U.S. Excess Deaths

Even before the pandemic, the U.S. had an excess death problem. The number of excess deaths nearly doubled during the pandemic.

Excess deaths in the U.S.

Deaths above expected levels using population-weighted average death rate of western Europe

Source: Heuveline P (2023) The Covid-19 pandemic and the expansion of the mortality gap between the United States and its European peers. PLoS ONE 18(3): e0283153. Inspired by Impact Factor with F. Perry Wilson. Notes: “Excess" deaths is calculated by applying western Europe (England and Wales, France, Germany, Italy, and Spain) sex- and age-specific mortality rates to the U.S. population to create an alternative, or "counterfactual" estimate of deaths for the U.S., i.e. the # of expected U.S. deaths. Next, researchers arrive at "excess" deaths by subtracting that counterfactual estimate of U.S. deaths from the actual number of U.S. deaths. Estimates are also standardized to 2021 to control for population growth.

The excess death gap (the difference between observed deaths and expected deaths) between the U.S. and the 5 largest western European countries is higher than ever, nearly doubling from 465,617 excess deaths in 2017 to 892,491 excess deaths in 2021.¹ Most of the growth occurred between 2019 and 2021, when the number of U.S. excess mortalities grew by 84.9%, compared to 3.7% between 2017 and 2019. Earlier research indicates that the U.S. has had an excess death problem since at least 2000.²

50% of the excess deaths in 2021 were among Americans in their “prime of life” — between 15-64 years old. While Covid has been one of the leading causes of death in the U.S. since the start of the pandemic, rates of death by drug overdose, alcohol incidents, firearms, road rage and other vehicle incidents have spiked as well (Death rates, Drug overdose deaths).^3,4,5,6,7

In comparison to peer nations, the U.S. was also the only nation where life expectancy declined for a second year in a row, dropping from 78.8 years in 2019 to 77.0 years in 2020 to 76.4 years in 2021.⁸ Peer nations saw smaller decreases of life expectancy (approximately 0.5 years) from 2019-2020, and had modest increases in life expectancy (approximately 0.25 years) from 2020 to 2021.^9,10

1. “The Covid-19 pandemic and the expansion of the mortality gap between the United States and its European peers”. Heuveline. PLoS ONE. March, 2023. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0283153

2. “Excess mortality in the United States in the 21st century”. Preston, Vierboom. PNAS. April, 2021. https://www.pnas.org/doi/10.1073/pnas.2024850118 

3. “Drug Overdose Deaths”. CDC. https://public.tableau.com/app/profile/dcdd/viz/04_DrugOverdose/04_DrugOverdose 

4. “Effect of increased alcohol consumption during COVID-19 pandemic on alcohol-associated liver disease: A modeling study”. Julien, Ayer, Tapper, Barbosa, Dowd, and Chhatwal. AASLD. December, 2021. https://aasldpubs.onlinelibrary.wiley.com/doi/abs/10.1002/hep.32272 

5. “Gun Violence Archive 2023”. https://www.gunviolencearchive.org/

6. “2020 Fatality Data Show Increased Traffic Fatalities During Pandemic”. National Highway Traffic Safety Administration. June, 2021. https://www.nhtsa.gov/press-releases/2020-fatality-data-show-increased-traffic-fatalities-during-pandemic   

7. “Reports of Road Rage Shootings are on the Rise”. Burd-Sharps, Bistline. Everytown. April, 2022. https://everytownresearch.org/reports-of-road-rage-shootings-are-on-the-rise/  

8. “New Report Confirms U.S. Life Expectancy has Declined to Lowest Level Since 1996”. CDC. December, 2022. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/20221222.htm 

9. “CHANGES IN LIFE EXPECTANCY BETWEEN 2019 AND 2021 IN THE UNITED STATES AND 21 PEER COUNTRIES”. Masters, Aron, and Woolf. medRxiv. June, 2022. https://www.medrxiv.org/content/10.1101/2022.04.05.22273393v4

10. “U.S. Life Expectancy Is in Decline. Why Aren’t Other Countries Suffering the Same Problem?” Klobucista. Council on Foreign Relations. September, 2022. https://www.cfr.org/in-brief/us-life-expectancy-decline-why-arent-other-countries-suffering-same-problem