People in the South and Appalachian regions of the US are dying of heart disease at an alarming rate that far outpaces the disease impact in other parts of the US, a new report warns.
Premature deaths have been reduced in the US overall since the end of the 20th century, but cardiovascular death rates have stopped improving.
Medical advancements have driven reductions in deaths from feared diseases like cancer, but heart disease killed more people in states like Mississippi, Oklahoma and West Virginia in 2016 than it did in 2010.
The new study is the second this week from University of Washington’s Institute for Health Metrics and Evaluation to demonstrate the wide rift in the state of health in the US.
Heart disease was responsible for more than 5,000 our of every 100,00 men’s deaths in many states in the South in 2016, new research has revealed
Heart disease is responsible for one in every four deaths in the US, according to the Centers for Disease Control and Prevention, and some 735,000 suffer a heart attack year.
Like many diseases, heart disease risk factors – such as obesity, smoking, poor diet and lack of physical activity – are common across the board, but found in far greater concentrations among populations in certain regions and income brackets.
This may account in part for the substantial gaps the study authors found from state to state and even between cities and counties.
While the number of people dying of heart disease each year has largely stabilized, the researchers discovered that rates of mortality due to poor heart health have actually increased in 12 states in the US.
Of these, Mississippi continues to stand out as more people there die or lose years of healthy life than in any other state in the nation.
In the southern state, which is also the poorest in the nation, 4,982 out of every 100,000 deaths were due to heart disease.
Heart attacks, strokes and heart arrhythmias have also killed an increasing number of people in Kentucky, West Virginia, Alabama, Arkansas, Louisiana and Oklahoma.
‘These relative disparities may be of particular concern for Alabama, Mississippi, Oklahoma, and Tennessee, given their recent decision to not expand their respective Medicaid systems,’ the study authors noted.
According to the American Heart Association, 7.3 million Americans living with heart disease do not have insurance, leaving them without access to doctors to monitor the progress of their illness or medication to treat it.
For many of these people, private health insurance is too expensive but, without the Medicaid expansion, they earn too much money to qualify for publicly subsidized care.
These states where heart disease continues to strike down more and more Americans are experiencing roughly the equivalent burden of the condition to what states like Massachusetts, Connecticut, and New Jersey saw in 1990, according to the new report.
‘These findings support the idea that tremendous gains in cardiovascular health are possible even in states with lower socioeconomic levels but that relative disparities between states have changed very little,’ the authors wrote.
They also pointed to predictions that as Americans’ body masses increase, life expectancy in the US will decline – due to heart disease or any cause.
Though the numbers had been falling for years, ‘our finding of increasing [heart disease] burden is concerning and suggests that long-term decline in [heart disease] may ending,’ the researchers wrote.
‘New clinical or public health interventions delivered earlier in the life course may be required to alter this alarming trajectory,’ they added.
There may be one beacon of hope for the possible direction of heart health in the US however: The District of Columbia.
This ‘small urban area…is a notable outlier that demonstrates the potential for improvements in the burden of [heart disease] for cities,’ the researchers wrote.
Since 1990, Washington, DC has made a quick turnaround, in both its socioeconomic status and its heart disease burden.
Though the study authors emphasized that they were ‘intrigued’ to find that the association between heart disease and wealth was not one-to-one, in general ‘the causal relationship between socioeconomic status has been well described,’ and likely plays a key role in the progress made in DC.
The nation’s capital has also seen a recent influx of transplants from other parts of the country, and the authors theorize these movers may be healthier overall, driving down heart disease in the city.
Movements of this sort may also lead to improvements in the quality of health care available, as more health care-users, so too might better hospitals and doctors.
‘Variation in health care quality between states, another possible explanation [for heart disease disparities], has been less well documented than variation between specific hospitals or health care referral regions but may be substantial,’ the study authors noted.