LANSING, Mich. (AP) — Deaths exceeded births in Michigan in 2020, a rare result influenced by COVID-19, statistics show.

“We can blame a lot of deaths on COVID,” demographer Kurt Metzger told the Detroit Free Press, “but the fact is the trend of increasing deaths and decreasing births is a problem for Michigan outside of COVID.”

Slightly more than 117,000 people died in 2020, while there were 104,000 births in Michigan, according to the state health department.

COVID-19 was listed as the main cause of death for 11,362 people in the first year of the pandemic, although the virus could have contributed to more deaths, the department said.

Heart disease was the No. 1 cause of death in Michigan that year, followed by cancer.

“The number of deaths in Michigan are continuing to go up just because of our aging population. Birth rates, birth trends are indicating that those numbers will continue to go down,” said Metzger, the former mayor of Pleasant Ridge in suburban Detroit.

“I think the answer is how does Michigan attract immigrants? How does Michigan attract young folks in their child-bearing ages to come to the state?” he said. “It’s just another indication that Michigan has a lot of work to do.”

Michigan’s population was 10.07 million in 2020, according to the federal census, a slight increase over the 2010 count.