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Abstract
Introduction: This study used CDC WONDER data to examine U.S. adult epilepsy-related mortality trends from 1999–2020, focusing on demographic and geographic patterns to inform health policy and guide targeted interventions.
Objective: To evaluate epilepsy-related mortality trends among U.S. adults by age, sex, race/ethnicity, and geography.
Materials and Methods: A retrospective observational analysis of CDC WONDER mortality data (ICD-10 G40–G41) was conducted for adults ≥25 years. Crude death rates (CDR) and age-adjusted mortality rates (AAMR) per 100,000 were calculated with 95% confidence intervals and stratified by age group, sex, race/ethnicity, and U.S. region. Joinpoint regression identified significant trend changes over time.
Results: Nationally, the CDR nearly doubled from 0.6 to 1.1 per 100,000, while AAMR accelerated after 2011 (annual percent change +9.56%, p < 0.001). Males consistently had higher mortality than females (AAMR 10.5 vs. 6.0 in 2020). Black individuals bore the greatest burden (AAMR 13.0/100,000 in 2020). The steepest rise occurred in adults aged 25–34 years, whose AAMR increased from 3.0 to over 14.0. Geographic disparities were evident, with the highest state-level AAMRs in Michigan (1,113.26), California (746.46), and Florida (518.55). Several Central and Northwestern states had suppressed data because of low counts.
Conclusion: Epilepsy-related mortality in U.S. adults rose sharply from 1999–2020, with disproportionate increases among young adults, males, Black populations, and residents of certain states. The post-2011 inflection suggests changing risk factors or care gaps. Targeted strategies addressing structural inequities and improving regional resources are urgently needed.
Keywords: Epilepsy/mortality; Health Status Disparities; United States/epidemiology; Retrospective Studies; Population Surveillance