{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:41:46Z","timestamp":1777898506917,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2016,5,1]],"date-time":"2016-05-01T00:00:00Z","timestamp":1462060800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective.<\/jats:title>\n                    <jats:p>Many cardiovascular deaths can be avoided through primary prevention to address cardiovascular disease (CVD) risk factors or better access to quality medical care. In this cross-sectional study, we examined the relationship between four county-level health factors and rates of avoidable death from CVD during 2006\u20132010.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>We defined avoidable deaths from CVD as deaths among U.S. residents younger than 75 years of age caused by the following underlying conditions, using International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes: ischemic heart disease (I20\u2013I25), chronic rheumatic heart disease (I05\u2013I09), hypertensive disease (I10\u2013I15), or cerebrovascular disease (I60\u2013I69). We stratified county-level death rates by race (non-Hispanic white or non-Hispanic black) and age-standardized them to the 2000 U.S. standard population. We used County Health Rankings data to rank county-level z scores corresponding to four health factors: health behavior, clinical care, social and economic factors, and physical environment. We used Poisson rate ratios (RRs) and 95% confidence intervals (CIs) to compare rates of avoidable death from CVD by health-factor quartile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>In a comparison of worst-ranked and best-ranked counties, social and economic factors had the strongest association with rates of avoidable death per 100,000 population from CVD for the total population (RR=1.49; 95% CI 1.39, 1.60) and for each racial\/ethnic group (non-Hispanic white: RR=1.37; 95% CI 1.29, 1.45; non-Hispanic black: RR=1.54; 95% CI 1.42, 1.67). Among the non-Hispanic white population, health behaviors had the next strongest association, followed by clinical care. Among the non-Hispanic black population, we observed a significant association with clinical care and physical environment in a comparison of worst-ranked and best-ranked counties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion.<\/jats:title>\n                    <jats:p>Social and economic factors have the strongest association with rates of avoidable death from CVD by county, which reinforces the importance of social and economic interventions to address geographic disparities in avoidable deaths from CVD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/003335491613100310","type":"journal-article","created":{"date-parts":[[2016,6,29]],"date-time":"2016-06-29T15:47:01Z","timestamp":1467215221000},"page":"438-448","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["County Health Factors Associated with Avoidable Deaths from Cardiovascular Disease in the United States, 2006\u20132010"],"prefix":"10.1177","volume":"131","author":[{"given":"Sophia","family":"Greer","sequence":"first","affiliation":[{"name":"Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda J.","family":"Schieb","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Ritchey","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"George","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Casper","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention, Atlanta, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,5,1]]},"reference":[{"key":"bibr1-003335491613100310","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.03.023"},{"key":"bibr2-003335491613100310","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2008.081141"},{"key":"bibr3-003335491613100310","doi-asserted-by":"publisher","DOI":"10.1007\/s10198-012-0398-3"},{"key":"bibr4-003335491613100310","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2006.047092"},{"key":"bibr5-003335491613100310","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2011.0851"},{"key":"bibr6-003335491613100310","first-page":"E75","volume":"9","author":"Cheng ER","year":"2012","journal-title":"Prev Chronic Dis"},{"key":"bibr7-003335491613100310","doi-asserted-by":"publisher","DOI":"10.1007\/s11113-013-9309-2"},{"key":"bibr8-003335491613100310","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2011.0892"},{"key":"bibr9-003335491613100310","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2011.0196"},{"key":"bibr10-003335491613100310","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2003.008672"},{"key":"bibr11-003335491613100310","doi-asserted-by":"publisher","DOI":"10.1057\/jphp.2011.42"},{"key":"bibr12-003335491613100310","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000441139.02102.80"},{"key":"bibr13-003335491613100310","first-page":"1","volume":"62","author":"Heron M.","year":"2013","journal-title":"Natl Vital Stat Rep"},{"key":"bibr14-003335491613100310","unstructured":"Robert Wood Johnson Foundation. County health rankings & roadmaps [cited 2016 Feb 23]. Available from: http:\/\/www.countyhealthrankings.org."},{"key":"bibr15-003335491613100310","volume-title":"Health indicators 2013","author":"Canadian Institute for Health Information (CA)","year":"2014"},{"key":"bibr16-003335491613100310","volume-title":"Avoidable mortality in England and Wales, 2013","author":"Office for National Statistics (UK)","year":"2015"},{"key":"bibr17-003335491613100310","unstructured":"Avoidable mortality in the European Union: Towards better indicators for the effectiveness of health systems (AMIEHS). Rotterdam (NL): AMIEHS; 2011. Also available from: http:\/\/amiehs.lshtm.ac.uk\/publications\/reports\/amiehs%20final%20report%20vol%20i.pdf [cited 2016 Feb 23]."},{"key":"bibr18-003335491613100310","unstructured":"National Center for Health Statistics (US). National Vital Statistics System [cited 2016 Feb 19]. Available from: http:\/\/www.cdc.gov\/nchs\/nvss.htm."},{"key":"bibr19-003335491613100310","unstructured":"National Center for Health Statistics (US). U.S. census populations with bridged race categories. Updated 2015 Jun 30 [cited 2015 Oct 26]. Available from: http:\/\/www.cdc.gov\/nchs\/nvss\/bridged_race.htm."},{"key":"bibr20-003335491613100310","unstructured":"Census Bureau (UYS). 2010 population estimates [cited 2016 Feb 19]. Available from: https:\/\/www.census.gov\/popest\/data\/datasets.html."},{"key":"bibr21-003335491613100310","unstructured":"Centers for Medicare & Medicaid Services (US). International classification of diseases, tenth revision, clinical modification. 2015 [cited 2016 Feb 23]. 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