Map Details – Examining Geographic Patterns for Heart Disease Death Rates, Smoking Rates, And Businesses Exempted from the Clean Indoor Act in Pennsylvania, 2015-2017

Impact Statement

Heart disease is the leading cause of death in Pennsylvania. Cigarette smoking has been documented as a major risk factor for heart disease. Because cigarette smoking is a preventable risk factor, harms from cigarette smoking can be reduced through personal, medical, societal, governmental interventions. The Clean Indoor Air Act, which was signed into law on June 13, 2008 in Pennsylvania, is a good example of limiting cigarette smoking in public places through governmental and legislative efforts.

This map displays county-level heart disease mortality rates for the state of Pennsylvania for the years 2015-2017. The highest rates (396 - 481 per 100,000) are located primarily in the southwest and northeast regions of the state, and lowest rates (201 - 291 per 100,000) are located primarily in the east and southeast regions of the state. The current smoking rate appears to be higher in areas where heart disease mortality rates were high. It also appears that some areas with high heart disease mortality rates had more businesses with smoking exception (i.e., businesses that allowed customers to smoke during business operation).

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This map demonstrates the average heart disease mortality rates in counties of Pennsylvania from 2015 to 2017. The highest heart disease mortality rates (396 – 481 per 100,000) were located primarily in the southwest and northeast areas of the state, while the lowest heart disease death rates (201 – 291 per 100,000) were primarily located in the central, east, and southeast areas of the state. Geographically, areas with higher heart disease mortality rates also had higher current smoking rates. Similarly, areas with higher heart disease mortality rates also had more businesses that were exempted from Clean Indoor Act (i.e., customers were allowed to smoke at these business facilities) in Pennsylvania.

ArcGIS

Pennsylvania Death Certificate, 2015–2017; Pennsylvania Clean Indoor Act, 2015-2017; Behavioral Risk Factor Surveillance System, 2015-2017

Heart disease death data was obtained from the Pennsylvania Death Certificate System. ICD-10 was used to abstract data for death from heart diseases. The total number of heart disease deaths in each county in Pennsylvania was calculated for 2015, 2016, and 2017. The total population in each county was calculated for 2015, 2016, and 2017 as well. The average heart disease death rate was calculated by dividing the total number of deaths by the total population in each county from 2015 to 2017. The average current smoking rate was obtained from the Pennsylvania Department of Health website at https://www.health.pa.gov/topics/HealthStatistics/VitalStatistics/CountyHealthProfiles/Documents/current/index.aspx.

Data on businesses with smoking exception was obtained from the Pennsylvania Clean Indoor Air Act System for the years 2015, 2016, and 2017. Only businesses that were approved for smoking exception were included. The number of businesses with smoking exception in each county was calculated for 2015, 2016, and 2017. The total number of businesses with smoking exception and the average number of business in each county were calculated for 2015 – 2017. The above three sets of data were used to produce the map. Heart disease death rate is illustrated as graduated colors in counties, with darker color indicating higher death rate. Current smoking rate is displayed as triangles (low smoking rate), squares (intermediate smoking rate), and circles (high smoking rate). The businesses exempted from the Clean Indoor Act are shown as dots.

Jun Yang, Pennsylvania Department of Health

Jun Yang, Pennsylvania Department of Health. Accessed from the Centers for Disease Control and Prevention’s Chronic Disease GIS Exchange https://www.cdc.gov/dhdsp/maps/gisx/mapgallery/pa-geographic-patterns.html