Cardiovascular Disease Mortality by County, Race, and/or Ethnicity, United States, 2000-2019 (JACC November 2026-1)-Article: Cardiovascular Disease Mortality by County, Race, and/or Ethnicity, United States, 2000-2019

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Researchers estimated cardiovascular disease (CVD) mortality across 3,110 U.S. counties from 2000 to 2019, examining 21 causes of death and five racial and ethnic groups. Using death-certificate data and small-area statistical models, they adjusted for race and ethnicity misclassification and reported age-standardized mortality rates.<br /><br />In 2019, the national CVD mortality rate was 237.8 deaths per 100,000 people. Rates were highest among Black people (304.8) and lowest among Asian people (140.3). Black populations had the highest mortality for 12 of 17 detailed CVD causes; Asian populations had the lowest for 13. Mortality varied substantially among counties—even within the same state—and geographic patterns differed by population and cause. High rates were especially concentrated in parts of the South and Appalachia, though some causes had distinct regional patterns.<br /><br />Overall CVD mortality fell 34% from 2000 to 2019, but improvement slowed after 2011. Rates declined for 12 of 17 detailed causes, while hypertensive heart disease, atrial fibrillation and flutter, and other cardiovascular and circulatory diseases increased. Ischemic stroke also rose slightly in the later period despite a longer-term decline.<br /><br />The study establishes a detailed pre-COVID baseline for evaluating subsequent trends. Its county-level findings can help health agencies and health systems target prevention and care, including blood-pressure control, to communities with the greatest burden and track whether disparities narrow. Estimates are subject to data and modeling uncertainty, particularly for smaller populations; Asian and Native Hawaiian or Pacific Islander populations could not be analyzed separately.

Meta Tag

Concept Cardiovascular Disease Mortality

Concept Age-Standardized Mortality Rate

Concept Race/Ethnicity

Concept Geographic Disparity

Concept Health Disparity

Keywords

cardiovascular disease

mortality rates

county-level analysis

racial disparities

ethnic disparities

age-standardized mortality

small-area statistical models

death certificate data

geographic variation

blood pressure control

Cardiovascular Disease Mortality

Age-Standardized Mortality Rate

Race/Ethnicity

Geographic Disparity

Health Disparity