PlainHealth

US Mortality Trends: 19 Years of CDC Data

Leading causes of death by total deaths, 2017

Heart disease and cancer together account for roughly six in ten tracked deaths

1. Heart disease647,4572. Cancer599,1083. Unintentional injuries169,9364. CLRD160,2015. Stroke146,3836. Alzheimer's121,4047. Diabetes83,5648. Influenza/pneumonia55,672

Change in age-adjusted death rate, 1999 to 2017

Stroke and heart disease rates fell ~40% and ~35%; Alzheimer's rose 83%

1. Alzheimer's+83%2. Unintentional injuries+41%3. Suicide+40%4. Diabetes-14%5. Cancer-23%6. Heart disease-35%7. Influenza/pneumonia-39%8. Stroke-40%

Total US deaths across the 10 leading causes, by year

The tracked-cause total rose with population even as age-adjusted rates fell

19991,905,82620031,912,11520071,846,30120111,869,32120152,013,01720172,081,531

CDC National Center for Health Statistics (NCHS) — Leading Causes of Death dataset, 1999-2017 · CDC WONDER online database

How have the leading causes of death in America changed since 1999? PlainHealth tracks finalized CDC mortality data across 19 years (1999-2017) and all 50 states plus DC, revealing patterns that shape public health policy and individual awareness.

Key Trend Patterns

  • 1. Heart disease had the largest improvement of any major cause: its age-adjusted death rate fell about 35% between 1999 and 2017, the clearest public-health win in the data.
  • 2. Stroke fell even faster in relative terms — roughly 40% — as blood-pressure control and acute stroke care improved. Cancer's age-adjusted rate dropped about 23% over the same window.
  • 3. Unintentional injuries (including drug overdoses) have been the fastest-growing major cause of death since 2000, driven primarily by the opioid crisis.
  • 4. Alzheimer's disease mortality has risen sharply as the population ages and diagnostic practices have changed, though coding differences make long-term trends harder to interpret.
  • 5. State-level variation remains enormous — the gap between the highest and lowest age-adjusted mortality rates across states exceeds 40% for most leading causes of death.

Two Decades of Cardiovascular Progress

The clearest story in the 1999-2017 data is the long decline of cardiovascular death. Heart disease, the nation's leading killer, saw its age-adjusted rate fall about 35% over the period, and stroke fell roughly 40%, as blood-pressure treatment, smoking cessation, and acute cardiac care all improved. Cancer rates dropped about 23% as screening and targeted therapies advanced. These declines represent millions of deaths averted and rank among the major public-health wins of the era.

Not every cause moved in the same direction. Diabetes edged down about 14% in age-adjusted terms, but Alzheimer's disease, suicide, and drug-related unintentional injuries all rose sharply, reshaping the bottom half of the leading-cause list even as the top two causes became less deadly.

Explore state-by-state mortality data on our state pages to see how these national patterns vary by geography, or compare specific causes on the causes of death pages.

The Rising Tide: Drug Overdoses and Despair

The most alarming trend in the data is the steady rise of unintentional injury deaths, driven heavily by drug overdoses. The age-adjusted rate for this category rose about 41% between 1999 and 2017 (and roughly 74% in raw counts), with the sharpest acceleration from 2013 onward as synthetic opioids, primarily fentanyl, entered the illicit drug supply.

This trend is geographically concentrated — Appalachian states and parts of the Northeast were hit earliest, but the crisis has since spread nationwide. State-level data on PlainHealth reveals which states are experiencing the sharpest increases and which have begun to see stabilization.

How to Use PlainHealth for Trend Analysis

Methodology Note

All rates shown on PlainHealth are age-adjusted using the year 2000 US standard population. The data source is the finalized NCHS Leading Causes of Death dataset (1999-2017), with rates from CDC WONDER. For details, see our methodology page.

Data source: CDC/NCHS, WONDER Mortality Database (1999-2017).

Analysis published: April 2026