Death rates from heart disease in New York City and its suburbs are among the highest recorded in the country, and no one quite knows why.

Heart disease is more common among poorer people. Yet Nassau County, one of the 15 highest-income counties in the country, suffers heart disease death at a rate 20 percent above the norm, a review of death certificate records by The New York Times shows. Some New Jersey counties have similar rates. All the city boroughs except Manhattan have rates as high as rural counties in the South and Appalachia.

The pattern has raised questions about whether people in the New York area live with an excess of heart disease risks -- stress, bad diets, too little exercise.

[...]

There is no obvious explanation. Some speculate about the potential role of stress. It is widely believed that life in New York is more difficult, and stress has been linked to higher heart disease mortality. A 1999 study showed that people were more likely to die of a heart attack in New York City than elsewhere. The authors suggested stress could play a role because the excess death rate affected both visitors and residents; they found no other explanation.

''There's an acute effect of being in New York,'' said Nicholas Christenfeld, a psychologist at the University of California at San Diego who did the study. ''You're wired the whole time.'' But stress is difficult to measure, and there is no proof that life is more stressful in and around New York, despite the popular notions.

There is also a growing volume of research showing that heart disease death rates are higher in places with big gaps between the rich and the poor. Metropolitan areas with less income inequality -- Seattle, Minneapolis, Salt Lake City -- have lower heart disease death rates. New York's metropolitan area ranks at the top in income inequality.

Well, I take solace from Manhattan apparently being an outlier to the effect, but it would still be good to know why this is. I was lucky enough to have my attack right across the street from a major hospital (Beth Israel) with a cardiac catherization lab, so I was able to walk into the ER within minutes of first becoming aware that something was happening. If I had started to walk home, the next hospital I would have passed (Cabrini) doesn't have such a unit, which would have delayed my treatment, perhaps signifcantly.

Obviously I lucked out in dodging that particular bullet.

I really don't have a clue why New York and its suburbs should have a higher rate of death for heart disease, but I do have a notion why Manhattan's rate is more in line with the national average, and that is that Manhattanites, to my observation, tend to walk more than New Yorkers from the outer boroughs or folks from the suburbs, and are therefore, perhaps, generally in better physical condition.

[Link via Follow Me Here]