Chronic Disease Deaths Decline Globally, but not in young U.S. adults - Sept 2025

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Perplexity online

While chronic disease deaths have fallen globally over the past decade, the United States stands as a troubling exception among high-income countries. Among younger American adults aged 20-45, deaths from chronic diseases actually increased from 2010 to 2019 — a phenomenon described as "rare among high-income Western countries," according to a comprehensive study published in The Lancet.cnn+1
The United States ranked dead last among 25 high-income Western nations in reducing chronic disease mortality during this period. Denmark achieved the greatest reduction in chronic disease deaths, while the U.S. showed the smallest improvement, with Germany performing only slightly better.eurekalert+1

The Scope of Rising Mortality Among Young US Adults

The crisis extends beyond chronic diseases alone. Death rates among Americans aged 25-44 were 70% higher in 2023 than they would have been if pre-2011 mortality trends had continued. This represents approximately 71,124 excess deaths among young adults in 2023 alone.bu+1
Drug overdoses emerged as the leading cause of death for Americans aged 18-45, with fentanyl responsible for nearly 70% of the nation's 107,000+ annual overdose deaths. From 2022 to 2023, however, there was encouraging news: drug overdose deaths among people aged 15-54 decreased, with individuals aged 20-29 reducing their risk by 47%.npr+1

Chronic Disease Epidemic Among Young US Adults

Nearly 60% of young adults (ages 18-34) now have at least one chronic condition, with approximately 27% having multiple chronic conditions. The most prevalent conditions include:cdc+1

• Obesity: Affecting over 40% of young adults, up from 33% in the previous decadenpr+1
• Diabetes: Rose from 3% to 4.1% among adults aged 20-44nam+1
• Depression: Increased dramatically from 16.4% to 25.0% among young adultscdc
• Hypertension: Rose from 9% to nearly 12%, with Black adults experiencing rates over twice as high as other racial groupsnpr+1

The "Deaths of Despair" Crisis

Beyond chronic diseases, young Americans face unprecedented rates of deaths from external causes:medicaleconomics+1

• Drug overdoses: The primary driver of excess deaths, with over 236,000 people aged 10-34 dying from overdoses since 2015npr
• Alcohol-related deaths: Excessive alcohol use causes 178,000 deaths annually, including 1 in 5 deaths among adults aged 20-49cdc
• Transportation accidents and homicides: Contributing significantly to preventable mortalitynationalacademies+1

Structural and Social Determinants

The U.S. health crisis reflects deeper systemic issues compared to peer nations like Denmark:

Healthcare System Failures

Despite spending nearly twice as much per capita on healthcare, the U.S. has lower life expectancy and worse health outcomes than comparable nations. Americans face substantial financial barriers to care that don't exist in universal healthcare systems.healthsystemtracker+3

Social Determinants of Health

Social factors create profound health disparities:pmc.ncbi.nlm.nih

• Educational level, income, and employment status all significantly impact health outcomes
• Racial and ethnic disparities persist across all health measures
• Geographic inequalities show rural Americans experiencing shorter life expectancy

Environmental and Policy Factors

Young adults have grown up during a period of:

• Economic uncertainty and downward mobility compared to previous generationsbu
• Expansion of industries affecting public health: processed foods, prescription drugs, and alcoholbu
• "Obesogenic" food environment with increased portion sizes and limited healthy food accesspmc.ncbi.nlm.nih

Denmark's Success Story: A Model for Improvement

Denmark's remarkable progress in reducing chronic disease deaths offers valuable lessons:linkedin+2

The Danish Heart Plan

Thirty years ago, Denmark faced poor cardiovascular outcomes with patients dying on waiting lists. The response was comprehensive:linkedin

• Centralized specialist services ensuring high-quality care within 30 minutes of travel
• National clinical guidelines harmonized across the country
• Strong political commitment and sustained funding
• Emphasis on prevention and early detection at the municipal levelhealthcaredenmark

Integrated Healthcare Approach

Denmark's system emphasizes:healthcaredenmark

• Patient-centered care with multisector collaboration
• Digital health solutions enabling data sharing and personalized treatment
• Prevention-focused primary care with 11 prevention packages for municipalities
• Health equity initiatives addressing social determinants

Healthcare Costs

Chronic diseases account for approximately 86% of U.S. healthcare spending, with the burden increasingly shifting to younger populations. The U.S. spends more on healthcare than any other nation while achieving worse outcomes.healthsystemtracker+2

Workforce Impact

Rising mortality among working-age Americans (25-64) threatens economic productivity and family stability. The crisis affects Americans during their most productive years and parenting years.nationalacademies

Intergenerational Effects

The concerning trend suggests future health outcomes may worsen as this generation ages, potentially creating an even larger burden on the healthcare system.bu

Looking Forward: Urgent Need for Comprehensive Action

The data reveals that the U.S. health crisis requires urgent, comprehensive intervention. Unlike other high-income countries that have successfully reduced chronic disease mortality, America faces a unique combination of:imperial+1

• Rising chronic diseases among young adults
• Persistent social and economic inequalities
• Fragmented healthcare system lacking universal coverage
• Environmental and policy factors promoting poor health

Prevention-focused policies, improved access to healthcare, and addressing social determinants of health emerge as critical strategies. Denmark's success demonstrates that with sustained political commitment, comprehensive planning, and integrated care approaches, dramatic improvements in population health are achievable even in relatively short timeframes.medicaleconomics+1
The stakes could not be higher: without decisive action, the U.S. risks losing an entire generation to preventable chronic diseases and deaths of despair, with cascading effects on families, communities, and the broader economy for decades to come.
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Non-communicable disease mortality - Lancet Sept 2025

Benchmarking progress in non-communicable diseases: a global analysis of cause-specific mortality from 2001 to 2019

Background
Non-communicable diseases (NCDs) have received substantial policy attention globally and in most countries. Our aim was to quantify how much NCD mortality changed from 2010 to 2019 in different countries, especially compared with the preceding decade and with the best-performing country in each region, and the specific NCD causes of death that contributed to change.

Methods
We used data on NCD mortality by sex, age group, and underlying cause of death for 185 countries and territories from the 2021 WHO Global Health Estimates. Our primary outcome was the probability of dying from an NCD between birth and age 80 years in the absence of competing causes of death, and was calculated using age-specific death rates from NCDs and lifetable methods. We calculated change in the probability of death as the difference between values in the final and first year of each period (2001–10 and 2010–19). For 51 countries with high-quality mortality data and 12 countries with large populations within their region, we used the Horiuchi method of decomposition to calculate how much specific causes of death and 5-year age groups contributed towards: (1) increases or decreases in NCD mortality from 2010 to 2019; (2) improvements or deteriorations compared with the preceding decade (2001–10); and (3) differences from the country that had the largest reduction in each region.

Findings
From 2010 to 2019, the probability of dying from an NCD between birth and age 80 years decreased in 152 (82%) of 185 countries for females and in 147 (79%) countries for males; it increased in the remaining 33 (18%) countries for females and 38 (21%) countries for males. The countries where NCD mortality declined for females accounted for 72% of the world female population in 2019, and those where NCD mortality declined for males accounted for 73% of the world male population. NCD mortality declined in all high-income western countries, with Denmark experiencing the largest decline for both sexes and the USA experiencing the smallest decline. Among the largest countries in other regions, NCD mortality declined for both sexes in China, Egypt, Nigeria, Russia, and Brazil, and increased for both sexes in India and Papua New Guinea. On average, females in countries in the central Asia, Middle East and north Africa region had the greatest reduction in NCD mortality followed by those in central and eastern Europe. For males, the largest reduction was among countries in central and eastern Europe, followed by those in central Asia, Middle East and north Africa. The smallest declines were those in the Pacific Island nations. Circulatory diseases were the greatest contributors to declines in NCD mortality from 2010 to 2019 in most countries, with some cancers (eg, stomach and colorectal cancers for both sexes, cervical and breast cancers for females, and lung and prostate cancers for males) also contributing towards lower NCD mortality in 2019 than in 2010 in many countries. Neuropsychiatric conditions and pancreatic and liver cancers contributed towards higher NCD mortality from 2010 to 2019 in most countries. In some countries, NCD mortality in working and older (≥65 years) ages changed in the same direction leading to large overall declines or increases; in others, it changed in opposite directions, diminishing the magnitude of the overall change. In 75 (41%) of 185 countries for females and in 73 (39%) countries for males, the change in NCD mortality from 2010 to 2019 was an improvement (ie, larger decline, smaller increase, or reversal of an increase) compared with the change from 2001 to 2010. These countries accounted for 29% and 63% of the world female and male population, respectively, and included both sexes in Russia and Egypt, and males in China, India, and Brazil. Decadal changes saw a deterioration (ie, smaller decline, larger increase, or reversal of a decline) in the remaining 110 (59%) countries for females and 112 (61%) countries for males, including in both sexes in the USA, Nigeria, and Papua New Guinea, and females in China, India, and Brazil. Change from 2010 to 2019 saw deterioration in direction or size compared with the preceding decade for both sexes in most high-income western countries, most countries in Latin America and the Caribbean, and in east and southeast Asia, and for females in south Asia. There was a decadal improvement in the direction or size of change for many countries in central and eastern Europe (eg, Russia) and central Asia, and in parts of the Middle East and north Africa. Improvements or deteriorations in the direction or size of change in NCD mortality between the two decades resulted from multiple NCD causes of death. Among causes of death, the decline in mortality from circulatory diseases was smaller from 2010 to 2019 than from 2001 to 2010 in most countries, except in countries in central and eastern Europe and some countries in central Asia, where these declines were larger from 2010 to 2019 than from 2001 to 2010. Change in lung cancer saw a decadal improvement in many countries, especially for males, and many other cancers saw a mix of improvement and deterioration.

Interpretation
From 2010 to 2019, NCD mortality declined in four of every five countries in the world. These improvements were not as large as the preceding decade for most countries, driven by smaller declines in mortality from multiple NCDs.
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