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February 26, 2025
Mortality rates among younger adults in the United States have surged since 1999, with drug overdoses, suicide, and homicide emerging as the primary culprits. The COVID-19 pandemic has only exacerbated this alarming trend, further fueling the rising death rates in this vulnerable age group.
A Worrying Trend
A new study led by Virginia Cafferky, MPH, from the Department of Epidemiology at the Boston University School of Public Health, analyzed US mortality data spanning from 1999 to 2021. The findings reveal a troubling increase in deaths among adults aged 18-39 years, driven largely by accidental poisoning (including drug overdoses), self-harm, and violent crime.
The study, published in the Journal of Adolescent Health on February 20, 2025, found that between 1999 and 2019, mortality rates among young adults increased by 10.8%, compared to just 1.5% in the broader US population. When factoring in the COVID-19 pandemic, the mortality rate among younger adults jumped a staggering 54.1% from 1999 to 2021 (P < .0001).
The Leading Causes of Death
Accidental poisoning and exposure to noxious substances, such as drug overdoses, accounted for over half of the overall mortality increase. These causes of death were consistently the most significant across all demographic groups. The leading contributors to rising mortality rates before the pandemic included:
- Accidental poisoning and exposure to noxious substances (23.3 deaths per 100,000)
- Suicide (3.6 deaths per 100,000)
- Homicide by firearms (1.6 deaths per 100,000)
After the onset of the pandemic, infectious and parasitic diseases, including COVID-19, also played a significant role, contributing to 13.8 deaths per 100,000 people.
Racial and Ethnic Disparities
The study highlights stark racial and ethnic disparities in mortality trends. American Indian and Alaskan Native populations saw the highest increase in mortality, with an 87.5% rise over the 22-year study period. Differences in mortality rates were also observed based on sex and ethnicity, underlining the need for targeted public health interventions.
Addressing the Crisis
The study’s authors emphasize the urgency of addressing this crisis through research and intervention. “Drawing attention to the troubling rise in mortality within this group may provide the impetus for further research to elucidate underlying causes of this trend, and to intervene,” they wrote. “Resources should be calibrated to address persisting drivers of mortality and to support this generation, who are the present and future of our nation.”
Study Methodology and Limitations
The research was conducted using US mortality data from the Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. The study assessed crude mortality rates and trends over the 22-year period, using the Cochran-Armitage test for statistical significance.
However, the study has some limitations. The reliability of race and ethnicity data varied, and sex data were binary, excluding gender minorities from analysis. Additionally, reliance on death certificates may have resulted in inaccuracies, and the study did not capture mortality trends among undocumented individuals.
Funding and Disclosures
The study was supported by the National Institute of Mental Health of the National Institutes of Health. One author was specifically funded by the NIH, but no relevant conflicts of interest were disclosed.
Conclusion
The alarming rise in mortality among younger US adults underscores the urgent need for public health initiatives to curb drug overdoses, suicide, and homicide rates. With targeted interventions and further research, policymakers and healthcare professionals may be able to mitigate this devastating trend and safeguard the future of this generation.
Disclaimer: This article is based on findings from a published study and is intended for informational purposes only. Readers are encouraged to refer to the original research and consult public health experts for further guidance.
