America Is Living Longer Again. The Mortality Ledger Shows What Changed — and What Didn’t.
A new National Center for Health Statistics report sharpens the picture of U.S. deaths in 2024: mortality fell, life expectancy reached 79 years, overdose deaths plunged, and COVID-19 left the top 10. Yet heart disease and cancer still dominate, suicide returned to the list, and large longevity gaps remain.
The national mortality story is no longer simply a pandemic story. By 2024, the United States was seeing broad declines in death rates across nearly every age group and every leading cause, while the causes at the top of the list looked strikingly familiar.
Deaths fell after adjustment for age, and the improvement reached most of the country’s age spectrum
Final NCHS data count 3,072,666 U.S. resident deaths in 2024, 18,298 fewer than in 2023. More important for comparing one year with another, the age-adjusted death rate fell from 750.5 deaths per 100,000 people in 2023 to 722.1 in 2024, a decline of 3.8%. Age adjustment matters because the United States is getting older; it lets researchers compare mortality while reducing the effect of changes in the population’s age structure.
That distinction helps explain why the raw number of deaths and the underlying risk can move differently. A larger, older population can record more deaths even as the age-adjusted rate improves. NCHS uses the year 2000 U.S. standard population for age adjustment and cautions that an age-adjusted rate is best treated as a comparative index rather than the literal risk faced by an individual.
The age pattern was unusually broad. Death rates decreased from 2023 to 2024 for every age group age 1 and older except children ages 5 to 14, whose small change was not statistically significant. The steepest percentage declines were among adults ages 25 to 34, down 15.9%; ages 15 to 24, down 12.9%; and ages 35 to 44, down 9.9%. Rates also fell among older adults, though by smaller percentages: 2.0% for ages 65 to 74, 1.9% for ages 75 to 84 and 3.2% for people 85 and older.
Life expectancy moved with those improvements. At birth, U.S. life expectancy rose from 78.4 years in 2023 to 79.0 in 2024. For males, it rose 0.7 year to 76.5; for females, it rose 0.3 year to 81.4. The female-male gap narrowed to 4.9 years. At age 65, remaining life expectancy reached 19.7 years, meaning that a person who reached 65 under the mortality conditions of 2024 could expect, on average, to live to about 84.7.
Heart disease and cancer remain the center of America’s mortality burden
The headline ranking did not undergo a revolution. Heart disease remained the leading underlying cause of death in 2024 with 683,491 deaths, followed by cancer with 619,876. Unintentional injuries ranked third at 197,449. Stroke, chronic lower respiratory disease, Alzheimer’s disease, diabetes, kidney disease, chronic liver disease and cirrhosis, and suicide completed the top 10.
Together, those 10 causes accounted for 70.9% of all U.S. deaths. That concentration is a reminder that improvements in national longevity still depend heavily on long-running problems: cardiovascular disease, malignancy, metabolic disease, respiratory illness, neurodegenerative disease and injury. The post-pandemic improvement changed the rates, but it did not erase the chronic-disease structure of American mortality.
There was, however, improvement within every one of the top 10 causes when measured by age-adjusted rates. The largest decline was for unintentional injuries, whose rate fell 14.4%, from 62.3 to 53.3 deaths per 100,000. Heart disease fell 2.8%, cancer 1.7%, stroke 1.0%, chronic lower respiratory diseases 3.0%, Alzheimer’s 2.2%, diabetes 3.1%, kidney disease 3.8%, chronic liver disease and cirrhosis 2.3%, and suicide 2.8%.
The sharp drop in overdose deaths helped reshape the younger-adult mortality curve
One of the most consequential changes beneath the national numbers was the drop in drug-overdose mortality. NCHS recorded 79,384 overdose deaths in 2024. The age-adjusted overdose death rate fell 26.2%, from 31.3 deaths per 100,000 in 2023 to 23.1 in 2024 — the largest one-year percentage decline in the 2014-to-2024 series analyzed by the agency.
The decline extended across sex, age, and race and Hispanic-origin groups in the NCHS analysis. The rate involving synthetic opioids other than methadone — a category that includes fentanyl and fentanyl analogs — fell 35.6%, from 22.2 to 14.3 per 100,000. Cocaine-involved overdose mortality fell 26.7%, while the rate involving psychostimulants such as methamphetamine fell 19.8%.
drug-overdose death rate change for ages 15–24 from 2023 to 2024
rate change for overdoses involving synthetic opioids other than methadone
final number of U.S. resident drug-overdose deaths in 2024
The large mortality declines among people in their teens, 20s and 30s overlap with this overdose improvement. That does not mean overdose alone explains each age group’s change; the age-specific mortality tables summarize deaths from all causes. But the scale of the overdose decline makes it an important part of the broader injury story.
Recent provisional data require caution. CDC’s rolling overdose dashboard warns that provisional counts can be affected by reporting delays and incomplete records, and that true declines or plateaus are not fully established until final data are available. The 2024 figures, by contrast, are final. That is why the 2024 drop is more than a promising signal: it is now part of the settled annual mortality record.
The third-leading cause is a bundle of preventable risks
Unintentional injuries include multiple mechanisms, not a single epidemic. The national ranking is useful for scale, but prevention depends on understanding which kinds of injury are driving deaths in specific ages and communities.
COVID-19 fell out of the top 10. Suicide moved back in.
For 2024, COVID-19 was no longer among the 10 leading underlying causes of death in the United States. NCHS counted 31,426 deaths for which COVID-19 was the underlying cause, down 37.1% from 49,932 in 2023. The disease ranked 15th in 2024 after ranking 10th in 2023.
That movement is one of the clearest markers of how the mortality landscape has changed since the pandemic years. It does not mean COVID-19 vanished from death certificates or stopped contributing to mortality. National leading-cause tables assign one underlying cause to each death for ranking purposes, while other conditions reported on the certificate can still be captured as contributing or multiple causes.
Suicide, meanwhile, became the 10th leading underlying cause of death, with 48,824 deaths in 2024. Its age-adjusted rate fell from 14.1 per 100,000 in 2023 to 13.7 in 2024, a 2.8% decline. The rank changed not because suicide mortality rose, but because the relative order of causes changed as COVID-19 fell more sharply.
Rank is not the same as trend. A cause can move higher on the list even while its death rate falls, because other causes are falling faster.
The biggest percentage gains came earlier in adulthood, but longevity improved at older ages too
Looking across age groups reveals a pattern that a single national rate cannot show. Adults ages 25 to 34 experienced the largest decline in the all-cause death rate from 2023 to 2024, followed by those ages 15 to 24 and 35 to 44. Middle-aged and older adults also improved, but the year-over-year percentage changes were smaller.
Death rate fell from 76.8 to 66.9 per 100,000.
Death rate fell from 148.1 to 124.5 per 100,000.
Death rate fell from 237.3 to 213.9 per 100,000.
Death rate fell from 411.8 to 386.9 per 100,000.
Death rate fell from 899.6 to 859.8 per 100,000.
Death rate fell from 1,809.6 to 1,772.9 per 100,000.
Children ages 5 to 14 were the exception to the broad decline: their rate moved from 14.7 to 14.5 deaths per 100,000, a difference NCHS did not consider statistically significant. Infant mortality was also essentially stable. The 2024 infant mortality rate was 552.5 deaths per 100,000 live births, or about 5.53 per 1,000, compared with 560.2 per 100,000 in 2023. NCHS found that change was not statistically significant.
Those details matter because an improving national average can coexist with groups that see little or no measurable improvement. Population health is not a single line moving up or down; it is a set of overlapping age, cause, demographic and geographic patterns.
Everyone gained ground in 2024, but the distance between population groups remains large
The 2024 U.S. life tables show improvement across every major race and Hispanic-origin group reported by NCHS. Yet the level of life expectancy remained far from equal. Life expectancy at birth was 81.8 years for the Hispanic population. Among non-Hispanic groups, it was 85.8 for Asian people, 78.9 for White people, 74.8 for Black people, and 71.1 for American Indian and Alaska Native people.
Each group improved from 2023. The largest gain was 1.0 year for the American Indian and Alaska Native population, followed by 0.8 year for the Black population, 0.6 year for the Asian population, and 0.5 year each for the Hispanic and White populations. Improvement therefore occurred at the same time as a wide longevity gap persisted.
These figures describe population outcomes; they do not identify a biological cause for the differences and should not be read as destiny for individuals. Life expectancy is influenced by many conditions that are not isolated by the life table itself, and the NCHS tables are descriptive rather than a causal explanation of why groups differ.
A death certificate turns a complicated medical history into one underlying cause for ranking
Leading-cause tables are powerful because they make millions of deaths comparable. They are also simplified by design. A death certificate can list several diseases, injuries or conditions. For national ranking, one is selected as the underlying cause: the condition or injury that began the chain of events leading to death, or the circumstances of the fatal injury. Other conditions can remain in the record as contributing or multiple causes.
That distinction is especially important for older adults and people with multiple chronic conditions. A person may have heart disease, diabetes, kidney disease and another illness at the same time, but the leading-cause table will not count all of those diagnoses as separate underlying causes for that one death. Researchers can use multiple-cause data for a fuller picture.
The distinction between final and provisional data is also central to the 2026 news cycle. Final 2024 numbers are now the baseline. A July 2026 NCHS report then offered provisional data for 2025, based on 99.9% of 2025 death records received and processed by May 10, 2026. Those early figures suggest the improvement continued.
Provisional 2025 data point to another decline — but the cause mix is still evolving
The early 2025 picture is notable. NCHS estimated 3,094,593 deaths in 2025 and an age-adjusted death rate of 689.2 per 100,000, 4.6% lower than the final 2024 rate. The agency described it as a record low. Rates fell for every age group and for both males and females in the provisional data.
The absolute number of deaths was higher than in 2024 even as the age-adjusted rate was lower. That is not a contradiction: population growth and aging can push up the number of deaths while standardized mortality risk falls. This is one reason the age-adjusted rate is the better tool for year-to-year national comparisons.
Heart disease and cancer remained the top two estimated causes in 2025, at 694,708 and 622,832 deaths, respectively, with unintentional injuries third at 184,265. The provisional ranking also shifted lower down the list: influenza and pneumonia moved up to eighth, while suicide moved from 10th in the final 2024 ranking to 11th in the provisional 2025 ranking.
Those 2025 numbers are not final. The hierarchy can change as records are completed and coded. But taken together with the final 2024 decline, they suggest that the post-pandemic improvement in U.S. mortality extended beyond a single rebound year.
A healthier national average does not mean the work is finished.
The 2024 mortality record is an unmistakable improvement: fewer deaths than the year before, a lower age-adjusted death rate, a longer average life expectancy, a historic fall in overdose mortality and a sharp retreat in deaths attributed to COVID-19. Yet the leading causes remain dominated by chronic disease, injury and suicide, and the life tables show years of difference in expected lifespan among population groups.
That combination — broad progress with persistent structural burdens — is the clearest way to read America’s new mortality ledger. The country moved in a better direction in 2024, and provisional 2025 data suggest the movement continued. The public-health challenge now is to make those gains durable, and more evenly shared.
Quick answers
What was the leading cause of death in the United States in 2024?
Heart disease, with 683,491 deaths, followed by cancer with 619,876.
Did U.S. life expectancy rise in 2024?
Yes. Life expectancy at birth rose from 78.4 years in 2023 to 79.0 in 2024.
Was COVID-19 still a top-10 cause of death?
No. COVID-19 fell to 15th in 2024, with 31,426 deaths for which it was the underlying cause.
Why did suicide enter the top 10 if its rate declined?
Rankings are relative. Suicide’s age-adjusted rate fell 2.8%, but COVID-19 deaths fell much faster, changing the order of the list.
Are the 2025 mortality figures final?
No. The 2025 figures cited here are provisional estimates released by NCHS in July 2026 and can be revised.
Sources and methodology
- National Center for Health Statistics, Deaths: Leading Causes for 2024, National Vital Statistics Reports, dated Sept. 22, 2026.
- National Center for Health Statistics, Mortality in the United States, 2024, Data Brief No. 548, January 2026.
- National Center for Health Statistics, Drug Overdose Deaths in the United States, 2023–2024, Data Brief No. 549, January 2026.
- National Center for Health Statistics, United States Life Tables, 2024, National Vital Statistics Reports, Aug. 25, 2026.
- National Center for Health Statistics, Provisional Data: U.S. Death Rate Fell to a Record Low in 2025, July 2, 2026.
- National Center for Health Statistics, Cause of death: Sources and Definitions.
- National Center for Health Statistics, Age adjustment: Sources and Definitions.
- National Center for Health Statistics, Leading Causes of Death, National Vital Statistics System.
Comments
Post a Comment