DOI: 10.1161/circ.148.suppl_1.15337 ISSN: 0009-7322

Abstract 15337: Study of Relationship Between Neighborhood Racial Segregation and Heart Failure Mortality

Anna L Richards, Aya M Badran, Brandon T Towns, Rabia R Razi, Qiaoling Chen, Claudia Nau, Mingsum Lee
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Background Upstream factors, including socioeconomic status, healthcare access, structural environment, contribute to the presence of disparities in cardiovascular outcomes. The impact of neighborhood-level racial segregation on cardiovascular outcomes is not well understood.

Research Question The goal of this study was to evaluate the association between neighborhood racial segregation and heart failure mortality.

Methods/ Approach This is a retrospective, cohort study performed at Kaiser Permanente Southern California that included patients hospitalized for heart failure between January 2010 and December 2017. Data regarding demographics, comorbidities, and outcomes, was linked to the diversity index from the US Census Bureau. This is a measure of racial segregation, the likelihood that any two people from an area will be from different race/ ethnicity groups. The cohort was divided into tertiles by diversity index. Mortality rates for each racial group was calculated. Multivariate logistic regression models were constructed to evaluate the association between race/ethnicity and mortality.

Results/ Data There were 19,322 patients included in our analysis. After adjusting for demographics, socioeconomic markers, neighborhood characteristics, and comorbidities, higher mortality was noted for Black patients compared to White patients in the least diverse tertile (adjusted OR [95% CI]: 1.42 [1.15-1.74]). In the most diverse tertile, no significant difference between Black and White patients was observed (adjusted OR [95% CI] 1.02 [0.83-1.26]). Asian and White patients did not show a difference in mortality across tertiles. Hispanic patients had a statistically significant decreased mortality in the two more diverse tertiles.

Conclusion: Heart failure mortality is lower in Black patients in more diverse neighborhoods. Further work is needed to look at the pathway that connects racial segregation to heart failure outcomes.

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