Reconciling Regional-, State-, and County-Level Trends in U.S. Cardiovascular Disease Mortality

Leah Abrams , Tufts University
Nora Brower-Snelson, Tufts University
Mikko Myrskyla, Max Planck Institute for Demographic Research
Neil Mehta, University of Texas Medical Branch

Since 2010, the U.S. has experienced adverse trends in cardiovascular disease (CVD) mortality, which dramatically slowed long-standing life expectancy improvements. The extent to which the national trend masks heterogeneity across regions, states, and counties is poorly understood. In this project, we aim to provide a detailed accounting of post-2010 trends in CVD mortality by U.S. region, state, and county. We then examine how features of places (e.g., population composition and socioeconomic status) relate to trends at these different levels. Preliminary results reveal differing trends and associations at different geographic levels of analysis. We explore whether these paradoxical findings can be attributable to the Simpson’s Paradox, floor effects, confounding by race/ethnicity, or other processes. Results point to policy-modifiable aspects of economic, social, and built environments that may be targeted to return CVD mortality declines across the United States.

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 Presented in Session 110. Social Inequalities in Health, Wellbeing and Morbidity