Abstract HUP11: Mortality Trends and Inequities for Stroke in Diabetic Patients: A CDC WONDER Database Analysis

Introduction: Diabetes mellitus significantly increases the risk and worsens outcomes for cerebrovascular diseases, making the comorbidity of stroke and diabetes a critical public health concern. This study aims to assess age-adjusted mortality trends among U.S. adults with concurrent stroke and diabetes, identifying disparities across demographic and urbanization strata. Methods: Multiple causes of death data were extracted from the CDC’s WONDER database, encompassing ICD-10 codes for cerebrovascular diseases (I60-I69) and diabetes mellitus (E10-E14) for individuals from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated using the 2000 U.S. Standard Population. Data were stratified by year, urbanization levels, race/ethnicity, and sex. Results: Overall, AAMRs for stroke in diabetic patients showed a general decline, from 7.08 per 100,000 in 1999 to 4.90 per 100,000 in 2020. However, significant disparities persisted. Black or African American individuals consistently had higher AAMRs compared to other racial groups. For example, in large central metropolitan areas in 1999, Black or African American females had an AAMR of 8.5 per 100,000, compared to 3.7 per 100,000 for White females. This disparity persisted into 2020, with rates of 4.7 for Black or African American females and 2.6 for White females in the same region. Furthermore, sex-based differences in mortality also varied by race and urbanization. Black or African American females occasionally had higher mortality rates than their male counterparts in certain urban settings. The AAMR for Black females was 8.5 in large central metro areas in 1999, compared to 7.4 for Black males. Conclusion: From 1999 to 2020, AAMRs for stroke in diabetic patients declined nationally. However, persistent and significant disparities were observed, with Black or African American individuals and residents of less urbanized areas bearing a disproportionately higher mortality burden. The consistent data limitations for American Indian or Alaska Native and Asian or Pacific Islander populations highlight a critical gap in health surveillance. These findings underscore the urgent need for targeted public health interventions that address systemic inequities and improve healthcare access and quality in underserved communities.