Shaik Ayesha, Chobufo Muchi D, Gonuguntla Karthik, Patel Neel, Sattar Yasar, Thyagaturu Harshith, Ludhwani Dipesh, Gulati Martha
Department of Cardiology, Hartford Hospital, University of Connecticut, Hartford, CT.
Department of Cardiology, West Virginia University, Morgantown, WV.
Curr Probl Cardiol. 2023 Oct;48(10):101854. doi: 10.1016/j.cpcardiol.2023.101854. Epub 2023 Jun 7.
Social determinants of health (SDOH) play a major role in cardiovascular outcomes. The social vulnerability index (SVI) is a tool designed by the Center for Disease Control (CDC) to measure a community's vulnerability to respond and recover from disasters. The parameters of SVI can be used to gauge social disparities amongst different US counties and its association with acute myocardial infarction (AMI) related to age- adjusted mortality rate (AAMR) by using the multiple causes of death database from CDC, Prevention's Wide-Ranging Online Data for Epidemiological Research (WONDER 2016-2020) and Agency for Toxic Substances and Disease Registry (ATSDR). We used segmented regression models to evaluate the association between quintiles of SVI scores and AAMR using STATA. A total of 2908 of 3289 US counties were used in the analysis. The mean AAMR was 89.3 per 100,000 (95% CI: 87.1-91.5) from 2016 to 2020. US counties with higher SVI were associated with higher AMI-related age-adjusted mortality when compared to counties with lower SVI. Counties with the highest SVI and AAMR were in the mid-western and southern states The findings of our study can guide focused care for a uniform upliftment of CV health across the nation by identifying the distribution of socio-economically disadvantaged counties.
健康的社会决定因素(SDOH)在心血管疾病结局中起着重要作用。社会脆弱性指数(SVI)是美国疾病控制中心(CDC)设计的一种工具,用于衡量社区应对灾害和灾后恢复的脆弱性。通过使用CDC的多死因数据库、预防流行病学研究广泛在线数据(WONDER 2016 - 2020)以及有毒物质和疾病登记局(ATSDR),SVI的参数可用于评估美国不同县之间的社会差异及其与年龄调整死亡率(AAMR)相关的急性心肌梗死(AMI)的关联。我们使用分段回归模型,通过STATA评估SVI分数五分位数与AAMR之间的关联。分析中使用了美国3289个县中的2908个。2016年至2020年的平均AAMR为每10万人89.3例(95%置信区间:87.1 - 91.5)。与SVI较低的县相比,SVI较高的美国县与更高的AMI相关年龄调整死亡率相关。SVI和AAMR最高的县位于中西部和南部各州。我们的研究结果可以通过确定社会经济弱势县的分布,指导全国范围内统一提升心血管健康的重点护理。
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