Abstract 4373182: Trends and Disparities in Mortality Due to Congenital Circulatory Anomalies in the United States: A Nationwide Analysis from 1999 to 2020

Background: Congenital circulatory anomalies remain a significant cause of mortality in the United States, especially among infants and young children. Understanding long-term mortality trends and disparities across demographics and geography is crucial for targeted public health interventions. Methods: Mortality data for congenital circulatory anomalies were extracted from CDC WONDER for the years 1999 to 2020. Annualized Percentage Change (APC) in absolute death counts was calculated using log-linear regression models, stratified by state, census region, urbanization, sex, age group, race, and Hispanic origin. Results: Nationally, deaths declined from 4,436 in 1999 to 3,011 in 2020, reflecting an APC of –2.14%. Among census regions, the Northeast experienced the steepest decline (APC: –2.37%), followed by the Midwest (–2.25%), South (–2.05%), and West (–2.02%). Urbanization-wise, the greatest reduction was noted in NonCore (–2.53%) and Large Fringe Metro areas (–2.01%), while Small Metro areas had a milder decline (–1.44%). State-level analysis showed that Alaska had an increasing trend (APC: +4.66%), while several states showed moderate-to-high declines, with California (–3.12%) and Texas (–2.84%) among the top. Age-specific trends revealed significant reductions in the 1–4 year age group (APC: –1.70%) and 75–84 year group (–1.56%), with relatively stable trends among those aged 55–64 (–0.04%). Sex-stratified analysis showed a sharper decline in females (–2.33%) compared to males (–1.97%). Racial disparities were evident: White individuals experienced the highest decline (–2.36%), followed by Black or African American (–1.82%), American Indian or Alaska Native (–0.60%), while Asian or Pacific Islanders showed a slight increase (APC: +1.02%). By Hispanic origin, deaths among Hispanic or Latino populations declined with an APC of –1.20%, while those not of Hispanic origin declined more steeply (–2.29%). The "Not Stated" category also declined (–2.13%). Conclusion: Despite overall declining mortality from congenital circulatory anomalies in the U.S. from 1999 to 2020, marked disparities persist across race, state, age, and urbanization level. Targeted efforts are needed to reduce the widening gaps and address the concerning upward trends observed in specific states and ethnic groups.