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Heart Disease Kills 13% More People Than Average in the Southern United States

Heart Disease Kills 13% More People Than Average in the Southern United States

COVID-19 could present a score of new dangers to Americans with heart disease, especially in areas with sporadic access to medical care.
man chest pains
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ValuePenguin analyzed data from the Centers for Disease Control and Prevention (CDC) on heart disease in the United States and found that the population's susceptibility to heart disease varies wildly depending on state and county. People living in the South are disproportionately affected by fatal heart conditions, including heart attacks, hypertension, coronary artery disease and strokes.

For context, the CDC determined that heart disease killed more than 469,000 middle-aged Americans from 2016 to 2018 — a rate of about 153 per 100,000 people. During this same period, Mississippi, the state that led the nation in fatal cases of cardiovascular disease, had 301 fatalities per 100,000 people — nearly double the national average rate.

We also found that the communities most at risk of fatal heart conditions tend to lack access to adequate health care. While this is a health emergency in its own right, the ongoing pandemic adds a potential complication — the CDC states that there is substantial evidence that shows people with preexisting heart conditions may be more adversely affected by COVID-19.

Key findings:

Heart disease was most lethal in the South, where the number of fatal cases was about 13% higher than the national average.

On average, nationally there were 218 fatal cases of heart disease per 100,000 people from 2016 to 2018, with most deaths stemming from hypertension. Compared to this number, the number of deaths from heart disease in the area the Census Bureau designates as the South was 247 per 100,000 people. The rate of cardiovascular deaths in the South was higher than in the nation's other areas.

There were 20 states that had higher-than-average rates of deaths from heart disease. Thirteen of these states are located in the South.

Of all states, Mississippi had the highest rate of deaths from all forms of heart disease relative to its population. In the Magnolia State, there were 301 fatal cases of heart disease per 100,000 people. This figure is 38% greater than the national average.

When we examined the number of fatal cases that were caused by common forms of heart disease, such as coronary heart disease, heart attacks, hypertension and strokes, we found that the South was again disproportionately affected. Moreover, the lethality of heart disease in some areas was especially divergent from the mean.

Arkansas led the country in fatal heart attacks and coronary heart disease. In fact, in Arkansas, the rate at which people died from heart attacks was nearly triple the country's average. In Oklahoma, hypertension killed 123% more people than average. And finally, Mississippians were the most likely to die from strokes — though its population had only a 38% greater chance of experiencing a fatal stroke than the rest of the country.

Total cardiovascular deaths per 100,000
Average per-state rate218
West Virginia255
District of Columbia250
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Conversely, the western portion of the U.S. experienced an average of only 196 deaths per 100,000 people during the same period — the lowest rate of any region. Specifically, states in the "Mountain" subregion had the lowest rates of heart disease deaths. In Colorado, the rate of deaths was 21% lower than the national average.

Heart disease killed more men than women in most cases, while Black Americans were the most disproportionately affected group of people.

Men have a much greater risk than women of dying from heart disease. Hypertension remains the most lethal form of heart disease for any age group, but a middle-aged woman (age 45 to 64) is about half as likely to die from hypertension as a man of the same age. Additionally, men are about three times as likely as women to die from coronary heart disease or a heart attack.

While senior-aged men are still much more likely to die from heart disease than senior women, the difference in the rate of fatalities between the sexes shrinks with age. Older men are about one and a half times more likely to be killed by a cardiovascular condition than women of the same age. However, strokes kill men and women at virtually equal clips, with women slightly more at risk than men.

The CDC's data reveals that Black Americans were more likely to die from heart disease than other groups. Compared to the average of all other races, middle-aged Black men and women were more than two times more likely to die from hypertension and strokes. Furthermore, on average, the rate of fatal cases of heart disease among Black seniors was 140% greater than that of other groups.

Fatal cases of heart disease among different people

In nine of the 10 counties with the highest proportion of cardiovascular deaths, more than 20% of residents were below the poverty line.

Franklin Parish, Louisiana, had the highest rate of deaths from cardiovascular disease of any county in the country from 2016 to 2018. In Franklin Parish, the rate of fatalities was more than two times greater than the average rate in every county in the entire country.

We found that Franklin Parish is also in the bottom quartile of all counties for poverty. While the national poverty rate is about 10.5%, more than 27% of the people in Franklin Parish live below the poverty line. In fact, on average, more than a quarter of people live in poverty in the 10 counties with the highest rates of cardiovascular deaths.

While Franklin Parish led the country in fatal cases of heart disease among seniors, Desha County, Arkansas, had the highest rate of deaths among middle-aged residents. Desha County, where the poverty rate was over 23%, is especially notable for the number of people killed by heart attacks. In Desha County, there were 294 deaths per 100,000 people from heart attacks. For comparison, the nationwide per-county average for heart attacks among all people was about 41 per 100,000 — a seven-fold increase in Desha County.

These counties have the highest rates of fatal heart disease cases

counties with most heart disease deaths

Access to health care can be another problem facing areas that have notably high rates of cardiovascular deaths. From 2016 to 2018, there were 683 counties that had no hospitals. Of the 10 counties most at risk of fatal cases of heart disease, there were four counties with zero hospitals. Additionally, while the number of uninsured residents in the most at-risk counties is mostly aligned with the national average, the cost of Medicare per capita is higher than average in six of 10.

At this moment, it's difficult to determine what effect the rate of fatal heart disease cases will have on the number of COVID-19 deaths at the end of the coronavirus pandemic. The rural quality of the most at-risk counties may have limited the transmission of COVID-19, resulting in a lower mortality rate than what's been observed on a national level. But, considering the CDC's warning that heart disease does exacerbate the effects of COVID-19, more densely populated counties with unreliable access to medical care and a history of preexisting conditions could result in more COVID-19-related deaths.


ValuePenguin analyzed heart disease data published by the CDC for middle-aged adults (age 45 to 64) and seniors. We consolidated the CDC's state and county information to break down the effects that heart attacks, coronary heart disease, hypertension and stroke have on communities across the country. The numbers presented in this study comprise deaths per 100,000 residents from 2016 to 2018 — the most recent data published by the CDC. The CDC's extensive databases also gave us information on the cost of Medicare, the number of uninsured Americans and those living in poverty.