America is a uniquely sick, unhealthy country — just ask Americans. We’re addicted to ultraprocessed food and succumb to deaths of despair. The current US health secretary, who insists we’ve been raising the “sickest generation” ever, has built an entire political movement around the idea that there is something uniquely unwell about America as a country.
So it might surprise you to learn that the US actually just set a new record low in its death rate, the average American’s odds of dying in a given year. According to provisional data released by the Centers for Disease Control (CDC) this week, the US registered 689.2 deaths per 100,000 people in 2025. That is the lowest level on record. Not the lowest level since the Covid pandemic. The lowest level since the US started keeping organized data more than 125 years ago, and given the obvious public health advances in the 20th century, it is almost certainly America’s lowest death rate through the entire 250 years of its existence.
The new age-adjusted rate is down 4.6 percent from the year before, and about 4 percent below where it was in 2019 before the pandemic. Translate that dropping death rate into years of life gained, and it’s likely US life expectancy will come in at another record high in 2025, after reaching 79 years for the first time in 2024.
In fairness, it’s reasonable to be surprised. The US may not be the toxic hellhole some MAHA adherents think, but for most of the past decade plus, the country experienced something that’s not supposed to happen to a rich nation: life expectancy stalled and dropped, going from 78.9 years in 2014 all the way down to 76.4 percent in 2021. Covid was obviously the major factor, killing more than a million Americans, but even before the pandemic, death rates were rising thanks to drug overdoses, gun homicides, alcohol, and metabolic disease.
But the latest data shows the US has resumed its long-term trend of ever-falling death rates and rising life expectancy. This is how we got back on track.
The drugs that killed
The single biggest factor is the dramatic decline in drug overdoses that have killed tens of thousands of young Americans over the past few decades.
In 2013, just 3,105 Americans died from an overdose of synthetic opioids — which basically meant fentanyl. In the decade that followed, deaths from synthetic opioids went up 23-fold to 72,776 in 2023, the major factor in an overdose spike that hit 114,000 in the 12 months ending in late 2023. The problem seemed unsolvable.
And yet, by 2025, overdose deaths had fallen to roughly 70,000, a drop of nearly 40 percent in two years. It is one of the fastest declines for any major cause of death on record. We don’t really know why. Researchers credit some mix of wider naloxone distribution, a shift in the illicit fentanyl supply, and some grim but simple math: the population of drug users has already lost many of its most vulnerable members.
All this matters for the top line number because overdoses move life expectancy more than almost anything else, precisely because of who they kill. A death at 29 subtracts far more years from the national average than a death at 89. “As we see a dramatic decline in drug overdose among younger adults, that will have a more measurable impact on the overall life expectancy of the population,” Mark Mather of the Population Reference Bureau told CNN. The numbers bear him out: the overall death rate for Americans ages 25 to 34 fell about 16 percent in 2024 alone, and kept falling in 2025.
As overdoses dropped, so did homicides, another direct threat to the young. The national murder rate fell about 13 percent in 2023 and roughly 15 percent in 2024 — at the time, the largest one-year drop on record. It’s now on track to fall another 20-plus percent in 2025, which would set a new record for the largest single-year decline ever. Covid deaths have also fallen off, declining 37 percent in 2024, whenthe virus dropped from the 10th leading cause of death to the 15th.
While the deaths from Covid were the negative image of overdose deaths — primarily the old rather than the young — they were part of a broad decline in deaths from all sorts of causes. In 2024, age-adjusted death rates fell for all ten of the leading causes of death, heart disease and cancer included. That’s the most encouraging sign here: all around, America is becoming a less deadly place to live.
The longest winning streak
If you really want to see an unhealthy country, go back to shortly after the 100th anniversary of the United States’ founding, when American life expectancy was less than 40 years. An American born now can expect roughly four additional decades of life compared with one born around the time of the centennial — a sustained gain in the length of human life that is essentially unprecedented in the history of the species.
And while doctors deserve some credit, most of the improvement came from the less glamorous work of plumbers, sanitary engineers, and vaccine makers. The CDC credited the control of infectious disease alone with much of a 29-year jump in life expectancy over the 20th century, the product of clean water, sewage systems, food safety, childhood immunization, and antibiotics. In 1900, pneumonia, tuberculosis, and diarrheal disease caused a third of all deaths, 40 percent of them in children under 5. As late as a century ago, in 1926, the US had a life expectancy slightly below that of contemporary Somalia. But by the end of the 20th century, those ancient diseases were a rounding error in the US.
The killers that remain today are primarily the slow diseases of old age — but there, too, progress is continuing. Cancer death rates are down 34 percent since 1991, which means an estimated 4.8 million deaths were averted — roughly the population of Louisiana — thanks to less smoking, earlier detection, and better drugs. Deaths from heart attacks, once a near-certain death sentence, have fallen for decades.
Now, a class of drugs that barely existed a decade ago is rewriting what’s possible. GLP-1s like Ozempic have already pushed adult obesity down from a record 39.9 percent in 2022 to 37 percent in 2025, the first sustained decline in a generation. That matters for life expectancy because obesity feeds four of the ten leading causes of death: heart disease, several cancers, diabetes, and kidney disease. And the benefit may extend beyond weight loss: in a 17,000-person trial, semaglutide cut the risk of heart attack, stroke, and cardiovascular death by 20 percent.
No one knows what happens when tens of millions take such a drug for decades rather than thousands for a few years. But if even a fraction of that effect holds at scale, the GLP-1 era could extend Americans’ lives the way statins and the war on smoking once did.
Behind the record
To keep things in perspective, US life expectancy is a bit like US men’s soccer — pretty good and better than it used to be, but still not top class.
At 79 years, American life expectancy trails the average of comparable wealthy nations — Japan, Switzerland, Australia, France — by 3.7 years. For all the recent progress in fatal overdoses and homicides, that gap is still primarily driven by Americans dying young: the US death rate under age 70 is nearly double the average in our peer countries. To top it all off, we spend far more on health care than any of them, and still get shorter lives in return.
That national average also hides staggering gaps within the US. Life expectancy in Hawaii runs about eight years longer than in West Virginia; being born in the wrong state can cost more years than a lifetime of smoking. The richest 1 percent of American men live about 15 years longer than the poorest 1 percent. The gap between Americans with a college degree and those without has widened to 8.5 years, up from about 2.5 in the early 1990s. (Though as my former colleague Dylan Matthews once wrote, the expansion of college means that non-grads tend to be poorer and less healthy than they were 30-plus years ago, intensifying the difference.)
While the nation as a whole has recovered, the primary forces behind the lost decade of life — guns, alcohol, metabolic disease — “have not been resolved, and they’re continuing to claim lives,” as Steven Woolf, a mortality researcher at Virginia Commonwealth University, told CNN
But countries like Japan and Switzerland aren’t inherently healthier than the US — instead, they’re proof that several more years of American life are sitting on the table, reachable with tools that already exist. Though the nascent (and very American) field of longevity medicine might be overhyped, there is real promise in new approaches that could extend not just the sheer number of years we live, but what really matters — the years we spend in good health.
Today marks the 250th anniversary of the adoption of the Declaration of Independence, in which you’ll find the iconic phrase “life, liberty, and the pursuit of happiness” (along with a long list of more petty grievances). When it comes to pursuing happiness, well, let’s just say we haven’t quite caught it yet, and liberty hasn’t been looking all that great lately.
But when it comes to the promise of life, at least, America is once again a success story.
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