Colorado heart attack resources
CDPHE: Heart Disease and Stoke Prevention
National heart attack resources
National Environmental Public Health Tracking Network: Heart Attacks and Environment
American Heart Association: Air Pollution and Cardiovascular Disease
CDC: Heart Attack
EPA: Particle Pollution and Your Health

National Public Health Tracking Program
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Age-adjusted rate (direct adjustment)
A measure of the frequency of an event per population unit that has been statistically adjusted to minimize the effect of different age distributions in different populations. People of different ages are more or less susceptible to certain illnesses, and more or less likely to engage in behaviors that might protect their health or put it at risk. Age-adjusted rates show if there are differences among groups independent of the age distributions within the groups. They also show differences in a group over time independent of the changing age structure of the group.
 
 
Age-specific rate
A rate in which the number of events and population at risk are restricted to an age group (e.g., the birth rate for women age 15 to 19; death rate for people age 45 to 64).
 


Dataset details

Interpreting the data
 
What these data tell us:
  • These data can be used to identify trends and patterns in the occurrence of hospitalizations due to heart attack among Colorado residents over time and across counties.
  • These data present state and county incidence of heart attack hospitalizations. That is the number of hospitalizations due to heart attack that occurred during a specified time among those of a specified age and residents of a specified geography.
What these data do not tell us:
  • These data do not describe the prevalence of heart attacks. That means they do not tell us the number of people in Colorado who have had a heart attack.
  • Comparisons of these heart attack hospitalization data to environmental measures are done at the aggregate level, and just because events occur in the same geographic area does not mean that one must cause the other for each individual person. Elevated rates of heart attack hospitalizations in geographic areas with higher than average environmental exposures do not necessarily indicate that the environmental exposure is causing the heart attack hospitalizations. There may be other factors contributing to the disease for different individuals.
 

Numerator/Denominator Information
 
Event/numerator data: Heart attack (acute myocardial infarction) hospital discharges, Hospital Discharge Dataset, Colorado Hospital Association

Population/denominator data:
2009-based midyear resident population estimates, State Demography Office, Colorado Department of Local Affairs

 

Limitations of the data
 
It does not include all heart attack cases.
Hospitalization data does not include heart attacks among individuals who are not hospitalized for at least one night. Those who do not receive medical care, receive medical treated in outpatient settings, or die without being admitted to a hospital are not included in this data.

Differences in rates by year or county may reflect differences or changes in diagnostic techniques, changes in coding of heart attack for hospital admissions, or changes in access to medical care. Multiple admissions are not identified so the true number of people hospitalized for heart attack may be overestimated.
Although duplicate records are excluded, the measures are based upon events, not individuals. So if a person is admitted to the hospital due to a heart attack, then admitted to the hospital again due to heart attack, that would be counted twice, as two separate events, even though it was the same person.

It does not take into account many factors affecting hospitalization rates.
Rates may differ due to sociodemographic characteristics and associated behaviors. Factors such as access to medical care can affect the likelihood of a person being hospitalized for a heart attack.

Reporting rates at the state and county level is a broad measure.
These data will not show the true heart attack burden at a more local level, such as the neighborhood level. And these data are not geographically specific enough to be linked with many types of environmental exposure which may vary across the county.

 


Data not included
 
  • These data do not include hospital discharges from Federal facilities in Colorado, namely the Denver and Grand Junction Veterans Affairs Medical Centers.
 

Calculation methods
 
  • Heart attack (acute myocardial infarction) hospitalizations identified by ICD-9 Code 410
  • Age-specific hospitalization rates are computed per 10,000 population in respective age group and geographic population.
  • Age-adjusted rates are computed per 100,000 population and are adjusted by direct method using the Year 2000 U.S. Standard Population.
 

Metadata
 

 
What is a heart attack?
 

A heart attack - also called a myocardial infarction (MI) - is when part of the heart muscle gets damaged or dies because it isn’t getting enough blood. This is usually because of a blocked artery in the heart.

 

Why are heart attacks a concern?
 
  • Heart disease is a leading cause of death for both men and women in Colorado and in the United States
  • Every year about 1.2 million Americans have a first or recurrent heart attack, and about 1 in 3 of these people die, according to the American Heart Association
 

What is known about heart attacks and the environment?
 

The primary risk factors for heart attack are due to lifestyle and genetics, but many studies have found that environmental air pollution also increases risk of heart attack. Even though air pollution is not one of the primary risk factors for heart attack it is still a concern because so many people are exposed to air pollution throughout their lives.

There are many kinds of air pollution, but particulate matter air pollution seems to be especially damaging to the heart and lungs. Sources of this type of air pollution include traffic, power plants, industrial combustion, metal processing and construction activities. There are also natural sources including windblown soil, forest fires and molds.
 

Who is at risk?
 
There are many things that put people at risk for heart attack. According to the American Heart Association:
  • Men are at greater risk than women
  • Risk inceases with age
  • People with a family history of heart disease are at increased risk
Some major risk factors can be modified through lifestyle choices and/or medication. These risk factors include:
  • Smoking
  • Excess weight/obesity
  • Diabetes
  • High Blood Pressure
  • High Cholesterol
  • Physical Inactivity

People who have diabetes, heart disease or respiratory problems, elderly people, and lower socioeconomic communities might be at increased risk of heart attack due to particulate air pollution.

Know the warning signs of a heart attack:
  • Pain or discomfort in the jaw, neck or back
  • Feeling weak, light-headed or faint
  • Chest pain or discomfort
  • Pain or discomfort in arms or shoulder
  • Shortness of breath
If you suspect a heart attack, call 911 immediately.

 

How can risk be reduced?
 
The best ways to reduce risk of heart attack are to quit smoking, lose weight, eat a healthy diet and exercise. The American Heart Association has more information on how to learn about your risk of heart attack and reduce your risk of heart attack.

People at high risk for heart attack are advised to avoid strenuous activity in areas with elevated particulate air pollution – for example, not to jog along a busy street. Some days air pollution is more severe than others, and the Environmental Protection Agency (EPA) provides daily updates on the air quality in many cities across the country.
 

How are heart attacks tracked?
 

The Tracking Network uses admissions data from hospitals. The hospitals report how many admissions they have due to heart attack.

 


Video: Study Shows Air Pollution Poses Greater Link to Heart Attack, Stroke
Source: Voice of America
Running Time: (2:27)
Release Date: 08/04/2010

 
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