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The South is falling well behind the rest of the nation in fighting heart disease.

In the early 1970s, the Northeast and Midwest had some of the highest rates of heart disease mortality. But states like New York, Pennsylvania, and Ohio managed to bring death rates down over the next 30 years. So by the start of this decade, the map had shifted: The counties with the highest rates of fatal cardiovascular disease were concentrated in Louisiana, Alabama, Mississippi, and Oklahoma.

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The data from the Centers for Disease Control and Prevention, covering the period 1973 through 2010, were published Monday in the journal Circulation.

The good news, health policy researcher Dr. David Blumenthal said, is that heart disease mortality has been reduced across the board. It’s just that the North has improved much more than the South.

The better news is that it wouldn’t take a lot to improve outcomes in the South, said cardiologist Dr. Michael Miedema of the Minneapolis Heart Institute.

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“If the rate of smoking goes down just a little in the South, or the rate of exercise goes up, it can reduce the death rate dramatically,” said Miedema, who was not involved in the CDC’s research. “A 1 or 2 percent drop means a lot over a large number of people.”

Blumenthal, president of the Commonwealth Fund, a health policy think tank, said the South’s struggle with cardiovascular disease may be due in part to lower incomes and higher obesity rates. “There may also be some relationship to quality of care,” he said.

Heart disease map U.S.
CDC