Decrease in U.S. mortality levels

Births in 2023 began to outpace deaths in over half of U.S. states as mortality declined, inching closer to pre-pandemic levels, according to U.S. Census Bureau population estimates released Dec. 19. 

By July 1, 2023, natural change had rebounded slightly with only 19 states experiencing natural decrease, according to provisional data. The South and the Northeast returned to being the regions with the most states with more deaths than births, although the levels were still much lower than during the two previous periods.

Natural increase (more births than deaths) had been on the decline since 2020 and more states had natural decrease (more deaths) in the first years of the decade than at any point in the 2010s, driven largely by mortality hikes combined with smaller decreases in births. 

Areas with large older populations often experience natural decrease and shrinking populations in the absence of migration. 

Prior to 2020, natural increase for the U.S. hovered around 1M per year. It began declining in 2020 but this national trend obscured widespread natural decrease at the state level since the beginning of the decade. 

In the 2010s, only four states (Maine, New Hampshire, Vermont and West Virginia) consistently had more deaths than births. 

But from 2020-21 and 2021-22, half of all states experienced natural decrease. While 19 states rebounded slightly, 15 - mostly in the South - experienced natural decrease during all estimate-periods between April 1, 2020 (Census Day) and July 1, 2023.

Six states switched from having natural decrease to increase: Arizona, Louisiana, Oklahoma, Tennessee, Wisconsin and Wyoming. The change was driven by a decrease in mortality in these states of at least 10% (except in Wisconsin where it was approximately 8%).

Fifteen states had natural decrease during all four periods between April 1, 2020, and June 30, 2023: Nearly half were in the South: Alabama, Delaware, Florida, Kentucky, Mississippi, South Carolina and West Virginia. (Census Bureau 12/19/23) Continued Decrease in Mortality Brings Natural Increase Closer to Pre-Pandemic Levels (census.gov)