Trends in mortality due to asthma in young adults between 1999 and 2020: an analysis of CDC WONDER database

Asthma remains a major public health concern, with marked mortality disparities by sex and race and related mortality trends among US young adults aged 25 to 54 from 1999 to 2020.

Age-adjusted mortality rates (AAMR) from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) were stratified by demographics and geography. Trends were assessed using Mann-Kendall test, t test, and analysis of variance.

The overall AAMR was 1.886 per 100,000, higher in females than males (2.085 vs 1.655, P < 0.001). Male mortality rose (P = 0.002); female rates nonsignificantly declined (P = 0.18). Nonmetropolitan areas showed a rising trend (P < 0.001), but the rates were not higher than in metropolitan areas (P = 0.20). The Northeast (1.979) and Midwest (1.954) had the highest regional rates, with rising male mortality in the Midwest (P = 0.005) and West (P = 0.04). Black populations had the highest mortality (5.164), though declining (P = 0.004); White rates rose (P < 0.001), especially in males. State-level disparities were evident, highest in the District of Columbia (3.202) and lowest in New Hampshire (1.167).

Asthma mortality in young US adults reveals persistent disparities and troubling trends in historically lower-risk groups. These findings signal critical gaps in early diagnosis, access to care, and exposure management. Without timely, equity-focused public health action, preventable asthma deaths may rise.