Trends in respiratory disease mortality in the United States, 1999–2024

Wenjing Wu, Ruonan Tian, Huaqing Guo, Zhiguang Duan

Background Respiratory diseases are a leading cause of death in the US. This study examines mortality trends from 1999 to 2024 using CDC WONDER data, focusing on disparities by sex, age, race/ethnicity, and region. Methods An ecological time-trend study calculated crude and age-adjusted mortality rates (AAMR) and used Joinpoint regression to estimate annual changes. Results From 1999 to 2024, respiratory disease deaths increased from 227,985 to 263,209 (+15.5%), while AAMR declined from 129.37 to 91.70 per 100,000 (AAPC = −1.37). The decline accelerated after 2018. AAMR was consistently higher in males, but decreased more steeply in males. All regions showed declining AAMR, with the West having the largest reduction, whereas the South had the largest rise in death counts. All racial/ethnic groups saw AAMR declines, yet non-Hispanic Whites bore the highest burden, and Hispanics/other races showed larger absolute death increases. Older adults carried the heaviest burden, while adults aged 25–34 years experienced a slight AAMR increase. Conclusion Although age-adjusted respiratory mortality declined continuously from 1999 to 2024, the absolute number of deaths rose, with marked subgroup heterogeneity. Future strategies should target men, older adults, Southern residents, and younger adults.