Trends in mortality from nutritional and metabolic diseases in the United States (1999–2020): An epidemiologic analysis using CDC WONDER

Nutritional, and metabolic diseases are a major public health issue in the United States, affecting population health significantly. This study aims to analyze the mortality trends of these diseases and related demographic disparities in the US from 1999 to 2020. Data on deaths from nutritional, and metabolic diseases in the US (1999–2020) and demographic characteristics (sex, census region, race, urbanization, and age group) were collected. Age-adjusted mortality rates (AAMRs) were calculated, with crude mortality rates used as a substitute for AAMR in age group analyses. The average annual percent change (AAPC) with 95% confidence intervals (CIs) was estimated to quantify trends, with P < .05 considered statistically significant. From 1999 to 2020, the total number of deaths from these diseases in the US decreased by 25.04% (from 631 to 473), with an overall AAMR dropping from 1.04 (95% CI: 0.96–1.12) to 0.80 (95% CI: 0.72–0.87) and an AAPC of −1.71% (95% CI: −2.16 to −1.26%, P < .05). Significant declines were observed across sex (females: −28.77%, AAPC = −1.82%; males: −21.83%, AAPC = −1.77%), census regions (Midwest with the largest decrease: −33.81%, AAPC = −1.21%), urbanization levels (metropolitan: −25.62%, AAPC = −1.81%; nonmetropolitan: −22.12%, AAPC = −1.49%), and age groups (<1 year with the largest decrease: −43.68%, AAPC = −2.66%). By race, Non-Hispanic (NH) White individuals had the most substantial death reduction (−40.66%, AAPC = −2.06%), while Hispanic (20.24%) and NH Other (47.83%) groups saw increased deaths; NH Black individuals had a 19.53% decrease (AAPC = −1.49%), and the AAPC for NH Other was nonsignificant (−0.51%, P > .05). Mortality from nutritional, and metabolic diseases in the US showed a significant downward trend from 1999 to 2020, but demographic disparities persisted across sex, region, race, urbanization, and age groups. Targeted interventions for high-risk subgroups are essential to further reduce mortality and eliminate disparities.