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Heart disease, cancer, and COVID-19 were responsible for nearly half of the deaths nationwide in 2021. Still, the age-adjusted death rates of both cancer and heart disease have declined over the last 20 years.

The Centers for Disease Control and Prevention (CDC) reports that 3.46 million people died in the US in 2021. Overall, 10 causes accounted for 74.5% of deaths that year.

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For comparison, the top 10 causes in 1999 accounted for approximately 80% of all deaths.

Have deaths increased over time?

Nationwide, deaths rose to 3.46 million in 2021 from 3.38 million in 2020, up 2.4%. The rate rose 18.5% between 2019 and 2020 largely due to COVID-19.

According to the CDC, lower heart disease and cancer risk could initially be attributed to decreased smoking and lung cancer. More recently, the agency has attributed the decline to improved treatment for heart issues, increased cancer screenings, plus reductions in risk factors such as cholesterol and high blood pressure.

The age-adjusted death rate decreased from 1999 to 2021 for six of the 10 leading causes of death in 1999, with influenza and pnuemonia (-55.3%), heart disease (-34.8%), and strokes (-33.3%) dropping the most over the 22 years.

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On the opposite end, Alzheimer’s disease and unintentional injury rates nearly doubled, increasing 88% and 83%, respectively. Unintentional injuries are a broad category that includes car accidents, falls, accidental poisonings (including drug overdoses), and more.

Leading causes of death by age

Age is generally the most influential predictor of death, with people 85 years and older having the highest crude death rates across 14 of the 16 leading causes of death in 2021.

The only exceptions were chronic liver disease and cirrhosis — with the highest crude death rates for those ages 55 to 64 — and homicide, which was most common among people ages 25 to 34.

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Also, while the average life expectancy at birth in the US was 76.4 years in 2021, if someone lived to be 65 years old, they are much more likely to make it to 85.

According to the Social Security Administration, the average 65-year-old man in the US has a 1.9% chance of dying before turning 66, while the average woman has a 1.1% chance.[1] The chances are 4.1% and 2.8%, respectively, that they’ll pass away before reaching 75, and 11% and 8.3% that they’ll pass away before 85.

How do causes of death vary by gender and race?

Observing causes of death by gender and race helps identify disparities between different demographic groups. Identifying these disparities can help policymakers address public health matters for potentially underserved or at-risk populations.

For one, women tend to live longer than men. Men have a higher age-adjusted death rate compared to women, totaling 1,048.0 per 100,000 compared to 733.3 per 100,000 people, respectively. This difference can partially be explained by men’s greater vulnerability to cardiovascular disease and higher prevalence of smoking.

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In 2021, men had a 61.9% higher age-adjusted death rate from heart disease, were more than twice as likely to die from unintentional accidents, and were four times more likely to die from suicide. Conversely, women had a 47.5% higher age-adjusted death rate from Alzheimer's disease, which is understandable given that women live longer than men, and the greatest risk-factor for the disease is age.

Death rates by race and ethnicity

Age-adjusted differences in death rates by race can indicate significant disparities in health outcomes among racial groups, even when considering differences in age distributions. These differences might reflect varying access to healthcare, social determinants of health, and systemic inequalities.

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Some examples of disparities include higher rates of heart disease and hypertension among Black or African Americans, higher rates fo unintentional injuries and chronic liver disease and cirrhosis among American Indians or Alaskan Natives, and increased rates of diabetes among Native Haiwaiians or other Pacific Islanders, as well as the two aforementioned groups.

These are only a few examples of health disparities by racial and ethnic groups.

Where does this data come from?

All data collected for these visuals comes from CDC Wonder data, which offers a variety of public health-related data on Americans, including mortality statistics, natality data, cancer incidence, behavioral risk factors.

What counts as a cause of death?

The CDC compiles data on causes of death in the US based on death certificates. Each certificate lists an underlying causes of death, which is the disease or injury that initiated the chain of events leading to death. Medical professionals determine a cause based on clinical assessments, tests, and other evidence.

The CDC categorizes these causes using the International Statistical Classification of Diseases and Related Health Problems. This allows for standardized statistics that provide an understanding of the primary reasons people die, rather than just the immediate circumstances of their death.

What is age-adjusted data?

Age-adjusted data helps to compare health data over time or between groups more fairly by accounting for the age differences in populations.

For example, suppose Population A has a higher average age than Population B. In that case, age-adjusting ensures that Population A's naturally higher death rate due to age doesn't skew comparisons of overall health between the two. This measurement makes death statistic comparisons more accurate than crude death rates.

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WONDER Data: Underlying Causes of Death
Last updated
January 11, 2023
National Center for Health Statistics

Projected death probabilities are for people born in 2020.