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. 2025 Jun 23:23:101050.
doi: 10.1016/j.ajpc.2025.101050. eCollection 2025 Sep.

Cardiometabolic deaths in premenopausal black and white women

Rebecca Arden Harris  1   2   3 , Sameed Ahmed M Khatana  2   4   5 , Judith A Long  2   5   6
Affiliations

Cardiometabolic deaths in premenopausal black and white women

Rebecca Arden Harris et al. Am J Prev Cardiol. .

Abstract

Background: Black women in the United States bear a disproportionate burden of cardiometabolic disease (CMD) beginning in adolescence, while CMD mortality is often thought to emerge at menopause. This study estimates and compares CMD mortality risks in Black and White women aged 25-44 years.

Methods: Using National Vital Statistics System data and life table methods, we estimated CMD mortality risk in hypothetical cohorts of non-Hispanic Black and White women aged 25-44, with cohort sizes matched to the 2022 U.S. population. We estimated cumulative risk and quantified excess mortality, proportional mortality, and years of life lost (YLL).

Results: The cumulative CMD mortality was 0.90 % (95 % CI: 0.86 % to 0.93 %) for Black women and 0.33 % (95 % CI: 0.32 % to 0.34 %) for White women (risk ratio: 2.74, 95 % CI: 2.64 to 2.85). Of the 2,716 expected CMD deaths in the Black cohort, 1,735 or 63.89 % (95 % CI: 62.53 % to 65.24 %) were excess deaths. CMD accounted for 20.13 % (95 % CI: 19.45 % to 20.80 %) of deaths in Black women (rising from 7.8 % at age 25 to 27.6 % at age 44) versus 10.73 % (95 % CI: 10.40 % to 11.06 %) in White women (rising from 6.0 % to 15.6 %). Average YLL was 4.42 months (95 % CI: 4.40 to 4.44) for Black women and 1.70 months (95 % CI: 1.69 to 1.71) for White women.

Conclusions: CMD mortality was higher in younger Black than White women and emerged well before menopause. Reducing these disparities requires earlier screening, improved healthcare access, and structural reforms.

Keywords: Black women; Cardiometabolic mortality; Life table analysis; Premenopausal; Racial disparities; Years of life lost.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Unlabelled image
Central illustration: Risk of cardiometabolic death: Black vs. White premenopausal women.
Fig 1
Fig. 1
Proportional mortality (percent of all deaths due to cardiometabolic diseases) for Black and White women ages 25-44 years*.
Fig 2
Fig. 2
Black and White female cardiometabolic mortality rate, 1999-2023.
See this image and copyright information in PMC

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