









Mortality risks

In February 2020, a new mortality risk, the novel coronavirus disease 2019, known as COVID-19, was named by the World Health Organization (WHO). The outbreak was first identified in Wuhan, China, in January 2020. Symptoms of the disease include mild to severe respiratory illness with fever, cough, and difficulty breathing. By April the virus had spread to every continent except Antarctica. As of September 21, the WHO reported that there were 31.0 million cases world-wide, and that more than 959,000 people had died from the virus. Updates from the WHO can be found here.

In the United States, the first confirmed case of COVID-19 infection was reported on January 20, 2020 in Snohomish County, Washington. As of April, the virus was reported in all 50 states and most territories. According to the U.S. Centers for Disease Control and Prevention (CDC), by September 21 there were 6.8 million cases of COVID-19 in the United States. The virus has claimed 199,000 lives. Daily updates are available here. The number of COVID-19 deaths in the United States is more than triple the 55,672 deaths in 2017 (latest data for final deaths) attributed to influenza and pneumonia.











Top 15 Major Causes of Death, 2017 Age-adjusted death rate (1) Rank Cause of death Number of deaths Rate Percent change

from 2016 1 Heart disease 647,457 165.0 –0.3% 2 Malignant neoplasms (tumors) 599,108 152.5 –2.1 3 Accidents (unintentional injuries) 169,936 49.4 4.2 4 Chronic lower respiratory diseases 160,201 40.9 0.7 5 Cerebrovascular diseases (stroke) 146,383 37.6 0.8 6 Alzheimer's disease 121,404 31.0 2.3 7 Diabetes 83,564 21.5 2.4 8 Influenza and pneumonia 55,672 14.3 5.9 9 Kidney disease 50,633 13.0 –0.8 10 Intentional self-harm (suicide) 47,173 14.0 3.7 11 Chronic liver disease and cirrhosis 41,743 10.9 1.9 12 Septicemia 40,922 10.6 –0.9 13 Hypertension (2) 35,316 9.0 4.7 14 Parkinson's disease 31,963 8.4 5.0 15 Pneumonitis due to solids and liquids 20,108 5.1 –1.9 All other causes 561,920 NA NA All deaths 2,813,503 731.9 0.4% (1) Per 100,000 population; factors out differences based on age.

(2) Essential (primary) hypertension and hypertensive renal disease. NA=Not applicable. Source: National Center for Health Statistics. View Archived Tables

Heart disease was the leading cause of death in the United States, accounting for 647,457 fatalities in 2017, the latest year for which final data exist, according to the National Center for Health Statistics. Age-adjusted death rates (which factor out differences based on age) space increased significantly in 2017 compared with 2016 for 10 out of the 15 leading causes of death. However, there was a significant decrease in the 2017 death rate for cancer. Influenza and pneumonia ranked eighth in 2017, with 55,672 fatalities. However, pandemic influenza viruses have the potential to be far more deadly. An estimated 675,000 Americans died during the 1918 Spanish influenza pandemic, the deadliest and most infectious known influenza strain to date.











Odds of dying from accidental injuries

The chart below shows the likelihood, or odds, of dying as a result of a specific type of accident. The odds of dying over a one-year period are based on the U.S. population as a whole, not on participants in any particular activity or on how dangerous that activity may be. For example, more people are killed in auto accidents than in motorcycle accidents or airplane crashes, not because riding a motorcycle or traveling in an airplane is more or less dangerous, but because far more people travel by car. Drug poisoning is the leading cause of injury death in the United States. The lifetime chances of dying from accidental drug poisoning were one in 71 in 2018, compared with one in 608 in a car accident and one in 180,746 for fatal injuries caused by lightning.











Odds Of Death In The United States By Selected Cause Of Injury, 2018 (1) Number of deaths, 2018 One-year odds Lifetime odds Cause of death Accidental poisoning by and exposure to noxious substances 62,399 5,243 67 Drug poisoning 58,908 5,554 71 Opioids (including both legal and illegal) 42,518 7,695 98 All motor vehicle accidents 39,404 8,303 106 Car occupants 6,837 47,852 608 Pedestrians 7,680 42,600 541 Motorcycle riders 4,669 70,072 890 Assault by firearm 13,958 23,439 298 Exposure to smoke, fire and flames 2,972 110,083 1,399 Fall on and from stairs and steps 2,509 130,398 1,657 Drowning and submersion while in or falling into swimming pool 746 438,562 5,573 Fall on and from ladder or scaffolding 485 674,572 8,571 Firearms discharge (accidental) 458 714,339 9,077 Air and space transport accidents 372 879,482 11,175 Cataclysmic storm (3) 76 4,304,835 54,699 Flood 44 7,435,624 94,481 Bitten or struck by dog 35 9,347,641 118,776 Earthquake and other earth movements 26 12,583,363 159,890 Lightning 23 14,224,671 180,746 (1) Based on fatalities and life expectancy in 2018. Ranked by deaths in 2018.

(2) Includes all types of medications including narcotics and hallucinogens, alcohol and gases.

(3) Includes hurricanes, tornadoes, blizzards, dust storms and other cataclysmic storms. Source: National Center for Health Statistics; National Safety Council. View Archived Tables The odds of dying from an injury in 2018 were 1 in 1,334 according to the latest data available.

The lifetime odds of dying from an injury for a person born in 2018 were 1 in 17.

The odds of dying from a drug poisoning of any kind were 1 in 5,554 in 2018; the lifetime odds were 1 in 71 for a person born in 2018.











The opioid crisis

Opioid abuse and addiction is recognized as a significant public health problem in the United States. Drug overdose, from prescription and illegal drugs combined, is the leading cause of injury death in the United States. Between 2000 and 2017 deaths from drug overdoses increased four-fold from 17,415 in 2000 to 70,237 in 2017, according to the Centers for Disease Control and Prevention (CDC). In 2018, drug overdose deaths fell 4.1 percent from 2017 to 67,367. Opioid analgesics, a group of prescription drugs that are used to alleviate chronic and acute pain, have been increasingly involved in the rise of drug overdose deaths over the same period. In 2000 there were 8,407 deaths attributed to opioids of all kinds, with prescription drugs and illegal drugs such as heroin, accounting for about half of all drug overdose deaths. By 2017 (latest data available) that proportion had grown to close to 70 percent. Heroin alone accounted for 11 percent of all drug overdose deaths in 2000 and grew to 22 percent in 2017.











Number Of Drug Overdose Deaths, 2000-2018 num_of_drug_poisoning_deaths_00-18.gif (1) Drug overdose caused by prescription and illegal drugs. Source: Centers for Disease Control and Prevention, National Center for Health Statistics. View Archived Graphs

Many states and municipalities have filed lawsuits against the pharmaceutical companies that they hold responsible for the current opioid epidemic. The lawsuits are an attempt to seek reimbursement for healthcare expenses, substance abuse treatment, social services, court and correctional expenses and other costs resulting from opioid abuse. In 2018 around 2,300 lawsuits against opioid manufacturers, distributors and pharmacies were consolidated under one federal judge. The plaintiffs included almost 200 municipal governments, all pursuing reimbursement for the costs of drug addiction and its collateral damage. One case, the State of Oklahoma v. Purdue Pharma, ended in March as the company and its owners, the Sackler family, ultimately agreed to pay $270 million. This was the first class action settlement related to opioid litigation. In October 2019, the court of the Northern District of Ohio was set to try three consolidated Ohio lawsuits in a test case against four entities—three distributors and one manufacturer. The case was ultimately settled for $260 million, with the money set to help fight opioid addiction.

A June 2017 report issued by the Blue Cross Blue Shield Association found that diagnoses of opioid-use disorder (addiction to opioids, including prescription painkillers and illegal narcotics such as heroin) increased almost 500 percent between 2010 and 2016. The study examined claims from 30 million people who had commercial insurance provided by Blue Cross Blue Shield insurers. It found that opioid-use disorder was 40 times more likely in patients prescribed high doses for a short duration, compared with low doses for a short duration. Opioid-use disorder was seven times more likely when patients were prescribed a high dose for a long duration, rather than a low dose for a long duration. In addition, 21 percent of Blue Cross and Blue Shield (BCBS) commercially-insured members filled at least one opioid prescription in 2015, according to the report.