Trends and disparities in mortality due to coexisting diabetes mellitus and chronic obstructive pulmonary disease among adults in the U.S. (1999-2023): insights from the CDC WONDER database.

Background

Diabetes mellitus (DM) and chronic obstructive pulmonary disease (COPD) are major health concerns in the United States, with both diseases contributing significantly to mortality. However, the trends in mortality due to the co-occurrence of these conditions from 1999 to 2023 remain underexplored.

Methods

This study utilized data from the CDC WONDER database, focusing on death certificates with both DM and COPD listed as causes. We analyzed deaths among individuals aged 35 and older, categorized by demographic (age, sex, race/ethnicity) and geographic factors. Crude mortality rates (CMRs) and age-adjusted mortality rates (AAMRs) were calculated. Joinpoint regression analysis was used to assess mortality trends, with the annual percent change (APC) and average annual percent change (AAPC) determining rate shifts across time periods.

Results

From 1999 to 2023, the AAMR for DM and COPD increased by 1.5 times, peaking in 2021 before declining by 2023. Significant increases in mortality were observed across sexs, with males consistently showing higher rates. Racial disparities were evident, with non-Hispanic Black and American Indian populations experiencing higher AAMRs. Age group analysis revealed a sharp rise in mortality among older adults, particularly those aged 65+. Geographically, rural areas exhibited higher AAMRs than metropolitan regions, with the South showing the highest mortality rates.

Conclusions

The mortality burden from coexisting DM and COPD has significantly increased over the past two decades, particularly among older adults and certain racial/ethnic groups. These findings highlight the need for targeted public health interventions and healthcare strategies to address these disparities.