COVID-19 was the fourth leading cause of death in Alaska in 2020, according to a vital statistics report from the state Department of Health and Social Services.

The leading cause of death statewide in 2020 was cancer, followed by heart disease and accidental, unintentional injuries.

COVID was responsible for 231 deaths in 2020, making up about 4.6% of all deaths that year, the report said.

The data refers to the crude death rate as the number of deaths per 100,000 residents. Because areas with higher proportions of older residents will naturally have higher crude death rates, the state configured an age-adjusted death rate so as not to skew the data.

The age-adjusted death rate represents standardized deaths per 100,000 residents between populations with different age demographics.

According to the report, American Indian and Alaska Native residents had the highest age-adjusted death rate by race, at 100.1 per 100,000 people. Seniors were the most likely to die of the virus, with 78.4% of COVID deaths occurring among residents 65 and older. More men died of COVID than women.

The data found that contributing causes of COVID deaths in 2020, also called comorbidities, were heart disease, diabetes and chronic respiratory diseases.

In 2020, 28.6% of COVID deaths occurred in individuals with heart disease, and 11.3% in those with diabetes. Additionally, 10.4% of people who died of COVID had chronic lower respiratory diseases.

The first COVID case in Alaska was announced on March 12, 2020, and the first COVID deaths by underlying cause also occurred that month. December had the most COVID deaths in 2020.

The report also states that the majority — 78.8% — of COVID deaths in 2020 occurred in an inpatient hospital, compared to the usual 33.3% of total deaths that typically occur at a hospital.

As of Monday, there had been a total of 1,052 COVID deaths among Alaska residents since the pandemic began, with the overwhelming majority occurring in September and October of 2021. COVID deaths and hospitalizations remain low, even now as the state is reporting the most cases it ever has.

The other six leading causes of death in 2020 in descending order were cerebrovascular diseases, chronic lower respiratory diseases, suicide, diabetes, chronic liver disease and cirrhosis, and Alzheimer’s disease.

Read the full 2020 vital statistics reports at https://dhss.alaska.gov/dph/VitalStats/Pages/data/default.aspx.

This article has been updated to accurately describe the age-adjusted death rate metric as a standard number of deaths per 100,000 taking populations with different ages into account, and to correct an error in the DHSS vital statistics report about when the first COVID-related death in Alaska occurred.

Reach reporter Camille Botello at camille.botello@peninsulaclarion.com.