The COVID-19 pandemic began over five years ago, but it’s still fresh in everybody’s mind. People still face its after effects, like lingering symptoms from the disease. Some have yet to regain their energy levels, sense of taste and smell, memorization abilities, and overall respiratory health. Children may struggle with development and learning because of their disrupted education. And many individuals still mourn the loss of loved ones due to the virus. In 2020, over 385,000 people in the U.S. died from COVID-19, and in 2021, that increased to over 463,000, according to the CDC. The public was more tuned in to death rates around this time, but a team of researchers made a shocking discovery recently. The U.S. had a high mortality rate before the pandemic, and it has been high ever since.
Death Rates Before and After COVID-19
According to the study from May 2025, the number of “excess U.S. deaths reached an estimated 14.7 million” between 1980 and 2023. “Excess deaths” are defined as the difference between the number of expected deaths and the number of observed deaths during a designated period of time. The authors noted that excess deaths peaked in 2021, but there were still over 1.5 million in 2022 and 2023. The growing number of deaths began in the 1980s and has continued since. Compared to other rich countries, America has a high mortality rate. This continued to be true during the pandemic, where America’s non-elderly seemed to be hit harder than those in other countries.
There are many theories on why this is the case. The study authors and mortality experts, Jacob Bor, Rafeya V. Raquib, and Elizabeth Wrigley-Field, write about a few on Slate. “One influential theory focuses on deindustrialization and the way that Americans without a college degree, in particular, have been left behind. Another focuses on the way that social safety nets in this country, such as for unemployment, sickness, and pensions, remain small and insufficient compared with other wealthy countries.” The countries in the study include Australia, Canada, New Zealand, Iceland, Japan, and much of Western Europe.
Other theories point to flaws in the U.S. health care system, such as uninsurance, underinsurance, and high co-payments and deductibles, and to underlying trends in chronic diseases that might be caused by nutritional policy failures. Still others highlight America’s permissive gun laws and the large amount of time we spend in our cars.” The high mortality could be from a number of causes, but take note that all of the above factors predate COVID-19.
Unprecedented Death Rates for Millennials and early Gen Zers
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Unfortunately, the researchers made another unnerving discovery. The population most represented in these excess death rates is aged 25–44, making them millennials and older Gen Zers. They found the number one cause of death for this age group to be overdoses or drug poisoning. This is followed by traffic accidents, alcohol-related deaths, suicide, homicide, and natural causes, which may have been partially caused by cardiometabolic conditions such as obesity, heart disease, and diabetes.
Before 2010, the average life expectancy of Americans was increasing, but this is no longer the case. In fact, since the pandemic, millennials face an increased death rate, which the authors attribute to the U.S.’s social structure and health system. For comparison, American millennials are 2.6 times as likely to die as their peers in other rich countries. “Young adult deaths are, to a large extent, preventable,” says Andrew Stokes, an SPH associate professor of global health to Boston University’s publication The Brink. He co-led the study with Wrigley-Field of the University of Minnesota. “There are several major areas where we desperately need policy intervention.”
Stokes notes how this generation grew up during economic crises and decreased social mobility. They’ve also grown alongside the “expansion of industries that affect public health,” such as “processed foods and beverages, prescription drugs and OxyContin, alcohol, combined with this creeping effect of the obesity epidemic.” They were also disproportionately impacted by the job loss and insecurity during the pandemic. Alongside this, they reported increased alcohol consumption and drug use, and higher rates of depression.
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A Trend or a Blip?
Unfortunately, millennials are experiencing unprecedented higher heart disease-related death rates, as shown by a 2024 study. “Usually, it takes a lifetime to manifest cardiovascular disease and related mortality,” said Stokes. “These are the ages, 25 to 44, in which behaviors become entrenched and life course risks start to develop. And if we’re seeing this excess mortality in this generation now, it’s also an indication of what may happen to population health as a whole in decades ahead as this generation ages.”
It’s important to note the weaknesses of the study. For instance, it didn’t explore how numbers vary depending on race, gender, and income. However, it does indicate how overall poor health and policies pertain to people in this demographic. The authors recommend policymakers look to other countries for insight on how to improve health outcomes. “Other countries show that investing in universal healthcare, strong safety nets, and evidence-based public health policies leads to longer, healthier lives,” says Stokes. However, the U.S. has many obstacles to overcome in order to do this. “…Public distrust of government and growing political polarization have made it harder to implement policies that have proven successful elsewhere.”
Bor named other impediments to the Minnesota Population Center. “Deep cuts to public health, scientific research, safety net programs, environmental regulations, and federal health data could lead to a further widening of health disparities between the US and other wealthy nations, and growing numbers of excess, and utterly preventable, deaths to Americans.”
Remember that negative predictions do not necessarily mean negative outcomes. As a 2024 review notes, “short-term fluctuations in mortality are not uncommon,” while longer-term trends are overall consistently positive in high-income countries.
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