Urban–Rural Disparities in Pulmonary Hypertension Mortality
Consuelo Macías, J. Frank Wharam, Bradley A. Maron, Mei‐Sing Ong
Abstract
Urban–rural disparities in life expectancy in the United States have been widely documented, and this gap appears to be widening (1, 2). Published studies have shown that rural Americans are more likely to die of a range of cardiopulmonary diseases because of poor access to specialty care (2, 3). To date, there remains a paucity of similar data in the populations of patients with pulmonary hypertension (PH)—an often overlooked cause of morbidity and mortality in many cardiopulmonary disorders. Here, we examined urban–rural disparities in all-cause mortality in a nationally representative cohort of patients with PH in the United States. We performed a retrospective cohort study of nonelderly adults with PH (18–64 yr old) drawn from a commercial health insurance/Medicare Advantage database (years 2000–2011), including enrollees across all 50 states of the United States. The database comprises administrative claims and all-cause mortality data derived from the U.S. Centers for Disease Control and Prevention National Death Index database. The study was approved by the Harvard Pilgrim Health Care Institutional Review Board (1209843).