Health Disparities
Intersectional demographic trends in infective endocarditis among 18-64 year olds in 2012-2021 Tamara Rushovich* Tamara Rushovich Alina Schnake-Mahl Ana V. Diez-Roux Neal Goldstein
Background: The estimated number of people who use injection drugs in the US has more than quadrupled since 2010. Infective endocarditis (IE), a serious infection of the heart which can be caused by bacteria introduced during injection drug use, is a growing concern. Existing descriptive epidemiology of IE shows disparities by singular demographic groups, however disparities may differ by intersectional demographic groups, and over time.
Methods: Using data from AHRQ’s State Inpatient Database and the American Community Survey, we calculated rates of IE hospitalization for 18-64 year olds, from 2012-2021, in 13 US states, by age, sex, racialized group, and ZIP code area poverty.
Results: IE rates per 100k people increased from 8.0 in 2012 to 11.9 in 2018 and decreased to 8.7 in 2021. From 2012-2021, the rates among 35-64 year olds were higher than those among 18-34 year olds. IE rates were highest among American Indian or Alaskan Native people (AMIAN)(15.6) followed by non-Hispanic (NH) White (11.9), NH Black (9.6), Hispanic (5.1) and Asian and Pacific Islander (2.0). Rates were higher among men than women (11.4 and 8.5) and highest in ZIP codes with the highest poverty levels (13.0).
Among those 18-34 years, women had higher rates than men (10.1 vs 7.7), but among those 35-46 years men had higher rates than women (13.7 vs 7.6). Among those 35-46 years, in the lowest poverty zip codes, Black rates were similar to White rates, but among the same age group in higher poverty zip codes, White rates were higher than Black rates. Among those 18-34 years, AMIAN and White rates were highest among all racialized groups in all poverty level ZCTAs.
Conclusion: Investigating disparities using multiple demographic categories revealed distinct vulnerable groups: AMIAN individuals, younger women, Black individuals in low poverty ZIP codes and White individuals in high poverty ZIP codes. Findings can help tailor interventions and guide resource allocation.
