Premature death rate spiked during COVID, with 30% increase in drug overdoses

It's been known for a while now that the pandemic did a number on the mental health of a broad swath of the population, and that it caused a spike in drug overdoses and addiction, including opioids and cigarettes. 

Now, the America’s Health Rankings 2022 Annual Report from the United Health Foundation shows just how bad it got, with premature deaths, particuarly those from drug overdoses, spiking over the last few years. 

The report, which analyzed more than 80 measures at the national and state levels to reflect the impact of the pandemic at its height, found that the premature death rate, meaning years of potential life lost before age 75 per 100,000 population, increased 18% between 2019 and 2020, from 7,337 to 8,659; that's the sharpest increase over a single year in the history of the Annual Report.

The states highest increases came in New York, with 31%, followed by 26% in Arizona, and 24% in New Jersey; only Hawaii and New Hampshire saw no significant increase in premature deaths over that time period. 

When broken down along racial lines, the Hispanic population saw a 16% increase in premature deaths, while the American Indian/Alaska Native population saw a 14% increase, Black people saw a 10% increase, Asian/Pacific Islanders saw a 7% increase, and white people saw their premature deaths grow 3%.

The leading causes of premature death in 2020 were unintentional injury, cancer, heart disease, COVID-19, suicide, homicide, liver disease and diabetes. 

The report also specifically looked at drug deaths, which is the leading cause of injury: they increased 30% nationally, from 21.5 in 2019 to to 27.9 2020, the largest year-over-year increase since 2007. In 2020, 91,799 people in the U.S. died due to drug injury, an increase of 21,169 over 2019, and roughly 75% of those involved an opioid.

The drug death rate significantly increased in 36 states and the District of Columbia, with the largest increase coming in West Virginia, with 54%, and South Carolina with 53%, followed by Kentucky, with 51%.

While nearly all age, racial/ethnic and gender groups experienced significant increases in the drug death rate, the largest increase came among those aged 15 to 24, with a 49% increase, while drug deaths increased 45% among people who are multiracial, 43% among Black people, 38% among the American Indian/Alaska Native people, 37% among the Hispanic population, 36% among Asians, and 25% among white people. By gender, drug deaths increased 32% among males and 23% among females. 

Perhaps unsurprisingly, the rise in drug overdoses coincided with a rise in mental health problems, as the prevalence of frequent mental distress increased 11%, from 13.2% to 14.7%, between 2020 and 2021. The report defines frequent mental distress as "persistent and likely severe mental health issues, defined by 14 or more days of poor mental health a month."

Seven states saw significantly increases, with the biggest increase in Alaska, with 41%, in Illinois with 29%, and in Maine with 21%.

By group, the largest increases in mental health problems were among Asian adults, with a 45% increase. There was a 13% increase among those with incomes less than $25,000 and those making $25-$49,999, a 12% increase among those ages 18-44, and a 10% increase among both males and those with a high school diploma or GED degree.

There is some good news in all of this, though: there was also a spike in people to help. The percentage of mental health providers increased 7%, and the supply of primary care providers increased 5% between 2021 and 2022.