Abstract
ObjectivesWe examined temporal trends, spatial variation, and gender differences in rates of hospitalization due to acute myocardial infarction.MethodsWe used data from the Centers for Disease Control National Environmental Public Health Tracking Network to evaluate temporal trends, geographic variation, and gender differences in 20 Environmental Public Health Tracking Network states from 2000 to 2008. A longitudinal linear mixed effects model was fitted to the acute myocardial infarction hospitalization rates for the states and counties within each state to examine the overall temporal trend.ResultsThere was a significant overall decrease in age-adjusted acute myocardial infarction hospitalization rates between 2000 and 2008, with most states showing over a 20% decline during the period. The ratio of male/female rates for acute myocardial infarction hospitalization rates remained relatively consistent over time, approximately two-fold higher in men compared to women. A large geographic variability was found for age-adjusted acute myocardial infarction hospitalization rates, with the highest rates found in the Northeastern states. Results of two ecological analyses revealed that the NE region remained significantly associated with increased AMI hospitalization rates after adjustment for socio-demographic factors.ConclusionsThis investigation is one of the first to explore geographic differences in AMI age adjusted hospital rates in individuals 35+ years of age for 2000–2008. We showed a decreasing trend in AMI hospitalization rates in men and women. A large geographic variability in rates was found with particularly higher rates in the New England/Mid-Atlantic region of the US and lower rates in the mountain and Pacific states of the tracking network. It appeared that over time this disparity in rates became less notable.
Highlights
Since 2002, the Centers for Disease Control and Prevention (CDC) has been building the infrastructure to create, organize and maintain a national data network which will permit the collection, use and dissemination of nationally consistent information to mount an effective national response to environmentally mediated acute and chronic disease ‘‘outbreaks.’’ To further develop the National Environmental Public Health Tracking Program, the CDC is working closely with state and local health departments to provide the resources and methods for assembling and presenting available hazard, exposure and health outcome data
Information on acute myocardial infarction (AMI) incidence and prevalence has been limited to community studies [2,3,4,5,6,7,8,9,10], survey samples [11], and large cohort studies [12,13]
Data were obtained from individual state hospital inpatient discharge record repositories and were provided to the CDC Environmental Public Health Tracking Network (EPHTN) by the environmental public health tracking program in each state
Summary
Since 2002, the Centers for Disease Control and Prevention (CDC) has been building the infrastructure to create, organize and maintain a national data network which will permit the collection, use and dissemination of nationally consistent information to mount an effective national response to environmentally mediated acute and chronic disease ‘‘outbreaks.’’ To further develop the National Environmental Public Health Tracking Program, the CDC is working closely with state and local health departments to provide the resources and methods for assembling and presenting available hazard, exposure and health outcome data. This new data source provides the opportunity to examine time trends, assess geographic variation and demographic patterns, including differences by gender, and to evaluate primary and secondary prevention efforts
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