Facts + Statistics: Mortality risk

 

Gun deaths and injuries

The number of U.S. deaths by firearms, which are defined as the types of guns that can be carried by a person, is higher than the number of Americans killed in motor vehicle crashes. In 2019 about 39,707 people died by firearms, basically unchanged from 39,740 deaths in 2018. In contrast, according to latest data from the National Highway Traffic Safety Administration, 36,096 people died in U.S. motor vehicle crashes in 2019. (See data here.)

 

The COVID-19 pandemic

In February 2020 a new mortality risk emerged: the novel coronavirus disease 2019, now commonly known as COVID-19, was officially identified by the World Health Organization (WHO). The first outbreak was detected in Wuhan, China, in January 2020. Symptoms of the disease generally include mild to severe respiratory illness with fever, cough, and difficulty breathing, although some who contract the virus may be asymptomatic and contagious. By April the virus that caused the disease had spread to every continent except Antarctica. The WHO is tracks the number of deaths due to the Coronavirus and the updated tallys can be found under the Numbers at a Glance section here.

In the United States, the first confirmed case of COVID-19 infection was reported on January 20, 2020, in Snohomish County, Washington. By April, the virus was reported in all 50 states and most territories. The U.S. Centers for Disease Control and Prevention, updates total cases and deaths in the United States due to COVID-19. COVID-19 deaths in the United States have surpassed the number of deaths caused by the 1918 Flu Pandemic, which killed an estimated 675,000 Americans.

 

Major causes of death

COVID-19 was added as the third leading cause of death in 2020, according to the latest year for which final data exists from the National Center for Health Statistics. Heart disease continues to be the leading cause of death in the United States, accounting for 696,962 fatalities in 2020, followed by cancer with 602,350 deaths. The 10 leading causes of death accounted for 74.1 percent of all deaths in the United States in 2020, as shown in the chart above.

 

Odds of dying from accidental injuries

The chart below shows the likelihood, or odds, of dying as a result of a specific type of accident. The odds of dying over a one-year period are based on the U.S. population as a whole, not on participants in any particular activity or on how dangerous that activity may be. For example, more people are killed in auto accidents than in motorcycle accidents or airplane crashes, not because riding a motorcycle or traveling in an airplane is more or less dangerous, but because far more people travel by car. Drug poisoning is the leading cause of injury death in the United States. The lifetime chances of dying from accidental drug poisoning were one in 67 in 2019, compared with one in 632 in a car accident and one in 138,849 for fatal injuries caused by lightning.

 

The opioid crisis

Opioid abuse and addiction is recognized as a significant public health problem in the United States. Drug overdose, from prescription and illegal drugs combined, is the leading cause of injury death in the United States. Between 2000 and 2020 deaths from drug overdoses increased more than four-fold from 17,415 in 2000 to 91,799 in 2020, according to the Centers for Disease Control and Prevention (CDC). In 2020 drug overdose deaths rose 30 percent from 2019 to 91,799. Opioid analgesics, a group of prescription drugs that are used to alleviate chronic and acute pain, have been increasingly involved in the rise of drug overdose deaths over the same period. In 2000 there were 8,407 deaths attributed to opioids of all kinds, with prescription drugs and illegal drugs such as heroin, accounting for about half of all drug overdose deaths. By 2020 that proportion had grown to 75 percent. Heroin alone accounted for 14 percent of all drug overdose deaths in 2020.

In 2019 California and Florida had the most drug overdose deaths, 6,200 and 5,300, respectively. When ranked by the rate of death per 100,000 people, West Virginia ranked first with 52.8 deaths per 100,000 people followed by Delaware with 48.0 deaths per 100,000 people. From April 2020 to April 2021, California and Florida had the most drug overdose deaths, 10,500 and 7,900 respectively. Vermont had the highest percentage increase, 69.9 percent, according to preliminary data from the Centers for Disease Control.

Many states and municipalities have filed lawsuits against the pharmaceutical companies that they hold responsible for the current opioid epidemic. The lawsuits attempt to seek reimbursement for healthcare expenses, substance abuse treatment, social services, court and correctional expenses and other costs resulting from opioid abuse. In 2018 around 2,300 lawsuits against opioid manufacturers, distributors and pharmacies were consolidated under one federal judge. The plaintiffs included almost 200 municipal governments, all pursuing reimbursement for the costs of drug addiction and its collateral damage.

One case, the State of Oklahoma v. Purdue Pharma, was settled in March 2019 as the company and its owners, the Sackler family, ultimately agreed to pay $270 million. This was the first class-action settlement related to opioid litigation. The company declared bankruptcy in September. In October 2020 Purdue Pharma pled guilty to three criminal charges brought by the U.S. Justice Department for conspiracy to defraud the United States, violate an anti-kickback law and false representation. The company faces more than $8 billion in financial penalties. Sackler family members who own Purdue Pharma said they would provide $4.275 billion to help settle about 3,000 lawsuits brought by U.S. communities seeking to hold them and Purdue responsible for damage from its product, OxyContin. The offer was included in a bankruptcy restructuring plan, which blocked further civil litigation but does not release the Sacklers from criminal investigation. Among its provisions the plan would have created a new company whose revenues would be devoted exclusively to alleviating the addiction epidemic caused by its product. In December 2021, a federal judge rejected the plan because it would shield the Sacklers from civil litigation on the grounds that federal bankruptcy statutes do not allow a bankruptcy judge to grant such a block. Purdue Pharma appealed the decision, but on January 3, 2022, a U.S. judge ordered the company and Sackler family members along with nine states to enter mediation through January 14, 2022. If no agreement is reached at that time, the appeal will be allowed to continue.

In October 2019 the court of the Northern District of Ohio was set to try three consolidated Ohio lawsuits in a test case against four entities—three distributors and one manufacturer. The case was ultimately settled for $260 million, with the money designated to help fight opioid addiction.

In 2020, an estimated 2.7 million people in the United States had an opioid use disorder in the past 12 months, including 2.3 people with a prescription opioid use disorder, according to the National Institute on Drug Abuse.