Disparities in hernia-related mortality among older adults in the U.S. A 21-year analysis of the CDC-WONDER database

Introduction: Hernias are common conditions often requiring surgical intervention. Despite advancements in medical techniques, hernia-related mortality remains a significant concern, particularly among older adults. This study aims to analyze the mortality trends and disparities in hernia-related deaths among U.S. adults aged 65 and older over a 21-year period, focusing on demographic and geographic discrepancies. Methods: Data from the CDC-WONDER database, spanning from 1999 to 2020, was used to identify hernia-related deaths among individuals aged 65 and older, classified by ICD-10 codes K40-46. Mortality rates were stratified by age, sex, race, geography, and place of death. Annual age-adjusted mortality rates (AAMRs) were calculated using the 2000 U.S. population as a baseline, and trends were analyzed using Joinpoint regression v.5.2.0 to estimate annual percent changes (APCs) and overall average annual percent changes (AAPCs) from 1999 to 2020. Results: The study identified 32,597 hernia-related deaths in older adults, with a predominance in females (61.39%) over males (38.61%). AAMR values showed stability overall but were consistently higher among older men (3.54 per 100,000 95% CI: 3.48–3.60) compared to older women (3.52 per 100,000, 95% CI: 3.47–3.57). Racial disparities were notable, with non-Hispanic Whites exhibiting the highest AAMRs (3.66 per 100,000) with a rising trend ((AAPC NH White: 0.46; 95% CI: 0.22 to 0.73)), while non-Hispanic Black and Hispanic populations showed declining or stable trends. Throughout the study duration, rural areas had higher overall AAMRs versus urban areas, with overall AAMR values of 4.07 (95% CI: 3.98–4.17) and 3.43 (95% CI: 3.38–3.47), Conclusion: While overall hernia-related mortality rates have remained stable, significant demographic and geographic disparities persist. Older men, non-Hispanic Whites, and residents of rural areas and the Midwest are at higher risk. These findings highlight the need for targeted public health interventions to address these disparities and reduce the mortality burden from hernias among older adults.