U.S. Cities with the Highest Heart Disease Rates Have High Black Populations

In the United States, heart disease is the top killer, leading to 610,000 deaths a year, or one in every four fatalities. Blacks have the highest rates of heart disease in the U.S. – over 40% of Blacks have heart disease.

Recently heart health writer Hristina Byrnes wrote an article listing the cities with highest rates of heart disease. To identify the heart disease capitals in the United States, 24/7 Wall St. reviewed data from the Centers for Disease Control and Prevention for the largest 500 cities in the country. 

The 20 cities listed are those where at least 7.5% of people over 18 years of age report having been told by a health professional that they had angina or coronary heart disease in 2015. 

Additional data came come from the CDC’s Behavioral Risk Factor Surveillance System data, and the Census Bureau’s 2017 American Community Survey.

Below is the listing of the top 11 cities with heart disease, out of these eleven cities 81% had Black populations of over 40%, six of the cities had Black populations over 54%.

Flint, Michigan

> Heart disease incidence: 8.7%
> Current lack of health insurance: 21.8%
> Smoking: 31.5%
> Obesity: 42.0%
> Adults who report poor physical health: 18.9%

> Black population 57%

The lead contamination crisis in Flint may help partially explain why the city has the highest share of heart disease incidence of any major city. Chronic exposure to lead and higher concentrations of lead in blood cause hypertension, ECG abnormalities, peripheral arterial disease, and cardiovascular disease. Flint has the highest rates of arthritis (34.9%), asthma (13.4%), chronic obstructive pulmonary disease (10.9%), and smoking (31.5%) - all of which significantly increase the risk of heart disease.

2. Detroit, Michigan

> Heart disease incidence: 8.6%
> Current lack of health insurance: 23.6%
> Smoking: 31.4%
> Obesity: 45.1%
> Adults who report poor physical health: 18.7%

> Black population 84%

Among the 500 largest U.S. cities, Detroit has the third highest adult diabetes rate, the second highest arthritis and obesity rates, and the highest rates of high blood pressure and smoking. Also, Detroit is No. 2 in people with asthma, which has been linked to a 57% higher risk of heart disease.

3. Reading, Pennsylvania

> Heart disease incidence: 8.6%
> Current lack of health insurance: 31.5%
> Smoking: 26.3%
> Obesity: 43.8%
> Adults who report poor physical health: 19.4%

> Black population 9%

Of the seven cities in Pennsylvania on the list, Reading is the only one where the rate of heart disease went up between 2014 and 2015, although by just 0.1 percentage point. The city's problems with heart disease extent to wider health issues. Among Reading adults, 19.1% report at least 14 days of poor health per year, the highest share of all 500 cities in the database.

4. Youngstown, Ohio

> Heart disease incidence: 8.5%
> Current lack of health insurance: 21.0%
> Smoking: 30.6%
> Obesity: 40.6%
> Adults who report poor physical health: 18.7%

> Black population 45%

Youngstown was No. 1 on the list of cities with the highest rates of heart disease in 2014. The slight improvement of 0.1% brought it down to fourth place a year later. A combination of several factors associated with heart disease help keep the city in the top five, including a high rate of chronic obstructive pulmonary disease, at 10.8% of adults - the second highest among the 500 largest U.S. cities. COPD is linked to a higher risk of heart conditions due to elevated pulse rates during both rest and exercise.

5. Dayton, Ohio

> Heart disease incidence: 8.4%
> Current lack of health insurance: 17.1%
> Smoking: 27.5%
> Obesity: 39.7%
> Adults who report poor physical health: 17.7%

> Black population 43%

Cardiovascular disease accounts for 37% of all deaths in the state, compared with a quarter of deaths nationwide. The Ohio Department of Health supports several initiatives to reduce the risk, and they may have been a factor in the positive effect between 2014 and 2015. All nine cities in Ohio on the list had a decrease in the incidence of heart disease. Dayton's share fell by 0.2 percentage points, which was not enough to keep the city from having one of the five highest shares among the nation's major cities.

6. Gary, Indiana

> Heart disease incidence: 8.3%
> Current lack of health insurance: 23.3%
> Smoking: 26.9%
> Obesity: 45.2%
> Adults who report poor physical health: 18.3%

> Black population 81%

Of all 500 cities on the list, Gary has the highest rate of diabetes - 18.4%; the second highest stroke rate among adults - 5.9%; and the third highest rate of people with high blood pressure. Hypertension can lead to hardened arteries, stroke, or heart attack because the force with which the heart is pushing blood through arteries is too high.

7. Camden, New Jersey

> Heart disease incidence: 8.3%
> Current lack of health insurance: 30.3%
> Smoking: 26.8%
> Obesity: 40.9%
> Adults who report poor physical health: 19.4%

> Black population 42%

In Camden, 41.8% of adults have high blood pressure, the ninth highest share among major cities and well above the 29.4% of American adults who do. Almost 45% of adults in the New Jersey city don't exercise in their spare time -- the highest rate of lack of physical activity on the list. Also, Camden has the second highest rate of adults with diabetes. The city is also in the top 10 for obesity among adults.

8. Cleveland, Ohio

> Heart disease incidence: 8.2%
> Current lack of health insurance: 19.9%
> Smoking: 28.3%
> Obesity: 40.1%
> Adults who report poor physical health: 17.9%

> Black population 53%

Cleveland has a high rate of adults who have had a stroke - 5.3%, the sixth highest share among major cities. Also, many city residents smoke too - 28.3%, the fourth highest share. High blood pressure is also very common in the city - almost 69% take medication for it, the ninth highest share among major cities.

9. Macon, Georgia

> Heart disease incidence: 7.9%
> Current lack of health insurance: 25.5%
> Smoking: 25.8%
> Obesity: 41.2%
> Adults who report poor physical health: 17.9%

> Black population 68%

Macon is in the top 20 for many health conditions that pose a high risk for developing heart disease. One that particularly stands out is stroke. Close to 6% of the adult population have had a stroke, the third highest rate among the 500 largest U.S. cities. Stroke is associated with coronary heart disease because both share common risk factors, such as high LDL (bad) cholesterol, high blood pressure, diabetes, and being overweight.

10. Canton, Ohio

> Heart disease incidence: 7.7%
> Current lack of health insurance: 15.7%
> Smoking: 27.8%
> Obesity: 38.3%
> Adults who report poor physical health: 16.6%

> Black population 24%

Canton also has a high proportion of adults with arthritis the sixth highest on the list but it also has a large number of people smoking over 10%, the fourth highest rate. Smoking is a major contributor to coronary heart disease because the chemicals in the smoke cause the blood to thicken and form clots, blocking circulation.

11. Birmingham, Alabama

> Heart disease incidence: 7.6%
> Current lack of health insurance: 19.8%
> Smoking: 24.6%
> Obesity: 42.7%
> Adults who report poor physical health: 16.4%

> Black population 74%

About a third of adults in Birmingham have arthritis. Similarly to heart disease, arthritis is an inflammation process. This is why people with arthritis are at a greater risk of developing heart disease, including irregular heartbeats, high blood pressure, heart failure and plaque in the arteries. More than half of premature deaths in people with rheumatoid arthritis result from cardiovascular disease.