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Racial Disparities in Heart Disease Mortality in the 50 Largest U.S. Cities

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Abstract

Heart disease is not only the leading cause of death in the U.S. but also the main contributor to racial disparities in life expectancy. Despite this, heart disease mortality rates and racial disparities in these rates are not readily available at the city level where they can be the most quickly and effectively addressed. We calculated age-adjusted heart disease mortality rates and corresponding racial rate ratios (RRs) and rate differences (RDs) for the non-Hispanic Black (Black) and non-Hispanic White (White) populations for the years 1990–1994 and 2005–2009 for the U.S. and the 50 largest cities therein. We then examined relationships between the disparities and city-level population indicators. Nationally, mortality rates were significantly higher among Blacks than Whites at both time periods. Larger improvements in rates for Whites compared to Blacks resulted in a significant increase in disparities over the 20-year period for 11 cities. There were 19,448 excess Black deaths in the U.S. annually. City-level income inequality, as well as the overall city and White median household income, contributed to these disparities. By identifying city-specific disparities and trends, health care providers, public health agencies, and researchers can target the areas with the most need and can look at cities without disparities for clues on how to best advance health equity in heart disease morbidity and mortality.

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Acknowledgments

We thank Adelina Huo for her assistance with developing the figure for this paper.

Contributors

Benjamins and Hunt conceptualized the study. Benjamins and Hunter were the main authors of the manuscript. Hirschtick, Hunt, and Hughes developed the statistical procedures, performed the analyses, and wrote up the results. All authors contributed to the interpretation of findings.

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Authors and Affiliations

  1. Sinai Urban Health Institute, Sinai Health System, Mount Sinai Hospital, 1500 S. Fairfield Ave, Rm K443, Chicago, IL, 60608, USA

    Maureen R. Benjamins, Jana L. Hirschtick, Bijou R. Hunt & Michelle M. Hughes

  2. Chicago Medical School, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Rd, North Chicago, IL, 60064, USA

    Maureen R. Benjamins & Brittany Hunter

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  1. Maureen R. Benjamins
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  2. Jana L. Hirschtick
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Correspondence to Jana L. Hirschtick.

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Benjamins, M.R., Hirschtick, J.L., Hunt, B.R. et al. Racial Disparities in Heart Disease Mortality in the 50 Largest U.S. Cities. J. Racial and Ethnic Health Disparities 4, 967–975 (2017). https://doi.org/10.1007/s40615-016-0300-6

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  • DOI: https://doi.org/10.1007/s40615-016-0300-6

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