Abstract Body: Introduction:
Examining geographic and sociodemographic differences in Poor Cardiovascular Health (PCVH) across U.S. neighborhoods can help identify where the most significant disparities in cardiovascular disease exist. We sought to map and examine the distribution of PCVH across U.S. census tracts by levels of social vulnerability and rurality from 2017 to 2021.
Hypothesis
We hypothesize that PCVH will be more prevalent in regions with greater social vulnerability and in rural areas.
Methods:
We examined area-level PCVH score based on the Life’s Essential 8 (LE8) framework across 60,632 U.S. census tracts (~85% of Continental U.S. census tracts). Prevalence data for seven LE8 components (high blood pressure, poor sleep, physical inactivity, diabetes, smoking, obesity, and high cholesterol), as well as the Social Vulnerability Index (SVI) were from the Centers for Disease Control and Prevention. Rural-Urban Commuting Area (RUCA) codes and limited access to healthy food, used as a proxy for poor diet, were obtained from the U.S. Department of Agriculture. Percentile estimates from the eight components were averaged to generate a composite PCVH score for each tract (range 0-100), then classified as quartiles based on percentile ranking (Q4=poorest PCVH). We then mapped PCVH quartiles across census tracts (Figure 1). Differences in PCVH score were analyzed across SVI quartiles, urbanicity status (metro vs. rural), U.S. census regions, and racial/ethnic groups.
Results:
The median PCVH score was 62.5, with an interquartile range of 46.8 to 78.1. The mean PCVH score was higher in rural (61.2, SD = 16.6) compared to metropolitan (47.2, SD = 22.7) tracts. Tracts with the lowest SVI (less vulnerable) had a mean PCVH of 30.9 (SD = 15.2), while those in the highest quartile had 69.4 (SD = 17.4) (data not shown). Additionally, tracts in the South [60.7 (SD = 22.1)] and Midwest [52.9 (SD = 21.4)] states had a higher PCVH score compared to West and Northeast [35.3 (SD = 18.1] and 44.5 (SD = 19.5), respectively]. Tracts with larger Black or African American populations were overrepresented in the upper PCVH quartiles [30.1% (SD = 31.79) in PCVH Q4 vs 4.6% (SD = 7.1) in Q1].
Conclusion:
These findings highlight geographic and sociodemographic disparities in PCVH across U.S. census tracts, with a higher burden found in the South and Midwest, as well as in rural and more socially vulnerable census tracts.