In 2020, COVID-19 joined what had been a fairly stable list of leading causes of death in the United States, coming in at No. 3 behind heart disease and cancer. The pandemic also contributed heavily to a dip in projected lifespan compared to 2019.
Life expectancy at birth in 2020 was 77 years overall in the United States, down nearly two years from the projection for those born in 2019, according to data released Wednesday by the National Center for Health Statistics in the Centers for Disease Control and Prevention. Females are expected to live 5.7 years longer than males, at 79.9 years vs. 74.2 years. Both those numbers dropped compared to 2019 predictions.
The age-adjusted death rate for the whole population rose from 715.2 per 100,000 in 2019 to 835.4 in 2020. Increases in the age-adjusted death rate for ethnic and racial groups varied from just over 12% for non-Hispanic white females to a nearly 48% jump for Hispanic males.
Overall, age-adjusted death rates rose the most for Hispanics, followed by non-Hispanic Blacks, whose rates were double those of non-Hispanic whites. An age-adjusted death rate weights age-specific rates for each group by the proportion of each group in the population. The new report notes that the age-specific death rate increased in each age group 15 and older between 2019 and 2020.
Unintentional injuries, stroke, chronic respiratory disease, Alzheimer’s, diabetes, influenza/pneumonia and kidney disease rounded out the top 10 list of leading causes of death in the U.S. in 2020.
Overall, the report said, 3,383,729 resident deaths were recorded in the United States in 2020, up 528,891 compared to 2019.
The 16.8% increase in the age-adjusted death rate for the total population was the biggest single-year increase since the data collection began, and the decrease in life expectancy was the largest single-year decrease in more than 75 years.
As of Dec. 20, 2021, 804,046 deaths had been attributed to COVID-19 on death certificates. In 90% of cases, CDC reported, COVID-19 was listed as the underlying cause of death, while the others listed it as a contributing cause of death. The report said the largest number of COVID-19 deaths reported in a single week came in early January of 2021, when 25,984 deaths were attributed to the pandemic.
COVID-19 changed a trajectory that had been trending toward longer life. A year ago, the final data on 2019 deaths compared to 2018 showed that life expectancy had increased for the second year in a row, “despite an increase in deaths from drug overdoses and an all-time high of over 2.85 million deaths in the U.S.,” that earlier report said.
Drug overdose and homicide
The CDC said that drug overdose deaths make up more than a third of all accidental deaths in the country and had increased in 2019, after they declined in 2018 for the first time in 28 years.
2020 brought other death-related challenges, as well. In July, the CDC reported that drug overdose deaths were up 30% compared to the previous year. And in October the agency reported that 2020 brought the “largest one-year increase in the U.S. homicide rate.”
Provisional data found that in 2020, the homicide rate in the United States was 7.8 per 100,000, compared to 6.0 the year before — and the highest rate since 1995, “but significantly lower than the early 1980s, which topped 10 homicides per 100,000.”
The new report said 19,582 children younger than age 1 died in 2020, which was 1,339 fewer than in 2019.
Among infants, the leading causes of death were the same as in 2019: congenital malformations, low birth weight, sudden infant death syndrome, unintentional injuries, maternal complications, cord and placental complications, bacterial sepsis, respiratory distress, diseases of the circulatory system and neonatal hemorrhage.
There was a statistically significant increase in sudden infant death syndrome, from 33.3 to 38.4 per 100,000 live births in 2019 compared to 2020. Low birth weight was the only category where deaths among infants decreased meaningfully, from 91.9 to 86.9 per 100,000.
The CDC has an interactive web dashboard where the leading causes of death are regularly updated.