The growing wave of mortality in younger adults in the US

Topline:

Mortality among young adults in the United States has increased since 1999, determined by overdose, suicide and homicide, Covid-19 aggravating the tendency. Accidental intoxication and exposure to harmful substances, such as drug overdoses, were the main causes of death in all demographs.

METHODOLOGY:

• The researchers carried out an observational study using US mortality data (1999-2021) from US centers for the control of wide online diseases for the epidemiological research database.
• The study focused on younger adults in the US aged between 18 and 39 to analyze the mortality rates specific to the cause and subgroup (sex, race and ethnicity).
• In general, 15 causes with the highest rates of gross mortality were analyzed in 1999 and 2021 and 15, with the highest increase in mortality.
• The data that extends over 22 years, including pre-Covid-19 and during Covid-19 periods, were examined to evaluate the temporal tendencies of gross mortality and percentage changes.
• The general tendencies of mortality from 1999 to 2021 were evaluated using the Cochran army test.

TAKE AWAY:

• From 1999 to 2019, mortality rates in younger adults pre-pandemic increased by 10.8% (P <.0001) compared with 1.5% in the wider US population. Moreover, from 1999 to 2021, mortality rates among younger adults, including pandemia increased by 54.1% (P <.0001).
• Racial disappearances were noted, American native Indian populations or Alaskane suffering an 87.5% increase in mortality.
• Accidental poisoning and exposure to harmful substances, such as drug overdoses, represented more than half of the general increase of mortality in younger adults and remained the main cause of death in all examined demographic subgroups.
• From 1999 to 2019, the main pre-pandemic factors of raised rates of gross mortality were accidental poisoning and exposure to harmful substances (23,3 deaths/100,000), suicide (3.6 deaths/100,000) and firearms by firearms (1.6 deaths/100,000). From 1999 to 2021, the best factors of increased gross mortality rates included accidental poisoning and exposure to harmful substances (38.3 deaths/100,000) and infectious and parasitic diseases, including Covid-19 (13.8 deaths/100,000). The differences were noted on the basis of race, ethnicity and sex.

IN PRACTICE:

“Drawing attention to the disturbing growth of mortality within this group can provide the impulse of subsequent research to elucidate the causes underlying this trend and intervene,” the authors wrote. “Resources should be calibrated to address persistent mortality factors and to support this generation, which are the current and future of our nation,” they added.

SOURCE:

This study was led by Virginia Cafferky, MPH, from the Boston School of Public Health University Epidemiology department. Was published Online on February 20, 2025, in Journal of Adolescent Health.

Limitations:

The reliability of race and ethnic data varied between different groups, and the sexual data available were binary, limiting the analysis of gender minorities. This study was based on death certificates, so it did not surprise the tendencies of mortality among people without documents and may contain inaccuracies. In addition, the emphasis on the singular causes of death did not consider it possible for more comorbidities that contribute to mortality.

Disclosures:

This study was supported by the National Institute of Mental Health of the National Health Institutes. An author was supported by the national health institutes. The authors did not reveal any conflict of relevant interests.

This article was created using several editorial tools, including you, as part of the process. Human publishers examined this content before publishing.