To identify stroke-related mortality trends and disparities in the younger population using the Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) database.

We utilized the International Classification of Diseases (ICD)-10 codes I60-I69 to extract stroke-related mortality data from the CDC WONDER database for individuals aged 0 to 24 years in the US. Age-adjusted mortality rates (AAMR) were extracted and stratified according to gender, race, and geographic location. Trends in AAMRs were studied by calculating annual percentage change (APC) via Joinpoint regression (Joinpoint Regression Program V 5.2.0). 

A total of 24,577 stroke-related deaths occurred in children and young adults in the US from 1999 to 2020. The AAMR remained stable from 1999 to 2006 (APC: 0.02), followed by a decrease until 2014 (APC: -2.39) and an increment thereafter until 2020 (APC: 2.08). The AAMR for males (1.21) remained consistently higher than that for females (0.98). Disparities among races were noticed as well. The highest overall AAMR was observed among non-Hispanic (NH) Black or African Americans (1.74), followed by Hispanic or Latinos (1.05), NH Whites (0.96), and NH Asian or Pacific Islanders (0.89). Geographic stratification revealed a slightly higher AAMR in metropolitan counties (1.11) compared to non-metropolitan counties (1.07). Furthermore, the South exhibited the highest AAMR (1.14), followed by the Midwest (1.11), the West (1.11) and the Northeast (0.89). 

The highest stroke-related death rate in children and young adults was observed among males, NH Black or African Americans, and residents of metropolitan counties and the South. It is imperative to focus on policies to reduce mortality in this population.