Trends and disparities in heart failure-related mortality in the US adult population from 1999 to 2020
Irfan UllahOwais AhmadHanzala Ahmed FarooqiRushna SaleemIsra AhmedMuhammad IrfanA. Basit KhanEjaz Hassan KhanOsama Ali KhanAman GoyalZeeshan SattarMuzammil FarhanCaleb CarverRaheel AhmedMuhammad Sohaib Asghar
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Introduction The rising incidence of heart failure (HF) among the U.S. population has become a major concern for healthcare providers. This study aims to assess mortality trends related to HF across different age groups, racial demographics, and geographic locations from 1999 to 2020. Material and methods This descriptive analysis uses death certificate data from the CDC WONDER database to track mortality trends among HF patients from 1999 to 2020. Log-linear regression models were used to delineate trends. The study used deidentified public data, complying with ethical standards. Results Over 21 years, 1,426,657 HF-related deaths were recorded in individuals aged 15 and older, with a slight overall increase in mortality (AAPC = 0.11). Mississippi recorded the highest age-adjusted mortality rates (AAMRs) at 58.0 per 100,000. The Midwest showed the highest regional mortality rates, while the oldest individuals (≥ 85) exhibited the highest crude mortality rate (CMR) of 663.9. Males consistently demonstrated higher AAMRs than females, despite females accounting for 57.6% of the deaths. Black ancestry individuals experienced the highest mortality rates, with rising trends, particularly in non-metropolitan areas. After 2012, significant increases in mortality were noted, especially in individuals over 85, with stable rates in younger demographics. Conclusions Males and Black ancestry individuals are disproportionately affected, demonstrating the need for targeted interventions.Keywords:
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I have been promising (or threatening, depending on your point of view) for some time to write on the subject of SEG's demographics and now is the time. One could say that it is SEG's most important issue because our demographic profile says a lot about our society and deeply influences our future. Yet, I have been slow to bring the issue to the fore because I have been puzzled by some aspects of our demographics and also needed to collect some hard data. I think you may find the results interesting.
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The FirstBook of Demographics for the Republics of the Former Soviet Union, 1951-1990. Shady Side: New World Demographics, 1992. x, 151 pp. Figures. Tables. $199.00 paper. - The First Demographic Portraits of Russia, 1951-1990. Shady Side: New World Demographics, 1993. x, 129 pp. Figures. Tables. $199.00, paper. - Volume 54 Issue 4
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We analyzed mortality trends among people who died with a diagnosis of obstructive lung disease from 1979 through 1993, using death certificate reports of 31,314,160 decedents in the Multiple-Cause Mortality Files compiled by the National Center for Health Statistics. Of all the decedents, 2,554,959 (8.2%) had a diagnosis of obstructive lung disease (ICD-9 490 to 493.9, 496) listed on their death certificates; of these 2,554,959 decedents, only 1,106,614 (43.3%) had obstructive lung disease listed as the underlying cause of death. The age-adjusted mortality rate increased 47.3%, from 52.6 per 100,000 in 1979 to 77.5 per 100,000 in 1993. The age-adjusted mortality rate increased 17.1% among men, from 96.3% per 100,000 in 1979 to 112.8 per 100,000 in 1993, whereas this rate increased 126.1% among women, from 24.5 per 100,000 in 1979 to 55.4 per 100,000 in 1993. Over the study period, white males had the highest mortality rates (98.8 to 115.5 per 100,000), followed by black males (77.5 to 100.2 per 100,000), males of other races (38.1 to 58.6 per 100,000), white females (25.5 to 57.7 per 100,000), black females (14.9 to 38.5 per 100,000), and females of other races (10.9 to 20.9 per 100,000). We conclude that mortality related to obstructive lung disease is under-estimated in studies that look at only the underlying cause of death. Mortality rates of obstructive lung disease are starting to stabilize among men, but continue to increase among women, reflecting historical smoking trends in these populations.
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Background and Purpose Stroke mortality has decreased in most industrialized countries in recent decades. In Poland, as in other eastern European countries, mortality rates for stroke remain high. Methods The Warsaw Stroke Registry (WSR) registered patients in the Mokotów district of Warsaw from 1991 through 1992. The Warsaw Pol-MONICA study registered stroke patients in the North and South Praga regions of Warsaw from 1984 through 1992. Stroke incidence rates, case-fatality rates, and stroke mortality rates were computed based on both studies and compared with published mortality rates based on death certificates. Eight-year trends of stroke incidence, case-fatality rate, and mortality were derived from the Warsaw Pol-MONICA study. Results The WSR and Warsaw Pol-MONICA studies showed similar incidence rates, mortality rates, and 28-day case-fatality rates for stroke. Mortality rates from the WSR and the Warsaw Pol-MONICA study were similar to rates from death certificate data. Mortality rates in the group aged 35 to 64 years were higher in men (47.5 to 50/100 000 per year) than in women (30/100 000 per year). Conclusions Two different population-based studies suggest that stroke mortality is high in Poland because of high 28-day case-fatality rates. Stroke mortality failed to decline in Poland in the period 1984 through 1992 because neither case fatality nor stroke incidence declined in this period.
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Reducing and eliminating disparities in health is a matter of life and death. Each year in the United States, thousands of individuals die unnecessarily from easily preventable diseases and conditions. It is critical that we approach this problem from a broad public health perspective, attacking all of the determinants of health: access to care, behavior, social and physical environments, and overriding policies of universal access to care, physical education in schools, and restricted exposure to toxic substances. We describe the historical background for recognizing and addressing disparities in health, various factors that contribute to disparities, how the public health approach addresses such challenges, and two successful programs that apply the public health approach to reducing disparities in health. Public health leaders must advocate for public health solutions to eliminate disparities in health.
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The trends and current incidence of Creutzfeldt-Jakob disease (CJD) was examined by using a unique and potentially highly sensitive source for case ascertainment. We analyzed death certificate information for 1979–1990 from US multiple-cause-of-death mortality data, compiled by the National Center for Health Statistics, Centers for Disease Control and Prevention. We evaluated death certificate data for US residents for whom CJD was listed as one of the multiple causes of death on the death certificate (046.1) from the International Statistical Classification of Diseases, Injuries, and Causes of Death (9th revision). Age-adjusted and age-specific CJD death rates by gender, race, and region were calculated to measure the disease incidence because of the rapidly fatal course of the disease for most patients with CJD. We identified 2,614 deaths with CJD listed on the death certificates. The average annual age-adjusted mortality rate was 0.9 deaths per million persons (range 0.8–1.1). The mean age at death was 67 years. CJD-related deaths were uncommon among persons younger than 50 years of age (4.3% of all deaths). The highest average annual mortality rate was for those persons aged 70–74 years (5.9 deaths per million persons). A slight majority (53.0%) of the deaths was in females, but the age-adjusted mortality rate was 1.2 times higher for males. Most deaths (94.8%) were in whites; the mortality rate for blacks was only 40% of that for whites. The age-adjusted CJD mortality rate in the United States is similar to published estimates of the crude incidence of CJD worldwide. Annual review of national multiple-cause-of-death data may provide an efficient and cost-effective method to monitor the incidence of CJD in the United States. The relative paucity of cases among blacks requires further study to rule out detection biases, but may reflect, in part, differences in genetic and/or environmental factors.
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This paper examines the impact that demographics have on policy outcomes. The impact that aldermanic ward‐level demographics have on the number of liquor licenses is measured in two US cities. In one city there is a great deal of direct resident involvement in the issuance process, while in the other city, issuance decisions are handled by elected representatives. This research does find that demographics have a significant impact on policy outcomes. However, the paper does not find a significant difference in outcomes between decisions made by elected representatives and those made by the community.
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Fatal self-injury in the United States associated with deliberate behaviors is seriously underestimated owing to misclassification of poisoning suicides and mischaracterization of most drug poisoning deaths as "accidents" on death certificates.
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Reducing and eliminating disparities in health is a matter of life and death. Each year in the United States, thousands of individuals die unnecessarily from easily preventable diseases and conditions. It is critical that we approach this problem from a broad public health perspective, attacking all of the determinants of health: access to care, behavior, social and physical environments, and overriding policies of universal access to care, physical education in schools, and restricted exposure to toxic substances. We describe the historical background for recognizing and addressing disparities in health, various factors that contribute to disparities, how the public health approach addresses such challenges, and two successful programs that apply the public health approach to reducing disparities in health. Public health leaders must advocate for public health solutions to eliminate disparities in health.
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