After decades of decline, the death rate spiked during the COVID-19 pandemic.

The Centers for Disease Control and Prevention is the primary federal agency tracking deaths nationwide. It maintains the National Vital Statistics System, which gathers death information from every state. The death rate, also known as mortality rate, is determined using this data in combination with population data.

A simple per capita calculation — called the crude death rate — doesn't account for differences of population over time, geography, or demographic. For example, an area where more than 50% of the population is over 65 is expected to have a higher crude death rate than a place where 10% of the population is 65 or older. Age-adjusted death rates allow for comparison between two populations with different age makeups.

Despite these adjustments, there are differences in age-adjusted death rates by geography.

The share of the uninsured population dropped following the passage of the Affordable Care Act in 2010.

Health insurance in the US is available through various avenues. The primary way Americans get insurance is privately through employers. Publicly funded options include Medicare (primarily for people 65 and older), Medicaid (for low-income individuals), and plans available for active-duty military members and veterans. The Affordable Care Act expanded access to Medicaid and established an online marketplace where people could buy private coverage.

Data from the Census Bureau’s American Community Survey shows that the decrease occurred in every state, though some states had larger changes than others.

USAFacts categorizes government budget data to allocate spending appropriately, and to arrive at the estimate presented here. The health-related spending shown covers public health, hospitals, and other medical services. It does not include spending on government-run health insurance programs such as Medicare or Medicaid. In 2020, public health spending increased due to the COVID-19 pandemic. This included testing and vaccination for the virus.

Government revenue and expenditures are based on data from the Office of Management and Budget, the Census Bureau, and the Bureau of Economic Analysis. Each is published annually, although due to collection times, state and local government data are not as current as federal data. Thus, when combining federal, state, and local revenues and expenditures, the most recent year for a combined number may be delayed.