Identifying and Predicting Areas of Increasing Heart Disease Mortality in the United States

PURPOSE: Heart disease is currently the leading cause of mortality in the United States, with over 600,00 deaths per year. However, the age-adjusted mortality rate per 100,000 persons for heart disease has been steadily decreasing since the 1950s. It is expected that nationwide mortality rates for the disease should continue to decrease throughout all age groups, genders and races. Yet, little attention has been given to changes at the US county level, where heart disease mortalities may remain constant or even increase in specific regions. PROCEDURES: Data was collected from the Center of Disease Control and Prevention’s Heart Disease Maps and Data Sources website from 2006 through 2014. Heart disease deaths were defined according to the International Classification of Diseases codes for diseases of the heart in the tenth revisions of the International Classification of Diseases. A multiple linear regression model was developed using mortality rates as the response variable and the observed year and US county as the explanatory variables to determine areas where heart disease is continued to raise. OUTCOME: 704 counties were identified to have mortality rates that were heavily predicated on the year of observance. Of those counties identified, 322 of those counties are expected to see an average yearly increase of 4.54 mortalities per 100,00 persons. IMPACT: Despite the dramatic declines in heart disease mortality in the United States at the national level, several areas will continue to see stagnant or increasing death rates. This demonstrates the importance of increasing focus on small-area surveillance to reveal trends that are otherwise masked at the national level. It also gives those areas historical context and clues for understanding their current heart disease mortality rates and disparity in relation to other communities