Heart disease mortality in California is on the rise and strongly tied to social drivers of health in the state's marginalized communities, according to research presented at ACC Quality Summit 2025 and simultaneously published in JACC: Case Reports.

The multi-method secondary analysis, designed within a Socioecological Model framework, used data from the CDC WONDER database, the California Department of Public Health and peer-reviewed studies to analyze mortality trends at the county level between 2018 and 2022.

Results showed that heart disease mortality has increased from 141 deaths per 100,000 people in 2018 to 148 deaths per 100,000 people in 2020-2021. Low income, advanced age and male gender strongly impacted regional mortality, with hypertension, obesity and diabetes as comorbidities associated with higher mortality risk. There were significant disparities in mortality rates based on the average income of each county.

"The purpose was not only to measure disparities but also to highlight gaps where current strategies fall short," said Ryan Nazari, lead author of the study. "I expected to see variation between counties, but I was surprised at how strongly socioeconomic differences correlated with higher heart disease burden. The data showed that inequities are both persistent and widespread, which emphasizes the need for solutions that reach beyond standard medical care."

To combat these disparities, Nazari recommends implementing community-based interventions that prioritize education on nutrition, exercise and preventive care; enhancing accessibility to screenings and treatment in underserved areas; and introducing policy measures that address social drivers of health, such as income inequality and food insecurity. The project identified program models of promise, including mobile clinics to provide screening and coaching to farms and fairgrounds, worksite wellness programs incorporating on-site blood pressure checks, and strong tobacco control paired with education.

Learn more about ACC Quality Summit 2025, taking place Oct. 14-16 in Denver, CO. Plus, follow the ACC on social media and use the hashtag #ACCQuality25 to join the conversations.

Keywords: Medically Underserved Area, Public Health, Health Promotion, Heart Diseases, Policy, California, Quality Summit