Trends and disparities in mortality associated with co-mentioned diabetes mellitus and ischemic heart disease among the United States adults aged ≥ 25 years, 1999–2023: a CDC WONDER database analysis

Ischemic Heart Disease (IHD) and Diabetes mellitus (DM) are major global health threats. However, trends and demographic-geographic disparities in mortality associated with co-mentioned DM and IHD on the United States death certificates remain insufficiently characterized. Using Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) data (1999–2023), we analysed mortality associated with co-mentioned DM and IHD on death certificates among the US adults aged ≥ 25 years. Crude Mortality Rate (CMR) and Age-Adjusted Mortality Rate (AAMR) were calculated, stratified by year, sex, ethnicity, and region. Joinpoint regression estimated time trends, Annual Percent Change (APC), and Average Annual Percent Change (AAPC). A total of 763,977 deaths were documented (overall AAMR: 15.07/100,000). Males (17.48) had 1.5 times higher mortality than females (11.26). Non-Hispanic (NH) Blacks had the highest AAMR (23.21), followed by Hispanics (17.72), NH Whites (12.74), and NH Others (11.35). Mortality peaked in 85 + years (CMR: 104.77). Non-metropolitan areas (16.09) had higher rates than metropolitan areas (13.46). The South became the highest-risk region by 2023, with Arkansas recording the top state AAMR. While mortality associated with co-mentioned DM and IHD on death certificates declined overall in the US., substantial multidimensional disparities still exist. Targeted public health policies for high-risk groups (males, NH Blacks, the elderly) and regions (South, Non-metropolitan areas) are imperative to mitigate inequities.