Demographic and regional trends of pneumonia mortality in the United States, 1999 to 2022

Pneumonia is amongst the leading causes of death in the United States. In 2020, pneumonia accounted for over 53,000 deaths and 2.6 million emergency department visits. Further research is needed to study the evolution of country-wide trends and disparities. The centers for disease control and prevention wide-ranging online data for epidemiologic research (CDC WONDER) was used to identify pneumonia-related deaths within the United States from 1999 to 2022. Data on demographic and regional groups were analyzed by calculating age-adjusted mortality rates (AAMRs) and annual percentage change (APC) in AAMRs, for sex, race/ethnicity, age, urban-rural classification, region, and states. Overall, the AAMR per 100,000 from pneumonia-related deaths declined by 52.1% from 35.9 to 17.2 between 1999 and 2022. Both males and females experienced a similar decrease (Average APC -3.24%), though males maintained higher AAMR throughout 1999-2022. African American and Black people experienced the highest mortality throughout the duration of the study, while American Indians and Native Alaskans had the greatest reduction in mortality, by -59.5%. Nursing home deaths decreased over time, and in turn, hospice deaths substantially rose. AAMR in age groups ≥ 70 declined but not for younger age groups. Several geographical differences were found between urban-rural groups, states, and census regions. Despite a decrease in pneumonia-related mortality in the United States between 1999 and 2022, significant differences in AAMR have been observed to have persisted, with male sex, African American race, and rural areas being disproportionately affected. Improving access to timely and adequate health care and reducing disparities between population groups appear to be the most promising ways of continuing the downward trend.