Press Release

Facts About Heart Disease Among U.S. Women

Women and Heart Disease: An Atlas of Racial and Ethnic Disparities in Mortality features more than 200 national and state maps, including the first county-level maps, showing differences in U.S. women's heart disease death rates.

Developed by West Virginia University and the Centers for Disease Control and Prevention (CDC), the atlas provides critical data on geographic, racial, and ethnic inequalities in women's heart disease death rates for the five major racial and ethnic groups--African American women, American Indian and Alaska Native women, Asian and Pacific Islander women, Hispanic women, and white women--and for all women combined. Each national map shows heart disease death rates for all counties, including counties in Alaska, Hawaii, and the District of Columbia.

Women ages 35 years and older who lived in the United States during 1991 through 1995 were studied.

Statistically reliable heart disease death rates could not be calculated for many counties where populations of women of racial and ethnic minorities were too small or absent. A death rate was not calculated and the county was labeled "insufficient data" when there were fewer than 20 heart disease deaths among women of the specific race or ethnic group over the 5-year study period.

Findings for all women and for each racial and ethnic group

All women

Among all women 35 and older, there was a heart disease death rate of 401 per 100,000 population. Death rates from heart disease were higher in the east than in the west.

• Counties having the highest death rates for all women were in Appalachia, the Ohio-Mississippi River Valley, the Mississippi Delta, and the eastern Piedmont and coastal regions of Georgia, South Carolina, and North Carolina.
• Counties with the lowest death rates for all women were in the Pacific Northwest, the Rocky Mountain areas of Colorado and New Mexico, and parts of Wisconsin, North Dakota, and South Dakota.
• Women in Minnesota were least likely to die from heart disease. The states with the highest rates of heart deaths were Mississippi (ranked 51), New York (ranked 50), and West Virginia (ranked 49).

Social isolation (living alone and having limited mobility or ability to care for oneself) may also be an important contributor to heart disease deaths among elderly women.

• Between 25% and 40% of elderly women in most of the Mississippi Delta and Appalachian regions have limited mobility or ability to care for themselves, compared with fewer than 15% of elderly women in many counties in the western United States.

Many counties lack hospital coronary care and cardiac rehabilitation units, both of which help to reduce deaths among women living with heart disease.

African American women

Overall, African American women had a heart disease death rate of 553 per 100,000 population.

• Counties with the highest death rates were in the southern Mississippi River Valley and Delta region. A band of high-rate counties was seen across Alabama, Georgia, and South Carolina, and pockets of high-rate counties were scattered throughout the Northeast, Midwest, and parts of Texas and Oklahoma.
• Counties with lower heart disease death rates for African American women were in the western and southwestern states of Washington, Nevada, and New Mexico, but also throughout the Midwest, Northeast, Mid-Atlantic states, and Florida.
• African American women in Hawaii were least likely to die from heart disease. Among states with African American populations, the highest rates of heart disease death were in Mississippi (ranked 43), Nebraska (ranked 42), and Illinois and Michigan (both ranked 40).

American Indian and Alaska Native women

For the study period, the heart disease death rate for American Indian and Alaska Native women was 259 per 100,000 population.

• High heart disease death rates were seen in women living in South Dakota (predominately Dakota Nation), Montana, and Minnesota (predominantly Chippewa Nation). Lumbee Indian women in southeastern North Carolina also experienced high death rates from heart disease.
• Low rates were found in large metropolitan counties and surrounding areas, such as New York City, San Francisco, Los Angeles, Seattle, and Anchorage. Low rates were also found in women in Oklahoma (predominantly Cherokee Nation) and New Mexico (predominantly Navajo Nation).
• American Indian and Alaska Native women in Texas were least likely to die from heart disease. States with the highest rates of heart deaths among American Indian and Alaska Native women were Michigan (ranked 32), Nebraska (ranked 31), and South Dakota (ranked 30).

Asian and Pacific Islander women

The heart disease death rate among Asian and Pacific Islander women 35 years and older was 221 per 100,000.

• High rates of heart disease deaths were found in Asian and Pacific Islander women in New York City, most of California, southern Arizona, Salt Lake City, St. Louis, and Atlanta.
• Low rates were seen in the Houston, Dallas, and San Antonio metropolitan areas of Texas; central and southern Florida; northern New Jersey; Connecticut; and in the Boston, Minneapolis, and Chicago metropolitan areas.
• Asian and Pacific Islander women in Minnesota were least likely to die from heart disease. Among states with Asian and Pacific Islander populations, the highest rates of heart deaths were in Kentucky (ranked 35), Hawaii (ranked 34), and Kentucky (ranked 35).

Hispanic women

The heart disease death rate for Hispanic women during the study period was 265 per 100,000 population.

• The highest rates of heart disease deaths were seen in Hispanic women in New York City, eastern Pennsylvania, Miami, and in the rural areas of Texas, New Mexico, Arizona, Colorado, and California.
• Low rates of heart disease deaths were seen in Hispanic women in northern California and the Pacific Northwest; most of Florida; and in the Boston, Pittsburgh, Cleveland, Washington-Baltimore, Atlanta, and New Orleans metropolitan areas.
• Hispanic women in North Carolina were least likely to die from heart disease. Among states with Hispanic populations, the highest rates of heart death were in Arizona (ranked 41), Kentucky (ranked 40), and New York (ranked 39).

White women

Overall, the heart disease death rate among white women 35 and older during the study period was 388 per 100,000 women. The highest rates for white women were seen in the eastern United States and the lowest rates in western states.

• Counties with the highest death rates for women's heart disease were in Appalachia; the Mississippi-Ohio River Valley; Mississippi Delta; and the Piedmont and coastal regions of Georgia, South Carolina, and North Carolina.
• In Florida, most counties had low rates, but several northern counties had higher rates.
• Large sections of the northwestern states and Colorado and New Mexico had counties with the lowest women's heart disease death rates. Other areas with low rates included Alaska and Hawaii and parts of Wisconsin, North Dakota, and South Dakota.
• White women in Hawaii were least likely to die from heart disease. The highest rates of heart disease deaths among white women were in New York (ranked 51), Mississippi (ranked 50), and West Virginia (ranked 49).

Single copies of Women and Heart Disease: An Atlas of Racial and Ethnic Disparities in Mortality are available by contacting

Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Technical Information and Editorial Services Branch
MS K-13
4770 Buford Highway
Atlanta, GA. 30341-3724
(770) 488-5080

See also First atlas of geographic and racial and ethnic disparities in U.S. women's heart disease death rates released

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES