The most common way to understand the impact of a disease is to track its rates of prevalence and mortality because these metrics are derived from easily collected data. However, prevalence and mortality rates fail to capture whether a disease is becoming more dangerous without necessarily becoming more directly deadly.

This report uses multiple-cause mortality data for the universe of US death certificates from 2006 to 2019 to explore the distribution of factors contributing to death. We examine the role of “metabolic illnesses,” broadly defined as illnesses that occur due to abnormalities in the body’s metabolic process. Although these illnesses all impact the same system, they may have very different causes, presentations, risk factors, and impacts on quality of life.

We explore how these contributors changed in frequency for all causes of death and for each of the top causes of death in the United States between 2006 and 2019. We also examine how these changes differed based on sex, race, and ethnicity.