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POPULATION HEALTH: Trends in heart disease and cancer death rates by county shows geographic clusters in U.S.

Thirty years ago researchers first noted an ‘enigma of the Southeast’ with high mortality rates in that region, often due to stroke, and a range of possible causes including environmental exposures related to coal and metal mining, housing and population density, and access to health care.”

Death rates from different types of cardiovascular disease and 29 types of cancer were studied at the county level for the entire U.S. in these related articles out of the University of Washington’s Institute for Health Metrics and Evaluation.  Extensive variation was found in death rates between counties and some degree of clustering was found.  For example, there is a cluster of counties with high death rates from ischemic heart disease on a line between central Oklahoma and eastern Kentucky and also along the Mississippi River valley – although there were also counties with high mortality in other parts of the country.  Death rates from stroke and hypertension were found to be concentrated in the South.  Counties with higher rates of breast cancer death were found to be along the Mississippi River and in the South.  High death rates from lung and related cancers were found to be clustered in Kentucky and West Virginia.  Again, in each of these categories, there are also counties with high mortality rates in other parts of the country.

NOTE: There is also information in these articles about areas of the country where the mortality rates were found to be unusually low.


Roth, G.A., and others. (2017, May 16). Trends and patterns of geographic variation in cardiovascular mortality among US counties, 1980-2014. JAMA, 317(19), 1976-1992. Click here: http://jamanetwork.com/journals/jama/fullarticle/2626571?resultClick=3

Mokdad, A.H., and others. (2017, January 24). Trends and patterns of disparities in cancer mortality among US counties, 1980-2014. JAMA, 317(4), 388-406.  Click here: http://jamanetwork.com/journals/jama/fullarticle/2598772  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

MORTALITY: Some good news about major diseases

There has been a surprising – and perplexing – trends towards a decrease in mortality from a number of the traditional major causes of death, at least in developed countries.  Of course, much of this is due to prevention, early screening, new pharmacology, advances in surgical technique.  But scientists feel that there may be something else going on (or a combination of factors).  Witness stomach cancer – when our grandparents were young, this was the primary cause of cancer deaths.  Today, stomach cancer is responsible for only about 2 percent of cancer deaths.  Colon cancer deaths peaked in the ’80s, and have  has dropped subsequently by nearly half.  Hip fractures have been falling by as much as 20 percent per decade recently.  And there’s even good news for dementia:  incidence rates have been falling since the ’70s.  This brief opinion piece explores this topic, concluding that there may be some beneficial change occurring with the process of aging at the cell level.

Source: Kolata, G. (2016, July 8). A medical mystery of the best kind: Diseases in decline.  The New York Times.  Click here: http://www.nytimes.com/2016/07/10/upshot/a-medical-mystery-of-the-best-kind-major-diseases-are-in-decline.html?_r=0   Posted by AHA Resource Center (312) 422-2050, rc@aha.org