S2582 Alcohol Liver Disease-Related Mortality Trends Among US Women Revealed Through CDC WONDER Analysis [2018-2023]

Introduction: Alcoholic liver disease (ALD) is a major contributor to liver-related morbidity and mortality in the United States, with rising incidence and significant public health impact. Although historically more prevalent in men, evidence in recent years indicates a concerning increase in ALD mortality among women, who demonstrate greater susceptibility to alcohol-induced liver injury at lower consumption levels than men. Significant disparities are observed across racial and ethnic groups, yet woman-specific trends, however, remain underreported. This study examines ALD-related mortality trends among US women between the years 2018 to 2023, stratified by race, using nationally representative CDC WONDER data to inform targeted prevention strategies and address health inequities. Methods: We analyzed data from the CDC WONDER database for ALD (International Classification of Diseases, Tenth Revision [ICD-10] codes: K70.x) among US women from 2018-2023, stratified by race. Total ALD deaths and age-adjusted mortality rates (AAMR) were calculated for each racial group. Joinpoint regression analysis was conducted to identify significant changes in mortality trends. Annual percent change (APC) for each trend segment and average annual percent change (AAPC) for the overall period were calculated, with statistical significance defined as P < 0.05. Results: Over 2018-2023, the highest number of ALD-related deaths in women were reported in the White population (55797), with AAMR rising from 4.9 in 2018 to 7.2 in 2021 (APC: 13.69%, P = 0.002). Disproportionately high AAMR from ALD were noticed in American Indian or Alaska Native woman populations, with an increase from 22.5 in 2018 to 41 in 2021(APC: 6.55%, P = 0.026). Black or African American women also showed a considerable increase in AAMR from 3.1 in 2018 to 5 in 2021(APC: 14.99%, P = 0.005). All racial groups except Asians experienced a peak in ALD-related deaths in 2021, followed by a non-significant decline. Asians had the lowest number of ALD-related deaths and relatively stable AAMR. Conclusion: From 2018 to 2023, ALD mortality increased among women in all racial groups except Asians, with 2021 representing a critical inflection point, likely influenced by external factors such as the COVID-19 pandemic. These findings highlight the need for targeted prevention strategies to reduce disparities and address the rising burden of ALD in diverse woman populations. Future studies should explore drivers of disparities and assess intervention efficacy.