US Heart Disease Rates Declining Everywhere—Less So in the South by Dr Andrew Rudin MD

Even though Heart Disease is still the leading cause of death in the United States, the disease has actually been on the decline for decades. Unfortunately, it has been declining in certain areas of the country faster than others, according to new statistics published this week in Circulation.

A research team led by Michele Casper, an epidemiologist at the CDC’s Division for Heart Disease and Stroke Prevention, analyzed data collected from 1973-2010 to compare county-level patterns and geographic disparities in heart disease rates over time. It’s the first time a study of this size and scope has attempted to map heart disease on a county level.

Looking at heart disease data for individuals under the age of 35 in more than 3,000 US counties, researchers found that while heart disease mortality has declined overall, the geographical distribution of the most affected areas has shifted. Furthermore, some areas have seen much steeper declines in illness than others.

Some counties’ cardiac death rates were found to have dropped by more than 80% since the 1970s, while others had declined by less than 10%. Counties demonstrating the slowest decline in cardiac death rights had an apparent trend: they were mostly in the south (i.e. Mississippi, Alabama, Louisiana, Oklahoma, Arkansas, and Texas.) Areas with more substantial rates of improvement were mostly seen in the northern half of the US.

Even more discouraging was the fact that researchers found the disparity between the best and worst areas was growing. In fact, the gap between areas of the least heart disease and those with the most has nearly doubled.

In the 1970s, the highest rates of heart disease-related deaths were found spanning from northeastern counties into the Midwest, with the coastal areas of North Carolina, South Carolina, and Georgia also being affected.

In the map below, you can see the prevalence of heart disease by county in 1973.

Changing Geographic Patterns of Heart Disease Mortality in the US by American Heart Association
4 decades later, the map in 2009 looks very different.

Changing Geographic Patterns of Heart Disease Mortality in the US by American Heart Association 2While the scope of this particular research did not look into the reasons behind this shift, we can can assume factors like local health policies, socioeconomic factors, ease of access to healthy food, health care, promotion of smoke-free environments, and opportunities for physical activity could all play a part.

While this disparity between areas can feel disheartening, the overall message of this study is a positive one: we are lowering rates of heart disease. In fact, from 2003 to 2013 death rates attributable to cardiovascular disease (CVD) declined by a whopping 28.8%. Additionally, death rates attributable to coronary heart disease (CHD)the principal cause of CVD deathsdeclined by 38%.

Studies like these are crucial pieces of evidence doctors, healthcare professionals, and politicians alike can/should use to to enact changes in areas where the population is most vulnerable to this disease.

As the leading cause of mortality in the US, heart disease accounts for roughly 1 in 4 deaths with more than 600,000 people in America dying each year because of it.

Understanding who is at most risk can help us to better prevent, treat, and care for patients across the country.