There is no question that analyzing mortality data is a fundamental tool for improving public health, driving policy decisions, advancing scientific research, enabling social justice, and ultimately improving population well-being [
11]. The purpose of our analysis is exactly in line with these concepts, as we aim to provide here the most up-to-date data on mortality in the US, one of the most important and representative countries in the world. The main strength of our study lies in the source of information, as the mortality data generated by our search using the WISQARS Leading Causes of Death Visualization Tool are obtained from the NVSS and death certificates, standardized using ICD-10 coding, and further processed by the NCHS. Taken together, this process provides reliable, up-to-date information on mortality trends and causes of death that can be useful for supporting a variety of public health, research and policy-making activities.
As summarized in
Table 1, heart disease and cancer remained the leading causes of death in the US in 2022, echoing previously published data for 2015-2020 [
12], when the leading causes of death were also heart disease, cancer, unintentional injuries and stroke, with the exception of the year 2020, when COVID-19 became the third leading cause of death in the US. Thus, four years into the COVID-19 pandemic, which has nearly revolutionized healthcare and society [
13], the epidemiology of the cause of deaths in the US has remained nearly stable.
However, if we compare the number of deaths from heart disease and cancer between the years 2022 and 2020 [
12], a modest increase can be noted for both (heart disease: 702,880 vs. 690,882, +1.7%; cancer: 608,371 vs. 598.932, +1.6%), while the mortality for COVID-19 has fallen by nearly half (354,323 vs. 186,552, -47.3%), surpassed in the 2022 list by unintentional injuries, whose mortality also increased remarkably between the years 2022 and 2020 (227,039 vs. 192,176, +18.1%). Regarding specifically heart disease, the modest but not meaningless increase can be attributed at least in part to the impact of the COVID-19 pandemic, as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is per se a trigger of myocardial ischemia and thrombosis [
14]. The increase in cancer mortality is also a predictable phenomenon of the pandemic, as this has been accompanied by significant delays in cancer screening and cancer-related care [
15]. As concerns unintentional injuries, our data are consistent with those recently presented in a systematic literature review that included 189 articles from many countries around the world [
16], showing higher incidence of injuries/trauma (especially in men) during the pandemic. Notably, the increase relative to 2020 data can also be explained by a possible bias due to avoidance of referrals to healthcare facilities for overcrowding of emergency rooms and/or fear of infection during the initial period of the pandemic [
17]. As then concerns the other causes of death, the mortality for stroke has recorded a slight increase between 2022 and 2020 (165,393 vs. 159,050, +4.0%), which can also be attributed to the greater prevalence of COVID-19 cases and the direct biological impact of SARS-CoV-2 on vascular ischemic disease. [
18]. In contrast to the trend observed for the previous diseases, the 2022-2020 variation in mortality for chronic lower respiratory diseases was negative (147,382 vs. 151,637, -2.8%), as was that for Alzheimer's disease (120,122 vs. 151,637, -20.8%), although the figures for the latter case may be biased by the death of several older people in the first two years of the pandemic, which may have then contributed to reduce the overall mortality for Alzheimer's disease and other forms of dementia in 2022 [
19]. Interestingly, the number of deaths for diabetes mellitus remained almost stable comparing the years 2022 and 2020 (101,209 vs. 101,106, +0.1%). Although the prevalence of diabetes has tended to increase during the pandemic [
20], the almost unvaried mortality is not really surprising as it can take several years for diabetic complications to develop and become potentially fatal. It may therefore take years before the effects of an increased number of diabetes diagnoses recorded during the pandemic will translate into an increased diabetes-related mortality.
It is also worth noting that the cumulative number of suicides, which ranks 11th on the list of leading causes of death in the US in both 2022 and 2020, has also considerably increased by over 10% in the last two years (i.e., 49,476 vs. 44,834, +10.1%). This is also plausible given that a kaleidoscope of psychiatric illnesses (including depression) has increased significantly over the past three years for a variety of reasons, including direct biological injury to the brain from the virus, fear of disease, and the inevitable impact of societal restrictions that have severely limited personal freedom [
21].