The objective of this study is to quantify disparities by race, sex, and geographic region for mortality rates from neurologic disease among U.S adults aged 25-54 from 2018 - 2024.

Neurologic diseases are major cause of premature mortality, with growing concerns for an increasing burden among young and working age adults. Prior studies have suggested significant disparities in neurologic outcomes across race, sex, and geographic regions in the United States. However, contemporary population level take data evaluating the trends in premature neurologic mortalities and the extent of these disparities are limited.

We performed a retrospective observational study using the CDC WONDER Multiple cause of death database. Mortality data for neurologic diseases (ICD-10 codes G00-G99) among individuals aged 25 to 54 years were analyzed from 2018 to 2024. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated. Analysis was stratified by sex, race/ethnicity, and geographic regions. The temporal trends were assessed across the study, and the relative differences between these groups were compared.

A total of 56, 558 premature neurologic deaths from ages 25 to 54 were identified in the United States between 2018 and 2024. The overall age-adjusted mortality rates (AAMRs) demonstrate an increasing trend over the study period. Mortality rates are consistently higher among males compared to females. By race/ethnicity non-Hispanic black individuals exhibited the highest mortality rates with the persistent disparity which compared to non-Hispanic white individuals. Mortality rates also varied by geographic region with the Southern United States demonstrating the highest burden, followed by Midwest, then West, and the Northeast.

The premature neurologic mortality remains substantial in the United States with it with significant sex, race, and geographic disparities in the United States. These findings highlight need for targeted prevention strategies and improved access to neurologic care.