U.S. Life Expectancy Went Up Last Year, Prior to the Pandemic

December 22, 2020

Final data released today for 2019 provides a baseline perspective of mortality in the United States leading up to the COVID-19 pandemic of 2020.  The new data are featured in two reports that document the latest official numbers on life expectancy, leading causes of death, and drug overdose deaths for 2019.  The data show that after declining in two out of three years from 2015 to 2017, life expectancy in the United States increased in 2019 for the second consecutive year, despite an increase in deaths from drug overdoses and an all-time high of 2,854,838 total deaths in the country —  15,633 more deaths than the total reported in 2018.  Final data for 2020, which will reflect the mortality toll from the pandemic, are not yet available.

The age-adjusted death rate for the U.S. population as a whole decreased by 1.2% from 723.6 deaths per 100,000 population in 2018 to 715.2 in 2019.  As a result, life expectancy at birth for the U.S. population increased 0.1 year from 2018 to 78.8 years in 2019.  The 10 leading causes of death in 2019 remained the same as the year before, except kidney disease rose from 9th to 8th among leading causes with 51,565 deaths and influenza and pneumonia fell from 8th to 9th, among leading killers with 49,783 deaths.  Heart disease remained the leading cause of death in the U.S. (659,041 deaths), while cancer remained second (599,601 deaths), and accidents/unintentional injuries remained third (173,040 deaths).  The number of suicides in the U.S. declined from 48,344 in 2018 to 47,511 in 2019, and the suicide rate (the number of suicides per 100,000 population) also declined, from 14.2 in 2018 to 13.9 in 2019. 

Drug overdose deaths, featured in the second report released today, increased in 2019 after declining for the first time in 28 years in 2018.  The official number of drug overdose deaths among residents in the United States for 2019 was 70,630, nearly 5% higher than the 67,367 deaths in 2018.  Provisional monthly data released last week for the one-year period ending in May 2020 showed an 18% increase in drug overdose deaths from the same period the year before.  The drug overdose death rate was 21.6 overdose deaths per 100,000 population in 2019, higher than the rate of 20.7 in 2018.

There were familiar patterns of the types of drugs involved in overdose deaths.  The biggest surge in deaths was due to overdoses from synthetic opioids other than methadone, primarily fentanyl.  The death rate from these drugs increased from 9.9 in 2018 to 11.4 in 2019, but the annual rate of increase was actually much slower from 2017 to 2019 (about 9% annually) than it was from 2013-2017, when rates increased at a staggering rate of 75% per year.

Opioids aren’t the only drugs that have taken a devastating toll on American society.  From 2012 to 2019, the rate of drug overdose deaths involving cocaine more than tripled (from 1.4 to 4.9) and the rate for deaths involving psychostimulants with abuse potential (primarily methamphetamine) increased more than six-fold (from 0.8 to 5.0).

The new reports, “Mortality in the United States, 2019” and “Drug Overdose Deaths in the United States, 1999-2019” are both available on the NCHS web site.

QuickStats: Rate of Emergency Department (ED) Visits by Homeless Status and Geographic Region§ — National Hospital Ambulatory Medical Care Survey, United States, 2015–2018

December 18, 2020


During 2015–2018, there were annual averages of 42 ED visits per 100 total population, 42 ED visits per 100 nonhomeless persons, and 203 ED visits per 100 homeless persons.

Within each region, the rate of ED visits among homeless persons was higher than the rate for nonhomeless persons.

The rates of visits for nonhomeless persons did not differ by region; however, among homeless persons, visit rates were higher in the West (268) than in the Northeast (127) and South (170) and higher in the Midwest (234) than in the Northeast.

Source: National Center for Health Statistics, National Hospital Ambulatory Medical Care Survey, 2015–2018. https://www.cdc.gov/nchs/ahcd/ahcd_questionnaires.htm.


Overdose Deaths Jump 18% in the Past Year (through May 2020)

December 16, 2020

The latest monthly drug overdose death data for the United States was released today, and the numbers paint a disturbing picture about the on-going drug crisis facing the country.  According to these provisional data, there were an estimated 81,230 overdose deaths from June 2019 thru May of 2020 – a dramatic 18% increase from the 68,829 deaths from the same period a year ago.  After declining in 2018 – the first decline in 28 years – overdose deaths in the U.S. have increased at a rapid pace, beginning during the summer of 2019, and the increase has been growing more rapidly in recent months, coinciding with the on-set of the pandemic.  Drug overdose deaths were up during this period in all but four U.S. states – New Hampshire, Nevada, Utah, and Idaho (which saw no change), and the biggest increases were observed in Louisiana, Iowa, Wyoming, and Maine.  In some jurisdictions the increases were even greater.  In Washington, D.C., for example, the increase in the past year was 60% – a much larger jump than in any individual state.  There were over 10,000 more deaths nationwide during this period from opioid overdoses, particularly those involving fentanyl, as well as increases in deaths from cocaine and psychostimulants such as methamphetamine.  Deaths from heroin, which were slightly lower in this most recent period, have leveled off in recent years.  Below are some highlights from the release:

*Source: National Vital Statistics System, https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

Opioid-involved Emergency Department Visits in the National Hospital Care Survey and the National Hospital Ambulatory Medical Care Survey

December 15, 2020

Questions for Geoffrey Jackson, Health Statistician and Lead Author of “Opioid-involved Emergency Department Visits in the National Hospital Care Survey and the National Hospital Ambulatory Medical Care Survey.”

Q: Why did you decide to research opioid-involved emergency department (ED) visits?

GJ: From 2005 through 2014, it is estimated that the rate of ED visits due to opioid use increased 99.4%, from 89.1 per 100,000 population in 2005 to 177.7 per 100,000 population in 2014. We were struck by the large increase and know that ED data can provide critical information on opioid use-related treatments, such as opioid use disorder treatment, detoxification for safe opioid withdrawal, and management of adverse effects. NCHS hospital surveys can be used to monitor trends in opioid overdoses, as well as other opioid-related morbidity and mortality measures.

Q: Can describe the difference between the difference between the National Hospital Care Survey and the National Hospital Ambulatory Medical Care Survey?

GJ: Even though both surveys collect data from hospital emergency departments, the mode of data collection differs between the two surveys. The National Hospital Care Survey (NHCS) is an all-electronic data collection of administrative claims or billing data. NCHS receives all inpatient, ED, and outpatient hospitals for a calendar year.  In addition, to patient demographics, diagnoses, procedures, laboratory tests, and medications, NHCS collects patient name, address, and Social Security number, which allows patients to be followed over time and linkage to external data sources, such as the National Death Index, providing a more complete picture of patient care and post-acute mortality.

In contrast, the National Hospital Ambulatory Medical Care Survey (NHAMCS) data collection relies on medical record abstraction by U.S. Census Bureau field representatives during a 4-week period. A random sample of about 100 ED visits are selected from all visits during the reporting period, and data are manually abstracted directly from medical records by Census staff. NHAMCS collects similar information as NHCS, but NHAMCS does not collect patient identifiers.  As a consequence, NHAMCS data cannot be linked to other sources nor can patients be collected over time.

Q: Was there a specific finding in the data that surprised you from this report?

GJ: One finding that surprised me was the increase in percentage the patients that died of an opioid overdose 90 days after their hospital visits. Specifically, of the patients with an opioid-involved ED visit that died with 91 and 365 days after their ED visit, 20.6% died with an opioid overdose, compared to approximately 15% that died within 90 days post-ED visit died of an opioid overdose.

Q: Is this the most recent data you have on this topic?

GJ: The most recent NHCS data available in the NCHS Research Data Center (RDC) are from 2016. The 2016 NHCS data are linked to the 2016 and 2017 National Death Index and include information on specific drugs mentioned on the death certificate from the Drug-Involved Mortality file. Additionally, the 2016 NHCS RDC data include identification of opioids using an enhanced methodology that uses natural language processing and machine learning techniques. The most recent NHAMCS public use data file available are from 2018.

Q: What is the take home message for this report?

GJ: NHCS is an important data source for studying opioid-involved ED visits. Through the collection of patient identifiers, the data can be linked to the National Death Index to provide information on post-acute mortality. The information on post-acute mortality is not available in other hospital data sources. Even though the NHCS data are not nationally representative, the NHCS data have similar distributions to NHAMCS data for national estimates of ED visits of male and female opioid-involved ED visits and for persons aged 35 and over.

QuickStats: Percentage of Emergency Department (ED) Visits Made by Adults with Influenza and Pneumonia That Resulted in Hospital Admission, by Age Group

December 11, 2020

During 2017–2018, 37.2% of ED visits for influenza and pneumonia by adults aged 18 years or older resulted in a hospital admission.

The percentage increased with age from 14.4% for adults aged 18–54 years to 46.9% for adults aged 55–74 years and 69.7% for adults aged 75 years or older.

Source: National Center for Health Statistics. National Hospital Ambulatory Medical Care Survey, 2017–2018. https://www.cdc.gov/nchs/ahcd/ ahcd_questionnaires.htm.


Firearm Homicides in New York City, 1980 vs. 2018

December 7, 2020

On December 8, 1980, rock legend John Lennon was shot and killed outside his New York City home. The senseless killing served as an exclamation point for a violent decade – during the 1970’s there were well over 137,000 firearm homicides in the United States, culminating with 15,500 in 1980 alone. In the five boroughs that comprise New York City, there were over 1,000 firearm homicides in 1980, accounting for about 7 percent of the national total that year, with Lennon’s death being the most newsworthy. However, in the years that have passed since then, the number of firearm homicides in New York City have plummeted, to fewer than 200 in 2018. The national number of firearm homicides have also declined, although still total nearly 14,000 in 2018 (the most recent year for final data).

SOURCE: National Vital Statistics System, CDC WONDER, 1968-2018

Urgent Care Center and Retail Health Clinic Utilization Among Children: United States, 2019

December 3, 2020

Questions for Lindsey Black, Health Statistician and Lead Author of “Urgent Care Center and Retail Health Clinic Utilization Among Children: United States, 2019.”

Q: Why did you decide to research urgent care center and retail health clinic utilization among children? 

LB: This is a growing segment of health care delivery system where many American’s seek both preventative and acute care. In addition, 2019 was the first time that utilization of urgent care was assessed among respondents of the National Health Interview Survey.

Q: Was there a specific finding in the data that surprised you from this report?

LB: I was surprised there was not a linear relationship between age and utilization. Often, we see as age increases, service utilization decreases, and other work specific to urgent care utilization has found that adolescents and young adults are more likely to utilize urgent care and retail-based clinic care compared to children.

Q: Can you explain what retail health clinic utilization is?

LB: Urgent care and retail health clinics are facilities that provide health care services to patients and you do not need to make an appointment ahead of time. They can be free standing, or within a grocery store or retail store setting. Services provided often range from routine vaccination to non-emergency acute care.

Q: Is there any trend data for this report?

LB: No. This is the only year of data available that includes urgent care and retail health clinic utilization measures.

Q: What is the take home message for this report?

LB: More than 1 in 4 U.S. children (26.4%) have had one or more visits to an urgent care center or retail health clinic in past year according to 2019 data from the National Health Interview Survey.