America has been a difficult setting for a host of health challenges in the past five years.

Data from the National Center for Health Statistics reveals the toll of chronic illnesses and significant disruptions in the nation's leading causes of death.

These figures, collated between 2019–2023 using death certificates, present notable changes as a result of the pandemic.

Heart disease and cancer consistently hold the top two spots, with each disease claiming over half a million Americans lives each year.

Notably, the former has remained America's biggest killer for over 100 years, despite half the population not being aware of this.

COVID-19 made a dramatic entrance in 2020, immediately becoming the third leading cause of death and failing to exit the top 10 until 2023.

In a time defined by ventilators, quarantines and full-capacity hospitals, more people were dying of the virus than strokes, Alzheimer's disease and diabetes.

As the pandemic subsided, its immediate impact lessened. By 2023, COVID-19 had dropped to the tenth leading cause of death, but that isn't to say that its aftereffects aren't lingering.

For example, chronic liver disease/cirrhosis entered the rankings in 2021, which researchers estimated is due to more people drinking alcohol post-lockdown. During this time there was a 15 percent surge in the condition.

Influenza and pneumonia were mainstays of the top 10 for over a century but now rank outside it, at 12th, thought to be due to a greater societal awareness of virus prevention through masking and social distancing.

A 3D rendering of human lungs and trachea on a blue background. Death rates due to chronic lower respiratory disease, influenza and pneumonia were lower in 2023 than in 2019. A 3D rendering of human lungs and trachea on a blue background. Death rates due to chronic lower respiratory disease, influenza and pneumonia were lower in 2023 than in 2019. Getty Images

The third spot, which was temporarily occupied by COVID-19, is now typically held by unintentional injuries.

This includes deaths from accidents, such as car crashes and falls, but the most significant contributor in recent years has been drug overdoses.

Deaths due to unintentional injuries have surged by over 26 percent since 2019, largely driven by the opioid crisis and other substance abuse issues.

Again, it is suspected this went up as a result of the instability presented by the past half-decade.

Female patient wearing mask over mouth receives a sample taken from nose for a coronavirus PCR test. The ripple effects of the pandemic have extended to other illnesses. Female patient wearing mask over mouth receives a sample taken from nose for a coronavirus PCR test. The ripple effects of the pandemic have extended to other illnesses. Getty Images

No chronic conditions follow the same pattern.

Chronic lower respiratory diseases, Alzheimer's disease and diabetes round out the middle of the list.

Alzheimer's figures are broadly similar, whereas diabetes has fluctuated but remains a significant concern—roughly 100,000 Americans die due to it each year.

Respiratory illnesses have trickled downward slightly, which could be attributed to the same prevention tactics that reduced the influence of influenza and pneumonia.

Another paradoxical finding saw suicide continue to remain outside the top 10 causes of death since 2020, despite figures going up by over 3,000 since that year.

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References

Ahmad, F., Cisewski, J. & Anderson, R. (2024) Leading Causes of Death in the US, 2019-2023. JAMA. https://doi.org/10.1001/jama.2024.15563

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