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. 2025 May 12;17(5):e83957.
doi: 10.7759/cureus.83957. eCollection 2025 May.

Temporal Trends and Disparities in Chronic Liver Disease Mortality: An Analysis Using National Center for Health Statistics (NCHS) Data Ranging From 1999 to 2023

Victor C Ezeamii  1 , Chukwujindu I Arinzechi  2 , Oghenemaro O Oghotuoma  3 , Uwakmfonabasi Umoudoh  4 , Afolake A Adebayo  5 , Ogechukwu H Nnabude  6 , Taiwo Ajani  7 , Bolaji Ayinde  8 , Chinelo Anyaorah  9 , Gift Ojukwu  10
Affiliations

Temporal Trends and Disparities in Chronic Liver Disease Mortality: An Analysis Using National Center for Health Statistics (NCHS) Data Ranging From 1999 to 2023

Victor C Ezeamii et al. Cureus. .

Abstract

Background: Chronic liver disease (CLD) remains a significant global health concern, with fluctuating mortality trends over the past two decades. This study analyzes age-adjusted CLD mortality rates using data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) from 1999 to 2023, highlighting temporal trends and demographic disparities.

Methods: We conducted a retrospective analysis of CLD mortality rates stratified by year, gender, race, age group, and Hispanicity. Age-adjusted mortality rates were computed using direct standardization, and trends were examined over different periods.

Results: Between 1999 and 2006, CLD mortality rates declined from 9.6 to 8.8 per 100,000 population. However, from 2007 onward, mortality rates increased, peaking at 14.5 in 2021, largely driven by the COVID-19 pandemic. Males exhibited consistently higher mortality rates than females. Racial disparities were evident, with American Indian/Alaska Native populations experiencing the highest mortality rates. Age-related trends showed the greatest burden in older adults, while mortality rates in younger populations also rose in recent years. Hispanic individuals demonstrated a significant increase in CLD mortality, particularly post-2010.

Conclusion: CLD mortality has risen significantly since 2007, with a pronounced peak in 2021. Despite a post-pandemic decline, rates remain above pre-2019 levels. These findings emphasize the significance of customized public health interventions and strategies tackling alcohol use, various metabolic risk factors, and healthcare access, especially for high-risk individuals and populations.

Keywords: chronic liver disease; covid-19; epidemiology; gender disparities; mortality trends; public health; racial disparities.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Patterns of underlying causes of death due to chronic liver disease based on gender
Figure 2
Figure 2. Patterns of underlying causes of death due to chronic liver disease based on race
Figure 3
Figure 3. Patterns of underlying causes of death due to chronic liver disease based on age groups
Figure 4
Figure 4. Patterns of underlying causes of death due to chronic liver disease based on Hispanic race
See this image and copyright information in PMC

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