INTRODUCTION Anemia and chronic lower respiratory diseases (CLRD) are highly co-occurring conditions that increase the risk of mortality. Anemia impairs oxygen delivery, intensifying respiratory symptoms, while chronic inflammation in CLRD can worsen anemia. We analyzed understudied mortality trends from 1999 to 2023 related to Anemia and CLRD in U.S.

METHODS Using the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database, we conducted a retrospective analysis of death certificates of adults (aged 45≤) having both Anemia and CLRD. Age-adjusted mortality rates (AAMR) per 100,000 population and annual per cent changes (APC) in age-adjusted mortality rates were determined and measured across different demographics and geographics in the U.S.

RESULTS Anemia and CLRD have caused a total of 183,764 deaths. The overall AAMR increased from 5.7 to 6.5 from 1999 to 2023. From 1999, AAMR increased significantly till 2011 (0.91), followed by a sharp decrease until 2017 (APC: -3.42), after which it continued to increase greatly till 2021 (APC: 6.45) and then declined up to 2023. Males (7.4) had higher AAMR compared with females (5.3), and older individuals had 16-fold greater AAMR than adults in their Middle Ages. The top AAMR of 6.4 was seen in NH African Americans compared with other races/ethnicities. Geographically, AAMR was higher in non-metropolitan areas (7.9) and Midwest (6.9).

CONCLUSIONS High-risk demographics and geographics need proper resource allocation and targeted interventions to lower the Anemia and CLRD-related death burden.

Keywords: Anemia; chronic lower respiratory diseases; Age-Adjusted Mortality Rates; CDC Wonder; gender and racial disparities

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