Special Report

America's Heart Disease Capitals

Hristina Byrnes

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20. Pharr, Texas
> Heart disease incidence: 7.5%
> Current lack of health insurance: 47.6%
> Smoking: 15.7%
> Obesity: 39.8%
> Adults who report poor physical health: 18.2%

Pharr, a city of about 80,000 people, has the largest share of the population without health insurance. Research shows a connection between less care of hypertension and diabetes, two conditions that increase the risk of heart disease. The city has the third highest share of adults who have been diagnosed with diabetes, at just over 17% of the population, compared to the national share of 9.3% of adults who have been diagnosed.

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19. Laredo, Texas
> Heart disease incidence: 7.5%
> Current lack of health insurance: 43.6%
> Smoking: 17.3%
> Obesity: 40.2%
> Adults who report poor physical health: 17.7%

Laredo is another example of a correlation between lack of health insurance — it has the third highest share of working-age adults without insurance among the 500 largest U.S. cities — and incidence of heart disease. Also, similarly to Pharr, close to 17% of adults in the city have been diagnosed with diabetes — the fifth highest rate among the 500 cities included in the database. Diabetics are two to four times more likely to die from heart disease because they often have high blood pressure and high LDL cholesterol (the bad kind).

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18. Passaic, New Jersey
> Heart disease incidence: 7.5%
> Current lack of health insurance: 33.2%
> Smoking: 20.5%
> Obesity: 37%
> Adults who report poor physical health: 18.1%

Lack of exercise is a major cause of chronic disease. Over 42% of adults in Passaic report they don’t take time for physical activity, the second highest rate among the 500 largest U.S. cities after Camden, New Jersey. Among all American adults, the share is 25.5%. The American Heart Association recommends a minimum of 150 minutes per week of moderate exercise — about 21 minutes a day — or 75 minutes per week of vigorous exercise.

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17. Springfield, Massachusetts
> Heart disease incidence: 7.5%
> Current lack of health insurance: 17.9%
> Smoking: 24%
> Obesity: 36.6%
> Adults who report poor physical health: 17.8%

A third of the adults in Springfield have been diagnosed with high cholesterol. The body needs some cholesterol to build cells and produce hormones, but too much causes a problem for the heart. An excess of the fat-like waxy substance builds up in the walls of the arteries, causing cardiovascular disease. Also, about 35% of adults in Springfield report no leisure-time physical activity, compared to the 25.5% of adults nationwide who do not exercise during their free time.

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16. Hammond, Indiana
> Heart disease incidence: 7.5%
> Current lack of health insurance: 23.8%
> Smoking: 23.1%
> Obesity: 36.9%
> Adults who report poor physical health: 16.2%

While the rate of heart disease among Americans decreased nationwide from 6.0% of adults to 5.6% of adults, in Hammond, however, the rate of heart disease increased slightly between 2014 and 2015. No single factor clearly stands out as the culprit in Hammond’s high incidence of heart disease. Rather, a combination of very high rates of several factors are collectively driving up the risk of the illness. The city has among the highest shares high blood pressure, high cholesterol, and a lack of health insurance.