P1450 - Trends in Malnutrition-Related Mortality in the United States, 1999-2020: An Epidemiological Analysis

Muhammad Ali Khaqan, MD¹, Muhammad Shahzil, MD², Zainab Alvi, MBBS³, Luqman Munir, ³, Ali Akram Qureshi, ³, Syed Adeel Hassan, MD⁴, Terrence Barrett, MD^4
1John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; ²Penn State Health Milton S. Hershey Medical Center, Hershey, PA; ³King Edward Medical University, Lahore, Punjab, Pakistan; ⁴University of Kentucky, Lexington, KY

Introduction: Over the past two decades, malnutrition-related mortality in the United States has shown a troubling increase, posing significant public health challenges exacerbated by socio-economic disparities and systemic inequities. This study analyzes trends from 1999 to 2020 using age-adjusted mortality rates (AAMR) to understand patterns across demographics and regions.

Methods: Data from the CDC WONDER database were analyzed for malnutrition-related deaths from January 1, 1999, to December 31, 2020, across all age groups. We calculated age-adjusted mortality rates (AAMRs) per 100,000 population and the average annual percentage change (AAPC). Annual percentage changes (APCs) with 95% confidence intervals were assessed to understand AAMR trends using Joinpoint regression analysis. The Monte Carlo Permutation Procedure (MCPP) analyzed mortality trends. Statistically significant results were determined by a p-value < 0.05, using a two-sided t-test against a null value of 0.

Results: The analysis included 103,962 malnutrition-related deaths over the study period. After a decrease in age-adjusted mortality rate (AAMR) from 1999 to 2006, rates plateaued until 2013, then rose, reaching 3.449 in 2020. Higher AAMRs were seen among females (1.425), African Americans (2.047), non-metropolitan residents (1.651), and the Southern region (1.75). The average annual percent change (AAPC) for overall mortality was 3.9748. APC analysis showed a decline from 1999 to 2006 (APC -8.1051), stabilization from 2006 to 2013, and acceleration from 2013 to 2020 (APC 21.4189). Lower AAMRs were found in metropolitan areas (1.222) compared to non-metropolitan (1.539). The 85+ age group had the highest AAMR (199.6) and a significant recent rise. African Americans had substantially higher AAMRs (2.047) than Whites (1.354).

Discussion: Analysis of 22 years shows alarming malnutrition-related mortality disparities in the US across ethnicities, gender, urbanization, and regions. Urgent public health action is needed to address systemic inequities through enhanced food security, healthcare access, and socio-economic support to curb rising death rates.



Disclosures:


Muhammad Ali Khaqan, MD¹, Muhammad Shahzil, MD², Zainab Alvi, MBBS³, Luqman Munir, ³, Ali Akram Qureshi, ³, Syed Adeel Hassan, MD⁴, Terrence Barrett, MD⁴. P1450 - Trends in Malnutrition-Related Mortality in the United States, 1999-2020: An Epidemiological Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.