Missouri claimed the No. 9 spot in a state-by-state ranking of the prevalence of heart disease, according to a study released by the Centers for Disease Control and Prevention earlier this month.
The study, the first of its kind to collect state-specific data, estimates that more than one in every 14 Missourians have experienced a heart attack, angina or coronary heart disease. By contrast, fewer than 1 in every 20 people will face these complications in Colorado, the lowest-ranking state on the survey.
The CDC cites variations in states’ risk factors for heart disease as a possible explanation for geographic disparities in the number of heart attacks and the incidence of heart disease.
“Different regions have different dietary patterns, different acceptable activities for exercise and differences in the availability of safe, easily accessible places to go for physical activity,” said Jonathan Neyer, epidemiologist in the CDC’s division for heart disease and stroke prevention, who spearheaded the study.
Policies that regulate smoking in restaurants, healthy food in schools and heart health education also make a difference, Neyer said.
Missouri faces its own unique set of risk factors.
“Missouri is one of the states that faces high rates of obesity,” said Duc Nguyen, assistant professor in the cardiology division of internal medicine at MU. “States like Colorado have a high population of health-conscious individuals and plenty of opportunities for outdoor sports.”
Nguyen also points to relatively high rates of smoking and diets high in fat and cholesterol as issues that might be responsible for Missouri’s high rank.
In examining the prevalence of heart disease, Neyer and his colleagues also looked at differences in race, gender and education. For instance, American Indians are twice as likely to experience heart disease as Asian Americans. A high school dropout is nearly twice as likely to have heart disease as a college graduate.
Race and socioeconomic differences in health outcome are a part of a larger debate in public health research.
“It’s much easier to document differences than to explain them,” Neyer said. “It’s more complex than just a lack of access to health care. Differences in leisure time, quality of care, amount of healthy food people are able to afford and access to safe environments all factor into the equation.”
Treaka Young, director of the Lincoln University’s Paula J. Carter Center on Minority Health and Aging, says that lack of exercise, poor diet and lack of education are common reasons for certain minorities to have more health problems.
“There’s also a lack of trust in what doctors and health professionals have to say,” she said. “There’s a mind-set of, ‘If it’s not broken, don’t fix it.’ But if you don’t go to the doctor, how do you know what’s broken?”
Young said minority health and health care will slowly improve and she looks to growing enthusiasm for health care as proof.
“When we do a health fair that focuses directly on Hispanics, people come out in flocks. They are anxious to get health information.”
Neyer estimates that around 338,000 Missourians have heart disease.