{
  "alt": "Line chart of the observed national overdose death rate and the 2019 rate held constant, from 2018 to 2024. The observed line is below the flat line in 2018, rises well above it from 2020 to 2023, peaks in 2022 and is still above it in 2024. The area between the two lines from 2020 to 2024 is shaded.",
  "caption": "The shaded area between the lines is the excess: it opens in 2020, is widest in 2021 and 2022 and is still open in 2024, when the excess is {fact:x_od_24} deaths. The 2018 rate is below the 2019 rate, so the benchmark starts after a year of rise. Each total sums observed deaths minus the 2019 crude rate times the year's population over 2020 to 2024, with a 95% interval that treats the counts as Poisson. It is arithmetic and not an estimate of deaths caused by anything. The tabs switch to alcohol-induced deaths and to suicide.",
  "data": [
    {
      "cause": "Overdose",
      "rate": 20.591,
      "series": "Observed",
      "year": 2018
    },
    {
      "cause": "Overdose",
      "rate": 21.5178,
      "series": "At the 2019 rate",
      "year": 2018
    },
    {
      "cause": "Overdose",
      "rate": 21.5178,
      "series": "Observed",
      "year": 2019
    },
    {
      "cause": "Overdose",
      "rate": 21.5178,
      "series": "At the 2019 rate",
      "year": 2019
    },
    {
      "cause": "Overdose",
      "rate": 27.8614,
      "series": "Observed",
      "year": 2020
    },
    {
      "cause": "Overdose",
      "rate": 21.5178,
      "series": "At the 2019 rate",
      "year": 2020
    },
    {
      "cause": "Overdose",
      "rate": 32.1485,
      "series": "Observed",
      "year": 2021
    },
    {
      "cause": "Overdose",
      "rate": 21.5178,
      "series": "At the 2019 rate",
      "year": 2021
    },
    {
      "cause": "Overdose",
      "rate": 32.3867,
      "series": "Observed",
      "year": 2022
    },
    {
      "cause": "Overdose",
      "rate": 21.5178,
      "series": "At the 2019 rate",
      "year": 2022
    },
    {
      "cause": "Overdose",
      "rate": 31.3533,
      "series": "Observed",
      "year": 2023
    },
    {
      "cause": "Overdose",
      "rate": 21.5178,
      "series": "At the 2019 rate",
      "year": 2023
    },
    {
      "cause": "Overdose",
      "rate": 23.3406,
      "series": "Observed",
      "year": 2024
    },
    {
      "cause": "Overdose",
      "rate": 21.5178,
      "series": "At the 2019 rate",
      "year": 2024
    },
    {
      "cause": "Alcohol-induced deaths",
      "rate": 11.4098,
      "series": "Observed",
      "year": 2018
    },
    {
      "cause": "Alcohol-induced deaths",
      "rate": 11.8947,
      "series": "At the 2019 rate",
      "year": 2018
    },
    {
      "cause": "Alcohol-induced deaths",
      "rate": 11.8947,
      "series": "Observed",
      "year": 2019
    },
    {
      "cause": "Alcohol-induced deaths",
      "rate": 11.8947,
      "series": "At the 2019 rate",
      "year": 2019
    },
    {
      "cause": "Alcohol-induced deaths",
      "rate": 14.8902,
      "series": "Observed",
      "year": 2020
    },
    {
      "cause": "Alcohol-induced deaths",
      "rate": 11.8947,
      "series": "At the 2019 rate",
      "year": 2020
    },
    {
      "cause": "Alcohol-induced deaths",
      "rate": 16.348,
      "series": "Observed",
      "year": 2021
    },
    {
      "cause": "Alcohol-induced deaths",
      "rate": 11.8947,
      "series": "At the 2019 rate",
      "year": 2021
    },
    {
      "cause": "Alcohol-induced deaths",
      "rate": 15.3594,
      "series": "Observed",
      "year": 2022
    },
    {
      "cause": "Alcohol-induced deaths",
      "rate": 11.8947,
      "series": "At the 2019 rate",
      "year": 2022
    },
    {
      "cause": "Alcohol-induced deaths",
      "rate": 14.3135,
      "series": "Observed",
      "year": 2023
    },
    {
      "cause": "Alcohol-induced deaths",
      "rate": 11.8947,
      "series": "At the 2019 rate",
      "year": 2023
    },
    {
      "cause": "Alcohol-induced deaths",
      "rate": 13.7349,
      "series": "Observed",
      "year": 2024
    },
    {
      "cause": "Alcohol-induced deaths",
      "rate": 11.8947,
      "series": "At the 2019 rate",
      "year": 2024
    },
    {
      "cause": "Suicide",
      "rate": 14.7765,
      "series": "Observed",
      "year": 2018
    },
    {
      "cause": "Suicide",
      "rate": 14.4745,
      "series": "At the 2019 rate",
      "year": 2018
    },
    {
      "cause": "Suicide",
      "rate": 14.4745,
      "series": "Observed",
      "year": 2019
    },
    {
      "cause": "Suicide",
      "rate": 14.4745,
      "series": "At the 2019 rate",
      "year": 2019
    },
    {
      "cause": "Suicide",
      "rate": 13.9548,
      "series": "Observed",
      "year": 2020
    },
    {
      "cause": "Suicide",
      "rate": 14.4745,
      "series": "At the 2019 rate",
      "year": 2020
    },
    {
      "cause": "Suicide",
      "rate": 14.5176,
      "series": "Observed",
      "year": 2021
    },
    {
      "cause": "Suicide",
      "rate": 14.4745,
      "series": "At the 2019 rate",
      "year": 2021
    },
    {
      "cause": "Suicide",
      "rate": 14.8448,
      "series": "Observed",
      "year": 2022
    },
    {
      "cause": "Suicide",
      "rate": 14.4745,
      "series": "At the 2019 rate",
      "year": 2022
    },
    {
      "cause": "Suicide",
      "rate": 14.7249,
      "series": "Observed",
      "year": 2023
    },
    {
      "cause": "Suicide",
      "rate": 14.4745,
      "series": "At the 2019 rate",
      "year": 2023
    },
    {
      "cause": "Suicide",
      "rate": 14.3553,
      "series": "Observed",
      "year": 2024
    },
    {
      "cause": "Suicide",
      "rate": 14.4745,
      "series": "At the 2019 rate",
      "year": 2024
    }
  ],
  "id": "excess_deaths",
  "notes": [
    "The benchmark ignores the rise in the overdose and alcohol-induced rates before 2019 (the 2018 rates were {fact:w_od_b18} and {fact:w_alc_b18} below the 2019 rates) and any change in the age structure of the population, since the rates are crude. A different benchmark gives a different total.",
    "WONDER's national population estimate for 2024 comes from a new vintage and grows {fact:pop_g24} over 2023, which lowers the 2024 rates and the 2024 excess.",
    "North Carolina amended many 2023 overdose death certificates after WONDER's final 2023 file, so WONDER's 2023 overdose counts for that state, and the 2023 overdose points built from them, are low. The 2023 excess for overdose is therefore low."
  ],
  "source": "CDC WONDER underlying cause of death, 2018-2024; crude rates, full counts",
  "spec": {
    "annotations": [
      {
        "label": "First pandemic year",
        "type": "x-rule",
        "x": 2020
      }
    ],
    "colors": {
      "At the 2019 rate": "muted",
      "Observed": "overdose"
    },
    "dashed": [
      "At the 2019 rate"
    ],
    "gap": {
      "between": [
        "Observed",
        "At the 2019 rate"
      ],
      "label": "Deaths above the 2019 rate"
    },
    "series": "series",
    "x": "year",
    "xDomain": [
      2018,
      2024
    ],
    "xLabel": "Year",
    "xTicks": "data",
    "y": "rate",
    "yDomain": [
      0,
      36
    ],
    "yFormat": {
      "digits": 1
    },
    "yLabel": "Deaths per 100,000 residents"
  },
  "subtitle": "Observed national crude death rate per 100,000 residents and the 2019 rate held constant, United States, 2018 to 2024",
  "title": "From 2020 to 2024 the United States had {fact:x_od_total} more overdose deaths than a flat 2019 rate gives",
  "type": "line",
  "views": [
    {
      "filter": {
        "cause": "Overdose"
      },
      "id": "overdose",
      "label": "Overdose"
    },
    {
      "caption": "The excess opens in 2020, is widest in 2021 and is still open in 2024, when it is {fact:x_alc_24} deaths. The 2018 rate is below the 2019 rate. Each total sums observed deaths minus the 2019 crude rate times the year's population over 2020 to 2024, with a 95% interval that treats the counts as Poisson.",
      "filter": {
        "cause": "Alcohol-induced deaths"
      },
      "id": "alcohol",
      "label": "Alcohol-induced deaths",
      "spec": {
        "colors": {
          "At the 2019 rate": "muted",
          "Observed": "alcohol"
        },
        "yDomain": [
          0,
          20
        ]
      },
      "title": "From 2020 to 2024 the United States had {fact:x_alc_total} more alcohol-induced deaths than a flat 2019 rate gives"
    },
    {
      "caption": "The observed rate is below the 2019 level in 2020 and 2024 and above it in 2021 to 2023, so the shaded areas on the two sides nearly cancel. The total has a 95% interval that treats the counts as Poisson.",
      "filter": {
        "cause": "Suicide"
      },
      "id": "suicide",
      "label": "Suicide",
      "spec": {
        "colors": {
          "At the 2019 rate": "muted",
          "Observed": "suicide"
        },
        "yDomain": [
          0,
          20
        ]
      },
      "title": "Suicide deaths from 2020 to 2024 differ from the number a flat 2019 rate gives by {fact:x_su_total}, an interval that includes zero"
    }
  ],
  "width": "wide"
}