Death rates from heart disease decreased by 68 percent for Americans from 1968 to 2015, according to a new analysis, but the mortality decline was greater for whites than blacks.
As a result, the black-white ratio of heart disease death rates increased from 1.04 in 1968 to 1.21 in 2015, lead author Miriam Van Dyke, MPH, and colleagues reported in a Morbidity and Mortality Weekly Report for the CDC.
“Black-white differences in the magnitude and patterns of decrease in heart disease death rates observed in this report 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 in the United States,” wrote the authors, who were split between the CDC’s Division for Heart Disease and Stroke Prevention and Emory University’s Department of Epidemiology. “Specifically, differential or delayed access to or adoption of heart disease prevention and treatment across time among blacks compared with whites could be contributing to the observed increases in black-white disparities.”
The researchers noted about half of the reduction of coronary heart disease deaths in the U.S. from 1980 to 2000 was attributed to better medical treatment, including coronary revascularization and the development of lipid-lowering and antihypertensive medications. The other half was reported to be an improvement in cardiovascular risk factors, but blacks have been found to have higher burdens of obesity, diabetes, hypertension and physical inactivity than whites.
Socioeconomic factors such as income and access to quality healthcare are suspected to play a role in the disparity, along with race-related factors such as discrimination and residential segregation, the authors noted.
The heart disease death rate gap between blacks and whites widened the most in the 1970s and 1980s, the researchers said, and increased more slowly throughout the 1990s and early 2000s. But the margin has shrunk since 2005 as both races are beginning to plateau in their death-rate decline—whites more so than blacks.
Still, the remaining disparity must continue to be monitored, Van Dyke and colleagues noted.
“In addition to using evidence-based strategies, standard treatment protocols, and culturally relevant tools to promote heart-healthy living, ensuring that heart disease prevention and treatment efforts are designed to benefit all groups equally is important,” they wrote. “Ongoing attention to eliminating racial disparities in social determinants of health also are important to address racial disparities in heart disease prevention and treatment.”
Daniel joined TriMed’s Chicago editorial team in 2017 as a Cardiovascular Business writer. He previously worked as a writer for daily newspapers in North Dakota and Indiana.