When the COVID-19 pandemic first swept across the globe, excess deaths became a key metric for understanding its devastating impact. Excess deaths are defined as the number of deaths above what would normally be expected in a given period. While many hoped that once the worst of the pandemic passed, U.S. mortality rates would quickly return to baseline, new data shows otherwise. The U.S. continues to report excess deaths well into 2022 and 2023, long after vaccines and treatments became widely available.

This raises critical questions: Why are U.S. death rates still higher than expected? Who is most affected? And what changes are necessary to prevent these unnecessary losses?

What Are Excess Deaths?

Excess deaths measure the gap between observed deaths and the number of deaths that would have been predicted based on historical trends. For example, if 2.8 million deaths would normally occur in a year but 3.2 million occur instead, the 400,000 difference is counted as excess deaths. This metric is crucial because it captures not only direct deaths from COVID-19, but also indirect effects such as delayed care, strained health systems, and worsening chronic diseases.

What the Data Shows

A 2025 analysis from Boston University School of Public Health revealed that U.S. excess deaths continued at elevated levels through 2022 and 2023, long after many countries had stabilized. If the U.S. had matched mortality rates of peer nations such as Canada or Germany, hundreds of thousands of deaths could have been avoided.

• 2020–2021: Early pandemic spikes were expected due to COVID-19 waves.
• 2022–2023: Even after vaccines, treatments, and mitigation measures, U.S. deaths remained higher than projected.
• Gap with peers: Excess mortality in the U.S. outpaced most other wealthy countries, signaling deeper systemic problems.

Why Excess Deaths Persisted

Several overlapping factors contributed to continued U.S. excess deaths after the acute pandemic phase:

• Chronic disease burden: The U.S. entered the pandemic with high rates of obesity, diabetes, and cardiovascular disease, all of which elevate risk for severe illness and premature death.
• Delayed care: Millions skipped screenings, surgeries, and preventive visits during 2020–2021, leading to worsened health outcomes later.
• Healthcare access gaps: Unlike peer countries with universal systems, the U.S. has millions uninsured or underinsured, delaying care and medication adherence.
• Drug overdose crisis: Fentanyl and other synthetic opioids drove overdose deaths to record levels in 2022 and 2023, disproportionately affecting working-age adults.
• Mental health struggles: Depression, anxiety, and suicide rates rose sharply amid pandemic stressors and economic instability.

Who Was Most Affected?

The persistence of excess deaths has not been evenly distributed across the U.S. Certain groups and communities bore the brunt:

• Working-age adults: Adults aged 25-64 saw a significant share of excess mortality, partly due to overdoses and untreated chronic diseases.
• Rural populations: Distance from hospitals and specialist care increased mortality from both emergencies and chronic conditions.
• Racial and ethnic minorities: Disparities in healthcare access, economic stability, and exposure risk worsened outcomes for Black, Latino, and Indigenous populations.
• Low-income households: Financial barriers to care, poor housing conditions, and food insecurity magnified risks.

Comparison With Other Countries

One of the most striking aspects of the U.S. excess death story is how different it looks compared to peer nations. Countries like Canada, Germany, and Japan saw their excess mortality taper off significantly after vaccination campaigns and public health measures. In contrast, the U.S. remained stuck above baseline, reflecting structural challenges that extend beyond COVID-19 itself.

The Human and Societal Cost

Excess deaths are not just numbers—they represent real lives lost too soon. The continued rise after COVID-19 means:

• Thousands of families grieving preventable losses each month.
• Communities losing workers, parents, and leaders in their prime years.
• Economic productivity declining due to reduced labor force participation.
• Increased strain on healthcare systems from preventable conditions.

What Can Change?

Experts agree that while the U.S. faces structural health challenges, there are actionable steps to reduce excess mortality going forward:

• Invest in preventive care: Expanding screenings, checkups, and early treatment for chronic conditions.
• Address the overdose crisis: Broader naloxone access, addiction treatment programs, and harm-reduction strategies.
• Expand healthcare access: Policies that close insurance gaps and ensure affordable medication access.
• Strengthen mental health services: Integrating behavioral health into primary care and scaling community support networks.
• Public health infrastructure: Sustained funding for local health departments to prepare for future crises and manage chronic disease prevention.

Why It Matters for NewDeaths Readers

At NewDeaths, we strive to look beyond headlines and examine the deeper forces shaping mortality trends. The persistence of excess deaths after COVID-19 is not just a medical story—it’s a social one. By highlighting who is most affected and why, we hope to inform conversations around prevention, equity, and resilience.

Related Articles on NewDeaths

• Current Affairs Archive — global mortality patterns in the news.
• Death Tributes & Obituary Blog — honoring lives lost in today’s mortality data.
• Family Loss, Remembrance & Support — resources for those impacted by sudden loss.

Conclusion

Excess deaths in the United States did not vanish when the acute phase of the COVID-19 pandemic ended. Instead, they reveal long-standing weaknesses in healthcare, public health, and social support systems. By learning from peer countries, investing in preventive measures, and addressing inequities, the U.S. has the chance to reduce these losses. Every excess death represents a preventable tragedy—and every policy change that reduces them means more lives lived fully, more families kept whole, and fewer obituaries that arrive too soon.

What are your thoughts on the continued rise of excess deaths? Join the conversation and share your perspective with the NewDeaths community.