ups. "The general perception is that death rates are much higher in African Americans males compared to Caucasians," Sekikawa says. "But we found considerable variation from state to state. For example, in 1994, African Americans in Mississippi, ages 35 to 44, had a death rate of 89 per 100,000. In New Jersey, the death rate for that group was 28 per 100,000, a rate very similar to that of Caucasians in that state -- 26 per 100,000."

The regional differences were seen in the death rates for Caucasians. In Tennessee, Caucasian males had a death rate of 47 per 100,000, compared to a rate of 18 per 100,000 for Kansas -- the state with the lowest heart disease death rate.

The researchers also found a link between educational levels and the risk of early death from heart disease. States with the highest number of men who did not graduate from high school also had the highest mortality rates, whereas the states with the most male high school graduates had the lowest mortality rates. "We found dramatic differences among the states with regard to early death from heart disease," says study co-author Lewis H. Kuller, M.D., Ph.D, professor and chairman of epidemiology at the University of Pittsburgh School of Public Health. "In the United States, heart disease deaths are strongly associated with both cigarette smoking and, to a lesser degree, with educational level. These tremendous differences throughout the U.S. are due to the differences in lifestyles.

"These differences tell us a great deal about a huge public health problem -- the inequality of heart disease in this country," says Kuller.

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Contact: Carole Bullock
caroleb@heart.org
214-706-1279
American Heart Association
7-Nov-1999

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