Where you live and who you are: The unequal face of cancer and diabetes mortality in the United States.

e22556 Background: Cancer and diabetes represent leading causes of mortality in the United States, with considerable disparities in rates across demographic and geographic factors. Despite advancements in medical research and healthcare interventions, mortality rates for both conditions remain persistently high, particularly among certain populations. These variations are influenced by multiple factors, including gender, race, socioeconomic status, and geographic location. The findings aim to inform public health strategies to address these disparities and improve health outcomes. Methods: Mortality data from the CDC WONDER database were retrospectively analyzed for adults aged 25 years and older who died with cancer and diabetes between 1999 and 2020. Temporal and demographic trends were assessed using the Joinpoint Regression Program (Version 5.3.0.0), providing insights into changes over time by age, gender, race, and geographic location. Results: From 1999–2020, the age-adjusted mortality rate (AAMR) rose from 157.3 to 189.4, with a significant surge from 2015–2020. Males consistently exhibited higher AAMRs than females, with both genders experiencing notable increases in recent years. Racial disparities were stark, as non-Hispanic Black populations had the highest AAMRs, followed by non-Hispanic American Indian/Alaskan Natives and Hispanics, with substantial increases from 2018–2020. Non-metropolitan areas displayed persistently higher mortality rates than metropolitan regions, with a marked surge between 2016–2020. Across all age groups, the 25–44 year old cohort showed the steepest AAMR increase, particularly from 2018–2020. Conclusions: This study highlights the growing burden of cancer and diabetes mortality in the U.S. and underscores widening demographic and geographic disparities. Addressing these inequities requires targeted public health strategies, improved healthcare access, and resource prioritization to support high-risk populations and underserved regions. Efforts should focus on health equity and reducing disparities to mitigate the rising mortality trends effectively. Deaths and age-adjusted mortality rates (AAMRs) per 1,000,000 for diabetes and cancer among adults in the United States between 1999 and 2020. Variable Deaths (n) AAMR (95% CI) Non-Hispanic American Indians 5,775 224.9 (218.9 to 231) Non-Hispanic Asians 22,268 125.6 (123.9 to 127.3) Non-Hispanic Blacks 106,192 247.7 (246.1 to 249.2) Non-Hispanic Whites 586,117 154.3 (153.9 to 154.7) Hispanics 60,631 173.4 (172 to 174.9) Northeast 138,546 148.1 (147.3 to 148.8) Midwest 192,804 179.6 (178.8 to 180.4) South 278,389 158.7 (158.1 to 159.3) West 172,791 169.5 (168.7 to 170.3)