Coronary Heart Disease and Stroke Deaths — United States, 2009
Volume 62, Supplement, No. 3
November 22, 2013
PDF of this issue
Coronary Heart Disease and Stroke Deaths — United States, 2009
SupplementsNovember 22, 2013 / 62(03);157-160
Corresponding author: Cathleen D. Gillespie, MS, Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, CDC. Telephone: 770-488-5855; E-mail: firstname.lastname@example.org.
IntroductionHeart disease and stroke are the first and fourth leading causes of death, respectively in the United States (1,2). In 2008, heart disease and stroke were responsible for nearly a third of all deaths in the United States (30.4%), killing more than three-quarters of a million people that year (1). Coronary heart disease (CHD) is the cause of more than two-thirds of all heart disease-related deaths (1,2). One of the Healthy People 2020 objectives includes reducing the rate of CHD deaths by 20% from the baseline rate of 126 deaths per 100,000 population per year, to a goal of 100.8 deaths per 100,000 (objective HDS-2) (3). The objectives also include reducing the rate of stroke deaths by 20% over the baseline of 42.2 deaths per 100,000, to a goal of 33.8 deaths per 100,000 population. Although the rates of death from both CHD and stroke have declined continuously in recent decades and the Healthy People 2010 goals for these two objectives were met among the overall U.S. population in 2004, the death rates remain high, particularly among men and blacks (4–6).
This heart disease and stroke analysis and discussion that follows is part of the second CDC Health Disparities and Inequalities Report (2013 CHDIR) (6). The 2011 CHDIR (7) was the first CDC report to assess disparities across a wide range of diseases, behavioral risk factors, environmental exposures, social determinants, and health-care access. The topic presented in this report is based on criteria described in the 2013 CHDIR Introduction (8). This report provides more current information on CHD and stroke deaths among different age and racial/ethnic groups. The purposes of the coronary heart disease and stroke mortality report are to discuss and raise awareness of differences in the characteristics of persons dying from coronary heart disease and stroke, and to prompt actions to reduce disparities.
MethodsTo examine the number and age-specific CHD and stroke mortality rates of persons of all ages, by sex, age group, and race/ethnicity, CDC analyzed final 2009 data from the National Vital Statistics System (NVSS). NVSS data are described in detail elsewhere (http://www.cdc.gov/nchs/nvss.htm). Race was defined as white, black, American Indian/Alaska Native (AI/AN), and Asian/Pacific Islander (A/PI). Ethnicity was defined as Hispanic or non-Hispanic. Sociodemographic information beyond age, sex, and race/ethnicity is not available in the NVSS.
CDC estimated the number of deaths and the rate of death per 100,000 population for which coronary heart disease or stroke were the underlying cause of death (ICD-10 codes I20–I25 for CHD, I60–I69 for stroke), and 95% confidence intervals were calculated based on a Poisson distribution, consistent with NCHS methodology (1). Rates per 100,000 population were age-adjusted to the 2000 U.S. standard population, except where stratified by age group (9). Disparities were measured as the deviations from a "referent" category rate and by characteristics that included sex, age, and race/ethnicity. Absolute difference was measured as the simple difference between a population subgroup estimate and the estimate for its respective reference group. The relative difference, a percentage, was calculated by dividing the difference by the value in the referent category and multiplying by 100. Significant differences between rates were determined by nonoverlapping 95% confidence intervals. All tests for differences in age-adjusted death rates were significant compared with the indicated referent group after Bonferroni adjustment for multiple comparisons.
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