The overall age-adjusted mortality rate (both sexes) from all causes of death recorded the historically highest increase of published records dating back to 1900 of 16.8% in 2020, following a 1.2% decrease in 2019. The increase eclipsed the size of recent years’ annual volatility and exceeded the 11.7% increase in 1918 that occurred during the Spanish influenza pandemic. When COVID deaths are removed, all other CODs’ (Cause of Death) combined mortality increased by 4.9%, which was last exceeded by a 5.6% increase in 1936.
All other CODs featured in this report had increased 2020 mortality. In many instances, the single year mortality increases were the largest for the span of this report. Heart disease and Alzheimer’s/Dementia had 4.7% and 7.8% increases, respectively. Other physiological CODs with lower death rates had double-digit increases. Diabetes, liver and hypertension had increases of 14.9%, 16.0% and 13.3%, respectively. The external CODs of assaults and opioid overdoses had extreme increases at ages 15-24 of 35.9% and 61.2%, respectively.
Jerome Holman, FSA, MAAA, RJH Integrated Solutions, LLC Cynthia S. MacDonald, FSA, MAAA, Society of Actuaries Research Institute
The overall age-adjusted mortality rate for 2020 was 828.7 deaths per 100,000 of population. This rate was 15.9% greater than the 2019 overall age-adjusted mortality rate. This high level of mortality has not been experienced in the U.S. since 2003.
If deaths coded as COVID (COVID deaths)3 were excluded, the overall age-adjusted 2020 mortality rate would have been 737.2 per 100,000 or 3.1% higher than the 2019 rate. This increase excluding COVID deaths is also noteworthy because it reverses the two previous calendar years of decreasing mortality; however, some or all of this may be due to the misclassification of CODs as discussed in Section 6.
2020 mortality rates increased in both sexes, with the male rates increasing more than the female rates. The differences in the increases between males and females were about 3% when all causes of death (CODs) are included and about 1% when COVID deaths are excluded.
The slope of the 2020 COVID mortality curve by age group is not as steep as the slope of the non-COVID deaths, indicating that COVID impacts younger ages more evenly across age groups that all other non-COVID CODs combined.
In the review of the 2020 mortality rates by age group, it is interesting to see that the highest percentage increases were in the younger adult ages, not at the very old ages. When COVID deaths were removed, ages 15-44 saw the largest increases in mortality rates.