ArticleJournal of the American Heart Association2019
Regional Variation in the Association of Poverty and Heart Failure Mortality in the 3135 Counties of the United States.
Article in Journal of the American Heart Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed.
- Examining the association between spatial accessibility to emergency cardiac care centers and cardiovascular mortality in Georgia, United States.BMC cardiovascular disorders · 2026Article
- Epidemiology of non-ischaemic dilated cardiomyopathy.Nature reviews. Cardiology · 2026Review
- County-Level Contributors to Geographic Variation in Medicare Fee-for-Service Stroke Hospitalization Rates: A Cross-Sectional Study.Journal of the American Heart Association · 2026Article
- The Health of First Generation Caribbeans Across the Diaspora: Findings from 2000-2005 Population Data Surveys from Guyana, Jamaica, Canada, the United States, and the United Kingdom.Journal of racial and ethnic health disparities · 2025Article
- A social determinants-based county-level cardiovascular mortality index to identify high-risk counties in the USA.BMC medicine · 2025Article
- Racial and Ethnic Disparities and the National Burden of COVID-19 on Inpatient Hospitalizations: A Retrospective Study in the United States in the Year 2020.Journal of racial and ethnic health disparities · 2025Observational
- Role of Cardiovascular Deaths on Changes in the Longevity Gap Between U.S. and Other Countries.American journal of preventive medicine · 2025Observational
- The impact of area deprivation on access to and utilization of health services in the last year of life: A retrospective population-based cohort study.Palliative care and social practice · 2025Article
- Cohort study examining social determinants of health and their association with mortality among hospitalised adults in New York and California.BMJ public health · 2025Article
- Latent class analysis of chronic disease co-occurrence, clustering and their determinants in India using Study on global AGEing and adult health (SAGE) India Wave-2.Journal of global health · 2024Article
- Trends and disparities in heart failure-related mortality in the US adult population from 1999 to 2020.Archives of medical sciences. Atherosclerotic diseases · 2024Article
- Disparities in Postdischarge Ambulatory Care Follow-Up Among Medicaid Beneficiaries With Diabetes, Hospitalized for Heart Failure.Journal of the American Heart Association · 2023Article
- Prevalence of Social Determinants Among US Residents With Heart Failure by Race/Ethnicity and Household Income.The American journal of cardiology · 2023Article
- Rural and socioeconomic differences in the effectiveness of the HEART Pathway accelerated diagnostic protocol.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Article
- Impact of Socioeconomic Status on Heart Failure.Journal of community hospital internal medicine perspectives · 2023Review
- The where of when: Geographic variation in the timing of recent increases in US county-level heart disease death rates.Annals of epidemiology · 2022Article
- Socioeconomic Deprivation and Premature Cardiovascular Mortality in the United States.Mayo Clinic proceedings · 2022Article
- County-Level Social Vulnerability Is Positively Associated with Cardiometabolic Disease in Colorado.International journal of environmental research and public health · 2022Article
- Association between median household income, state Medicaid expansion status, and COVID-19 outcomes across US counties.PloS one · 2022Article
- Particulate matter 2.5, metropolitan status, and heart failure outcomes in US counties: A nationwide ecologic analysis.PloS one · 2022Article
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8 authors.
Funding
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Abstract
Background There is significant geographical variation in heart failure (HF) mortality across the United States. County socioeconomic factors that influence these outcomes are unknown. We studied the association between county socioeconomic factors and HF mortality and compared it with coronary heart disease (CHD) mortality. Methods and Results This is a cross-sectional analysis of socioeconomic factors and mortality in HF and CHD across 3135 US counties from 2010 to 2015. County-level poverty, education, income, unemployment, health insurance status, and cause-specific mortality rates were collected from the Centers for Disease Control and Prevention and US Census Bureau databases. Poverty had the strongest correlation with both HF and CHD mortality, disproportionately higher for HF (r=0.48) than CHD (r=0.24). HF mortality increased by 5.2 deaths/100 000 for each percentage increase in county poverty prevalence in a frequency-weighted, demographic-adjusted, multivariate regression model. The greatest attenuation in the poverty regression coefficient (66.4%) was seen after adjustment for prevalence of diabetes mellitus and obesity. Subgroup analysis by census region showed that this relationship was the strongest in the South and weakest in the Northeast (6.1 versus 1.4 deaths/100 000 per 1% increase in county poverty in a demographics-adjusted model). Conclusions County poverty is the strongest socioeconomic factor associated with HF and CHD mortality, an association that is stronger with HF than with CHD and varied by census region. Over half of the association was explained by differences in the prevalence of diabetes mellitus and obesity across the counties. Health policies targeting improvement in these risk factors may address and possibly minimize health disparities caused by socioeconomic factors.
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