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Atlas details heart disease, stroke in Indian Country
Tuesday, May 17, 2005

• PDF: Stroke Death Rates
Source: Atlas of Heart Disease and Stroke Among American Indians and Alaska Natives

Heart disease is now the leading cause of death among American Indians and Alaska Natives, federal health officials reported on Monday.

Native Americans suffer from coronary heart disease at nearly twice the rate of the general population, according to the Indian Health Service and the Centers for Disease Control and Prevention. Additionally, the rates for early cardiovascular disease appear to be higher than any other racial or ethnic group in the country.

Stroke also has become the sixth major killer of Native Americans, the two health agencies said. By the end of the 1990s, stroke deaths were 14 percent higher among American Indians and Alaska Natives than for the rest of the population.

Highlighting the disparities, heart disease and stroke deaths have declined in the United States. The same can't be said for Indian Country, officials warned.

"These alarming trends underscore the importance of enhancing our efforts to support innovative, community-based strategies for reducing the risk for heart disease and stroke among American Indians and Alaska Natives," said Darwin R. Laberthe, the acting chief of the Cardiovascular Health Branch at the CDC.

The publication of the "Atlas of Heart Disease and Stroke Among American Indians and Alaska Natives," is part of that effort, added Dr. Charles Grim, a member of the Cherokee Nation and the director of the IHS. He said the dissemination of information will give greater insight into where heart disease and stroke occur in Indian Country and, perhaps more importantly, how they might be prevented.

The atlas provides county-by-county maps of heart disease and stroke deaths among Native Americans. It also provides state-specific rates of eight major risk factors -- including diabetes, which has reached epidemic levels in Indian Country -- for these two problems.

Nationally, the age-adjusted death rate for heart disease was 278 per 100,000 for Native women and 445 per 100,000 for Native men during 1996-2000. Native people in certain parts of the country, however, are more prone to heart disease deaths, according to the data.

"The map indicates that the highest heart disease death rates were located primarily in South and North Dakota, Wisconsin and Michigan," the report stated. The Plains and the Great Lakes are home to dozens of tribes.

The map also shows high heart disease death rates in counties along the North Carolina-South Carolina border, where the Eastern Cherokee Band and the Lumbee Tribe are located, and in Mississippi and Oklahoma, where dozens more tribes are based.

On the other hand, low rates were seen mostly in California, home to the largest number of Native Americans, and Florida, home to two tribes. Deaths were also lower than average in the Southwest, home to dozens of tribes, including the Navajo Nation, the largest in the country.

For strokes, the nationally age-adjusted death for Native women was 77 per 10,000 and for Native men, it was 80 per 100,000 from 1991-1998. Again, Natives in certain areas were more prone to stroke deaths but the pattern differed somewhat from the heart disease death analysis.

"Counties with high rates were reported primarily in Alaska, Washington, Idaho, Montana, Wyoming, South Dakota, Wisconsin and Minnesota," the report stated, with the North Carolina-South Carolina border making a reappearance. On the other hand, low stroke death rates were reported in central Oklahoma and southern California.

The risk factors associated with heart disease and stroke, not surprisingly, can be correlated to counties with high and low death rates. The atlas shows state-by-state prevalence of high blood pressure, high cholesterol, cholesterol screening, diabetes, cigarette smoking, obesity, physical inactivity and poor health.

For example, Natives in New Mexico and southern California suffered fewer heart disease and stroke death rates than other Native Americans. They also were less likely to have high blood pressure and high cholesterol, more likely to have cholesterol screening, less likely to smoke cigarettes and more likely to exercise on a regular basis.

But Natives who suffered from high heart disease and stroke death rates were more likely to have high blood pressure and high cholesterol, less likely to have cholesterol screening, more likely to smoke and less likely to exercise.

However, there was one common risk factor across Indian Country. In nearly every county and state, American Indians and Alaska Natives suffered from high rates of diabetes and obesity, which both contribute to heart disease and stroke.

The atlas is the latest government report to show disparities in health among American Indians and Alaska Natives. Data shows that Native people suffer from the highest rates of certain chronic diseases, infant mortality, certain sexually transmitted diseases and unintentional injuries.

Get the Data:
Atlas of Heart Disease and Stroke Among American Indians and Alaska Natives (May 2005)

Relevant Links:
Indian Health Service - http://www.ihs.gov
Cardiovascular Health, CDC - http://www.cdc.gov/cvh