In 2017, 45.8% of US counties failed to meet Healthy People 2020 targets for stroke mortality, and 26.1% failed for CHD mortality.
Observational
Yes
A significant proportion of US counties failed to meet Healthy People 2020 mortality reduction targets for stroke and CHD, highlighting unequal geographic progress.
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.
Woodruff et al. (Thu,) conducted a observational in Stroke and coronary heart disease mortality. County-level mortality trends vs. Healthy People 2020 targets was evaluated on Proportion of counties achieving neither the national Healthy People 2020 target nor a 20% reduction in stroke mortality (95% CI 42.9-48.3). In 2017, 45.8% of US counties failed to meet Healthy People 2020 targets for stroke mortality, and 26.1% failed for CHD mortality.