US Death Rates Have ‘Worsened Significantly”‘ for Midlife Adults

U.S. working-age adults are dying at higher rates than their peers in comparable high-income countries, a new study suggests.

Over the past three decades, most high-income countries have seen a significant decline in midlife mortality between the ages of 25 to 64. However, according to researchers at Oxford and Princeton Universities, mortality declines in the U.S. for this age bracket have been significantly slower than in other countries, and have even reversed in recent years.

Using data from the World Health Organization Mortality Database between 1990 and 2019, the team concluded that by 2019, all-cause midlife mortality rates in the U.S. were 2.5 times higher than the average rates in other high-income countries. The study, which was published in the International Journal of Epidemiology on March 21, did not evaluate data during the years of the COVID-19 pandemic, when the life expectancy gap between the U.S. and other high-income countries widened even further.

These higher mortality rates were driven by several causes of death, including transport accidents, homicide, suicide and drug overdoses. For example, between 2000 and 2019, drug related deaths in the U.S. increased by up to 10 fold. The researchers also highlighted a stalling of improvements in deaths from cardiovascular disease and an increase in deaths from metabolic disease, and conditions of the respiratory and nervous systems.

“Over the past three decades midlife mortality in the US has worsened significantly compared to other high-income countries, and for the younger 25 to 44 year old age-group in 2019 it even surpassed midlife mortality rates for Central and Eastern European countries,” co-author Katarzyna Doniec, from Oxford’s Leverhulme Center for Demographic Science, said in a statement. “This is surprising, given that not so long ago some of these countries experienced high levels of working-age mortality, resulting from the post-socialist crisis of the 1990s.”

The study also highlighted a stark health disadvantage among younger US females between the ages of 25 to 44 who were the only group across all 25 countries studied to experience higher mortality rates in 2019 than in 1990.

However, the U.S. was not alone in these declines. The U.K. too appears to be falling behind its high-income peers, with midlife mortality rising among those aged 45 to 54. And while the U.K. performed relatively well on external causes of death such as suicide and traffic accidents, improvements were stalled for deaths by cardiovascular disease and cancer, as well as an increase in drug-related deaths.

The researchers stressed that understanding the causes of these rising mortalities in the U.S. and U.K. were important to being able to target these health effects.