Geospatial and Demographic Characteristics of Sudden Cardiac Death in Fulton County, GA, 2006-2008 Open Access

Abstract

Abstract

Geospatial and Demographic Characteristics of
Sudden Cardiac Death in Fulton County, GA, 2006-2008
Objective: Sudden cardiac death is a leading cause of death and often the first sign of coronary
heart disease. It is critical to identify characteristics of this disease in order to design effective
interventions. The aim of this study was to examine whether socioeconomic status is associated
with an increased risk of sudden cardiac death.
Methods: Death certificate data was used to identify all out-of-hospital cardiac deaths that
occurred in Fulton County, GA between 2006-2008. Geospatial characteristics were evaluated in
ArcGIS. A Poisson regression analysis was conducted to examine the relationship between
poverty and the risk of cardiac death, while controlling for age, race and gender.
Results: Poverty increases the risk of sudden cardiac death, however as median age increases, the
effect of poverty decreases. The average median age by census tract was 34.2 years and at this
age, poverty increased the risk of death by 13% (RR 1.13; CI 1.05, 1.21). When the median age
increases by 1 standard deviation to 40.3 years, poverty increases the risk of death by 8% (RR
1.08; CI .99, 1.19).
Conclusion: The results highlight the importance of identifying areas with a high density of
cardiac arrest and using this information to better understand the population characteristics of the
disease as well as target interventions.

Table of Contents

TABLE OF CONTENTS

Introduction ...................................................................................................................................... 1
Hypothesis………………………………………………………………………………………….2
Literature Review............................................................................................................................. 3
Methods ........................................................................................................................................... 7
Results ............................................................................................................................................ 11
Discussion ...................................................................................................................................... 15
References ...................................................................................................................................... 34
Tables and Figures ......................................................................................................................... 17
Table 1. Event place type of out-of-hospital cardiac deaths from Fulton County death certificate
records, 2006-2008………………………………………………………………………...…...17
Table 2. Age categories of out-of-hospital cardiac deaths from Fulton County death certificate
records, 2006-2008…………………………………...……………………………………...…18
Table 3. Age categories of out-of-hospital cardiac deaths from Fulton County death certificate
records, 2006-2008. .................................................................................................................... 19
Table 4. Gender distribution of out-of-hospital cardiac deaths from Fulton County death
certificate records, 2006-2008…………………………..………..…………………………….20
Table 5. Race distribution of out-of-hospital cardiac deaths from Fulton County death
certificate records, 2006-2008………………………………………………………………….21
Table 6. Distribution of race by age category of out-of-hospital cardiac deaths from Fulton
County death certificate records, 2006-2008…………………………………………………..22
Table 7. Distribution of race and gender by age category of out-of-hospital cardiac deaths from
Fulton County death certificate records, 2006-2008…………………………………………...23
Figure 1. Kernel density of deaths of cardiac etiology occurring at home in Fulton County, GA
between 2006-2008 from death certificate records. …………………………………………...24
Figure 2. Population Density in Fulton County, GA between 2006-2008 (2005-2009 American
Community Survey data)………………………………………………………….………..….25
Figure 3. Raster Algebra Results of Kernel Density of Deaths of Cardiac Etiology in Fulton
County, GA between 2006-2008 Controlling for Population Density of Census
Tracts…………………………………………………………………………………………...26

About this Master's Thesis

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School	Rollins School of Public Health
Department	Career Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	sudden cardiac death cardiac arrest death certificate geospatial analysis of cardiac death
Committee Chair / Thesis Advisor	Kramer, Michael M, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs Georgia state or local health department CDC

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