Counties with the highest social vulnerability experienced a greater age-adjusted mortality rate from ischemic heart disease, with a cumulative excess of 20.91 deaths per 100,000 person-years.
Cross-Sectional (n=9,108,644)
Does higher social vulnerability and specific demographic factors increase ischemic heart disease mortality in the United States?
Despite a nationwide decline in ischemic heart disease mortality from 1999 to 2020, significant disparities persist, with higher mortality strongly associated with greater social vulnerability, male gender, Black race, and nonmetropolitan locations.
Effect estimate: RR 1.4
Absolute Event Rate: 111.3% vs 90.39%
Background: Cardiovascular disease is a leading cause of morbidity and mortality, largely dominated by ischemic heart diseases (IHDs). Social determinants of health, including geographic, psychosocial, and socioeconomic factors, influence the development of IHD. Objectives: This study aimed to evaluate yearly trends and disparities in IHD mortality and to assess the impact of social vulnerability. Methods: We performed cross-sectional analyses using United States county-level mortality data and social vulnerability index (SVI) obtained from the Centers for Disease Control and Prevention databases. Age-adjusted mortality rates (AAMRs) per 100,000 population were compared between aggregated U.S. county groups, stratified by demographic information and SVI quartiles. Log-linear regression models were used to identify mortality trends from 1999 to 2020, with inflection points determined through the Monte-Carlo permutation test. Results: We identified a total of 9,108,644 deaths related to IHD between 1999 and 2020. Overall AAMR decreased from 194.6 in 1999 to 91.8 in 2020. Males (AAMR: 161.51) and Black (AAMR: 141.49) populations exhibited higher AAMR compared to females (AAMR: 93.16) and White (AAMR: 123.34) populations, respectively. Disproportionate AAMRs were observed among nonmetropolitan (AAMR: 136.17) and Northeastern (AAMR: 132.96) regions. Counties with a higher SVI experienced a greater AAMR, with a cumulative excess of 20.91 deaths per 100,000 person-years associated with increased social vulnerability. Conclusions: Despite a decline in IHD mortality from 1999 to 2020, disparities persisted among racial, gender, and geographic subgroups. A higher SVI was linked to increased IHD mortality. Policy interventions should prioritize integrating the SVI into health care delivery systems to effectively address these disparities.
Ibrahim et al. (Thu,) conducted a cross-sectional in Ischemic Heart Disease (n=9,108,644). High Social Vulnerability (SVI Quartile 4) vs. Low Social Vulnerability (SVI Quartile 1) was evaluated on Age-adjusted mortality rate (AAMR) per 100,000 population (RR 1.4). Counties with the highest social vulnerability experienced a greater age-adjusted mortality rate from ischemic heart disease, with a cumulative excess of 20.91 deaths per 100,000 person-years.