Although cardiovascular disease death rates decreased substantially for both blacks and whites from 1968 – 2015, black-white disparities are still persistent and concerning, according to a U.S. Centers for Disease Control and Prevention (CDC) report published March 30 in the Morbidity and Mortality Weekly Report.

Miriam Van Dyke, MPH, et al., examined the National Vital Statistics System data files on cardiovascular disease deaths in the U.S. from 1968 – 2015. National and state-specific cardiovascular disease death rates were calculated for the total population and by race for adults 35-years-old and above, along with the national and state-specific black-white cardiovascular disease mortality ratios.

Results showed that cardiovascular disease death rates decreased for the total U.S. population among adults 35-years-old and above, from 1,034.5 to 327.2 per 100,000 population, respectively, with variations in the magnitude of decreases by race and state. Death rates also decreased for the total population an average of 2.4 percent per year, with greater average decreases among whites (2.4 percent per year) than blacks (2.2 percent per year).

The study authors also found that cardiovascular disease death rates for blacks and whites at the national level were similar at the start of the study period but began to deviate in the late 1970s, as rates for blacks remained mostly stable and rates for whites continued to decrease. Cardiovascular disease death rates among blacks remained higher than whites for the remainder of the study period.

Furthermore, the black-white ratio of cardiovascular disease death rates increased nationwide from 1.04 in 1968 to 1.21 in 2015, with large increases occurring during the 1970s and 1980s followed by small but steady increases until 2005. Since 2005, only modest decreases have occurred in the black-white ratio of cardiovascular disease death rates at the national level. The number of states with black-white mortality ratios greater than 1 increased from 16 (40 percent) to 27 (67.5 percent) throughout the study.

"Future research and initiatives should focus on improving national and state-level black-white disparities related to heart disease," the study authors write. "The elimination of racial disparities in heart disease death rates, along with continued decreases in heart disease death rates for all persons in the U.S., is important for the overall state of health."

Kim A. Williams, MD, MACC, a past-president of the ACC and co-chair of ACC's Task Force on Diversity and Inclusion, comments that "these data are striking in that the cardiovascular mortality differences reported in recent years did not exist 50 years ago." He adds, "consistent with what we know about the effects of education, poverty and unemployment on health care access and outcomes, we can infer that the curves separated over decades of remarkable progress in the management of heart disease, and that the progress has not reached all aspects of our society."

Keywords: Poverty, African Americans, Vital Statistics, Morbidity, Cardiovascular Diseases, Heart Diseases, Centers for Disease Control and Prevention, U.S., Information Storage and Retrieval

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