On Apr. 23, 2023, the most comprehensive state-by-state analysis of the impacts of COVID-19 across the USA, published in The Lancet, revealed the underlying reasons why the pandemic played out in vastly different ways across the country.

The new analysis found that between January 1, 2020, and July 31, 2022, cumulative COVID-19 death rates varied widely across the USA, with Hawaii and New Hampshire having the lowest standardised rates (adjusted for age and comorbidities; 147 and 215 deaths per 100,000, respectively) and Arizona and Washington, DC having the highest (581 and 526 deaths per 100,000, respectively).