The COVID-19 pandemic radically altered the rankings of the leading causes of death in the United States in 2020, and although COVID ranks lower on the list of causes in 2023, its effects continue to be felt both directly and indirectly.

The leading causes of death in the nation from 2019 to 2023 remained relatively stable until the COVID-19 pandemic, according to researchers using death certificate data from the Centers for Disease Control and Prevention’s National Center for Health Statistics National Vital Statistics System. Their results were published online Thursday by JAMA.

In 2020, COVID-19 jumped to the third leading cause of death — behind heart disease and then cancer — and remained among the leading causes of death in subsequent years, but it fell to No. 10 in 2023.

Increases in drug overdose and alcohol use-related diseases during the pandemic may continue to affect other leading causes of death, including unintentional injuries and chronic liver disease and cirrhosis, according to the report authors.

The rate of heart disease increased 0.4% from 2019 to 2023, with sharper increases during the pandemic. The cancer death rate declined steadily from pre-pandemic rates, except for a brief spike in 2021.

Deaths due to unintentional injuries — which jumped 26.3% between 2019 and 2023 due to drug overdoses — was bumped by COVID-19 for third-leading cause of death in 2020-2021. COVID-19 dropped to No. 4 in 2022 and fell to No. 10 in 2023. Influenza and pneumonia, which were among the top 10 causes of death prior to the pandemic in 2019, dropped to No. 12 in 2023. Chronic liver disease and cirrhosis came in at No. 9 for 2023 after first entering the top 10 ranking in 2021. 

Although diabetes dropped to No. 8 during 2020-2022, diabetes deaths have increased in number and rate since 2019, the research found. Suicide was No. 10 in 2019 and in prior years but has not ranked in the top 10 causes of death since 2020.

Death rates attributed to chronic lower respiratory disease declined 12.5% from 2019 to 2023, whereas Alzheimer’s disease deaths dropped by 6.9% and influenza and pneumonia deaths were lower in 2023.

Underlying cause of death, 2023

  1. Heart disease
  2. Cancer
  3. Unintentional injuries
  4. Stroke
  5. Chronic lower respiratory diseases
  6. Alzheimer’s disease
  7. Diabetes
  8. Kidney disease
  9. Chronic liver disease and cirrhosis
  10. COVID-19
  11. Suicide
  12. Influenza and pneumonia

Source: Ahmad FB, Cisewski JA, Anderson RN. Leading Causes of Death in the US, 2019-2023. JAMA. Published online August 8, 2024. doi:10.1001/jama.2024.15563