The following is a summary of “Impact of Social Vulnerability on Diabetes‐Related Cardiovascular Mortality in the United States,” published in the October 2023 issue of Cardiology by Bashar et al.
Social vulnerability significantly influences the trajectory of diabetes and cardiovascular disease (CVD), yet little data exists concerning the association between social vulnerability and mortality related to diabetes-induced CVD.
Data extracted from the Centers for Disease Control multiple causes of death (2015–2019) and the 2018 Social Vulnerability Index databases provided county-level mortality data, categorizing them into quartiles based on Social Vulnerability Index ranking, ranging from least (first quartile) to most vulnerable (fourth quartile). Stratified analysis was conducted across demographic groups for overall CVD, including ischemic heart disease, hypertensive disease, heart failure, and cerebrovascular disease. In the 5-year study period, 387,139 diabetes-related cardiovascular mortality records were identified. Age-adjusted mortality rates for CVD were notably higher in the fourth quartile compared to the first quartile (relative risk [RR], 1.66 [95% CI, 1.64–1.67]), amounting to an estimated excess of 39,328 deaths. Among the youngest age group (<55 years), those in the highest social vulnerability quartile experienced 2 to 4 times higher rates of cardiovascular mortality than those in the first quartile: ischemic heart disease (RR, 2.07 [95% CI, 1.97–2.17]); heart failure (RR, 3.03 [95% CI, 2.62–3.52]); hypertensive disease (RR, 3.79 [95% CI, 3.45–4.17]); and cerebrovascular disease (RR, 4.39 [95% CI, 3.75–5.13]).
Counties displaying higher social vulnerability demonstrated elevated diabetes-related CVD mortality, particularly among younger adults. This underscores the necessity for targeted health policies aiming to mitigate these disparities.