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There are several states that have significantly higher death rates when compared to other states in the country. For example, in the finalized 2020 data Mississippi had a death rate of 1,138.7 per 100,000 people, while Alabama also had a very high death rate of 1,057.8 per 100,000 people.
This article includes a list of U.S. states sorted by birth and death rate, expressed per 1,000 inhabitants, for 2021, using the most recent data available from the U.S. National Center for Health Statistics.
- Overview
- Discussion
- References
On April 22, 2022, this report was posted online as an MMWR Early Release.
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From 2020 to 2021, the age-adjusted U.S. death rate increased by 0.7%, from 835.4 to 841.6 per 100,000 standard population. In 2021, COVID-19 was the underlying or a contributing cause of death for 460,513 deaths (111.4 deaths per 100,000). COVID-19 death rates were highest among males, adults aged ≥85 years, and NH/OPI and AI/AN persons. The highest numbers of overall deaths and COVID-19 deaths occurred during January and September. COVID-19 was the third leading underlying cause of death in 2021, for the second year since the disease emerged (6).
Demographic patterns of mortality were similar in 2020 and 2021, but certain populations experienced shifts in death rates. Although the overall and COVID-19 death rate remained higher for persons aged ≥85 years than for all other age groups, death rates decreased for this age group from 2020 to 2021. Age-adjusted total and COVID-19 death rates remained high for the AI/AN population. Rates decreased for Asian, Hispanic, and Black populations and increased for NH/OPI, White, and AI/AN populations.
The year 2021 saw the highest death rate since 2003, with increases in many leading causes of death, including COVID-19 and unintentional injuries. Although COVID-19 death rates decreased for persons aged ≥85 years, age groups <75 years saw large increases from 2020 to 2021. Unintentional injury deaths were largely driven by drug overdose deaths, and likely contributed to the increased death rate in younger populations. In 2020, drug overdose death rates increased more for persons aged 15–64 years than for persons aged ≥65 years (7).
The findings in this report are subject to at least three limitations. First, data are provisional, and numbers and rates might change as additional information is received. Described changes in mortality trends might be underestimates. Second, timeliness of death certificate submission can vary by jurisdiction. As a result, the national distribution of deaths might be affected by the distribution of deaths reported from jurisdictions reporting later, which might differ from those in the United States overall. Finally, there is a higher potential for misclassification of certain categories of race (i.e., AI/AN or Asian) and Hispanic ethnicity reported on death certificates (8). Thus, death rates for some groups might be underestimated or overestimated.
Provisional death estimates can give researchers and policymakers an early projection of shifts in mortality trends and provide actionable information sooner than do the final mortality data, which are released approximately 11 months after the end of the data year. These data can guide public health policies and interventions aimed at reducing mortality directly or indirectly associated with the pandemic and among persons most affected, including persons who are older, male, or from certain race and ethnic minority groups.
Corresponding author: Farida B. Ahmad, fbahmad@cdc.gov.
1.World Health Organization. ICD-10: international statistical classification of diseases and related health problems, 10th revision. 5th ed. Geneva, Switzerland: World Health Organization; 2016. https://apps.who.int/iris/bitstream/10665/246208/1/9789241549165-V1-eng.pdfpdf iconexternal icon
2.CDC, National Center for Health Statistics. National Vital Statistics System. Instructions for classifying the underlying cause of death. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics, 2022. https://www.cdc.gov/nchs/nvss/manuals/2022/2a-2022.htm
3.CDC. Technical notes: provisional death counts for Coronavirus Disease (COVID-19). Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2021. https://www.cdc.gov/nchs/nvss/vsrr/covid19/tech_notes.htm
4.Heron M. Deaths: leading causes for 2017. Natl Vital Stat Rep 2019;68:1–77. PMID:32501203external icon
5.Murphy SL, Kochanek KD, Xu JQ, Arias E. Mortality in the United States, 2020. NCHS data brief, no 427. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2021. https://www.cdc.gov/nchs/data/databriefs/db427.pdfpdf icon
6.US Census Bureau. National Population by characteristics: 2020–2021. Washington, DC: US Department of Commerce, US Census Bureau; 2021. https://www.census.gov/programs-surveys/popest/technical-documentation/research/evaluation-estimates/2020-evaluation-estimates/2010s-national-detail.htmlexternal icon
Feb 15, 2023 · States are categorized from highest rate to lowest rate. Although adjusted for differences in age-distribution and population size, rankings by state do not take into account other state specific population characteristics that may affect the level of mortality.
The age-adjusted death rate increased by 5.3% from 835.4 deaths per 100,000 standard population in 2020 to 879.7 in 2021. Age-specific death rates increased from 2020 to 2021 for each age group 1 year and over. Nine of the 10 leading causes of death in 2021 remained the same as in 2020.
US COVID-19 cases and deaths by state. How is the nation faring against COVID-19, both overall and at a state level? Get the answers here, with data on hotspots and infection rates. This map tracks the history of coronavirus cases in America, both recent and all-time. Latest update on Jul 23
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This report presents final 2021 U.S. mortality data on deaths and death rates by demographic and medical characteristics. These data provide information on mortality patterns among U.S. residents by variables such as sex, age, race and Hispanic origin, and cause of death.
