Reduce reported rate of hepatitis B-related deaths among Asian and Pacific Islander persons by 25% or more

Summary of Findings

Compared to the overall population, Asian and Pacific Islander (A/PI) persons had a much higher age-adjusted hepatitis B-related mortality rate in 2020 (0.45 vs. 2.46 per 100,000, respectively). Similar to the overall population age-adjusted hepatitis B-related mortality rate, in 2020 the mortality rate among A/PI persons increased to 2.46 per 100.000 population, above the 2020 target rate of 2.15. The increase in age-adjusted hepatitis B-related mortality observed during 2020 may have been affected by the overall increase in US mortality during 2020 due to the COVID-19 pandemic; therefore, 2020 data should be interpreted with caution.

Reduction needed to meet 2025 goal:

A 25% reduction from the 2020 rate of hepatitis B-related deaths among A/PI persons is needed to meet the 2025 goal of 1.84 deaths per 100,000 population.

This reduction can best be achieved by:

• Increasing implementation and expanding access to hepatitis B testing for all A/PI persons.
• Increasing access to appropriate treatment and care for A/PI persons with chronic hepatitis B.
• Developing and disseminating culturally affirming hepatitis B education materials that consider the needs of A/PI persons.
• Developing tools and resources to educate providers and key partners that engage with A/PI persons.
• Expanding access to specialty health care providers by using digital technology and telemedicine options tailored to the needs of A/PI persons.

Technical Notes

Data Sources:
CDC, National Vital Statistics System (NVSS)

Numerator:
Number of death records among non-Hispanic A/PI persons with a report of hepatitis B listed as the underlying or one of the multiple causes of death

Denominator:
Total US Census population of non-Hispanic A/PI persons

Indicator Notes:
(1) Death certificates are completed for all deaths registered in the United States. Information for death certificates is provided to funeral directors or cremation organizations by attending physicians, medical examiners, and coroners. Death certificates are filed in vital statistics offices within each state and the District of Columbia. Through the NVSS, information from death certificates is compiled by CDC to produce national multiple-cause-of-death data; causes of death are coded in accordance with the International Classification of Diseases, Tenth Revision. (2) National multiple-cause mortality data from NVSS were obtained and analyzed, and those death records with a report of hepatitis B (ICD-10: B16, B17.0, B18.0, or B18.1) listed as the underlying or one of the multiple (i.e., contributing) causes of death in the record were enumerated. Rates were calculated as the number of deaths related to hepatitis B among A/PI persons who were US residents in the 50 states and the District of Columbia divided by the total US Census population of A/PI persons in these jurisdictions using the bridged-race postcensal estimates of the July 1 resident population. Rates were standardized to the age distribution of the 2000 US Standard Population.

Goal Setting:
The 2025 goal of 1.84 hepatitis B-related deaths among A/PI persons per 100,000  population is consistent with CDC’s Division of Viral Hepatitis 2025 Strategic Plan and HHS’s 2021-2025 Viral Hepatitis National Strategic Plan. Annual targets assume a constant (linear) rate of change from the observed baseline (2017 data year) to the 2025 goal (2023 data year).

Limitations:
Mortality data must be interpreted with caution due to the potential for misclassification of ICD-10 codes on the death record, underrepresentation of certain racial/ethnic populations in US Census data and underreporting of viral hepatitis as a cause of death on death certificates.