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Men's Heart Disease Atlas: Table
of Contents
Source: Barnett E, Casper ML, Halverson JA, Elmes GA,
Brahan VE, Majeed ZA, Bloom AS, Stanley S. Men and Heart Disease:
An Atlas of Racial and Ethnic Disparities in Mortality, First Edition. Morgantown, WV:
Office for Social Environment and Health Research,
West Virginia University, 2001.
Note: Information is presented as at the time of publication. Some
reference, resource and contact information may not be current.
Men and Heart Disease: An Atlas of Racial and
Ethnic Disparities in Mortality
First Edition
Elizabeth Barnett, Michele L. Casper, Joel A. Halverson, Gregory A.
Elmes, Valerie E. Braham, Zainal A. Majeed, Amy S. Bloom, Shaun Stanley
Office for Social Environment and Health Research • West Virginia
University • National Center for Chronic Disease Prevention and Health
Promotion • Centers for Disease Control and Prevention
A Message from the Director of the Centers
for Disease Control and Prevention
June 2001
As the Nation's prevention agency, the Centers for Disease Control
and Prevention (CDC) is committed to reducing the burden of heart disease
— the leading cause of death and a major contributor to disability in
the United States. Deaths from heart disease are largely preventable, and
with targeted public health efforts, we can alleviate much of the heavy
burden of this disease. To meet this challenge, CDC works to closely
monitor geographic and temporal trends in heart disease among racial and
ethnic groups, strengthen the delivery of primary and secondary preventive
health services to all such groups, and implement policy changes that
support heart-healthy environments for all residents of the United
States.
Among men, mortality rates for heart disease are higher than the rates
for all forms of cancer combined. Approximately 356,598 men die of heart
disease each year, and approximately 5.8 million men alive today have
suffered a heart attack or angina pectoris (chest pain). In addition, the
burden of heart disease among men is not equally distributed among racial
and ethnic groups within the United States. Men and Heart Disease: An
Atlas of Racial and Ethnic Disparities in Mortality comprehensively
describes the unequal distribution of heart disease among these
groups.
In addition, Men and Heart Disease: An Atlas of Racial and Ethnic
Disparities in Mortality provides health professionals and concerned
citizens at the local, state, and national levels with information
essential to identifying populations of men at greatest risk of heart
disease and in greatest need of prevention efforts. Men and Heart
Disease provides, for the first time, county–level maps of heart
disease for men of the five largest racial and ethnic groups in the United
States—American Indians and Alaska Natives, Asians and Pacific
Islanders, Blacks, Hispanics, and Whites. In addition, Men and Heart
Disease includes maps that depict geographic patterns of local
economic and medical care resources and population distributions for each
racial and ethnic group. These maps provide crucial information for
tailoring prevention efforts to the communities in need.
This publication is the second in a series of atlases related to
cardiovascular disease that are being developed through a collaboration
between CDC and West Virginia University. The first atlas was Women and
Heart Disease: An Atlas of Racial and Ethnic Disparities in Mortality.
Now, I am pleased to share Men and Heart Disease: An Atlas of Racial
and Ethnic Disparities in Mortality with you. I encourage you to use
these data to improve the delivery of preventive health services and to
create heart-healthy environments for all men.
[signature]
Jeffrey P. Koplan, M.D., M.P.H.
Director, Centers for Disease Control and Prevention
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A Message from the Centers for Disease
Control and Prevention’s Associate Director for Minority Health
June 2001
There is an increasing awareness of the health needs of minority
populations in the United States. Government and nongovernment health
agencies are beginning to identify the gaps in health care and health
outcomes that exist among racial and ethnic groups and are beginning to
develop strategies to reduce these gaps. Since the inception of the
Centers for Disease Control and Prevention’s (CDC) Office of Minority
Health in 1988, this Office has been committed to improving the health
status of racial and ethnic minority populations throughout the United
States.
A central focus of our activities in the Office of Minority Health is
implementing the Department of Health and Human Services’ Initiative to
Eliminate Racial and Ethnic Disparities in Health. Cardiovascular disease
is one of the six health status areas that have been targeted for
eliminating such disparities by the year 2010. We recognize that to
achieve this goal, a major national commitment to identifying and
addressing the underlying causes of the racial and ethnic disparities is
required. New insights are needed to understand the determinants of the
racial and ethnic disparities in cardiovascular disease and to apply our
knowledge toward eliminating these gaps. In this regard, Men and Heart
Disease: An Atlas of Racial and Ethnic Disparities in Mortality is a
timely publication that provides a new perspective on the racial and
ethnic patterns of cardiovascular disease at the community level.
The maps will enable health researchers to develop new hypotheses
regarding the determinants of the geographic patterns of heart disease for
each racial and ethnic group, and will also enable health professionals in
local, state, and national health agencies to design new programs and
policies tailored to the needs of the communities with the highest rates
of heart disease mortality.
As we continue to identify the health needs of racial/ethnic minority
populations, additional opportunities will arise to expand and modify our
public health and medical care strategies for preventing and treating
heart disease among all men.
[signature]
Walter W. Williams, M.D., M.P.H.
Associate Director for Minority Health
Centers for Disease Control and Prevention
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Foreword
June 2001
I am pleased to present Men and Heart Disease: An Atlas of Racial
and Ethnic Disparities in Mortality. Heart disease is the leading
cause of death for men and women of all racial and ethnic groups. While
approximately half of all heart disease deaths occur among men and half
among women, more than 70 percent of premature heart disease deaths (i.e.,
before age 65) occur among men.
This landmark document supports the Department of Health and Human
Services' Initiative to Eliminate Racial and Ethnic Disparities in
Health and addresses the important need to reduce the risk of heart
disease among men of all racial and ethnic groups. The maps in Men and
Heart Disease depict heart disease mortality rates among men,
county–by–county, for the entire United States, and identify the places
where men of each of the five major racial and ethnic groups experience
the highest rates of mortality from heart disease. With this information,
public health professionals at the local, state, and national levels will
be able to target prevention resources to populations of men in greatest
need of services.
Although mortality from heart disease has been declining for several
decades, the rate of decline has varied by racial and ethnic group,
resulting at times in a widening of the gap between such groups for both
men and women. Moreover, recent trends indicate a slowing down in the rate
of decline of heart disease mortality and underscore the importance of
enhancing our efforts to support innovative community–based strategies for
reducing the risk of heart disease. For men of all racial and ethnic
groups (as well as for women), it is through prevention that we can expect
to achieve the greatest cardiovascular health benefits. Men and Heart
Disease indicates where those programs are most needed and can have the
greatest benefit.
It is my hope that Men and Heart Disease: An Atlas of Racial and
Ethnic Disparities in Mortality will be used to guide the distribution
of funds and resources to those communities of men experiencing excess
mortality from heart disease and will promote the development of
culturally sensitive prevention strategies.
[signature]
James S. Marks M.D., M.P.H.
Director, National Center for Chronic Disease Prevention and Health
Promotion
Centers for Disease Control and Prevention
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Contents
| A Message from the Director
of the Centers for Disease Control and Prevention |
iii |
| A Message from the Centers
for Disease Control and Prevention’s Associate Director for
Minority Health |
v |
| Foreward by James Marks,
M.D., M.P.H. |
vii |
List of Figures |
xiii |
Introduction
|
15 |
| Section 1. Racial and
Ethnic Disparities in Heart Disease among Men |
19 |
| The Social Construction of
Race |
20 |
| Misreporting of Race and
Ethnicity on Death Certificates |
21 |
| Specific Categories of Heart
Disease Deaths among Men |
22 |
| Age Distribution of Heart
Disease Deaths among Men |
22 |
| Heart Disease Death Rate
Trends for 1991-1995 |
23 |
County Variation in Heart
Disease Death Rates
|
24 |
| Section 2. Reader's
Guide to Understanding and Interpreting the Maps |
27 |
| Calculation of Heart Disease
Death Rates |
28 |
| National Heart Disease
Mortality Map Layouts |
29 |
| National Map Projections |
29 |
| Scale of the National Maps |
30 |
| Guide to National Maps of
Local Social Environment |
30 |
| National Population
Distribution Map Layouts |
31 |
| Guide to State Maps of Heart
Disease Mortality |
31 |
| State Map Layouts |
32 |
| State Map Projections |
32 |
Scale of the State Maps
|
32 |
| Section 3. Local Social
Environment and Men’s Risk for Heart Disease Mortality |
35 |
| Population Distributions |
39 |
| Local Economic Resources |
51 |
Medical Care Resources
|
55 |
Section 4. National Maps
of Heart Disease Mortality among Men
|
63 |
| Section 5. State Maps of
Heart Disease Mortality among Men |
79 |
| Alabama |
82 |
| Alaska |
84 |
| Arizona |
86 |
| Arkansas |
88 |
| California |
90 |
| Colorado |
92 |
| Connecticut |
94 |
| Delaware |
96 |
| District of Columbia |
98 |
| Florida |
100 |
| Georgia |
102 |
| Hawaii |
104 |
| Idaho |
106 |
| Illinois |
108 |
| Indiana |
110 |
| Iowa |
112 |
| Kansas |
114 |
| Kentucky |
116 |
| Louisiana |
118 |
| Maine |
120 |
| Maryland |
122 |
| Massachusetts |
124 |
| Michigan |
126 |
| Minnesota |
128 |
| Mississippi |
130 |
| Missouri |
132 |
| Montana |
134 |
| Nebraska |
136 |
| Nevada |
138 |
| New Hampshire |
140 |
| New Jersey |
142 |
| New Mexico |
144 |
| New York |
146 |
| New York City |
148 |
| North Carolina |
150 |
| North Dakota |
152 |
| Ohio |
154 |
| Oklahoma |
156 |
| Oregon |
158 |
| Pennsylvania |
160 |
| Rhode Island |
162 |
| South Carolina |
164 |
| South Dakota |
166 |
| Tennessee |
168 |
| Texas |
170 |
| Utah |
172 |
| Vermont |
174 |
| Virginia |
176 |
| Washington |
178 |
| West Virginia |
180 |
| Wisconsin |
182 |
Wyoming
|
184 |
| Appendix A. State
Rankings of Heart Disease Mortality among Men |
187 |
| Appendix B.
Methodological and Technical Notes |
201 |
| Appendix C. Resources |
211 |
| Index |
225 |
| About the Authors |
231 |
List of Figures
|
|
Figure 1.1
Specific categories of heart disease deaths among men 35 years of
age and older, by race and ethnicity, 1991–1995 |
22 |
Figure 1.2
Age distribution of heart disease deaths among men 35 years of age
and older, by race and ethnicity, 1991–1995 |
23 |
Figure 1.3
Trends in heart disease mortality among men 35 years of age and
older, by race and ethnicity, 1991–1995 |
24 |
Figure 1.4
Frequency distribution of smoothed county heart disease death rates
for men 35 years of age and older, by race and ethnicity, 1991–1995 |
25 |
Figure 2.1
Example of layout for national heart disease mortality maps |
30 |
Figure 2.2
Example of layout for national population distribution maps |
31 |
Figure 2.3
Example of layout for state heart disease mortality maps |
33 |
Figure 3.1
Asian populations in the United States, 1990 |
42 |
Figure 3.2
Hispanic populations in the United States, 1990 |
46 |
Figure 4.1
Frequency distribution of smoothed heart disease death rates for
counties, all men, 1991–1995 |
66 |
Figure 4.2
Frequency distribution of smoothed heart disease death rates for
counties, American Indian and Alaska Native men, 1991–1995 |
68 |
Figure 4.3
Frequency distribution of smoothed heart disease death rates for
counties, Asian and Pacific Islander men, 1991–1995 |
70 |
Figure 4.4
Frequency distribution of smoothed heart disease death rates for
counties, black men, 1991–1995 |
72 |
Figure 4.5
Frequency distribution of smoothed heart disease death rates for
counties, Hispanic men, 1991–1995 |
74 |
Figure 4.6
Frequency distribution of smoothed heart disease death rates for
counties, white men, 1991–1995 |
76 |
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Date last reviewed:
05/12/2006
Content source: Division for Heart Disease and Stroke
Prevention,
National Center for Chronic Disease Prevention and
Health Promotion
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