A new study from the University of Minnesota reveals that death rates among adults aged 25–44 surged during the COVID-19 pandemic and remain significantly higher than expected even after the pandemic.
The research, published in JAMA Network Open, shows that this increase in mortality was not just a short-term effect of COVID-19 but rather part of a longer trend that began around 2010. If death rates had continued at pre-2010 levels, early adult mortality in 2023 would have been about 70% lower than it is today.
A Worsening Trend
Researchers from the University of Minnesota and Boston University analyzed death records from 1999 to 2023. They found that death rates among early adults jumped significantly between 2019 and 2021, which were the peak pandemic years. Even in 2023, the death rate remained nearly 20% higher than in 2019.
One of the most concerning findings was that drug-related deaths were the leading cause of excess mortality in 2023, meaning that if previous trends had continued, far fewer drug-related deaths would have been expected.
Other major contributors to the rise in deaths included cardiovascular and metabolic diseases, as well as external causes such as car accidents.
A Complex Public Health Crisis
Elizabeth Wrigley-Field, lead author of the study, pointed out that while the opioid crisis has played a major role in rising mortality rates, the problem is far more complex.
“What we didn’t expect is how many different causes of death have really grown for these early adults,” Wrigley-Field said.
“It’s drug and alcohol deaths, but it’s also car crashes, circulatory and metabolic diseases—causes that are very different from each other. That tells us this isn’t one simple problem to fix, but something broader.”
Andrew Stokes, co-author of the study from Boston University, emphasized the need for structural policy changes to improve young adult health.
“Our findings highlight the urgent need for comprehensive policies to address the underlying causes of worsening health among recent generations of young adults,” Stokes said. “Solutions may include expanding access to nutritious foods, strengthening social services, and increasing regulation of industries that affect public health.”
Review and Analysis
This study sheds light on a troubling reality: the health crisis among young adults is not just a pandemic-driven issue but a continuation of a long-term decline. While COVID-19 accelerated mortality rates, the rise in deaths began more than a decade earlier, pointing to deeper systemic problems.
The fact that drug-related deaths are the single largest contributor to excess mortality is unsurprising given the ongoing opioid epidemic. However, the study also highlights the role of other factors, such as heart disease and metabolic disorders, which are often linked to lifestyle and access to healthcare.
The findings suggest that improving public health outcomes for young adults will require a multi-faceted approach. Expanding access to mental health care and addiction treatment, improving road safety, addressing food insecurity, and strengthening economic and social support systems could all help reverse these trends.
As researchers continue to investigate the lasting effects of the pandemic, it is clear that the solutions will need to be broad and long-term, addressing both the immediate health crises and the underlying social and economic conditions that contribute to worsening health in young adults.
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The research findings can be found in JAMA Network Open.
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