S2423 Geographic and Demographic Disparities in Fatty Liver Disease and Cardiovascular Disease Mortality Trends in the United States, 1999-2023

Introduction: Fatty liver disease has emerged as a significant public health concern with increasing prevalence, while cardiovascular disease remains a leading cause of mortality in the United States. This study aims to analyze trends in fatty liver disease mortality and cardiovascular disease mortality from 1999 to 2023, examining demographic and geographic disparities. Methods: Mortality data were collected from CDC WONDER database for the years 1999–2023 using International Classification of Diseases, Tenth Revision (ICD-10) codes K76 for fatty liver disease and I00-I99 for cardiovascular disease. Age-adjusted mortality rates (AAMRs) were calculated for different demographic groups including sex, race/ethnicity, and metropolitan status. Joinpoint regression analysis was used to determine annual percentage changes (APCs) and identify significant trend changes over time. Results: Multiple joinpoint models revealed distinct mortality patterns across demographic groups. For fatty liver disease, Large Central Metro areas showed multiple trend changes with APCs ranging from 0.12% to 22.23% across different time periods. Female mortality demonstrated 3 joinpoints with significant increases, particularly from 2018-2021 (APC: 21.57%). Male mortality showed 2 joinpoints with varying trends including a notable increase from 2014-2021 (APC: 13.21%). Racial and ethnic disparities were evident, with Hispanic or Latino populations showing 2 joinpoints and significant increases in recent years (APC: 15.32% from 2013-2021), while Asian populations demonstrated the highest recent increase (APC: 7.96% from 2012-2023). Geographic analysis revealed substantial state-level variations in mortality rates, with certain regions showing disproportionately higher burden. Conclusion: Fatty liver disease and cardiovascular disease mortality trends demonstrate significant demographic and geographic disparities, with concerning increases in recent years across multiple population groups. The accelerating trends, especially among certain racial/ethnic groups and in specific geographic regions, highlight the urgent need for targeted prevention strategies, early detection programs, and improved access to care to address these growing public health challenges.