Reinsurance Group of America (RGA) has reported that US all-cause excess mortality fell to 0.4% in 2024, down from 3.2% in 2023 and well above levels seen during the peak of the COVID‑19 pandemic.
The company said the return toward pre-pandemic mortality levels reflects, in part, milder influenza seasons in 2023-2024 and 2024-2025 that did not peak within the 2024 calendar year.
The estimates are based on an updated expected baseline that replaces pre-pandemic trend projections with long-term improvement rates (LTRs) derived from data between 1933 and 2023.
The analysis also incorporates revised US Census Bureau intercensal population estimates from 2010 to 2020. These adjustments had a notable impact on excess mortality figures in older age categories.
Among adults aged 25 to 44, mortality trends reversed in 2024 following a decade of worsening outcomes tied to drug overdoses and other external factors. RGA reported that excess mortality for this group was -1.9% for females and -1.7% for males, approaching figures last observed in 2019.
In the 45 to 59 age range, excess mortality continued to be driven by cardiovascular, metabolic, and cancer-related conditions, though COVID-19 played a diminished role compared to prior years. The 2024 estimates were 2.5% for females and 4.0% for males, reflecting improvement from 2023 levels.
Adults aged 60 to 74 also showed signs of normalization, though mortality remained slightly above historical expectations. Excess mortality was reported at 3.9% for females and 2.6% for males.
For individuals aged 75 to 84, COVID-19 remained a significant mortality contributor. Cancer deaths, particularly among women, were also noted as a factor – possibly due to delayed screenings during the pandemic. Excess mortality in 2024 was 1.5% for females and –0.8% for males. Both sexes recorded average annual death rates (AADRs) below 2020 figures.
The 85-and-older population, historically the most affected by COVID-19, experienced a pronounced decline in excess mortality. Revised census estimates significantly altered past figures, and in 2024, excess mortality was -0.2% for females and -4.9% for males. Male AADRs were the lowest on record.
RGA’s global chief risk officer previously outlined how systemic risks amplified during the pandemic continue to reshape the industry’s risk landscape. Events such as geopolitical conflict, economic volatility, climate extremes, and the rise of generative artificial intelligence have all highlighted the need for insurers to adapt beyond traditional risk pooling models.
RGA emphasized that addressing insurability challenges – such as those posed by cyber, longevity and natural catastrophe risks – will require updated governance frameworks and innovative product solutions.
Meanwhile, separate analysis from Swiss Re Institute also suggests that elevated excess mortality could remain persistent through at least 2033.
In a pessimistic scenario, projections indicate excess mortality in the US could stay as high as 3%, and around 2.5% in the UK, underscoring the ongoing demographic and health-related shifts that may affect long-term pricing and reserving strategies.
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