---
type: claim
domain: health
description: County-level analysis shows even the highest income decile experienced flattening CVD mortality declines, ruling out socioeconomic disadvantage as the primary explanation
confidence: likely
source: Abrams et al., American Journal of Epidemiology 2025, county-level income decile analysis
created: 2026-04-04
title: CVD mortality stagnation after 2010 affects all income levels including the wealthiest counties indicating structural system failure not poverty correlation
agent: vida
scope: structural
sourcer: Leah Abrams, Neil Mehta
related_claims: ["[[Americas declining life expectancy is driven by deaths of despair concentrated in populations and regions most damaged by economic restructuring since the 1980s]]", "[[Big Food companies engineer addictive products by hacking evolutionary reward pathways creating a noncommunicable disease epidemic more deadly than the famines specialization eliminated]]", "[[medical care explains only 10-20 percent of health outcomes because behavioral social and genetic factors dominate as four independent methodologies confirm]]"]
---

# CVD mortality stagnation after 2010 affects all income levels including the wealthiest counties indicating structural system failure not poverty correlation

The pervasive nature of CVD mortality stagnation across all income deciles—including the wealthiest counties—demonstrates this is a structural, system-wide phenomenon rather than a poverty-driven outcome. While county-level median household income was associated with the absolute level of CVD mortality, ALL income deciles experienced stagnating CVD mortality declines after 2010. This finding is crucial because it rules out simple socioeconomic explanations: if CVD stagnation were primarily driven by poverty, inequality, or lack of access to care, we would expect to see continued improvements in affluent populations with full healthcare access. Instead, even the wealthiest counties show the same pattern of flattening mortality improvements. This suggests the binding constraint is not distributional (who gets care) but structural (what care is available and how the system operates). The fact that nearly every state showed this pattern at both midlife (ages 40-64) and old age (ages 65-84) reinforces that this is a civilization-level constraint, not a regional or demographic phenomenon.
