Abstract TP182: Trends and Disparities in Malnutrition and Stroke-Related Deaths Among Adults in the United States: A CDC WONDER Analysis (1999-2023)

Background: Stroke and malnutrition remain significant contributors to preventable mortality in the United States. Stroke is a leading cause of death and disability, while malnutrition, often underrecognized, exacerbates neurological and systemic vulnerability. Characterizing long-term national and subgroup-specific mortality patterns is critical for guiding public health interventions and policies. Methods: Mortality data for stroke ( I60–I64) and malnutrition (E40–E46) were analyzed from 1999 to 2023 using the CDC WONDER database. Age-adjusted mortality rates per 1000,000 population were calculated with the 2000 U.S. standard population. Joinpoint regression was applied to estimate average annual percent change (AAPC) with 95% confidence intervals (CIs). Analyses were stratified by sex, race/ethnicity, census region, metropolitan status, and state. Results: From 1999 to 2023, 44,368 deaths were attributed to stroke and malnutrition. The national AAMR rose from 12.11 in 1999 to 14.75 in 2023, with an overall AAPC of 0.88% (95% CI: –0.14 to 1.91). Males had higher mortality (8.06) than females (7.57). By race and ethnicity, Black or African American populations experienced the greatest burden (14.28), followed by White (7.28), Hispanic or Latino (6.53), and Asian or Pacific Islander (5.53) groups. Regionally, the South showed the highest rate (9.57), followed by the Midwest (8.29), West (7.80), and Northeast (4.21). Nonmetropolitan areas (9.20) exceeded metropolitan areas (6.52). At the state level, the highest rates were observed in South Dakota (14.74) and Arkansas (14.41), while Massachusetts recorded the lowest (2.57). Conclusion: From 1999 to 2023, combined mortality from stroke and malnutrition increased modestly nationwide, with enduring disparities across demographics and geography. The highest burdens fell on Black or African American individuals, people living in the South and nonmetropolitan areas, and certain central states. These findings highlight the need for region-specific prevention and better access to nutritional and neurological care.