How do leading causes of death for women vary by age group in the U.S.?
Executive summary
Across the female lifespan in the United States, the dominant causes of death shift sharply: injuries (including unintentional poisoning/overdose), homicide and certain infections predominate at younger ages, chronic noncommunicable diseases—chiefly heart disease and cancer—rise in importance through middle age, and neurodegenerative disease and fall-related injury dominate in the oldest groups [1] [2] [3]. Federal data assembled by CDC and analyses from public-health groups show that while heart disease and cancer are the top causes overall, the leading cause within any specific age bracket can be very different and has been changing recently because of the opioid epidemic, rising homicide and persistent disparities [3] [2] [4].
1. Young girls and adolescents: accidents, congenital and external causes lead
For children and adolescents, unintentional injuries are the top killer: accidents (unintentional injuries) are the leading causes of death for ages 1–19, with homicide and suicide also among the top five and congenital abnormalities and cancer appearing in younger subgroups, according to national reports and America’s Health Rankings summaries of vital statistics [5] [4]. CDC injury-focused research documents that injuries were the leading cause of death for females ages 1–41 in a past analysis, with motor vehicle crashes historically prominent but drug overdoses overtaking vehicle crashes for many younger age groups as overdose deaths climbed [1].
2. Young adults (20–34): accidental overdose and homicide climb; reproductive-age risks visible
Women in their twenties and early thirties now face accidental deaths—largely unintentional poisonings from drug overdose—as a leading cause, driven by the opioid and broader substance-use epidemics, with overdose rates for young women rising sharply since 2000 [2] [1]. PRB’s analysis of CDC data found accidental deaths to be the leading cause among women ages 25–34 and highlighted a steep increase in overdose mortality among pregnant and recently pregnant women between 2015 and 2019 [2]. Homicide rates among some cohorts have also increased recently and contribute disproportionately among younger adult women [2].
3. Middle age (35–64): chronic disease takeover—cancer and heart disease rise
By midlife, the pattern shifts to chronic noncommunicable disease: cancer and heart disease become the dominant causes of death, together accounting for a large share of female mortality, and these remain the top two causes overall in CDC compilations [3] [6]. America’s Health Rankings and NCHS-based reporting emphasize that many deaths in the reproductive and midlife years are preventable—screening, treatment access and safety interventions can alter trajectories—while diabetes and chronic liver disease also compose important causes in specific racial and ethnic groups [4] [7].
4. Older women (65+): heart disease, cancer, Alzheimer’s and falls
In older age groups, heart disease persists as a leading killer and cancer remains high, but Alzheimer’s disease and other dementias become disproportionately important for women because of greater longevity—women have higher age-adjusted death rates from Alzheimer’s disease—and fatal falls surge among the oldest women, accounting for the vast majority of fall deaths [3] [8] [1]. CDC’s leading-causes tables and injury analyses show that nearly 90% of fatal falls among females were in those 70 years or older in past injury data [1].
5. Patterns, disparities and recent shifts: race, region and the opioid era matter
National aggregates mask pronounced disparities: American Indian/Alaska Native and non-Hispanic Black women face higher proportions of injury, homicide and diabetes deaths in certain age ranges, and Black women historically had higher age-adjusted heart disease mortality than cancer in some analyses [7] [9]. The opioid-driven rise in unintentional poisoning amplified accidental deaths among young and reproductive-age women, and recent years saw changes—declines in some injury categories and the disappearance of COVID-19 from some leading-cause lists in 2023—that alter the age-patterns year to year [2] [5].
6. Implications: age-targeted prevention, surveillance and equity are essential
Because leading causes rotate with age, prevention must be age-specific: injury prevention, overdose treatment access and intimate-partner-violence interventions for younger women; cancer screening and cardiovascular risk control in midlife; and fall prevention and dementia care for the oldest women, while addressing racial and geographic inequities across all ages [1] [4] [5]. The CDC’s compilations and independent analyses together underscore that national “all-ages” headlines—heart disease and cancer lead overall—are accurate but misleading if they obscure the real, urgent killers among younger women like accidental overdose and homicide [3] [2].