Striking variation in coronary heart disease mortality in the United States among black and white women aged 45-54 by state

Coronary heart disease (CHD) is the leading cause of death for women in the United States. There has been a substantial decrease in CHD mortality in t he past few decades in the United States for both women and men. The change in lifestyle after World War II may affect the incidence of and mortality from CHD in a more recent birth cohort, such as the 45-54-year-old age grou p. CHD mortality among women aged 45-54 by state and race in the United Sta tes and other countries in 1994 was evaluated. Correlation of the CHD morta lity with state-specific and race-specific educational attainment (% of not a high school graduate) and state-specific prevalence of smoking was exami ned. There was a 2.5-fold difference in CHD mortality (ICD 410-414, 429.2) between black and white women aged 45-54: 78/100,000 for black versus 31/10 0,000 for white women; a 3-fold difference in CHD mortality among white wom en by state: 16/100,000 in Colorado versus 53/100,000 In Louisiana; and a 3 -fold difference in CHD mortality among black women by state: 45/100,000 in New Jersey versus 124/100,000 in Arkansas. CHD mortality was correlated wi th educational attainment among white women (r = 0.62, p = 0.001) and with prevalence of smoking (r = 0.39, p = 0.021). There is a large variation in CHD mortality among women aged 45-54 in the United States by race and state . These differences may reflect variations in coronary risk factors. More d etailed evaluation of determinants of CHD mortality by area is needed, as a re public health programs that can reduce the marked disparity in CHD morta lity in the United States.