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Racial Disparities in Heart Disease Mortality in the 50 Largest U.S. Cities
Maureen R Benjamins1,2, Jana L Hirschtick3, Bijou R Hunt1
1Sinai Urban Health Institute, Sinai Health System, Mount Sinai Hospital, 1500 S. Fairfield Ave, Rm K443, Chicago, IL, 60608, USA.
Insights
Heart disease mortality disproportionately affects Black Americans, with significant racial disparities evident even at the city level. Addressing these disparities requires targeted interventions based on local data and socioeconomic factors.
Area of Science:
- Public Health
- Epidemiology
- Health Equity
Background:
- Heart disease is the leading cause of death in the U.S.
- It significantly contributes to racial disparities in life expectancy.
- City-level data on heart disease mortality and racial disparities are lacking.
Purpose of the Study:
- To calculate age-adjusted heart disease mortality rates and racial disparities for non-Hispanic Black and White populations.
- To analyze trends in these disparities from 1990-1994 to 2005-2009 for the U.S. and 50 largest cities.
- To examine the relationship between racial disparities in heart disease mortality and city-level socioeconomic indicators.
Main Methods:
- Calculated age-adjusted mortality rates, rate ratios (RRs), and rate differences (RDs) for Black and White populations.
- Analyzed data for two time periods: 1990-1994 and 2005-2009.
- Correlated disparities with city-level income inequality and median household income.
Main Results:
- Nationally, Black individuals had significantly higher heart disease mortality rates than White individuals in both periods.
- Disparities increased over time in 11 cities due to larger rate improvements among Whites.
- An estimated 19,448 excess Black deaths occurred annually in the U.S.
- City income inequality and median household income were associated with disparities.
Conclusions:
- City-specific heart disease mortality data are crucial for addressing health inequities.
- Socioeconomic factors like income inequality play a role in racial disparities in heart disease.
- Targeted public health interventions can help reduce heart disease morbidity and mortality among minority populations.
Abstract:
Heart disease is not only the leading cause of death in the U.S. but also the main contributor to racial disparities in life expectancy. Despite this, heart disease mortality rates and racial disparities in these rates are not readily available at the city level where they can be the most quickly and effectively addressed. We calculated age-adjusted heart disease mortality rates and corresponding racial rate ratios (RRs) and rate differences (RDs) for the non-Hispanic Black (Black) and non-Hispanic White (White) populations for the years 1990-1994 and 2005-2009 for the U.S. and the 50 largest cities therein. We then examined relationships between the disparities and city-level population indicators. Nationally, mortality rates were significantly higher among Blacks than Whites at both time periods. Larger improvements in rates for Whites compared to Blacks resulted in a significant increase in disparities over the 20-year period for 11 cities. There were 19,448 excess Black deaths in the U.S. annually. City-level income inequality, as well as the overall city and White median household income, contributed to these disparities. By identifying city-specific disparities and trends, health care providers, public health agencies, and researchers can target the areas with the most need and can look at cities without disparities for clues on how to best advance health equity in heart disease morbidity and mortality.
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