Meningitis remains a significant cause of morbidity and mortality in the United States despite advances in vaccination, antimicrobial therapy, and critical care. However, long-term national mortality patterns across demographic and geographic subgroups remain incompletely characterized. This study evaluated temporal trends in meningitis-associated mortality among U.S. adults aged ≥25 years from 1999 to 2024 using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Multiple Cause of Death database. Death certificates listing meningitis as either the underlying cause or a contributing cause of death were identified using ICD-10 codes to capture meningitis-associated mortality. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated using the 2000 U.S. standard population. Temporal trends were assessed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Across the study period, meningitis-associated mortality demonstrated an early decline followed by stabilization and more recent increases in several subgroups. AAMRs decreased significantly from 1999 to 2001 (APC: −14.09%; p = 0.0029) and from 2001 to 2013 (APC: −4.74%; p < 0.000001), followed by a significant increase from 2013 to 2024 (APC: 1.78%; p = 0.0059). Despite these later increases, the overall AAPC across the full study period remained significantly negative (AAPC: −2.73%; p < 0.000001). Earlier analyses using shorter observation windows did not demonstrate a statistically significant overall trend; the significance observed in the present analysis reflects the inclusion of extended mortality data through 2024. Mortality rates were consistently higher among males and adults aged ≥65 years. Non-Hispanic Black individuals experienced increasing mortality after 2013, while Hispanic individuals demonstrated a sustained increase across the entire study period. Regional analyses showed recent increases in the Northeast, South, and West, while non-metropolitan areas did not experience statistically significant improvement through 2020. In summary, meningitis-associated mortality among U.S. adults declined significantly during the early study years but has shown stabilization and recent increases in several demographic and geographic subgroups since approximately 2013. Although overall mortality across the full study period remains lower than baseline levels, these emerging disparities highlight the importance of continued surveillance and targeted public health interventions.

Unspecified degenerative nervous system disorders (ICD-10 G31.9) increasingly contribute to neurological mortality, yet national temporal patterns remain u

Background: Cardiomyopathy and hypertensive diseases are major contributors to cardiovascular mortality in the United States. Chronic hypertension is associated with adverse myocardial remodeling and may increase the risk of cardiomyopathy. However, national mortality trends involving their coexistence remain poorly characterized. Methods: We analyzed CDC WONDER Multiple Cause of Death data (1999–2025) for adults aged ≥ 25 years with cardiomyopathy (ICD-10: I42) and hypertension (ICD-10: I10–I15) listed anywhere on the same death certificate. Age-adjusted mortality rates (AAMRs) were calculated using the 2000 U.S. standard population, and temporal trends were assessed using Joinpoint regression to estimate APCs and AAPCs. Results: A total of 223,574 deaths were identified. Overall AAMR increased from 2.13 to 4.16 per 100,000 between 1999 and 2025 (AAPC: 2.10%; 95% CI: 1.36–2.64; p < 0.001). Mortality was consistently higher among males than females and was highest in Black individuals (mean AAMR: 8.12) and lowest in Asian/Pacific Islanders (2.34). Mortality increased with advancing age. Regionally, the South had the highest mean AAMR (3.94) and the Northeast the lowest (2.76), whereas the Midwest had the highest AAMR in 2025 (4.83). Non-metropolitan populations experienced greater mortality increases than metropolitan populations (AAPC: 3.53% vs. 1.94%). The District of Columbia had the highest state-level AAMR (7.2), whereas Massachusetts had the lowest (1.4). Home was the largest single setting of death (35.1%). Conclusion: Mortality involving cardiomyopathy and comorbid hypertensive diseases increased from 1999 to 2025, with disparities by sex, race, age, geography, and urbanization. These findings identify populations and regions with disproportionately high mortality and may help inform future research, prevention strategies, and health policy interventions.