ArticleProceedings of the National Academy of Sciences of the United States of America2024
Excess natural-cause mortality in US counties and its association with reported COVID-19 deaths.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Urban and Rural Disparities in COVID-19 Outcomes in the United States: A Systematic Review.Medical care research and review : MCRR · 2025Pooled it
- Disaggregating Middle Eastern and North African Populations in Mortality Records to Better Understand COVID-19 Inequalities in Virginia.Journal of racial and ethnic health disparities · 2026Article
- Article
- Sex differences in excess mortality during the COVID-19 pandemic: a longitudinal ecological analysis of 34 high-income countries.EClinicalMedicine · 2026Article
- Unequal goodbyes: disparities in end-of-life care before and after the outbreak of the COVID-19 pandemic across 28 countries.BMC palliative care · 2026Article
- Same household, different choices: variation in health behaviors related to respiratory viruses in Illinois.medRxiv : the preprint server for health sciences · 2026Article
- Pharmacokinetic profiling of limnetrelvir in non-Japanese and Japanese populations: results of two phase 1 single- and multiple-dose studies.Antimicrobial agents and chemotherapy · 2026Article
- Demonstrating Clinical Performance of the Elecsys Anti-SARS-CoV-2 Anti-Nucleocapsid Immunoassay Using Real-World Data to Support Regulatory Decision-Making in the USA.Infectious diseases and therapy · 2026Article
- Applying machine learning to identify unrecognized COVID-19 deaths recorded as other causes of death in the United States.Science advances · 2026Article
- Infection-Independent Effect of the COVID-19 Pandemic on Diabetes and Cardiovascular Disease Mortality: An Illinois Vital Records System Analysis, 2019-2021.Public health reports (Washington, D.C. : 1974) · 2026Article
- Trends in maternal mortality rates by state, United States, 2018 to 2023.American journal of obstetrics and gynecology · 2026Article
- COVID-19 Vaccine Effectiveness Against Mortality in the Omicron Period: Evidence from Linked Mortality and Vaccination Records.Vaccines · 2025Article
- Hidden COVID-19 deaths? Exploring the Spatial context of excess death rates during the COVID-19 pandemic.International journal of health geographics · 2025Article
- Changing socioeconomic inequalities in the incidence and case fatality rates of COVID-19 in Germany, March 2020 through May 2022: an ecological study.BMC public health · 2025Article
- US-born and foreign-born life expectancy by race and Hispanic origin before and during the COVID-19 pandemic in the United States.Social science & medicine (1982) · 2025Article
- Suppression of COVID-19 death incidence on open west coasts in the USA.Scientific reports · 2025Article
- Factors influencing COVID-19 vaccine uptake among vulnerable communities in Texas: Perceptions of 2-1-1 helpline callers.Vaccine · 2025Article
- Excess Deaths in California During the COVID-19 Pandemic, by Healthy Places Index Quartile, February 2020-April 2022.Public health reports (Washington, D.C. : 1974) · 2025Article
- Excess Mortality Estimation.Annual review of statistics and its application · 2025Article
- Analysis of social media language reveals the psychological interaction of three successive upheavals.Scientific reports · 2025Article
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Authors and funding
12 authors.
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Abstract
In the United States, estimates of excess deaths attributable to the COVID-19 pandemic have consistently surpassed reported COVID-19 death counts. Excess deaths reported to non-COVID-19 natural causes may represent unrecognized COVID-19 deaths, deaths caused by pandemic health care interruptions, and/or deaths from the pandemic's socioeconomic impacts. The geographic and temporal distribution of these deaths may help to evaluate which explanation is most plausible. We developed a Bayesian hierarchical model to produce monthly estimates of excess natural-cause mortality for US counties over the first 30 mo of the pandemic. From March 2020 through August 2022, 1,194,610 excess natural-cause deaths occurred nationally [90% PI (Posterior Interval): 1,046,000 to 1,340,204]. A total of 162,886 of these excess natural-cause deaths (90% PI: 14,276 to 308,480) were not reported to COVID-19. Overall, 15.8 excess deaths were reported to non-COVID-19 natural causes for every 100 reported COVID-19 deaths. This number was greater in nonmetropolitan counties (36.0 deaths), the West (Rocky Mountain states: 31.6 deaths; Pacific states: 25.5 deaths), and the South (East South Central states: 26.0 deaths; South Atlantic states: 25.0 deaths; West South Central states: 24.2 deaths). In contrast, reported COVID-19 death counts surpassed estimates of excess natural-cause deaths in metropolitan counties in the New England and Middle Atlantic states. Increases in reported COVID-19 deaths correlated temporally with increases in excess deaths reported to non-COVID-19 natural causes in the same and/or prior month. This suggests that many excess deaths reported to non-COVID-19 natural causes during the first 30 mo of the pandemic in the United States were unrecognized COVID-19 deaths.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.