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Background <p>Cardiovascular diseases (CVDs) are the leading cause of mortality in Georgia, U.S., accounting for over 21,000 deaths annually. Due to the acute nature of cardiac complications and patients' urgent need for immediate medical attention, optimal access to emergency healthcare is essential. Despite this urgency, spatial accessibility to emergency cardiac care (ECC) centers and its relationship with CVD mortality remains underexplored.</p> Methods <p>We implemented an enhanced two-step floating catchment area method to explore spatial disparities in access to ECC centers in Georgia. Moreover, we proposed two complementary equity metrics, Health Disparity Index (HDI) and Localized Health Outcome Index (LHOI), to quantify disparities. We further examined the potential association between spatial access to ECC centers and CVD mortality rates using Social Vulnerability Index-adjusted ordinary least squares regression models. </p> Results <p>ECC centers were clustered primarily in the Atlanta Metropolitan area, while more remote and rural areas in the central and southernmost regions have the lowest access to emergency medical resources. The estimated HDI value of 0.61, along with high LHOI values observed in 64 counties, indicates substantial inequity in CVD mortality and highlights that many high-mortality counties lack adequate emergency cardiac resources. Poorer access to ECC centers was significantly associated with higher CVD mortality rates (P &lt; 0.05). </p> Conclusions <p>Our integrated framework reveals pronounced spatial disparities in access to ECC across Georgia and underscores the need for targeted, place-based interventions.</p>

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Examining the association between spatial accessibility to emergency cardiac care centers and cardiovascular mortality in Georgia, United States

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月18日

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  • Nima Kianfar,
  • X. Angela Yao,
  • Behzad Kiani,
  • Abe Mollalo

摘要

Background

Cardiovascular diseases (CVDs) are the leading cause of mortality in Georgia, U.S., accounting for over 21,000 deaths annually. Due to the acute nature of cardiac complications and patients' urgent need for immediate medical attention, optimal access to emergency healthcare is essential. Despite this urgency, spatial accessibility to emergency cardiac care (ECC) centers and its relationship with CVD mortality remains underexplored.

Methods

We implemented an enhanced two-step floating catchment area method to explore spatial disparities in access to ECC centers in Georgia. Moreover, we proposed two complementary equity metrics, Health Disparity Index (HDI) and Localized Health Outcome Index (LHOI), to quantify disparities. We further examined the potential association between spatial access to ECC centers and CVD mortality rates using Social Vulnerability Index-adjusted ordinary least squares regression models.

Results

ECC centers were clustered primarily in the Atlanta Metropolitan area, while more remote and rural areas in the central and southernmost regions have the lowest access to emergency medical resources. The estimated HDI value of 0.61, along with high LHOI values observed in 64 counties, indicates substantial inequity in CVD mortality and highlights that many high-mortality counties lack adequate emergency cardiac resources. Poorer access to ECC centers was significantly associated with higher CVD mortality rates (P < 0.05).

Conclusions

Our integrated framework reveals pronounced spatial disparities in access to ECC across Georgia and underscores the need for targeted, place-based interventions.