ArticleThe American journal of the medical sciences2025
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.
Article in The American journal of the medical sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Mental Distress and Smoking in Relation to Cardiovascular Mortality in the United States Population.Brain and behavior · 2026Article
- Evaluation, Management and Therapeutic Approach of Cardiovascular-Kidney-Metabolic Syndrome: A Multidisciplinary Delphi Expert Consensus.Journal of clinical medicine · 2025Article
- Echoes of Inequity: A Critical Examination of the Past, Present, and Future of Cardiac Health Equity.Current cardiology reports · 2025Review
- County-level modeled extreme heat risk and premature all-cause mortality related to cardio-kidney-metabolic syndrome in the United States: A cross-sectional analysis.American journal of preventive cardiology · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundThe 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.
methodsWe 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.
resultsIn 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).
conclusionsIn 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.
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