Abstract Wed174: Where you live matters: County-level social vulnerability index negatively impacts cardiovascular disease hospitalizations

Background: Cardiovascular disease (CVD) is the leading cause of morbidity, hospitalization and mortality among adults in the United States (US): every 33 seconds, one person dies from a CVD. Social Vulnerability Index (SVI) is used to identify and prioritize communities that need more support during disasters .Previous studies have shown a significant association between SVI and the prevalence and risk factors of CVD, However, little is known about the collective impact of SVI and CVD-related hospitalization rate (CVDHR) in the US. Objectives: To examine the association between county-level SVI and CVDHR among adults aged 35 years and older in terms of gender, race and state in the top 5 populated US states between 2019 to 2021. Methods: This was a retrospective cross-sectional study of county-level SVI data from the top 5 populated states in the US (California, Texas, Florida, New York,Pennsylvania).The data were obtained from the Centers for Disease Control and Prevention Interactive Atlas of Heart Disease and Stroke database. This data was linked to county-level SVI data obtained from the Agency for Toxic Substances and Disease Registry. The linked data was divided into quartiles based on SVI percentile scores with SVI-Q1(0-0.25, least vulnerable)to SVI-Q4(0.75-1, most vulnerable). The CVDHR(per 100,000) persons and the 95% confidence interval (CI) were computed for the overall population and then stratified by gender, race, state of residence, and SVI quartile. The outcome was the rate difference between SVI-Q4&SVI-Q1 and a negative impact by SVI was characterized by a higher CVDHR within SVI-Q4 compared with SVI-Q1 and nonoverlapping CIs. Results: The overall mean CVDHR for SVI-Q4 (41.3; CI: 39.8-42.7) was higher than that for SVI-Q1 (38.4: CI: 37.1-39.7) with an excess of 2.9 .For Females SVI-Q4 vs SVI-Q1 [(36.8; CI:35.4-38.3 vs 33.1: CI:32.0-34.3); excess of 3.7];Hispanics, [(33.9; CI:30.5-37.3 vs 32.0; CI:30.4-33.5); excess of 4.3] and in Whites [(41.4; CI:39.3-42.9 vs 40.1; CI:39.4-40.8);excess of 2.9]. In California, SVI-Q4 vs SVI-Q1 [34.4; CI: 31.3-37.5 vs 28.2; CI:25.8-30.5); excess of 6.2]. There was no significant difference between SVI-Q4 &-Q1 for males, Black people, and the other states. Conclusion: Higher county-level social vulnerability was associated with increased CVDRH, and in specific demographic groups. More attention should be focused on vulnerable communities ie. increasing preventive care measures and awareness on healthy lifestyles.