DENVER — Older Coloradans have mostly recovered from a pandemic-era increase in death rates, but middle-aged people continue to die younger than expected, mostly from overdoses.

In the long run, everyone dies, but state health officials watch how death rates compare to what they’d expect based on the size of the population and the mix of ages within it. If younger people are dying in higher numbers than normal, it tells them that something has gone wrong.

Death rates shot up in 2020 and 2021 as COVID-19 and an increasingly dangerous illicit drug supply took out Coloradans at rates not seen in decades. They started to fall again over the following two years, but not back to their 2019 levels.

That pattern continued last year: six of the top 10 causes of death killed fewer people in 2024 than in 2023, according to newly finalized state data.

After adjusting for population growth and aging, death rates from cancer and Alzheimer’s disease also went down. The suicide death rate remained unchanged, after adjustment, while the diabetes death rate ticked up.

Most age groups are still above their pre-pandemic rates, after adjusting for population growth, though.

For people over 55, the difference is relatively small: death rates are within 3.5% of what they were in 2019. In their cases, reductions in deaths from cancer, heart disease, certain lung conditions and Alzheimer’s disease mostly offset increased mortality from overdoses, alcohol-related complications and, for the oldest Coloradans, malnutrition.

Physicians and coroners have gradually shifted away from ascribing deaths to “old age” or “failure to thrive,” and malnutrition is one of the causes they increasingly use to be more precise, according to the Colorado Department of Public Health and Environment.

Middle-aged people fared worse. The death rate in Colorado last year was still about 22% above 2019 levels for people between 35 and 44, and 11% higher for people in the 45 to 54 age group. Drug overdoses were the primary driver of increased deaths for both groups, though they did trend down last year.

The picture was more mixed for children and the youngest adults. Death rates went up for most groups under 25 from 2023 to 2024, with the exception of youth between 15 and 18. Those older teens had lower death rates than they did before the pandemic, as did infants, while the 1 to 14 group and adults under 25 had higher rates.

For children and younger teens, homicide and traffic accidents kept their death rates above pre-pandemic levels, while for adults under 25, the biggest contributors were transportation accidents and overdoses.

Death rates tend to fluctuate for people between 1 and 24, while infant deaths are more stable, according to the state health department. The causes of infant mortality, such as premature birth, don’t change as drastically from year to year as do accidents, homicide and suicide, which are the leading killers of children and teens, the agency said in a statement.

Nationwide, “deaths of despair” – those caused by drugs, alcohol or suicide – peaked in 2021 and began to gradually fall over the next two years, with preliminary data suggesting a more significant improvement in 2024.

Overdose deaths, nationally and in Colorado, especially dropped among young people, perhaps reflecting that teenagers are reporting less opioid use. Another possibility is that, since overdoses among teens already were uncommon, normal fluctuation produced seemingly dramatic changes, according to the state health department.

“Despite promising decreases in overdose deaths appearing in nationwide data, thousands of people across the country are still dying from preventable overdoses,” said Kirk Bol, manager of the state health department’s vital statistics program. “As the illicit drug supply continues to evolve, it remains essential to provide individuals with factual drug information and encourage engagement in proven public health strategies.”

But a reduction in deaths doesn’t necessarily point to fewer people using drugs or having nonfatal overdoses — it could simply reflect that friends or bystanders are more likely to have naloxone on hand to revive the victims than in previous years, said Dr. Anuj Mehta, a pulmonologist and critical care physician at Denver Health.

Younger people are more likely to survive an overdose, because their organs are generally healthier and better able to recover even if they went without oxygen for a time, he said.

Naloxone is likely an important contributor to the drop in deaths, and communities need to keep working to get it to the people who could help prevent an overdose from becoming a fatality, Mehta said. But ultimately, the way out of the overdose crisis is to help people get treatment for the addictions and mental health conditions that push them to take the risk of using illicit drugs, he said.

“We need to think broadly about mental health,” he said. “The data shows that deaths are decreasing, but it doesn’t show substance use is decreasing.”

©2025 MediaNews Group, Inc. Visit at denverpost.com. Distributed by Tribune Content Agency, LLC.