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APHA Scientific Session and Event Listing

Nalini Ranjit, PhD and George A. Kaplan, PhD. Center for Social Epidemiology and Population Health, University of Michigan at Ann Arbor, 1214 S. University, Ann Arbor, MI 48104, 734-615-9216, nranjit@umich.edu

Perhaps the most notable public health achievement of the 20th century was the rapid decline in infectious disease mortality. We utilized the fact that the speed of this decline was uneven by race and state to evaluate the emerging theory that infection in early childhood has consequences for later cardiovascular disease (CVD) mortality. Using historical death registration data from the US Census Bureau, we constructed the lifetime mortality experience by state, race and cause of death for the birth cohorts of 1921 and 1931 respectively. We hypothesized that cohort differences in CVD mortality after age 45 could arise from the shared infectious disease environment that members of a particular birth cohort experienced during childhood (ages 0-9). Cohort mortality from infectious disease in the first 5 years of life was strongly associated with later CVD mortality in that cohort. Across cohorts, and net of age effects, a 1% increase in the mortality rate from infectious disease was associated with approximately 40 excess deaths per 100000 population. The corresponding estimate for exposure to non-infectious disease was much smaller, at just 7 /100000. This nearly 6-fold difference between the effects of infectious and non-infectious disease mortality on later cohort CVD mortality does not appear when we examine childhood mortality at ages 5-9, suggesting that the role of infectious disease in later CVD mortality may be limited to exposure in early rather than late childhood. Additional analyses will extend the range of cohorts and add the role of secular changes in smoking and diet.

Learning Objectives:

• To evaluate the epidemiological theory that childhood infection is related to later cardiovascular mortality, using cohort-aggregated Vital Statistics data from the United States.

Keywords: Chronic (CVD), Infectious Diseases

Presenting author's disclosure statement:

Not Answered