Trends and Disparities in U.S. Mortality Rates Including COVID-19: An Analysis Using NCHS VSRR Provisional Estimates (2022-2024).

PURPOSE: To examine recent trends, disparities, and geographic variation in US mortality rates using National Center for Health Statistics (NCHS) Vital Statistics Rapid Release (VSRR) provisional estimates from 2022 through 2024, with attention to ongoing effects of COVID-19 and implications for public health planning.

DESIGN

Secondary analysis of nationally reported quarterly mortality data using a quantitative, descriptive epidemiological approach.

METHODS

Quarterly provisional mortality estimates were obtained from NCHS VSRR and supplemented with demographic and geographic data from CDC WONDER and COVID-19 mortality reports. Publicly available data required no institutional approval. Temporal trends were assessed from 2022 Q1 through 2024 Q3. Mortality rates were analyzed by sex and by state to identify demographic and regional disparities. Post-pandemic patterns were evaluated to assess indirect effects of COVID-19.

FINDINGS: Overall mortality declined from early 2022 through mid-2023, followed by a resurgence in 2024. Male mortality remained higher than female mortality across all quarters. Geographic disparities persisted, with elevated mortality concentrated in Appalachian and Southern states and lower rates in states with stronger healthcare infrastructure. The 2024 increase suggests continued vulnerability related to delayed chronic disease management, behavioral health challenges, and residual pandemic disruptions.

CONCLUSIONS

Although mortality declined after the acute phase of COVID-19, the 2024 rebound highlights ongoing health system strain and persistent inequities across the US.

CLINICAL RELEVANCE: Findings support targeted prevention, chronic disease monitoring, and equity-focused interventions to reduce post-pandemic mortality disparities and improve population health outcomes.