# Osteoporosis-Associated Mortality in Postmenopausal Women in the United States From 1999 to 2023: A CDC WONDER-Based Study

## TL;DR

This study shows a significant decline in osteoporosis-related deaths among postmenopausal women in the U.S. from 1999 to 2023, but disparities remain.

## Contribution

The study provides a comprehensive 24-year analysis of osteoporosis-related mortality trends and disparities in postmenopausal women using CDC data.

## Key findings

- Osteoporosis-related mortality rates dropped from 29.35 to 12.00 per 100,000 from 1999 to 2023.
- Mortality rates were highest in the Midwest and West regions, with Vermont having the highest state-level rate.
- Recent years saw non-significant increases in mortality, possibly linked to healthcare disruptions during the pandemic.

## Abstract

Background and Aim: Osteoporosis remains a significant contributor to illness and death among postmenopausal women, primarily due to complications from fractures. This study examined national trends and disparities in osteoporosis-related mortality over a 24-year period.
Methods: Mortality records of postmenopausal women from 1999 to 2023 were analyzed using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database to assess osteoporosis-related deaths. Age-adjusted mortality rates (AAMRs) were calculated and examined across time, demographic groups, geographic regions, and fracture involvement. Statistical trend analysis was used to evaluate changes in mortality patterns over time.
Results: A total of 232,877 osteoporosis-related deaths were recorded. The overall AAMR declined from 29.35 in 1999 to 12.00 in 2023 (average annual percent change (AAPC): -3.75%; 95% CI: -4.71 to -2.77; p < 0.000001). Mortality due to osteoporosis with pathological fracture showed a sharper decline (AAPC: -5.14%) compared to osteoporosis without fracture (AAPC: -3.62%). White women had the highest AAMRs throughout, though all racial/ethnic groups experienced significant reductions. Regional analysis revealed the highest mortality rates in the Midwest and West, with Vermont reporting the highest state-level AAMR (74.97). Recent years (2018-2021) showed non-significant increases in mortality across subgroups, which may be associated with healthcare disruptions during COVID-19.
Conclusion: Osteoporosis-related mortality among postmenopausal women significantly declined over the past 25 years, reflecting advances in diagnosis, treatment, and prevention. However, persistent racial, geographic, and fracture-related disparities underscore the need for targeted public health interventions and equitable access to osteoporosis care.