BY TIM BONFIELD
The Cincinnati Enquirer
LEXINGTON -- Experts say high heart-disease rates in the 12-state "Coronary Valley" cause as many as 50,000 unnecessary deaths a year.
That estimate comes from calculating how many lives would be saved if those dozen states, which include Ohio, Kentucky and Indiana, could change health trends enough to match New Mexico, which boasts the nation's lowest heart-disease death rate.
"This is a public health failure, especially for people in lower socioeconomic status," Dr. Aaron Folsom, an epidemiologist with the University of Minnesota, said Thursday.
"Coronary heart disease is largely preventable. It is going down in the United States, but it's going down more for the affluent than the non-affluent," Dr. Folson said. "That means our public health system is not reaching the lower economic groups."
Dr. Folson spoke during a break at a two-day conference to analyze regional disparities in heart-disease rates. The conference, which continues today at the University of Kentucky, gathered more than 20 heart-disease experts and epidemiologists.
The concentration of heart disease in the nation's heartland is so intense that Dr. James Muller, UK chief of cardiovascular medicine, has dubbed the region "Coronary Valley." Other states included are West Virginia, Michigan, Tennessee, Illinois, New York, Missouri, Arkansas, Louisiana and Oklahoma.
For these states, the combined coronary death rate was 116.2 deaths per year per 100,000 residents, according to American Heart Association statistics. By contrast, the death rate for the 12 lowest states -- mostly Western states -- was 73.4. The national average is 95 deaths per 100,000 people.
The nation's highest coronary death rate was New York, at 135.9 deaths a year per 100,000 population. Kentucky was fifth at 116.7; Indiana was seventh at 113.1; and Ohio was 10th at 111.3.
Explanations for the disparity range widely. Some experts point to genetic factors. Some say poor, uneducated people are more likely to lead unhealthy lifestyles. Some say environmental conditions contribute, be they natural variations in altitude and climate or problems caused by pollution.
The links between heart disease and urban vs. rural lifestyles were discussed extensively Thursday. In areas that included large cities like Cincinnati, Louisville and Lexington, heart deaths were much higher farther from the city, with pockets of high death rates in the inner-city areas.
Heart deaths were especially high in rural Appalachian areas, such as Southeast Ohio and Eastern Kentucky. But heart deaths were low in rural parts of Western states.
The good news: Since the 1970s, the annual death rate from heart disease has dropped about 40 percent nationwide. Rates also have been falling in the Coronary Valley. The challenge, experts say, will be explaining why the death rates have fallen faster in some parts of the country than others.
