Health Aff (Millwood). 2026 Apr;45(4):387-394. doi: 10.1377/hlthaff.2025.01313.
ABSTRACT
It is not currently understood whether the COVID-19 pandemic led to a lengthy period of elevated mortality rates or whether rates have returned to prepandemic trends. To examine this, I calculated age-adjusted excess mortality rates and percent excess mortality overall, by cause, and for population subgroups. COVID-19 death rates in the US fell 93 percent from 2021 to 2024, whereas excess non-COVID-19 death rates declined just 48 percent, with sustained excess mortality likely in the future, particularly for many natural causes. Suicide death rates did not rise, drug and homicide death rates jumped initially but declined relatively quickly, and transport death rates grew more moderately but showed greater persistence. Demographic-group differences were pronounced, with substantial lasting effects for females, American Indian/Alaska Native people, and seniors. This reflects heterogeneity in the prepandemic composition of deaths and in cause-specific percent excess mortality rates across groups. These results indicate important clinical and policy challenges, especially for natural causes of death and for groups facing relatively high cause-specific excess mortality rates.
PMID:41941671 | DOI:10.1377/hlthaff.2025.01313
