Sociodemographic Determinants of Acute Myocardial Infarction Hospitalization Risks in Florida

Autor: Nicholas N. Nagle, Evah W Odoi, Kristina W. Kintziger, Melissa Jordan, Russell Zaretzki, Chris DuClos
Rok vydání: 2020
Předmět:
Adult
Male
Rural Population
medicine.medical_specialty
Time Factors
Adolescent
Social Determinants of Health
Epidemiology
geographically weighted regression
Myocardial Infarction
myocardial infarction hospitalization risks
socioeconomic determinants of health
030204 cardiovascular system & hematology
Risk Assessment
03 medical and health sciences
Young Adult
0302 clinical medicine
Sociodemographic determinants
Divorce
Risk Factors
Medicine
Humans
030212 general & internal medicine
Myocardial infarction
Social determinants of health
Child
Aged
Retrospective Studies
Original Research
Medically Uninsured
business.industry
Infant
Newborn
Infant
Middle Aged
medicine.disease
Geographically Weighted Regression
Health equity
Race Factors
Black or African American
Hospitalization
Socioeconomic Factors
Child
Preschool
Emergency medicine
Florida
Educational Status
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
ISSN: 2047-9980
Popis: 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 RR , 0.995; P =0.018). However, they were significantly lower in counties with high proportions of rural ( RR , 0.996; P 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 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.
Databáze: OpenAIRE
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