S2811 Trends and Disparities in Liver Disease and Viral Hepatitis-Related Mortality in Adults ≥65 Years From 1999 to 2023 in the United States

Introduction: Liver disease and viral hepatitis are common, and both are interrelated, and their concurrence is associated with poorer outcomes and accelerated mortality. Research on liver disease and viral hepatitis-related mortality trends stratified by demographic and regional classifications in the United States is limited. This study analyzes national liver disease and viral hepatitis-related mortality trends among adults ≥65 years from 1999 to 2023. Methods: The CDC WONDER Multiple-Cause-of-Death dataset (1999–2023) was used to assess mortality trends among adults ≥65 years using International Classification of Diseases, Tenth Revision (ICD-10) codes for liver disease (K70-K76) and viral hepatitis (B15-B19). Data were stratified by year, demographic, and geographic classifications. Age-adjusted mortality rates (AAMR) were calculated per 100,000 persons with 95% confidence intervals (95% CI). Average annual percent change (AAPC) was calculated via the Joinpoint regression model, with statistical significance defined as P < 0.05. Results: A total of 64,053 liver disease and viral hepatitis-related deaths occurred from 1999 to 2023. Overall, AAMR remained stable from 5.7 in 1999 to 6.0 in 2023. Men, in comparison to women, had higher average AAMR and had stable rates, while women had declining rates (AAPC: -1.76; 95% CI: -2.96 to -0.54). Racially, non-Hispanic (NH) Asian/Pacific Islanders had the highest average AAMR, and had declining rates along with Hispanic/Latinos (AAPC NH Asian/Pacific Islander: -2.63; 95%CI: -3.68 to -1.56, AAPC Hispanic/Latino: -1.58; 95%CI: -2.60 to -0.55). NH Black/African Americans had increasing rates (AAPC: 1.51; 95%CI: 0.33 to 2.70), while NH Whites saw stable rates. Regionally, the West had the highest average AAMR, and the Northeast had the highest rate of decline (AAPC: -5.70; 95%CI: -8.73 to -2.58). From 1999 to 2020, urban areas, in comparison to rural areas, had higher average AAMR, but rural areas saw increasing rates compared to stable rates for urban areas (AAPC rural areas: 1.76; 95%CI: 0.03 to 3.51). Conclusion: While liver disease and viral hepatitis-related mortality among adults ≥65 years was stable from 1999 to 2023, marked disparities across demographic and geographic groups were noted. These disparities emphasize the urgency for targeted strategies and public health policy changes to decrease mortality rates in at-risk communities.