US Excess Deaths Remain Alarmingly High Post-Pandemic

A new study led by Boston University School of Public Health (BUSPH) researchers highlights a troubling trend: over 1.5 million “missing Americans” in 2022 and 2023—deaths that could have been avoided if the US mortality rates matched those of other high-income nations. Published in JAMA Health Forum, the study underscores a decades-long crisis in US health outcomes, exacerbated but not solely caused by the COVID-19 pandemic.

The study analyzed mortality data from 1980 to 2023, comparing US death rates with those of 21 peer countries, including Canada, France, and Japan. Despite a post-pandemic decline, excess US deaths in 2023 (705,331) remained significantly higher than pre-pandemic levels (631,247 in 2019). Shockingly, 46% of deaths among Americans under 65 were deemed avoidable if US mortality rates aligned with its peers.

Dr. Jacob Bor, the study’s lead author, emphasized the systemic nature of the crisis: “The US has been in a protracted health crisis for decades, with outcomes far worse than other wealthy nations.” The disparity is driven by preventable causes such as drug overdoses, gun violence, and inadequate healthcare access—issues that predate the pandemic.

Dr. Andrew Stokes, a senior author, noted, “These deaths reflect policy neglect and systemic failures, not individual choices.” A related study earlier this year identified drug-related deaths as the leading cause of mortality for adults aged 25-44.

• “Imagine the lives saved if the US performed at the average of our peers. One in two deaths under 65 is likely avoidable—this is a national scandal,” said Dr. Bor.
• *”The 700,000 excess deaths in 2023 fit the pre-pandemic trend, proving COVID-19 wasn’t the sole culprit,”* added coauthor Dr. Elizabeth Wrigley-Field.

The study calls for urgent policy reforms, citing universal healthcare and evidence-based public health measures as proven solutions in peer nations. However, political polarization and distrust in government pose significant barriers. Without action, the researchers warn, preventable deaths will continue to rise, widening the gap between the US and other high-income countries.