Demographic and regional trends in pneumonia and sepsis related mortality in the U.S., 1999–2020: a CDC wonder database analysis

Background: Pneumonia and sepsis remain major health issues in the United States. Despite a high mortality burden and interconnected nature, they remain underexplored in terms of population-level mortality trend analyses. Understanding their impact is essential for improving therapeutic strategies and reducing preventable deaths. Objective: We aimed to explore long-term demographic and geographical trends of pneumonia and sepsis-related mortality in the United States from 1999 to 2020. Methods: The CDC WONDER national database was utilized to analyze differences in mortality associated with pneumonia and sepsis. Age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and Jointpoint Regression Program was used to determine the trends in mortality. Results: The results demonstrated that 806,434 deaths occurred during the study period, with a significant increase in AAMR from 16.66 in 1999 to 25.06 in 2020. Males consistently maintained higher AAMRs than females throughout the observed period (overall AAMR men: 21.16 vs. women: 13.94). AAMRs were highest among NH African Americans and lowest among NH Asians or Pacific Islanders. AAMR also varied substantially by region (overall AAMR: Midwest 14.45; South: 18.82; West: 16.92; Northeast: 16.21). Similarly, higher AAMRs were observed in non-metropolitan areas (17.32) compared with metropolitan areas (16.86). Conclusion: Despite all the limitations, the findings provide a valuable foundation for future research and targeted public health interventions.