Even as medicine has developed more effective treatments for multiple sclerosis, a twelve-year study of over 42,000 American deaths reveals that MS mortality rates have continued to climb — and that the burden of dying falls with particular cruelty on Black patients, who succumb nearly a decade earlier than their white counterparts. The disease itself is not the only force at work; unmanaged cardiovascular conditions, delayed diagnoses, and the accumulated weight of systemic inequity appear to be shaping who lives and who dies. This is a story not merely about a neurological illness, but about
MS Death Rates Rise Despite Treatment Advances, With Stark Racial Disparities
Black patients with MS die significantly younger than white patients, with mortality peaking 10 years earlier; racial and ethnic minorities experience up to 10-year delays in MS diagnosis.
We continue to see increasing death rates despite treatment advances
Mark
Why would death rates go up when treatments have gotten better? That seems backwards.
Mimi
Because the treatments are working on the MS itself—stopping the disease from progressing—but patients are dying from other things. High blood pressure, heart problems. The MS treatment doesn't touch those.
Mark
So it's like we fixed one problem and ignored the others?
Mimi
Exactly. And for Black patients, it's worse because they're also waiting longer to get diagnosed in the first place. By the time they start MS treatment, other conditions have already taken root.
Mark
Ten years longer to diagnose? How does that even happen?
Mimi
Part of it is access—where you live, what doctors you see. Part of it is that symptoms can look like other things. But there's also the reality that minority patients sometimes aren't believed or taken seriously until the disease is obvious.
Mark
And that ten-year gap in death age—65 to 74 for Black patients versus 75 to 84 for white patients—that's not just the disease, is it?
Mimi
No. It's the disease plus everything else that wasn't managed. It's the whole picture of care, or lack of it.
The Pulse
- Despite a generation of improved MS therapies, death rates among MS patients rose steadily from 2012 to 2023 — a paradox that researchers say signals a failure of comprehensive care, not just disease management.
- Black MS patients face the sharpest edge of this crisis, dying at the highest rates and a full decade earlier than white patients, with Hispanic women also showing rising mortality across middle and older age.
- High blood pressure emerged as a growing contributor to MS-related deaths, particularly after 2019, suggesting that treatable cardiovascular conditions are being overlooked in patients whose neurological disease commands most clinical attention.
- Diagnosis delays compound the danger — minority patients wait up to ten years longer for an MS diagnosis, allowing the disease and its complications to advance before any treatment begins.
- Researchers are now turning to advances in brain imaging and preventive care strategies, hoping earlier and more accurate diagnosis can begin to close the gap between who medicine can save and who it currently does not.
Even as medicine has developed more effective treatments for multiple sclerosis, a twelve-year study of over 42,000 American deaths reveals that MS mortality rates have continued to climb — and that the burden of dying falls with particular cruelty on Black patients, who succumb nearly a decade earlier than their white counterparts. The disease itself is not the only force at work; unmanaged cardiovascular conditions, delayed diagnoses, and the accumulated weight of systemic inequity appear to be shaping who lives and who dies. This is a story not merely about a neurological illness, but about the distance between medical progress and the communities it has yet to fully reach.
A study of more than 42,000 death certificates spanning twelve years has uncovered a troubling contradiction: Americans with multiple sclerosis are dying at higher rates than they were a decade ago, even as treatments for the disease have grown more sophisticated. The analysis, led by researchers at USC's Keck School of Medicine and published in Neurology, reveals not only rising mortality but deep inequalities in who bears the greatest cost.
Multiple sclerosis attacks the brain and spinal cord, producing symptoms that range from vision loss to muscle weakness and fatigue. People with MS already face shorter life expectancies than the general population, but the new data suggest that forces beyond the disease itself are driving the increase in deaths. Examining CDC records from 2012 to 2023, the researchers found mortality climbing steadily even after accounting for age.
The racial disparities are among the study's most urgent findings. Black patients had the highest MS-linked death rates and tended to die between ages 65 and 74 — a full decade earlier than white patients, who most often died between 75 and 84. Hispanic women showed rising death rates across a broad age range. Geographically, mortality clustered in northern and midwestern states including Wyoming, Minnesota, Michigan, and Maine.
Drilling into co-occurring conditions, the researchers identified high blood pressure as a significant and growing contributor to MS deaths, particularly after 2019. Cardiac arrest also rose as a factor, especially among Black patients. Lead researcher Dr. Lilyana Amezcua noted the core problem plainly: MS treatments are improving, yet death rates are not falling — because the broader health needs of MS patients are going unaddressed.
Diagnosis delays add another layer of harm. Prior research has shown that minority patients wait up to ten years longer than white patients for an MS diagnosis, allowing the disease and its complications to accumulate unchecked. Cardiovascular damage can even mimic MS on brain scans, further muddying the diagnostic picture. Amezcua's team is now investigating these delays, with hope that improved brain imaging could enable earlier, more accurate identification of the disease.
The study's limitations — death certificates cannot capture disease severity, treatment history, or health care access, and pandemic-era data may be skewed — do not diminish its central message: medical progress has not translated equally into longer lives. Closing that gap will require not just better MS drugs, but faster diagnosis and more comprehensive care for the patients history has most often left behind.
A study of more than 42,000 death certificates spanning twelve years has revealed a troubling pattern: Americans with multiple sclerosis are dying at higher rates now than they were a decade ago, even as treatments for the disease have improved. The analysis, published in the journal Neurology and led by researchers at USC's Keck School of Medicine, exposes stark disparities in who dies and when—with Black patients experiencing the highest mortality rates and dying roughly a decade earlier than their white counterparts.
Multiple sclerosis damages the brain and spinal cord, causing vision loss, muscle weakness, fatigue, and a host of other symptoms that vary widely from person to person. People with MS already have shorter life expectancies than the general population, but the new findings suggest that something beyond the disease itself is driving the increase in deaths. The researchers examined 42,205 death certificates from the CDC's epidemiological database, looking at deaths between 2012 and 2023 where MS was listed as the underlying cause. What they found was mortality climbing steadily across the period, even when accounting for age.
The racial disparities are stark. Black individuals had the highest death rates linked to MS, followed by white individuals, with lower rates among other racial groups. But the timing of death differed significantly: Black patients with MS tended to die between ages 65 and 74, while white patients were most likely to die between ages 75 and 84—a ten-year gap. Among Hispanic women with MS, death rates climbed across the ages 45 to 84 range. Geographic patterns also emerged, with the highest death rates concentrated in parts of the northern and midwestern United States, including Wyoming, Oregon, Utah, Nebraska, Kansas, Minnesota, Michigan, New Hampshire, and Maine.
When the researchers dug into the death certificates to identify co-occurring health conditions, a clear culprit emerged: high blood pressure. Between 2019 and 2023, MS-related deaths involving hypertension increased notably, particularly among white and Black patients. Cardiac arrest also rose as a contributing factor in MS deaths between 2019 and 2022, especially for Black patients. These findings point to a gap in how MS patients are being cared for—the disease itself is being treated, but the broader health picture is being neglected.
Dr. Lilyana Amezcua, the lead researcher, framed the puzzle plainly: advances in MS treatments should have flattened mortality trends over time, yet the opposite is happening. "We continue to see increasing death rates," she said. "That tells us we still have work to do, particularly when it comes to managing other health conditions that affect people with MS." Many of these conditions are preventable or treatable, she noted, which suggests that comprehensive care—addressing not just MS but the full constellation of a patient's health needs—could save lives.
Another layer of the problem involves diagnosis itself. Previous research has found that patients from racial and ethnic minority groups wait up to ten years longer for an MS diagnosis than white patients, a delay that allows the disease to progress unchecked and complicating factors to accumulate. Cardiovascular damage, for instance, can look like MS on brain scans, making it harder for doctors to distinguish between the two conditions and delaying treatment. Amezcua's team is now investigating why some patients receive diagnoses later than others, with hopes that advances in brain imaging might help doctors identify MS earlier and more accurately.
The study has limitations—the researchers could not account for MS severity, specific treatments received, or health care access from death certificates alone, and the COVID-19 pandemic may have skewed the final years of data. But the message is clear: despite a generation of medical advances, people with MS are dying sooner and more unequally than they should be. The path forward requires not just better MS drugs, but better overall health management and faster diagnosis, particularly for patients from communities that have historically faced barriers to care.
Notable Quotes
We continue to see increasing death rates. That tells us we still have work to do, particularly when it comes to managing other health conditions that affect people with MS.— Dr. Lilyana Amezcua, lead researcher, Keck School of Medicine of USC
Many of these conditions are preventable or treatable. Instead of focusing solely on MS, it's important to provide comprehensive care that takes a person's overall health into account.— Dr. Lilyana Amezcua
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