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While COVID-19 in 2021 was again the third leading cause of death in the U.S., racial and ethnic disparities narrowed from the year before, provisional CDC data indicated.

Overall, 65.2% of the COVID-19 deaths in 2021 were among white individuals, 16.5% were among Hispanic individuals, and 13.3% were among Black individuals. In 2020 these proportions were 59.6%, 18.6%, and 16.1%, respectively, reported Benedict Truman, MD, of the CDC and COVID-19 Emergency Response Team, and colleagues in the .

From 2020 to 2021, respectively, a number of racial and ethnic groups saw decreases in COVID-19-related age-adjusted death rates (AADRs):

• Hispanic: 155.5 vs 153.7 per 100,000
• Black/African American: 142.0 vs 133.4
• Asian: 63.1 vs 61.9

However, AADRs from 2020 to 2021 were higher among white individuals (66.6 to 90.0 per 100,000), American Indian/Alaska Native persons (175.9 to 182.5), and non-Hispanic Native Hawaiian and other Pacific Islander individuals (112.4 to 189.2).

Thus, although the slew of public health strategies that had been implemented to address racial and ethnic disparities in COVID seem to have paid off -- by helping local communities with COVID surveillance, isolation, contact tracing, mobile diagnostic testing, vaccination, and outpatient treatment, for example -- the researchers emphasized that disparities still persist.

Indeed, a , published in the same issue of MMWR, found both COVID-specific and total death rates in 2021 were highest among individuals 85 and older, as well as males and non-Hispanic American Indian, Alaska Native, and Black people.

Farida Ahmad, MPH, of the CDC, and colleagues reported that COVID death rates in 2021 trailed only heart disease, responsible for 693,000 deaths, and cancer, which took roughly 605,000 lives. COVID-19 stayed the third leading cause of death for the second year in a row, according to provisional mortality data collected from death certificates.

Behind the top three causes of death were unintentional injuries, stroke, chronic lower respiratory diseases, Alzheimer's disease, diabetes, kidney disease, and suicide. Unintentional injuries was a category largely driven by drug overdose deaths, which led to a disproportionate increase in the deaths among younger people.

According to the CDC's National Vital Statistics System, roughly 75,000 more people died from COVID in 2021 versus 2020. For deaths that listed COVID-19 as the sole cause or a contributing cause, this number increased from 384,536 in 2020 to 460,513 in 2021.

In total, the AADR increased by 0.7% from 2020 to 2021, jumping from 3,383,729 to 3,458,697 total deaths. The death rate peaked during the second half of January and during the beginning half of September.

Both studies from Truman and Ahmad's groups relied on provisional mortality data for the year 2021.

"Provisional death estimates can give researchers and policymakers an early projection of shifts in mortality trends and provide actionable information sooner than do the final mortality data, which are released approximately 11 months after the end of the data year," Ahmad and colleagues wrote, noting that these numbers can now help guide public health policies and interventions to help curb the rising death rate.

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