Disparities in Premature Cardiac Death Among US Counties From 1999-2017: Temporal Trends and Key Drivers
Yinzi Jin1,2, Suhang Song3, Lin Zhang4
1Department of Global Health School of Public Health Peking University Beijing China.
Journal of the American Heart Association
|August 5, 2020
Summary
Geographic disparities in premature cardiac death (PCD) rates widened across US counties, with out-of-hospital deaths increasing. Factors like demographics and socioeconomic status contribute to these widening gaps in cardiac health.
Area of Science:
- Public Health
- Epidemiology
- Cardiovascular Disease Research
Background:
- Premature cardiac death (PCD) rates show significant disparities across US counties, potentially hindering global reduction efforts.
- Understanding these disparities is crucial for targeted interventions to improve cardiovascular health outcomes.
Purpose of the Study:
- To estimate disparities in premature cardiac death (PCD) rates across US counties.
- To investigate county-level factors associated with these disparities.
Main Methods:
- Utilized US mortality data (1999-2017) and county-level demographic, socioeconomic, healthcare, and population health data.
- Defined PCD as cardiac deaths in individuals aged 35-74 years using ICD-10 codes.
- Analyzed geographic disparities using the Theil index and quantified contributing factors.
Main Results:
- PCD rates declined overall, but out-of-hospital PCDs increased proportionally.
- Geographic disparities in PCD rates widened significantly from 1999 to 2017, with within-state differences being substantial.
- Demographic composition, socioeconomic features, healthcare environment, and population health status were all associated with disparities in both in-hospital and out-of-hospital PCD rates.
Conclusions:
- Significant disparities in PCD rates persist across US counties, linked to decelerated progress in middle-aged adults.
- The increasing proportion of out-of-hospital PCDs necessitates focused strategies for better health outcomes.
- Addressing these disparities requires precision targeting and sustained efforts to reduce premature cardiac mortality.
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