Geographic Location and Heart Disease

Coronary heart disease, the leading cause of death across the globe and in the United States, is brought on by a combination of hereditary, geographic and environmental factors. The American Heart Association estimates that 1.26 million Americans face a new or recurrent episode of the condition annually. A 2010 study from a governmental agency indicates that the region--and even the county--in which one lives plays a significant role in the likely development of the disease.

Identification

• In March of 2010, the Centers for Disease Control and Prevention (CDC) released the first ever study detailing the hospitalization rates of adults over the age of 65 with heart disease. The geographic research detailed statistics on a county-by-county basis and discovered that African-Americans, particularly those living in Texas, Oklahoma, the Mississippi Delta and Appalachia, have higher rates of heart disease than the general population.

Significance

• In Mississippi Delta states such as Louisiana, 95.2 hospitalizations for heart disease occurred for every 1,000 Medicare recipients, compared to only 44.8 hospitalizations per 1,000 government health beneficiaries in Hawaii. "These data bring into sharp focus the differences in heart disease hospitalization rates that exist across this country," said Michele Casper, Ph.D., epidemiologist in CDC's Division for Heart Disease and Stroke Prevention. It is expected that county health officials in severely affected areas will develop initiatives to address heart disease epidemics in their area.

Geography

• The study, called the "Atlas of Heart Disease Hospitalizations among Medicare Beneficiaries," surveyed the Medicare records of more than 28 million people annually between 2000 and 2006, seeking information on citizens in all 50 states, Washington D.C., Puerto Rico and the U.S. Virgin Islands. Overall, some 2.1 million hospitalizations related to heart disease occurred each year. Coronary heart disease runs rampant as the leading cause of death in the United States, projected to cost $316.4 billion in medications, health care services and lost productivity in 2010.

Hospitals

• The geographic disparity in heart disease treatment is especially highlighted when researching hospitals equipped to deal with the disease. "In 2005, 21 percent of all counties in the United States had no hospital, and 31 percent lacked a hospital with an emergency room," reports the study. "Specialized cardiac services are even more limited, with 63 percent of U.S. counties lacking a cardiologist outside the Veterans Affairs system." African-Americans are especially at risk, with the study reporting 85.3 heart disease hospitalizations among every 1,000 black Medicare recipients, compared to 74.4 per 1,000 for whites and 73.6 per 1,000 for Hispanics.

Women

• A 2009 article in Medscape Medical News detailed a University of Pittsburgh study that showed significant differences in the mortality rate among women with heart disease, based on geographic location. The study (looking at American women between 45 and 54 years of age) discovered a rate of 125 deaths per 100,000 black women in Arkansas compared to 17 deaths per 100,000 white women in Colorado. The death rate was highest for white women in Louisiana, Mississippi and Oklahoma, and lowest in Minnesota, Washington state and Colorado.