Objectives. To estimate excess mortality from non–COVID-19 causes during the COVID-19 pandemic in Philadelphia, Pennsylvania, and understand disparities by race/ethnicity, age, and sex.

Methods. We used Poisson regression models of weekly deaths using data from Pennsylvania’s vital registration system (2018–2021).

Results. There was significant excess mortality as a result of heart disease, homicide, diabetes, drug overdoses, traffic crashes, and falls in 2020–2021; the burden of this excess non–COVID-19 mortality fell on non-Hispanic Black Philadelphians. Among younger non-Hispanic Black men, homicide and drug overdoses were responsible for 54% and 18% of excess deaths—more than COVID-19 (17%). For younger non-Hispanic Black women, drug overdoses accounted for 51% of excess deaths, whereas COVID-19 accounted for 40%.

Conclusions. Excess mortality was not solely caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; the causative agent of COVID-19), particularly at younger ages. Indirect pandemic mortality exacerbated prepandemic disparities by race/ethnicity.

Public Health Implications. Excess mortality as a result of non–COVID-19 causes may reflect indirect pandemic mortality. National cause-of-death data lag behind local cause-of-death data; local data should be examined as an early indication of trends and disparities. Public health practitioners must center health equity in pandemic response and planning. (Am J Public Health. 2022;112(12):1800–1803. https://doi.org/10.2105/AJPH.2022.307096)