ArticleJournal of the American Heart Association2026
Variable Association of Neighborhood Deprivation and Race With Postoperative Survival After Coronary Artery Bypass Grafting.
Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSocial determinants of health, including neighborhood deprivation measured by the Area Deprivation Index, are key drivers of disparities in health outcomes, including survival after cardiac surgery. We evaluated whether the association between neighborhood deprivation and survival differs across racial and ethnic groups undergoing coronary artery bypass grafting.
methodsWe conducted a retrospective study of 739 335 Medicare beneficiaries who underwent isolated coronary artery bypass grafting between 2008 and 2019. A flexible parametric survival model with time-dependent effects was implemented to estimate standardized (over demographics, clinical, and procedural characteristics) survival probabilities. Primary end points were differences in 30-day and 5-year standardized survival probabilities between beneficiaries from the lowest and highest quintiles of neighborhood deprivation (LDNs and HDNs), stratified by race and ethnicity.
resultsUnadjusted median survival was substantially higher among beneficiaries in LDNs compared with HDNs (10.65 [95% CI, 10.55-10.76] versus 9.20 [95% CI, 9.14-9.27] years). In our risk-adjusted model, the magnitude of this difference varied significantly by race and ethnicity. At 30 days, standardized survival differences between LDNs and HDNs were 1.49% [95% CI, 0.45-2.53] among Asian American or Native Hawaiian/Pacific Islander, 1.06% [95% CI, 0.94-1.19] among White, 0.94% [95% CI,0.583-1.31] among Black, and 0.56% [95% CI, 0.25-0.91] among Hispanic beneficiaries. At 5 years, Asian American or Native Hawaiian/Pacific Islander and White beneficiaries showed the largest standardized survival differences between LDNs and HDNs (8.07% [95% CI, 5.37-10.77] and 5.01% [95% CI, 4.62 -5.39], respectively), whereas Black and Hispanic beneficiaries had smaller differences (2.00% [95% CI, 0.71-3.28] and 1.15% [95% CI, 0.05-2.26], respectively).
conclusionsAlthough LDN (compared with HDN) residence was associated with improved survival after coronary artery bypass grafting, these survival differences were not equally distributed across race and ethnicity. Policies aiming to reduce socioeconomic disadvantage may yield uneven outcomes unless tailored to the specific challenges faced by different racial and ethnic populations.
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