Early- to Mid-Adulthood Cardiometabolic Deaths among Black and White Men

Introduction

The disproportionate burden of cardiometabolic disease (CMD) among Black men in the United States begins in adolescence and early adulthood, with complications and mortality commonly thought to emerge in middle age. This study aims to bridge the gap in understanding CMD mortality during the transition from early adulthood to middle age.

Methods

Using National Vital Statistics System data and standard period life table methods, we estimated the risk of CMD death in cohorts of non-Hispanic Black and White men from age 25 to 45 years.

Results

Of the 325,134 Black men aged 25 years in the initial cohort, the cumulative risk of cardiometabolic death before age 45 was 1 in 61 individuals (95% CI, 59–62). For White men, the risks were markedly lower. Of the 1,185,384 White men aged 25 years in the initial cohort, the cumulative risk of cardiometabolic death before age 45 was 1 in 149 individuals (95% CI, 146–152). The study also found that of the 5,358 expected CMD deaths in the Black cohort, 59.31% (95% CI, 58.00–60.63) were excess deaths relative to the White cohort. Further, the attributable fraction of all deaths due to CMD among Black men was 19.96% (95% CI, 19.48–20.44), rising from 6.57% at age 25 to 38.96% at age 44, compared to 11.80% (95% CI, 11.56–12.04) among White men, which increased from 5.14% at age 25 to 20.79% at age 44.

Conclusion

This investigation shows the profound racial disparities in CMD mortality from early to mid-adulthood.