Geographic and Demographic Patterns in Influenza- and Pneumonia-Related Mortality Among Older Adults: A Nationwide Analysis Using the CDC WONDER Database, 1999–2020

Geographic and Demographic Patterns in Influenza- and Pneumonia-Related Mortality Among Older Adults: A Nationwide Analysis Using the CDC WONDER Database, 1999–2020 | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 29 July 2025 V1 Latest version Share on Geographic and Demographic Patterns in Influenza- and Pneumonia-Related Mortality Among Older Adults: A Nationwide Analysis Using the CDC WONDER Database, 1999–2020 Authors : Meer Murtaza 0009-0009-6730-0028 , Asia Batool , Iffat Ambreen Magsi , Syed Ayesha Ali , Mazhar Ali Shah , Muhammad Bilal Khanzada , Fatima Aslam , Aniqua Aftab , Tirath Patel 0009-0002-8099-238X , Makhzan Ali Akbar , Raheel Ahmed [email protected] , and Ali Hasan Authors Info & Affiliations https://doi.org/10.22541/au.175381757.77207397/v1 407 views 342 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Background Although influenza and pneumonia are among the leading causes of death in adults aged ≥65, their long-term mortality trends and demographic disparities remain underexplored, which we aim to analyze in this study. Methods CDC WONDER Multiple Cause of Death database (1999-2020) was used to identify deaths in adults aged ≥65 years with influenza and/or pneumonia (ICD-10: J09–J18) as contributing causes. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 U.S. standard population. Joinpoint regression estimated annual percentage changes (APCs) with 95% confidence intervals (CIs), stratified by sex, race/ethnicity, region, urbanization, place of death, and state . Results From 1999 to 2020, 3,462,340 deaths were recorded. Most occurred in medical facilities (65.45%) and nursing homes (23.7%). AAMR declined from 585.69 to 473.44, with a significant drop from 1999-2018 (APC: -4.97), followed by a sharp rise from 2018-2020 (APC: 38.14), reflecting early COVID-19 impact. Males (463.84) had higher AAMR than females (316.04). NH Americans (408.47) had the highest burden; NH Asians (301.78) lowest. Geographically, the Midwest (381.65), Kentucky (506.63), and rural (NonCore) areas (445.68) had the highest AAMR; the South (368.75), Florida (235.6), and urban (Large Fringe Metro) areas (348.09) lowest. Conclusion After decades of decline, influenza-and pneumonia-related mortality rose sharply post-2018 likely due to COVID-19. Findings highlight widening disparities and the urgent need for target prevention in Midwestern, NH American Males of rural and high-burden states. Supplementary Material File (title page abstract mainuscript with figures and tables.docx) Download 811.43 KB Information & Authors Information Version history V1 Version 1 29 July 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords cdc wonder disparities influenza mortality older adults pneumonia trends Authors Affiliations Meer Murtaza 0009-0009-6730-0028 Liaquat University of Medical & Health Sciences View all articles by this author Asia Batool Sir Syed College of Medical Sciences for Girls View all articles by this author Iffat Ambreen Magsi Shaheed Mohtarma Benazir Bhutto Medical College View all articles by this author Syed Ayesha Ali Dow Medical College View all articles by this author Mazhar Ali Shah Khyber Medical College View all articles by this author Muhammad Bilal Khanzada Liaquat University of Medical & Health Sciences View all articles by this author Fatima Aslam University of Bradford Institute of Cancer Therapeutics View all articles by this author Aniqua Aftab Jinnah Sindh Medical University View all articles by this author Tirath Patel 0009-0002-8099-238X Trinity School of Medicine View all articles by this author Makhzan Ali Akbar North Sichuan Medical College View all articles by this author Raheel Ahmed [email protected] Imperial College London View all articles by this author Ali Hasan Imperial College London View all articles by this author Metrics & Citations Metrics Article Usage 407 views 342 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Meer Murtaza, Asia Batool, Iffat Ambreen Magsi, et al. Geographic and Demographic Patterns in Influenza- and Pneumonia-Related Mortality Among Older Adults: A Nationwide Analysis Using the CDC WONDER Database, 1999–2020. Authorea . 29 July 2025. DOI: https://doi.org/10.22541/au.175381757.77207397/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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