic Black and Hispanic populations were far greater, increasing by nearly 43% among Hispanic males and more than 32% among Hispanic females (compared with approximately 13% for non-Hispanic White males and 12% for non-Hispanic White females) and by 28% among non-Hispanic Black males and nearly 25% among non-Hispanic Black females.
Death rates for all age groups 15 years or older also increased from 2019 to 2020. However, the report cited one exception: a drop in the nation鈥檚 infant mortality rate, which decreased nearly 3%, from 558.3 infant deaths per 100鈥�000 live births in 2019 to a record low of 541.9 infant deaths per 100鈥�000 live births in 2020. Still, the new 鈥渞ecord low鈥� US infant mortality rate remains substantially higher compared with the .
Although heart disease (causing 168.2 deaths per 100鈥�000 population) and cancer (resulting in 144.1 deaths per 100鈥�000) remained the top 2 causes of death in 2020, COVID-19 became the third leading cause of death. Suicide dropped off the list of the 10 top causes in 2020, the report said.
The remaining leading causes of death in 2020 after heart disease, cancer, and COVID-19 were unintentional injuries (which includes fatal drug overdoses), stroke, chronic lower respiratory diseases, Alzheimer disease, diabetes, influenza and pneumonia, and kidney disease.
These 10 leading causes accounted for about 74% of all US deaths in 2020. Age-adjusted death rates increased between 2019 and 2020 for 6 of these conditions (4.1% for heart disease, 16.8% for unintentional injury, 4.9% for stroke, 8.7% for Alzheimer disease, 14.8% for diabetes, and 5.7% for influenza and pneumonia). The death rate for kidney disease remained the same, whereas rates declined 1.4% for cancer and 4.7% for chronic lower respiratory diseases.
Researchers have noted that increases in deaths attributed to causes other than COVID-19 suggest that the pandemic may adversely affect health in indirect ways, including people foregoing medical care for a variety of reasons, such as job loss and or in care settings. Increases in other leading causes of death鈥攕uch as heart disease, Alzheimer disease, and diabetes鈥攎ay stem from disruptions in health care that hindered preventive care and hampered early detection and management of diseases.
Published: January 4, 2022. doi:10.1001/jamahealthforum.2021.5286
Open Access: This is an open access article distributed under the terms of the CC-BY License. 漏 2022 Stephenson J. JAMA Health Forum.
Corresponding Author: Joan Stephenson, PhD, Consulting Editor, JAMA Health Forum (Joan.Stephenson@jamanetwork.org).
Conflict of Interest Disclosures: None reported.