Americans are dying at higher rates than people in other wealthy nations not only because of drug overdoses, suicides and homicides but increasingly because of a broad range of chronic diseases, according to a new study that found the U.S. mortality crisis extends far beyond the commonly cited "deaths of despair." The study's corresponding author, Dr. Steven Woolf from Virginia Commonwealth University's School of Medicine, found that rising death rates from conditions such as hypertensive disease, endocrine and metabolic disorders, alcoholic liver disease, neurologic diseases, and genitourinary diseases have contributed to a widening life expectancy gap between the U.S. and other "high-income countries." Experts told Newsweek that problems with health care access, affordability and prevention may be driving the trend. The findings concluded that U.S. life expectancy ranked 38th among countries with populations exceeding 1 million in 2023, while residents of 60 countries faced a lower risk of dying before age 40 than Americans.
Newsweek has contacted the study's representative for more information. The study examined mortality data from 1999 to 2023 in the U.S. and compared it with 16 other high-income countries. Researchers drew on data from the United Nations, the U.S.
Mortality Database, the Centers for Disease Control and Prevention, and the Organization for Economic Co-operation and Development. While external causes of death—especially drug overdoses, suicides and homicides—remain major contributors to excess mortality, researchers found that they do not fully explain the U.S. health disadvantage. Among young adults aged 25 to 44, all-cause mortality increased by 71.2 percent between 2010 and 2021.
In addition to overdoses and other external causes, deaths from early-onset diseases including hypertensive disease, endocrine and metabolic disorders, and alcoholic liver disease rose sharply. Middle-aged adults experienced increased mortality from many of the same conditions, alongside higher death rates from nervous system and genitourinary diseases. Older adults also saw growing mortality from neurologic diseases and endocrine and metabolic disorders.
Since 2010, the mortality gap between the U.S. and comparable countries has increasingly been driven by circulatory diseases, respiratory illnesses, nervous system diseases, endocrine and metabolic disorders, and external causes, the study said. COVID-19 also worsened the trend, becoming a leading cause of death among middle-aged and older adults. However, the researchers noted that non-COVID causes continued to claim lives even as the pandemic subsided.
Mónika López Anuarbe, a professor of economics at Connecticut College and health economist affiliated with the college's Public Health Pathway, said the findings highlight long-standing shortcomings in the U.S. health system. "When trying to understand why the U.S. is where it is in terms of mortality rates, the iron triangle of health care comes to mind: access to care, cost containment and quality of care," she told Newsweek. López Anuarbe said rising costs increasingly affect insured and middle-class Americans, causing some to delay or forgo treatment.
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