Abstract 142: Lives Lost Due To Disparities Quantified: Black-White And Rural-Urban Disparities In Cerebrovascular Mortality Among Middle-Aged Adults

Abstract

Introduction: We aimed to quantify and trend excess cerebrovascular deaths among middle-aged adults that could be attributed to Black-white and rural-urban disparity in the US. Methods: Annual age-adjusted mortality rates (AAMR) for ischemic stroke (IS), intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH) among middle aged adults (ages 35-64) were obtained from Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiological Research database from 1999 to 2019. AAMR difference between African-Americans and whites (Black-white disparity), as well as residents of Non-Metro and Large Metro counties (Rural-Urban disparity) was used to estimate excess event- and gender- specific annual deaths attributable to each disparity. Linear AAMR epochs and parallelism were assessed with Joinpoint. Results: Lives lost to Black-white disparity decreased from 3850 in 1999 to 2750 in 2013 and stagnated since. The finding was driven by decline in SAH and ICH mortality between 1999 and 2019, and recent increase in excess deaths due to IS (105 in 2014, 240 in 2019). Lives lost to Rural-urban disparity increased from 360 in 1999 to 740 in 2019, driven by excess deaths due to ICH (-30 in 1999, 100 in 2019) and recently IS (50 in 2013, 130 in 2019). Conclusion: Black-white disparity accounting for ~2750 excess deaths among blacks per year remains the leading inequity in cerebrovascular mortality. This is 3.7 times more deaths than Rural-Urban disparity in 2019.