Leading Causes of Death in the US
Where does Covid rank as a leading cause of death right now?
This is the second of my Thanksgiving week articles with good news about decreasing Covid mortality in the US: Covid is no longer the third or fourth leading cause of death in the US.
Happy Thanksgiving, everyone!
In May 2023, the CDC published an MMWR announcing that Covid-19 had dropped from the 3rd to the 4th leading cause of death in the US overall. I had predicted it would be the 4th leading cause for 2022 on Feb. 10, nearly three months before the CDC’s report was released:
In May, in response to the CDC’s report, I wrote a short thread on Twitter about the 2022 data and a look ahead for 2023. I’ve shared the thread many times when people try to claim that Covid is still the 4th leading cause of death in the US, and I thought now would be a good time to expand it into a more thorough Substack article. In the thread, I explained that the 2022 ranking was heavily skewed by high Covid deaths reported during the initial Omicron wave in January and February 2022.
By the time the CDC published their MMWR about the 2022 ranking of leading causes of death, it was clear that Covid had already fallen further down the rankings as a leading cause of death on a rolling 12-month basis in 2023. I don’t typically like making predictions, but in May 2023, I felt confident tweeting, “Covid is on pace to be near the bottom of the top 10 leading causes for 2023.” Based on the latest data, it appears I was right on target.
Below is a table showing the top 10 leading causes of death for rolling 12-month periods by the ending month shown. (I included rankings once per quarter since it doesn’t change frequently.) Covid dropped from 4th to 8th by March 2023, and it has stayed at 8th through the 12-month period ending September 2023.
Note that all of the numbers and rankings shown are based on Covid being listed as the underlying cause of death from the death certificate. That is what the CDC’s leading causes of death ranking uses.
Looking Ahead
Will Covid remain the 8th leading cause of death in the US for all of 2023? It’s hard to say. That will be determined based on how US deaths from October - December 2023 compare to October - December 2022. If Covid deaths in Q4 2023 are less than in Q4 2022 as expected, Covid could definitely drop further down in the ranking. The graph below shows how the rolling 12-month total of Covid deaths has declined during 2023, so that Covid-19 is now very close to kidney disease (currently 9th), and approaching liver disease (currently 10th). Suicides and flu/pneumonia are in 11th and 12th place in the rankings for now (suicide data is only displayed through April because the CDC has a 6-month lag in reporting external causes of death).
Revisiting “Expert” Predictions
In September 2022, NBC News ran a story that claimed Covid would be a leading cause of death in the US “indefinitely.” The article estimated that “the U.S. could expect 113,000 to 188,000 deaths a year from Covid, putting it on par with Alzheimer’s, chronic lower respiratory diseases and stroke,” and later added that “experts said Covid is likely to remain among the U.S.'s 10 leading causes of death for the foreseeable future.” For some reason, this headline began to recirculate among the ZeroCovid community on Twitter last week.
For 2022, Covid did rank as the 4th leading cause of death in the US, with around 186,500 deaths. However, deaths are on track to be less than one-third of that this year. If current trends continue, Covid could easily drop out of the top 10 in 2024, if not sooner.
To be fair, the article also included the caveat that “some experts are hopeful that Covid could drop in the U.S. cause-of-death rankings over time.” Of course that was buried half way down the text, and it certainly wasn’t reflected in their click-bait headline….
While the analysis in this article is all based on provisional mortality data from CDC WONDER, we are far enough through the year that the ranking and trends are fairly well established. The unknown is just how the final quarter of 2023 will go, but we’re over half way through November and hospitalizations with Covid are lower than this time last year, which seems promising. I’ll revisit this mortality data again in February 2024 when we have provisional data through the end of 2023.
Also see my earlier article from this week on pediatric Covid mortality:
