> World Socialist Web Site http://www.wsws.org
> ------------------------------------------------------------------------
> The impact of social polarization
>
> Study shows higher cardiac death rates in major US cities, rural South
>
> By Fred Mazelis
> 22 February 2000
>
> A new study by the Centers for Disease Control in Atlanta, Georgia has found
> death rates from heart disease for US women to be highest in four major
> cities as well as in the rural South.
>
> One of the reasons for this detailed study covering every part of the
> country with breakdowns by region, race and ethnic origin was to counter
> the
> popular misconception that heart disease is not a major problem for women.
> Statistics reveal that 370,000 women died of heart disease in the US as
> whole in 1997. Annual mortality rates from heart disease for women are 401
> per 100,000. Despite the seriousness of such threats as breast and ovarian
> cancer, deaths from heart disease are greater than for all forms of cancer
> combined.
>
> The average of 400, however, conceals wide differences between different
> regions of the country. In parts of the West, for instance, the rate is
> about 200 per 100,000, while in New York City it is nearly 600.
>
> The higher death rates in rural areas of Appalachia and the South are not
> unexpected. These are areas of endemic poverty, relatively few doctors,
> longer distances to hospitals and modern medical centers. Many of the
> elderly poor live alone in isolated circumstances and are unable to care for
> themselves. They are also cut off from the opportunity for timely and
> up-to-date care.
>
> The study also found, however, that the death rates from heart disease were
> just as high in New York, Chicago, Detroit and New Orleans as they were in
> such areas as the Mississippi Delta.
>
> Dr. Antonio Gotto of the Weill Cornell Medical College in New York City
> reported to the press that life style might be responsible for much of
> the
> heart disease in New York. The New York Times reported Gotto commenting on
> ethnic, cultural and economic diversity producing great differences in ways
> of living and patterns of behavior.
>
> Economic diversity is a rather awkward euphemism for social polarization.
> New York is home to people who were born in every part of the world, but it
> is also home to the wealthiest and some of the poorest residents of the
> United States.
>
> The high death rates for women as a whole in New York, while masking big
> differences based on social class, also reflect the deep and growing poverty
> of millions of people. Mississippi, for instance, had the highest death rate
> for black women from heart disease, at 686. In New York City the comparable
> figure was 587.
>
> New York is the most economically polarized and heavily immigrant city in
> the country, but the high death rates for Detroit, Chicago and New Orleans
> reflect similar trends. In Detroit and New Orleans the wealthy have fled and
> the remaining residents have been devastated by unemployment and cutbacks in
> social services. Chicago shares some of the characteristics of both Detroit
> and New York; while not enjoying the same kind of boom that Wall Street has
> brought to New York, it remains a major financial and commercial center in
> the Midwest.
>
> In New York the poor supposedly have access to some of the leading hospitals
> and modern technology, but in practice a two-tier health system is in place.
> Living conditions, poor nutrition and health habits, and stress, including
> depression, all contribute to heart disease and to poor outcomes for those
> affected.
>
> For the CDC study, see: http://www.cdc.gov.