New UCLA research reveals that the U.S. has substantially higher death rates at all but the oldest age groups than five similarly high-income European countries.

The study, conducted by UCLA sociologist Patrick Heuveline, also found that the gap between the U.S. and the five other nations — England and Wales, France, Germany, Italy and Spain — widened during the first two years of the COVID-19 pandemic. However, the study reveals, only a portion of that phenomenon was directly attributable to COVID-19.

Heuveline found that between 2019 and 2021 in the U.S., the annual number of excess deaths — meaning the difference between the actual number of deaths and the number that would have been expected under normal condtions — nearly doubled. But his research concluded that 45% of that rise was due to causes other than COVID-19.

The findings were published today in the open-access journal PLOS One.

“The mortality gap widened during the pandemic, but not just due to the U.S. handling of the crisis mortality from COVID-19,” Heuveline said. “The chronic toll of excess deaths due to causes other than COVID-19 continued to increase as well, further demonstrating the U.S. health policy failure to integrate the social, psychological and economic dimensions of health, from a weak social security net and lack of health care access for all to poor health behaviors.”

Calculating excess death rates can be useful for comparing mortality between different countries or subpopulations, as well as before and after the onset of a health crisis. Previous studies have documented a substantial widening of the mortality gap between the U.S. and the five European countries between 2000 and 2017. And mounting evidence suggests that the U.S. experienced even higher mortality from COVID-19 than the other countries.

Building on those earlier studies, Heuveline calculated excess death rates in the U.S. and the five other countries for 2017 through 2021. His calculations account for different population sizes between the countries.

The study found that the number of excess deaths between the U.S. and the five European countries did indeed increase between 2017 and 2021, and that COVID-19 mortality contributed to the increase — but perhaps to a smaller degree than might have been expected.

In 2021, for example, 25% of all excess deaths in the U.S. were attributed to COVID-19, representing 223,266 deaths out of 892,491 total excess deaths from any cause.

Further research will be needed to identify specific underlying reasons for how, exactly, the COVID-19 pandemic contributed to the widening gap in excess deaths between the U.S. and the other five nations. For instance, Heuveline said, additional studies could explore differences in vaccination rates or social conditions that place a disproportionate impact on minority populations.