Disparities persist in CVD mortality rates by state, race and ethnicity
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Key takeaways:
- Cardiovascular health disparities by state, race and ethnicity are getting worse in the U.S.
- Policy changes and commitment to health equity are among the factors needed to reverse the trends.
CVD mortality trends vary by state and race and ethnicity groups, highlighting persistent and pervasive inequities in health care, researchers reported.
“This analysis extends previously generated state-level estimates to include estimates by race and ethnicity, enabling comparisons across detailed CVD causes, both between and within states by race and ethnicity,” Catherine O. Johnson, PhD, MPH, public health researcher at the Institute for Health Metrics and Evaluation at University of Washington, Seattle, and colleagues wrote in the JAMA Cardiology. “Our results quantify the worsening cardiovascular health disparities in this country, which require urgent attention.”
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In a cross-sectional study utilizing U.S. Census Bureau data, population surveys and U.S. vital registration records from 1990 to 2019, Johnson and colleagues examined 25,397,029 individuals who died of CVD (mean age, 78.2 years; 51.53% women; 11.5% Black, 4.57% Hispanic, 83.93% white) to identify disparities in CVD mortality by state and race and ethnicity groups.
Researchers used the following race/ethnicity groups for the study: Hispanic (any race), Black (non-Hispanic ethnicity) and white (non-Hispanic ethnicity). Data were analyzed between 2020 and September 2022.
Johnson and colleagues found that age-standardized CVD mortality per 100,000 persons in 2019 was higher among Black (194.4; 95% uncertainty interval [UI], 172.7-207.4) individuals compared with Hispanic (107.7; 95% UI, 92.9-121.4) and white (153.8; 95% UI, 133.8-163.8) individuals.
According to the researchers, there was a smaller median percentage change across states from 2010 to 2019 compared with 1990 to 2000 in white men and women, as well as Black and Hispanic men.
Meanwhile, researchers found that there was a larger percentage change across states from 2010 to 2019 compared with 1990 to 2000 in Black and Hispanic women.
“Eliminating observed health disparities will require a multisectoral approach: community engagement for healthy lifestyle interventions, such as access to affordable healthy food options and safe neighborhoods that promote increased physical activity; government-level policies to address systemic racism and health inequities; and efforts to provide equitable access to medical care, including removing structural barriers and reluctance to seek medical care,” Johnson and colleagues wrote.
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