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In addition to overall mortality rates, the “years of life lost” metric marks the extent of premature deaths within a population by providing more weight to deaths at younger ages. The U.S. and comparable OECD countries have made progress in reducing years of life lost from 1990 to 2019 (down 24% and 42%, respectively), although the gap between the U.S. and comparable countries has increased over time.
The U.S. had the highest increase in premature deaths due the pandemic in 2020 and 2021. The per capita premature excess death rate in the U.S. was over twice as high as the next closest peer country, the U.K. The higher rate of new premature deaths in the U.S. compared to peer countries was driven in part by racial disparities within the U.S. The premature excess death rates for American Indian and Alaska Native, Black, Hispanic, and Native Hawaiian and other Pacific Islander populations in the U.S. were 3 times higher than the rates among White or Asian populations. The U.S. health system consistently results in higher rates of mortality and premature deaths among people of color.
Children and teens in the U.S. are less likely to make it to adulthood than in peer countries, with the U.S having higher rates of motor vehicle accidents, firearm deaths, and suicide deaths among children and teens.
Disease burden, which accounts for both premature death and years living with disability, is often measured using disability adjusted life years (DALYs). As of 2019 — the most recent year with available data — DALYs have declined in the U.S. and comparable countries since 2000, though the U.S. continued to have higher age-adjusted disease burden rates than peer countries. In 2019, the DALY rate was 37% higher in the U.S. than in comparable countries, on average.
