Reason Roundup

U.S. Saw Fewer Suicide Deaths in 2020 but More Drug Overdose Deaths

Plus: Safe deposit box seizures spawn lawsuit, at-home COVID-19 testing finally legal, and more...


Suicide was 11th leading cause of U.S. mortality in 2020. There was a lot of speculation last year that business shutdowns and stay-at-home orders associated with COVID-19 would cause suicide rates to spike. Now, new evidence published in The Journal of the American Medical Association (JAMA) suggests this prediction may have been wrong. In fact, the number of U.S. deaths by suicide seems to have been slightly lower in 2020 than it was in the four preceding years.

Last year saw 44,834 Americans kill themselves, according to provisional data from the National Center for Health Statistics (NCHS) and the National Vital Statistics System (NVSS). That's down from 47,511 in 2019, 48,344 in 2018, 47,173 in 2017, and 44,965 in 2016.

We do not know from the data in question whether the number of attempted suicides changed at all last year.

It's also worth noting that another category of so-called deaths of despair—drug overdose deaths—did increase significantly in 2020.

In total, the U.S. saw 3,358,814 deaths last year—up 17.7 percent from 2019—according to the provisional data. The 2020 numbers include 345,323 deaths from COVID-19, making the novel coronavirus the new third-leading cause of death.

Suicide was the 11th leading cause of death last year, having been pushed out of the top 10 by COVID-19.

"Cause-of-death data are based on the underlying cause of death, which is the disease or condition responsible for initiating the chain of events leading to death," notes JAMA. The provisional data it reported last week are "based on currently available death certificate data from the states to the NCHS as of March 21, 2021. Final mortality data will be available approximately 11 months after the end of the data year."

The leading U.S. cause of death last year remained heart disease, with 690,882 heart disease deaths last year. This number has been slowly but steadily ticking up over the past five years, from 633,842 heart disease deaths in 2015.

The second leading cause of death remained cancer, with slightly fewer cancer deaths last year than in 2017–2019. The provisional data list 598,932 cancer deaths last year.

Unintentional injuries were the fourth leading cause of U.S. mortality in 2020—with 192,176 deaths last year, up from 173,040 in 2019. "Increases in unintentional injury deaths in 2020 were largely driven by drug overdose deaths," according to the JAMA analysis.

These were followed by stroke (159,050 deaths), chronic lower respiratory diseases (151,637 deaths), Alzheimer's disease (133,382 deaths), diabetes (101,106 deaths), influenza and pneumonia (53,495), and kidney disease (52,260 deaths).

"Most of the increase in deaths from 2019 to 2020 was directly attributed to COVID-19. However, increases were also noted for several other leading causes of death," note the JAMA researchers.

These increases may indicate, to some extent, underreporting of COVID-19, ie, limited testing in the beginning of the pandemic may have resulted in underestimation of COVID-19 mortality.6 Increases in other leading causes, especially heart disease, Alzheimer disease, and diabetes, may also reflect disruptions in health care that hampered early detection and disease management.

In other news related to COVID-19 and mortality: New estimates from the Centers for Disease Control and Prevention (CDC) suggest the virus is deadlier than previous estimates let on.

"According to the 'best estimate' in the most recent version of the CDC's COVID-19 Pandemic Planning Scenarios, 9 percent of people 65 or older who are infected by the COVID-19 virus die from the disease," notes Reason's Jacob Sullum.

The estimated infection fatality rates (IFRs) for other age groups are much lower but still generally higher than the numbers the CDC was using prior to March 19.

The estimated IFR is 0.002 percent for people 17 or younger, 0.05 percent for 18-to-49-year-olds, and 0.6 percent for 50-to-64-year-olds. The CDC's prior estimates used somewhat different age groups, which makes direct comparisons tricky. But the estimated IFR for the oldest age group has risen dramatically, from 5.4 percent for 70+ to 9 percent for 65+.

The new estimates are also higher for the second-oldest group (0.6 percent for 50-to-64-year-olds now vs. 0.5 percent for 50-to-69-year-olds previously) and the second-youngest group (0.05 percent for 18-to-49-year-olds vs. 0.02 percent for 20-to-49-year-olds). The new estimate for the youngest age group is lower (0.002 percent for 17 or younger vs. 0.003 percent for 19 or younger), but that may reflect the lower cutoff.


FBI goes on fishing expedition at safe-deposit box store. Concerned about the possibly illegal contents in some safe deposit boxes at Beverly Hills-based U.S. Private Vaults, the FBI and Drug Enforcement Agency (DEA) raided the whole place and seized the contents of every safe deposit box there. The move has already set off a (much-deserved) legal battle. "Earlier this week, one customer went to court claiming that the government overreached by confiscating the belongings in every security box without showing why it suspected each person of committing crimes," notes the Los Angeles Times.


FDA finally legalizes at-home COVID-19 testing. The U.S. Food and Drug Administration could have helped save a lot of lives last year. Instead…


• Pediatricians are speaking out against an Arkansas law that will ban hormone therapy and gender confirmation procedures for anyone under age 18. The Libertarian Party of Arkansas has also condemned the measure, saying it "steps all over the doctor-patient-parent relationship."

• California teachers unions say members need free child care in order to go back to work in person. "The demand is salt in the wound for parents who struggled with distance learning at home amid intense reopening negotiations that have dragged on for a year," writes Mackenzie Mays at Politico.

• Never underestimate New York City's nanny state capabilities:

• "Wartime rationing changed how America ate for a century," notes Reason's Liz Wolfe. Will the pandemic do the same?

• "New York Gov. Andrew Cuomo and state lawmakers are nearing a budget agreement that would increase corporate and income taxes by $4.3 billion a year and would make top earners in New York City pay the highest combined local tax rate in the country," The Wall Street Journal reports. "Legislators were briefed on a plan under which income-tax rates would rise to 9.65% from 8.82% for single filers reporting more than $1 million of income and joint filers reporting more than $2 million, the people said."

Reason's Ron Bailey explores "the therapeutic possibilities of mRNA technology," which "extend beyond infectious diseases and cancers."

The Washington Post takes us "inside the Teen Vogue mess."

• Conor Friedersdorf interviews Ndona Muboyayi, one of the parents leading the charge against anti-racism curriculum in Evanston, Illinois.

• All culture war, all the time (sighhhhhh):