Heart Disease and Diseases of the Circulatory System in Westchester

Westchester County 2016.01

Department of Health KEEP HEALTHY @wchealthdept AND Community Health Assessment Data Update GET #keephealthy THE STATS

In this issue:  Heart disease as a Heart disease is the number one cause of death in Westchester County. leading cause of death in Westchester county In 2012, heart disease accounted for 2,113 deaths or 31% of all deaths  Deaths due to heart disease across different in the county. Adding in 490 deaths due to stroke and other diseases population and risk of the circulatory system, total deaths from circulatory disease are groups 60% higher than the next leading cause of death - cancer.  Hospitalizations due to cardiovascular disease- related conditions, Selected Causes of Death in Westchester County, 2012 including diseases of the heart  Emergency room visits 2% 3% 7% due to cardiovascular disease-related 3% conditions  Selected risk factors 4% that contribute to Heart Disease, cardiovascular disease 4% in Westchester county 31% 5%

9% Cerebrovascular Jiali Li, Ph.D. Director of Disease (Stroke), Research & Evaluation Neoplasms 5% Planning & Evaluation (Cancer), 24% Other Circulatory, Renee Recchia, MPH 3% Acting Deputy Commissioner of Administration Heart Disease Cerebrovascular Disease (Stroke) Project Staff: Other Circulatory Neoplasms (Cancer) Bonnie Lam, MPH Respiratory Diseases External Causes (e.g. accidents) Medical Data Analyst Communicable Diseases Nervous System Diseases Milagros Venuti, MPA Digestive System Diseases Endocrine/Metabolic Diseases Assistant Statistician Genitourinary System All Other Causes

Robert P. Astorino, Westchester County Executive

Sherlita Amler, MD, Commissioner of Health

Heart Disease By Age and Sex

Heart and Circulatory System Disease-Related Deaths by Age Group, Westchester County, 2012

2000

Heart Disease 317 1500

Other Circulatory Disease

1000 Deaths 1442 500 117 44 398 12 214 0 59 0-49 years 50-64 years 65-79 years 80+ years Age Group

Myth: “Heart disease is for old people”

Deaths from heart disease were observed across the age spectrum from young to old. In 2012, there were 273 premature deaths (under 65 years) due to heart disease and an additional 56 premature deaths due to stroke and other circulatory disease. In total, there were 329 premature deaths due to heart and circulatory system diseases.

Myth: “It’s a man’s disease”

In Westchester County  women accounted for 54 of every 100 deaths from heart disease.

Heart Disease By Race and Ethnicity

Heart and Circulatory Disease-Related Deaths as Percentage of All Deaths by Race and Ethnicity, Westchester County, 2012

All Circulatory Disease [CD] Deaths CD Deaths as % of All Deaths

2500 45.0% 38.6% 37.3% 40.0%

2000 35.0% 28.6% 30.0% 1500 25.0%

2191 20.0% 1000 15.0% 500 10.0% 5.0% 345 131 0 0.0% White Black Hispanic

 In 2012, over one-third of all deaths among White and Black individuals and more than one-quarter of all deaths among Hispanics in Westchester County were due to heart and circulatory system diseases.

Heart Disease-Related Deaths as Percentage of All Deaths by Race and Ethnicity, Westchester County, 2012

Heart Disease [HD] Deaths HD Deaths as % of All Deaths

2000 35.0% 31.5% 29.8% 30.0% 1600 22.5% 25.0%

1200 20.0%

1784 800 15.0% 10.0% 400 5.0% 276 103 0 0.0% White Black Hispanic

Heart Disease by Race and Ethnicity

Premature Deaths (before 65 years) as a Percentage of All Deaths due to Heart and Circulatory Diseases by Race and Ethnicity, Westchester County, 2012

40.0% 34.0% 35.0% 31.3% Circulatory System Diseases 30.0% Heart Disease 24.1% 25.0% 21.6% 20.0%

15.0% 12.7% 12.7% 10.7% 11.0% 10.0%

5.0%

0.0% Total White Black Hispanic

 Among those who died of heart disease and other circulatory system diseases, individuals who are Black or Hispanic were more likely to die prematurely before the age of 65.

Ratio of the Percentage of Premature Deaths due to Diseases of

the Heart by Race and Ethnicity, Westchester County, 2012

4.00

3.10 3.00

1.97

2.00 PrematureDeaths

Ratio Ratio Percentage of of 1.00

0.00 Non-Hispanic Black to Non-Hispanic White Hispanic to Non-Hispanic White

Heart Disease: Hospitalizations

Cardiovascular Related Hospitalizations, Westchester County, 2011-2013

18,000

15,495 14,865 14,461

15,000 All Cardiovascular Diseases (includes stroke) 12,000

9,000 10,411 9,928 9,769

6,000 Diseases of the Heart TotalHospitalizations 3,000

0 2011 2012 2013 Year

 From 2011 to 2013, approximately 14% of all Westchester hospital admissions had heart disease, stroke, or other circulatory system disease as the primary diagnosis.

More than 50% of all Westchester hospital admissions had at least one diagnosis related to diseases of the circulatory system.

Coronary heart disease and congestive heart failure are the leading primary diagnoses among those hospitalized due to diseases of the heart and circulatory system. 

18,000

Coronary Heart 15,000 Disease Congestive Heart 12,000 Failure Heart Attack 9,000 Hypertension

6,000 TotalHospitalizations

3,000 Stroke

0 All other Cardiovascular 2011 2012 2013 Year

Heart Disease: Emergency Room Admissions

Emergency Room Visits due to Cardiovascular Disease Related Events, Westchester County, 2010

Other Diseases of

the Cardiovascular System 27% Discomfort in Chest 36%

Hypertensive Disease

Cerebrovascular Disease (stroke) Ischemic Heart 9% Disease Heart Failure 11% 9%

In 2010, there were a total of 29,486 emergency room visits due to diseases of the cardiovascular system.

This accounts for nearly 10% of all emergency room visits in Westchester County. The largest proportion can be attributed to discomfort in the chest.

 Discomfort in the chest  Ischemic heart disease is can occur when the heart the term given to heart muscle doesn't get enough problems caused by oxygen-rich blood, a narrowed heart arteries. symptom of heart disease.

Selected Cardiovascular Disease Risk Factors for Westchester County, 2013-2014

Obesity Physical Activity

35 100

30 25 75 20 50 94.5% 15 30.9% 77.2% 78.7% 24.7% Days 72.9% 73.4% 10 18.1% 16.8% 25

5 %Adults Who Are Obese 0 0 25-34 yrs 35-44 yrs 45-64 yrs 65+ yrs % Reporting Activity Past in 30 18-24 25-34 35-44 45-64 65+ Age Group Age Group

NH White, NH Black, Hispanic, NH White, NH Black, Hispanic, 17.8% 39.7% 28.1% 83.4% 78.2% 62.0%

 Adults in the 35-44 age group and identified  Adults in the 35-44 age group and identified as Non-Hispanic Black reported more obesity as Hispanic were the least likely to report any than other age groups and race/ethnicities. physical activity in the past 30 days.

High Blood Pressure Diabetes

70 25 60 20

50 40 15 30 59.5% 10 19.9% 20 28.0% 5

10 6.9% % Adults % withPhysician

NA NA 13.8% Diagnosed Diabetes NA NA NA % Adults with Physician %Physician with Adults

DiagnosedHigh BloodPressure 0 0 18-24 25-34 35-44 45-64 65+ 18-24 25-34 35-44 45-64 65+

Age Group Age Group

NH White, NH Black, Hispanic, NH White, NH Black, 25.7% 45.5% 17.3% 4.7% 17.7%

 Adults in the 65+ age group and identified  Adults in the 65+ age group and identified as Non-Hispanic Black reported the most physician- as Non-Hispanic Black reported the most physician- diagnosed high blood pressure compared to other diagnosed diabetes compared to the 45-64 age group age groups and race/ethnicities. and Non-Hispanic Whites.

Data Sources and Other Resources

Data Sources

1. New York State Department of Health: a. Vital Statistics b. Statewide Planning and Research Cooperative System (SPARCS) c. Behavioral Risk Factor Surveillance System (BRFSS)

2. US Census Bureau - American Community Survey 1-Year Estimates for Westchester County - used to calculate rates.

Other Resources

1. Centers for Disease Control and Prevention (CDC), Division for Heart Disease and Stroke Prevention (DHDSP) homepage. Available at http://www.cdc.gov/dhdsp/.

2. National Institutes of Health, U.S. National Library of Medicine, Health Topics: Blood, Heart and Circulation. Available at https://www.nlm.nih.gov/medlineplus/bloodheartandcirculation.html.  Health Topic: Heart Diseases. Available at https://www.nlm.nih.gov/medlineplus/heartdiseases.html  Health Topic: Vascular Diseases. Available at https://www.nlm.nih.gov/medlineplus/vasculardiseases.html

3. American Heart Association (AHA) homepage. Available at http://www.heart.org/HEARTORG/.

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