Overall deaths rose to a record high in 2021, according to CDC. And while the trend can largely be attributed to Covid-19, there are several additional factors that led to the increase, Mike Stobbe reports for the Associated Press.

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Deaths rise in 2021

The United States saw 3.465 million deaths last year, according to CDC's updated provisional death tally, roughly 80,000 more deaths than the record-setting total in 2020, marking 2021 the deadliest year in U.S. history.

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According to Robert Anderson, who oversees CDC's work on death statistics, that increase in deaths was largely due to Covid-19. In 2021, there were 415,000 Covid-19 deaths, up from 351,000 in 2020. Experts said this was largely due to new coronavirus variants and large numbers of Americans refusing to get vaccinated against Covid-19 or wear masks, Stobbe reports.

However, Covid-19 wasn't solely responsible for the increase in deaths. CDC also found that cancer deaths rose slightly, as did deaths related to diabetes, chronic liver disease, and stroke.

Drug overdose deaths also rose, CDC found, hitting 105,000 deaths in 2021, up from 93,000 in 2020. There was an especially large jump in overdose deaths among 14- to 18-year-olds, CDC found.

According to a paper published in JAMA, adolescent drug overdose deaths have generally been around 500 each year for a decade, but CDC found that number jumped to 954 in 2020 and 1,150 in 2021.

Reaction

Some experts were optimistic at the start of 2021 that Covid-19 deaths would drop, in part because vaccines were finally available for Americans, Stobbe reports. "We were wrong, unfortunately," said Noreen Goldman, a researcher at Princeton University.

Joseph Friedman, a researcher at the University of California, Los Angeles and lead author of the JAMA study, said the jump in adolescent drug overdose deaths is "unprecedented."

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Experts said the increase can be attributed to fentanyl, the highly lethal drug that is often cut into heroin and recently has been pressed into counterfeit prescription pills that adolescents sometimes abuse, Stobbe reports.

Experts also expressed concern that the U.S. life expectancy could drop for the second year in a row. Generally, U.S. life expectancy has slowly increased each year, but in 2020, U.S. life expectancy was 77 years, over a year and a half lower than the rate in 2019.

CDC hasn't made its life expectancy calculation yet, but Goldman and others have made their own, estimating that U.S. life expectancy dropped five to six months in 2021, the same rate it was at 20 years ago.

A preprint study published in medRxiv recently estimated that U.S. life expectancy in 2021 was 76.6 years—a decline from 76.99 years in 2020 and 78.86 years in 2019. This would mean that over the two years of the pandemic, U.S. life expectancy saw a net loss of 2.26 years.

Losing more than two years of life expectancy over the course of two years "is mammoth," Goldman said.

The medRxiv study also looked at death rates in the United States and compared them to 19 other high-income countries. The researchers found the United States fared the worst of the group.

"What happened in the U.S. is less about the variants than the levels of resistance to vaccination and the public's rejection of practices, such as masking and mandates, to reduce viral transmission," said Steven Woolf, an author on the study from Virginia Commonwealth University

Some experts are concerned that life expectancy numbers won't bounce back to where they once were, as the long-term effects of Covid-19 may increase deaths of people with chronic health problems, Stobbe reports.

Preliminary data from CDC suggests there were at least 805,000 deaths in the United States in the first three months of 2022, lower than the same period last year but higher than that period in 2020.

"We may end up with a 'new normal' that's a little higher than it was before," Anderson said. (Stobbe, Associated Press, 4/12)