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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.

Sources:

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 TRENDS: Heart disease still leading cause of death but cancer is catching up

Heart disease is the leading cause of death in the U.S. and has been for decades.  In 2014, there were more than 614,000 deaths from heart disease.  However, a look at the long term trend lines shows that the number of deaths from heart disease is a curve that went up in the 70s and 80s  and then has been coming back down in more recent years.  The inflection point was 1985 with over 770,000 deaths from heart disease.

Cancer deaths meanwhile have been steadily increasing in a more or less straight line fashion from about 210,000 in 1950 to nearly 600,000 in 2014.  Cancer is the second leading cause of death and has now nearly caught up with heart disease.

As of the most recent year, 2014, there were 22 states in which cancer deaths have surpassed heart disease deaths.  The statisticians who wrote this brief note that the “leading-cause crossover” between heart disease and cancer was expected for the nation as a whole sometime around 2010, but that there was an uptick in heart disease mortality that kept this from happening at that time.

Source: Heron, M., and Anderson, R.N. (2016, Aug.). Changes in the leading cause of death: Recent patterns in heart disease and cancer mortality. NCHS Data Brief, 254.  Click here for free full text: http://www.cdc.gov/nchs/data/databriefs/db254.pdf   Also, data tables here: http://www.cdc.gov/nchs/data/databriefs/db254_table.pdf#1  Posted by AHA Resource Center (312) 422-2050, rc@aha.org