A Number One Ranking That No One Wants

Posted: December 16, 2016    |   John Ehinger

A new study was published in this week’s Journal of the American Medical Association.  This research looked at patterns in the causes of death across counties in the U.S. from 1980 – 2014.

Unfortunately for all of us, Cardiovascular Disease (CVD) remains the biggest threat to our lives.  On a national basis, CVD is the leading cause of death, killing 32% more people than the second leading cause of death (cancer).  At the county level, the stats are equally bleak with CVD claiming the most lives in 97% of the counties in the US.

However, your outlook is certainly better in some places than others.  The study demonstrates a huge discrepancy from county to county with the difference in deaths per 100,000 people varying by 147 from counties in the 90th percentile to counties in the 10th percentile.  This is by far the greatest disparity across all causes of death (almost twice as much as the range for the next closest).

Much has already been written about certain places, such as the Seattle area, where cardiac arrest survival is vastly better than other parts of the country.  The new study adds counties in central Colorado and those in the border areas of Idaho, Montana, and Wyoming to the list of safer places as well.

Perhaps more helpfully, the research also shines a light on areas where survival significantly lags, including a broad stretch of our country from Oklahoma to Mississippi and up to Kentucky.  While there is benefit to be gained everywhere, this new data can serve as a guiding point to help direct resources to better address the problem.  Certainly, this knowledge can be used at the business level when companies consider their overall strategies for the health and wellness of their employees.

More positively, the study provides hope for all of us, as it demonstrates that that national average death rate from CVD has dropped by over 50% since 1980.  With this marked improvement, it is only logical to ask how and why.

Answering this question in depth is beyond the scope of this post, but certainly, greater health awareness, improved medical treatments, as well as increased use of CPR and AEDs have all played a role.  In line with this, conclusions from a few of the presentations at the American Heart Association’s November Scientific Sessions offer some interesting guiding points:

  • “Telephone CPR” where 911 dispatchers coach untrained lay people to perform CPR increases the likelihood of the victim being in a shockable rhythm when paramedics arrive and improves the odds of the victim’s survival to hospital discharge. (Panczyk et al).


  • Sweden demonstrated a massive (84%+) increase in bystanders providing CPR from 2000 to 2014 with 70% of victims receiving CPR in 2014. This change was driven by increased use of Compression-Only CPR.  Importantly, no difference was shown in survival between those receiving Compression-Only or Traditional (with breaths) CPR.  Those receiving any type of CPR survived 2.5 times more often than those not receiving CPR.  (Riva et al)


  • Another group looked at CPR performance for those trained by only watching a 22-minute video vs. those watching the video and practicing on a manikin. The study showed a difference in compression depth of only 5 millimeters between the two groups and no clinical difference in compression frequency. (Blewer et al)

With the benefits of CPR already clear, these three examples show that there is much to be gained by thinking and acting progressively.  Importantly from the company perspective, workforce CPR training can now be done both easily and affordably, regardless of location and headcount.  Obviously, CPR is completely portable.  So, not only does training more people protect those in the workplace, it pays dividends in our communities and will help CVD lose its number one ranking.

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