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Budget The federal government collected nearly $4.5 trillion in revenue in fiscal year 2023 (FY 2023). The federal government spent almost $6.2 trillion in FY 2023, including funds distributed to states. Federal revenue decreased 15.5% in FY 2023 but remained almost 8% higher than in FY 2019. Federal spending decreased by 8.4% in FY 2023, the second year of decreased spending since a record high in FY 2021. Federal revenue in FY 2023 was $13,341 per person and spending was $18,406. The federal government spent 38.0% more than it collected in FY 2023, resulting in a $1.7 trillion deficit. The national debt hit nearly $33.2 trillion at the end of fiscal year 2023.
Economy US gross domestic product (GDP) increased 1.9% in 2022 and another 2.5% in 2023. Year-over-year inflation — the rate at which consumer prices increase — was 3.1% in January 2023. The Federal Reserve raised interest rates seven times in 2022 and four times in 2023. It raised the target rate to between 5.25% to 5.50% in late July 2023 and has left rates unchanged since then. Workers’ average hourly earnings were up 4% in December 2023 compared to a year prior. However, when accounting for inflation, it was less than 1%. The ratio of unemployed people to job openings hit a record low in 2022 but trended upward in 2023. The 2023 average of 0.64 unemployed people per opening was 0.11 higher than in 2022. The unemployment rate was 3.4% at the beginning of 2023 and 3.7% by the end. The labor force participation rate was 62.5% in January 2024, up 0.1 percentage points over January 2023. Last year, the US continued to import more than it exported; however, the trade deficit fell 22% from $990.3 billion in 2022 to $773.4 billion.
Standard of Living In 2021, the middle 20%, or middle class, families received an average market income of $62,094 from wages, retirement, and investments. Middle-class families received $34,611 in government assistance and paid $19,595 in taxes in 2021, after adjusting for inflation. More employees are getting retirement benefits, paid vacation time, sick leave, and family leave than in 2010. Wealth increased for all income quintiles except the middle class over the first three quarters of 2023. The net worth of the middle class averaged about $449,200 per household or a combined $11.9 trillion, over the first three quarters of 2023. The poverty rate was 11.5% in 2022. It has hovered around 11.5% from 2020 through 2022, but remains 1 percentage point higher than the pre-pandemic low of 10.5% in 2019. The federal government spent $1.3 trillion on assistance to individuals in fiscal year 2023. This was 24.9% higher than in FY 2019 after adjusting for inflation, but 46.1% less than the peak in FY 2021. The number of people experiencing homelessness increased in 2023 to 653,104, and has been trending upward since 2017.
Immigration Authorized immigration to the US rebounded in FY 2022 after declining almost 50% in FY 2020. Excluding tourism and unauthorized arrivals, most people arriving in the US are temporary workers, students, or coming to be with their families. Federal immigration and border security spending rose in FY 2023 after two consecutive years of decline following a FY 2020 high. The number of immigrants turned away or apprehended at US borders reached 3.2 million in FY 2023, the most since at least 1980. Immigration officials removed nearly 109,000 people from the US in FY 2022, the most recent year where data is available. This is the fewest removals since 1996, except for 2021. In 2022, there were about 46.2 million foreign-born people in the US, an increase from 44.7 million in 2018. The federal government estimated 11.4 million unauthorized immigrants were in the country in 2018. About 13.9% of people in the US were foreign-born in 2022. Immigrants are more likely to be in the labor force and a married-couple family than people born in the US.
Population 334.9 million people lived in the United States in 2023. The population grew more last year than in recent years, but 2023 still had the fifth-lowest growth in US history after 2021’s record low. Population growth rates vary between states. Nevada residents almost quadrupled between 1980 and 2023, while West Virginia’s population decreased by 9%. The birth rate fell slightly to 1,101 births per 100,000 people in 2022. According to preliminary data, the death rate fell in 2023 for the second consecutive year. It remains above pre-pandemic levels. The country is growing more racially and ethnically diverse. The population is getting older. Single adults without kids comprised 29.0% of all US households in 2023, up from 13.1% in 1960.
Health Provisional data for 2022 shows that life expectancy increased by 1.1 years to 77.5, after decreasing in 2020 and 2021. Accidents have consistently been the leading cause of death for children since data collection started in 1999. In 2022, nearly half of those deaths were motor vehicle accidents. About 3.3 million people died in 2022, 5.3% fewer than in 2021, but 14.9% more than 2019. The top three causes — heart disease, cancer, and accidents — accounted for 47% of deaths. Fentanyl-involved overdose deaths increased from 0.8 per 100,000 people (or 2,628 deaths) in 2012 to 22.8 per 100,000 people (74,127) in 2022. Fentanyl has been involved in more overdose deaths than any other drug annually since 2016. In 2022, an estimated 23.1% of US adults suffered from a mental illness. The federal government spent nearly $117.0 billion on public health in 2023 — 35.9% less than in 2022 but 59.1% more than in 2019. In 2022, 92.1% of the population (304.0 million people) had health insurance. This is back to pre-pandemic levels after dropping below 92% in 2020 and 2021. Per-enrollee spending fell across Medicare, Medicaid, CHIP, and private insurance plans in 2022.
Crime & Justice In 2022, the violent crime rate fell for the second consecutive year, down to 380.7 per 100,000 people. The property crime rate increased for the first time since 2001, up 6.7% to 1,954.4 per 100,000 people. For the first time in two decades, larceny-theft crime rates increased (up 7.4%) in 2022. In 2022, violent crime rates per 100,000 people decreased across all types of crimes, except for robbery. Federal, state, and local governments spent $282.1 billion on law enforcement and corrections in 2021 — the most since at least 1980 (after adjusting for inflation). By 2022, the number of police officers per 100,000 people had fallen 8.9% from its 2009 peak. Nearly 5.6 million people were in prison, jail, or on probation or parole when counted in 2021, though an estimated 6.9 million were admitted to jail throughout the year. The share of state prisoners whose most serious offense, as defined by the FBI, was a drug crime has declined annually since 2007. The firearm death rate dropped to 14.5 deaths per 100,000 people in 2022, but remained higher than any year from 1999 to 2020.
Defense Defense spending increased 2.9% to $994.6 billion in 2023, but was 14.0% lower than its 2010 peak. The nation spent $73.9 billion on foreign aid in FY 2022, a 23.9% increase from FY 2021 and 1% of the federal budget. According to preliminary data, the US made $13.1 billion in Ukraine aid obligations in FY 2022, more than 23 times higher than FY 2021 and nearly 32 times higher than the 2000–2021 average. There were about 1.3 million active-duty military in 2023, 41% fewer than in 1987 — the recent peak. There were 168,571 permanently assigned active-duty troops abroad in 2023. Veterans consistently have a lower unemployment level than the national rate.
Education Eighth-grade math and reading proficiency fell between 2019 and 2022 to the lowest rates in at least 15 years. The public-school student-teacher ratio dropped from 15.9 in fall 2019 to 15.4 in fall 2020 and remained unchanged in 2021. Public schools spent an average of $16,280 per student in the 2020–2021 school year, more than any previous year after adjusting for inflation. Of the students who started high school in 2011, 24% completed a four-year college degree by 2021. Another 13% had enrolled in a four-year college within one year of high school graduation but had not completed their degree. The median student loan balance per household decreased between 2019 and 2022, but it dropped most for Black-led households, falling 25% to $27,070 in 2022. Forty-eight percent of the population ages 25 and older has a college degree. On average, people whose highest level of education is a bachelor’s degree earned $1,493 per week in 2023, roughly 66% more than workers with a high school diploma.
Infrastructure About 44% of 2023 federal transportation and infrastructure spending* was for highway transportation and 23% was for air travel. The rest was for rail and mass transit (22%) and water (10%). The federal government spent $44.8 billion on infrastructure in 2023 and transferred an additional $81.5 billion to states. The Federal Emergency Management Agency (FEMA) has so far allocated more than $210.0 million for repairing and rebuilding infrastructure after natural disasters that occurred in 2023. Air travel increased in 2023 but is down from 2019, with 7.6% fewer scheduled flights January through November. About 44% of the nation’s bridges are in good condition, down 3 percentage points since 2012. Eleven percent of rural roads and 32% of urban roads were in unsatisfactory condition in 2020. In 2022, 16.7% of American households did not have a fixed broadband subscription at home.
Energy In 2022, the US exported about 27.1% more energy than it imported. Average prices for a gallon of regular-grade gas fluctuated between $3.29 and $3.81 in 2023 after reaching nearly $6 in June 2022. Average energy consumption per person, as measured by a 12-month average, has trended downward since 2000. Petroleum and natural gas sources accounted for 72% of energy consumed in the US in 2022, while renewable and nuclear sources accounted for 17%. Coal was 10% of energy consumption. Coal was the most common fossil fuel produced in the United States from the late 1980s until April 2011*; since then, average monthly coal production has dropped 47%. Nuclear energy production, the nation’s leading non-fossil fuel energy source since the mid-1970s, has remained flat for more than two decades. Out of 8.1 million energy-related jobs in 2022, jobs in energy efficiency technology employed more people than any other field: 2.2 million people.
Environment In 2023, the average global temperature reached the highest recorded average temperature since data collection began in 1850. In 2023, the US experienced 28 "billion-dollar" disasters, resulting in a total cost of $92.9 billion. Wildfires burned 2.7 million acres in 2023. Thirty-five major US cities had a combined total of 597 unhealthy air quality days in 2022. The average American generated 4.9 pounds of trash daily in 2018. Carbon dioxide emissions from energy consumption* have generally been decreasing since mid-2008. The federal government spent $35.1 billion on the environment and natural resources in FY 2023.
Home / Reports / State of the Union / Health

Health

What are the top causes of death for Americans, and what is the state of the healthcare system?

Health

Provisional data for 2022 shows that life expectancy increased by 1.1 years to 77.5, after decreasing in 2020 and 2021.

It’s now 0.5 years higher than in 2020 but 1.3 years lower than in 2019. Waning COVID-19 mortality accounted for approximately 84% of the rise in life expectancy.

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Health

Accidents have consistently been the leading cause of death for children since data collection started in 1999. In 2022, nearly half of those deaths were motor vehicle accidents.

Homicide went from being the fourth leading cause of death in 2019 to the second in 2022, surpassing suicide and cancer. Firearms were the primary weapon in 77% of child homicides in 2022.

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Health

About 3.3 million people died in 2022, 5.3% fewer than in 2021, but 14.9% more than 2019. The top three causes — heart disease, cancer, and accidents — accounted for 47% of deaths.

COVID-19 dropped from the third leading cause of death to fourth in 2022. Preliminary 2023 data shows that 3.07 million people died from January 1 through December 31.

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Health

Fentanyl-involved overdose deaths increased from 0.8 per 100,000 people (or 2,628 deaths) in 2012 to 22.8 per 100,000 people (74,127) in 2022. Fentanyl has been involved in more overdose deaths than any other drug annually since 2016.

Methamphetamine and cocaine-related deaths have also been increasing, since 2008 and 2012, respectively.

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Health

In 2022, an estimated 23.1% of US adults suffered from a mental illness.

Women, people of two or more races, white people, the unemployed, and part-time workers have higher rates of mental illness than the national rate. Mental illness is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder.

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Health

The federal government spent nearly $117.0 billion on public health in 2023 — 35.9% less than in 2022 but 59.1% more than in 2019.

Most of the decrease from 2022 to 2023 was due to a reduction in Public Health and Social Services Emergency Fund spending, which was elevated in 2020, 2021, and 2022 due to COVID-19.

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Health

In 2022, 92.1% of the population (304.0 million people) had health insurance. This is back to pre-pandemic levels after dropping below 92% in 2020 and 2021.

The share of people with private health insurance fell 2.4 percentage points from 2019 to 2022. Meanwhile, the share of Americans with Medicare, Medicaid, or other public health insurance grew by 2.0 percentage points.

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Health

Per-enrollee spending fell across Medicare, Medicaid, CHIP, and private insurance plans in 2022.

Medicare and Medicaid cover older and low-income populations and spend more per enrollee than private insurance. However, the amount spent per enrollee decreased more for Medicare and Medicaid than private health insurance from 2021 to 2022.

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