Gastric cancer (GC) remains a major cause of cancer-related mortality worldwide, driven by multiple risk factors including infection, diet, genetics, and lifestyle behaviors. Tobacco use is a well-established modifiable risk factor that contributes to gastric carcinogenesis through chronic mucosal injury. This study aimed to evaluate long-term mortality trends of tobacco-associated GC among United States adults aged ≥ 25 years. We conducted a retrospective cross-sectional analysis using the CDC WONDER Multiple Cause of Death database from 2003 to 2023. Adults aged ≥ 25 years with GC (International Classification of Diseases, Tenth Revision: C16) and tobacco use disorder (International Classification of Diseases, Tenth Revision: F17) listed as underlying or contributing causes of death were included. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated. Temporal trends were assessed using Joinpoint regression, reporting annual percent change and average annual percent change (AAPC). A total of 17,357 deaths were attributed to tobacco-associated GC (overall AAMR: 0.34). Mortality was higher among males (AAMR: 0.58) compared with females (AAMR: 0.15), with comparable temporal trends (AAPC: 4.59% vs 4.58%, respectively). Overall AAMR increased significantly from 0.15 in 2003 to 0.40 in 2023 (AAPC: 4.60%; 95% confidence interval: 3.11–6.18). Across racial groups, non-Hispanic (NH) Black individuals exhibited the highest mortality burden (AAMR: 0.56). However, NH White individuals demonstrated the steepest relative increase over time (AAPC: 3.89%). Regionally, the Midwest had the highest mortality burden (AAMR: 0.45) and the fastest growth (AAPC: 7.33%). Nonmetropolitan areas showed higher mortality (AAMR: 0.45) and a greater increase (AAPC: 4.73%) than metropolitan areas (AAMR: 0.33; AAPC: 4.14%). Tobacco-associated GC mortality has increased significantly in the United States from 2003 to 2023. While NH Black individuals bear the greatest overall mortality burden, NH White individuals exhibit the steepest rise in mortality rates. Higher burden and growth in the Midwest and rural areas highlight persistent geographic disparities.

Background: Sepsis and liver disease represent significant and intersecting public health challenges, yet trends in sepsis-related mortality among individuals with liver disease remain poorly characterized. This study examines national mortality trends from 1999 to 2020, evaluating disparities by sex, race/ethnicity, and geographic location. Methods: Using CDC WONDER data, we analyzed age-adjusted mortality rates (AAMRs) for sepsis-related deaths among individuals with liver disease (ICD-10 codes K70-K76 and A40-A41). Joinpoint regression identified temporal trends, and annual percent change (APC) quantified rate variations. Analyses were stratified by sex, race/ethnicity, urbanization level, and census region. Results: Mortality rates showed a significant nationwide increase, particularly accelerating after 2009. Disparities emerged across demographic groups, with American Indian/Alaska Native populations experiencing the highest mortality rates overall, while Black/African American communities saw alarming late-period surges. Geographic patterns revealed particular challenges in rural areas and Midwestern states, where mortality rates climbed most steeply. Urban-rural divides widened over time, with non-metropolitan areas eventually surpassing urban mortality rates. Sex-based differences persisted, with males maintaining higher baseline mortality but females experiencing faster rate increases in recent years. These patterns suggest evolving epidemiological challenges that disproportionately affect certain populations and regions. The findings highlight the complex interplay between clinical, geographic, and socioeconomic factors influencing outcomes for this vulnerable patient population. Conclusions: Sepsis-related mortality among individuals with liver disease has risen markedly, with inequitable burdens across demographic and geographic subgroups. The findings underscore the need for targeted interventions addressing systemic disparities in healthcare access, social determinants, and clinical management.

Background: Ischemic heart disease (IHD) is a leading cause of mortality in the United States, with significant variations across demographic and geographic factors. This study analyzes trends in IHD-related mortality among adults (> 25 years) from 1968 to 2023 using the CDC WONDER database. Methods: We analyzed death certificates of adults aged >25 years from the CDC-WONDER database with IHD (ICD-8 codes: 410-413, ICD-9 codes: 410-414 and ICD-10 codes: I20-I25) from 1968-2023. Age-adjusted mortality rates (AAMR) per 100,000 population were stratified by gender, race, census region, and year. Join-Point analysis was performed to estimate annual percent change (APC) and average annual percent change (AAPC), complemented by spatiotemporal modeling to capture the geographic variations and evolving patterns of IHD mortality over time. Results: Between 1968 and 2023, IHD caused 27,685,173 deaths in adults aged >25 years. Throughout the study period, the overall AAMR demonstrated a sustained and significant decline, falling from 746.29 in 1968 to 127.07 in 2023 with an AAPC (−3.12; 95% CI: −3.51 to −2.73; p<0.001). Additionally, the overall AAMR for males (452.99) was higher than that of females (260.08). Non-Hispanic (NH) Black or African American displayed slightly higher AAMR (346.75) as compared to NH white (345.38). The Northeast had the highest overall AAMR (379.61), followed by the Midwest (351.31), the South (329.15), and the West (303.15). Older adults (≥65 years) had the highest overall crude mortality rate (CMR) (1312.66), followed by middle-aged adults (45–64 years) (171.67). Younger adults (25–44 years) had the lowest rate (12.18). Conclusion: Mortality rates due to IHD have decreased in the United States over the last few decades. However, the rate of decline has decreased in the past decade. In addition, significant disparities still exist across different sexes, age, race/ethnicity, and geographic regions. These disparities highlight the need for targeted interventions and improvement of clinical care facilities in high-risk populations.

Background: Sepsis is a life-threatening condition that complicates major diseases like myeloid leukemia. Both conditions can lead to morbidity and mortality. Despite its clinical significance, trends in sepsis among myeloid leukemia patients remain understudied. Methods: Nationwide mortality records were obtained from the CDC-WONDER database for U.S. adults aged ≥25 with myeloid leukemia (ICD-10 code C92) and sepsis (ICD-10 codes A40, A41) from 1999 to 2023. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated for variables. Joinpoint analysis was utilized to evaluate annual percent changes (APCs). Results: From 1999 to 2023, a total of 35,075 deaths were recorded. The overall AAMR showed a modest but statistically significant increase (0.62) per 100,000 (AAPC 0.31; 95% CI 0.09 to 0.53; p = 0.007). Males experienced higher AAMRs (AAPC: 0.17, 95% CI: -0.05 to 0.40; p = 0.113) than females (0.82 vs.0.48) (AAPC: 0.33, 95% CI: -0.01 to 0.67; p = 0.056). Time trends within each sex were not statistically significant. The highest overall AAMR was recorded among NH Blacks (0.68), followed by NH Whites (0.64). Regional AAMRs were similar; the Northeast showed the largest decline, while the West increased modestly. The overall AAMR was slightly higher in metropolitan areas (0.64) compared to non-metropolitan areas (0.60). Older adults aged ≥ 65 years consistently exhibited the highest CMRs (1.86). Most deaths occurred in inpatient medical facilities (88.80%). Conclusion: Trends in sepsis mortality among myeloid leukemia patients increased modestly. Higher trends observed in urban areas and NH Blacks. Declines were observed in the Northeast region.

Stroke and malnutrition remain significant contributors to preventable mortality in the United States. Stroke is a leading cause of death and disability, while malnutrition, often underrecognized, exacerbates neurological and systemic vulnerability. Characterizing long-term national and subgroup-specific mortality patterns is critical for guiding public health interventions. Mortality data for stroke and malnutrition were analyzed from 1999 to 2023 using the Centers for Disease Control and Prevention's Wide Ranging Online Data for Epidemiologic Research (CDC WONDER) database. Age-adjusted mortality rates (AAMR) per 1,000,000 population were calculated and stratified by sex, race/ethnicity, census region, state and urbanization status. Joinpoint regression estimated average annual percent change (AAPC) with 95% confidence intervals (CIs). From 1999 to 2023, 44,368 deaths were attributed to malnutrition and stroke. The overall AAMR rose from 12.11 in 1999 to 14.75 in 2023, with an overall AAPC of 0.88% (95% CI: -0.14 to 1.91). Males had higher AAMRs than females. By race, Non Hispanic (NH) Black experienced the greatest AAMRs, whereas NH Asian had the lowest rates. Regionally, the South showed the highest rate, whereas Northeast had the lowest. Nonmetropolitan areas exceeded metropolitan areas. At the state level, the highest rates were observed in South Dakota and Arkansas, while Massachusetts recorded the lowest rates. From 1999 to 2023, combined mortality from stroke and malnutrition increased modestly nationwide, with enduring disparities across demographics and geography. The highest burdens fell on NH Black individuals, people living in the South and nonmetropolitan areas, and certain central states. These findings highlight the need for region-specific prevention and better access to nutritional and neurological care.

Cardiovascular disease remains the leading cause of death in the United States, with heart failure (HF) and hyperlipidemia substantially contributing to mortality. This study aimed to examine national trends in HF-related mortality with coexisting hyperlipidemia from 1999 to 2024 and project future mortality patterns through 2035. Mortality data were obtained from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. Deaths were identified when heart failure and hyperlipidemia were listed on death certificates using the International Classification of Diseases, Tenth Revision (ICD-10) codes. Age-adjusted mortality rates (AAMRs) were calculated using the 2000 U.S. standard population and were stratified by sex, race/ethnicity, census region, and urbanization level. Temporal trends were evaluated using joinpoint regression analysis. Forecasts for 2025–2035 were generated using machine learning-based Seasonal Autoregressive Integrated Moving Average (SARIMA) time-series models. From 1999 to 2024, 283,161 deaths involving HF with hyperlipidemia were recorded on death certificates. The AAMR increased from 0.7 to 6.8 per 100,000 population, with a notable increase after 2018. Mortality rates were higher among men than women and were elevated in the non-Hispanic Black and American Indian/Alaska Native populations. Higher rates were also observed in nonmetropolitan counties and in the Midwest and West regions of the United States. Mortality involving HF with hyperlipidemia has increased over the past two decades, with persistent demographic and geographic differences. These findings highlight the importance of continued surveillance and targeted prevention strategies to address the cardiovascular health disparities in the United States.