Assessment of Racial Disparities in Mortality Rates Among Older Adults Living in US Rural vs Urban Counties From 1968 to 2016

Ferdows, Nasim B.; Aranda, María P.; Baldwin, Julie A.; Ahluwalia, Jasjit S.; Kumar, Amit

doi:10.1001/jamanetworkopen.2020.12241

Cited by 31 publications

(23 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Secondly, although older adults classified as Black had generally lower mortality rates than those classified as White prior to the pandemic, these rates increased substantially during the first wave throughout the state. The initially lower rates match the finding of Ferdows et al (2020) for crude rates at the national level, and they match trends we confirmed independently using the same CDC WONDER database. The effects of higher rates of mortality at younger ages, evident both in our data and in national studies ( Woolf and Schoomaker, 2019 ), may explain these lower rates in Georgia.…”

Section: Discussionsupporting

confidence: 82%

Racial disparities for COVID19 mortality in Georgia: Spatial analysis by age based on excess deaths

Shannon

Abraham

Adams

et al. 2022

Social Science & Medicine

View full text Add to dashboard Cite

Introduction This study uses multiple measures of excess deaths to analyze racial disparities in COVID-19 mortality across Georgia. Methods The Georgia Department of Public Health provided monthly mortality data for 2010–2020 stratified by race/ethnicity, age, county, and recorded cause of death. We first calculate crude mortality rates by health district during the time period for all groups for March through June for our historical period to identify significant time-series outliers in 2020 distinguishable from general trend variations. We then calculate the mean and standard deviation of mortality rates by age and racial subgroup to create historic confidence intervals that contextualize rates in 2020. Lastly, we use risk ratios to identify disparities in mortality between Black and White mortality rates both in the 2010–2019 period and in 2020. Results Time-series analysis identified three health districts with significant increases in mortality in 2020, located in metro Atlanta and Southwest Georgia. Mortality rates decreased sharply in 2020 for children in both racial categories in all sections of the state, but rose in a majority of districts for both categories in adult and older populations. Risk ratios also increased significantly in 2020 for children and older populations, showing rising disparities in mortality during the pandemic even as crude mortality rates declined for children classified as Black. Conclusions Increased mortality during the COVID-19 outbreak disproportionately affected African-Americans, possibly due, in part, to pre-existing disparities prior to the pandemic linked to social determinants of health. The pandemic deepened these disparities, perhaps due to unequal resources to effectively shelter-in-place or access medical care. Future research may identify local factors underlying geographically heterogenous differences in mortality rates to inform future policy interventions.

show abstract

Section: Discussionsupporting

confidence: 82%

Racial disparities for COVID19 mortality in Georgia: Spatial analysis by age based on excess deaths

Shannon

Abraham

Adams

et al. 2022

Social Science & Medicine

View full text Add to dashboard Cite

show abstract

“…Some of the factors that might influence this trend is that rural counties had lower per capita income, higher unemployment rates, lower median household income, higher poverty rates, and higher proportion of adults 65 years or older. 5 Though, this report remarks the importance of early diagnosis of a patient with ATTR-CM in a southern region, rural county in the United States; these regions have showed lower proportions of cardiac amyloidosis but have a population with risk characteristics. 4 , 5 ATTR-CM is more common in men, elderly and African Americans.…”

Section: Discussionmentioning

confidence: 71%

“… 5 Though, this report remarks the importance of early diagnosis of a patient with ATTR-CM in a southern region, rural county in the United States; these regions have showed lower proportions of cardiac amyloidosis but have a population with risk characteristics. 4 , 5 ATTR-CM is more common in men, elderly and African Americans. 2 The approach to suspected cases of ATTR-CM relies on the presence of heart failure, red flag symptoms and age >65 or >70 for men and women, respectively.…”

Section: Discussionmentioning

confidence: 71%

A Case of Early Hereditary Transthyretin Amyloid Cardiomyopathy Recognition With Genetic Screening: A Case Report

Juarez¹,

Rio‐Pertuz

Parmar

et al. 2022

J Prim Care Community Health

View full text Add to dashboard Cite

Background: Transthyretin amyloid cardiomyopathy (ATTR-CM) is one of the most common types of cardiac amyloidosis. Amyloid cardiomyopathy more commonly affects men, elderly, and 3% to 4% of the African-American population. ATTR-CM suspicion and diagnosis is challenging; however, awareness of the disease is increasing, and best practices to identify it are being proposed. The approach to suspected cases of ATTR-CM relies on the presence of heart failure, red flag signs and symptoms, and age >65 or >70 for men and women respectively. Little is known about cases when it presents in early ages. Case: We report a 62-year-old African American male with past medical history of hyperlipidemia, prostate cancer, hypertension, bilateral carpal tunnel surgery that had debuted with a cardiac arrhythmia at age 55 and was diagnosed with heart failure several years later. Restrictive cardiomyopathy was suspected, and genetic screening was sent for ATTRm which confirmed a pathogenic trasnthyretin gene mutation. Endomyocardial biopsy was performed which confirmed cardiac amyloid deposition. Discussion: ATTR-CM is a rare disease with an increasing prevalence. Cases with out of proportion signs and symptoms of heart failure with preserved ejection fractions should raise the suspicion of ATTR-CM despite age.

show abstract

“…These data build upon prior studies that have documented substantial county-level disparities in COVID-19 as well as a large body of literature demonstrating similar patterns in geographic disparities across the US in non-communicable diseases, such as cardiovascular disease [ 25 , 26 ]. Indeed, COVID-19 infection susceptibility and mortality has further amplified pre-existing place-based health disadvantage due to interrelated sociodemographic [ 27 ], health [ 28 ], and environmental factors [ 29 ] at the county-level and expand growing awareness of a “rural mortality penalty” [ 30 ] in the US. Recent investigations have demonstrated widening disparities in rural mortality rates due to noncommunicable diseases, such as chronic lung disease [ 31 ] and cardiovascular disease [ 32 ], compared with urban mortality rates.…”

Section: Discussionmentioning

confidence: 99%

Association between county-level risk groups and COVID-19 outcomes in the United States: a socioecological study

et al. 2022

View full text Add to dashboard Cite

Background Geographic heterogeneity in COVID-19 outcomes in the United States is well-documented and has been linked with factors at the county level, including sociodemographic and health factors. Whether an integrated measure of place-based risk can classify counties at high risk for COVID-19 outcomes is not known. Methods We conducted an ecological nationwide analysis of 2,701 US counties from 1/21/20 to 2/17/21. County-level characteristics across multiple domains, including demographic, socioeconomic, healthcare access, physical environment, and health factor prevalence were harmonized and linked from a variety of sources. We performed latent class analysis to identify distinct groups of counties based on multiple sociodemographic, health, and environmental domains and examined the association with COVID-19 cases and deaths per 100,000 population. Results Analysis of 25.9 million COVID-19 cases and 481,238 COVID-19 deaths revealed large between-county differences with widespread geographic dispersion, with the gap in cumulative cases and death rates between counties in the 90th and 10th percentile of 6,581 and 291 per 100,000, respectively. Counties from rural areas tended to cluster together compared with urban areas and were further stratified by social determinants of health factors that reflected high and low social vulnerability. Highest rates of cumulative COVID-19 cases (9,557 [2,520]) and deaths (210 [97]) per 100,000 occurred in the cluster comprised of rural disadvantaged counties. Conclusions County-level COVID-19 cases and deaths had substantial disparities with heterogeneous geographic spread across the US. The approach to county-level risk characterization used in this study has the potential to provide novel insights into communicable disease patterns and disparities at the local level.

show abstract

Assessment of Racial Disparities in Mortality Rates Among Older Adults Living in US Rural vs Urban Counties From 1968 to 2016

Cited by 31 publications

References 22 publications

Racial disparities for COVID19 mortality in Georgia: Spatial analysis by age based on excess deaths

Racial disparities for COVID19 mortality in Georgia: Spatial analysis by age based on excess deaths

A Case of Early Hereditary Transthyretin Amyloid Cardiomyopathy Recognition With Genetic Screening: A Case Report

Association between county-level risk groups and COVID-19 outcomes in the United States: a socioecological study

Contact Info

Product

Resources

About