Understanding mortality data: A step-by-step guide to CDC WONDER, joinpoint analysis, and forecasting models

Authors

• Abdalhakim Shubietah, Advocate Health - MidwestFollow
• Mohammed Ruzieh, Bluhm Cardiovascular Institute, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
• Belal Mohamed Hamed, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
• Sarah Saife, Department of Medicine, An-Najah National University, Old Campus Street 7, P.O. Box 7, Nablus, Palestine.
• Mohamed Abuelazm, Faculty of Medicine, Tanta University, Tanta, Egypt.
• Mohamed S. Elgendy, Faculty of Medicine, Tanta University, Tanta, Egypt.
• Ahmed Emara, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
• Ahmed Ibrahim, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
• Ameer Awashra, Department of Medicine, An-Najah National University, Old Campus Street 7, P.O. Box 7, Nablus, Palestine. ameer.awashra7@gmail.com.
• Ibrahim Gowaily, Department of Medicine, Creighton University School of Medicine, Omaha, NE, USA.
• Mohammed AbuBaha, Department of Medicine, An-Najah National University, Old Campus Street 7, P.O. Box 7, Nablus, Palestine.
• Ghada Shbeitah, Language Center, Faculty of Humanities, An-Najah National University, Nablus, West Bank, Palestine.
• Elsayed Balbaa, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
• Mohamed Saad Rakab, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
• Mohammed Mhanna, Division of Cardiovascular Medicine, University of Iowa, Iowa, IA, USA.

Recommended Citation

Shubietah A, Ruzieh M, Hamed BM, et al. Understanding Mortality Data: A Step-by-Step Guide to CDC WONDER, Joinpoint Analysis, and Forecasting Models. J Epidemiol Glob Health. 2026;16(1):55. Published 2026 May 8. doi:10.1007/s44197-026-00561-8

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Background: The use of mortality data in public health research has surged with the rise of open-access databases such as CDC WONDER. However, caution is needed when defining the relationship between ICD codes and when transitioning from older to newer versions of the data. This review provides a practical, step-by-step guide to using the CDC WONDER mortality database.

Methods: We outline key functionalities of the CDC WONDER interface, explain mortality rate calculations, and describe best practices for configuring queries using underlying and multiple causes of death. The review further introduces Joinpoint regression to identify temporal trend changes and compares forecasting approaches using traditional ARIMA models and modern deep learning architectures.

Results: Using illustrative examples and visual guides, we demonstrate how data interpretations can vary significantly depending on query configuration, Boolean logic (AND vs. OR), and coding practices. We highlight the strengths and limitations of different analytical strategies and show how misinterpretation can arise from common errors, such as misunderstanding age adjustment or combining ICD codes without appropriate logic.

Conclusion: CDC WONDER is a powerful tool for mortality analysis, but its effective use requires a clear understanding of its data structure, coding logic, and statistical tools. Joinpoint regression and forecasting models complement WONDER data by enabling trend segmentation and future projections. This guide empowers researchers to use these tools accurately, improving the rigor and reproducibility of public health research.

Type

Article

PubMed ID

42104049