477 Trends and disparities in mortality from pneumonia and cardiac arrest among older adults (≥65 years) in the United States, 1999–2023
Abstract
<h3>Introduction</h3> Pneumonia and cardiac arrest are most significant contributors of mortality in U.S among older adults. This study analyzes long-term trends and disparities in mortality from these conditions from 1999 to 2023, highlighting changes over time and differences across demographic and geographic groups. <h3>Methods</h3> We conducted a retrospective population-based study using the CDC WONDER Multiple Cause of Death database from 1999 to 2023. Pneumonia and Cardiac Arrest cases were identified by ICD-10 codes. We calculated age-adjusted mortality rates (AAMRs) per 100,000 population and stratified them by age group, sex, race/ethnicity, U.S. Census region, and urbanization status. Joint point regression estimated annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CIs). <h3>Result</h3> Overall mortality from pneumonia and Cardiac Arrest among adults aged ≥65 years declined significantly from 1999-2023. The AAMR declined from (69) to (29.8) (APC: -3.6%; 95% CI: −4.83 to −2.98). Trend analysis identified, a modest increase during 2018–2021(APC: 31.4%; 95% CI: 19.1 to 39.1), followed by a sharp decline during 2021–2023 (APC: −32.56%; 95% CI: −42.8 to −21.20). Men had consistently higher AAMR than women from 1999(AAMR men: 90.3vs women:56.7) to 2023 (AAMR men: 38.1 vs women: 23.7). All age groups showed notable long-term declines, with the most pronounced decrease seen in adults aged ≥85 years (APC: −4.34%; 95% CI: −5.36 to −3.79). A breakdown by race and ethnicity indicated that Hispanic or Latino individuals had the most substantial decrease (APC: −4.7%; 95% CI: −6.53 to −3.30), with black and African American showed considerable progressive inconsistency (APC: −3.95%; 95% CI: −5.20 to −2.8), White non-Hispanic individuals showed more modest reduction (APC: −3.76%; 95% CI: −4.96 to −3.12), Mortality rates by region also varied considerably with greatest decline in Northwest (AAPC: −4.35%) and the lowest in the Midwest (AAPC: −2.39%). Mortality declined in both groups but it was more pronounced in metropolitan areas and non-metropolitan areas maintained higher mortality levels (AAPC: −1.65% vs. −1.03%) (figures 1 and 2). <h3>Conclusion</h3> Mortality in Pneumonia and cardiac arrest among older adults ≥65 years declined dramatically since 1999. However, marked demographic and geographic disparities persist. Periodic increases in mortality highlight the ongoing vulnerability of older adults, underscoring the need for targeted prevention strategies, timely clinical management, and more equitable access to care for populations at greatest risk.