What were annual excess death totals in the US for 2017–2024 and how do they compare by administration?
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Executive summary
Best-available public analyses show a troubling rise in U.S. excess deaths from 2017 through 2024: a pre‑pandemic gap already evident in 2017, a massive spike during 2020–2021, and persistently elevated excess mortality in 2022–2024 relative to expected baselines and peer countries [1] [2] [3]. Exact year‑by‑year totals depend on methodology and baseline choice; national sources (NCHS/CDC) and consolidated databases (Our World in Data, Penn Wharton, academic studies) provide the primary—but not identical—estimates [4] [5] [2].
1. What the published tallies say about 2017–2019: a worrying baseline
An influential academic comparison that applied European age‑specific death rates to the U.S. population estimated roughly 400,700 “excess deaths” in 2017—showing the U.S. already lagged major peers well before COVID‑19 [1]. That study and other trend analyses make clear that excess mortality in the United States was rising in the 2010s; national vital statistics and cross‑country datasets covering 2015–2019 (compiled by Our World in Data and the Human Mortality Database) are the underlying sources used to establish that pre‑pandemic baseline [5] [6].
2. The pandemic years, 2020–2021: the large spike and cumulative toll
Multiple analyses converge on a sharp surge in excess deaths starting in March 2020: Penn Wharton’s aggregation estimates nearly 1.4 million excess all‑cause deaths from March 2020 through December 2022, capturing the pandemic’s direct and indirect effects [2]. CDC and NCHS provisional dashboards have tracked pandemic‑associated excess and COVID‑attributed deaths across quarters and years, documenting the same pattern of a large, concentrated increase in 2020–2021 [4] [7].
3. Post‑pandemic years, 2022–2024: persistence and the “missing Americans” framing
Researchers and universities reporting through 2024–2025 describe continued excess mortality after the acute pandemic phase: Boston University and related coverage characterize “over 1.5 million ‘missing Americans’ in 2022 and 2023” when comparing U.S. death rates to peer countries, and provisional NCHS reporting for 2024 shows death rates and cause‑of‑death patterns that kept overall mortality elevated relative to pre‑pandemic expectations [3] [8] [9]. Our World in Data’s 2015–2024 excess‑mortality series documents the same persistence, though the raw annual totals depend on the baseline chosen [5] [10].
4. Comparing by administration: trends, not simple attribution
Across administrations the story is one of trend change rather than tidy political causation: the Trump years included the 2017 excess documented against European peers and the COVID‑era surge beginning in 2020 [1] [2], while the Biden years saw lingering and in some measures growing excess mortality in 2022–2024 compared with pre‑pandemic baselines and peer nations [3] [9]. Different studies emphasize different comparisons—some measure excess relative to short‑term trends, others relative to peer‑country mortality—so attributing year‑to‑year changes to a specific administration’s policies requires caution and additional causal analysis beyond the mortality counts themselves [5] [6].
5. Methods, limitations, and why totals differ across sources
“Excess deaths” is a methodological construct: estimates vary by the baseline years chosen, whether analyses adjust for demographic aging or compare to peer‑country rates, and whether they count direct COVID deaths only or all‑cause deviations that include indirect pandemic effects and non‑COVID drivers such as overdoses or delayed care [2] [5] [4]. Public sources used here—NCHS/CDC provisional series, Our World in Data aggregates, Penn Wharton estimates, and academic comparisons—are robust but not identical; none of the provided sources delivers a single authoritative annual table of excess deaths for 2017–2024, so readers seeking exact year‑by‑year counts should consult NCHS monthly/quarterly provisional mortality tables and the Our World in Data country series for reproducible baselines [4] [5].
6. Bottom line: rising excess deaths, complicated explanations
The United States entered the COVID era with substantial pre‑existing excess mortality (≈400,700 by one European‑comparison estimate for 2017), experienced a massive pandemic‑era surge (cumulative excesss of roughly 1.4 million through 2022 by Penn Wharton), and continued to record elevated excess mortality into 2022–2024 when compared with expected baselines and peer countries [1] [2] [3]. These patterns map across multiple administrations, but isolating policy effects requires careful causal work and consistent baseline definitions beyond the scope of the mortality tallies summarized here [5] [4].