Language
English
Publication Date
4-1-2025
Journal
The American Journal of Medical Sciences
DOI
10.1016/j.amjms.2025.01.007
PMID
39848403
PMCID
PMC12046418
PubMedCentral® Posted Date
5-2-2025
PubMedCentral® Full Text Version
Author MSS
Abstract
Background: The American Heart Association recently defined cardio-kidney-metabolic (CKM) syndrome as the intersection between metabolic, renal, and cardiovascular disease. Understanding the contemporary estimates of CKM related mortality in the US is essential for developing targeted public interventions.
Methods: We analyzed state-level and county-level CKM-associated all-cause mortality data (2010-2019) from the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER). Median and interquartile (IQR) age-adjusted mortality rates (aaMR) per 100,000 were reported and linked with a multi-component metric for social deprivation: the Social Deprivation Index (SDI: range 0 - 100) grouped as: I: 0 - 25, II: 26 - 50, III: 51 - 75, and IV: 75 - 100. We fit pairwise comparisons between SDI groups and evaluated aaMR stratified by sex, race, and location.
Results: In 3101 counties, pooled aaMR was 505 (441-579). Oklahoma (643) and Massachusetts (364) had the highest and lowest values. aaMR increased across SDI groups [I: 454(404, 505), IV: 572(IQR: 495.9, 654.7); p < 0.001]. Men had higher rates [602 (526, 687)] than women [427 (368, 491)]. Metropolitan [476 (419, 542)] had lower rates than non-metropolitan counties [521 (454, 596)]. Non-Hispanic Black [637 (545, 731)] had higher rates than non-Hispanic White residents [497 (437, 570]. CKM associated aaMR remained reasonably constant between 2010 and 2019 (Mann Kendall test for trend p-value = 0.99).
Conclusions: In the US, CKM mortality disproportionately affects more socially deprived counties. Inability to reduce CKM mortality rates over the study period highlights the need for targeted policy interventions to curb the ongoing high burden.
Keywords
Humans, Male, Female, Social Determinants of Health, United States, Cross-Sectional Studies, Middle Aged, Cardio-Renal Syndrome, Aged, Cardiovascular Diseases, Adult, Cause of Death, Cardiovascular disease, Kidney disease, Renal failure, Diabetes, Obesity, Cardiometabolic health
Published Open-Access
yes
Recommended Citation
Cotton, Antoinette; Salerno, Pedro Rvo; Deo, Salil V; et al., "The Association Between County-Level Social Determinants of Health and Cardio-Kidney-Metabolic Disease Attributed All-Cause Mortality in the US: A Cross Sectional Analysis" (2025). Faculty and Staff Publications. 4294.
https://digitalcommons.library.tmc.edu/baylor_docs/4294