Key PointsQuestionHow did changes in rates of death among patients in the Veterans Affairs (VA) health system that occurred during the first year of the COVID-19 pandemic compare with changes in rates of death among the general US population?FindingsThis cohort study found that changes in death rates between the VA population and the general US population were comparable after accounting for demographic differences between the populations. The changes varied by race and ethnicity in both populations; these disparities changed over time.MeaningThis study suggests that the COVID-19 pandemic had a large association with rates of death in the US and, specifically, among veterans.