The United States death rate decreased by 3.8% in 2024 as COVID fell out of the top 10 leading causes of death for the first time in four years, new provisional federal data shows.

The overall rate declined from 750.5 per 100,000 people in 2023 to 722 per 100,000, according to the report from the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS).

This marks the lowest death rate recorded since 2020, during the first full year of the COVID-19 pandemic, and follows declines that began in 2022.

The report also found that overall deaths fell from 3.09 million in 2023 to 3.07 million in 2024.

Additionally, the report showed the three leading causes of death stayed the same from 2023 to 2024, with heart disease as the leading cause, followed by cancer and unintentional injury, respectively.

Suicide replaced COVID-19 as the 10th leading underlying cause of death, knocking the disease off the top 10 list for the first time since 2020.

“‘It’s pretty noteworthy that COVID-19 fell off the top 10 and suicide, which had been had fallen off in recent years, is … ranked again,” Farida Ahmad, corresponding author of the report and health scientist at NCHS, told ABC News. “I think that’s a pretty interesting finding given where we spent the last five years.”

Ahmad said fewer deaths from COVID in 2024 compared to 2023 may be a reason behind the 3.8% decline.

“Ever since it came onto the scene in 2020, COVID was one of the top 10 leading causes of death,” Ahmad said. “It started off as a third-leading cause and, in 2024, we see that it’s not ranked at all, actually. So, it’s still among the 15 leading causes, but not in the top 10.”

Dr. Sharonne Hayes, a professor of cardiovascular medicine at Mayo Clinic in Rochester, Minnesota, agreed that fewer cases of COVID-19 are likely driving the reduction in mortality.

“I think there’s a little less COVID, right? I mean, that’s part of it,” she told ABC News. “I think that the pandemic was such a time of both COVID-related deaths, but also just rising risk factors, particularly around cardiovascular disease, people’s lifestyles were less healthy. And maybe we are coming back to more of where we are before.”

Ahmad said another driver for the drop in deaths could be the decline in drug overdose deaths.

A CDC report published in May found that U.S. drug overdose deaths fell by nearly 27% in 2024 to the lowest levels seen in five years.

Dr. Katie Schmitz, a visiting professor of medicine in the department of medicine and cancer epidemiologist at the University of Pittsburgh, told ABC News that leading causes of death continue to be cardiac disease and cancer-related deaths due to an aging population, as well as underlying factors such as obesity.

Schmitz noted that we have an increase in proportion of the population with these co-morbidities and it’s important to highlight that access to health care can be limited, particularly for rural populations.

Other leading causes of death in the report included stroke, chronic lower respiratory disease, Alzheimer’s disease, diabetes, kidney disease and chronic liver disease and cirrhosis.

The report also found that death rates decreased from 2023 to 2024 among all racial/ethnic groups. Rates in 2024 were lowest for multiracial people at 332.3 per 100,000 and highest for the Black population at 884 per 100,000.

Death rates decreased from 2023 to 2024 for all age groups except infants younger than one year old, according to the report. Death rates in 2024 were lowest for children between ages 5 and 14 at 14.4 per 100,000 and highest for people age 85 and older at 13,835.5 per 100,000.

Schmitz said investments should be made that focus on prevention — such as addressing rising obesity rates — and early screenings, which can vary with socioeconomic status and geography.

Hayes said making lifestyle changes is hard, but it is one of the best ways to lower the risk of some of the leading causes of death, including heart disease and cancer.

“Whether it’s eating more vegetables, [decreasing] saturated fat, maintaining a healthy weight is going to help stroke, cancer, and heart disease risk as well as liver disease, kidney disease, and diabetes,” she said. “Aside from unintentional injury and suicide, virtually every other thing of that list would be impacted by lifestyle.”

Dr. Megha Gupta is a Neurology Resident Physician at Barnes-Jewish Hospital/Washington University in St. Louis and a member of the ABC News Medical Unit.