County-Level Poverty Strongly Tied to Heart Failure Mortality
FRIDAY, Sept. 6, 2019 -- County-level poverty is strongly associated with heart failure and coronary heart disease (CHD) mortality, and the correlation is stronger for heart failure mortality, according to a study published online Sept. 4 in the Journal of the American Heart Association.
Khansa Ahmad, M.D., from the Providence Veterans Affairs Medical Center in Rhode Island, and colleagues conducted a cross-sectional analysis of socioeconomic factors and mortality in heart failure and CHD across 3,135 U.S. counties from 2010 to 2015.
The researchers found that the strongest correlation was seen for the association of poverty with heart failure and CHD mortality, which was disproportionately stronger for heart failure than CHD (r = 0.48 versus 0.24). For each percentage increase in prevalence of county-level poverty, heart failure mortality increased by 5.2 deaths per 100,000 in a multivariable model adjusted for demographics. After adjustment for prevalence of diabetes mellitus and obesity, the greatest attenuation in the poverty regression coefficient was seen (66.4 percent). Subgroup analysis by census region showed that this correlation was strongest in the South and weakest in the Northeast (per percentage increase in county-level poverty, 6.1 versus 1.4 deaths/100,000).
"County poverty is more strongly associated with heart failure mortality compared with CHD mortality," the authors write. "Over half of the association was explained by differences in cardiovascular disease risk factor prevalence across the counties. These findings have relevance for future policy-oriented studies."
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Posted: September 2019
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