Good news is rare in public health these days. But there is a positive trend in mortality data in the United States. Last month, the Centers for Disease Control and Prevention released their provisional mortality report. Continuing a downward trend that began in 2022, the number of age-adjusted deaths per 100,000 people in 2025 was the lowest ever recorded in more than a century of tracking, surpassing the previous record low set in 2024. Overall, the mortality rate has fallen 22% since 2021. The average U.S. life expectancy reached a record high of 79 years in 2024.
Reasons for the decline in mortality rate in the past few years include continued decreases in Covid-19-related fatalities and illicit drug overdose deaths.
Heart disease, cancer and “unintentional injuries” (which include drug overdoses) remain the nation’s three leading causes of death.
Conspicuously, the lifespan gap between the U.S. and other wealthy, industrialized nations narrowed in 2024 from 4.1 to 3.7 years. Life expectancy in 2024 was 79 in the U.S. and 82.7 on average among countries in the 38-member Organization for Economic Cooperation and Development. [The figures for 2025 in the U.S. and OECD haven’t been released yet.] Notably, peers had only a 0.1-year increase between 2023 and 2024 while the U.S. was a more robust 0.6 year.
As the U.S. experiences a post-pandemic rebound, it’s closing a gap that had widened considerably at the height of the Covid-19 pandemic. However, this reflects short-term recovery from acute U.S. mortality shocks like Covid-19 and drug overdoses more than it does a structural change. The U.S. continues to lag its peers owing to persistent issues like higher rates of chronic disease (obesity and type 2 diabetes figure prominently), infant mortality, gun violence, traffic crashes and lack of universal access to healthcare.
More than 45 years ago, the U.S. tracked closely with other wealthy nations, but a stark divergence emerged around 1980. Worsening chronic disease indicators across all age groups have played a role. But what stands out in recent years is the fact that Americans in their 20s face a death rate that’s three times that of comparator nations.
And so, for several decades, while life expectancy steadily increased in peer nations growth leveled off, becoming almost stagnant by around 2012.
Even now, the welcome news of improvement in the life span of a typical American is tempered a bit by the fact that while death rates fell across all age groups there are still substantial differences among demographic groups. Life expectancy gains in the U.S. are not distributed equally, with sharp variations persisting based on race, ethnicity and socioeconomic status. The wealthiest Americans continue to outlive the poorest sub-populations by up to 15 years. This divide is much more severe than that seen in Europe, Australia, Japan and Canada.
Moreover, the U.S. has higher rates of deaths that could be prevented with timely and effective healthcare or a better diet and more exercise compared to other high-income nations. Sometimes this is an access problem. High numbers of un- and underinsured mean that patients may wind up seeking emergency acute treatment rather than preventive and ongoing care. Other times, individuals may have reasonable access but make relatively poor lifestyle choices that lead to worse underlying health conditions.
Besides this, there are pervasive problems such as gun violence leading to homicides and suicides, illicit drug overdoses, alcohol-related fatalities and a relatively high population-wide chronic disease burden.
The extent to which the positive recent trend in mortality data can be sustained will depend on addressing these systemic issues.
