Over the past quarter-century, deaths from obesity-related heart disease have more than doubled in the United States, with American Indian and Black communities bearing a disproportionate burden that reveals deep structural inequities in American healthcare.
Between 1999 and 2023, more than 267,000 Americans died from the combined effects of obesity and atherosclerotic cardiovascular disease. American Indian populations experienced the highest mortality rates at 5.47 deaths per 100,000, followed closely by Black Americans at 5.47 per 100,000. These rates far exceeded those of White Americans at 4.14 and Asian Americans at just 0.88 per 100,000.
The pandemic years proved particularly devastating. From 2018 to 2021, mortality rates surged by nearly 15%, with Hispanic communities seeing an alarming 21% increase during this period. American Indian mortality rates jumped by more than 20% between 2019 and 2023.
Researchers point to multiple factors driving these disparities, including genetic predisposition to early-onset hypertension and diabetes, limited access to nutritious food in minority neighborhoods, and underfunded healthcare systems like the Indian Health Service. Many American Indian and Black communities live in “food swamps” dominated by fast-food outlets rather than fresh produce, while facing reduced air quality and lower rates of specialist care.
The findings underscore how social and economic factors compound biological risk, creating a health crisis that demands targeted policy interventions and equitable preventive strategies for vulnerable populations.
See: “Trends and disparities in obesity and atherosclerotic cardiovascular disease mortality in a 25-year retrospective analysis” (25 November 2025)
