Affiliation:
1. Comparative and Experimental Medicine College of Veterinary Medicine The University of Tennessee Knoxville TN
2. Department of Geography The University of Tennessee Knoxville TN
3. Department of Business Analytics and Statistics The University of Tennessee Knoxville TN
4. Public Health Research Division of Community Health Promotion Florida Department of Health Tallahassee FL
5. Environmental Public Health Tracking Division of Community Health Promotion Florida Department of Health Tallahassee FL
6. Department of Public Health The University of Tennessee Knoxville TN
Abstract
Background
Identifying social determinants of myocardial infarction (
MI
) hospitalizations is crucial for reducing/eliminating health disparities. Therefore, our objectives were to identify sociodemographic determinants of
MI
hospitalization risks and to assess if the impacts of these determinants vary by geographic location in Florida.
Methods and Results
This is a retrospective ecologic study at the county level. We obtained data for principal and secondary
MI
hospitalizations for Florida residents for the 2005–2014 period and calculated age‐ and sex‐adjusted
MI
hospitalization risks. We used a multivariable negative binomial model to identify sociodemographic determinants of
MI
hospitalization risks and a geographically weighted negative binomial model to assess if the strength of associations vary by location. There were 645 935
MI
hospitalizations (median age, 72 years; 58.1%, men; 73.9%, white). Age‐ and sex‐adjusted risks ranged from 18.49 to 69.48 cases/10 000 persons, and they were significantly higher in counties with low education levels (risk ratio [
RR
]=1.033,
P
<0.0001) and high divorce rate (
RR
, 0.995;
P
=0.018). However, they were significantly lower in counties with high proportions of rural (
RR
, 0.996;
P
<0.0001), black (RR, 1.026;
P
=0.032), and uninsured populations (
RR
, 0.983;
P
=0.040). Associations of
MI
hospitalization risks with education level and uninsured rate varied geographically (
P
for non‐stationarity test=0.001 and 0.043, respectively), with strongest associations in southern Florida (
RR
for <high school education, 1.036–1.041;
RR
for uninsured rate, 0.971–0.976).
Conclusions
Black race, divorce, rural residence, low education level, and lack of health insurance were significant determinants of
MI
hospitalization risks, but associations with the latter 2 were stronger in southern Florida. Thus, interventions for addressing
MI
hospitalization risks need to prioritize these populations and allocate resources based on empirical evidence from global and local models for maximum efficiency and effectiveness.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Reference155 articles.
1. Heart disease and stroke statistics—2019 update: a report from the American Heart Association;Benjamin EJ;Circulation,2019
2. State of Disparities in Cardiovascular Health in the United States
3. Potentially preventable deaths from the five leading causes of death—United States, 2008–2010;Yoon PW;MMWR Morb Mortal Wkly Rep,2014
4. Centers for Disease Control and Prevention
. BRFSS prevalence & trends data. Available at: https://www.cdc.gov/brfss/brfssprevalence/. Accessed May 11 2018.
5. Florida Department of Health
. Florida Behavioral Risk Factor Surveillance System (BRFSS) 2014 data book. 2015. Available at: http://www.floridahealth.gov/statistics-and-data/survey-data/behavioral-risk-factor-surveillance-system/_documents/_documents/2014-brfss.pdf. Accessed May 17 2018.
Cited by
7 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献