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Changing rate orders of race-gender heart disease death rates: An exploration of county-level race-gender disparities
Journal article   Open access   Peer reviewed

Changing rate orders of race-gender heart disease death rates: An exploration of county-level race-gender disparities

Adam S. Vaughan, Harrison Quick, Linda Schieb, Michael R. Kramer, Herman A. Taylor and Michele Casper
SSM - population health, v 7, pp 100334-100334
04 Dec 2018
DOI: https://doi.org/10.1016/j.ssmph.2018.100334
PMID: 30581967
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1016/j.ssmph.2018.100334View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open

Abstract

BM, black men BW, black women CDC, Centers for Disease Control and Prevention County-level Gender Heart disease mortality ICD, International Classification of Diseases MCMC, Markov chain Monte Carlo NCHS, National Center for Health Statistics Race Spatiotemporal Temporal trends WM, white men WW, white women
A holistic view of racial and gender disparities that simultaneously compares multiple groups can suggest associated underlying contextual factors. Therefore, to more comprehensively understand temporal changes in combined racial and gender disparities, we examine variations in the orders of county-level race-gender specific heart disease death rates by age group from 1973–2015. We estimated county-level heart disease death rates by race, gender, and age group (35–44, 45–54, 55–64, 65–74, 75–84, ≥ 85, and ≥ 35) from the National Vital Statistics System of the National Center for Health Statistics from 1973–2015. We then ordered these rates from lowest to highest for each county and year. The predominant national rate order (i.e., white women (WW) < black women (BW) < white men (WM) < black men (BM)) was most common in younger age groups. Inverted rates for black women and white men (WW<WM<BW<BM) was observed nationally only for ages 35–44, but was observed in at least some counties for all age groups < 75. From 1973 through 1979, national rates for black men aged ≥ 35 were lower than those for white men. This national observation was found in a minority of counties, primarily among ages 55–64 and 65–74. The observed rates orders and their differences over time and place suggest that social and economic forces may be driving trends in heart disease mortality. Learning more about the places and times that deviate from the predominant rate order can further inform our understanding of these macro-level drivers of heart disease mortality trends. • Combined racial and gender disparities can suggest underlying contextual factors. • We examined counties’ rate orders of race-gender specific heart disease mortality. • Many counties experienced rate orders that were not observed nationally. • Many counties had higher rates for black women than white men. • Socioeconomic forces may drive heart disease mortality more than biology.

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13 citations in Web of Science
13 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#10 Reduced Inequalities
#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Public, Environmental & Occupational Health
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