Consulting medical director Michael Fulks, MD, comments on recent changes to the leading causes of death because of COVID-19, drugs, and firearms.
Although cancer and heart disease are still the leading causes of death for the general U.S. population, other causes are rapidly moving up the list and impacting younger lives, increasing the potential life lost for an insured population. The COVID-19 virus has risen to the third-leading cause of death, responsible for roughly 10% of all deaths, and most of the 16% increase in total mortality from 2019 to 2020 based on CDC data. Fortunately, we have reason to believe COVID-19 deaths will decrease as more recent variants appear less lethal, and – more importantly – the level of population immunity will increase and thus reduce deaths even amidst continued transmission. These deaths are also concentrated in the elderly and less healthy; this is no less tragic for each individual and family, but results in fewer years of potential life lost.
However, while COVID-19 may fade as a cause of death, two other causes – accidental drug deaths and firearm deaths – are rapidly increasing and have much greater impact on younger lives. These causes of death are resulting in more years of potential life lost and are less subject to treatment or control measures. For comparison, motor vehicle accidents claim about 40,000 lives per year and were previous the leading cause of accidental deaths. Today, drug overdoses (OD) kill over twice as many Americans, and firearm deaths have risen to 45,000 per year. The increase in OD deaths has now driven the category of “accidentally injury deaths,” which include ODs and motor vehicle deaths, to fourth place, exceeding deaths Alzheimer’s, strokes and diabetes.
OD deaths are largely being driven by the addition of fentanyl (and its variants) to the existing narcotics, cocaine and methamphetamines available on the street. Given the ease and low cost of lab production, the ease of transport (where one full shipping container is more than enough to kill every person in the U.S.), the impossibility of verifying the contents of a pill, and the challenges of living in American society today, I anticipate this epidemic will continue.
Prevention of firearm deaths presents equally daunting challenges. Firearms have become more prevalent and are highly lethal, with deaths resulting from suicides, homicides, and accidents in that order. Given the stresses in today’s America and the ease of both access and use, it seems likely this mortality trend will continue as well.
Taken together, OD and firearm deaths will exceed COVID-19 deaths within a few years and may eventually challenge the second-leading cause of cancer for years of potential life lost. This impacts the victims, families, and loved ones most directly but also the life insurance industry and our nation.
About the Author
Michael Fulks, MD, Consulting Medical Director, is board-certified in internal and insurance medicine. After leaving practice, he served as a medical director, creating or editing several underwriting manuals and preferred programs. More recently, Mike has consulted for CRL participating in its mortality research on laboratory test results, BP and build, and in the development of risk-scoring tools for laboratory and non-laboratory data.