Researchers have uncovered troubling new evidence showing that the United States has been experiencing far more deaths than other wealthy nations for more than two decades.
The study, published in JAMA Network Open by scientists from Boston University School of Public Health and other institutions, found that millions of Americans died earlier than expected between 1999 and 2022.
According to the researchers, these deaths likely would not have happened if the United States had mortality rates similar to countries such as Canada, Australia, France, Japan, and the United Kingdom.
The research team described these deaths as “missing Americans.” By their estimate, more than 12.7 million deaths during the study period could potentially have been avoided.
To understand the problem, scientists examined data from the World Health Organization Mortality Database. They analyzed causes of death by age, sex, and year across 18 wealthy countries.
The results showed that cardiovascular disease was the biggest driver of America’s excess deaths. Heart disease, stroke, and high blood pressure remained major causes of death throughout most of the study period.
Researchers found that cardiovascular disease alone accounted for a huge portion of the mortality gap between the United States and similar countries.
The study also showed growing problems linked to diabetes, kidney disease, obesity, and other metabolic illnesses. These conditions increased sharply after 2010 and became major contributors to excess deaths.
Among older adults, Alzheimer’s disease and other dementias became especially important causes of death.
At the same time, the United States also saw major increases in deaths connected to drugs, alcohol, and suicide. These deaths were particularly severe among younger adults and middle-aged people.
The researchers explained that drug overdose deaths increased dramatically after fentanyl became widespread in the illegal drug market around 2013. By 2022, overdose deaths in the United States were far higher than in comparable wealthy nations.
Although drug deaths received significant public attention, the study found that cardiometabolic diseases actually caused far more total deaths overall.
The findings suggest that the American health crisis is broad and affects many parts of society.
Scientists believe social and economic conditions may play a major role in explaining the problem. Factors such as poverty, stress, healthcare access, poor diet, unstable housing, lack of preventive care, and inequality may all contribute to higher disease rates.
The study also showed that the COVID-19 pandemic sharply worsened existing problems. COVID became one of the leading causes of excess American deaths between 2020 and 2022.
Researchers noted that respiratory diseases, transportation accidents, homicide, and HIV/AIDS also contributed to the higher death rates seen in the United States.
One especially important part of the study involved measuring “years of life lost.” This calculation focuses on people who die younger than expected.
Drug overdoses created especially large losses because many victims died at younger ages. The researchers say this measure helps show the deep social impact of these deaths on families and communities.
Interestingly, the study also found a few areas where the United States performed comparatively better. Death rates from several cancers were lower than in some peer countries, which researchers partly linked to improvements in cancer screening and treatment.
Still, the overall picture remained concerning. By 2022, the total death rate in the United States was 38% higher than in similar wealthy nations.
Researchers say solving the problem will require more than new medicines or better hospitals. While medical advances remain important, the study suggests that public health policies and social conditions may have a major influence on long-term survival.
Study author Dr. Andrew Stokes explained that if the United States could significantly reduce cardiometabolic diseases on a population level, the mortality gap with other wealthy countries could shrink substantially.
The researchers also suggested that policymakers should study why other wealthy countries achieve better health outcomes despite often having fewer medical resources.
The study adds to growing evidence that the health challenges facing the United States are deeply connected to broader social conditions and not simply individual medical choices.
In reviewing the findings, the study presents a powerful warning about the long-term health direction of the United States. The large number of preventable deaths suggests that the problem extends far beyond isolated diseases or temporary crises.
Instead, the findings point toward a system-wide public health issue involving chronic disease, addiction, inequality, and social conditions.
At the same time, the research also highlights possible opportunities for change. If policymakers can reduce heart disease, obesity, diabetes, addiction, and social inequality, millions of future deaths may potentially be prevented.
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Source: Boston University School of Public Health.
