Local Increases in Coronary Heart Disease Mortality Among Blacks and Whites in the United States, 1985–1995

Barnett, Elizabeth; Halverson, Joel

doi:10.2105/ajph.91.9.1499

Cited by 45 publications

(24 citation statements)

References 35 publications

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“…Our study also expands on a rich literature documenting geographic disparities in rates of declining heart disease mortality in the United States for selected time intervals. Studies have documented state-level disparities in declining heart disease death rates from 1999 to 2007, 8 geographic disparities among state economic areas in the onset of declining heart disease mortality in the 1960s and 1970s, 12 slower rates of declines among Metropolitan Statistical Areas for black women and men in comparison with white women and men from 1985 to 1995, 5 the impact of model choice on measuring spatiotemporal disparities in heart disease mortality at the county level, 11 and the timing of declines by race and sex. 25 …”

Section: Discussionmentioning

confidence: 99%

Changes in the Geographic Patterns of Heart Disease Mortality in the United States

et al. 2016

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Background Although many studies have documented the dramatic declines in heart disease mortality in the United States at the national level, little attention has been given to the temporal changes in the geographic patterns of heart disease mortality. Methods and Results Age-adjusted and spatially smoothed county-level heart disease death rates were calculated for 2-year intervals from 1973 to 1974 to 2009 to 2010 for those aged ≥35 years. Heart disease deaths were defined according to the International Classification of Diseases codes for diseases of the heart in the eighth, ninth, and tenth revisions of the International Classification of Diseases. A fully Bayesian spatiotemporal model was used to produce precise rate estimates, even in counties with small populations. A substantial shift in the concentration of high-rate counties from the Northeast to the Deep South was observed, along with a concentration of slow-decline counties in the South and a nearly 2-fold increase in the geographic inequality among counties. Conclusions The dramatic change in the geographic patterns of heart disease mortality during 40 years highlights the importance of small-area surveillance to reveal patterns that are hidden at the national level, gives communities the historical context for understanding their current burden of heart disease, and provides important clues for understanding the determinants of the geographic disparities in heart disease mortality.

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Section: Discussionmentioning

confidence: 99%

Changes in the Geographic Patterns of Heart Disease Mortality in the United States

et al. 2016

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“…These methods leverage the information of neighboring counties, nearby time periods, and other race–sex groups to obtain more precise estimates of the rates of heart disease deaths, especially in counties with small populations and few events. These powerful methods allow us to build on previous studies by using smaller geographic units and attaining greater precision in small‐area rates . In addition, unlike some other studies of temporal trends in heart disease mortality that relied on cohort data, this analysis used national vital statistics data that includes all deaths .…”

Section: Discussionmentioning

confidence: 99%

Disparities in Temporal and Geographic Patterns of Declining Heart Disease Mortality by Race and Sex in the United States, 1973–2010

Vaughan

Quick

Pathak

et al. 2015

JAHA

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BackgroundExamining small‐area differences in the strength of declining heart disease mortality by race and sex provides important context for current racial and geographic disparities and identifies localities that could benefit from targeted interventions. We identified and described temporal trends in declining county‐level heart disease mortality by race, sex, and geography between 1973 and 2010.Methods and ResultsUsing a Bayesian hierarchical model, we estimated age‐adjusted mortality with diseases of the heart listed as the underlying cause for 3099 counties. County‐level percentage declines were calculated by race and sex for 3 time periods (1973–1985, 1986–1997, 1998–2010). Strong declines were statistically faster or no different than the total national decline in that time period. We observed county‐level race–sex disparities in heart disease mortality trends. Continual (from 1973 to 2010) strong declines occurred in 73.2%, 44.6%, 15.5%, and 17.3% of counties for white men, white women, black men, and black women, respectively. Delayed (1998–2010) strong declines occurred in 15.4%, 42.0%, 75.5%, and 76.6% of counties for white men, white women, black men, and black women, respectively. Counties with the weakest patterns of decline were concentrated in the South.ConclusionsSince 1973, heart disease mortality has declined substantially for these race–sex groups. Patterns of decline differed by race and geography, reflecting potential disparities in national and local drivers of these declines. Better understanding of racial and geographic disparities in the diffusion of heart disease prevention and treatment may allow us to find clues to progress toward racial and geographic equity in heart disease mortality.

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“…Selection of covariates was based on previously identiWed risk factors or correlates of heart, respiratory or kidney disease (Barnett and Halverson 2001;Barnett et al 2000;HoVman and Paradise 2007;Iverson et al 2005;Jones-Burton et al 2007;Kunitz and Pesis-Katz 2005;Mannino and Buist 2007;Murray et al 2005;Ziembroski and Brieding 2006). Covariates included percent male population, college and high school education rates, poverty rates, race/ ethnicity rates, health uninsurance rates, physician supply, rural-urban continuum code, smoking rates, and Southern state (yes or no).…”

Section: Methodsmentioning

confidence: 99%

Mortality from heart, respiratory, and kidney disease in coal mining areas of Appalachia

Hendryx

2008

Int Arch Occup Environ Health

162

127

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Local Increases in Coronary Heart Disease Mortality Among Blacks and Whites in the United States, 1985–1995

Cited by 45 publications

References 35 publications

Changes in the Geographic Patterns of Heart Disease Mortality in the United States

Changes in the Geographic Patterns of Heart Disease Mortality in the United States

Disparities in Temporal and Geographic Patterns of Declining Heart Disease Mortality by Race and Sex in the United States, 1973–2010

Mortality from heart, respiratory, and kidney disease in coal mining areas of Appalachia

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