目的:按贫困水平和地区考察城乡心血管疾病(CVD)死亡率的差异。
方法:使用2021年县级人口和死亡率数据,将CVD死亡列为35-64岁成年人的潜在原因,我们计算了4类县的年龄标准化的CVD死亡率和比率(RR):高贫困农村,高贫困城市,低贫困农村,和低贫困城市(参考)。结果由全国和美国人口普查地区提供。
结果:心血管疾病死亡率的城乡差距因贫困和地区而异。在全国范围内,高贫困农村地区的CVD死亡率最高(每100,000中有191例死亡,RR:1.76,CI:1.73~1.78).按地区,南部高贫困农村地区的心血管疾病死亡率最高(每100,000人中有256人死亡),与低贫困城市地区的差距最大(RR:2.05;CI:2.01-2.09)。在中西部和西部,高贫困地区的心血管疾病死亡率高于低贫困地区,无论农村还是城市分类。
结论:结果强调了优先考虑高贫困农村地区的重要性,尤其是在南方,努力降低CVD死亡率。这些努力可能需要考虑社会经济条件和地区,除了城乡差距。
OBJECTIVE: To examine rural and urban disparities in cardiovascular disease (CVD) death rates by poverty level and region.
METHODS: Using 2021 county-level population and mortality data for CVD deaths listed as the underlying cause among adults aged 35-64 years, we calculated age-standardized CVD death rates and rate ratios (RR) for 4 categories of counties: high-poverty rural, high-poverty urban, low-poverty rural, and low-poverty urban (referent). Results are presented nationally and by US Census region.
RESULTS: Rural and urban disparities in CVD mortality varied markedly by poverty and region. Nationally, the CVD death rate was highest among high-poverty rural areas (191 deaths per 100,000, RR: 1.76, CI: 1.73-1.78). By region, Southern high-poverty rural areas had the highest CVD death rate (256 deaths per 100,000) and largest disparity relative to low-poverty urban areas (RR: 2.05; CI: 2.01-2.09). In the Midwest and West, CVD death rates among high-poverty areas were higher than low-poverty areas, regardless of rural or urban classification.
CONCLUSIONS: Results reinforce the importance of prioritizing high-poverty rural areas, especially in the South, in efforts to reduce CVD mortality. These efforts may need to consider socioeconomic conditions and region, in addition to rural and urban disparities.