Year of Publication



Public Health

Date Available


Degree Name

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

Committee Chair

Florence Fulk

Committee Member

Erin Haynes

Committee Member

Anna Hoover


Background: Cardiovascular disease (CVD) is a leading cause of death in the United States, and some regions, such as the Appalachian region, have relatively higher burdens of CVD deaths. CVD has been shown to be influenced by various social factors, with some leading to an increased risk of disease.

Objective: The objectives of this study were to determine the potential correlation between social vulnerability and cardiovascular disease outcomes in Kentucky and how this varies in the Appalachian versus non-Appalachian regions of the state.

Methods: Heart disease death rates and county social vulnerability index (SVI) values in Kentucky were evaluated to determine correlations. The 54 counties of Kentucky considered to be part of the Appalachian region were then compared with the 66 non-Appalachian counties to determine if there was a significant difference in heart disease deaths and social vulnerability index values. Linear regressions were used to explore whether overall SVI and each constituent SVI theme was correlated with heart disease deaths.

Results: The Appalachian region had higher rates of heart disease mortality and higher average SVI values than the non-Appalachian region. Analyses of individual themes revealed that while there were significant differences between the two regions in a few categories, only housing and transportation are significantly related to heart disease mortality.

Conclusion: Disparities in social factors may negatively affect cardiovascular disease health. These disparities, particularly ones regarding housing and transportation, are more likely to be seen in the Appalachian region, which helps explain the high rates of cardiovascular disease in the area. These issues are related to healthcare access, which is an ongoing problem for rural areas.

Available for download on Friday, April 24, 2026

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