Over roughly the last 4 decades, heart disease death rates in the US population have decreased 68%, but much less so for blacks, a new report shows.
Heart disease is the leading cause of death in the United States, claiming the lives of roughly 630,000 people in 2015, representing 1 in 4 deaths.
Using data from the National Vital Statistics System, Miriam Van Dyke, MPH, from Emory University and colleagues at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, analyzed historical trends in heart disease death rates among blacks and whites aged 35 years and older from 1968 to 2015.
This analysis of federal data was published online March 30 in the Morbidity and Mortality Weekly Report.
At the national level, heart disease death rates among blacks and whites decreased at similar rates during the early part of the study (1968 to the late 1970s) but then diverged from the late 1970s until the mid-2000s, the researchers found. During this time, whites had steady declines in heart disease death rates. Blacks also experienced declines, but the rate of decline was consistently slower than that for whites.
This produced a 26% increase in the black-white heart disease mortality ratio from 1.04 in 1976 to a peak of 1.31 in 2005, followed by a modest 7.6% decrease in the black-white ratio to 1.21 in 2015.
“Despite modest decreases in black-white disparities at the national level since 2005, in 2015, heart disease death rates were 21% higher among blacks than among whites,” Van Dyke and colleagues report.
At the state level, the data show that most states had increases in black-white mortality ratios from 1968 to 2015, and the number of states with black-white mortality ratios greater than 1 increased from 16 (40%) to 27 (67.5%).
For both blacks and whites, the geographic pattern of heart disease death rates changed over time.
In 1968, the highest rates for blacks were concentrated primarily in the mid-Atlantic states, along with several midwestern and northeastern states, and the highest rates for whites were concentrated largely in the Northeast and parts of the Midwest. In 2015, the highest rates for blacks were concentrated primarily in the northeastern, midwestern, and southern states, and the highest rates for whites were concentrated primarily in the south-central states.
The authors note that overall national decreases in heart disease deaths in the United States are thought to be equally attributable to advances in prevention and treatment. However, the black-white differences in the magnitude and patterns of decrease in heart disease death rates suggest that blacks have not benefitted equally from the improvements in prevention and treatment that have contributed to the overall decreases in heart disease deaths, they say.
Van Dyke and colleagues say eliminating racial disparities in deaths due to heart disease, coupled with continued declines in heart disease death rates for all Americans, is important for the overall state of health.
“The trends in black-white disparities in heart disease death rates observed in this report highlight the importance of continued surveillance of these trends at the national and state level,” they write.
The study had no specific funding. The authors have disclosed no relevant financial relationships.
Morb Mortal Wkly Rep Surveill Summ. Published online March 30, 2018. Full text
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