Sociodemographic Determinants of Acute Myocardial Infarction Hospitalization Risks in Florida

Abstract

Background Identifying social determinants of myocardial infarction ( MI ) hospitalizations is crucial for reducing/eliminating health disparities. Therefore, our objectives were to identify sociodemographic determinants of MI hospitalization risks and to assess if the impacts of these determinants vary by geographic location in Florida. Methods and Results This is a retrospective ecologic study at the county level. We obtained data for principal and secondary MI hospitalizations for Florida residents for the 2005–2014 period and calculated age‐ and sex‐adjusted MI hospitalization risks. We used a multivariable negative binomial model to identify sociodemographic determinants of MI hospitalization risks and a geographically weighted negative binomial model to assess if the strength of associations vary by location. There were 645 935 MI hospitalizations (median age, 72 years; 58.1%, men; 73.9%, white). Age‐ and sex‐adjusted risks ranged from 18.49 to 69.48 cases/10 000 persons, and they were significantly higher in counties with low education levels (risk ratio [ RR ]=1.033, P <0.0001) and high divorce rate ( RR , 0.995; P =0.018). However, they were significantly lower in counties with high proportions of rural ( RR , 0.996; P <0.0001), black (RR, 1.026; P =0.032), and uninsured populations ( RR , 0.983; P =0.040). Associations of MI hospitalization risks with education level and uninsured rate varied geographically ( P for non‐stationarity test=0.001 and 0.043, respectively), with strongest associations in southern Florida ( RR for <high school education, 1.036–1.041; RR for uninsured rate, 0.971–0.976). Conclusions Black race, divorce, rural residence, low education level, and lack of health insurance were significant determinants of MI hospitalization risks, but associations with the latter 2 were stronger in southern Florida. Thus, interventions for addressing MI hospitalization risks need to prioritize these populations and allocate resources based on empirical evidence from global and local models for maximum efficiency and effectiveness.

Barriers and facilitators of readiness for hospital discharge in patients with myocardial infarction: a qualitative study: quality improvement study

“…The results of the Kosobuka et al 11 study showed that the economic status of MI patients had a significant effect on RHD. Wangui Odoi et al 45 found that the lack of health insurance not only prevented timely access to cardiac care but also reduced access to preventive and therapeutic care necessary to minimize more diseases in the future. The effective role of society and social support and interactions in the RHD process emphasizes issues that are effective in creating well-being and comfort for patients and their families during illness and hospitalization.…”

Twenty Years of Leading the Way among Cohort Studies in Community-Driven Outreach and Engagement: Jackson State University/Jackson Heart Study

“…Details of the JHS, its development, participants, and overall procedures are described in earlier publications [ 1 , 2 , 3 , 4 ]. The public health burden caused by cardiovascular disease (CVD) continues to adversely affect individuals through cost, life expectancy, medical, pharmaceutical and hospital care, particularly in the case of African Americans [ 5 , 6 , 7 , 8 ].…”

Thoughts about the change in incidence, treatment, and outcomes of first myocardial infarctions across the 21st century

“…It is also essential to explore the effects of other factors that can affect the rate of first AMI presentations. For example, a 2020 retrospective study by Odoi et al 6 looking at the socio-demographic determinants of AMI hospitalization risks in Florida concluded that Black race, divorce, rural residence, low education level, and lack of health insurance were significant determinants of MI hospitalization risks. Therefore, these socio-demographic factors are essential to consider when considering the changes in incidence, treatment, and outcomes of first AMIs.…”