S2072 Trends in Mortality From Gastrointestinal Infections and Healthcare Burden in the US (1999-2023): A Retrospective Analysis of Health Disparities, Demographic, and Regional Variation

Introduction: Gastrointestinal (GI) infections have substantially contributed to adult mortality and continue to pose a health burden in the United States. While overall death rates have declined, persistent disparities by year, sex, race, age and region reflect an unequal disease burden, highlighting the need for targeted interventions across demographics and regions. To examine the trends in GI-infection-related mortality and hospitalisation rates from 1999 to 2023, with attention to demographic disparities and healthcare system impact. Methods: We analyzed CDC-WONDER data on deaths related to GI infection in adults aged ≥25 years from 1999 to 2023. Age-adjusted mortality rates (AAMRs) per 100,000 and annual percent change (APC) were calculated and categorized by year, sex, race, age, and geographic region. Results: A total of 294,178 GI-infection–related deaths were recorded from 1999 to 2023. AAMR increased from 1.25 in 1999 to a peak of 8.0 in 2011, then declined to 4.73 in 2023 (AAPC: 6.21; 95% confidence interval [CI]: 4.31 to 8.16). From 1999 to 2023, females had a higher mortality rate than males, rising from 0.50% to 9.29% vs 0.37% to 6.98% in males. From 1999 to 2023, among the non-Hispanic (NH) population, NH White had the highest mortality with an AAMR (1.29 vs 4.94) and AAPC (6.2183), with the lowest mortality rate reported by NH Asian, having an AAMR (0.48 vs 2.24) and AAPC (8.1968). The Hispanic population showed an AAMR (0.8 vs 3.66) and an AAPC of 6.4174. From 1999 to 2020, mortality was higher in metropolitan than non-metropolitan areas with AAMR (5.38 vs 5.14). AAPC was greatest for the South (7.5719), followed by the West (6.6267), Midwest (5.5983), and Northeast (4.5425). States in the top 90th percentile were Rhode Island, Ohio, Vermont, Maine, and New Hampshire, with approximately double the AAMRs as states in the lower tenth percentile. Conclusion: While the overall mortality from GI infection has declined over time, recent years show a rise in mortality in younger adults, with persistent disparities by sex, race, and region. These findings highlight the need for equity-focused interventions in high-risk and underserved populations.