Lead: Provisional data from the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS) show the U.S. death rate declined 3.8% in 2024, falling from 750.5 to 722.0 deaths per 100,000 people. Total deaths edged down from 3.09 million in 2023 to 3.07 million in 2024, the lowest recorded rate since 2020. For the first time since 2020, COVID-19 is not among the top 10 underlying causes of death; suicide returned to the 10th position. Public-health officials and clinicians cite fewer COVID fatalities, a sharp drop in drug overdose deaths and shifting population health patterns as likely contributors.
Key takeaways
- The overall age-adjusted death rate fell 3.8% from 750.5 per 100,000 in 2023 to 722.0 in 2024 (NCHS provisional data).
- Total deaths decreased from about 3.09 million in 2023 to 3.07 million in 2024, marking the lowest annual rate since 2020.
- Heart disease, cancer and unintentional injury remained the top three underlying causes of death in 2024.
- COVID-19 fell out of the top 10 causes for the first time since 2020; suicide re-entered the top 10 at No. 10.
- A separate CDC report found U.S. drug overdose deaths dropped nearly 27% in 2024, a likely factor in the overall decline.
- Death rates fell across all racial and ethnic groups; multiracial people had the lowest rate (332.3 per 100,000) and Black people the highest (884.0 per 100,000).
- By age, rates fell for every group except infants under one year; the lowest rate was among children 5–14 (14.4 per 100,000) and the highest among those 85+ (13,835.5 per 100,000).
Background
The NCHS releases provisional mortality estimates to capture recent trends before final vital statistics are compiled. Provisional data are used to detect emerging shifts in causes of death and to inform public-health responses. The COVID-19 pandemic, beginning in 2020, altered baseline mortality patterns: COVID surged to a leading cause of death in early pandemic years and contributed indirectly to rises in other causes, including cardiovascular events and overdoses.
After two years of high excess mortality, CDC data showed declines beginning in 2022; 2024’s provisional fall continues that trajectory. Multiple interacting forces shape annual mortality: infectious disease activity, patterns of substance use, population aging, healthcare access, and the prevalence of chronic risk factors such as obesity and hypertension. Stakeholders—federal agencies, hospitals, state health departments and community providers—use these signals to prioritize prevention, screening and treatment interventions.
Main event
The newly released provisional NCHS summary reports a 3.8% reduction in the age-adjusted death rate for 2024. Numerically, the rate dropped from 750.5 to 722.0 deaths per 100,000, and total deaths dipped roughly 20,000, from 3.09 million to 3.07 million. NCHS epidemiologists note this is the lowest annual rate observed since 2020 and follows a reversal from the pandemic peak.
One clear shift: COVID-19 is no longer in the top 10 underlying causes of death. Farida Ahmad, corresponding author of the NCHS report and a health scientist at NCHS, highlighted that COVID “is still among the 15 leading causes, but not in the top 10,” suggesting substantially fewer COVID-attributed deaths in 2024 versus 2023. Suicide moved into the 10th slot, reflecting changes in cause rankings rather than necessarily large absolute jumps in suicide counts.
Public-health experts point to multiple drivers. The CDC’s separate analysis showed drug overdose deaths fell nearly 27% in 2024, which would reduce mortality from unintentional injury. Clinicians also emphasize that some pandemic-era risk factors—reduced preventive care, weight gain and delayed management of chronic conditions—may be easing, contributing to fewer deaths from cardiovascular and metabolic causes.
Analysis & implications
The decline in the national death rate is material but modest. A 3.8% fall in age-adjusted mortality over a single year can reflect meaningful shifts in population health if sustained, but provisional numbers can change when final death-certificate processing is complete. Analysts will examine cause-specific trends across states and demographic groups to see whether declines are uniform or concentrated in particular populations.
Public-health implications vary by driver. If falling COVID mortality is the principal explanation, it reflects success in vaccination, therapeutics and natural immunity reducing severe outcomes. If overdose reductions account for a large share, that would signal progress in drug-supply interventions, treatment access and harm-reduction efforts. Each scenario requires different policy responses: immunization and healthcare access versus addiction treatment and social services.
The persistent lead of heart disease and cancer underscores the long-term burden of chronic disease and population aging. Experts warn that even with an overall decline, inequalities remain: the Black population’s mortality rate (884.0 per 100,000) is substantially higher than the multiracial group’s (332.3 per 100,000), highlighting ongoing disparities in social determinants of health and care access.
Comparison & data
| Measure | 2023 | 2024 (provisional) |
|---|---|---|
| Age-adjusted death rate (per 100,000) | 750.5 | 722.0 |
| Total deaths (millions) | 3.09 | 3.07 |
The table shows the headline shifts documented by NCHS. Analysts will also parse cause-specific counts and state-level patterns once final data are available. Provisional figures are useful for trend detection but can be revised.
Reactions & quotes
“It’s pretty noteworthy that COVID-19 fell off the top 10 … I think that’s a pretty interesting finding given where we spent the last five years.”
Farida Ahmad, Health Scientist, NCHS (corresponding author)
Ahmad framed the absence of COVID from the top 10 as a signal of changing mortality patterns compared with pandemic years. She stressed COVID remains among the leading 15 causes but at lower rank in 2024.
“I think there’s a little less COVID, right? I mean, that’s part of it.”
Dr. Sharonne Hayes, Professor of Cardiovascular Medicine, Mayo Clinic
Dr. Hayes noted pandemic-era lifestyle shifts may have temporarily raised cardiovascular risk and suggested partial reversion toward pre-pandemic behaviors could reduce some deaths. She emphasized lifestyle and prevention remain central to reducing heart disease and cancer mortality.
“Leading causes continue to reflect an aging population and persistent co-morbidities such as obesity; investments in prevention and screening are key.”
Dr. Katie Schmitz, Visiting Professor of Medicine and Cancer Epidemiologist, University of Pittsburgh
Dr. Schmitz urged targeted prevention—screening, obesity interventions and equitable access to care—to sustain mortality improvements across communities.
Unconfirmed
- The precise share of the 3.8% decline attributable to fewer COVID deaths versus overdose reductions is not finalized and requires cause-specific decomposition of provisional counts.
- State-level and county-level revisions could change rankings for some causes once final death-certificate processing is complete.
- Some 2024 cause-of-death assignments may be reclassified during final coding and quality review, altering absolute counts for specific causes.
Bottom line
Provisional NCHS data show a measurable improvement in U.S. mortality in 2024: a 3.8% lower age-adjusted death rate and a small decline in total deaths compared with 2023. The absence of COVID-19 from the top 10 causes is the most striking headline and likely reflects substantially fewer COVID-attributed fatalities in 2024, alongside marked reductions in overdose deaths.
However, the decline does not eliminate long-standing challenges: heart disease and cancer remain the largest causes of death, and racial and age-group disparities persist. Policymakers should view the provisional improvement as a window of opportunity—investing in prevention, equitable access to care, addiction treatment and chronic-disease management could help turn a single-year decline into sustained progress.
Sources
- ABC News (news report)
- Centers for Disease Control and Prevention — NCHS provisional leading causes of death (official federal data)
- Centers for Disease Control and Prevention — drug overdose provisional data (official federal data)
- Mayo Clinic (academic medical center)
- University of Pittsburgh (academic institution)