Compared to Peer Countries, the U.S. Had the Highest Rate of Mortality Among People Under Age 65 and Potential Years of Life Lost in 2020 Due to the Pandemic

A new KFF issue brief examines 2020 data on excess mortality – the number of deaths above what is expected in a typical year – and finds that among similarly large and wealthy nations, the United States had the highest premature excess mortality rate in 2020, indicating that younger people in the U.S. were more likely to have died due to the pandemic than younger people in other countries.

The excess mortality rate among Americans ages 15-64 was 58 per 100,000 people in the age group in 2020 – more than double that of the next closest peer nation, the United Kingdom (25 per 100,000).  Nearly half (48%) of excess deaths in the U.S. were among people younger than 75, compared to 18% for Belgium, a country with a comparable overall excess mortality rate.

The brief also estimates excess potential years of life lost (“premature excess deaths”) in the U.S. and peer nations. Excess potential years of life lost (up to age 75) is a measure of excess mortality and is used to compare differences in disease burden and longevity across countries. The analysis finds that the U.S. had 1,171 excess potential years of life lost up to age 75 per 100,000 people ages 0-74, which is over twice the rate of premature excess mortality in the next closest country, the U.K. (488 per 100,000 people). This approach, which follows OECD methods, may understate premature excess mortality in 2020, as excess deaths over age of 75 in 2020 were also premature compared to a typical year.

In comparison to a typical year, the U.S. lost an additional 3.6 million potential years of life in 2020. The high premature excess death rate in the U.S. was driven in part by racial disparities. American Indian and Alaska Native, Black, Native Hawaiian and Other Pacific Islander, and Hispanic people had over 3 times the premature excess death rate in the U.S. in 2020 than the rate among other groups. Thirty percent of the total excess potential years of life lost in the U.S. were among Black people, and 31% were among Hispanic people, rates disproportionate to their shares of the total U.S. population.

Prior to 2020, the U.S. already had the highest rate of premature deaths among peer countries. This analysis shows the gap in premature mortality rates between the U.S. and peer countries has increased due to the pandemic.

The analysis is available on the Peterson-KFF Health System Tracker, an online information hub dedicated to monitoring and assessing the performance of the U.S. health system.

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