Demographic and regional trends in pneumonia and sepsis related mortality in the U.S., 1999–2020: a CDC wonder database analysis

Abstract

Background Pneumonia and sepsis remain major health issues in the United States. Despite a high mortality burden and interconnected nature, they remain underexplored in terms of population-level mortality trend analyses. Understanding their impact is essential for improving therapeutic strategies and reducing preventable deaths. Objective We aimed to explore long-term demographic and geographical trends of pneumonia and sepsis-related mortality in the United States from 1999 to 2020. Methods The CDC WONDER national database was utilized to analyze differences in mortality associated with pneumonia and sepsis. Age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and Jointpoint Regression Program was used to determine the trends in mortality. Results The results demonstrated that 806,434 deaths occurred during the study period, with a significant increase in AAMR from 16.66 in 1999 to 25.06 in 2020. Males consistently maintained higher AAMRs than females throughout the observed period (overall AAMR men: 21.16 vs. women: 13.94). AAMRs were highest among NH African Americans and lowest among NH Asians or Pacific Islanders. AAMR also varied substantially by region (overall AAMR: Midwest 14.45; South: 18.82; West: 16.92; Northeast: 16.21). Similarly, higher AAMRs were observed in non-metropolitan areas (17.32) compared with metropolitan areas (16.86). Conclusion Despite all the limitations, the findings provide a valuable foundation for future research and targeted public health interventions.