Is there excess deaths in the US
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Executive summary
Yes — multiple recent studies and government reports find measurable “excess deaths” in the United States compared both to expected baselines and to peer high‑income countries. Academic analyses estimate roughly 1.5 million “missing Americans” (excess deaths relative to other wealthy nations) in 2022–23 and a cumulative US excess of millions of deaths since 1980 when compared with peers; US vital‑statistics reporting and provisional data systems also document ongoing elevated mortality and reporting lags [1] [2] [3] [4].
1. What we mean by “excess deaths” — a technical definition that matters
Excess deaths are the gap between observed deaths and the number expected in a given period; different studies and agencies estimate that baseline in different ways (five‑year averages, statistical models that account for population aging, or counterfactuals based on peer nations), and those choices change the headline number reported [5] [6]. The Office for National Statistics example shows many agencies now model expected deaths accounting for population size, age structure and trends rather than simple averages [6]. Our World in Data explains the common formula and warns that short baselines can misstate excess when populations are aging [5].
2. Excess deaths within the US during and after COVID
Peer‑reviewed work and news coverage show the US experienced clear excess mortality during COVID and that elevated mortality patterns continued afterward. A JAMA Health Forum cohort study and follow‑up reporting conclude excess US deaths rose before, during and after the pandemic [3] [1]. MedicalXpress summarized that there were “over 1.5 million ‘missing Americans’ in 2022 and 2023” when comparing US mortality to that of other high‑income countries, and that the working‑age population drove much of the excess [1].
3. How the US compares with other wealthy nations — the “missing Americans” narrative
Longitudinal international comparisons find a persistent US mortality disadvantage. A multi‑decade analysis cited in media and advocacy pieces reports nearly 15 million excess US deaths across 1980–2023 when the U.S. death rate is stacked against an average of 21 other high‑income countries; the gap widened in recent decades [2] [7]. These studies frame the gap as partly a structural problem—health system, policy and social‑determinant differences—rather than a one‑off pandemic artifact [2] [7].
4. Data caveats: provisional reporting and timing delays
U.S. provisional death counts are incomplete for weeks to months; the National Vital Statistics System estimates COVID‑19 death reporting is only ~65% complete after two weeks and ~95% after eight weeks, and final annual counts typically aren’t available until the following December [4]. That reporting lag means short‑term signals can change as records are finalized; agencies and analysts explicitly caution about interpreting very recent spikes or dips without waits for final data [4].
5. Age and cause patterns — who’s driving the excess
Multiple sources highlight that excess mortality in the U.S. is not evenly distributed: working‑age adults account for a substantial share of the excess when the U.S. is compared with peer countries, and non‑COVID causes (overdoses, chronic disease trends, injuries) contributed to midlife mortality rises pre‑dating the pandemic [1] [8]. The PNAS/Nature‑adjacent literature referenced documents shifts by age group and cause that broaden the mortality gap beyond pandemic deaths alone [7] [8].
6. What journalists and policymakers point to as causes — competing interpretations
Some studies and commentators attribute excess deaths to policy choices and systemic weakness (healthcare access, social safety net, public health investment), while others emphasize specific causes like COVID, drug overdoses, or delayed care. The powershealth summary of a large comparative study frames policy cuts and weakened public health as drivers; the academic work underlines complex, multi‑decade trends [2] [7]. Sources disagree on weightings but concur the phenomenon is real and multifactorial [2] [7] [1].
7. Bottom line and limits of current reporting
Available sources uniformly report measurable excess deaths in the U.S., whether measured against expected baselines or against other high‑income countries, and they document that excess has persisted after the acute pandemic period [3] [1]. Limitations: different methods produce different totals; provisional U.S. data are incomplete for recent weeks/months; and not all sources break down causes or subpopulations in the same way [5] [6] [4]. For more precise, up‑to‑date counts and age‑cause breakdowns consult finalized NCHS reports and the peer‑review literature cited above [9] [3].
If you want, I can pull the specific excess‑death estimates from the JAMA study and the Boston University/peer‑country analysis and show how method choices change the headline numbers [3] [2].