A new national analysis of mortality data reveals that Americans living with both stroke and diabetes continue to face sharply unequal health outcomes, with the steepest burdens falling on older adults, rural residents, and non-Hispanic Black communities. The study reports that the age‑adjusted mortality rate for people with both conditions declined from 16.47 to 9.70 per 100,000 between 1999 and 2023, yet the pace of improvement was “slower among individuals aged ≥85 years, non-Hispanic Black populations, and non-metropolitan area residents.”
Racial disparities were especially pronounced. Non-Hispanic Black adults had the highest mortality rate in 1999 at 33.42 per 100,000 and still recorded 18.04 in 2023—far above non-Hispanic Whites, whose rate fell to 8.35. The study notes that these inequities reflect “historically disadvantaged groups” facing disproportionately high comorbidity-related mortality.
Geography deepened the divide. Mortality rates “consistently been higher” in non-metropolitan areas, where declines were slower and pandemic-era increases more severe. The South also carried the highest regional burden across the study period.
Researchers found that the COVID‑19 pandemic caused a temporary reversal in progress, with many subgroups experiencing sharp increases from 2018 to 2021. They point to disruptions in chronic disease management and the heightened vulnerability of older adults as contributing factors.
Despite overall declines, the authors emphasize that mortality “remains elevated among older adults and populations with limited access to healthcare services,” underscoring the need for targeted, equity‑focused interventions.
See: “Temporal trends and disparities in stroke and diabetes mellitus comorbidity-related mortality from 1999 to 2023” (December 17, 2025)
