As much as medical professionals do their best to treat patients, dealing with death is an inevitable part of the job. Tracking the top causes of death helps set priorities for proper care and create preventative strategies to help people live longer and better lives.
The Centers for Disease Control and Prevention (CDC) has collected data on the leading causes of death in the US for more than three decades. This information is highly useful, but the statistics don’t always match up with the lived experience of physicians working daily on the front lines. Why is there a discrepancy between the CDC data and doctors’ expressed reality? Read on to learn what the leading causes of death in the US are and how certain factors continue to get lost in translation.
Leading cause of death according to the CDC
According to the CDC’s findings, these were the leading causes of death in America in 2023, with the number of deaths attributed to each condition:
- Heart disease: 680,981
- Cancer: 613,352
- Accidents (unintentional injuries): 222,698
- Stroke (cerebrovascular diseases): 162,639
- Chronic lower respiratory diseases: 145,357
- Alzheimer’s disease: 114,034
- Diabetes: 95,190
- Nephritis, nephrotic syndrome, and nephrosis: 55,253
- Chronic liver disease and cirrhosis: 52,222
- COVID-19: 49,932
The numbers tell a certain story about what afflicts most patients, but each person’s death is the endpoint of a personal journey heavily impacted by contributing factors both in and out of their control. All of the background details of a person’s life have a strong influence on when, how, and why they pass on. Many physicians recognize that basic numerical data is helpful, but has its limits. In a Sermo poll asking community members if they believe official mortality statistics fully reflect the reality of what drives patient deaths, 54% of participants said that the data often lacks sufficient context to be fully accurate. Only 23% of medical professionals agreed that the data is exact.
This sentiment is corroborated by more granular research into how people die. The 2023 National Healthcare Quality and Disparities Report outlined the five leading causes of death by age group per 100,000 people, and heart disease is only the most common cause for people over the age of 65. A CDC report of the top 15 causes of death in 2023 found that, while men and women died of similar causes, men died at a much higher rate of all causes except for Alzheimer’s disease. There are also disparities in life expectancy across racial lines. The top causes of death may be similar across demographics, but many variables can impact how at risk each person is of requiring care for different conditions.
Leading causes of death according to physicians on Sermo
Whatever misgivings physicians may have about the breadth of the CDC’s data, they do agree on the most fatal condition currently affecting Americans. 60% of those who answered the Sermo poll believed that cardiovascular disease is the leading cause of death in the US based on what they see in their practices.
Heart disease is a general term that applies to several conditions and cardiac events where plaque buildup in the arterial walls makes it harder for blood to flow throughout the body. Heart disease is also the top cause of death worldwide.
Here are the other common causes of death, listed by the percentage of votes they earned in our poll:
Complications from chronic disease (28%)
The CDC defines chronic diseases as conditions that last for more than a year and require ongoing medical attention or other forms of management to minimize their effects on your quality of life.
6 in 10 Americans currently live with at least one chronic disease, and 4 in 10 have two or more. Due to the prevalence of these conditions, the CDC names chronic illnesses as the leading cause of death in the US, although the organization also includes cardiovascular disease as part of that distinction. The consequences of chronic diseases can be lessened or exacerbated by a patient’s lifestyle choices, as this practitioner of internal medicine explained in the Sermo community. “The overall decline in general health, stemming in part from poor health habits, bad diet, lack of exercise, [and] obesity are enhancing the leading causes of death that we see on death certificates.”
Cancer (4%)
Cancer remains a persistent danger for people young and old, with the National Cancer Institute estimating that 2 million people in the US will be diagnosed with cancer in 2025, with about 618,000 people dying as a result. Lung cancer is expected to be responsible for the most deaths. While a cancer diagnosis is still a destabilizing moment for anyone, there are more reasons to remain hopeful in the face of this condition now than ever before. While the rate of new cancers has remained stable for men and increased for women, the NCI found that the death rate for both decreased between 2019 and 2023, suggesting that more patients can win their fight with cancer with the right treatment plan.
Drug overdoses / substance use (4%)
The trend lines are far less encouraging for the number of deaths connected to drug overdoses or substance abuse. According to the CDC, 105,007 drug overdose deaths occurred in the U.S., resulting in an age-adjusted rate of 31.3 deaths per 100,000 standard population. Opioids were the main culprit of this rise. This class of drugs was involved in over two thirds of total deaths, and synthetic opioids in particular were the fastest-growing category among overdose deaths. Men were twice as likely to die from a drug overdose, and the highest concentration of overdoses was located in the Northeast region of the country.
Mental health–related deaths (2%)
It can be hard to attribute deaths directly to mental health conditions, as the effects of depression, bipolar disorder, or schizophrenia can appear as other causes of death. For example, the 2023 United States National Survey on Drug Use and Health states that 20.4 million American adults suffered from mental health and substance abuse disorders in the same year. But none of that information should belittle the devastating toll of mental health episodes. Suicide was the second leading cause of death among people between the ages of 10 and 34 in 2023, with the suicide rate for men nearly 4 times higher than the rate for women. Native Americans and non-Hispanic males were the demographics with the highest rates.
The greatest threats to American life have not changed drastically – 47% of medical professionals asked in the Sermo poll agreed that the primary cause of patient death in their patient populations has remained consistent over the past decade – but the response plan may be in need of updating. When asked if they believe the US healthcare system is effectively addressing the leading causes of death, 61% of participants admitted that failures in certain areas offset success in others. Another 23% felt that the treatment focus was not aligned with the real mortality drivers.
The silent epidemics: underreported causes of death in the US
Conversations about the leading causes of death in the US can often hone in on the fatal conditions that directly lead to someone’s passing, but that framing ignores the systemic issues that inform every aspect of a person’s life. Here are the five causes that Sermo doctors described as being overlooked in public health discussions, ranked by the number of votes that they received:
Social determinants (43%)
People do not exist in equal circumstances. If you live in an area lacking in available resources, your overall health will suffer as a result. Research has shown that patients with diabetes who were lacking in several social determinants had twice the mortality rate as those who weren’t experiencing the same social disadvantages. It’s not just the compounding effects of these social obstacles that can shorten your lifespan.
A paper published by the University of California, Riverside found that poverty was the fourth-highest cause of death in the US, with an estimated 183,000 deaths in 2019 associated with the significant lack of income. Food insecurity and housing instability also correspond with premature deaths.
Polypharmacy / medication-related deaths (18%)
All prescriptions should be recommended with the best of intentions, but outcomes don’t always go as planned. Analysis conducted by the American Society of Pharmacovigilance stated that adverse drug events (ADEs) were estimated to be responsible for between 250,000 and 300,000 deaths in the US each year. ADEs is an all-inclusive term for several causes of death related to medications, such as:
- Prescription drug overdoses
- Prescription errors
- Misuse of prescription drugs
- Harmful interactions between multiple drugs
- Allergic reactions
Mental health and suicide (12%)
As mentioned before, mental health crises take a real toll on people, but the full extent of these conditions has yet to be explored and accepted across all relevant institutions. Mental health issues can arise from a myriad of sources – genetics, poor living circumstances, destabilizing events in one’s personal life – but the physical consequences often share some traits. According to the National Alliance on Mental Illness, nearly 58 million people experienced mental illness in 2021, and people with depression have a 40% higher risk of developing cardiovascular and metabolic diseases. People living with serious mental illness (about 14 million people) are almost twice as likely to develop these conditions.
Medical errors/system failures (7%)
While it is true that medical professionals are not infallible and all physicians must take action to demonstrate ethical behavior, the prevalence of medical errors that lead to a patient’s death is not as common as some may think and the exact ranking and number of deaths due to medical errors remain debated.
There have been some studies that have suggested that structural failures within a medical practice were the third leading cause of death, but recent research, such as this 2020 meta-analysis from Yale, found that preventable deaths amounted to a much lower estimate than what is commonly reported, most of whom were already deemed to have only a few months left to live. Some critiques argue that the estimates may be inflated or based on extrapolations from limited data, yet the consensus agrees that medical errors constitute a significant and preventable cause of death linked to failures within healthcare delivery systems.
How the leading causes of death in the US affect you as a physician
A patient’s health condition cannot be separated from their societal context and personal history. Understanding how systemic issues influence mortality rates is key to providing person-centered care that more accurately addresses their problems and prevents minor conditions from evolving into more problematic illnesses.
Physicians are uniquely positioned not only to diagnose and treat diseases but also to recognize the broader social determinants—such as poverty, education, housing, and access to care—that substantially impact patient health outcomes. By being alert to these factors during clinical encounters, physicians can offer interventions that extend beyond traditional medical treatment, facilitating access to community resources, advocating for patient needs, and tailoring care plans to fit the realities of their patients’ lives.
Knowledge of the social currents that underpin the leading causes of death should also compel physicians to support and advocate for public health policies that target overlooked factors and enable people to pursue healthier lifestyles.
Beyond individual patient care, physicians have an important leadership role in inspiring systemic change by raising awareness about social inequities in health, partnering with community organizations, and championing policies that reduce barriers to wellness and prevent premature deaths from chronic and preventable illnesses.
In essence, addressing the root causes of disease—including social and structural factors—is fundamental to advancing health equity, improving quality of care, and fulfilling the broader mission of medicine to relieve suffering across one’s lifespan.
Conclusion
To understand the mortality in America, you need a combination of cold, hard data and the grounded perspective of working physicians. While the findings from the CDC and other reputable organizations offer a good starting point, the gap between the numbers and what is being treated in medical practices on a daily basis shows that there is still work to be done to create a healthier environment for current and potential patients to thrive.
Sermo offers a community for physicians to discuss critical issues that affect their workplace with peers from around the world. Sign up today to join in on the conversation.
