Evaluating Heart Disease Presciptions-Filled as A Proxy for Heart Disease Prevalence Rates

Abstract

Heart disease is the leading cause of death in the U.S. Yet, prevalence rates are not reported at the county level. Not knowing how many have the disease, and where they are, may be a knowledge barrier to effective health care interventions. We use heart disease drug prescriptions-filled as a proxy measure for prevalence of heart disease. We test the correlation to the Behavioral Risk Factor Surveillance System (BRFSS) and find positive, statistically significant correlations. Next we illustrate the geographic patterns revealed using the county-level prevalence estimate maps. This information can be used to provide a better understanding of sub-state variations in disease patterns and subsequently target the delivery of health resources to small areas in need.

Get full access to this article

View all access options for this article.

References

American Heart Association. (2004) “Statistical Fact Sheet – Populations: At-a-glance Summary Tables Men and Cardiovascular Diseases.” 16 August 2006 <http://www.americanheart.org/presenter.jhtml?identifier=2011>.

Anderson

R. N.

and Rosenberg

H. M.

(1998) “Age Standardization of Death Rates: Implementation of the Year 2000 Standard.” National Center for Health Statistics. National Vital Statistics Reports 47(3).

Anderson

R. N.

and Rosenberg

H. M.

(1998) “Report on the Second Workshop on Age Adjustment.” National Center for Health Statistics. National Vital Health Statistics 4(30).

Anderson

R. N.

and Smith

B. L.

(2005) “Table C: Deaths and Percentage of Total Deaths for the 10 Leading Causes of Death: United States, 2001–02.” National Vital Statistics Reports, 53(17):7. 16 August 2006 <http://www.cdc.gov/nchs/data/nvsr/nvsr53/nvsr53_17.pdf>.

Ayanian

J. Z.

(2003 “Is Geography Destiny? Illuminating the Survival Advantage of Elderly Patients in New England after Acute Myocardial Infarction.” American Heart Journal. 146(2):207–209.

Azambuja

M. I.

and Duncan

B. B.

(2002 “Similarities in Mortality Patterns from Influenza in the First Half of the 20th Century and the Rise and Fall of Ischemic Heart Disease in the United States: A New Hypothesis Concerning the Coronary Heart Disease Epidemic.” Cadernos de Saude Pubica. 18(3):557–566.

Barnett

and Halverson

(2000 “Disparities in Premature Coronary Heart Disease Mortality by Region and Urbanicity among Black and White Adults Ages 35–64, 1985–1995.” Public Health Reports. 115(1):52–64.

Barnett

, Casper

M.L.

, Halverson

J.A.

, Elmes

G.A.

, Brahan

V.E.

, Majeed

Z.A.

, Bloom

A.S.

and Stanley

(2001) Men and Heart Disease: An Atlas of Racial and Ethnic Disparities in Mortality. Office for Social and Environment and Health Research, West Virginia University: Morgantown, WA. December 9, 2006 <http://0-www.cdc.gov.mill1.sjlibrary.org/dhdsp/library/maps/cvdatlas/atlas_mens/mens_download.htm>.

Beaglehole

and Magnus

(2002 “The Search for New Risk Factors for Coronary Heart Disease: Occupational Therapy for Epidemiologists?” International Journal of Epidemiology. 31:1117–1122.

10.

Blalock

H. M.

(1979) Social Statistics, Revised 2nd Edition, Upper Saddle River, New Jersey: McGraw-Hill, Inc.

11.

Brewer

(2003) Color Brewer: Web Tool for Selecting Colors for Maps, Pennsylvania State University, 16 August 2006 <http://www.personal.psu.edu/cab38/ColorBrewer/ColorBrewer_intro.html>.

12.

Brook

R. D.

, Franklin

, Cascio

, Hong

, Howard G., and others. (2004 “Air Pollution and Cardiovascular Disease: A Statement for Healthcare Professionals from the Expert Panel on Population and Prevention Science of the American Heart Association.” Circulation. 109(21):2655–2671.

13.

Centers for Disease Control and Prevention. CDC Wonder. 16 August 2006 <http://wonder.cdc.gov>.

14.

Centers for Disease Control and Prevention. (2004) Behavioral Risk Factor Surveillance System Survey, Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. 16 August 2006 < http://www.cdc.gov/brfss/index.htm>.

15.

Centers for Disease Control and Prevention. (1999) Behavioral Risk Factor Surveillance System Survey Questionnaire. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.

16.

Centers for Disease Control and Prevention. (2001) Behavioral Risk Factor Surveillance System Survey Questionnaire. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.

17.

Centers for Disease Control and Prevention. (2003) Behavioral Risk Factor Surveillance System Survey Questionnaire. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.

18.

Cooper

, Fortmann

S. P.

, Hogelin

, Friedman

, Cutler

, Desvigne-Nickens

, McGovern

, Havlik

and Marler

(2000) “Trends and Disparities in Coronary Heart Disease, Stroke, and Other Cardiovascular Diseases in the United States: Findings of the National Conference on Cardiovascular Disease Prevention.” Circulation. 102(25):3137–3147.

19.

Cossman

Jeralynn S.

, Cossman

R. E.

, James

W. L.

, Campbell

C.R.

, Blanchard

T.C.

and Cosby

A. G.

. “Persistent Clusters of Mortality in the U.S.” American Journal of Public Health. Forthcoming. Accepted for publication August 2006.

20.

Cossman

R. E.

, Cossman

J. S.

, Jackson

, and Cosby

(2003) “Mapping High or Low Mortality Places Across Time in the U.S.: A Research Note on a Health Visualization and Analysis Project.” Health & Place 9(4)361–369.

21.

Cossman

R. E.

and James

W. L.

(2003) “Characteristics of “Healthy and Unhealthy” Places in the U.S.” Presentation made to the Southern Demographic Association Annual Meeting. October 23–25, 2003. Arlington, VA.

22.

Cossman

R. E.

, Blanchard

T. C.

, James

W. L.

, Jackson-Belli

, and Cosby

(2002) “Healthy and Unhealthy Places in America: Are These Really Spatial Clusters?” Proceedings of the 22nd Annual ESRI International User Conference. ESRI Library 16 August 2006 <http://gis.esri.com/library/userconf/proc02/pap1064/p1064.htm>.

23.

Dartmouth Medical School.

24.

Wennberg

J.E.

Series Editor. (1998) The Darmought Atlas of Health Care 1998. Center for the Evaluative Clinical Science. Dartmouth Medical School, Hanover, New Hampshire.

25.

Geiss

L. S.

, William

W. H.

, and Smith

P. J.

(1995) “Chapter 11: Mortality in Non-Insulin-Dependent Diabetes.” In Diabetes in America, 2nd edition. National Diabetes Data Group, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Disease (NIH Publication No. 95–1468). p. 236. 16 August 2006 <http://diabetes,niddk.nih.gov/dm/pubs/america/>.

26.

Gillum

R. F.

(1994 “Prevalence of Cardiovascular and Pulmonary Disease and Risk Factors by Region and Urbanization in the United States.” Journal of the National Medical Association. 86(2):105–112.

27.

Goodman

D. C.

, Mick

S. S.

, Bott

, Stukel

, Chang

, Martin N., and others. (2003) “Primary Care Service Areas: A New Tool for the Evaluation of Primary Care Services.” Health Services Research 38(1–p1):287–309.

28.

Hajjar

and Kotchen

(2003 “Regional Variations of Blood Pressure in the United States are Associated with Regional Variations in Dietary Intakes: The NHANES-III data.” The Journal of Nutrition. 133:211–214.

29.

Hahn

R. A.

, Heath

G. W.

, and Chang

M. H.

(1998 “Cardiovascular Disease Risk Factors and Preventive Practices among Adults – United States, 1994: A Behavioral Risk Factor Atlas.” MMWR CDC Surveillance Summary. 47(5):35–69.

30.

IMS Health, IMS National Disease and Therapeutic Index™, Plymouth Meeting PA. (2004) “Heart Disease Therapeutic Classes from 1999–2003 Database.” October 2004. Database.

31.

IMS Health, IMS Xponent™, Plymouth Meeting PA. (2004) “Heart Disease, Stroke and Diabetes therapeutic classes from 1999–2003 Database.” December 2004. Database.

32.

IMS Health. (2005) U.S. Prescription Activity by Channel, 2004. National Prescription Audit Plus, 2005. 16 August 2006 <http://www.imshealth.com/ims/portal/front/articleC/0,2777,6599_49695974_68913551,00.html>.

33.

James

W. L.

, Cossman

R. E.

, Cossman

J. S.

, Campbell

, and Blanchard

(2004) “A Brief Visual Primer for the Mapping of Mortality Trend Data.” International Journal of Health Geographics 3(7). 16 August 2006 <http://www.ij-healthgeographics.com/content/3/1/7>.

34.

Krause

R. M.

(1979) “The Influence of Infection on the Geography of Heart Disease.” Circulation. 60(5):972–976.

35.

Krumholz

H. M.

, Chen

, Rathore

S. S.

, Wany

, and Radford

M. J.

(2003) “Regional Variation in the Treatment and Outcomes of Myocardial Infarction: Investigating New England's Advantage.” American Heart Journal 146(2):242–249.

36.

Levin

, Lamar-Welch

V. L.

, Bell

R. A.

and Casper

M. L.

(2002 “Geographic Variation in Cardiovascular Disease Risk Factors among American Indians and Comparisons with the Corresponding State Populations.” Ethnicity & Health. 7(1):57–67.

37.

Levy

J. L.

, Houseman

E. A.

, Spengler

J. D.

, Loh

and Ryan

(2001) “Fine Particulate Matter and Polycyclic Aromatic Hydrocarbon Concentration Patterns in Roxbury, Massachusetts: A Community-Based GIS Analysis.” Environmental Health Perspectives. 109 (4): 341–347.

38.

Levy

J. L.

, Greco

S. L.

, and Spengler

J. D.

(2002) “The Importance of Population Susceptibility for Air Pollution Risk Assessment: A Case Study of Power Plants Near Washington, D.C.” Environmental Health Perspectives. 110 (12): 1253–1260.

39.

MacEachren

(2000 “What Is a Map?” Online Research Penn State. 21(2). 16 August 2006 <http://www.rps.psu.edu/0005/mapedge.html>.

40.

Marmot

(2001 “Inequalities in Health.” New England Journal of Medicine. 345(2):121.

41.

Mummolo

“Health: Mapping a Disease.” Newsweek Magazine. August 21, 2006. p. 12.

42.

National Center for Health Statistics. (2000) Compressed Mortality File: 1968–88. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Hyattsville, Maryland.

43.

National Center for Health Statistics. (2001a) Compressed Mortality File: 1989–98. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Hyattsville, Maryland.

44.

National Center for Health Statistics. (2001b) Documentation for the Compressed Mortality File: 1989–98. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Hyattsville, Maryland.

45.

National Center for Health Statistics. (2005) NAMCS Description. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Hyattsville, Maryland. 16 August 2006 <http://www.cdc.gov/nchs/about/major/ahcd/namcsdes.htm>.

46.

Openshaw

and Turner

(1997) GIS in Health and Crime Analysis. School of Geography, University of Leeds. 16 August 2006 <http://www.geog.leeds.ac.uk/presentations/97-2/>.

47.

Patterson

K. D.

and Pyle

G. F.

(1991 “The Geography and Mortality of the 1918 Influenza Pandemic.” Bulletin of Historical Medicine. 65(1):4–12.

48.

Pearson

, Barker

M. E.

, Russell

, and Campbell

M. J.

(2005) “Do Food Deserts Influence Fruit and Vegetable Consumption? – A Cross-Sectional Study.” Appetite. 45(2):195–197.

49.

Pickle

L. W.

and Gillum

R. F.

(1999 “Geographic Variation in Cardiovascular Disease Mortality in US Blacks and Whites.” Journal of the National Medical Association. 91(10):545–556.

50.

Rith-Najarian

S. J.

, Gohdes

D. M.

, Shields

, Skipper

, Moore K. R., and others. (2002 “Regional Variation in Cardiovascular Disease Risk Factors among American Indians and Alaska Natives with Diabetes.” Diabetes Care. 25(2):279–283.

51.

Shaw

H. J.

(2006) “Food Deserts: Towards the Development of a Classification.” Geografiska Annaler Series B: Human Geography. 88 (2):231.

52.

Smith

L. J.

, Harper

, and Hillemeier

(2004) “Is Income Inequality a Determinant of Population Health?” Part 2. The Milbank Quarterly. 82(2):355–400.

53.

Stagnitti

M. N.

and Pancholi

(2004) Chronic Conditions and Outpatient Prescription Medicines for Persons 18 and Older in the U.S. Civilian Noninstitutionalized Population, 1987 and 2001. Statistics Brief #58, Agency for Healthcare Research and Quality. 16 August 2006 <http://www.meps,ahrq.gov/papers/st58/stat58.pdf>.

54.

Stuchlak

Senior Principal, IMS Management Consulting, Plymouth Meeting, PA <wstuchlak@us.imshealth.com>. Re: IMS Data, email to Ronald E. Cossman. March 31, 2006.

55.

Taylor

H. A.

, Hughes

G. D.

, and Garrison

R. J.

(2002 “Cardiovascular Disease among Women Residing in Rural America: Epidemiology, Explanations, and Challenges.” American Journal of Public Health. 92(4): 548–551.

56.

Thom

, Haase

, Rosamond

, Howard

, Rumsfeld J., and others. (2006a update) “Heart Disease and Stroke Statistics.” A Report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. p. 3. 11 January 2006 <http://circ.ahajournals.org>.

57.

Thom

, Haase

, Rosamond

, Howard

, Rumsfeld J, and others. (2006b update) “Heart Disease and Stroke Statistics.” A Report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. p. 2. 11 January 2006 <http://circ.ahajournals.org>.