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. 2021 Apr 20;118(16):e2024850118.
doi: 10.1073/pnas.2024850118.

Excess mortality in the United States in the 21st century

Samuel H Preston  1 , Yana C Vierboom  2
Affiliations

Excess mortality in the United States in the 21st century

Samuel H Preston et al. Proc Natl Acad Sci U S A. .

Abstract

We use three indexes to identify how age-specific mortality rates in the United States compare to those in a composite of five large European countries since 2000. First, we examine the ratio of age-specific death rates in the United States to those in Europe. These show a sharp deterioration in the US position since 2000. Applying European age-specific death rates in 2017 to the US population, we then show that adverse mortality conditions in the United States resulted in 400,700 excess deaths that year. Finally, we show that these excess deaths entailed a loss of 13.0 My of life. In 2017, excess deaths and years of life lost in the United States represent a larger annual loss of life than that associated with the COVID-19 epidemic in 2020.

Keywords: age-specific death rates; international comparisons; mortality.

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Conflict of interest statement

The authors declare no competing interest.

Figures

Fig. 1.
Fig. 1.
Age-specific comparisons of US and European mortality: 2000, 2010, 2017. Source: HMD (12). (A) Ratio of US age-specific death rate to European standard. (B) Change in US death count if US had European age-specific death rates. (C) Years of life lost based on US life expectancies and US/European comparisons of age-specific death rates.
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