Ohio had more deaths than births in 2020, a grim first in state history amid COVID-19

Max Filby
The Columbus Dispatch
The number of Ohioans who died surpassed the number of Ohioans born in 2020 for the first time since record keeping began in 1909.

More Ohioans died than were born in 2020, a first in the state's recorded history that experts say was expedited by COVID-19.

About 143,661 Ohioans died last year while 129,313 were born, according to data from the Ohio Department of Health. So far in 2021, Ohio has logged 107,462 deaths and 100,781 births.

In the 112 years since statewide record keeping began in 1909, data compiled by The Dispatch and Ohio History Connection shows deaths never previously surpassed births despite countless wars, economic downturns and disease. Of course, the historic reversal came as the world was in the midst of the deadly COVID-19 pandemic.

"It doesn't surprise me at all," said Dr. Joseph Gastaldo, medical director of infectious diseases for OhioHealth. "It's COVID, clearly."

Birthrate in Ohio already in steady decline for decades

Ohio's birthrate has been declining for years while the number of deaths across the state has risen, meaning the two metrics were likely to swap places at some point. But data shows the pandemic rapidly hastened the switch.

The virus killed an estimated 13,927 Ohioans in 2020 alone, according to the state health department. That means, the pandemic may account for 97% of the 14,348-person difference in births and deaths in 2020.

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In 2021, the more than 9,400 Ohioans that COVID has killed more than accounts for the 6,681 difference in births and deaths.

Dr. Bruce Vanderhoff, director of the Ohio Department of Health, declined through a spokesperson to be interviewed on deaths surpassing births in the state. In a prepared statement, Vanderhoff noted the gap had been closing steadily in recent years and said the change shows "the pandemic has certainly taken a toll on Ohioans."

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It's not just COVID deaths that led to the change.

A pandemic baby boom some health officials predicted would occur with people cooped up at home never actually came to pass. In fact, the past 20 months have proven to be more of a baby bust, said Ken Johnson, senior demographer at the University of New Hampshire's Carsey School of Public Policy.

Births in Ohio remained nearly level for the last decade. Then in 2020, births declined by almost 4%, marking the steepest decline since the Great Recession in 2007, according to population records.

"One of the things that happens when times are unsteady is that women will delay birth," Johnson said. "The question is: Are women going to have those babies later?... If they're going to have children, they're probably going to want to have them soon and yet they've been hit by one thing after another."

Half of U.S. states also saw deaths exceed births

Ohio wasn't alone in seeing more deaths than births last year.

In 2020, a record 25 states had deaths exceed births, including each of Ohio's neighboring states of Michigan, Pennsylvania, Indiana, Kentucky and West Virginia, according to research from the University of New Hampshire. In 2019, just five states saw more deaths than births.

While it's believed this is the first time many states had more deaths than births, researchers aren't completely sure due to spotty recordkeeping.

Some of the country's first states have birth and death numbers dating back to the 1800s but others didn't begin keeping track until the national statistics system was created in the 1930s, Johnson said. Ohio's earliest data was collected in 1909, about 106 years after it became a state.

Still, Johnson's research shows the surplus of births over deaths added just 229,000 to the population in 2020 compared to 892,000 in 2019. That accounts for a monumental decline of 74%

"There's never been anything like it before," Johnson said of COVID's effect on births and deaths. "It's the first time it's ever happened ... It's astonishing."

Although COVID's impact may be unlike anything to come before it, there were a few times when the number of deaths came close to surpassing the number of births in Ohio.

The 1918 flu pandemic, which coincided with the end of World War I and which the COVID pandemic recently surpassed to become the deadliest disease in American history, was another time when deaths skyrocketed and the number of people born plummeted.

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In 1918, deaths increased by 22% in Ohio while births decreased by 31%. The following year births declined again by another 9% before rebounding in 1920, data shows.

The era of the Great Depression also yielded a drop in Ohio births. Births decreased by 17.5% from the start of the depression in 1929 until its end in 1933 before climbing again in 1934.

Will births bounce back in Ohio?

A pattern of decline developed after each of those historic events, but births bounced back. Strangely, that pattern didn't hold true following the Great Recession that began in 2007 and ended by 2010, said John Casterline, a professor of sociology and former director of the Institute for Population Research at Ohio State University.

The financial crisis resulted in a nearly 8% drop in births in Ohio, data shows. While experts assumed the birth rate would again rebound, Casterline said it never did and many have been left wondering if it simply yielded a "new normal" brought on by financial anxiety and uncertainty.

"The great recession was a big deal. It was quite a setback for a lot of people," Casterline said. "As is always the case when you have a big recession, people don't have kids for a while. There's usually a bounce back but it didn't happen ... It's something that demographers are struggling to understand."

If more Ohioans continue to die than are born every year, it could result in a wide array of changes, both economic and societal.

Some, like Johnson, believe it could cause broad changes that have already begun in some rural areas of the country where there have been fewer babies born than people dying for decades.

In those regions, Johnson said school districts have shrunk or eventually combined with neighboring ones. Maternity wards in some areas have also closed because of a lack of business.

Eventually, Johnson said some of those adjustments will reverberate through the U.S. economy. One result could be more people drawing from Social Security and other benefits than are paying into those programs.

Casterline, on the other hand, doesn't think the changes will be so dire.

Births outpacing deaths is often used as a "measure of societal health," Casterline said. Casterline described that metric as "too crude" to gauge the success of an entire nation because there are other ways to influence population changes and bolster economic prosperity.

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"We don't need to have the hand wringing that you sometimes see out there on this topic," he said. "It's not very difficult to solve. ... I don't think it trumps other factors. It can be worked around."

If the U.S. population were to eventually shrink, then the workforce would decline and negative economic ramifications would follow, said Bill LaFayette, owner of the Columbus-based economic consulting firm Regionomics. Something similar is already happening in Japan where more than a quarter of the population is age 65 or older and the country's workforce is expected to shrink by 20% compared to 2017.

LaFayette agreed with Casterline that the U.S. could find a way around Japan's current problems.

To make up for a lack of newborns, LaFayette said the U.S. could expand immigration to grow the population. Immigrants tend to be a younger part of the workforce, and they're also more likely to have more children than native-born U.S. citizens.

Politics could get in the way though as the Trump administration purposefully diminished immigration to the U.S. Even after Trump left office, immigration remained a divisive political issue so dramatically expanding programs — even under a different administration — could prove slow and challenging.

While it's an option, LaFayette is convinced it won't become necessary to prevent the U.S. population from shrinking. Births, he said, will eventually bounce back once the pandemic is at bay and society gets back to normal.

"It's all due to COVID and so it's not going to continue," LaFayette said. "We'll just have to wait see what happens this year and next year ... But I think it's an anomaly."