A comparative analysis of the most common causes of mortality and substance use by age

Public Health. 2026 May 20;257:106306. doi: 10.1016/j.puhe.2026.106306. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare cause-specific mortality patterns between US youth and adults in 2022, with emphasis on alcohol- and drug-involved deaths.

STUDY DESIGN: Cross-sectional descriptive analysis of national mortality records.

METHODS: We analyzed 2022 national mortality data from the CDC’s restricted-use Multiple Cause of Death files. Deaths were stratified into youth (10-24 years) and adults (≥25 years). Cause categories were identified using ICD-10 codes across all multiple cause fields. We calculated crude mortality rates and proportional mortality distributions, estimated proportional odds ratios (pORs) comparing the distribution of causes between youth and adults with 95% confidence intervals.

RESULTS: There were 39,271 youth deaths (rate: 60.0 per 100,000) and 3,222,599 adult deaths (rate: 1402.9). Among youth, unintentional injuries (40%) and suicide (17%) predominated, whereas adults were dominated by heart disease (22%) and cancer (19%). Overall, 20% of youth deaths involved alcohol or drugs compared with 6% of adult deaths. Substance involvement ranked second by share among youths versus sixth among adults.

CONCLUSIONS: Youth mortality is disproportionately driven by preventable external causes, frequently involving alcohol and drugs. Targeted prevention addressing substance use, injury reduction, and mental health is critical to reducing premature deaths.

PMID:42160945 | DOI:10.1016/j.puhe.2026.106306