Abstract Details

Title Regional Disparities in Chronic Respiratory Diseases and Stroke Mortality Across the United States from 1999 to 2020

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S8 - Disparities and Outcomes in Cerebrovascular Disease (4:06 PM-4:18 PM)

Poster/Presentation
Number 004

Background Individuals with CRD face a heightened risk of cardiovascular events like stroke, which exacerbates morbidity and mortality. However, comprehensive mortality data on the co-occurrence of CRD and stroke, as well as disparities across demographic and geographic groups, are lacking.

Objective

This study aims to assess temporal and regional trends in chronic respiratory diseases (CRD) and stroke-related mortality among adults aged ≥55 in the US.

Design/Methods Utilizing data from the CDC WONDER database, CRD and stroke-related deaths from 1999 to 2020 were identified. Age-adjusted mortality rates (AAMRs) per 100,000 individuals were determined. Joinpoint regression was used to analyze trends and annual percentage change (APC).

Results From 1999 to 2020, 271,986 CRD and stroke-related deaths were identified. Most occurred in inpatient medical facilities (35.7%), followed by nursing homes/long-term care facilities (31.2%), homes (20.6%), and hospice/outpatient/ER facilities (4.3% each). AAMRs declined from 1999 to 2009 (APC -4.6), plateaued until 2019, then increased significantly until 2020 (APC 9.2). Males had higher AAMRs (21.3) than females (14.7), although the decline was more pronounced in males. While most inpatient deaths were male, a greater proportion of female deaths occurred in nursing homes or long-term care facilities (54.2% vs 45.8%). Large metropolitan areas had the highest incidence of deaths (41.5%), but greater AAMRs were observed in rural areas (23.6 vs. 14.2). AAMRs also varied regionally: Midwest (18.8), South (18.7), West (17.8), and Northeast (12.8). States in the upper 90th percentile of CRD and stroke-related deaths included West Virginia, Oklahoma, Mississippi, Kentucky, Tennessee, and Vermont, which had triple the AAMRs of states in the lower 10th percentile.

Conclusions Following a period of decline, CRD and stroke-related mortality in the US has plateaued since 2009. Persistent disparities exist, particularly among males and individuals in the Midwest and rural areas, highlighting the need for targeted interventions and policy amendments for vulnerable groups and regions.

Authors/Disclosures
Muhammad Inam Ul Haq, MD, MBBS PRESENTER	Dr. Inam Ul Haq has nothing to disclose.
Adeena Jamil, MBBS	Dr. Jamil has nothing to disclose.
Obaid Ur Rehman	Mr. Rehman has nothing to disclose.
Muteia Shakoor, MBBS	Miss Shakoor has nothing to disclose.
Aamna Kamdi, MBBS	Miss Kamdi has nothing to disclose.
Eeshal Fatima	Mr. Fatima has nothing to disclose.
Hiba Sohail, MBBS	Miss Sohail has nothing to disclose.
Zain A. Nadeem (Allama Iqbal Medical College)	Mr. Nadeem has nothing to disclose.
FNU Pirih, MBBS	Dr. Pirih has nothing to disclose.
Zunera Khalid, MBBS	Ms. Khalid has nothing to disclose.
Syed H. Inam, MD (Marshall Neurology)	Dr. Inam has nothing to disclose.

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