US deaths at ages 25–44 up 71%: the data, charted

+71.2% Death rate, ages 25–44 2010 to 2021. The steepest rise of any age group. See the rise → 7× Overdose deaths, ages 25–44 7.73 to 54.34 per 100,000, 1999–2021. What is killing them → 38th US life expectancy rank, 2023 Among countries of more than 1 million people. It was 14th in 1980. The world ranking → 60 Countries safer before 40 Places where a newborn is less likely than an American to die before turning 40. Compare countries →

1 · The rise

No other age group lost ground this fast

The death rate at ages 25–44 fell through the 2000s to a low in 2010. By 2019, before the pandemic, it was already 20% higher, mostly because of overdoses. It then surged to a peak in 2021. It has fallen every year since, but in 2024 it was still 24% above 2010.

Deaths per 100,000 people aged 25–44

All causes, age-adjusted, 1999–2024. Hover, tap or use the arrow keys to read any year.

139.82010, the low point

239.22021, the peak

173.32024, +24% on 2010

Source: CDC WONDER, Underlying Cause of Death, 1999–2024, ages 25–44, age-adjusted per 100,000.

Show the numbers

Death rate at ages 25–44 by year
Year	Deaths per 100,000
1999	154.4
2000	154.6
2001	159.0
2002	159.1
2003	158.3
2004	153.6
2005	154.8
2006	154.3
2007	150.2
2008	146.5
2009	145.6
2010	139.8
2011	141.4
2012	141.0
2013	142.0
2014	144.8
2015	151.3
2016	163.5
2017	166.8
2018	164.7
2019	167.2
2020	207.8
2021	239.2
2022	213.6
2023	196.7
2024	173.3

Change in death rate by age group since 2010

Deaths per 100,000 within each ten-year age group. Older groups die at far higher rates, but none rose as steeply, and by 2024 most were back at or below their 2010 level.

15–2467.7 → 88.9 +31.3%
25–34102.9 → 180.8 +75.7%
35–44170.5 → 287.9 +68.9%
45–54407.1 → 531.0 +30.4%
55–64851.9 → 1,117.1 +31.1%
65–741,875.1 → 2,151.3 +14.7%
75–844,790.2 → 5,119.4 +6.9%
85+13,934.3 → 15,743.3 +13.0%

15–2467.7 → 66.9 −1.2%
25–34102.9 → 124.5 +21.0%
35–44170.5 → 213.9 +25.5%
45–54407.1 → 386.9 −5.0%
55–64851.9 → 859.8 +0.9%
65–741,875.1 → 1,772.9 −5.5%
75–844,790.2 → 4,264.0 −11.0%
85+13,934.3 → 13,834.0 −0.7%

Source: CDC WONDER, Underlying Cause of Death, 1999–2024, deaths per 100,000 by ten-year age group; the same figures NCHS publishes in its annual mortality data briefs.

Show the numbers

Death rate by age group, 2010, 2021 and 2024
Age group	2010	2021	2024	2010–2021	2010–2024
15–24	67.7	88.9	66.9	+31.3%	−1.2%
25–34	102.9	180.8	124.5	+75.7%	+21.0%
35–44	170.5	287.9	213.9	+68.9%	+25.5%
45–54	407.1	531.0	386.9	+30.4%	−5.0%
55–64	851.9	1,117.1	859.8	+31.1%	+0.9%
65–74	1,875.1	2,151.3	1,772.9	+14.7%	−5.5%
75–84	4,790.2	5,119.4	4,264.0	+6.9%	−11.0%
85+	13,934.3	15,743.3	13,834.0	+13.0%	−0.7%

2 · What is killing them

Overdoses led the surge, but almost everything rose

Drugs, violence, road deaths, suicide, and chronic diseases that usually strike decades later. Tap a card for the detail. Each measures change from its own starting year, as the paper does, so the cards are not a league table.

Details 7× Unintentional drug overdoses 1999–2021 · per 100,000 aged 25–44 7.73 per 100,000 in 1999, 54.34 in 2021. 2024: 35.53 (−35% since 2021)

The single largest change. Overdose deaths at ages 25–44 went from 7.73 to 54.34 per 100,000 between 1999 and 2021, and in 2015 overtook circulatory diseases as the leading cause of death in this age group. The series counts unintentional overdoses only, so it runs below CDC headline figures that also include suicides and undetermined intent.

ICD-10 X40–X44 · age-adjusted · CDC WONDER via Woolf (2026)

Details +75.5% Homicide 2014–2021 · per 100,000 aged 25–44 7.75 per 100,000 in 2014, 13.60 in 2021. 2024: 9.58 (−30% since 2021)

Up 75.5% in seven years. Woolf links the rise in homicides and suicides to firearm access and to the growing prevalence of depression and other affective disorders.

ICD-10 X85–Y09 · age-adjusted · CDC WONDER via Woolf (2026)

Details +43.5% Transport accidents 2014–2021 · per 100,000 aged 25–44 12.93 per 100,000 in 2014, 18.56 in 2021. 2024: 15.50 (−16% since 2021)

Up 43.5% over the same seven years. This counts every transport death, not only car crashes. The paper suggests weaker motor-vehicle and road-safety policy may explain the high US rate, alongside faster driving and car-dependent cities.

ICD-10 V01–V99 · age-adjusted · CDC WONDER via Woolf (2026)

Details +41.3% Suicide 2000–2023 · per 100,000 aged 25–44 13.36 per 100,000 in 2000, 18.88 in 2023. 2024: 18.02 (−5% since 2023)

Up 41.3% since 2000. The suicide rate at ages 25–44 is higher than in any other age group, according to the paper.

ICD-10 X60–X84 · age-adjusted · CDC WONDER via Woolf (2026)

Details 2.2× Alcoholic liver disease 2010–2023 · per 100,000 aged 25–44 2.75 per 100,000 in 2010, 6.11 in 2023. 2024: 5.86 (−4% since 2023)

More than doubled from 2010 to 2023. Deaths from alcohol-use disorders (F10) more than tripled over the same years, from 1.10 to 3.95 per 100,000. The paper suggests obesity-related liver disease may be making alcohol damage worse.

ICD-10 K70 · age-adjusted · CDC WONDER via Woolf (2026)

Details 2.1× Hypertensive disease 2000–2023 · per 100,000 aged 25–44 2.05 per 100,000 in 2000, 4.26 in 2023. 2024: 4.23 (−1% since 2023)

High blood pressure is usually thought of as a disease of older age, yet deaths from it at ages 25–44 more than doubled between 2000 and 2023. The absolute rate is small. The paper connects it to obesity and to what it calls an obesogenic food environment.

ICD-10 I10–I15 · age-adjusted · CDC WONDER via Woolf (2026)

The crossover: overdoses became the leading cause of death at 25–44

Deaths per 100,000, age-adjusted. In 2014 circulatory disease still led (22.5 against 20.6); in 2015 overdoses passed it (24.4 against 22.7) and have stayed ahead, even after falling to 35.5 in 2024. Tap a name to hide or show it.

Source: CDC WONDER, Underlying Cause of Death, 1999–2024, ages 25–44, age-adjusted per 100,000. Overdoses are unintentional only (X40–X44); circulatory I00–I99; cancer C00–C97; suicide X60–X84.

Show the numbers

Leading causes of death at ages 25–44 by year
Year	Unintentional overdoses	Circulatory diseases	Cancer	Suicide
1999	7.7	25.4	24.8	13.6
2000	7.9	24.9	24.4	13.4
2001	8.5	25.3	24.7	13.8
2002	10.5	25.9	24.1	14.2
2003	11.2	26.2	23.5	14.0
2004	11.8	25.3	22.6	14.1
2005	13.1	25.1	22.5	14.0
2006	15.1	24.7	21.8	14.0
2007	15.2	24.0	20.9	14.6
2008	15.2	23.5	20.4	14.7
2009	15.4	23.2	20.6	14.7
2010	16.2	22.7	19.7	15.1
2011	17.9	22.8	19.5	15.5
2012	17.6	22.4	19.2	15.7
2013	18.7	22.3	19.2	15.6
2014	20.6	22.5	18.9	15.9
2015	24.4	22.7	18.5	16.5
2016	31.2	23.0	18.5	16.9
2017	35.1	22.8	18.2	17.7
2018	33.6	22.5	17.8	17.9
2019	35.0	22.4	17.6	17.8
2020	47.4	25.5	17.5	17.8
2021	54.3	26.3	17.7	18.7
2022	54.1	25.1	17.6	18.8
2023	51.0	23.3	17.4	18.9
2024	35.5	22.9	17.4	18.0

3 · Not only the young

At 45–64, COVID deaths nearly doubled in the year vaccines arrived

Woolf found similar trends among Americans aged 45–64: more deaths from overdoses, alcohol, hypertension, and endocrine and metabolic disorders. Then, in 2021, COVID-19 deaths in this age group rose from 64.51 to 122.66 per 100,000, even as vaccines let other countries bring their COVID death rates down.

Among Americans over 65, COVID-19 mortality rose only 1.6% that year.

COVID-19 deaths per 100,000, ages 45–64

Age-adjusted. The 2021 bar is the year vaccines became widely available.

2020 64.51
2021 122.66
2022 37.14
2023 5.16

Source: CDC WONDER, as reported by Woolf (2026), text and Appendix Figure 8 (which labels the 2021 value 122.76).

4 · The world ranking

The US has slipped from 14th to 38th

The gap with other countries opened in the 1990s and widened sharply after 2010, when deaths before 40 stopped falling in the US while they kept falling elsewhere. The US now trails not only western Europe, Canada, Japan and Australia, but also Chile, Costa Rica, Slovenia, Czechia, Panama and South Korea.

US life-expectancy rank

Among countries with more than 1 million people. Lower on the chart is worse.

Source: UN World Population Prospects 2024, as analysed by Woolf (2026).

Chance of dying before 40, 2023

Deaths before age 40 per 1,000 live births. The US (orange) sits beside Georgia, Costa Rica and Tunisia. 60 of the 65 other countries in the table do better; only 5 do worse.

Lower than the US (60) United StatesHigher (5: Argentina, Türkiye, Morocco, Algeria, Russia)

Source: UN World Population Prospects 2024, Table 2 of Woolf (2026). This is a probability per 1,000 births, not a death rate per 100,000.

Show the numbers

Probability of dying before 40, per 1,000 live births, 2023
Country	Per 1,000
Australia	5.31
South Korea	7.54
Cyprus	9.55
Hong Kong	9.95
Spain	10.36
Singapore	10.41
Italy	10.78
Greece	10.96
Switzerland	12.12
Norway	12.18
Denmark	12.36
Japan	12.65
Netherlands	13.27
United Arab Emirates	13.35
Slovenia	13.58
Qatar	13.60
Germany	13.72
Portugal	13.93
Sweden	14.00
Ireland	14.39
Austria	15.25
Belgium	15.43
France	16.23
Czechia	16.97
Croatia	17.09
Hungary	17.36
Finland	17.45
North Macedonia	17.50
Taiwan	18.75
United Kingdom	19.00
Bosnia and Herzegovina	19.65
Bahrain	19.69
Estonia	19.79
Kosovo	19.79
Israel	19.98
Serbia	20.00
Sri Lanka	21.36
Canada	21.64
New Zealand	21.97
Slovakia	22.10
Poland	22.39
Cuba	24.01
Oman	24.21
Romania	24.68
Albania	25.01
Armenia	25.47
Chile	26.05
China	26.53
Bulgaria	26.83
Jordan	28.18
Kuwait	28.41
Saudi Arabia	28.56
Belarus	29.07
Latvia	30.62
Lithuania	32.22
Malaysia	32.62
Lebanon	33.50
Tunisia	34.10
Costa Rica	34.31
Georgia	34.54
United States	35.10
Argentina	36.24
Türkiye	36.47
Morocco	38.42
Algeria	39.60
Russia	58.54

Life expectancy at birth, 2023: the 37 countries ahead of the US

UN estimates, which put the US at 79.3 years. The CDC's own 2023 figure is 78.4; the two are not mixed here. Switch to the 16 wealthy peers the paper compares against.

1Hong Kong 85.5
2Japan 84.7
3South Korea 84.3
4Switzerland 84.0
5Australia 83.9
6Singapore 83.7
7Italy 83.7
8Spain 83.7
9France 83.3
10Norway 83.3
11Sweden 83.3
12United Arab Emirates 82.9
13Canada 82.6
14Ireland 82.4
15Israel 82.4
16Qatar 82.4
17Portugal 82.4
18Netherlands 82.2
19Belgium 82.1
20New Zealand 82.1
21Austria 82.0
22Denmark 81.9
23Finland 81.9
24Greece 81.9
25Cyprus 81.7
26Slovenia 81.6
27Germany 81.4
28United Kingdom 81.3
29Bahrain 81.3
30Chile 81.2
31Costa Rica 80.8
32Taiwan 80.6
33Kuwait 80.4
34Oman 80.0
35Czechia 79.8
36Albania 79.6
37Panama 79.6
38United States 79.3
39Estonia 79.2
40Saudi Arabia 78.7
41Poland 78.6
42Croatia 78.6
43Slovakia 78.3

Source: UN World Population Prospects 2024, Table 1 of Woolf (2026), which lists the countries ahead of the US and the five just behind it.

5 · State by state

A 9.9-year gap between Hawaii and Mississippi

The national average hides how far apart the states are. Woolf compares Hawaii, the longest-lived state, with western European countries and Canada, and Mississippi with countries such as Libya, Venezuela, Belarus and Ecuador. Tap any state for its figures.

Life expectancy at birth by state

2021, coloured against the US figure of 76.4 years. Or switch to the change since 2019.

Shorter than the USLonger than the US

Smaller lossLarger loss

Source: US Mortality Database state life tables, as printed in Woolf (2026), Table 3 and Appendix Table 2. The table has no row for the District of Columbia.

Show the numbers

Life expectancy at birth by state, 2019 and 2021
State	2019	2021	Change
Hawaii	81.6	80.9	−0.7
Massachusetts	80.6	79.8	−0.8
Connecticut	80.6	79.4	−1.2
New York	81.1	79.4	−1.7
New Jersey	80.4	79.3	−1.1
Minnesota	80.7	79.0	−1.7
Rhode Island	79.8	78.8	−1.0
New Hampshire	79.7	78.7	−1.0
California	81.2	78.6	−2.6
Vermont	80.0	78.6	−1.4
Washington	80.2	78.3	−1.9
Utah	79.9	78.2	−1.7
North Dakota	79.2	78.0	−1.2
Colorado	80.3	77.9	−2.4
Nebraska	79.4	77.9	−1.5
Iowa	79.2	77.8	−1.4
Wisconsin	79.3	77.8	−1.5
Maryland	79.0	77.5	−1.5
Oregon	79.7	77.5	−2.2
Illinois	79.2	77.3	−1.9
Idaho	79.7	77.2	−2.5
Virginia	79.3	77.0	−2.3
Maine	78.5	76.9	−1.6
Florida	79.5	76.7	−2.8
South Dakota	78.5	76.7	−1.8
Delaware	78.4	76.5	−1.9
Pennsylvania	78.5	76.5	−2.0
Kansas	78.3	76.1	−2.2
Montana	78.6	76.0	−2.6
Michigan	78.1	75.7	−2.4
Texas	78.8	75.7	−3.1
Arizona	79.3	75.5	−3.8
Nevada	78.3	75.4	−2.9
Wyoming	78.3	75.2	−3.1
North Carolina	77.8	75.0	−2.8
Alaska	78.1	74.8	−3.3
Missouri	77.1	74.8	−2.3
Indiana	77.1	74.7	−2.4
Georgia	77.8	74.6	−3.2
Ohio	77.0	74.6	−2.4
South Carolina	76.9	73.6	−3.3
New Mexico	77.2	73.3	−3.9
Oklahoma	75.9	72.8	−3.1
Arkansas	75.9	72.7	−3.2
Kentucky	75.6	72.4	−3.2
Tennessee	75.8	72.4	−3.4
Louisiana	75.9	72.3	−3.6
Alabama	75.5	72.2	−3.3
West Virginia	74.7	71.1	−3.6
Mississippi	74.5	71.0	−3.5
United States	78.9	76.4	−2.5

In 2021, Woolf writes, life expectancy in Mississippi (71.0) and West Virginia (71.1) "resembled that of Bulgaria, Bangladesh, Azerbaijan, and Iraq". Mississippi lost 3.5 years between 2019 and 2021; Hawaii lost 0.7.

What the paper says about governors, and what it does not. Woolf charted every state's life expectancy from 1941 to 2022 against the party of its governor. From the Second World War to the 1970s, the states with the lowest life expectancy mostly had Democratic governors. From 2010 onward they mostly had Republican ones. During COVID-19, he writes, the partisan divide created "a macabre natural experiment in which the results of governors' decisions could be measured within weeks in death counts." The chart is descriptive, not a statistical model, and he adds: "Association does not prove causation."

6 · Why

Five systems, one pattern

Overdoses, suicides, road deaths and chronic disease are usually tackled one at a time. Woolf argues they rise together because they share causes in how the country is organised. The five domains below come from the 2013 National Research Council and Institute of Medicine report his analysis builds on.

Health care and public health

Unlike its peers, the United States does not offer universal access to health care. Americans are more likely to skip care because of out-of-pocket costs, to have no primary care provider, and to receive fragmented care. The public health system is fragmented and chronically underfunded.

Individual behaviours

Americans smoke less than people in peer countries. But they consume more calories per head, use more illicit drugs, drive faster and are more likely to own firearms. During the COVID-19 pandemic they were also more resistant to rules that restricted personal behaviour.

Household income and inequality

In 2022, only Türkiye, Mexico and Costa Rica had more income inequality than the US among OECD countries, and only Costa Rica had a higher poverty rate. American households also face more food insecurity and housing-cost burden, and have lower social mobility.

Physical and social environment

US cities are built around cars and long, sedentary commutes, with less green space, walking, cycling and affordable transit than cities in peer countries. American society is also less cohesive: more isolation, more residential segregation and more political polarisation.

Public policy and social values

The paper describes US policy as favouring limited government, low taxes, low social-welfare spending and light regulation of industry. The Second Amendment limits firearm restrictions, and the Tenth Amendment leaves most health policy to the states. It also cites a lax regulatory environment for tobacco, drugs, firearms, food and fossil fuels.

"The problem in the United States is not a lack of policy solutions but of political will."

— Steven H. Woolf, The Milbank Quarterly, 2026

The paper also sets aside some popular explanations. Despair alone, it argues, cannot explain rising deaths from causes ranging from neurological disease and hypertension to car crashes. Explanations such as food contaminants, phones, pollutants and vaccines "often rely on scant evidence". Blaming COVID-19 vaccines is implausible, it notes, because US death rates began rising decades before they existed.

7 · Checked

What the headlines got slightly wrong

News coverage of this study got its numbers right, but four of its framings were off. We read the paper and its appendix; here is what it actually says.

ReportedOverdoses overtook cardiovascular disease as the leading cause of death at 25–44 in 2015.

The paperThe paper says circulatory diseases, a wider group that also includes stroke and hypertensive disease.
ReportedThe overdose rate has risen to more than 54 per 100,000.

The paper54.34 is the 2021 peak, and it counts unintentional overdoses only. CDC WONDER puts the same measure at 50.95 in 2023 and 35.53 in 2024.
ReportedMississippi's life expectancy was comparable to countries with significantly lower incomes.

The paperMost of the countries the paper names (Libya, Venezuela, Belarus, Ecuador) are classed as middle-income. Only Syria on that list is low-income.
ReportedIn states with Republican governors, life expectancy often stopped increasing or declined.

The paperThe paper says something narrower. Since 2010, the states with the lowest life expectancy have mostly had Republican governors. From the Second World War to the 1970s, they mostly had Democratic ones. Woolf adds: "Association does not prove causation."

Sources

Steven H. Woolf. US Life Expectancy and Increasing Mortality Rates: An Analysis of the Crisis. The Milbank Quarterly, published online 2026-09-23. doi:10.1111/1468-0009.70118 · appendix (PDF) · PubMed. Open access.
CDC WONDER, Underlying Cause of Death 1999–2020 (bridged race) and 2018–2024 (single race), queried 2026-09-30. Our age-adjusted pull for ages 25–44 reproduces all 14 values the paper prints.
United Nations, World Population Prospects 2024: country life expectancy and the probability of dying before 40.
Barbieri M, Winant C. United States Mortality Database: state life tables.

How to read these numbers

Death rates are age-adjusted deaths per 100,000 people within each age band. Age adjustment means a group getting slightly older does not by itself push its rate up.
"Dying before 40" is a probability per 1,000 live births, not a rate, and cannot be compared with the rates above.
Country life expectancies are UN model estimates, which put the US at 79.3 years for 2023; the CDC's official figure is 78.4. The 38th place counts Hong Kong and Taiwan, as the UN data does, and leaves out Puerto Rico, a US territory. Counted other ways from the same UN data, the US lands between 36th and 39th.
State figures come from the US Mortality Database, the paper's source. The CDC's official state life tables differ by up to a year (for 2021 they give Hawaii 79.9 rather than 80.9, and Mississippi 70.9 rather than 71.0), but both put Hawaii first and Mississippi last.
The ages 25–44 series follows the paper's cause definitions. It reproduces every value the paper prints, to two decimal places.
The cause cards use the paper's own start and end years, which differ by cause. They show what changed, not which cause is biggest.

Figures checked against the sources above on 2026-09-30.

Death rates for Americans aged 25–44 rose 71% in 11 years

No other age group lost ground this fast

Deaths per 100,000 people aged 25–44

Change in death rate by age group since 2010

Overdoses led the surge, but almost everything rose

The crossover: overdoses became the leading cause of death at 25–44

At 45–64, COVID deaths nearly doubled in the year vaccines arrived

COVID-19 deaths per 100,000, ages 45–64

The US has slipped from 14th to 38th

US life-expectancy rank

Chance of dying before 40, 2023

Life expectancy at birth, 2023: the 37 countries ahead of the US

A 9.9-year gap between Hawaii and Mississippi

Life expectancy at birth by state

Five systems, one pattern

What the headlines got slightly wrong

Sources

How to read these numbers