Cancer and heart disease are the most common causes of death in the US

SSince its emergence in 2020, Covid has shuffled the list of the top 10 causes of death in the United States. It roared to third place in 2020, but has now fallen to 10th This is reported by the National Center for Health Statistics Thursday.

Heart disease and cancer remained the first and second leading causes of death, followed by unintentional injuries as No. 3. Overall, deaths in 2023 were 6.1% lower than in 2022.

“We are going in the wrong direction when it comes to heart disease. We are moving somewhat in the right direction on cancer,” said Eric Topol, founder and director of the Scripps Research Translational Institute. As a cardiologist and geneticist, he was not involved in the analysis. “There are many things that rank highest on this list, and there are many things we can do to prevent them. And hopefully we’ll continue to see the numbers drop. But if you just look at pre-pandemic to now, that’s not a good trend.”

The report was based on death certificates from 2019 through 2023. Covid-19 was documented as the underlying or contributing cause of 76,446 deaths in 2023, a decrease of 68.9% from the previous year.

These related circumstances are telling, said Asaf Bitton, a general practitioner and researcher. Executive Director of Ariadne Labs, a healthcare systems innovation center at Brigham and Women’s Hospital and Harvard Chan School of Public Health, he did not participate in the investigation reported on Thursday. Covid has killed many elderly people with multiple serious chronic conditions, from kidney disease to liver disease and Alzheimer’s disease, he pointed out. Diabetes and heart disease also increased the risk of dying from Covid.

“Covid has been an X-ray and has exacerbated systemic inequities and inequities in our system,” Bitton said. “It has also magnified and underscored the incredible burden of chronic conditions in our healthcare system and how our lack of systems that adequately address these important chronic conditions is highlighted when an infection like Covid attacks people with those conditions.”

As Covid-19 deaths fell, unintentional injuries rose back to third. Farida Bhuiya Ahmad, chief of mortality surveillance at the Distribution of Vital Statistics at NCHS and co-author of a position on the death figures published Thursday in JAMAtold STAT that the increase in these accidental deaths is a “major exception” to the otherwise fairly stable trends in leading causes tracked by her agency, part of the Centers for Disease Control and Prevention.

“The increase in accidents, largely driven by overdose deaths, has been steady, but more gradual than the changes we saw with Covid-19,” she wrote in an email..

That increase in accidental deaths can plausibly be traced back to the pandemic, when rates of drug use disorders and alcohol-related illnesses soared, the authors argue. Drug- and alcohol-related diseases could also increase rates of chronic liver disease and cirrhosis, they write, which are now among the top 10 but show a 15.3% increase between 2019 and 2023.

Topol said more evidence is needed.

“It’s certainly possible that some of these are related to the pandemic, because we know that some of the impacts are multi-organ and include things like increased diabetes, increased kidney disease, worsening lung disease and heart disease,” he said. “It is certainly possible, but speculative.”

In one positive development, Bhuiya Ahmad took notice Suicide disappeared from the top 10 causes in 2020 and remains so.

“Heart disease and cancer have consistently ranked as the top two causes of death, and still cause more than half a million deaths every year,” she said.

Deaths from stroke climbed to fourth place, along with heart disease, and shared the same dangers as atherosclerosis and clotting problems. Although the rise in stroke death rates started before Covid, the percentage increase in those rates grew again after 2019 NCHS report released on Thursday, according to.

“Heart disease and stroke, we can do so much more there. These are diseases that take more than twenty years to take root,” Topol said. “Many heart diseases and strokes are considered 80% preventable.”

Bitton ties fall life expectancy in the US to the inability to treat patients in a timely manner, starting with primary care.

“We have not managed our chronic conditions well over the past five years, including but not limited to Covid,” he said. “We know how to deliver better cardiology, outpatient care and primary care. And we know how to integrate behavioral health care into outpatient care. It requires investment, focus and discipline on the part of a healthcare system to deliver what it ostensibly promises.”

In the absence of a better system for delivering care, he said, “we will see the resurgence of these nasty chronic conditions inequitably take their terrible toll. And we’re basically leaving a lot of preventable deaths on the table.”

Although Covid-19 is no longer among the top five causes of death, it is still in the top 10 causes of death, causing almost 50,000 deaths last year.

“Covid is not going away,” Bitton said. “I mean, it’s bumping along, and we have to be very careful about a bird flu event.”

If you or someone you know is considering suicide, contact the 988 Suicide & Crisis Lifeline: call or text 988 or chat 988lifeline.org. For TTY users, use your preferred relay service or dial 711 then 988.

STAT’s coverage of chronic health conditions is supported by a grant from Bloomberg Philanthropies. Us financial supporters are not involved in decisions about our journalism.