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

  • Maureen R. Benjamins
  • Jana L. HirschtickEmail author
  • Bijou R. Hunt
  • Michelle M. Hughes
  • Brittany Hunter


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.


Disparities Heart disease Mortality Epidemiology 



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


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.

Compliance with Ethical Standards

Funding Sources


Conflict of Interest

The authors declare that they have no conflict of interest.

Animal and Human Studies

No animal or human studies were carried out by the authors for this article.

Supplementary material

40615_2016_300_MOESM1_ESM.docx (12 kb)
Supplemental Table 1 (DOCX 11 kb)


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Copyright information

© W. Montague Cobb-NMA Health Institute 2016

Authors and Affiliations

  • Maureen R. Benjamins
    • 1
    • 2
  • Jana L. Hirschtick
    • 1
    Email author
  • Bijou R. Hunt
    • 1
  • Michelle M. Hughes
    • 1
  • Brittany Hunter
    • 2
  1. 1.Sinai Urban Health Institute, Sinai Health SystemMount Sinai HospitalChicagoUSA
  2. 2.Chicago Medical SchoolRosalind Franklin University of Medicine and ScienceNorth ChicagoUSA

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