News Release

Report On Heart Disease And Stroke Lists Hospitalization Rates By Counties

Peer-Reviewed Publication

University of California - San Francisco

Ten California counties have significantly higher hospitalization rates for coronary heart disease compared to the rest of the state, according to a new report by UC San Francisco and the California Department of Health Services. The majority of the counties with higher hospitalization rates for Ischemic Heart Disease (IHD), commonly known as coronary artery and heart disease, are located in the central valley and southern California including Merced, Los Angeles, Tulare, Kern, Stanislaus, San Bernardino, San Joaquin, Riverside, Alameda and Kings.

IHD includes heart attacks and related heart problems caused by a narrowing of the coronary arteries and a subsequent decreased supply of blood and oxygen to the heart.

In addition, the report found that seven California counties have higher hospitalization rates for stroke compared to the statewide level. These seven counties are Tulare, Los Angeles, Alameda, Kern, San Francisco, Merced, and San Bernardino.

"This study examines hospital stays for heart disease and stroke at a county level," said Jeannie Gazzaniga, PhD, RD, epidemiologist, Institute for Health and Aging, UCSF School of Nursing, and co-author of the study. "It gives us the opportunity to identify high risk areas and groups and to let leaders in these areas know there is a problem and that there are solutions; heart disease and stroke are largely preventable."

She added that many counties in California have developed heart healthy policies such as expanding farmer's markets, promoting biking and walking, economically developed impoverished areas, and creating zoning laws to reduce air pollution. Researchers used hospital discharge data from the Office of Statewide Health Planning and Development (OSHPD) collected from all California hospitals, except federal facilities, to calculate rates in all 58 California counties for the years 1989-1991.

The report is released today, Wednesday, July 22, 1998, by the Cardiovascular Disease Outreach, Resources and Epidemiology (CORE) Program. CORE was established in 1992 by Patrick Fox, PhD, associate professor, UCSF School of Nursing, and member of the UCSF Institute for Health and Aging, through an interagency agreement with the California Department of Health Services. The report also found that IHD and stroke accounted for 27 percent of all non-pregnancy related hospitalizations in California from 1989-1991. In addition, close to one million California residents were hospitalized for IHD and 400,000 for stroke. Men accounted for 55 percent of the IHD hospitalizations and women for 45 percent; and there were 18 percent more stroke hospitalizations for women than men.

According to the study, hospitalization rates for IHD and stroke varied dramatically by race/ethnicity throughout California. Statewide, white men had the highest hospitalization rate for IHD with 323 hospitalizations per 10,000 people followed by black women (299) and black men (292). Stroke hospitalization rates were significantly higher for black women and black men compared to both genders for whites, Hispanics and others. Black women were reported as having the highest incidence of stroke hospitalizations (201) while Hispanic men (83) and women (85) had the lowest.

"Leaders in counties with high rates can play an important role in bringing the study results and ideas for solutions to the attention of community leaders," said Chi Kao, PhD, biostatistician, Institute for Health and Aging, UCSF School of Nursing, and co-author of the study. "Hospitals, county governments, businesses and neighborhood associations can all contribute to healthier communities."

The CORE Program was created to heighten awareness of cardiovascular disease among Californians and to focus on gathering resources to combat the disease. For a copy of the report, The Burden of Cardiovascular Disease: Hospitalizations for Heart Disease and Stroke in California Counties, please contact the CORE Program at 916-324-1329, FAX 916-324-7764 or email at farvizo@hw1.cahwnet.gov.

Rank Of Counties With Significantly Higher IHD Hospitalization Rates In California From 1989-1991

COUNTY RATE PER 10,000 PEOPLE
Merced 351.53
Los Angeles 348.45
Tulare 334.27
Kern 319.71
Stanislaus 303.89
San Bernardino 300.05
San Joaquin 295.68
Riverside 274.88
Alameda 273.88
Kings 271.76

California Rate: 252.24

All other counties are either not significantly different that the state rate, have insufficient numbers in the less populated counties or are lower than the state rate. Rates are age, race, and sex adjusted to the 1990 California population.

Ranks Of Counties With Significantly Higher Stroke Hospitalization Rates From 1989-1991

COUNTY RATE PER 10,000 POPULATION
Tulare 120.85
Los Angeles 117.97
Alameda 117.82
Kern 117.52
San Francisco 115.98
Merced 110.63
San Bernardino 107.55

California Rate: 104.22

All other counties are either not significantly different than the state rate, have insufficient numbers in the less populated counties or are lower than the state rate. Rates are age, race, and sex adjusted to the 1990 California population.

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