Osteoporosis-Associated Mortality in Postmenopausal Women in the United States From 1999 to 2023: A CDC WONDER-Based...

Osteoporosis remains a significant contributor to illness and death among postmenopausal women, primarily due to complications from fractures. This study examined national trends and disparities in osteoporosis-related mortality over a 24-year period.

Mortality records of postmenopausal women from 1999 to 2023 were analyzed using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database to assess osteoporosis-related deaths. Age-adjusted mortality rates (AAMRs) were calculated and examined across time, demographic groups, geographic regions, and fracture involvement. Statistical trend analysis was used to evaluate changes in mortality patterns over time.

A total of 232,877 osteoporosis-related deaths were recorded. The overall AAMR declined from 29.35 in 1999 to 12.00 in 2023 (average annual percent change (AAPC): -3.75%; 95% CI: -4.71 to -2.77; p < 0.000001). Mortality due to osteoporosis with pathological fracture showed a sharper decline (AAPC: -5.14%) compared to osteoporosis without fracture (AAPC: -3.62%). White women had the highest AAMRs throughout, though all racial/ethnic groups experienced significant reductions. Regional analysis revealed the highest mortality rates in the Midwest and West, with Vermont reporting the highest state-level AAMR (74.97). Recent years (2018-2021) showed non-significant increases in mortality across subgroups, which may be associated with healthcare disruptions during COVID-19.

Osteoporosis-related mortality among postmenopausal women significantly declined over the past 25 years, reflecting advances in diagnosis, treatment, and prevention. However, persistent racial, geographic, and fracture-related disparities underscore the need for targeted public health interventions and equitable access to osteoporosis care.