Analysis

As shown in Chart 1 and Table 1 below, the heart disease death rate has declined since 2004, but it still remains the second-leading cause of death in Minnesota. More men die of heart disease than women, and at younger ages, which explains the higher age-adjusted death rate for men compared to women. Total deaths were lowest in 2010 and have risen by 20% in the years since, with 1,400 more deaths in 2018 compared to eight years earlier. Most of that increase has been in men. Even though the number of deaths has started to increase, death rates have remained relatively stable. This can be explained by our aging population, with the number of older people who are at a risk of dying from heart disease also increasing each year.

Chart 1: Death Rate due to Heart Disease for all Minnesotans and by sex, 2004-2018

Table 1: Total Deaths and Death Rate due to Heart Disease for all Minnesotans and by sex, 2004-2018

Year	Total Number of Deaths	Total Age-Adjusted Death Rate (per 100,000)	Number of Deaths, Females	Age-Adjusted Death Rate (per 100,000 Females)	Number of Deaths, Males	Age-Adjusted Death Rate (per 100,000 Males)
2004	7,888	144.3	3,933	112.3	3,955	185.8
2005	7,915	141.3	3,804	106.4	4,111	188.6
2006	7,506	133.6	3,624	101.5	3,882	177.4
2007	7,565	131.2	3,720	101.1	3,845	172.0
2008	7,453	128.0	3,618	98.2	3,835	167.8
2009	7,233	121.8	3,396	89.2	3,837	165.3
2010	7,144	118.7	3,437	90.7	3,707	154.4
2011	7,234	116.9	3,411	88.8	3,822	153.1
2012	7,471	118.8	3,489	89.6	3,982	155.8
2013	7,671	118.9	3,546	88.9	4,125	156.9
2014	7,570	115.1	3,508	87.3	4,062	150.5
2015	7,797	115.9	3,679	89.4	4,118	149.1
2016	7,823	114.8	3,558	86.2	4,265	151.1
2017	8,230	119.1	3,749	89.5	4,481	155.8
2018	8,553	121.1	3,891	91.5	4,662	157.8

Even though Minnesota has a very low rate of heart disease deaths compared to the United States, there are large disparities in the state. As shown in Chart 2 and Table 2, the death rate due to heart disease is highest in American Indian communities in Minnesota and lowest in Asian/Pacific Islander and Hispanic communities. The last column of Table 2 shows a rate ratio, which compares two rates to describe how much one group is impacted compared to another. Any number larger than 1 means that the group of interest is higher than the comparison group. Any number smaller than 1 means that the group of interest is lower than the comparison group. In Table 2, populations of color are compared to the white population. American Indians die from heart disease at a rate 1.53 times higher than whites. While the age-adjusted death rate shows little difference in heart disease deaths between white and African-American/African Minnesotans, a different picture emerges when looking at death by age groups starting at 35 years.

Chart 2: Death Rate due to Heart Disease by Race and Ethnicity, 2014-2018

Table 2: Total Deaths and Death Rate due to Heart Disease by Race and Ethnicity, 2014-2018

Race/Ethnicity	Total Deaths, 2014-2018	Annual Age-Adjusted Death Rate (per 100,000), 2014-2018	Rate Ratio, compared to White
White	37,959	116.5	-
African-American/African	998	111.7	0.96
American Indian	458	178.7	1.53
Asian/Pacific Islander	466	68.1	0.58
Hispanic	286	56.6	0.49

Chart 3 and Table 3 highlight major disparities in heart disease deaths between whites, African Americans, and American Indians in Minnesota. Chart 3 below shows the difference in death rates between African Americans/Africans and American Indians compared to whites in Minnesota from 2014-2018 by using a rate ratio. Bars that rise above the solid black line show groups that die at higher rates than whites, while bars that remain below the solid black line show groups that die at lower rates than whites.

Among those aged 35 through 64, African American/African Minnesotans die from heart disease at about 2 times the rate of white Minnesotans. For American Indians, this disparity is even greater, with death rates more than 3.5 times higher than whites among those aged 35 to 54, and more than twice as high among those aged 55 to 74. Both African-Americans/Africans and American Indians over the age of 85 die from heart disease at a lower rate than whites, but this may be because those who have heart disease in these groups are dying at much younger ages. Table 3 shows the death rates for all three race groups and the rate ratio comparing African Americans/Africans and American Indians to whites. Asian/Pacific Islanders and Hispanic communities have lower death rates than whites in every age group and are not shown in Chart 3 or Table 3.

Chart 3: Rate Ratio of Heart Disease Deaths for African Americans/Africans and American Indians vs. Whites, 2014-2018

Table 3: Rate Ratio of Heart Disease Deaths by Race and Age Group, 2014-2018

Age Group (years)	Crude Death Rate (per 100,000), Whites	Crude Death Rate (per 100,000), African Americans/ Africans	Rate Ratio of African Americans/Africans to Whites	Crude Death Rate (per 100,000), American Indians	Rate Ratio of American Indians to Whites
35-44	14.4	33.3	2.31	50.5	3.51
45-54	46.1	85.6	1.86	166.7	3.62
55-64	101.1	188.6	1.87	280.5	2.77
65-74	220.8	322.6	1.46	590.8	2.68
75-84	726.3	665.7	0.92	1175.3	1.62
85 and Over	3286.3	1637.5	0.50	1714.0	0.52

The number of deaths due to heart disease increases in older age groups. Table 4 shows the number of deaths and death rate due to heart disease over the three most recent five-year time periods. Over that 15 year period, the largest declines in death rates have been for Minnesotans ages 65 to 84, as shown in Chart 4. For Minnesotans ages 55 to 64, the declines have only been one-half as large. For Minnesotans ages 45 to 54 and 85 or older, the declines have been very small, and for Minnesotans under age 45, there has been almost no change in the heart disease death rate.

Table 4: Total Deaths and Death Rate due to Heart Disease by Age Group, 2004-2018

Age Group (years)	Number of Deaths, 2004-2008	Crude Death Rate (per 100,000), 2004-2008	Number of Deaths, 2009-2013	Crude Death Rate (per 100,000), 2009-2013	Number of Deaths, 2014-2018	Crude Death Rate (per 100,000), 2014-2018	Change over 15 years
35-44	627	16.5	538	15.9	559	16.3	-1%
45-54	2,038	51.8	2,001	50.3	1,795	49.4	-5%
55-64	3,138	117.4	3,381	103.6	3,886	105.5	-10%
65-74	4,529	290.3	4,483	239.5	5,324	225.7	-22%
75-84	10,343	959.4	8,666	774.7	8,784	724.5	-24%
85 and Over	17,361	3,373.8	17,409	3,157.8	19,325	3,239.8	-4%

Chart 4: Percent change in Death Rate due to Heart Disease by Age Group, from 2004-2008 to 2014-2018

Other Resources

• Minnesota Vital Statistics Interactive Queries
  These data are population based and include all deaths in Minnesota regardless of where the event occurred. Users can group data by cause of death, age, sex, race, ethnicity, county, and year.


• CDC Wonder Online Mortality Database
  These data are population based and include all deaths and allows users to look at multiple causes of death. Users can group data by cause of death, age, sex, race, ethnicity, county, year, and some additional characteristics. Minnesota can be compared against other states.


• Interactive Atlas of Heart Disease & Stroke
  Online mapping tool from CDC with health indicators (including mortality and hospitalizations), risk factors, social and economic data, health care delivery, insurance, and health care costs data for states and counties. Some census tract data is also available.

Data Source

Annual death records from 2004 to the present were obtained from the Minnesota Department of Health Center for Health Statistics.

Measure Definition

Since 1999, Heart disease deaths are identified as the underlying cause of death on death certificates as ICD-10: I00-I09, I11, I13, and I20-I51. This includes the following broad categories: Acute rheumatic fever, chronic rheumatic heart disease, hypertensive heart disease, hypertensive heart and renal disease, ischemic heart diseases, pulmonary heart disease and diseases of pulmonary circulation, and other forms of heart disease.