Analysis of Acute Myocardial Infarction Mortality Trends in the African American Population in the United States (1999 - 2020)

Abstract

Background: Acute myocardial infarction (AMI) remains a leading cause of mortality in the African American population, warranting an examination of regional and demographic trends to inform health policies.

Methods: Utilizing the Centers for Disease Control and Prevention’s WONDER death certificate database, we conducted a comprehensive analysis of AMI mortality from 1999 to 2020 in African Americans and overall adults aged 25 and older. Age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated and stratified by year, sex, race, and geographic region. Joinpoint regression facilitated the assessment of mortality trends, revealing average annual percentage changes (AAPCs) with 95% confidence intervals (CIs).

Results: Over the study period (1999 - 2020), there were 3,015,339 total deaths due to AMI in adults aged 25 and older. African Americans had the highest AAMR, at 71.5, followed by Whites, at 63.5, and the lowest among Asians, at 32.6. Overall, AAMR decreased in the African American population from 128.5 in 1999 to 48.5 in 2020, with an AAPC of -5.29 (95% CI: -5.69 to -4.9). AAMR decreased from 109 in 1999 to 37.6 in 2020 in African American females. African American males experienced a decline from 157.8 to 63.4 in AAMR. African American males had a higher overall AAMR (88.6) than females (59.3). Regionally, AAMR was highest in the South (77.6) and lowest in the Northeast (57.6) among African Americans.

Conclusions: While AMI mortality has declined, persistent differences persist in the African American community. African American males experience a higher mortality rate as compared to females. Regional variations, notably the higher AAMR in the Southern region, emphasize the need for targeted health policies to mitigate disparities and enhance healthcare access. These measures may include expanding insurance coverage and improving access to healthcare, education, food, and employment for African Americans.