To estimate the trend in mortality from ischaemic heart disease and diabetes mellitus specifically in urban and non-urban areas in Italy and Spain from 2003 to 2019.
Key Findings:
Mortality rates from ischaemic heart disease and diabetes decreased from 2003 to 2019 in both countries, with urban areas showing a more significant reduction.
In Italy, the APC for ischaemic heart disease was -4.0% in urban and -3.6% in non-urban areas; for diabetes, it was -1.5% and -1.3%, respectively, highlighting the disparity.
In Spain, the APC for ischaemic heart disease was -4.4% in urban and -3.7% in non-urban areas; for diabetes, it was -3.3% and -2.0%, respectively, indicating a similar trend.
Urban areas showed a greater reduction in mortality compared to non-urban areas, emphasizing the need for targeted interventions.
Interpretation:
The study indicates a significant disparity in mortality reduction between urban and non-urban areas, suggesting that urban residents experience greater improvements in health outcomes related to ischaemic heart disease and diabetes, which has implications for public health policy.
Limitations:
Data only covers the years 2003 to 2019, excluding the impact of the COVID-19 pandemic.
Mortality trends may not reflect changes in healthcare access or quality between urban and non-urban areas, and potential biases in data collection could affect results.
Conclusion:
The findings highlight the need for targeted public health interventions in non-urban areas, such as increased access to healthcare services and education on risk factors, to address the growing inequalities in mortality from ischaemic heart disease and diabetes.
In a target-trial emulation of more than 600,000 veterans, GLP-1 RA initiators saw fewer new substance use disorders—and patients with existing SUDs had fewer overdoses, hospitalizations, and deaths.
