Evolving trends and disparities in mortality from skin and subcutaneous tissue disease among older U.S. adults: public health insights from CDC WONDER 1968 to 2023.

BACKGROUND: Diseases of the skin and subcutaneous tissue represent a crucial yet understudied contributor to morbidity and mortality, particularly in older adults. Despite an aging population and substantial disease burden, national mortality patterns, temporal trends, and demographic disparities remain poorly described. METHODS: This study utilized CDC WONDER Underlying Cause of Death data from 1968 to 2023 to identify deaths amongst U.S adults aged ≥65 years attributed to skin and subcutaneous tissue diseases. Age-adjusted mortality rates (AAMRs) per 100,000, crude mortality rates (CMRs) per 100,000, average annual percent change (AAPC), and annual percent change (APC) by period were calculated and stratified by sex, race, age, census region, and state. RESULTS: A total of 161,822 deaths from skin and subcutaneous tissue disease occurred among U.S. adults ≥65 years from 1968 to 2023. Overall AAMRs increased from 6.74 in 1968 to 9.83 in 2023 (AAPC: 0.91; 95% CI: 0.76 to 1.12, p < 0.001), and the greatest rate of increase in AAMRs was from 7.60 in 2017 to 9.83 in 2023 (APC: 5.65; 95% CI: 3.60 to 10.14, p < 0.001). Women had a similar mean AAMR (9.10) to men (8.75); however, men had a greater rise in AAMR, increasing from 6.41 in 1968 to 10.00 in 2023 (AAPC: 1.17; 95% CI 1.01 to 1.39, p < 0.001). White Americans had a lower mean AAMR (7.87) than Black or African Americans (23.15), but had a greater rise in AAMR, increasing from 6.37 in 1968 to 9.59 in 2023 (AAPC: 1.02; 95% CI 0.87 to 1.20, p < 0.001). Regionally, the South had the greatest mean AAMR (10.72), but had the lowest rate of increase in AAMR, increasing from 8.23 in 1968 to 9.54 in 2023 (AAPC: 0.65; 95% CI: 0.47 to 0.90, p < 0.001). State-wise deaths were highest in New York (n = 12,682, 7.92%) and lowest in Alaska (n = 119, 0.07%). CONCLUSION: Skin and subcutaneous tissue-related disease mortality significantly rose from 1968 to 2023, with recent mortality trends highlighting a cause for concern. The marked heterogeneity in disease burden between demographic and geographical groups highlights the urgent need for equitable and targeted public health interventions.