Interstitial Lung Disease Mortality Disparities Along the US-Mexico Border, 1999-2020.

Abstract

Background: Optimal diagnosis and management of interstitial lung diseases (ILDs) needs access to specialized centers, frequent monitoring, and complex therapeutic options. In underprivileged areas, these necessities can often lead to barriers in delivering care.

Research question: What are the ILD mortality disparities in the regions along the US-Mexico (US-MX) border?

Study design and methods: We obtained ILD mortality information through death certificate queries from the Centers for Disease Control and Prevention repository. Death data were adjusted for age and stratified by US-MX border regions and nonborder regions in the United States. Log-linear regression models were used to analyze mortality trends in the period from 1999 to 2020 followed by calculation of annual percentage changes (APCs). Age-adjusted mortality rates (AAMRs) were compared across cumulative and subdemographic populations.

Results: ILD-related mortality among border regions (AAMR, 5.31) was higher than nonborder regions (AAMR, 4.86). Mortality within border regions remained unchanged from 1999 to 2020 (APC, 0.3; P = .269). Nonborder regions experienced a significant rise in mortality rates (APC, 2.6; P = .017) from 1999 to 2005 and remained unchanged from 2005 to 2020. Mortality was higher within both men (AAMR, 6.57) and women (AAMR, 4.36) populations among border regions compared with their nonborder counterparts (AAMR, 6.27 and 3.87, respectively). Hispanic populations among the border regions experienced higher mortality rates (AAMR, 6.15) than Hispanic populations within nonborder regions (AAMR, 5.44). Non-Hispanic populations encountered similar mortality rates between the two regions. Mortality rates among Hispanic (APC, 0.0; P = .938) and non-Hispanic (APC, 0.2; P = .531) populations in the border regions remained unchanged from 1999 to 2020.

Interpretation: These results revealed ILD-related mortality disparities among the US-MX border regions, emphasizing the importance of public health measures to increase access to equitable medical care and implement targeted interventions among these vulnerable populations.