Evaluating the effectiveness of New York City health policy initiatives in reducing cardiovascular disease mortality, 1990-2011

Paulina Ong, Gina S. Lovasi, Ann Madsen, Gretchen Van Wye, Ryan T. Demmer

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Beginning in 2002, New York City (NYC) implemented numerous policies and programs targeting cardiovascular disease (CVD) risk factors. Using death certificates, we analyzed trends in NYC-specific and US mortality rates from 1990 to 2011 for all causes, any CVD, atherosclerotic CVD (ACVD), coronary artery disease (CAD), and stroke. Joinpoint analyses quantified annual percent change (APC) and evaluated whether decreases in CVD mortality accelerated after 2002 in either NYC or the total US population. Our analyses included 1,149,217 NYC decedents. The rates of decline in mortality from all causes, any CVD, and stroke in NYC did not change after 2002. Among men, the decline in ACVD mortality accelerated during 2002-2011 (APC = -4.8%, 95% confidence interval (CI): -6.1, -3.4) relative to 1990-2001 (APC = -2.3%, 95% CI: -3.1, -1.5). Among women, ACVD rates began declining more rapidly in 1993 (APC = -3.2%, 95% CI: -3.8, -2.7) and again in 2006 (APC = -6.6%, 95% CI: -8.9, -4.3) as compared with 1990-1992 (APC = 1.6%, 95% CI: -2.7, 6.0). In the US population, no acceleration of mortality decline was observed in either ACVD or CAD mortality rates after 2002. Relative to 1990-2001, atherosclerotic CVD and CAD rates began to decline more rapidly during the 2002-2011 period in both men and women-a pattern not observed in the total US population, suggesting that NYC initiatives might have had a measurable influence on delaying or reducing ACVD mortality.

Original languageEnglish (US)
Pages (from-to)555-563
Number of pages9
JournalAmerican journal of epidemiology
Issue number5
StatePublished - Sep 1 2017

Bibliographical note

Funding Information:
This research was funded by grant P13-000369 from the New York Community Trust (to G.S.L. and R.T.D) and by National Institutes of Health grants DE018739 (to R.T.D.) and HD067390 (to G.S.L.). Conflict of interest: none declared.


  • Cardiovascular disease
  • Chronic disease
  • Health policy
  • Health promotion
  • Mortality
  • Vital statistics

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