To determine the variability in county cardiovascular (CV) premature mortality explained
by integrated metrics of socioeconomic deprivation and to explore temporal trends
in CV mortality by county socioeconomic deprivation.
This is a cross-sectional analysis of US county-level death certificate data from
1999 to 2018 of age-adjusted premature (25 to 64 years) CV mortality. Integrated metrics
of socioeconomic deprivation (Social Deprivation Index [SDI] and county Area Deprivation
Index [ADI]) were associated with mortality using linear regression analysis. Relative
change in county CV mortality from 1999 to 2018 was associated with indices using
linear regression analysis.
Counties with higher quartile SDI and ADI had significantly higher total, non-Hispanic
Black/African American, and female premature CV mortality (P<.001). Both SDI and ADI were significantly associated with CV mortality by linear
regression (P<.001) explaining 40% and 44% of county variability in CV mortality, respectively.
Counties with lower deprivation indices experienced a larger decreased in premature
CV mortality (P<.001).
This study demonstrates an association between multiple integrated metrics of socioeconomic
deprivation and premature cardiovascular mortality and shows potentially worsening
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Published online: March 15, 2022
In Press Corrected Proof
Potential Competing Interests: Dr Al-Kindi has received grants from Wolfe Research Scholar Funds and the University Hospitals Informatics Pilot Award. The remaining authors report no potential competing interests.
© 2022 Mayo Foundation for Medical Education and Research