Adverse Mortality Trends have Increased the Number Bereaved in the United States

U.S. life expectancy plateaued since 2010 and declined in 2014-2017 and 2020–2021, increasing the gap between the United States and its peers. This analysis calculated U.S. trends in the number of individuals who lost a close kin, such as a mother, father, at least one sibling, or at least one child, and how the number of bereaved people changes under counterfactual mortality conditions. We found that adverse mortality in 2010–2019 and spikes in mortality in 2020–2021 resulted in a substantial increase in the number of individuals bereaved annually. Increases over time were especially large for individuals bereaved by sibling loss. If the United States had maintained its rates of mortality improvement from 2000–2009, about 2.7 million fewer people would have experienced at least one close-kin loss during 2010–2019. By 2021, the excess number of individuals who had ever been bereaved since 2010 had grown to 5.6 million. Considering single years, in 2019 alone 8.6% of all bereaved individuals—around 0.9 million people—would not have lost any close relative had the United States maintained its previous pace of mortality improvement. In 2021, the corresponding annual excess rose to 25%, or about 3.2 million individuals. Excess bereavement is similar when applying the concurrent rates of mortality improvement of countries like Japan and Switzerland. Decomposition analyses revealed that excess bereavement in the United States can be explained primarily by adverse mortality trends, rather than by differences in size or composition of the population at risk. Considering population health trends from the perspective of the number bereaved shifts the focus from individual deaths to their rippling effects on surviving family, at a population scale.