Cardiovascular Disease Deaths Have Fallen by Half Since 1980, but There Are Large Differences Between Counties

Deaths from heart disease in the US have fallen by half since 1980. But the death rate has not fallen evenly. The risk of dying from common heart diseases can be twice as high depending on county according to a new study published in JAMA, Trends and Patterns of Geographic Variation in Cardiovascular Mortality Among US Counties, 1980–2014.

In 1980, there were 507.4 deaths per 100,000 people from cardiovascular diseases. This decreased to 252.7 deaths per 100,000 people by 2014, for a more than 50% decrease.

The overall decrease is just part of the good news. The researchers also found that when they compared the bottom 10% of counties in 1980 and 2014 with the top 10% of counties in 1980 and 2014, the difference between the bottom and top had narrowed by 15%. This means that the counties with the highest risk of death from cardiovascular disease decreased risk at a faster rate than the counties with the lowest risk.

But the difference between counties are still substantial, particularly for ischemic heart disease and stroke mortality.

The largest concentration of counties with high cardiovascular disease mortality extended from southeastern Oklahoma along the Mississippi River Valley to eastern Kentucky. The lowest cardiovascular mortality rates were found in the counties surrounding San Francisco, California, central Colorado, northern Nebraska, central Minnesota, northeastern Virginia, and southern Florida.

The California data is a great illustration of how dramatically data cardiovascular disease varies by county. There is no gradient of low risk counties to high risk counties, and, instead, we find that very low risk counties, such as Placer County, can be right next to the highest risk counties, such as Yuba.

Source: CDC

The editors of JAMA argue that this means that there is a lot more that can be done to prevent heart disease. For example, avoiding tobacco, walking 30 minutes per day 5 days per week, and eating a healthy diet are steps that everyone can take to reduce their risk of cardiovascular disease death.

Heart disease is still the leading cause of death in the US, but it is almost completely preventable.


William Lewis is General Counsel at MORE Health where he manages the company’s legal risks in global health law, corporate governance, and cybersecurity.