ArticleSSM - population health2017
The legacy of slavery and contemporary declines in heart disease mortality in the U.S. South.
Article in SSM - population health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 1 of them a synthesis that pooled it.
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Who cites it
47 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Structural racism and adverse maternal health outcomes: A systematic review.Health & place · 2022Pooled it
- Historical slavery predicts contemporary disparities in mortality between Black and White Americans.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- Bridging the Crisis Gap: A Scoping Review of Psychological Distress and Help-Seeking Behaviors in Black Americans Using Crisis Hotlines.Community mental health journal · 2026Article
- Reparations for Caribbean slavery and the potential impact on human well-being.BMJ global health · 2026Review
- CVD Environmental Health Disparities Tool: systematic evidence mapping of psychosocial stressors, environmental exposures, and cardiovascular diseases to inform disparities research and action.Environmental health : a global access science source · 2026Review
- Birthplace, perinatal loss, and the parity-post-reproductive mortality relationship: Evidence from the Jim Crow-era American South.Social science & medicine (1982) · 2026Article
- Disparities in Patterns of Preterm and Early Term Second Births Among Non-Hispanic Black and White Mothers.Paediatric and perinatal epidemiology · 2026Article
- Trends and sociodemographic disparities in the circulatory disease prevalence in the United States: An analysis of the National Health Interview Survey database (2019-2022).BMC cardiovascular disorders · 2025Article
- An epigenome-wide analysis of DNA methylation, racialized and economic inequities, and air pollution.Clinical epigenetics · 2025Article
- Multilevel Racism and Discrimination and Cardiovascular Disease and Related Biopsychosocial Mechanisms: An Integrated Scoping and Literature Review and Future Research Agenda.Current cardiology reports · 2025Article
- 'Little Baby's gone to Heaven': A Mixed-Methods Study of Black Children's Survival Disadvantage in Jim Crow-Era Arkansas.Social science history · 2025Article
- Conceptualizing and Measuring Systemic Racism.Annual review of public health · 2025Review
- Using spatial Bayesian models to estimate associations between structural racial discrimination and disparities in severe maternal morbidity.Social science & medicine (1982) · 2025Article
- Slavery, homeownership, and contemporary perinatal outcomes in the southeast: a test of mediation and moderation.American journal of epidemiology · 2024Article
- Cancer mortality and geographic inequalities: a detailed descriptive and spatial analysis of social determinants across US counties, 2018-2021.Public health · 2024Observational
- Spatiotemporal Changes in the Slavery-Inequality Relationship: The Diffusion of the Legacy of Slavery.Demography · 2024Article
- Does everyday discrimination account for the increased risk of vasomotor symptoms in Black women?: the Study of Women's Health Across the Nation (SWAN).Menopause (New York, N.Y.) · 2024Article
- Historical Redlining and Heart Failure Outcomes Following Hospitalization in the Southeastern United States.Journal of the American Heart Association · 2024Article
- Structural Racism and Health Stratification: Connecting Theory to Measurement.Journal of health and social behavior · 2024Article
- Perceived Religious Influence on Health Is Associated with Beneficial Health Behaviors in Members of Predominantly Black Churches.Ethnicity & disease · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundThis study aims to characterize the role of county-specific legacy of slavery in patterning temporal (i.e., 1968-2014), and geographic (i.e., Southern counties) declines in heart disease mortality. In this context, the U.S. has witnessed dramatic declines in heart disease mortality since the 1960's, which have benefitted place and race groups unevenly, with slower declines in the South, especially for the Black population.
methodsAge-adjusted race- and county-specific mortality rates from 1968-2014 for all diseases of the heart were calculated for all Southern U.S. counties. Candidate confounding and mediating covariates from 1860, 1930, and 1970, were combined with mortality data in multivariable regression models to estimate the ecological association between the concentration of slavery in1860 and declines in heart disease mortality from 1968-2014.
resultsBlack populations, in counties with a history of highest versus lowest concentration of slavery, experienced a 17% slower decline in heart disease mortality. The association for Black populations varied by region (stronger in Deep South than Upper South states) and was partially explained by intervening socioeconomic factors. In models accounting for spatial autocorrelation, there was no association between slave concentration and heart disease mortality decline for Whites.
conclusionsNearly 50 years of declining heart disease mortality is a major public health success, but one marked by uneven progress by place and race. At the county level, progress in heart disease mortality reduction among Blacks is associated with place-based historical legacy of slavery. Effective and equitable public health prevention efforts should consider the historical context of place and the social and economic institutions that may play a role in facilitating or impeding diffusion of prevention efforts thereby producing heart healthy places and populations. Graphical abstract.
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