Alcoholic cardiomyopathy mortality and social vulnerability index: A nationwide cross-sectional analysis

Mahek Shahid; Ramzi Ibrahim; Anna Arakelyan; Kamal Hassan; Enkhtsogt Sainbayar; Hoang Nhat Pham; Mamas A Mamas

doi:10.1016/j.ijcrp.2023.200224

Alcoholic cardiomyopathy mortality and social vulnerability index: A nationwide cross-sectional analysis

Int J Cardiol Cardiovasc Risk Prev. 2023 Nov 5:19:200224. doi: 10.1016/j.ijcrp.2023.200224. eCollection 2023 Dec.

Authors

Mahek Shahid¹, Ramzi Ibrahim¹, Anna Arakelyan², Kamal Hassan³, Enkhtsogt Sainbayar¹, Hoang Nhat Pham¹, Mamas A Mamas⁴

Affiliations

¹ Department of Medicine, University of Arizona Tucson, Tucson, AZ, USA.
² Department of Anesthesiology, University of Arizona Tucson, Tucson, AZ, USA.
³ New York Presbyterian/Weill Cornell Medical Center, New York, NY, USA.
⁴ Cardiovascular Research Group, Keele University, UK.

Abstract

Background: Social vulnerability index (SVI) plays a pivotal role in the outcomes of cardiovascular diseases and prevalence of alcohol use. We evaluated the impact of the SVI on alcoholic cardiomyopathy (ACM) mortality.

Methods: Mortality data from 1999 to 2020 and the SVI were obtained from CDC databases. Demographics such as age, sex, race/ethnicity, and geographic residence were obtained from death certificates. The SVI was divided into quartiles, with the fourth quartile (Q4) representing the highest vulnerability. Age-adjusted mortality rates across SVI quartiles were compared, and excess deaths due to higher SVI were calculated. Risk ratios were calculated using univariable Poisson regression.

Results: A total of 2779 deaths were seen in Q4 compared to 1672 deaths in Q1. Higher SVI accounted for 1107 excess-deaths in the US and 0.05 excess deaths per 100,000 person-years (RR: 1.38). Similar trends were seen for both male (RR: 1.43) and female (RR: 1.67) populations. Higher SVI accounted for 0.06 excess deaths per 100,000 person-years in Hispanic populations (RR: 2.50) and 0.06 excess deaths per 100,000 person-years in non-Hispanic populations (RR: 1.46).

Conclusion: Counties with elevated SVI experienced higher ACM mortality rates. Recognizing the impact of SVI on ACM mortality can guide targeted interventions and public health strategies, emphasizing health equity and minimizing disparities.

Keywords: Alcohol; Disparities; Epidemiology; Social vulnerability.