Despite strong decreases in coronary heart disease (CHD) mortality over past decades, there is evidence that racial and socioeconomic disparities in CHD mortality are increasing. CHD surveillance efforts that examine trends within these population subgroups are an important first step in quantifying and reducing disparities. Yet, only one U.S. population-based CHD surveillance study includes black populations and none has monitored trends by socioeconomic status (SES). The Atherosclerosis Risk in Communities (ARIC) Study has monitored rates and trends in validated hospitalized myocardial infarction and fatal CHD among black and white adults aged 35 to 74 years in four U.S. communities since 1989. The proposed study will expand the scope of ARIC surveillance by examining variations in the rates and temporal trends in CHD by SES, measured at the level of census tract. For CHD events already included in ARIC surveillance (1992- 2002), addresses will be obtained from medical records and death certificates and geocoded so that they can be matched with identifiers for census based geographical areas. The ARIC study will contribute yearly updates of abstracted CHD events and addresses for subsequent years (2003-2005). Each event will be linked with census tract level SES indicators available from the 1990 and 2000 censuses. This novel effort will permit an examination of disparities by SES in rates and trends in fatal CHD, hospitalized myocardial infarction, case fatality, use of invasive cardiac procedures and prescription of efficacious medication at time of hospital discharge. In addition, the extent to which racial disparities in CHD and associated treatments are explained by SES will also be explored. This study would be the first U.S. population-based CHD surveillance study to include an assessment of variations in the burden of CHD by SES and thus, would provide valuable contributions to the scientific literature. Furthermore, the findings could be used to plan targeted public health interventions aimed at reducing CHD disparities. ? ?

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
3R01HL080287-01S1
Application #
7118818
Study Section
Epidemiology of Chronic Diseases Study Section (ECD)
Program Officer
Myerson, Merle
Project Start
2005-04-01
Project End
2009-03-31
Budget Start
2005-04-01
Budget End
2006-03-31
Support Year
1
Fiscal Year
2005
Total Cost
$25,550
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
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Foraker, Randi E; Patel, Mehul D; Whitsel, Eric A et al. (2013) Neighborhood socioeconomic disparities and 1-year case fatality after incident myocardial infarction: the Atherosclerosis Risk in Communities (ARIC) Community Surveillance (1992-2002). Am Heart J 165:102-7
Rose, Kathryn M; Foraker, Randi E; Heiss, Gerardo et al. (2012) Neighborhood socioeconomic and racial disparities in angiography and coronary revascularization: the ARIC surveillance study. Ann Epidemiol 22:623-9
Foraker, Randi E; Rose, Kathryn M; Kucharska-Newton, Anna M et al. (2011) Variation in rates of fatal coronary heart disease by neighborhood socioeconomic status: the atherosclerosis risk in communities surveillance (1992-2002). Ann Epidemiol 21:580-8
Foraker, Randi E; Rose, Kathryn M; Whitsel, Eric A et al. (2010) Neighborhood socioeconomic status, Medicaid coverage and medical management of myocardial infarction: atherosclerosis risk in communities (ARIC) community surveillance. BMC Public Health 10:632
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Rose, Kathryn M; Suchindran, Chirayath M; Foraker, Randi E et al. (2009) Neighborhood disparities in incident hospitalized myocardial infarction in four U.S. communities: the ARIC surveillance study. Ann Epidemiol 19:867-74
Foraker, Randi E; Rose, Kathryn M; McGinn, Aileen P et al. (2008) Neighborhood income, health insurance, and prehospital delay for myocardial infarction: the atherosclerosis risk in communities study. Arch Intern Med 168:1874-9
Chichlowska, Kristal L; Rose, Kathryn M; Diez-Roux, Ana V et al. (2008) Individual and neighborhood socioeconomic status characteristics and prevalence of metabolic syndrome: the Atherosclerosis Risk in Communities (ARIC) Study. Psychosom Med 70:986-92