Mortality Trends

The epidemic messed up death reporting and at the same time, put it under a bigger spotlight.  A couple of new pieces of research try to identify trends over and at the tail end of the epidemic.  The first comes from the CDC, the official national compiler of death stats.  It looks at provisional final data for 2023.  Over 3 million people died in the US that year, 3,090,582 to be exact.  The overall rate of deaths was 750 per 100,000 population, and that represented a 6% lower rate than the prior year, primarily due to fewer CV-19 deaths.  Males die at a much higher rate than do females and minorities also have a higher rate of death.   The rate of death is obviously much higher among older persons, particularly those over age 85.  The rates of death are highest in winter, which is just shocking considering that global warming is killing millions, maybe billions of people.   (CDC Report)

The three largest causes of death were heart-disease at 680,909 deaths (a decrease from 703,000 in 2022), cancer–613,331 (an increase from 608,000 in 2022), and unintentional injury–222,518.  The latter is homicides, drug and alcohol overdoses and accidents and is likely understated due to delays in fully investigating cause.  It is also a shockingly high number.  I believe these represent underlying cause of death–the immediate cause, not contributing cause.  Other substantial causes of death were stroke, chronic respiratory diseases, dementia, diabetes, kidney disease and liver disease.  CV-19, always overstated as cause of death, was at almost exactly 50,000 in 2023, the tenth leading cause.  It was a contributing cause in another 25,000 or so deaths.

The second article was in the Journal of the American Medical Association.  It uses the same data but provides more trend information from 2019, the last year unaffected by the epidemic, until 2023.  Heart disease and cancer were always the top two causes by quite a margin.  Unintentional injuries also ranked high as a cause of death and one that is growing very rapidly, largely due to drug overdoses.  CV-19 obviously disrupted the trends for all deaths, as it did have a significant impact on mortality.   A large proportion of the people who had a death attributed to CV-19 during the epidemic would have died in that time period anyway, from some other cause.  An analysis of contributing causes likely would help fill in the blanks of what those persons would have died from in the absence of CV-19.  We see some impact of this in looking at dementia, which showed a dip in the epidemic years, likely reflecting pull forwards due to CV-19 and in flu and pneumonia deaths.     (JAMA Article)