Have we recovered? Indiana’s non-COVID death counts during the pandemic

Managing Editor, Indiana Business Research Center, Indiana University Kelley School of Business

Nationally, firearm deaths increased by 14% between 2019 and 2020. In Indiana, the increase was even more stark, with firearm death counts increasing by 21% from 958 deaths in 2019 to 1,159 in 2020.

Flashback to 2020. The world was hyper-focused on COVID-related mortality, while under the radar, non-COVID deaths saw increases in nearly every cause of death category, ranging from heart attacks to homicide.

In the wake of the COVID-19 pandemic, there was no shortage of information available on death counts attributed to the virus and its associated health effects. Organizations developed dashboards tracking daily death counts locally and worldwide, while news outlets were saturated with stories detailing pandemic-related spikes in mortality. Non‑COVID causes of death drew comparatively little attention.

The Wide-ranging Online Data for Epidemiologic Research (WONDER) tool makes available underlying cause of death data from the Centers for Disease Control and Prevention (CDC). WONDER, which provides monthly and annual cause of death data by age, sex, ethnicity, place of residence and educational attainment, uses demographic data from death certificates to provide county-level mortality statistics. Using this annual death data from 2019 to 2024 allows for some interesting non-COVID mortality patterns to emerge.

In Indiana, overall death counts increased 18.5% from a pre-pandemic total of 66,001 in 2019 to 78,194 in 2020. This surge closely mirrored the national trend, which also saw an increase of 18.5% during the same period. Indiana death counts peaked in 2021 with 78,317 total deaths. While total death counts have decreased each year since, the state still has not reached its pre-pandemic mortality level, recording 69,509 deaths in 2024.

On a county level, all but 18 of the state’s 92 counties saw a double-digit percentage increase in its overall death count between 2019 and 2020 (see Figure 1). Blackford County recorded the largest percentage increase with 51.8%, followed by Clinton (35.4%), Warren (35.2%), Ripley (33.8%) and Gibson (33.2%) counties. Surprisingly, two counties actually saw their death count decrease during the first year of the pandemic: Noble (-1.5%) and Switzerland (-3.7%).

Figure 1: Indiana county death count percent change, 2019-2020

Source: WONDER tool, Centers for Disease Control and Prevention

Though much of the pandemic-era discussion on mortality centered on COVID-related deaths, there were also spikes in most other non-COVID causes of death, including causes seemingly unrelated to the virus. These increases occurred on a national level but were often more pronounced in Indiana (see Table 1).

On a national level, firearm deaths increased by 13.9% between 2019 and 2020. Research has indicated that school and job closures during the pandemic may have contributed to increases in violence, particularly in impoverished neighborhoods. Additionally, isolation during social distancing, a lack of social support, more unstructured time and prolonged emotional and financial stress likely contributed to increases in violence. In Indiana, the increase was even more stark, with firearm death counts increasing by 21% from 958 deaths in 2019 to 1,159 in 2020. These death counts remained high, peaking with 1,258 firearm deaths in 2023. The number still hadn’t reached pre-pandemic levels in 2024, with 1,196 deaths by firearm recorded.

Homicides (firearm or otherwise) also surged during the first year of the pandemic, with a staggering increase of 28.4% in the United States and an increase of 33% in Indiana. Indiana’s homicide count increased from 466 in 2019 to 620 in 2020 and reached a peak in 2021 with 624 recorded. Fortunately, the number of homicides in the state has decreased each year since, nearly returning to pre-pandemic levels in 2024 with 482.

Table 1: Death counts for Indiana and the U.S. by selected cause of death

Unintentional poisoning deaths, which include substance overdoses, household chemical ingestion, medication errors and environmental exposure, saw large increases in both Indiana and the U.S during the pandemic. Many reasons have been identified for this increase, including depression, stress, job loss, financial concerns, physical separation from others and changes in treatment for substance use disorders, among others. Unintentional poisoning deaths increased 32.9% in the U.S. from 2019 to 2020 and Indiana saw a similar increase during that period of 33.7%. In Indiana, unintentional poisoning deaths peaked in 2021 with 2,684 deaths and have decreased every year since. In 2024, the state recorded 1,630 deaths from that cause, making a full return to pre-pandemic levels.

Surprisingly, even motor vehicle accident deaths increased during the pandemic, though not as drastically as the causes mentioned above. Indiana and the U.S. saw similar increases in vehicle-related mortality between 2019 and 2020, recording increases of 10% and 8.3%, respectively. In Indiana, these counts peaked in 2022 with 979 motor vehicle accident deaths and have been decreasing but are yet to return to pre-pandemic levels. Research suggests that, although there were fewer people commuting to work during the pandemic, those who did drive regularly may have “engaged in riskier behavior,” such as speeding, not wearing seat belts or driving under the influence.

Given the heightened stress, strain and social isolation during the pandemic, one might have expected suicide counts to increase during that period. However, suicide mortality remained unexpectedly stable throughout the pandemic. In Indiana, suicides increased slightly by 5.3% between 2019 and 2020, but suicide mortality actually decreased on a national level (-3.2%). Researchers have speculated that the strong sense of community at the beginning of the pandemic may have provided social support and solidarity that helped sustain citizens. Increased time spent at home with loved ones, reduced routine stress from the workplace and financial safety nets may have played a role in stabilizing suicide rates.

Analysis of mortality data allows policymakers to identify areas of continued public health concern, such as firearm deaths and suicides, and allocate resources appropriately. To learn more about county- or state-level death counts by underlying cause from 1999 to 2024, visit the CDC WONDER tool.