Geographic disparities of cardiovascular and cancer mortality in the USA: 1981–2019.

This article analyzes county-level trends in cardiovascular and cancer mortality improvements across the United States from 1981–83 to 2017–19, using age-adjusted mortality data from the CDC WONDER database. It finds that while both causes of death have declined nationally, cardiovascular mortality decreased more substantially (mean county improvement ~51.55%) than cancer mortality (~13.37%), with cancer showing 68% greater geographic disparities in improvement. Improvements were concentrated primarily in populous coastal counties, whereas many rural and interior counties, especially in the Southeast, experienced less or no improvement; notably, 566 counties had no reduction in cancer mortality compared to only seven for cardiovascular mortality. The study highlights significant place-based disparities in mortality trends, suggesting that geographic location strongly influences health outcomes and that diffusion of knowledge and interventions to lower-performing areas could help reduce these disparities.