The Atlas of American Society

6. Health and Disease

6 Health and Disease 6.1 OVERAL L HEALT H The Northwestern Nationa l Life Insuranc e Company ha s developed a comprehensive ranking of th e relativ e healthfulnes s o f th e 5 0 state s based o n 1 7 components tha t measur e disease , lifestyle, acces s to health care, occupational safet y an d disability, and mortality. The 1 7 components include : prevalenc e o f smoking ; moto r vehicl e deaths ; violen t crime ; ris k fo r hear t disease; high schoo l graduation ; unemployment; adequac y o f prenatal care ; lack of acces s to primary medica l care ; suppor t fo r publi c healt h care ; occupational fatalities ; wor k disabilit y status; heart disease; cancer cases; infectious disease; total mortality; infant mortality; and premature death. Many of these variables are mapped in this atlas. The overall pattern of social and bodily health serve s a s a n excellen t introductio n t o thi s sectio n o n Healt h an d Disease . The states are divided into categories of average, above average and below average health based o n Northwester n Nationa l Life' s score s fo r 1993 . Tw o regions stan d ou t a s area s o f above-average health: New England (except Rhode Island), and a band of western and interior states from Utah to Wisconsin. Virginia and Hawaii are the only two states with above-average scores that lie outside these two regions. States scoring below average are even more distinctly clustered. The y for m on e large bloc throughout th e South eas t of Texa s an d Oklahoma , an d extend north into Kentucky an d Wes t Virginia. Alaska, New Mexico an d Nevada ar e outliers in the below-average category. In this ranking system, Michigan has the most average or typical pattern o f overal l health . Th e highes t ranke d state , Minnesota (wit h a score o f +22) , lies a t the opposite end of a north-south axi s from th e lowest-ranked state , Mississippi (wit h a score of minu s 19) . Many o f the indicators o f health selecte d b y Northwestern measur e disease s tha t wil l be shown on the maps in this section . A s an introduction t o these maps, the chart below show s the leading causes of death in the United States. Heart disease alone kills one-third of Americans; cancer account s fo r anothe r 2 4 percent. Afte r thes e two leading cause s of death , only strok e (6.6%) is responsible for a significant portion of American deaths. The chart also shows several causes of death not related to disease: accidents (4% of deaths); suicide (1.4%); and homicide (1.2%). LEADING CAUSES OF DEATH, 1992 CANCER 23.9 % ALL OTHER CAUSE S 18.3 % HEART DISEAS E 33.1 % Source: National Center for Health Statistics 78 6.1 OVERAL L HEALT H NORTHWESTERN NATIONA L LIF E RANKINGS , 199 3 79 6.2 HEAR T DISEAS E Heart diseas e is the leadin g caus e of deat h i n the United States . It account s fo r one-thir d of deaths, more than cancer, which accounts for about 24 percent. Coronary disease killed almost half a million American s i n 1990 , about 300,00 0 o f who m die d befor e reachin g a hospital. The most obvious form of heart disease is heart attack. Other important forms of heart disease include rheumati c hear t disease , congenita l hear t defect s an d congestiv e hear t failure . The death rate from heart disease is highest for white males (148 deaths per 100,000 population) but slightly lower (143) for black males. While women had significantly lowe r rates than men, the rate was higher for black wome n (91 ) than for whit e women (71) . Women , however, ar e more likely to have a second heart attac k within four year s afte r th e first tha n men ; they ar e more likel y t o di e withi n a year fro m th e attac k tha n ar e me n (39 % to 31%) , and a t olde...