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Assessing disparity in mortality rates for ischemic heart disease using CDC-WONDER database: A retrospective analysis
Nithin Karnan1, Abdirahman Hassan Abdirahman2, Gayathri Kilaru3
1K.A.P. Viswanatham Medical College, Tiruchirapallii, Tamil Nadu, India.
Insights
Ischemic heart disease mortality declined overall from 1999-2020, but rural areas consistently showed higher rates than urban areas. A notable increase in mortality occurred in 2019 for both settings.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Ischemic heart disease (IHD) is a leading global cause of death, contributing to 17.9 million deaths in 2019.
- Cardiovascular events accounted for 32% of global deaths in 2019.
- Persistent disparities in IHD diagnosis and treatment exist, particularly between urban and rural populations.
Purpose of the Study:
- To analyze trends in ischemic heart disease mortality.
- To compare IHD mortality rates between urban and rural populations.
- To examine IHD mortality disparities across demographic groups.
Main Methods:
- Retrospective study utilizing the CDC WONDER database (1999-2020).
- ICD-10 codes I20-I25 for Ischemic Heart Disease.
- Data stratified by rural/urban classification, age, gender, and race.
Main Results:
- Overall decline in IHD mortality from 1999-2020 in both urban and rural areas.
- Rural areas consistently demonstrated higher IHD mortality rates than urban areas.
- A significant increase in IHD mortality was observed in 2019 across both settings.
Conclusions:
- Significant disparities in IHD mortality persist between urban and rural populations.
- These disparities are evident across all age, gender, and racial groups.
- Further research and public health interventions are needed to address the causes of these differences.
Introduction:
Ischemic heart disease remains a leading global cause of death, impacting healthcare systems worldwide. In 2019, 32% of global deaths were estimated to be due to cardiovascular events, accounting for approximately 17.9 million people worldwide. Despite technological advances improving diagnosis and treatment, disparities persist, especially between urban and rural areas.
Methods:
We conducted a retrospective study using the CDC WONDER database extracted on 17th March 2024, ICD-10 code: I20-I25 (Ischemic Heart Disease). We selected the years 1999-2020: Underlying Cause of Death by Bridged-Race Categories divided based on rural and urban deaths, based on 2013 urbanization classification, and grouped by age (10-year age range), gender, and race.
Results:
Our research indicates a consistent decline in ischemic heart disease mortality across urban and rural regions within all demographic groups from 1999 to 2020. However, a notable exception occurred in 2019 when mortality rates increased in both urban and rural settings. Notably, throughout the entire period under study, rural areas consistently exhibited higher mortality rates compared to their urban counterparts.
Conclusion:
This study sheds light on the big disparity in mortality rates due to ischemic heart disease in urban versus rural areas in all groups of age, gender, and race. We hope our findings prompt further research to determine the causes of this discrepancy and public health interventions to address it.
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