Trends in asthma mortality in the United States from 1999 to 2023: analysis of the CDC WONDER database

This study analyzes asthma-related mortality trends among U.S. adults (≥25 years) from 1999 to 2023 using the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database, calculating age-adjusted mortality rates (AAMRs) per 100,000 population stratified by demographics and geography. By fitting log-linear regression models to estimate annual percent changes (APCs) with 95 % confidence intervals (CI). Results show a significant overall decline in AAMR from 2.46 (95 % CI: 2.39–2.53) in 1999 to 1.33 (95 % CI: 1.29–1.38) in 2023 (average annual percent change, AAPC: −2.43). Adults aged 45–64 years accounted for the largest proportion of asthma-related deaths (32.22 % of deaths), with significant decline (AAPC: −1.71). Women accounted for 64.62 % of deaths, exhibiting persistently higher AAMR than men (AAPC: −2.60). Non-Hispanic (NH) Black individuals had the highest overall AAMR in 1999 (5.56) and 2023 (2.84), with a transient 2017–2020 surge (APC: 9.40). The Northeast surpassed the West as the highest-burden region by 2023, while Louisiana achieved the lowest state-level AAMR (0.76). Strategies are recommend, including workplace screening (ages 45–64); sex-specific strategies for women; culturally tailored community health workers for NH Black individuals; and improved asthma action plans in the Northeast.