Evaluating Disparities in Places of Death in the United States Among Patients With Intellectual Disabilities: A 22-Year Analysis Using the CDC-WONDER Database

Background In the United States, intellectual disabilities are related to higher death rates. Given the relationship between intellectual disabilities and places of death, it is important to evaluate trends and disparities in places of death to direct physician and patient education and improve the chances of patients who will receive end-of-life care to be suitable with their preferences and values. In this study, the data from the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) database was used to examine mortality trends in places of death of patients with intellectual disabilities in the United States between 1999 and 2020. Methodology The data were collected with the International Classification of Diseases 10th Revision codes F70-F79 (intellectual disability) from the CDC WONDER website on July 20, 2023, to evaluate disparities in places of death. R programming software was used to conduct statistical analysis for predicting death trends in hospice or home care for age groups, genders, census regions, and races. Results In total, 9,432 patients with intellectual disabilities died between 1999 and 2020. The highest number of deaths was in the age group of 55-64 years (2,281) and the lowest was in the age group of 1-4 years (55). The data showed that mortality rates among various demographic groups varied significantly. The age group of 25-34 years was more likely to die in a home/hospice setting (odds ratio (OR) = 2.137, confidence interval (CI) = 1.452, 3.145, p < 0.001), considering 85+ years as the reference age. The age group of 1-4 years had the lowest risk of death at home or hospice (OR = 0.147, CI = 0.108, 0.2, p = 0.001). Conclusions The deaths from intellectual disabilities from 1999 to 2020 were higher in medical facilities than those in home or hospice care. The mortality was higher for older adults, whites, and males in the Midwest and the South regions, as well as in medical faculties compared to other categories.