Racial Disparities in Heart Disease Mortality in the 50 Biggest US Cities

• In Event: 201 - Regular Session. Place and Mortality - Mechanisms

Abstract

The long-term decline in heart disease mortality is well documented, but data analyzing overall rates, as well as disparities, at the city level have not been available. The objective of the current study is to determine whether racial disparities in heart disease mortality vary across US cities and whether and how disparities have changed over time. To do this, age-adjusted heart disease mortality rates and corresponding racial rate ratios (RRs) were calculated for the non-Hispanic Black (Black) and non-Hispanic White (White) male, female, and total populations for the years 1990-1994 and 2005-2009 for the US and the 50 largest therein. At the final time point, 44 RRs were greater than 1, 35 of them significantly so, indicating that the Black mortality rate is higher than the White rate in the majority of cities. Of the cities included in the analysis, 37 saw an increase in the Black:White RR over the 20-year period, 11 significantly so. In the majority of cities, this disparity widened because the declines in mortality rates were substantially greater for Whites than Blacks. There were 19,448 excess Black deaths annually, an average of 53 per day. These unique data show that the Black:White disparity in heart disease mortality has widened over the past two decades in the US, but that many large cities were able to avoid following that trend. These data are critical for targeting the cities in greatest need and finding models for effective city-level interventions to reduce racial disparities in heart disease mortality.

Authors

• Maureen Reindl Benjamins, Sinai Urban Health Institute

• Kristin R. Hunt, University of Maryland

• Brittany Hunter, Rosalind Franklin University