Provisional Data Provide Insights Into Mortality Rates, Causes in the US in 2023

The National Center for Health Statistics’ (NCHS) National Vital Statistics System (NVSS) released provisional data regarding estimated causes of death throughout the United States in 2023. The data, published in the CDC Morbidity and Mortality Weekly Report,¹ showed that mortality was associated with sex, race, and comorbidities within the US population.

Annual mortality statistics are compiled by the NCHS NVSS using death certificate data. Although the final results will not be official for another several months, the provisional data provide an early estimate on deaths and causes of death, including those that were associated with COVID-19. This report aimed to summarize these preliminary data as well as give an adequate comparison to deaths in 2022 to help guide public health policies.

All data came from deaths occurring from January to December of 2023 using NVSS death certificate data. The number and rate of overall deaths by age, sex, race, and ethnicity were tabulated by the NCHS, including rates of COVID-19 deaths in those subsets. Ethnicity was categorized as non-Hispanic Asian, non-Hispanic American Indian or Alaska Native, non-Hispanic Black (Black), non-Hispanic Native Hawaiian or Pacific Islander, non-Hispanic White, non-Hispanic people who identify as more than 1 race (multiracial), Hispanic or Latino, or unknown.

Provisional data on mortality can help to prepare for new policies and interventions | Image credit: spotmatikphoto - stock.adobe.com

The International Classification of Diseases, Tenth Revision, was used to code causes of death by the NCHS. COVID-19 could be listed as either an underlying or contributing cause of death. Underlying cause of death was used to rank the leading causes of death. Overall, less than 0.01% of death certificates did not include age, and 0.33% did not include race or ethnicity. Number of deaths per week was also calculated.

There were an estimated 3,090,582 total deaths in the United States in 2023, which amounted to approximately 750.4 deaths per 100,000. This was an overall decrease of 6.1% from 2022.² The weeks ending in January 7 and December 30 were responsible for the 2 highest rates of death compared with other weeks. All age groups experienced a decrease in death rates from 2022 to 2023, although the ages 0 to 4 years demographic did not have a significant decrease.

Men had a higher age-adjusted death rate per 100,000 in 2023 compared with women (884.2 vs 632.8); the age-adjusted death rate for men was lower in 2023 than in 2022 (884.2 vs 954.2). All race and ethnicity groups experienced a decrease in age-adjusted death rates per 100,000 with each individual group. People who identified as Black had the highest age-adjusted death rate at 924.3 per 100,000, whereas people who identified as multiracial had the lowest at 352.1 per 100,000. Heart disease (680,909), cancer (613,331), and unintentional injury (222,518) made up the 3 leading causes of death.

COVID-19 ranked as the tenth leading cause of death, with 49,928 deaths attributed to its underlying presence. COVID-19 had a decrease of 68.9% in death rate compared with 2022 when it was either the underlying or contributing cause of death. All age groups experienced a decrease in the COVID-19 death rate, though men had a higher death rate compared with the women (22.1 vs 15.4 per 100,000).

The report does have some limitations. The data reported are all preliminary and could change by the time the final report is released as more data is received, which could increase the death rate. National distribution of deaths could be affected by the timeliness of death certificate submission. There is also the potential for misclassification of race and ethnicity, which could under- or overestimate the death rates in these groups.

The provisional mortality rates for people in the United States can help policymakers and researchers come up with action plans prior to the final data being revealed. This can help to develop policies and interventions to reduce the mortality rates within the United States.

References

1. Ahmad FB, Cisewski JA, Anderson RN. Mortality in the United States — provisional data, 2023. MMWR Morb Mortal Wkly Rep. 2024;73(31):677-689.
2. Kochanek KD, Murphy SL, Xu J, Arias E. Mortality in the United States, 2022. Updated March 21, 2024. Accessed August 8, 2024. https://www.cdc.gov/nchs/products/databriefs/db492.htm