How do leading causes of death for women aged 18–44 compare across racial and ethnic groups in the U.S.?
Executive summary
Deaths among U.S. women aged 18–44 are led by external causes—unintentional injuries, suicide and homicide—with chronic conditions like heart disease, cancer, diabetes and HIV appearing unevenly across racial and ethnic groups; the ranking and burden shift substantially by race/ethnicity, reflecting both disease patterns and social drivers [1] [2]. National reports and analyses show rising mortality in this age range since the 2010s and striking variation—American Indian/Alaska Native and non-Hispanic Black women face higher rates for several causes that are less prominent in Asian and some Hispanic groups [1] [3] [4].
1. What the national numbers say about women 18–44
For women in early and mid adulthood, unintentional injuries (including drug poisonings), suicide and homicide are the principal causes of death—external causes account for a larger share of mortality than chronic diseases in the 25–44 grouping—and total death rates in this age band rose notably from 2013 to 2020, peaking with pandemic-era increases in 2020 [1] [5]. The CDC’s aggregate leading-causes materials for females emphasize that the top causes for all ages include heart disease and cancer, but when looking specifically at younger adults the external causes dominate and rankings vary by age and race [2] [6].
2. Racial and ethnic contrasts: where patterns diverge
Non-Hispanic Black women experience higher mortality from homicide and certain chronic conditions compared with White women, and HIV historically ranks higher among Black women in reproductive ages than among other groups [4] [7]. American Indian and Alaska Native women show disproportionate burdens from unintentional injuries, chronic liver disease, diabetes and suicide in some reports, producing elevated death rates relative to other groups [8] [9]. Asian and Pacific Islander women tend to have lower death rates from heart disease and some external causes but higher proportional deaths from stroke and certain cancers in older cohorts, underscoring heterogeneity across subgroups [9] [4]. Hispanic women often show mixed patterns—lower heart disease and cancer mortality in some analyses but higher diabetes mortality than White women in historical data—again varying by age and place [9] [4].
3. External causes: overdose, motor crashes, firearms and disparities
Injury-related deaths—poisonings (largely drug overdoses), motor vehicle crashes and firearms—are the leading contributors to mortality for women of reproductive age nationally, but their impact is uneven: drug overdose and poisoning drove large increases in accidental deaths across racial groups, while firearm deaths are far higher for Black women than Asian women and vary widely by state, amplifying geographic and racial inequities [3] [1]. Analysts note that the opioid epidemic and pandemic-era stresses produced sharp recent upticks in accidental and suicide deaths for young women across multiple racial/ethnic groups [10] [1].
4. Chronic diseases and infectious threats: heart disease, cancer, diabetes, HIV
Although chronic diseases dominate older-age mortality, heart disease and cancer still appear among top causes for some women under 45 and rank differently by race: diabetes is consistently a more prominent cause of death among American Indian/Alaska Native, non-Hispanic Black and Hispanic women, while HIV has been a leading cause in younger Black women in some local analyses [9] [7] [4]. National-level CDC material stresses that heart disease and cancer remain leading causes overall, but the age-specific and race-specific rankings change the picture for younger women [6] [2].
5. Why these differences exist—risk factors and social context
The observed racial and ethnic differences reflect a combination of higher prevalence of risk factors (hypertension, diabetes, substance use), differential exposure to violence and firearms, unequal access to care and prevention, and place-based disparities in socioeconomic resources and public health infrastructure; multiple sources emphasize social determinants and structural factors as central explanatory forces [4] [3] [11]. Policy and program responses therefore must address both proximate causes (overdose treatment, mental-health crisis response, obstetric safety) and upstream drivers (poverty, racism, health-care access) to bend these disparate curves [3] [11].
6. Limits of available reporting and practical implications
Public reports provide clear patterns but also important gaps: many national summaries aggregate ages or races, hiding subgroup heterogeneity and regional variation, and some analyses use differing age bands (18–44 versus 25–44), complicating direct comparisons across every source; where sources do not disaggregate a claim, this account notes that limitation rather than asserting absence [2] [1] [5]. The policy takeaway is stark: younger women’s mortality in the U.S. is dominated by preventable external causes that hit racial and ethnic groups differently, and addressing those disparities requires both targeted interventions (overdose response, violence prevention, maternal health) and structural investments in communities most affected [3] [4].