Variations in Heart Disease Mortality among Counties of New York State

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Abstract
A study was undertaken to determine geographic variations in mortality due to arteriosclerotic heart disease within New York State. Age-adjusted, sex-specific rates for this cause (ISC 420) for New York City and the remaining 57 counties were examined, and demographic characteristics were studied for correlation with the mortality rates. Part of the analysis covered, in addition to casue 420, three other cause groups vascular lesions affecting the central nervous system (ISC 330-334.), hypertension with heart disease (ISC 440-443), and hypertension without mention of heart disease (ISC 444-447). Among the causes examined, only arteriosclerotic heart disease showed a clustering of counties with major industrial centers among the counties with high rates. This was true for both males and females. Statistically significant positive rank correlation coefficients were found between mortality due to arteriosclerotic heart disease and several indices of urbanization: percentage of population which is urban, percentage of population which is nonwhite, and average number of physicians. Examination of medical certification practices yielded no evidence to substantiate a hypothesis that high rates were associated with "better" certification.

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