​What Are Americans Dying From?

​​What Are Americans Dying From?

The Answer Depends on How We Read the Data.

I downloaded a national mortality file and began with a simple question: what are people in the United States dying from? I expected a straightforward ranking. Instead, I found a useful reminder that the way we arrange data can change the story we see. I used the CDC’s 2024 Multiple Cause of Death file, the latest final annual mortality public-use file listed when I checked in October 2026, and loaded it into a local database. My analysis includes 3,072,666 U.S.-resident deaths: 1,599,440 men and 1,473,226 women. Men and women here refer to sex recorded on death certificates.[1] Although the file can contain several conditions for one person, I started with just one: the underlying cause of death, meaning the disease or injury recorded as starting the chain of events that led to death. Each death is counted once.[3]

First look at individual causes

My first charts rank individual ICD-10 codes, the standardized codes used to classify causes of death. I deliberately kept them separate rather than combining cancers, heart conditions or other related diagnoses. Among women, “Alzheimer disease, unspecified” (G30.9) was the most frequent individual code, with 72,142 deaths. Among men, atherosclerotic heart disease (I25.1) came first, with 89,612. Lung cancer, recorded under C34.9, was second for men, with 64,336 deaths.

Figure 1 . Ten most frequent individual underlying-cause codes for men and women, ranked by death count.

The women’s result caught my attention. But “the most frequent individual code” is a narrower statement than “the leading cause of death.” Heart disease has several entries in these charts. Cancer is divided by site and other details. A category spread across many codes can look smaller when each piece stands alone.

Then ask at what age

Next, I took the same ten codes for each sex and sorted them by median age at death, from highest to lowest. The median is the middle age among people who died with that code recorded as the underlying cause. It is not an estimate of how long a person with that diagnosis can expect to live.

For men, unspecified Alzheimer disease and unspecified dementia both had a median age of 85. For women, unspecified dementia and the code labeled “senile degeneration of brain, not elsewhere classified” both had a median of 88; unspecified Alzheimer disease had a median of 87.

Figure 2. The same ten common codes, reordered by median age at death. These are not the ten highest-age causes selected from the whole database.

My first thought was a very human one: if we survive heart disease, cancer and other threats, does the brain eventually become one of our greatest vulnerabilities? The charts made me ask that question. They cannot answer it. A file of deaths does not tell us how many people of the same age were still alive, with or without dementia. It also does not establish that the brain has a fixed limit, that dementia is inevitable, or that it will happen to most of us. Even within these selected causes, old age is not unique to brain-related diagnoses. Congestive heart failure also had a median age of 87 among women. The age charts describe different patterns among people who died; they are not a timetable for what will happen to an individual.

Finally bring related causes together

For the third view, I used the CDC’s standard leading-cause groupings. All malignant cancers became one category, and the defined heart-disease codes became another. I selected the top ten separately for men and women from the standard rankable causes, avoiding overlapping parent categories and their components.[2]

The picture changed. Heart disease now led both lists: 376,875 deaths among men and 306,616 among women. Cancer was second, with 325,806 and 294,070, respectively. Unintentional injuries were third among men; stroke was third among women.

The bigger surprise for me was unintentional injuries, often labeled ‘accidents’: 129,755 deaths among men, making this the third-leading broad cause after heart disease and cancer. That is a lot of lives. Suicide, classified as intentional self-harm, also appeared in the top ten, ranking seventh with 38,977 deaths. But the accident total was more than three times as large.

Figure 3. Ten leading broad underlying-cause categories using standard NCHS ranking definitions.

These groupings also combine chronic lower respiratory diseases, diabetes, several kidney diseases, and influenza and pneumonia. The definitions matter: heart disease does not mean every circulatory condition, so stroke remains separate.

Dementia is another useful example. A broader dementia-related grouping using F01, F03, G30 and G31 yields 102,332 deaths among men and 196,860 among women. That is a separate editorial view, not the Alzheimer-only category in the standard charts. It would replace Alzheimer disease, not be added beside it, because that would count some deaths twice.[4]

What the accidents category includes

The accident category became even more revealing when I looked inside it. Among men, unintentional drug overdoses accounted for 51,753 deaths, almost 40% of the total, followed by transport injuries and falls. Among women, falls were the largest component: 23,830 deaths, or about 35% of all unintentional injury deaths. That deserves attention. But it does not necessarily mean women are more likely to fall: these figures count deaths, and differences in age and population size matter. Men actually had slightly more fall-related deaths, at 24,478. For me, the takeaway is that “accidents” hides very different problems, and fall prevention deserves a prominent place in the conversation about safety as we age.

Transport injuries include more than road crashes. The accidents category also includes other accidental poisonings, drowning, fires, threats to breathing and other injuries.

Figure 4. Unintentional injuries separated by mechanism, for men and women. Drug overdoses are part of the accidents total, not an additional category.

I would keep the standard broad ranking, then show this separate breakdown. It makes the overdose burden visible without counting those deaths twice. If we replace the accidents category, we need to split it into unintentional drug overdoses and all other unintentional injuries.

Only unintentional drug overdoses belong in this breakdown. Overdose deaths classified as suicide, homicide or undetermined intent fall outside the accidents category.[5]

What I take from this

The underlying records did not change. The questions did. Individual codes show the detail of how deaths were classified. Median ages add another dimension. Broader groups reveal a pattern that is harder to recognize when related diagnoses are scattered across separate entries.

There are limits to every view. Death certificates depend on what was recognized, documented and coded. These are counts, not age-adjusted rates, and they do not establish that a man and a woman of the same age face different risks. Nor do they tell the whole medical story of any one person.

For me, the practical lesson is to look beyond the first ranking. Before drawing a conclusion from a chart, ask what was counted, what was combined, and what information is still missing.

Sources and method

Analysis uses the final 2024 public-use file, December 8, 2025 revision, restricted to U.S. residents. One underlying cause per death; no multiple-cause mention counts. Unknown ages remain in death totals and are excluded from medians. Broad charts use the 52 standard NCHS rankable causes.

[1] CDC data portal and downloadable mortality files

[2] NCHS Deaths Leading Causes for 2024 and ranking definitions

[3] 2024 mortality public-use file documentation

[4] NCHS dementia code definition used for the optional grouping

[5] NCHS drug overdose classification by intent

Editorial note: The linked NCHS dementia report concerns ages 65 and older and is cited for its code definition, not for these counts.