Missing Americans: Early death in the United States—1933–2021

Abstract

We assessed how many U.S. deaths would have been averted each year, 1933-2021, if U.S. age-specific mortality rates had equaled those of other wealthy nations. We refer to these excess U.S. deaths as “missing Americans”. The U.S. had lower mortality rates than peer countries in the 1930s-50s and similar mortality in the 1960s and 70s. However, beginning in the 1980s, the U.S. began experiencing a steady increase in the number of excess deaths, reaching 622,534 in 2019 alone. Excess U.S. deaths surged during the COVID-19 pandemic, reaching 1,009,467 in 2020 and 1,090,103 in 2021. Many missing Americans died young. In 2020 and 2021, half of all U.S. deaths under 65 years and 90% of the increase in under-65 mortality from 2019 to 2021 would have been avoided if the U.S. had the mortality rates of its peers. In 2021, there were 26.4 million years of life lost due to excess U.S. mortality relative to peer nations. Black and Native Americans made up a disproportionate share of the missing Americans, although the majority of missing Americans were White.

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