"Go west, young man."
Newswise — More than a century ago, American newspaperman Horace Greeley extolled the benefits of westward expansion as a source of opportunity and adventure. Now, nearly 150 years later, the same words could be used to apply to Canadians who want to improve the state of their hearts.
The further east in Canada you live, according to the Canadian Cardiovascular Atlas, the greater your chance of dying of heart disease. The Atlas is a project of the Canadian Cardiovascular Outcomes Research Team, or CCORT. It found the highest death rate from cardiovascular disease in Newfoundland and Labrador - 320 per 100,000 population - and the lowest in British Columbia, at 223 deaths per 100,000 population, according to Statistics Canada data from 1995-97. That's a 40% difference. The Atlas also found that, across Canada, deaths from heart disease are highest in rural areas of Canada and lowest in major urban centres.
The Atlas, developed with funding from the Canadian Institutes of Health Research, is the largest study of its kind to examine the influence of geography on heart disease.
Close to half of the regional variation can be attributed to a greater prevalence of risk factors for heart disease, such as smoking, poor diet, lack of exercise and obesity, in eastern Canada and rural communities. This is, paradoxically, good news. It means that communities have it within their reach to improve their rates of cardiovascular deaths, through measures such as anti-smoking programs and obesity prevention efforts.
"Our work suggests that the biggest bang for the buck for preventing heart disease would come from encouraging people to develop healthier lifestyles - smoking less, eating more healthily and exercising more," says Dr. Jack Tu, Atlas editor and Senior Scientist at the Institute for Clinical Evaluative Sciences in Toronto.
What about differences in the health care system? Ultimately, these don't make as much of a difference, says Dr. Tu.
"The differences aren't explained by differences in the quality of care," he says. "In fact, in some areas of care, Atlantic Canada is doing quite well."
The problem, he says, is that when more people develop heart disease in the first place, more people are going to die of it - no matter how good the care they receive.
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