CDC Identifies Regions with Highest Heart Disease Rates

Heart disease hospitalization rates among Americans 65 years and older vary substantially depending on where they live, according to a report recently released by the Centers for Disease Control and Prevention (CDC).

The Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries shows that the highest hospitalization rates occur among blacks compared to other racial and ethnic groups. Hospitalization rates were also highest in counties located primarily in Appalachia, the Mississippi Delta, Texas, and Oklahoma. A significant number of Medicare beneficiaries live in counties without hospitals capable of providing specialized heart disease treatment.

The atlas provides for the first time statistics about heart disease hospitalizations at the county level. Data came from Medicare records of more than 28 million people between 2000 and 2006 in the 50 states, Washington, D.C., Puerto Rico and the U.S. Virgin Islands. The report documented an average of 2.1 million hospitalizations for heart disease each year.

“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. “Importantly, with county-level information, health professionals at the local, state and national levels will be able to tailor heart disease prevention programs and polices to the needs of people living in communities with high rates of heart disease.”

Heart disease is the nation’s leading cause of death. In 2010, it is estimated to cost the United States $316.4 billion in health care services, medications and lost productivity.

In states with the highest heart disease hospitalization rate, the burden is generally two times higher than states with the lowest rates. For instance, in Louisiana there were 95.2 hospitalizations for every 1,000 Medicare beneficiaries, compared with 44.8 in Hawaii over the same six-year period.

The atlas also brings to light significant racial and ethnic disparities. The heart disease hospitalization rate is much higher among blacks (85.3 hospitalizations per 1,000 beneficiaries) than for whites (74.4 per 1,000) or Hispanics (73.6 per 1,000). While these rates declined slowly between 2000 and 2006 for Hispanic and white Americans aged 65 years and older, they remained steady among older black Americans.

The atlas also points out geographical differences in access to hospitals with the capability to treat heart disease patients. In 2005, 21 percent of all counties in the United States had no hospital, and 31 percent lacked a hospital with an emergency room. Specialized cardiac services are even more limited, with 63 percent of U.S. counties lacking a cardiologist outside the Veterans Affairs system.

“Heart disease is largely preventable, and reducing the toll of this disease on society is a national priority,” said Darwin Labarthe, M.D., Ph.D., director of CDC’s Division for Heart Disease and Stroke Prevention. “With targeted public health efforts, such as prevention and early identification of risk factors, and increased access to appropriate medical care, the burden of heart disease can be reduced.”

The atlas is the sixth in a series of CDC atlases related to heart disease and stroke. The full atlas is available at http://www.cdc.gov/DHDSP/library/heart_atlas/index.htm.

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