Racial/ethnic disparities in mortality related to congenital heart defects among children and adults in the United States.
BACKGROUND: Congenital heart defects (CHD) are the most common birth defect and are a major cause of childhood illness and death. Recent progress in management of persons with CHD may have decreased CHD-related mortality. METHODS: Year 2000 US death records were used to determine CHD-related mortality by age, sex, and race/ethnicity in children and adults. CHD-related mortality was defined as all deaths with any mention of CHD on the death certificate. Age-, sex-, and racial/ethnic-specific population counts were obtained from the 2000 US Census and used as denominators in mortality rates. RESULTS: In 2000 there were 5441 (.23%) CHD-related deaths and CHDs were mentioned 6121 times as the underlying or contributing cause of death. In 68.4% of CHD-related deaths, CHD was the underlying cause of death. Non-Hispanic Black males had greater risk of CHD-related death than did non-Hispanic White males (RR 1.25, 95% CI 1.08-1.45). Both Hispanic males and females had lower rates of CHD-related deaths than did non-Hispanic Whites (RR .72, 95% CI .60-.85; RR .52, 95% CI .42-.65, respectively). "Unspecified congenital malformation of the heart" was the most common cause of death overall; however, "malformation of the coronary vessels" was most often a cause of death for non-Hispanic Blacks and children aged 10-19 years. CONCLUSIONS: Racial/ethnic differences in CHD-related mortality exist in the United States. Management of CHD, access to adequate care, and misclassification in cause of death reporting on death records may explain the observed differences.
Nembhard, WN; Pathak, EB; Schocken, DD
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