Temporal analysis of sickle cell disease mortality in adults (1999-2020): insights from the CDC WONDER database

This study aimed to evaluate temporal trends in adult sickle cell disease (SCD) mortality in the United States from 1999 to 2020, stratified by age, sex, race, and geography, to identify disparities and guide targeted interventions.

A retrospective observational study was conducted using national mortality data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiological Research (CDC WONDER) database. The sample included adults aged ≥15 years who died from SCD between 1999 and 2020 (n = 17,443). Age-adjusted mortality rates (AAMRs) were calculated and stratified by demographic and geographic variables. Temporal trends were assessed using Mann-Kendall trend tests, and t-tests were applied to compare continuous variables across subgroups. Statistical significance was defined as P < 0.05.

The AAMR for adult SCD increased by 132% over the study period (P = 0.014). The greatest rise in mortality was observed among adults aged ≥65 years (P = 0.008) and women (P = 0.015). Black individuals accounted for 97.5% of SCD-related deaths, underscoring severe racial disparities. Geographically, the Southern region exhibited the highest AAMR and was the only region with a statistically significant increase in mortality over time (P = 0.001).

Adult SCD mortality in the United States has risen significantly from 1999 to 2020, with disproportionate increases among older adults, women, and individuals in the Southern region. The findings highlight urgent needs for targeted national interventions, development of age-specific care models, and implementation of equity-focused health policies to address persistent racial and regional disparities in SCD outcomes.