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After almost a decade of improvement, the early death rate among adults ages 65-74 increased dramatically during the first year of the COVID-19 pandemic, disproportionately affecting older Americans of color.

Early Death

Those who are 65 should expect to live another 18.5 years, down 1.1 years from 2019, according to 2020 life expectancy estimates. Yet while the death rate among adults ages 65-74 — considered an early death — decreased steadily over the last decade, there was a sudden, significant increase between 2019 and 2020, and much of this increase was attributed to the COVID-19 pandemic. COVID-19 became a new top-10 cause of death in 2020 and the third-leading cause of death among older adults, causing 76,277 deaths. There were also more deaths from cancer, heart disease, diabetes, stroke, unintentional injury, liver disease, kidney disease and influenza/pneumonia in this age group in 2020 compared with 2019. The early death rate may continue to grow, as provisional death data revealed that more deaths due to COVID-19 occurred in 2021 than in 2020.
Between 2019 and 2020
Nationally, the number of deaths per 100,000 adults ages 65-74 significantly increased 17% from 1,765 to 2,072, corresponding to an increase of 118,948 deaths over this time. This followed a 4% decrease between 2011 and 2019. The early death rate significantly increased in 45 states and the District of Columbia, led by: 34% in the District of Columbia (1,932 to 2,593 deaths per 100,000 adults ages 65-74), 33% in New York (1,528 to 2,026), 30% in New Jersey (1,562 to 2,036) and 23% in both Arizona (1,591 to 1,962) and Louisiana (2,184 to 2,691).
All racial/ethnic and gender subpopulations experienced significant increases in the early death rate. Increases greater than the national change included: 48% among Hispanic (1,323 to 1,955 deaths per 100,000 adults ages 65-74), 32% among American Indian/Alaska Native (1,925 to 2,548), 31% among Asian (832 to 1,094), 29% among Black (2,477 to 3,184) and 19% among multiracial (848 to 1,005) adults, as well as 18% among males (2,179 to 2,582).
Disparities in 2020
The COVID-19 pandemic disproportionately affected some people of color, with American Indian/Alaska Native and Black populations experiencing much higher COVID-19 mortality rates compared with non-Hispanic white and Asian populations. According to the CDC, inequities in the social determinants of health are driven by the negative effects of interpersonal and structural racism, placing communities of color at risk for poor health outcomes.
The early death rate was lowest in Hawaii (1,527 deaths per 100,000 adults ages 65-74), Vermont (1,611) and New Hampshire (1,637); it was highest in Mississippi (3,024), Oklahoma (2,781) and Alabama (2,767).
The early death rate significantly varied by race/ethnicity and gender. The rate was 3.2 times higher among Black adults (3,184 deaths per 100,000 adults ages 65-74) than among multiracial adults (1,005) and 1.6 times higher among males (2,582) than among females (1,627).

Early Death Racial Disparity

Between 2019 and 2020
Nationally, the ratio of the early death rate among Black adults (3,184 deaths per 100,000 adults ages 65-74) compared with the rate among white adults (1,999) increased 14% from 1.4 to 1.6 between 2019 and 2020.
Disparities in 2020
Arkansas had the largest early death racial disparity ratio at 4.4, followed by the District of Columbia (3.8), South Dakota (3.6) and North Dakota (3.5). In Arkansas, Hawaiian/Pacific Islander adults had the highest early death rate at 11,504 deaths per 100,000 adults ages 65-74, compared with 2,630 among white adults. New Hampshire had the smallest early death racial disparity ratio at 1.0, followed by Kentucky and Rhode Island (both 1.2). In New Hampshire, there was no relative difference in the early death rate between white (1,664) and Hispanic (1,109) adults. In Kentucky and Rhode Island, Black adults (3,229 and 2,228, respectively) had similar early death rates compared with white adults (2,622 and 1,845, respectively).

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