Primary Care Physician Supply by County-Level Characteristics, 2010-2019

Liu, Mengmeng; Wadhera, Rishi K.

doi:10.1001/jama.2022.15106

Cited by 11 publications

(6 citation statements)

References 6 publications

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“…First, patients living in socioeconomically disadvantaged communities continue to face barriers to accessing reliable, longitudinal outpatient care, which may lead to lower rates of screening, identification, and treatment of cardiovascular risk factors. [25][26][27] Second, the presence of green space and recreational spaces needed, as well as the availability of healthy foods, is more limited in disadvantaged communities, 25,[28][29][30][31] while exposure to air pollution and other environmental stressors is higher. [32][33][34] In addition, adults living in these communities are more likely to experience poverty, housing instability, job insecurity, and food insecurity, all of which contribute to a higher burden of cardiovascular risk factors and disease.…”

Section: Discussionmentioning

confidence: 99%

Community Socioeconomic Status, Acute Cardiovascular Hospitalizations, and Mortality in Medicare, 2003 to 2019

Wadhera,

Secemsky,

et al. 2024

Circ: Cardiovascular Quality and Outcomes

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BACKGROUND: Socioeconomically disadvantaged communities in the United States disproportionately experience poor cardiovascular outcomes. Little is known about how hospitalizations and mortality for acute cardiovascular conditions have changed among Medicare beneficiaries in socioeconomically disadvantaged and nondisadvantaged communities over the past 2 decades. METHODS: Medicare files were linked with the Centers for Disease Control and Prevention’s social vulnerability index to examine age-sex standardized hospitalizations for myocardial infarction, heart failure, ischemic stroke, and pulmonary embolism among Medicare fee-for-service beneficiaries ≥65 years of age residing in socioeconomically disadvantaged communities (highest social vulnerability index quintile nationally) and nondisadvantaged communities (all other quintiles) from 2003 to 2019, as well as risk-adjusted 30-day mortality among hospitalized beneficiaries. RESULTS: A total of 10 942 483 Medicare beneficiaries ≥65 years of age were hospitalized for myocardial infarction, heart failure, stroke, or pulmonary embolism (mean age, 79.2 [SD, 8.7] years; 53.9% female). Although age-sex standardized myocardial infarction hospitalizations declined in socioeconomically disadvantaged (990–650 per 100 000) and nondisadvantaged communities (950–570 per 100 000) from 2003 to 2019, the gap in hospitalizations between these groups significantly widened (adjusted odds ratio 2003, 1.03 [95% CI, 1.02–1.04]; adjusted odds ratio 2019, 1.14 [95% CI, 1.13–1.16]). There was a similar decline in hospitalizations for heart failure in socioeconomically disadvantaged (2063–1559 per 100 000) and nondisadvantaged communities (1767–1385 per 100 000), as well as for ischemic stroke, but the relative gap did not change for both conditions. In contrast, pulmonary embolism hospitalizations increased in both disadvantaged (146–184 per 100 000) and nondisadvantaged communities (153–184 per 100 000). By 2019, risk-adjusted 30-day mortality was similar between hospitalized beneficiaries from socioeconomically disadvantaged and nondisadvantaged communities for myocardial infarction, heart failure, and ischemic stroke but was higher for pulmonary embolism (odds ratio, 1.10 [95% CI, 1.01–1.20]). CONCLUSIONS: Over the past 2 decades, hospitalizations for most acute cardiovascular conditions decreased in both socioeconomically disadvantaged and nondisadvantaged communities, although significant disparities remain, while 30-day mortality is now similar across most conditions.

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Section: Discussionmentioning

confidence: 99%

Community Socioeconomic Status, Acute Cardiovascular Hospitalizations, and Mortality in Medicare, 2003 to 2019

Wadhera,

Secemsky,

et al. 2024

Circ: Cardiovascular Quality and Outcomes

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“…Moreover, the stark disparities in life-expectancy, that existed before COVID-19 but widened during the pandemic, highlight differences in place-based risks and resource deficits experienced by Black communities in the US. Uneven distribution of primary care services [17][18][19][20] along racial lines, for example, have been extensively documented and highlight the burden of systemic Anti-Black racism in the US healthcare system 21 .…”

Section: Discussionmentioning

confidence: 99%

Assessing the impact of one million COVID-19 deaths in America: economic and life expectancy losses

Silva

Goosby

Reid

2023

Sci Rep

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Between February 2020 and May 2022, one million Americans have died of COVID-19. To determine the contribution of those deaths to all-cause mortality in terms of life expectancy reductions and the resulting economic welfare losses, we calculated their combined impact on national income growth and the added value of lives lost. We estimated that US life expectancy at birth dropped by 3.08 years due to the million COVID-19 deaths. Economic welfare losses estimated in terms of national income growth supplemented by the value of lives lost, was in the order of US$3.57 trillion. US$2.20 trillion of these losses were in in the non-Hispanic White population (56.50%), US$698.24 billion (19.54%) in the Hispanic population, and US$579.93 billion (16.23%) in the non-Hispanic Black population. The scale of life expectancy and welfare losses underscores the pressing need to invest in health in the US to prevent further economic shocks from future pandemic threats.

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“…The outcome, prevalence of self-reported poor or fair health, was obtained from the CDC’s PLACES database, which provides Census tract–level estimates of health outcomes. Neighborhoods with a high proportion of minority residents were defined as Census tracts in the top decile by proportion of Black and Hispanic residents . In accordance with the Common Rule, this study was exempt from review and informed consent.…”

Section: Methodsmentioning

confidence: 99%

“…ity residents were defined as Census tracts in the top decile by proportion of Black and Hispanic residents. 5 In accordance with the Common Rule, this study was exempt from review and informed consent.…”

mentioning

confidence: 99%

Association of Neighborhood-Level Environmental Injustice With Health Status in the US

et al. 2023

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Primary Care Physician Supply by County-Level Characteristics, 2010-2019

Abstract: This study evaluates and compares US trends between 2010 and 2019 in per-capita primary care physician supply by county-level racial and ethnic minority concentration, poverty, rurality, and region.

Cited by 11 publications

References 6 publications

Community Socioeconomic Status, Acute Cardiovascular Hospitalizations, and Mortality in Medicare, 2003 to 2019

Community Socioeconomic Status, Acute Cardiovascular Hospitalizations, and Mortality in Medicare, 2003 to 2019

Assessing the impact of one million COVID-19 deaths in America: economic and life expectancy losses

Association of Neighborhood-Level Environmental Injustice With Health Status in the US

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