New national data show major declines in RA mortality among older women, alongside enduring racial and geographic inequities.
Rheumatoid arthritis (RA)–related mortality among postmenopausal women in the United States has declined substantially from 1999 to 2023, though meaningful disparities by race, geography, and age remain, according to a new population-based analysis published in iMetaMed. The findings suggest that advances in RA treatment and broader access to care have translated into real survival gains, while also highlighting populations that continue to experience a disproportionate burden of disease.1
The study examined RA-related mortality trends among women in the United States aged 55 years and older between 1999 and 2023, using data from the CDC’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. Because menopausal status is not recorded in national mortality data, the researchers used an age cutoff of 55 years to identify postmenopausal women, a threshold commonly applied in epidemiologic research.
Key methodological features included age-adjusted mortality rates (AAMRs) calculated per 100,000 population using the 2000 US Standard Population, Joinpoint regression to estimate annual percentage change, and forecasting models to project mortality trends through 2030.
Between 1999 and 2023, a total of 42,497 postmenopausal women in the United States died from RA-related deaths. Over that period, mortality declined markedly1,2:
Analyses separating RA deaths with and without COVID-19 involvement suggested that pandemic-related disruptions and infection risk disproportionately affected people living with RA during that period.1
Despite overall progress, the study identified consistent disparities across demographic groups. By race and ethnicity, non-Hispanic White women experienced the highest RA-related mortality rates throughout most of the study period, followed by Hispanic or Latino women, non-Hispanic Black women, and other racial groups.1,2
Geographic variation was also pronounced:
Age-stratified analyses showed that women aged 85 years and older had the highest mortality rates across all years studied, underscoring the compounded risks associated with advanced age, comorbidities, and immunosenescence.1
Using forecasting models, the researchers projected that RA-related mortality among postmenopausal women will continue to decline over the remainder of the decade. By 2030:
While these projections point to continued improvement, the authors emphasized that future healthcare disruptions or emerging public health crises could alter this trajectory.
"RA mortality among postmenopausal women has significantly declined since 1999, reflecting advances in treatment and healthcare delivery,” the study investigators concluded. “Despite these gains, persistent disparities across racial, ethnic, regional, and age groups underline the need for targeted public health interventions and equitable access to care for vulnerable populations.”
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