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JAMA Patient Page
January 19, 2016

Death in the United States: Changes From 1969 to 2013

JAMA. 2016;315(3):318. doi:10.1001/jama.2015.17432

Americans are becoming healthier, living longer, and losing fewer years of life to preventable disease.

How Many People Are Dying?

A study published in the October 27, 2015, issue of JAMA looked at death certificates gathered by the Centers for Disease Control and Prevention from all 50 states between 1969 and 2013 and provides information on the rates and causes of death in the United States.

From 1969 to 2013, the overall death rate in the United States decreased by more than 40%. In 1969, about 1279 people per 100 000 died. In 2013, this number decreased to 730 people per 100 000. These rates are age standardized, meaning they are adjusted for the fact that over the years, the US population has been getting older, so there are many more elderly Americans (in whom death is more common) now than in 1969.

Another way of looking at the overall health of the nation is to look at trends in prematuredeaths by estimating the years of “potential life” lost. Between 1969 and 2013, the years of potential life lost decreased by more than 50%, from 135 per 1000 years to 64 per 1000 years.

Major Causes of Death

The leading causes of death in 2013 were

Heart disease


Chronic obstructive pulmonary disease (COPD)

Unintentional injuries


Alzheimer disease


Influenza and pneumonia

Kidney disease


Overall, the death rate is higher for men than for women. The leading 3 causes of death for men in 2013 were heart disease, cancer, and unintentional injuries. The leading 3 causes of death for women in 2013 were cancer, heart disease, and COPD. Deaths due to 5 of these 6 causes of death (everything except COPD) decreased overall from 1969 to 2013. The rate of death due to COPD has increased since 1969, but most of this increase was from 1969 to 1999, and since 1999 the rate has been slowly decreasing.

What Does This Mean?

As a nation, the United States has made significant progress in improving overall health and lowering overall death rates. Thousands of premature deaths have been prevented each year by controlling major risk factors for heart disease, cancer, and COPD such as high blood pressure, high cholesterol, and smoking. However, for obesity-related diseases such as diabetes, heart disease, and stroke, the rates of decline in mortality have slowed in recent years. This illustrates the serious health risks that continue to be posed by the obesity epidemic in the United States. As the US population continues to age, continued efforts to control obesity, blood pressure, cholesterol, and smoking in both children and adults will be crucial.

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For More Information

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at www.jama.com. Spanish translations are available in the supplemental content tab.

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
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Article Information

Source: Ma J, Ward EM, Siegel RL, Jemal A. Temporal trends in mortality in the United States, 1969-2013. JAMA. 2015;314(16):1731-1739.

Topic: Public Health