U.S. life expectancy hits record high in 2024 as overdose deaths plunge, CDC says

On a humid August night in Dayton, Ohio, paramedics found a 24-year-old man slumped on a bathroom floor, not breathing. A few years ago, a call like that might well have ended in a death certificate. This time, a $35 nasal spray made the difference.

“We gave two doses of naloxone, and within a minute he was breathing and talking,” said Lt. Marcus Hall, a Dayton Fire Department paramedic supervisor. “Five years ago, we were seeing multiple fatal overdoses in a shift. Now we’re seeing more saves.”

Scenes like that are playing out across the country, and new federal data suggest they are adding up to something once thought years away: a clear reversal in America’s mortality crisis.

New figures from the Centers for Disease Control and Prevention show that U.S. life expectancy at birth climbed to 79.0 years in 2024, the highest level ever recorded and above its pre-pandemic peak. The age-adjusted death rate fell nearly 4% from the year before, and deaths from drug overdoses dropped by more than a quarter, the steepest decline in at least a decade.

At the same time, COVID-19 fell out of the nation’s 10 leading causes of death for the first time since 2019. Suicide moved into the 10th spot, underscoring how the country’s health threats are shifting even as overall numbers improve.

“Life expectancy in the United States has not only recovered from the declines seen during the COVID-19 pandemic, it has reached a new high,” the CDC’s National Center for Health Statistics said in a Jan. 29 data brief. The agency called the 26% fall in the drug overdose death rate “the largest decline ever recorded” in its recent series.

A record high after pandemic whiplash

The new life expectancy figure — 79.0 years for a baby born in 2024 — represents a gain of 0.6 years from 2023 and 0.2 years above 2019, the last full year before COVID-19.

Women can now expect to live 81.4 years on average, up from 81.1. For men, life expectancy rose to 76.5 years, a larger increase than for women and one that narrowed the gender gap in longevity to 4.9 years.

The overall age-adjusted death rate fell from 750.5 to 722.1 deaths per 100,000 people, a 3.8% drop. The number of deaths declined as well, from about 3.09 million in 2023 to 3.07 million in 2024.

Those improvements cap a wild six-year swing. Life expectancy stood at 78.8 years in 2019, plunged to 77.0 in 2020 and bottomed out at 76.4 in 2021, the lowest level since the mid-1990s. COVID-19 briefly became the nation’s third leading cause of death, and drug overdoses and other injuries surged.

By 2022 and 2023, as vaccines spread and treatments improved, life expectancy began to climb back. The 2024 figures mark the first time it has clearly surpassed its pre-COVID level.

Still, the United States remains an outlier among wealthy nations. Countries such as Japan, Spain and Italy routinely report life expectancies above 82 or 83 years, and the new U.S. record does not close that gap.

The overdose death rate drops off a cliff

The most dramatic shift in the 2024 data involves drug overdoses, which had driven much of the country’s midlife mortality problem in the years before and during the pandemic.

The age-adjusted overdose death rate fell from 31.3 deaths per 100,000 people in 2023 to 23.1 in 2024, a 26.2% decline. The number of overdose deaths dropped to 79,384.

Opioids, particularly illicit fentanyl and related synthetic drugs, accounted for most of that shift. Deaths involving any opioid fell sharply, and the death rate tied to synthetic opioids other than methadone — a category dominated by fentanyl — declined by more than a third.

Overdose death rates fell for every major age group. Young adults saw some of the largest improvements: among people 15 to 24, the rate dropped by about 37%, and among those 25 to 34, by a third. Rates also declined for both men and women and across all major racial and ethnic groups, including Black, white, Hispanic, American Indian and Alaska Native, and Asian Americans.

Even with those gains, overdose deaths remain far higher than they were a decade ago. In 2014, the overdose death rate was 14.7 per 100,000. In 2019, it was 21.6.

Public health officials and outside researchers point to a combination of factors behind the sudden downturn.

One is the drug supply itself. A recent study published in the journal Science, described by The Washington Post, linked part of the U.S. overdose decline to stepped-up enforcement in China against chemical companies that produce the precursor ingredients used to make fentanyl. Those actions appear to have disrupted supply chains, lowering the purity and availability of fentanyl in U.S. street markets.

Another factor is the wider reach of overdose reversal and addiction treatment tools.

The Food and Drug Administration has approved several versions of naloxone, an emergency medication that can rapidly reverse an opioid overdose, for over-the-counter sale. States and local governments have spent opioid settlement funds and federal grants to place naloxone in the hands of police, firefighters, librarians, teachers, families and drug users themselves.

At the same time, telehealth flexibilities adopted during the pandemic have made it easier for people with opioid use disorder to start and maintain medications such as buprenorphine and methadone, which studies have found can cut the risk of a fatal overdose by more than half.

“None of this is an accident,” said Regina LaBelle, a former acting director of the White House Office of National Drug Control Policy who now directs an addiction policy program at Georgetown University. “We’ve seen investments in harm reduction, in treatment, in data systems, and now we’re finally seeing them reflected in the mortality numbers.”

COVID-19 retreats, suicide enters the top 10

The reshuffling of the country’s leading causes of death may be the most visible symbol of how the pandemic’s grip has loosened — and of the problems that remain.

Heart disease and cancer were once again the top two killers in 2024, together accounting for more than two in five deaths. Unintentional injuries, a category that includes overdoses and traffic crashes, stayed in third place, though its death rate fell by more than 14%.

COVID-19, which ranked as the third leading cause of death at the height of the pandemic and 10th in 2023, dropped to 15th in 2024. Underlying-cause COVID deaths fell from 49,932 to 31,426, a 37% decline, as widespread immunity, antiviral drugs and less severe variants blunted the virus’s toll.

Suicide moved into the 10th spot, with 48,824 deaths. That shift does not reflect a surge in suicide deaths last year; the age-adjusted suicide rate actually declined slightly, from 14.1 to 13.7 per 100,000, and there were about 500 fewer deaths than in 2023.

Instead, suicide’s new rank reflects its stubborn persistence at historically high levels even as other major causes of death — from COVID to overdoses to chronic illnesses — improved more quickly.

Suicide remains one of the leading causes of death among teenagers and young adults. The CDC has estimated that, in recent years, nearly 50,000 Americans have died by suicide annually — “one every 11 minutes,” as the agency has put it.

Federal and state officials have tried to expand crisis services. In 2022, the Substance Abuse and Mental Health Services Administration and the Federal Communications Commission launched the 988 Suicide & Crisis Lifeline, a three-digit number intended to be as easy to remember as 911. The Department of Veterans Affairs has promoted a dedicated 988 extension for veterans, and many large health systems have adopted universal screening for suicidal thoughts.

But access to mental health care remains uneven, especially in rural areas, and debates over firearm policy and support for vulnerable groups, including LGBTQ+ youth, continue to shape the field.

Gains are broad, but uneven

The 2024 mortality improvements were not limited to overdoses and COVID-19. Age-adjusted death rates declined for all 10 of the leading causes of death, including heart disease, cancer, stroke, chronic lower respiratory diseases, Alzheimer’s disease, diabetes, kidney disease and chronic liver disease and cirrhosis.

Deaths fell for nearly every age group older than 1 year. The largest percentage declines in all-cause death rates occurred among people 15 to 54 years old.

Every major racial and ethnic group saw statistically significant decreases in overall mortality. Black and American Indian and Alaska Native Americans, who experienced some of the most severe pandemic-era losses, registered some of the largest percentage improvements in 2024. Yet their age-adjusted death rates remained higher than those of white and Asian Americans.

Infant mortality edged down from 560.2 to 552.5 deaths per 100,000 live births, a change CDC statisticians did not consider meaningful. That stagnation points to continuing problems in maternal and child health that the overall life expectancy figure can obscure.

“This is very good news, and it’s important to acknowledge that,” said Ellen Meara, a health economist at Dartmouth College who studies mortality trends. “But the U.S. still lags similar countries, and the benefits of this rebound are not being shared equally. We’re seeing improvement layered on top of longstanding inequities.”

A turning point with uncertain staying power

The latest CDC numbers arrive as policymakers in Washington and state capitals debate the future of many of the interventions that may be driving the mortality gains.

Some pandemic-era telehealth rules that made it easier to prescribe buprenorphine are set to expire unless Congress or federal agencies extend them. States are still deciding how to spend billions of dollars from opioid settlements with drugmakers, distributors and pharmacies, with advocates pressing for those funds to go toward proven prevention and treatment programs rather than general budget gaps.

Funding for 988 call centers, community mental health clinics and public health departments remains subject to annual appropriations and state politics.

Experts warn that the drug supply could shift again as traffickers adapt to enforcement and chemical controls. New synthetic substances have periodically emerged in response to crackdowns on earlier drugs. Economic downturns, policy changes or new infectious threats could also alter the trajectory of deaths from chronic illnesses, injuries and suicide.

For now, though, the data show a country that is, on average, living longer and dying less often than it did just a few years ago — and one where a late-night overdose call that once meant another loss can increasingly end with a second chance.

“We’re not out of the woods,” Hall, the Dayton paramedic, said. “But compared to where we were at the height of the fentanyl wave and COVID, it finally feels like we’re moving in the right direction.”