A large national study published on July 22, 2026, in Neurology® Open Access, an official journal of the American Academy of Neurology, reveals that Black multiple sclerosis patients die significantly younger than white patients, with death rates peaking between ages 65 and 74. Researchers also identified high blood pressure and cardiac arrest as growing, co-occurring cardiovascular contributors to mortality across specific racial groups.
Mortality Disparities Across Age and Race
An analysis of more than 42,000 U.S. deaths linked to multiple sclerosis uncovered stark demographic disparities in multiple sclerosis death rates by age, race and geography. The study reviewed data on deaths in the overall U.S. population as well as deaths that listed MS as a cause of death from the mainland United States between 2012 and 2023, utilizing data from the U.S. Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiological Research (WONDER) database.
While multiple sclerosis is known to reduce life expectancy compared to the general population, the new findings show that the burden falls unevenly. Black individuals recorded the highest death rates linked to the condition. Furthermore, multiple sclerosis deaths occur earlier among Black patients, peaking between the ages of 65 and 74. By contrast, death rates for white patients peaked later, between ages 75 and 84. In the Hispanic population, death rates increased among female patients between ages 45 and 84.
Overall death rates for people with the condition stood at 1.10 per 100,000 people, with a rate of 1.34 for female individuals and 0.82 for male individuals. When broken down by sex and ethnicity, the rates were highest for Black people, with rates of 1.56 for females and 0.97 for males. White individuals saw comparable figures at 1.54 for females and 0.92 for males, while Hispanic populations recorded lower rates of 0.38 for females and 0.26 for males. For other races and ethnicities, the rates were 0.18 for females and 0.11 for males.
The Growing Impact of Cardiovascular Complications
Beyond demographics, the researchers examined co-occurring health conditions listed on death certificates. Their analysis revealed that multiple sclerosis-related deaths involving high blood pressure increased between 2019 and 2023, particularly among white and Black individuals. Additionally, deaths involving cardiac arrest rose between 2019 and 2022, especially for Black patients.
These results highlight the urgent need to develop targeted interventions to better control high blood pressure, including earlier screening, improved access to primary care and approaches to reduce the effects of cardiovascular complications, especially among groups at elevated risk, Amezcua said
Lilyana Amezcua, MD, study author, University of Southern California in Los Angeles and a Fellow of the American Academy of Neurology
Researchers note that these overlapping cardiovascular conditions can complicate clinical care. Damage caused by cardiovascular disease can mimic multiple sclerosis lesions on brain scans, potentially introducing delays in accurate diagnosis. Previous studies indicate that patients from racial and ethnic minority groups may wait up to 10 years longer for a multiple sclerosis diagnosis than white patients.
Geographic Trends and Unresolved Questions
The study also mapped geographic variations, finding the highest mortality rates concentrated in northern and midwestern states (Wyoming, Oregon, Utah, Nebraska, Kansas, Minnesota, Michigan, New Hampshire and Maine). While multiple sclerosis traditionally exhibits higher prevalence in northern regions, investigators emphasize that health care access, demographics and other factors may also help explain these patterns.
Despite analyzing more than a decade of national data, investigators caution that relying on death certificates meant the researchers could not account for factors such as MS severity, treatments or health care access. They also note that the COVID-19 pandemic may have influenced mortality trends in the final years of the study.
Lilyana Amezcua, MD, an associate professor of neurology and division chief for neuroimmunology and multiple sclerosis at the Keck School of Medicine of USC
Comprehensive Care as a Path Forward
The persistent rise in mortality rates over the 12-year window surprised researchers, who anticipated that advances in treatments for MS might flatten these trends over time. Instead, the data underscores that managing other health conditions that affect people with MS is critical to improving longevity for vulnerable populations.
Funding for the research was provided by the U.S. Department of Defense and the Bristol Myer Squibb Foundation. The research team is continuing to investigate the underlying factors driving diagnostic delays and disparate health outcomes across diverse patient groups.
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