• Abdul Mannan Khan Minhas, Ofer Kobo, Mamas A Mamas, Sadeer G Al-Kindi, Layla A Abushamat, Vijay Nambi, Erin D Michos, Christie Ballantyne, and Dmitry Abramov.
• Department of Medicine, University of Mississippi Medical Center, Jackson.
• Am. J. Med. 2024 Feb 1; 137 (2): 122127.e1122-127.e1.

PurposeThe association of social vulnerability and cardiovascular disease-related mortality in older adults has not been well characterized.MethodsThe Centers for Disease Control and Prevention database was evaluated to examine the relationship between county-level Social Vulnerability Index (SVI) and age-adjusted cardiovascular disease-related mortality rates (AAMRs) in adults aged 65 and above in the United States between 2016 and 2020.ResultsA total of 3139 counties in the United States were analyzed. Cardiovascular disease-related AAMRs increased in a stepwise manner from first (least vulnerable) to fourth SVI quartiles; (AAMR of 2423, 95% CI [confidence interval] 2417-2428; 2433, 95% CI 2429-2437; 2516, 95% CI 2513-2520; 2660, 95% CI 2657-2664). Similar trends among AAMRs were noted based on sex, all race and ethnicity categories, and among urban and rural regions. Higher AAMR ratios between the highest and lowest SVI quartiles, implying greater relative associations of SVI on mortality rates, were seen among Hispanic individuals (1.52, 95% CI 1.49-1.55), Non-Hispanic-Asian and Pacific Islander individuals (1.32, 95% CI 1.29-1.52), Non-Hispanic- American Indian or Alaskan Native individuals (1.43, 95% CI 1.37-1.50), and rural counties (1.21, 95% CI 1.20-1.21).ConclusionSocial vulnerability as measures by the SVI was associated with cardiovascular disease-related mortality in older adults, with the association being particularly prominent in ethnic minority patients and rural counties.Copyright © 2023 Elsevier Inc. All rights reserved.

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