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We then used a joinpoint regression model to evaluate mortality trends overall and by sex and race.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 1968 to 2015, there were 46,798 deaths with SSc recorded as the \u201cunderlying\u201d cause of death and 106,058,839 non\u2010SSc deaths. There were an additional 9,063 deaths with SSc recorded as a \u201ccontributing\u201d cause of death from 1999 to 2015. Whereas the non\u2010SSc ASMR decreased throughout the 48\u2010year time period, the SSc ASMR increased from 1968 to 2000, followed by decreases each year from 2001 to 2015. The SSc ASMR also decreased for deaths where SSc was a contributing cause from 1999 to 2015. Women and Black persons had higher SSc ASMRs and SSc ASMR to non\u2010SSc ASMR ratios than men and White persons, respectively. Additionally, SSc ASMRs and SSc ASMR to non\u2010SSc ASMR ratios increased at higher rates in women and White persons than in men and Black persons, respectively, during the initial three decades.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Mortality attributable to SSc increased from 1968 to 2000, followed by a steady decline from 2001 to 2015. However, SSc mortality relative to non\u2010SSc mortality remains high. SSc mortality has disproportionately changed by sex and race over the 48\u2010year period assessed in the present study.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.24411","type":"journal-article","created":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T07:33:43Z","timestamp":1596872023000},"page":"1502-1510","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Trends in Systemic Sclerosis Mortality Over Forty\u2010Eight Years, 1968\u20132015: A US Population\u2013Based Study"],"prefix":"10.1002","volume":"73","author":[{"given":"Eric Y.","family":"Yen","sequence":"first","affiliation":[{"name":"University of California David Geffen School of Medicine  Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devanshu R.","family":"Singh","sequence":"additional","affiliation":[{"name":"University of California David Geffen School of Medicine, Los Angeles, and Whiting School of Engineering and Zanvyl Krieger School of Arts and Sciences Johns Hopkins University  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6831-4538","authenticated-orcid":false,"given":"Ram R.","family":"Singh","sequence":"additional","affiliation":[{"name":"University of California David Geffen School of Medicine, and Jonsson Comprehensive Cancer Center  Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,31]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"765","article-title":"Clinical and laboratory profile of systemic sclerosis in northern India","volume":"38","author":"Kumar A","year":"1990","journal-title":"J Assoc Physicians India"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30933-9"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2005.069484"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2014.05.010"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker269"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40027"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/37.7.750"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-005-2210-5"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.11073"},{"key":"e_1_2_7_11_1","unstructured":"Centers for Disease Control and Prevention.CDC WONDER online databases. 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