This document is a supplement to “Data Brief: 2020 and 2021 Increases in Deaths in California (7.1.2022)”, and provides an update with data through 2022. The charts and tables below are through 2022 with text focusing on observations pertinent to 2022. Please see the original Data Brief for an overall summary, comments on 2020 and 2021 observations, detailed methods, conclusions, and a section of exploratory material.


Summary

New observations based on 2022 excess mortality data include:


Findings

Deaths were higher in 2020, 2021 and 2022 compared to 2019

Table 1 - Number, Age-Adjusted Rate, and Increase in Rate from Prior Year, Deaths from All Causes in California, 2017-2022

  • In 2022 there were 309,782 deaths in California (corresponding to an age-adjusted all-cause death rate of 624.8 per 100,000 population), a decrease of -9.0% from 2021.

Figure 1 - All-Cause Death Rate by Quarter and Year, California 2017-2022

  • In all quarters of 2022, the death rate was lower than the 2020 and 2021 pandemic period death rates. In quarters 1, 3, and 4, the 2022 rates were higher than the 2019 rate—in Quarter 2 it was similar to the 2019 rate.

Multi-line trend chart with one line for each year, 2017 to 2021; trend in all-cause age-adjusted death rate in California by quarter. This chart highlights the important seasonal pattern in deaths, and the increase in deaths in 2020 compared to the prior 3 years.



Deaths increased more among some race/ethnicity groups than others

Figure 2 - Percentage Increase in Race-Specific Age-Adjusted Death Rates 2019 to 2020/2021/2022

  • In 2022, the increase in death rate compared to the prepandemic baseline was lowest among Whites (2.8%) and ranged between 8% and 14% among the other racial/ethnic groups.

Bar chart; bars show percent increase in age-adjusted death rate for each race/ethnicity in California. This chart highlights disparities in the increases in deaths in 2020.



Figure 3a - Trends in All Cause Age-Adjusted Mortality Rate by Race/Ethnicity by Quarter, 2020/2021/2022 and 2017-2019 Average

Complex multi-line trend chart; quarterly trend in age-adjusted all cause death rate with two lines for each race/ethnic group, one for 2020-2021 and one for the average of 2017 to 2019. This chart highlights increasing differences in deaths rates within and between race/ethnic groups as 2020 progressed.



Figure 3b - Percentage Increase in Age-Adjusted Death Rate by Quarter, 2020/2021/2022 and 2017-2019 Average, by Race/Ethnicity

  • Reflecting the patterns above, with only a few exceptions, increases in 2022 for all racial/ethnic groups were smaller than the corresponding increases in 2020 and 2021.

  • However, there was a large increase among NH/PI (31.7%) in Quarter 1 of 2022 compared to the baseline.

  • Death rates decreased in Quarter 2 among Blacks (-1.8%), Native Hawaiian and Pacific Islanders (-7.9%), and Whites (-4.3%), and in Quarter 4 among Native Hawaiian and Pacific Islanders (-2.2%).

Grouped bar chart; groups are quarter 1 to 4 for each race/ethnic group, showing percentage increase in age-adjusted death rate from average rate of 2017 to 2019 to 2020 and 2021; This chart highlights differences in deaths rates within and between race/ethnic groups as 2020 progressed.


Causes of death other than COVID-19 also increased

Table 2 - 2017 to 2022, Selected Causes of Death, ordered by percent increase 2019 to 2022 [note: table is sortable]

  • Compared to 2019, increases in death rates of over 25% were seen for drug overdoses, malnutrition, obesity, homicide, and alcohol-related in 2022.

  • Compared to 2019, the absolute number of deaths increased by over 1,000 for Alzheimer’s disease, drug overdoses, ischemic heart disease, hypertensive heart disease, stroke, kidney diseases, alcohol-related, and diabetes in 2022.

  • Compared to 2019, deaths caused by hepatitis, COPD, pneumonia, influenza, lung cancer, and valve disorders all decreased by more than 10% in 2022.

Note: The criteria for inclusion in Table 2 changed from the original Data Brief. The data were first restricted to causes of death for which there were > 500 deaths in any year, 2017-2022. Then, among those causes, the data were restricted to causes that had among the top five relative (percent change in age-adjusted death rate) or absolute (change in number of deaths) increases, or among the bottom three relative or absolute decreases from 2019 to 2020, 2021, or 2022.




Figure 4 - Trends in Age-Adjusted Rates for Selected Causes of Death (log-y-axis), 2010-2022

  • Figure 4 below shows the trend from 2010 to 2022 of annual death rates for the causes with large increases noted above, and other selected leading causes of death.

  • Deaths from COVID-19 decreased sharply between 2021 and 2022, falling from the leading cause of death to the fourth leading.

  • Other notable 2022 trends include an encouraging leveling off of drug overdose deaths, and decreases in alcohol-related deaths and homicides.


The amount of increase in deaths, and conditions associated with the increase, differed substantially by age and race/ethnicity


Figure 5 - Percent Increase in Number of Deaths 2019 to 2020/2021/2022 by Age Group and Race/Ethnicity and Proportion of Increase due to COVID-19

  • Compared to the increases described previously for 2020 and 2021, many of the age and race/ethnicity specific changes are attenuated in 2022. For example, and possibly of particular note, the increase in deaths among Blacks ages 5-14 was much lower in 2022 than in prior years. While COVID-19 caused less deaths in 2022 compared to 2020 and 2021, it still led to increases in deaths of more than 20% from 2019 to 2022 among AI/AN 35-44 and 55-84, Asians 35-44 and 65-74, Latinos 25-84, and NH/PI 25-64 and 75-84.

Complex multi-panel horizontal stacked bar chart; shows percent increase in number of deaths by age group, with stacked bars representing deaths from COVID-19 versus all other causes, and panels for each race/ethnic group. This chart highlights important differences in increases in deaths by age, and by race, and that the cause of increases (COVID-19 versus other causes) differs by age.

Note: The “cause index” is, rather than a direct proportion, the ratio of the number of COVID-19 deaths in 2020, 2021, and 2022 to the total increase in deaths from 2019 to 2020, 2021, and 2022, and is truncated at 1.0. See the Methods section for details.
*For younger NH/PI and AI/AN age groups, the underlying number of deaths for 2019 and 2020, 2021 or 2022 is <25 so data are not shown
**25-34 year old AI/AN experienced an overall decrease in deaths, and had a small number of deaths from COVID-19