TY - JOUR
T1 - Stroke-related mortality in the united states-mexico border area of the united states, 1999 to 2018
AU - Khan, Safi U.
AU - Kalra, Ankur
AU - Yedlapati, Siva H.
AU - Dani, Sourbha S.
AU - Shapiro, Michael D.
AU - Nasir, Khurram
AU - Virani, Salim S.
AU - Michos, Erin D.
AU - Alkhouli, Mohamad
N1 - Funding Information:
Dr Kalra reports being Chief Executive Officer and Creative Director of makeadent.org. Dr Virani reports grant support from the Department of Veterans Affairs, World Heart Federation, and Tahir and Jooma Family and honorarium from the American College of Cardiology (Associate Editor for Innovations; acc.org) and is a steering committee member of the PALM (Patient and Provider Assessment of Lipid Management) registry at the Duke Clinical Research Institute (no financial remuneration). Dr Shapiro reports scientific advisory activities with Alexion, Amgen, Esperion, and Novartis. Dr. Kalra reports being Chief Executive Officer and Creative Director of makead-ent.org. The remaining authors have no disclosures to report.
Publisher Copyright:
© 2021 The Authors.
Copyright:
Copyright 2022 Elsevier B.V., All rights reserved.
PY - 2021/7/6
Y1 - 2021/7/6
N2 - BACKGROUND: The United States (US)-Mexico border is a socioeconomically underserved area. We sought to investigate whether stroke-related mortality varies between the US border and nonborder counties. METHODS AND RESULTS: We used death certificates from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database to examine stroke-related mortality in border versus nonborder counties in California, Texas, New Mexico, and Arizona. We measured average annual percent changes (AAPCs) in age-adjusted mortality rates (AAMRs) per 100 000 between 1999 and 2018. Overall, AAMRs were higher for nonborder counties, older adults, men, and non-Hispanic Black adults than their counterparts. Between 1999 and 2018, AAMRs reduced from 55.8 per 100 000 to 34.4 per 100 000 in the border counties (AAPC, −2.70) and 64.5 per 100 000 to 37.6 per 100 000 in nonborder counties (AAPC, −2.92). The annual percent change in AAMR initially decreased, followed by stagnation in both border and nonborder counties since 2012. The AAPC in AAMR decreased in all 4 states; however, AAMR increased in California’s border counties since 2012 (annual percent change, 3.9). The annual percent change in AAMR decreased for older adults between 1999 and 2012 for the border (−5.10) and nonborder counties (−5.01), followed by a rise in border counties and stalling in nonborder counties. Although the AAPC in AAMR decreased for both sexes, the AAPC in AAMR differed significantly for non-Hispanic White adults in border (−2.69) and nonborder counties (−2.86). The mortality decreased consistently for all other ethnicities/races in both border and nonborder counties. CONCLUSIONS: Stroke-related mortality varied between the border and nonborder counties. Given the substantial public health implications, targeted interventions aimed at vulnerable populations are required to improve stroke-related outcomes in the US-Mexico border area.
AB - BACKGROUND: The United States (US)-Mexico border is a socioeconomically underserved area. We sought to investigate whether stroke-related mortality varies between the US border and nonborder counties. METHODS AND RESULTS: We used death certificates from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database to examine stroke-related mortality in border versus nonborder counties in California, Texas, New Mexico, and Arizona. We measured average annual percent changes (AAPCs) in age-adjusted mortality rates (AAMRs) per 100 000 between 1999 and 2018. Overall, AAMRs were higher for nonborder counties, older adults, men, and non-Hispanic Black adults than their counterparts. Between 1999 and 2018, AAMRs reduced from 55.8 per 100 000 to 34.4 per 100 000 in the border counties (AAPC, −2.70) and 64.5 per 100 000 to 37.6 per 100 000 in nonborder counties (AAPC, −2.92). The annual percent change in AAMR initially decreased, followed by stagnation in both border and nonborder counties since 2012. The AAPC in AAMR decreased in all 4 states; however, AAMR increased in California’s border counties since 2012 (annual percent change, 3.9). The annual percent change in AAMR decreased for older adults between 1999 and 2012 for the border (−5.10) and nonborder counties (−5.01), followed by a rise in border counties and stalling in nonborder counties. Although the AAPC in AAMR decreased for both sexes, the AAPC in AAMR differed significantly for non-Hispanic White adults in border (−2.69) and nonborder counties (−2.86). The mortality decreased consistently for all other ethnicities/races in both border and nonborder counties. CONCLUSIONS: Stroke-related mortality varied between the border and nonborder counties. Given the substantial public health implications, targeted interventions aimed at vulnerable populations are required to improve stroke-related outcomes in the US-Mexico border area.
KW - Epidemiology
KW - Mortality
KW - Stroke
KW - US-Mexico border
UR - http://www.scopus.com/inward/record.url?scp=85110406934&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85110406934&partnerID=8YFLogxK
U2 - 10.1161/JAHA.120.019993
DO - 10.1161/JAHA.120.019993
M3 - Article
C2 - 34212760
AN - SCOPUS:85110406934
VL - 10
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 13
M1 - e019993
ER -