Abstract 15662: Age-Adjusted Premature Cardiac Mortality Rate Among United States Counties by Social Vulnerability Index From 2018 to 2021

Abstract

Background: Considerable differences in premature cardiovascular disease (CVD) mortality rates exist across counties in the United States. Ecological examination and the association with county-level social vulnerability Indices (SVI) are limited. Aims: This study provides an updated analysis of age-adjusted premature CVD mortality rates and association with county-level SVI from 2018 to 2021. Methods: In this ecological cross-sectional study, we used United States county-level CVD mortality data from the Centers for Disease Control and Prevention (CDC) WONDER database (2018-2021) for non-elderly adults (<65 years) and CDC SVI classified into quartiles (1st least vulnerable and 4th most vulnerable). We calculated age-adjusted CVD mortality rates per 100,000 persons including Ischemic heart disease (IHD), stroke, heart failure, and hypertension ICD-10 codes: I20-I25, I60-I69, I50 and I10-I13, I15 respectively. A multivariable mixed negative binomial regression model with county intercept examined the association between SVI and CVD mortality rate adjusted for gender, and ethnicity. Results: Overall, the age-adjusted CVD mortality rate per 100,000 persons was 111.0 (IHD 68.1 (95% CI:67.8-68.4), stroke 8 (95% CI: 7.9-8.0), heart failure 3.7 (95% CI:3.6-3.8), and hypertension 26.3 (95% CI 26.1-26.5)), increasing in a stepwise manner from the 1st to 4th SVI quartile. Counties in the 4th quartile had significantly higher mortality compared to the 1st quartile for CVD IRR=2.5 (IHD IRR=2.27 (95% CI:1.65-3.11), stroke IRR=2.72 (95% CI: 1.84-4.02), heart failure IRR=2.84 (95% CI:1.74-4.62), and hypertension IRR=2.83 (95% CI 1.79-4.45)). Conclusions: We observed a higher premature CVD mortality rate in the most vulnerable compared to the least vulnerable counties, adjusting for demographic characteristics. Targeted public health interventions are needed to effectively mitigate the growing burden of premature CVD in vulnerable populations.