Temporal trends and demographic and geographic disparities in deaths involving diseases of the eye and adnexa among US adults, 1999–2024: a nationwide analysis using CDC WONDER

Objective To examine long-term temporal trends and demographic and geographic disparities in deaths involving diseases of the eye and adnexa among US adults aged 35 years or older from 1999 to 2024. Methods Data were obtained from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) Multiple Cause of Death database. Deaths were identified when an International Classification of Diseases, 10th Revision code for diseases of the eye and adnexa (H00–H59) was recorded on the death certificate. Analyses were stratified by sex, age, race and ethnicity, Census region, state, and urban–rural classification (1999–2020 only). Death counts, crude mortality rates, and age-adjusted mortality rates (AAMRs) were calculated. Joinpoint regression estimated annual percent changes (APCs), average annual percent changes (AAPCs), and 95% confidence intervals (CIs). Results From 1999 to 2024, 69,167 deaths involving diseases of the eye and adnexa were recorded. Annual deaths increased by 7.34%, from 2,984 to 3,203, whereas the AAMR decreased from 2.16 to 1.47 per 100,000 population. The AAMR declined significantly overall (AAPC, −1.22%; 95% CI, −2.11% to −0.33%) but increased significantly from 2015 to 2024 (APC, 2.48%; 95% CI, 1.28% to 3.69%). Recent increases were observed among men after 2012, non-Hispanic White individuals after 2016, residents of the South after 2014, and residents of the West after 2010. Mortality was highest among adults aged 85 years or older. Although mortality declined significantly overall in all age groups aged 65 years or older, increases emerged during the later years. From 1999 to 2020, AAMRs remained consistently higher in nonmetropolitan than metropolitan areas, with later increases in both groups. Substantial heterogeneity was also observed across states. Conclusions The AAMR for deaths involving diseases of the eye and adnexa declined overall but increased significantly in recent years, with marked demographic, regional, and urban–rural disparities. These data capture ocular disease documented on death certificates and cannot establish causation. Enhanced surveillance is warranted for older adults, men, rural residents, and populations in areas with increasing mortality trends. Further research should assess the contributions of specific ocular diagnoses, systemic comorbidities, and health care access.