{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:50:21Z","timestamp":1792021821955,"version":"4.4.0"},"reference-count":37,"publisher":"Elsevier BV","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jacc.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["JACC: Advances"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.jacadv.2026.103085","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:04:11Z","timestamp":1785456251000},"page":"103085","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["County-Level Geographic Access and Cardiovascular Disease Outcomes in Washington State"],"prefix":"10.1016","volume":"5","author":[{"given":"Vladislav","family":"Baglaev","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hovan","family":"Dermendjian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serj","family":"Dermendjian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7146-7385","authenticated-orcid":false,"given":"Alexander","family":"Mammar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest","family":"Balezi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabella M.","family":"Hochschild","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay D.","family":"Pal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jacadv.2026.103085_bib1","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1001\/jama.2021.5469","article-title":"The Leading causes of death in the US for 2020","volume":"325","author":"Ahmad","year":"2021","journal-title":"JAMA"},{"key":"10.1016\/j.jacadv.2026.103085_bib2","series-title":"Washington State Vital Statistics","year":"2023"},{"key":"10.1016\/j.jacadv.2026.103085_bib3","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.36022","article-title":"Longitudinal trajectories and factors associated with US county-level cardiovascular mortality, 1980 to 2014","volume":"4","author":"Rao","year":"2021","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.jacadv.2026.103085_bib4","doi-asserted-by":"crossref","first-page":"e65","DOI":"10.1161\/CIR.0000000000001256","article-title":"Forecasting the burden of cardiovascular disease and stroke in the United States through 2050-Prevalence of risk factors and disease: a presidential advisory from the American heart Association","volume":"150","author":"Joynt Maddox","year":"2024","journal-title":"Circulation"},{"key":"10.1016\/j.jacadv.2026.103085_bib5","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1136\/thoraxjnl-2013-204949","article-title":"The exposome: a new paradigm to study the impact of environment on health","volume":"69","author":"Vrijheid","year":"2014","journal-title":"Thorax"},{"key":"10.1016\/j.jacadv.2026.103085_bib6","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.1161\/CIRCULATIONAHA.117.029652","article-title":"Socioeconomic status and cardiovascular outcomes: challenges and interventions","volume":"137","author":"Schultz","year":"2018","journal-title":"Circulation"},{"key":"10.1016\/j.jacadv.2026.103085_bib7","first-page":"260","article-title":"Socioeconomic status, cardiac risk factors, and cardiovascular disease: a novel approach to determination of this association","volume":"15","author":"Davari","year":"2019","journal-title":"ARYA Atheroscler"},{"key":"10.1016\/j.jacadv.2026.103085_bib8","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1038\/s41598-023-27474-x","article-title":"Family income and cardiovascular disease risk in American adults","volume":"13","author":"Minhas","year":"2023","journal-title":"Sci Rep"},{"key":"10.1016\/j.jacadv.2026.103085_bib9","doi-asserted-by":"crossref","DOI":"10.1111\/jrh.12874","article-title":"Rural-urban disparities in cardiovascular disease mortality vary by poverty level and region","volume":"41","author":"Sekkarie","year":"2025","journal-title":"J Rural Health"},{"key":"10.1016\/j.jacadv.2026.103085_bib10","first-page":"134","article-title":"Widening geographical disparities in cardiovascular disease mortality in the United States, 1969-2011","volume":"3","author":"Singh","year":"2015","journal-title":"Int J MCH AIDS"},{"key":"10.1016\/j.jacadv.2026.103085_bib11","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1001\/jama.2020.2047","article-title":"Rural-Urban differences in cardiovascular mortality in the US, 1999-2017","volume":"323","author":"Cross","year":"2020","journal-title":"JAMA"},{"key":"10.1016\/j.jacadv.2026.103085_bib12","doi-asserted-by":"crossref","DOI":"10.1016\/j.jocmr.2025.101921","article-title":"Temporal trends and geographic accessibility to cardiac magnetic resonance readers across the United States: an analysis of medicare Part B data","author":"El Yaman","year":"2025","journal-title":"J Cardiovasc Magn Reson"},{"key":"10.1016\/j.jacadv.2026.103085_bib13","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.jcct.2024.08.002","article-title":"Regional and socioeconomic disparities in calcium scans","volume":"19","author":"Sachs","year":"2025","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"10.1016\/j.jacadv.2026.103085_bib14","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1016\/j.healthplace.2010.08.004","article-title":"Geographic issues in cardiac rehabilitation utilization: a narrative review","volume":"16","author":"Leung","year":"2010","journal-title":"Health Place"},{"key":"10.1016\/j.jacadv.2026.103085_bib15","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCOUTCOMES.123.010133","article-title":"Mapping geographic proximity to cardiologists across the United States","volume":"16","author":"Motairek","year":"2023","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"10.1016\/j.jacadv.2026.103085_bib16","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1161\/CIRCULATIONAHA.124.071778","article-title":"Geographic disparities in availability of hospital-based cardiac services across the United States","volume":"151","author":"Benavidez","year":"2025","journal-title":"Circulation"},{"key":"10.1016\/j.jacadv.2026.103085_bib17","doi-asserted-by":"crossref","first-page":"2456","DOI":"10.1056\/NEJMp1802313","article-title":"Making neighborhood-disadvantage metrics accessible - the neighborhood atlas","volume":"378","author":"Kind","year":"2018","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacadv.2026.103085_bib18","series-title":"Critical Access Hospital (CAH) Program - Washington State Rural Health Plan","year":"2020"},{"key":"10.1016\/j.jacadv.2026.103085_bib19","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jacc.2024.09.1215","article-title":"Rural-Urban differences in cardiovascular mortality in the United States, 2010-2022","volume":"85","author":"Marinacci","year":"2025","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jacadv.2026.103085_bib20","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1097\/00005650-200001000-00006","article-title":"Impact of geographic proximity to cardiac revascularization services on service utilization","volume":"38","author":"Gregory","year":"2000","journal-title":"Med Care"},{"key":"10.1016\/j.jacadv.2026.103085_bib21","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/1476-072X-9-27","article-title":"Drive time to cardiac rehabilitation: at what point does it affect utilization?","volume":"9","author":"Brual","year":"2010","journal-title":"Int J Health Geogr"},{"key":"10.1016\/j.jacadv.2026.103085_bib22","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.ahj.2021.02.018","article-title":"Access to cardiac surgery centers for cardiac and non-cardiac hospitalizations in adolescents and adults with congenital heart defects\u2014a descriptive case series study","volume":"236","author":"Insaf","year":"2021","journal-title":"Am Heart J"},{"key":"10.1016\/j.jacadv.2026.103085_bib23","doi-asserted-by":"crossref","DOI":"10.1016\/j.jth.2024.101819","article-title":"Impact of distance and\/or travel time on healthcare service access in rural and remote areas: a scoping review","volume":"37","author":"Mseke","year":"2024","journal-title":"J Transp Health"},{"key":"10.1016\/j.jacadv.2026.103085_bib24","doi-asserted-by":"crossref","first-page":"3166","DOI":"10.3390\/ijerph20043166","article-title":"Driving time to the nearest percutaneous coronary intervention-capable hospital and the risk of case fatality in patients with acute myocardial infarction in Beijing","volume":"20","author":"Chang","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"10.1016\/j.jacadv.2026.103085_bib25","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.124.039031","article-title":"Impact of social determinants of health on cardiovascular disease","volume":"14","author":"Bazoukis","year":"2025","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.jacadv.2026.103085_bib26","doi-asserted-by":"crossref","DOI":"10.1016\/j.carrev.2025.04.001","article-title":"Impact of social determinants of health in patients undergoing percutaneous coronary intervention","author":"Kumar","year":"2025","journal-title":"Cardiovasc Revasc Med"},{"key":"10.1016\/j.jacadv.2026.103085_bib27","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1001\/jamainternmed.2018.7624","article-title":"Association of primary care physician supply with population mortality in the United States, 2005-2015","volume":"179","author":"Basu","year":"2019","journal-title":"JAMA Intern Med"},{"key":"10.1016\/j.jacadv.2026.103085_bib28","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1016\/j.mayocp.2022.01.018","article-title":"Socioeconomic deprivation and premature cardiovascular mortality in the United States","volume":"97","author":"Bevan","year":"2022","journal-title":"Mayo Clin Proc"},{"key":"10.1016\/j.jacadv.2026.103085_bib29","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.120.018835","article-title":"County-level factors associated with cardiovascular mortality by race\/ethnicity","volume":"10","author":"Zuma","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.jacadv.2026.103085_bib31","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1186\/s12889-023-16659-8","article-title":"Cardiovascular disease and all-cause mortality associated with individual and combined cardiometabolic risk factors","volume":"23","author":"Cao","year":"2023","journal-title":"BMC Public Health"},{"key":"10.1016\/j.jacadv.2026.103085_bib32","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/j.jacc.2024.06.045","article-title":"Influence of subclinical atherosclerosis burden and progression on mortality","volume":"84","author":"Fuster","year":"2024","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jacadv.2026.103085_bib33","doi-asserted-by":"crossref","first-page":"164","DOI":"10.4103\/hm.HM-D-23-00022","article-title":"Risk of mortality associated with preexisting chronic diseases and prior year diagnosis of a mental disorder in survivors of a first myocardial infarction or stroke: a cohort study","volume":"7","author":"Ngueta","year":"2023","journal-title":"Heart Mind"},{"key":"10.1016\/j.jacadv.2026.103085_bib34","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1038\/s41440-025-02151-w","article-title":"Long-term risk of cardiovascular mortality according to age group and blood pressure categories of the latest guideline","volume":"48","author":"Satoh","year":"2025","journal-title":"Hypertens Res"},{"key":"10.1016\/j.jacadv.2026.103085_bib35","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.25874","article-title":"Evaluation of STEMI regionalization on access, treatment, and outcomes among adults living in nonminority and minority communities","volume":"3","author":"Hsia","year":"2020","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.jacadv.2026.103085_bib36","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCOUTCOMES.120.007195","article-title":"Association of cardiac care regionalization with access, treatment, and mortality among patients with ST-Segment elevation myocardial infarction","volume":"14","author":"Shen","year":"2021","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"10.1016\/j.jacadv.2026.103085_bib30","doi-asserted-by":"crossref","first-page":"3806","DOI":"10.3390\/jcm11133806","article-title":"Volume-outcome relationship in surgical and cardiac transcatheter interventions with a focus on transcatheter aortic valve implantation","volume":"11","author":"Mauler-Wittwer","year":"2022","journal-title":"J Clin Med"},{"key":"10.1016\/j.jacadv.2026.103085_bib37","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1016\/j.cardfail.2023.09.003","article-title":"Outcomes of patients transferred to tertiary care centers for treatment of cardiogenic shock: a cardiogenic shock working group analysis","volume":"30","author":"Garan","year":"2024","journal-title":"J Card Fail"}],"container-title":["JACC: Advances"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2772963X26005065?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2772963X26005065?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:27:16Z","timestamp":1792020436000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2772963X26005065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":37,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["S2772963X26005065"],"URL":"https:\/\/doi.org\/10.1016\/j.jacadv.2026.103085","relation":{},"ISSN":["2772-963X"],"issn-type":[{"value":"2772-963X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"County-Level Geographic Access and Cardiovascular Disease Outcomes in Washington State","name":"articletitle","label":"Article Title"},{"value":"JACC: Advances","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jacadv.2026.103085","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.","name":"copyright","label":"Copyright"}],"article-number":"103085"}}