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Southeast States Lead in Preventable Deaths; Health Status by ZIP Code?

Posted May 07 2014 12:00am

In previous notes, I discussed the so-called stroke belt, the southeastern U.S. states with a very high incidence of strokes as well as a number of other chronic diseases (see: Drop Me Off at the ER as Soon as I Finish My Fried Fish DinnerCognitive Decline Documented in the U.S. Southern "Stroke Belt" States ). This trend continues as described in a recent article with an excerpt posted below (see: States With Highest Rates of Preventable Deaths ):

People in the southeastern United States have a much greater risk of dying early from any of the nation's five leading causes of death....Those living in eight southern states -- Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee -- endure 28 percent to 33 percent of all potentially preventable deaths from heart disease, cancer, chronic lower respiratory disease, stroke and unintentional injury, according to [the CDC]...."This data is yet another demonstration that when it comes to health in this country, your longevity and health are more determined by your ZIP code than they are by your genetic code," CDC director Dr. Tom Frieden said ....The top five causes of death accounted for nearly two-thirds of all U.S. deaths in 2010, and nearly 900,000 Americans die prematurely every year from these causes....Death rates for each cause of death vary greatly from state to state. So CDC researchers compared all states against the states with the lowest rates of death to estimate how many deaths could be prevented if those low rates were a national trend.....[The number of preventable deaths is]... particularly important for the southeastern states, which led the nation with the highest numbers and rates of preventable deaths in all five top causes of death. The southeastern states have a combination of unhealthy trends that increases the overall risk of premature death, including higher smoking rates, greater obesity rates, lower rates of physical activity and less blood pressure control, Frieden said. "The Southeast has sometimes been referred to as the 'Stroke Belt.' This report confirms that," he said.

A couple of key concepts jump out at me from this article. The first is the basic categories of preventable deaths: heart disease, cancer, chronic lower respiratory disease, stroke and unintentional injury. I had not thought much about unintentional injury as an element in the list of preventable deaths but it makes perfect sense. The lifestyle issues that contribute to preventable deaths such as smoking and lack of physical activity undoubtedly a factor in unintentional injuries. Many of the people with chronic diseases probably have difficulty in just walking and are probably prone to slips and falls.

Here's what I think is the most revealing statistic from the article: people in only eight states account for 28 percent to 33 percent of all potentially preventable deaths from heart disease, cancer, chronic lower respiratory disease, stroke and unintentional injury. This percentage puts the idea of the "stroke belt" in high relief. How does one begin to understand how and why this situation is occurring in this particular geographic area? I am sure that some of the explanation is linked to cultural preferences in the South regarding factors such as diet and smoking behavior. I am also sure that educational levels makes a major contribution to the problem. Here's a quote that goes to this very point (see: The Effects of Education on Health ):

There is a well known, large, and persistent association between education and health. This has been observed in many countries and time periods, and for a wide variety of health measures. The differences between the more and the less educated are significant: in 1999, the age-adjusted mortality rate of high school dropouts ages 25 to 64 was more than twice as large as the mortality rate of those with some college.

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