Race, geography are key factors in heart disease, report says

ATLANTA, Georgia (CNN) -- A new report on heart disease among American males shows a man's race and where he lives can make a huge difference in his chances of dying, with blacks and those living in economically depressed areas at greatest risk.

African-American men are 26 percent more likely than white men and almost twice as likely as Hispanic men to die of heart disease, says the report, "Men and Heart Disease," authored by Elizabeth Barnett of West Virginia University and the Centers for Disease Control and Prevention in Atlanta.

The survey found similar differences when statistics were broken down according to location, with much higher death rates in parts of the rural South.

But Barnett said that race and geography are not in themselves the determining factors, but instead reflect social conditions.

Differences reflect social inequalities

"Racial and ethnic disparities (in death rates) are not due to genetics or inborn differences in people of different races, but rather that they reflect social inequalities," she said. "Similarly, geographic disparities that we see across the country are not due to climate but reflect the social environment and local economies."

In general, death rates are lower in large cities, which provide the best access to health care facilities.

"The highest rates in death from heart disease for men are found in the regions of this country with the poorest economies and few health care resources, particularly in underdeveloped rural areas," said Barnett, director of WVU's Office for Social Environment and Health Research.

"High risks of heart disease are also concentrated in groups of men who have historically been socially disadvantaged, often as a result of racism and other forms of discrimination," she said.

The report, which looked at death rates between 1991 and 1995 for U.S. men over age 35, includes more than 200 national and state maps that show geographic patterns in heart disease death rates. Maps of local economic resources and availability of medical care "provide information on the underlying community characteristics that can influence the opportunities men have to live heart-healthy lives," the CDC said in a prepared release.

Racial disparities persist

The highest death rates, Barnett said, are found in areas where "there have been a lack of opportunities for people to experience healthy living compared to other areas."

The maps show that death rates by county ranged from a low of 377 per 100,000 men to a high of 1,102 per 100,000. Hardest hit were men living in Appalachia, the Ohio-Mississsippi River Valley, the Mississippi Delta and the eastern Piedmont and coastal regions of Georgia, South Carolina and North Carolina.

Although previous studies have found that African-Americans have a higher rate of heart disease, "It's still shocking that these disparities continue to exist," Barnett said.

While the overall death rate from heart disease is 675 per 100,000 men, when broken into racial and ethnic groups the rate ranges from a high of 841 per 100,000 for African-American men down to 372 per 100,000 for Asian and Pacific Islander men.

The report also found African-American men are more likely to die from heart disease at a young age than are men of other racial groups. It estimates that about 40 percent of deaths due to heart disease in African-American men occur before age 65, compared with 21 percent in white men.

New report a companion to earlier

"Too many men, particularly men of color, are dying from a disease that we know can be prevented by changing lifestyles and social conditions in communities, including access to affordable, heart-healthy foods and recreational facilities and jobs in healthy workplaces," said U.S. Surgeon General David Satcher, quoted in the CDC's prepared release.

"This atlas provides a valuable sense of perspective about the threat that heart disease poses to this nation's fathers, husbands, and brothers."

The new report is a companion of a similar atlas, "Women and Heart Disease," released last year. "These state and racial/ethnic-specific data are especially critical when states are deciding how to target their funds to populations in greatest need of heart disease prvention services," said CDC Director Dr. Jeffrey Koplan.