Early adult death rates spiked during COVID-19 and stayed high in 2023, driven by drug deaths and other health crises. Experts urge broad policy action to address worsening young adult health trends.
New research from the University of Minnesota and Boston University School of Public Health (BUSPH) reveals that death rates among adults aged 25 to 44 increased sharply during the COVID-19 pandemic and remain elevated beyond expected levels in the post-pandemic period.
This surge exacerbated a pre-existing upward trend in mortality for this age group, which began around 2010. By 2023, death rates for early adults were approximately 70% higher than they would have been if mortality rates had remained stable instead of rising over the past decade.
Drug-Related Deaths Lead Excess Mortality
The researchers analyzed death rates between 1999-2023. Published in JAMA Network Open, the study found:
- For early adults, there was a large jump in the death rate between 2019 and 2021, which are considered the core pandemic years. In 2023, the death rate remained nearly 20 percent higher than in 2019.
- Drug-related deaths are the single largest cause of 2023 excess mortality, compared with the mortality that would have been expected had earlier trends continued.
- Other important contributing causes were a variety of natural causes, including cardiometabolic and nutritional causes, and a variety of other external causes, including transport deaths.
“The rise in opiate deaths has been devastating for Americans in early and middle adulthood,” said Elizabeth Wrigley-Field, lead author and an associate professor in the University of Minnesota College of Liberal Arts and Institute for Social Research and Data Innovation. “What we didn’t expect is how many different causes of death have really grown for these early adults. It’s drug and alcohol deaths, but it’s also car collisions, it’s circulatory and metabolic diseases—causes that are very different from each other. That tells us this isn’t one simple problem to fix, but something broader.”
“Our findings underscore the urgent need for comprehensive policies to address the structural factors driving worsening health among recent generations of young adults,” said study coauthor Andrew Stokes, associate professor of global health at BUSPH. “Solutions may include expanding access to nutritious foods, strengthening social services, and increasing regulation of industries that affect public health.”
Future research will explore the ongoing consequences of the COVID-19 pandemic and the trends that were already in place when it began.
Reference: “Mortality Trends Among Early Adults in the United States, 1999-2023” by Elizabeth Wrigley-Field, Rafeya V. Raquib, Kaitlyn M. Berry, Keeley J. Morris and Andrew C. Stokes, 31 January 2025, JAMA Network Open.
DOI: 10.1001/jamanetworkopen.2024.57538
Funding was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the Robert Wood Johnson Foundation, the National Institute on Aging, the W.K. Kellogg Foundation and the Minnesota Population Center.
