Study Reveals Young Adult Mortality 70% Higher Than Anticipated, Primarily Due to Unnatural Causes
The rise in mortality among individuals aged 25–44 is primarily influenced by drug poisoning, cardiometabolic diseases, and social factors.
In America, young adults are facing alarming mortality rates, as highlighted by a recent study that attributes this increase to factors such as drug poisoning, alcohol-related deaths, and various emerging health issues.
In 2023, deaths among young adults were recorded at 70 percent higher than the expected figures had pre-2011 trends persisted.
The Effects of Drug and Alcohol Misuse
The research, published in JAMA Network Open, analyzed over 3.3 million deaths among Americans aged 25–44 from 1999 to 2023. The findings identified two distinct trends in rising mortality: a gradual increase from 2011 to 2019 and a sharper rise from 2020 to 2023.
In 2023, drug poisoning was the leading cause of death among young adults, accounting for a third of all fatalities.
Since 2014, drug poisoning has consistently topped the list of causes of death in this demographic, with a significant spike observed in 2020 followed by a steady excess death rate since then. However, the researchers did not delve into specifics regarding the impact of drug poisoning on these mortality rates.
Excluding COVID-19, few of the major causes of death among young adults were medically related.
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Aside from drug poisoning, the next leading causes of death in 2023 included natural causes (16 percent of excess deaths), transport-related incidents (over 14 percent), alcohol-related deaths (almost 9 percent), and homicide (just above 8 percent).
Compared to trends prior to 2011, mortality rates for most causes were significantly elevated. This “excess mortality” reached 35 percent higher in 2019, and then surged during the pandemic, nearly tripling by 2021, as reported by the authors.
Despite a slight reduction in excess deaths in 2023, figures remained significantly above pre-pandemic levels. Overall, the mortality rate for young adults in 2023 was 70 percent greater than expected, resulting in 71,124 additional deaths.
The two distinct phases of rising mortality prior to and post-2020 may indicate the need to address the ongoing effects of the COVID-19 pandemic. Such effects may emerge in death causes related to long-term health complications, healthcare disruptions, and social challenges, alongside negative health trends that existed beforehand, the authors elaborated.
Courtesy of Wrigley-Field E et al, JAMA Network Open
Wrigley-Field expressed concern over the substantial increase in mortality at these relatively young ages, stating, “This indicates that, if these trends are not reversed, we may see a significant rise in deaths as these cohorts transition into midlife and beyond.”
Factors contributing to the rise in drug and alcohol-related deaths include various psychosocial issues such as pain and social isolation, along with supply-side dynamics like the availability of fentanyl. She noted it was significant that these trends began to emerge shortly after the Great Recession (2008).
‘Deaths of Despair’
Wrigley-Field mentioned that the concept of “deaths of despair” offers a crucial perspective for understanding the increase in mortality rates around 2010, “though it’s not the only framework,” she noted.
Wrigley-Field highlighted that individuals currently aged 25 to 44 were born from 1981 onwards. Those at the upper end of this range likely entered the workforce shortly after the Great Recession, while younger individuals may have faced the challenges presented by the COVID-19 pandemic during a critical juncture in their transition to adulthood.
“This cohort has encountered soaring housing costs and an evolving job market, where work hours have increased in many sectors, making it challenging to maintain a healthy lifestyle,” she remarked. Many are caught in a cycle of long work hours to manage high housing expenses, leading to little time for health and wellbeing, which in turn can trigger a host of physical and mental health challenges.
Looking Beyond Drug-Related Fatalities
Despite drug poisoning being the major contributor to excess deaths in 2023, the researchers highlighted that “numerous other external and natural factors surpassed prior projected trends.” This includes a range of incidents, some of which resulted in non-specific causes of death, as clarified by Wrigley-Field.
The combined impact of cardiometabolic conditions, which includes circulation-related, endocrine disorders, and nutritional issues, is described as “significant” by the authors.
“The cardiometabolic causes of death are particularly concerning because they serve as indicators of the overall health of the population,” Wrigley-Field explained. “These causes are highly sensitive to the fundamentals of healthy living: access to nutritious food, physical activity, restorative sleep, reduced exposure to tobacco and air pollution, coupled with the experience of manageable stress.”
Another considerable aspect within this category is kidney-related fatalities, which Wrigley-Field identified as a significant contributor to mortality in this age group. Additionally, deaths associated with pregnancy and childbirth, as well as various other less prevalent causes of death, also fall under this category.
To mitigate the increase in excess deaths among young adults, the researchers pointed out the need to tackle underlying issues such as opioid misuse, alcohol dependency, road safety, and unhealthy diets. As the rise in fatalities occurred in two segments (prior to and following 2020), any solutions must accommodate both the lasting implications of the pandemic (like ongoing health challenges, disrupted healthcare systems, and social issues) and the detrimental health trends that already existed.
The study has limitations; the data for 2023 remains preliminary, and the analysis was focused on overall trends without disaggregating specific groups based on race, ethnicity, or gender, the team of Wrigley-Field noted.
While the study does not provide explanations for the increasing death rates—a subject the researchers intend to explore in future work—Wrigley-Field underscored that the variety of causes suggests a need for attention to broad, systemic issues.
