Obesity mortality on the rise: A 54-year US perspective

Obesity has emerged as a significant public health concern in the US over the past five decades. This study analyses obesity mortality trends from 1968 to 2021, focusing on disparities across age, sex, race, and geographic regions. This population-based descriptive study used national mortality data from the CDC WONDER. Obesity deaths among individuals aged ≥25 years, recorded as the underlying cause, were identified using ICD codes from 1968 to 2021. Age-adjusted mortality rates (AAMRs) per 100 000 individuals were calculated. Temporal trends were analysed using Joinpoint regression. From 1968 to 2021, 174 625 obesity deaths were recorded. AAMRs increased from 1.15 (95% CI: 1.09-1.22) in 1968 to 3.39 (95% CI: 3.31-3.46) in 2019; AAMR rates increased from 3.39 (95% CI: 3.31-3.46) in 2019 to 4.54 (95% CI: 4.45-4.62) in 2021. The decline was noted from 1968 to 1985, followed by an increase until 2019; there was a substantial increase from 2019 to 2021 during the COVID-19 pandemic. Males had higher AAMRs than females during the latter part of the study period. Racial disparities persisted, with Black or African American individuals having higher AAMRs than White individuals during the study period. Between 1999 and 2019, obesity mortality rates ranged from 1.62 (95% CI: 1.44-1.80) in Hawaii to a high of 4.46 (95% CI: 4.21-4.72) in West Virginia. After a decline from 1968 to 1985, obesity AAMRs rose until 2019, and spiked during the pandemic, reaching their highest recorded level in 2021. Disparities persist across sex, race, and geography, warranting targeted public health strategies.