HEART DISEASE: Hospitalization Rates Vary Widely By County
Hospitalization rates for heart disease and stroke are much higher in certain counties than in the rest of the state, according to a new study, and some health officials suspect that pollution and a lack of health care access may be partly to blame, the Los Angeles Times reports. Researchers from the state health department's Cardiovascular Disease Outreach, Resources and Epidemiology Program analyzed 1989-91 hospitalization rates across the state by race and gender. They found that 10 counties "had coronary heart disease hospitalization rates that were significantly higher than the state average," with Merced, Tulare and Kern counties "topping the list." Consistent with previous studies were researchers' findings that "blacks have higher hospitalization rates for stroke than other racial groups, and men have higher rates for heart disease than women." However, even adjusting for those factors did not remove the geographical differentiation that gave white males in Yuba county "a coronary heart disease hospitalization rate four times higher than those in Del Norte." The study also found that Tulare, Los Angeles and Alameda counties had the "highest hospitalization rates from stroke." Santa Barbara County had the lowest rate of coronary heart disease-related hospitalizations.
What's To Blame?
University of California-San Francisco's Jeannie Gazzaniga, lead author of the report, said "poor air quality may be a big factor" in some areas. "[T]here's something that's affecting almost all races and gender groups. The chances are very strong there's something in the environment that everybody is being exposed to," she said. Dr. David Faxon of the University of Southern California said that without improved access to health care, "most people don't know they have high blood pressure or high cholesterol," which constitute significant risk factors for heart disease.
Tool For Change
Gazzaniga said the findings can "be used as a screening tool" that can prompt local and state officials to take needed action. Health officials "agree that even though the results do not explain why some places have higher" rates, Californians can use them "to take steps to reduce the risk of heart disease and stroke." Dr. Jonathan Fielding, director of public health for Los Angeles County, said, "From a public health standpoint, it means we need to redouble our efforts to control these chronic diseases. While we don't know exactly what these differences are attributable to, there is abundant evidence of key risk factors for heart disease, such as elevated cholesterol, a high-fat diet, smoking and obesity." The Times notes that cardiovascular disease is the No. 1 killer in California, accounting for 42% of all deaths (Yang, 7/23).