Year of Publication



Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Sarah B. Wackerbarth, PhD; Dr. Kathi L. H. Harp, PhD

Committee Member

David Mannino, MD


Cardiovascular disease is the cause for a large portion of the mortalities in the United States. Furthermore, Kentucky has one of the highest heart disease mortality rates out of all 50 U.S. States. This study hypothesized that heart disease mortality in Kentucky counties has a positive relationship with lack of accessibility to healthcare. Furthermore, this ecological study hypothesized that because there is no available usual source of a healthcare providers and ultimately a lack of accessibility to receive diagnostic/preventative services for this population, the high rate of cardiovascular disease mortality in Kentucky is dependent on access to healthcare services.

This study examined various other factors that may also have an impact on heart disease mortality such as lifestyle factors and sociodemographic factors. Obesity, smoking, and hypertension are known to contribute to heart disease mortality and were held constant in this analysis. Sociodemographic factors such as household income, age, gender, and race were also held constant as independent variables in a regression analysis.

Data collected from the U.S. Census Bureau as well as the CDC were used to conduct a multivariate regression analysis. This analysis was performed to determine significance and examine the relationship of healthcare access to heart disease mortality. Although significance was not found between the two main variables of interest, this study affirmed what previous research has found which is that smoking, obesity, and old age are positively correlated with cardiovascular disease. Future researchers may look to determine significance by examining the insurance status of those who have heart disease and following up with them regarding their insurance status and usual source to ultimately see what preventative services were performed.

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