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Despite sustained declines in overall cardiovascular disease mortality in the U.S., disparities based on race, ethnicity and place persist, with mortality varying far more across counties than states, according to a county-by-cause-by-population analysis published in Journal of the American College of Cardiology.

Cardiovascular disease is the leading cause of death around the world. In the United States, it is a major contributor to mortality and health disparities, with mortality rates varying widely across racial and/or ethnic groups. Public health efforts to educate the public on prevention and treatment have helped to reduce death rates, but the decline has slowed over the last 15 years.

The new analysis explores county-level cardiovascular disease mortality by race and/or ethnicity and cardiovascular disease cause of death. Researchers estimated age-standardized mortality rates (ASMRs) for five racial and/or ethnic groups across 3,110 counties and 21 causes of cardiovascular disease death from 2000 to 2019 using death certificate data from the U.S. National Vital Statistics System. They used methods previously developed for estimating cause-specific mortality by county and race and/or ethnicity for a comprehensive set of causes of death from the Global Burden of Diseases cause list.

"Detailed knowledge of county-level variation is important for all racial and/or ethnic populations," said George A. , FACC, lead author of the study and director of the Center for Translation Research and Implementation Science at the National Heart, Lung, and Blood Institute.

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