Regional and demographic disparities in multiple myeloma and cardiovascular disease mortality (1999–2020).

Abstract

e13537 Background: Multiple Myeloma (MM) and cardiovascular disease (CVD) significantly impact U.S. mortality. This study examines regional and demographic trends in MM and CVD mortality (1999–2020) to identify high-risk populations and inform public health policies. Methods: CDC WONDER data for adults 25+ (1999–2020) were analyzed. Mortality data were stratified by census region, urbanization, state, and place of death. Age-adjusted mortality rates (AAMRs) per million were calculated. Trends were evaluated using Joinpoint regression, with average annual percentage change (AAPC), 95% confidence intervals (CIs), and p-values. Results: Region: The South reported the most deaths (35,141), followed by the West (22,861), Northeast (22,207), and Midwest (21,016). AAMRs were highest in the Northeast (23.74/million; 95% CI 23.42–24.05) and lowest in the Midwest (19.62/million; 95% CI 19.35–19.88). AAMRs declined significantly in the Northeast (AAPC: -1.46%; 95% CI -1.92 to -0.97; p < 0.000001), while other regions showed non-significant trends. Urban vs. Rural: Urban areas had more deaths (83,680; AAMR: 21.38/million), while rural areas had fewer deaths (17,545) but slightly higher AAMRs (20.84/million; 95% CI 20.53–21.15). Trends were not statistically significant in either group. State: The District of Columbia had the highest AAMR (30.94/million), and Arizona had the lowest (14.04/million). California recorded the most deaths (14,300), while Alaska had the fewest (90). Place of Death: Most deaths occurred in inpatient facilities (43,872), followed by homes (27,295) and nursing homes (16,038). Conclusions: Regional and demographic disparities in MM and CVD mortality underscore the need for targeted public health efforts. The Northeast’s significant decline contrasts with stable trends elsewhere. Addressing disparities in rural areas and high-burden states like California and the District of Columbia is critical to reducing mortality and improving outcomes.