Mid-Career Adults Face 19% Increase in Death Rate

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Americans continued to face an elevated death rate in 2023, and the biggest threats for people under 65 were drugs and alcohol, not COVID-19.

The National Center for Health Statistics, part of the U.S. Centers for Disease Control and Prevention, reports in a new batch of mortality data for 2023 that the overall age-adjusted death rate was 750.5 deaths per 100,000 people.

That was 9.4% lower than in 2022, when the COVID-19 pandemic was still killing many people, but 4.9% higher than in 2019, before COVID-19 showed up.

Overall life expectancy was 78.4 years at birth. That was up from 77.5 years in 2022 but still down from 78.8 years in 2019.

Similarly, life expectancy at age 65 was 19.5 years — up from 18.9 years in 2022, but down, slightly, from 19.6 years in 2019.

The numbers were much worse for adults ages 25 through 44, mainly because of substance use.

The death rate per 100,000 lives increased 15% between 2019 and 2023 for people ages 25 through 34, to 148.1, and 19.1% for people ages 35 through 44, to 411.8.

What it means: Helping clients use life insurance to plan for mortality risk and annuities to plan for longevity risk is still be trickier than it was even five years ago.

Clients and their advisors need to find ways to take the effects of any substance use into account and may find life insurance underwriters giving the topic more attention.

The details: The CDC Wonder system, which draws on somewhat different figures than the new mortality report and analyzes the numbers differently, shows an overall age-adjusted mortality rate increase of 19% for all people in the 25-age group, to 198.9 deaths per 100,000 lives, or 31.7 extra deaths per 100,000 lives.

COVID-19 accounted for just 0.9 of the extra 31.7 deaths per 100,000 people in the 25-44 age group.

About 21.9 of the extra deaths were attributed to "external factors." An increase in the number of deaths related to drug overdoses and other drug-related causes to 66.2 per 100,000 lives in 2023, from 46.9 four years earlier, accounted for 19.3 of the extra deaths due to external causes.

An increase in alcohol-related mortality accounted for most of the rest of the increase in deaths due to external causes.

For people ages 25 through 44, mortality due to cardiovascular conditions increased to 22.9 per 100,000 lives, from 20.2. The increase in that category may reflect the long-term effects of COVID-19 on people's health and on the state of the health care system.

Mary Pat Campbell's views: Mary Pat Campbell, a well-known actuary and actuarial blogger, has been recommending for years that life and annuity actuaries pay close attention to drug-related mortality. She has noted that the increase in mortality for adults ages 25 through 44 has been linked mainly to use of synthetic opioids such as tramadol and fentanyl.

The CDC's headquarters in Atlanta. Credit: John Disney/ALM