Key result
Nearly ~46% of US counties miss 2020 mortality reduction targets for stroke.
Why the study?
Documenting the proportion and geographic distribution of counties failing to meet Healthy People 2020 stroke and CHD mortality targets can identify high-priority geographic areas for intervention.
Observational (n=3,136)
A substantial proportion of US counties, particularly outside traditionally high-burden areas, are failing to meet national targets for reducing stroke and CHD mortality, highlighting the need for geographically targeted interventions.
Many US counties miss stroke and CHD mortality targets; hypothesis-generating for geographically focused prevention research.
BACKGROUND AND PURPOSE: Healthy People establishes objectives to monitor the nation's health. Healthy People 2020 included objectives to reduce national stroke and coronary heart disease (CHD) mortality by 20% (to 34.8 and 103.4 deaths per 100 000, respectively). Documenting the proportion and geographic distribution of counties meeting neither the Healthy People 2020 target nor an equivalent proportional reduction can help identify high-priority geographic areas for future intervention. METHODS: codes I60-I69) and CHD (I20-I25) and bridged-race population estimates were used. Bayesian spatiotemporal models estimated age-standardized county-level death rates in 2007 and 2017 which were used to calculate and map the proportion and 95% credible interval of counties achieving neither the national Healthy People 2020 target nor a 20% reduction in mortality. RESULTS: In 2017, 45.8% of counties (credible interval, 42.9-48.3) met neither metric for stroke mortality. These counties had a median stroke death rate of 42.2 deaths per 100 000 in 2017, representing a median 12.8% decline. For CHD mortality, 26.1% (credible interval, 25.0-27.8) of counties met neither metric. These counties had a median CHD death rate of 127.1 deaths per 100 000 in 2017, representing a 10.2% decline. For both outcomes, counties achieving neither metric were not limited to counties with traditionally high stroke and CHD death rates. CONCLUSIONS: Recent declines in stroke and CHD mortality have not been equal across US counties. Focusing solely on high mortality counties may miss opportunities in the prevention and treatment of cardiovascular disease and in learning more about factors leading to successful reductions in mortality.
No takes yet. Share an insight, caveat, or question.
Woodruff et al. (2021) conducted an observational in Stroke and Coronary Heart Disease Mortality (n=3,136). Time period 2007-2017 (Geographic and temporal trends) was evaluated on Proportion of counties meeting neither the national Healthy People 2020 target nor a 20% reduction in stroke mortality (95% CI 42.9-48.3). In 2017, 45.8% and 26.1% of US counties achieved neither the national Healthy People 2020 target nor a 20% mortality reduction for stroke and coronary heart disease, respectively.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: