Minnesotans Are Still Dying More Than They Were Before COVID. Why?

By Maya S. Chari, Minnesota Reformer

June 26, 2025

Deaths in Minnesota declined for the second year in a row in 2023, but mortality is still higher than it was in 2019, according to data from the Centers for Disease Control and Prevention. In 2023, the most recent year with data available, Minnesota’s age-adjusted death rate was 681.7 per 100,000, compared to 649.2 in 2019 and 756.5 at the pandemic’s peak in 2021.

This mirrors nationwide trends, though Minnesota’s death rate is lower than the national one. Relative to the United States as a whole, Minnesota has a low poverty rate and strong access to health care. In 2023, 3.8% of Minnesotans were uninsured, compared to 7.6% of Americans.

Still, the data underscore Minnesota’s vast and longstanding disparities in health and other outcomes of well-being. The mortality rate among Black and Indigenous Minnesotans was higher to begin with and rose more sharply during the pandemic. Across the country, Black and Hispanic Americans are more likely to experience unemployment and to live in poverty, both of which are correlated with an increased risk of death. These economic gaps are especially stark in Minnesota, which is by many measures one of the nation’s least racially equitable states.

The pandemic served to reinforce the disparities. People of color were more likely to work jobs that involve a high risk of COVID-19 exposure and less likely to have adequate access to medical care. The latter was especially true of Indigenous Americans who live on reservations. Researchers at the University of Minnesota studied neighborhood-level death rates before and during the outbreak of COVID-19. They found that, in general, death rates were higher in poorer neighborhoods. Members of racial minorities are much more likely to live in disadvantaged neighborhoods. Before the pandemic, though, people of color living in disadvantaged neighborhoods were actually less likely to die than white residents of the same neighborhoods. But the COVID-19 death rate was higher for people of color, even when controlling for geography.

For all racial groups, however, the overall death rate fell in 2022 and 2023, but remained elevated.

This elevation is significantly more dramatic for non-white Minnesotans. For example, white Minnesotans saw a rise in death rate of 25 people per 100,000 between 2019 and 2023. The death rate for Black Minnesotans rose by 80 people per 100,000 in that same time period.

COVID is one driver. While the COVID-19 death rate in Minnesota has plummeted since the height of the pandemic — from 71.9 per 100,000 people in 2021 to 12 in 2023 — it’s still obviously higher than in 2019. And not all of the increase in mortality during the pandemic was from the disease itself. In 2022, researchers at the Mayo Clinic released a paper studying changes in Minnesota mortality in 2020. They found that gun homicides, accidental poisoning, malnutrition, alcoholic liver disease and other types of liver disease also increased.

As the pandemic waned, not all of these causes of death declined as dramatically as COVID. In fact, as of 2023, deaths from starvation and non-alcoholic chronic liver disease were trending upward.

Rates of food insecurity started rising in 2020 and haven’t stopped, with the Minnesota Department of Children, Youth and Families reporting that food shelf visits increased for the fourth straight year in 2024, bringing them to 2.5 times the pre-pandemic number. Households of color and those with school-aged children are more likely to experience food insecurity. The Mayo Clinic study, however, found that those most vulnerable to malnutrition deaths were women 85 years and older, white women and rural residents. Older people who needed help eating were particularly at risk during the pandemic. The Star Tribune reported on multiple cases of nursing home residents who stopped eating during COVID isolation and starved to death.

Firearm homicides, on the other hand, were more common in inner cities. Nationally, the murder rate has fallen each year since 2020, reaching pre-pandemic levels in 2024. But Minneapolis hasn’t yet seen a similar decline. The murder rate in the city has remained high since the pandemic and rose slightly in 2024, though early numbers show that it is trending down this year.

There’s some evidence that more Americans began drinking heavily during the pandemic, resulting in more alcohol-related deaths. But nationally and in the state, binge drinking and alcohol-related deaths have been trending upward since well before 2020.

Minnesota’s binge drinking rate is one of the nation’s highest.

Many age groups have seen elevated death rates in the wake of the pandemic, even those less likely to die of COVID. Infant mortality rates, for example, increased during the pandemic and remain slightly higher than they were, though infants are very unlikely to die of COVID. Reduced access to medical care may be responsible, as maternal mortality rates also increased. But the increase in mortality is most pronounced among older Americans, who made up 90% of COVID-19 deaths in 2023.

Overall, the data shows that bringing the death rate down to pre-pandemic levels will take more than controlling one disease. It will require attacking the root causes of excess deaths, such as food insecurity, social isolation, and inadequate health care access, with special attention paid to vulnerable populations such as seniors and those giving birth.

The Minnesota Reformer is an independent, nonprofit news organization dedicated to keeping Minnesotans informed and unearthing stories other outlets can’t or won’t tell..