Abstract
BACKGROUND: Asthma remains a major public health concern, with marked mortality disparities by sex and race and related mortality trends among US young adults aged 25 to 54 from 1999 to 2020. METHODS: Age-adjusted mortality rates (AAMR) from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) were stratified by demographics and geography. Trends were assessed using Mann-Kendall test, t test, and analysis of variance. RESULTS: The overall AAMR was 1.886 per 100,000, higher in females than males (2.085 vs 1.655, P < 0.001). Male mortality rose (P = 0.002); female rates nonsignificantly declined (P = 0.18). Nonmetropolitan areas showed a rising trend (P < 0.001), but the rates were not higher than in metropolitan areas (P = 0.20). The Northeast (1.979) and Midwest (1.954) had the highest regional rates, with rising male mortality in the Midwest (P = 0.005) and West (P = 0.04). Black populations had the highest mortality (5.164), though declining (P = 0.004); White rates rose (P < 0.001), especially in males. State-level disparities were evident, highest in the District of Columbia (3.202) and lowest in New Hampshire (1.167). CONCLUSIONS: Asthma mortality in young US adults reveals persistent disparities and troubling trends in historically lower-risk groups. These findings signal critical gaps in early diagnosis, access to care, and exposure management. Without timely, equity-focused public health action, preventable asthma deaths may rise.