(WCMH) — New data from the U.S. Centers for Disease Control and Prevention says COVID was the third-largest cause of death through 2021.

According to a CDC release, about 460,000 deaths occurred in the U.S. through 2021 for which COVID-19 was the underlying cause. Accounting for roughly twice as many deaths as accidents, COVID was associated with more deaths than any single cause but cancer and heart disease for the second year in a row.

COVID related deaths were about as concentrated in older age groups as with non-COVID deaths. About 80% of COVID deaths occurred in ages 55 and older.

Men accounted for about 50% more COVID deaths than did women.

COVID death rates were highest among American Indian/Alaska Natives and Native Hawaiian/other Pacific Islanders and lowest among non-Hispanic Asians and whites.

Whites were 66% of COVID deaths, followed by Hispanics at 16% and Black non-Hispanics at 13%.

Coronavirus-related complications were also the third leading cause of death in 2020, CDC reports. There were 350,831 COVID-19 deaths in 2020, which was the year the disease became widespread. Overall, there were about 60,000 more deaths in 2021 than 2020.

There’s been some confusion since the start of the pandemic over what constitutes a COVID death.

CDC Dr. Robert Anderson, chief of Mortality Statistics, explains COVID-19 is often listed as the “underlying cause” on death certificates of those who die from COVID.

“The underlying cause of death is the condition that initiated the chain of events leading to death,” Anderson said in a CDC interview. “When the death certificate is filled out, the person who’s reporting the cause of death is asked to identify a chain of events, sort of a causal pathway, working from the immediate cause back to the underlying cause.”

Anderson explained that COVID-19 could allow for a potential other condition, like flu, to infect a person and then the flu could be what kills them. In this instance, COVID-19 would still be considered a cause of death, per CDC.