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 2018 about 39,740 people died by firearms, down 0.1 percent from 39,773 deaths in 2017. In contrast, according to latest data from the National Highway Traffic 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, 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 had spread to every continent except Antarctica. Between January 2020 and October 4, 2021, the WHO reported that there were 235 million cases worldwide, and 4.8 million people had died from the virus. Updates from the WHO can be found 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. According to the U.S. Centers for Disease Control and Prevention, between January 21, 2020 and October 4, 2021 there were 43.6 million cases of COVID-19 in the United States and the virus had claimed 700,200 lives. Daily updates can be found here. 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

Heart disease was the leading cause of death in the United States, accounting for 659,041 fatalities in 2019, the latest year for which final data exist, according to the National Center for Health Statistics. The composition of the top 10 was unchanged from 2018 with the exception of kidney disease which moved to the eighth position from the ninth in 2018. Deaths from influenza ranked ninth with 47,511 deaths which occurred before the COVID-19 pandemic took hold. Pandemic influenza viruses have the potential to be far more deadly. An estimated 675,000 Americans died during the 1918 Spanish influenza pandemic, the deadliest and most infectious known influenza strain to date.

 

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 71 in 2018, compared with one in 608 in a car accident and one in 180,746 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 2019 deaths from drug overdoses increased four-fold from 17,415 in 2000 to 70,630 in 2019, according to the Centers for Disease Control and Prevention (CDC). In 2019 drug overdose deaths rose 4.8 percent from 2018 to 70,630, following a 4.1 percent decline in 2018 that was the first decline in 28 years. 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 2019 that proportion had grown to 71 percent. Heroin alone accounted for 11 percent of all drug overdose deaths in 2000 and grew to 20 percent in 2019.

 

Number Of Drug Overdose Deaths, 2000-2019

 

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(1) Drug overdose caused by prescription and illegal drugs.

Source: Centers for Disease Control and Prevention, National Center for Health Statistics.

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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.

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 is included in a bankruptcy restructuring plan, which blocks further civil litigation but does not release the Sacklers from criminal investigation. Among its provisions the plan would create a new company whose revenues would be devoted exclusively to alleviating the addiction epidemic caused by its product.  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.

A June 2017 report issued by the Blue Cross Blue Shield Association found that diagnoses of opioid-use disorder (addiction to opioids, including prescription painkillers and illegal narcotics such as heroin) increased almost 500 percent between 2010 and 2016. The study examined claims from 30 million people who had commercial insurance provided by Blue Cross Blue Shield insurers. It found that opioid-use disorder was 40 times more likely in patients prescribed high doses for a short duration, compared with low doses for a short duration. Opioid-use disorder was seven times more likely when patients were prescribed a high dose for a long duration, rather than a low dose for a long duration. In addition, 21 percent of Blue Cross and Blue Shield (BCBS) commercially-insured members filled at least one opioid prescription in 2015, according to the report.