Racial disparities in CHD mortality from 1968-1992 in the state economic areas surrounding the ARIC study communities

PURPOSE: This study examined racial variations in CHD (coronary heart disea se) mortality rates (1968-1992) of residents aged 35-84 in the state econom ic areas (SEAs) surrounding the ARIC (Atherosclerosis Risk in Communities) study. The quarter century of CND mortality rates are discussed in relation to racial and gender differences in baseline risk factors measured in the ARIC cohort and to the incidence of hospitalized myocardial infarction and case fatality rates obtained from the community surveillance component of t he ARIC study between 1981 and 1994, inclusive. METHODS: Five-year average annual, gender- and age-specific CHD mortality r ates were compared across race groups, based on National Vital Statistics d ata for state economic areas. RESULTS: Five-year average annual CHD mortality declined 2.6% for white men and women and 1.6% and 2.2% for black men and women, respectively. The bla ck-white mortality rate ratio increased over time for men and women. The bl ack-white mortality age crossover (higher black than white mortality in you ng men, lower black than white: mortality at older ages) had disappeared by the end of the observation. CHD mortality was markedly greater in black th an white women at all ages and time periods. The black disadvantage in CHD mortality was increasingly greater in the ARIC SEAs than in the United Stat ;es as a whole. CONCLUSIONS: Persistent and increasing racial disparities in CHD mortality occurred in the ARIC SEAs concurrently with racial differences in risk fact ors, the incidence of myocardial infarction, and case fatality rates. Ann E pidemiol 1999;9:472-480. (C) 1999 Elsevier Science Inc. All rights reserved .