HEART DISEASE: Rural Women Have High Death Rates
Women living in the "impoverished, rural areas of Appalachia, the Mississippi Delta and elsewhere in rural Southern states" exhibit the highest death rates from heart disease, according to the first-ever national study of heart disease in women by region, race and ethnic origin, the New York Times reports. Additionally, the study by the CDC and West Virginia University found that women in "four densely populated cities: New York, Chicago, Detroit, and New Orleans" had high death rates from heart disease. Overall, Mississippi, New York and West Virginia had the highest death rates. On the other hand, states in the Pacific Northwest and the Rocky Mountain region of Colorado and New Mexico, as well as parts of Wisconsin, North Dakota and South Dakota, had the lowest rates. Areas in the Midwest had low to moderate rates. The study also found that significantly more African-American women die of heart disease than any other group, while white women are much more likely to die from heart disease than Asian and Pacific Islanders, American Indians and Alaska Natives. Nationwide, about 370,000 women died from heart disease in 1997 and annual mortality rates run about 401 per 100,000 women. Surgeon General David Satcher said, "Contrary to what many people believe, heart disease is the leading cause of death for women."
Lifestyle, Access Differences
CDC Epidemiologist and the study's lead author Dr. Michele Casper explained the regional disparities, saying that "many rural areas had no coronary units that could sometimes prevent heart attacks or cardiac rehabilitation centers that could prevent recurrences." Similar conditions could apply to women living in densely populated areas, Casper said (Noble, 2/16). Lynne Smaha, American Heart Association president, said that genetic variations, amount of exercise, smoking habits, ethnic diets and other social or cultural traditions might explain the differing death rates. Additionally, social isolation and limited mobility might explain the high rates in rural areas (Smith, AP/Detroit Free Press, 2/16). Dr. Nancy Krieger, associate professor of health and social behavior at the Harvard School of Public Health, said, "Epidemiology research shows that what matters are the conditions you lived in when you grew up, as well as how you are able to live as an adult and the quality of care you receive."
More Study Needed
While further studies will examine the causes of heart disease, Casper said this study "was designed specifically to pinpoint differences in death rates among different groups of women and how the rates varied from region to region" (New York Times, 2/16). Casper added, "We wanted to raise awareness among state and local health communities about the problem so they can tailor policies to develop heart-healthy programs for women" (Guthrie, Atlanta Journal-Constitution, 2/16).