Epidemiology of cardiovascular mortality-geographic and ethnic.

Abstract

NO COUNTRY that publishes its vital statistics has a higher recorded death rate for the cardiovascular diseases among middle-aged males than does the United States, with the exception of South African whites.1-3 As one approach in the search for possible factors associated with this phenomenon, the present study deals with geographic and ethnic differences within the United States, and focuses attention upon the questions: Where are the areas with the highest rates? The areas with the lowest rates? What are some of the variables associated with-the differeces in rates? Rates have already been presented by state4'5 and for coronary heart disease by 163 metropolitan areas and the nonmetropolitan portions of 116 economic subregions,6 a total of 279 areas. Our emphasis is upon the mortality rates for all cardiovascular diseases for these areas, 1949-1951 for all whites ages 45-74 ageand sex-adjusted by ten-year groups, by the direct method, to the United States population in 1950. These adjustments are appropriate for epidemiological studies to hold these variables constant, so that we may study geographic and other factors. However, for health department people and others concerned primarily with programs serving patients, the actual number of deaths and ordinary crude rates are often much more useful.