Derived from a response of any length of time to the question, "About how long has it been since you last had your blood pressure checked? AND "yes" responses to the following questions:
Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure? AND
Do you still have high blood pressure?
(Females who responded "yes" to having been told had HBP only when pregnant are not included as having HBP.)

Derived from "yes" responses from respondents age 35 and older to the following questions:
Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked? AND Have you ever been told by a doctor, nurse, or other health professional that your blood cholesterol is high? AND
Do you still have high blood cholesterol?

Derived from "yes" response to the following question: Have you smoked at least 100 cigarettes in your entire life? AND "Everyday" or "some days" response to the following question: Do you now smoke cigarettes everyday, some days, or not at all?

Derived from ">=1" response to the following question:
Not including yourself, during the past seven days, how many days did anyone smoke cigarettes, cigars, or pipes anywhere inside your home?

Derived from "Yes" response to the following question:
As far as you know, in the past seven days, has anyone smoked in your work area?

Derived from "No" response to the following question:
During the past month, other than your regular job, did you participate in any physical activities or exercise such as running, calisthenics, golf, gardening, or walking for exercise?

Derived by calculating BMI using responses the following questions:
About how much do you weigh without shoes?
About how tall are you without shoes?

Derived by calculating BMI using responses the following questions:
About how much do you weigh without shoes?
About how tall are you without shoes?

Derived by calculating number of fruits and vegetables eaten per day using the following questions:
How often do you drink fruit juices such as orange, grapefruit or tomato?
Not counting juice, how often do you eat fruit?
How often do you eat green salad?
How often do you eat potatoes not including French fries, fried potatoes or potato chips?
How often do you eat carrots?
Not counting carrots, potatoes or salad, how many servings of vegetables do you usually eat?
Diabetes

Derived from "yes" response to the following question:
Have you ever been told by a doctor that you have diabetes?
(Females who responded "yes" to having been told they had diabetes only when pregnant and those that were told they had pre-diabetes or were borderline diabetes are not included as having diabetes.)

Respondents incorrectly answered one or more of the following questions or responded don't know or not sure:
Do you think pain or discomfort in the jaw, neck, or back are symptoms of a heart attack? (Correct answer is yes)
Do you think feeling weak, lightheaded, or faint are symptoms of a heart attack? (Correct answer is yes)
Do you think chest pain or discomfort are symptoms of a heart attack? (Correct answer is yes)
Do you think sudden trouble seeing in one or both eyes is a symptom of a heart attack? (Correct answer is no)
Do you think pain or discomfort in the arms or shoulder are symptoms of a heart attack? (Correct answer is yes) (283)
Do you think shortness of breath is a symptom of a heart attack? (Correct answer is yes) f.(Do you think) shortness of breath (is a symptom of a heart attack?)(284)

Woman respondents that responded "Yes" to "In the past 30 days, have you had a least one drink of any alcoholic beverage? AND drank 7 days per week AND 30 days in past 30 AND "2" or greater response to "Number of drinks" when drank in past 30 days.
Men respondents that responded "Yes" to "In the past 30 days, have you had a least one drink of any alcoholic beverage? AND drank 7 days per week AND 30 days in past 30 AND "3" or greater response to "Number of drinks" when drank in past 30 days.

Derived from "yes" response to the following question:
Has a doctor, nurse, or other health professional ever told you that you had angina or coronary heart disease?

Derived from "yes" response to the following question:
Has a doctor, nurse, or other health professional ever told you that you had angina or coronary heart disease?

Community Data Profiles and MICAs are based solely on data for Missouri residents. Following are the defintions of residence used for each type of data file.
Death Data
Residence is the place (county) where the decedent lived most of the time (usual place of residence at the time of death), regardless of where the death took place. Missouri receives death certificates from other states for Missouri residents dying in those states. Temporary residence such as a visit, business trip or vacation are not considered usual place of residence. However, place of residence during a tour of military duty or attendance at college is counted as usual place of residence. If a person had been living in a long-term institution, nursing home or prison, this is considered usual place of residence.

Hospital Data
(inpatient hospitalizations, outpatient visits and emergency room visits)
For hospital data (inpatient/outpatient stays and emergency room visits), the county of residence is what was reported by the patient or informant when the patient was admitted. In some instances, the discharge has been identified as a Missouri resident, but the county of residence is unknown or missing. In those instances where the county is unknown, but the patient can be identified as a Missouri resident, the discharge is included in the statewide calculations but is not included in any counts for the individual Missouri counties or sub-geographic areas. Thus, for any given hospital data item, the sum of all county totals may be different from (less than) the reported statewide total in the MICA or profile table. The Department of Health and Senior Services receives information on Missouri residents who are hospitalized in some hospitals in Iowa, Kansas, and parts of Illinois. Hospitalization data for Missouri counties near other state lines (and the Hannibal/Quincy area) need to be considered with particular caution, because the data from the bordering states may be incomplete or missing.

A percentage that has been calculated based upon the final weight in the Behavioral Risk Factor Surveillance System (BRFSS) survey data. The final weight in the BRFSS takes into account the unequal probability of selection, differential non-response, and possible deficiencies in the sampling frame.

An area's observed death rate should be considered an estimate of the true underlying mortality rate. The number of deaths in an area varies by chance, depending on the number of persons counted as residents there and the probability of the event (death, hospitalization, etc.). Because of this, rates based on small numbers are particularly unstable.

Stability is especially important when comparing areas with each other. Therefore, we performed statistical significance tests to determine whether the differences between the county rates and the corresponding state rates were probably the result of chance factors.

If an "H" or "L" is present, there is 95 percent confidence that the county rate is really higher ("H") or lower ("L") than the state's rate. That is, we estimate that there is only a 5 percent chance (1 in 20) that the difference between the county's rate and the corresponding state rate is due to random error (chance).

If there is no "H" or "L" noted, it is because we cannot state with confidence that the difference between the county rate and the state rate is not due to random variations. That is, the difference is not statistically significant.

For example, in the case of rates of death per 100,000 population, the significance of the difference between two rates is tested by:

((100,000) / (population X years)) X (1.96 X (square root of deaths))

If the result is less than the size* of the difference between the rates (regardless of the direction of the difference), then the difference is significant.

The number of years is included in the denominator in order to annualize the rates.

Statistical significance is easier to obtain with larger populations. For indicators for which the number of deaths (or hospitalizations) is less than 20 the observed rate may be very different from the true underlying rate, so that only a relatively large difference in rates would be considered significant. As the numbers grow larger, the chance component becomes less important and the observed rate is a better estimate of the true rate.
* The absolute value of the difference.

Resident deaths for which the underlying cause of death was given on the death certificate as heart disease (ICD codes below).

This category of "heart disease" is one of the National Center for Health Statistics standard categories for ranking the leading causes of death. It is the leading cause of death in Missouri and the US.

In addition to acute myocardial infarction ("heart attack"), some of the causes included are: rheumatic heart disease, hypertensive heart disease, pulmonary embolism, various valve disorders, cardiomyopathy, atrial fibrillation, and congestive heart failure.

For data through 1998, International Classification of Diseases (ICD-9) codes 390-398, 402, and 404, and 410-429.
For data years 1999 forward, International Classification of Diseases (ICD-10) codes I00-I09, I11,I13, and I20-I51.

Resident deaths for which the underlying cause of death was given on the death certificate as Acute Myocardial Infarction (ICD codes below). These deaths are included among deaths due to "heart disease." An acute myocardial infarction (AMI) is death of tissue in heart muscle due to an interruption in the blood supply. An AMI or "heart attack," is usually caused by a blood clot obstructing a coronary artery.

For data through 1998, International Classification of Diseases (ICD-9) code 410

. For data years 1999 forward, International Classification of Diseases (ICD-10) codes I21 and I22.

Resident hospitalizations with a principal diagnosis of heart disease. This includes acute myocardial infarction (heart attack), rheumatic heart disease, hypertensive heart disease, pulmonary embolism, various valve disorders, cardiomyopathy, atrial fibrillation, congestive heart failure, chest pain, tachycardia, heart palpitations, meningococcal carditis, cocksackie carditis, and problems with transplanted heart valves and cardiac devices (pacemaker, etc).
International Classification of Diseases (ICD-9-CM) codes according to the Clinical Classifications Software (CCS) categories:

96   Heart valve disorders

V422 V433 3940 3941 3942 3949 3950 3951 3952 3959 3960 3961 3962 3963 3968 3969 3970 3971 3979 4240 4241 4242 4243 42490 42491 42499 7852 7853

97   Peri , endo , and myocarditis, cardiomyopathy (except that caused by tuberculosis or sexually transmitted disease)

03282 03640 03641 03642 03643 07420 07421 07422 07423 11281 11503 11504 11513 11514 11593 11594 1303 3910 3911 3912 3918 3919 3920 393 3980 39890 39899 4200 42090 42091 42099 4210 4211 4219 4220 42290 42291 42292 42293 42299 4230 4231 4232 4238 4239 4250 4251 4252 4253 4254 4255 4257 4258 4259 4290

100   Acute myocardial infarction

4100 41000 41001 41002 4101 41010 41011 41012 4102 41020 41021 41022 4103 41030 41031 41032 4104 41040 41041 41042 4105 41050 41051 41052 4106 41060 41061 41062 4107 41070 41071 41072 4108 41080 41081 41082 4109 41090 41091 41092

101   Coronary atherosclerosis and other heart disease

V4581 V4582 4110 4111 4118 41181 41189 412 4130 4131 4139 4140 41400 41401 41403 41406 4148 4149

102   Nonspecific chest pain

78650 78651 78659

103   Pulmonary heart disease

4150 4151 41519 4160 4161 4168 4169 4170 4171 4178 4179

104   Other and ill defined heart disease

41410 41411 41412 41419 4291 4292 4293 4295 4296 42971 42979 42981 42982 42989 4299

105   Conduction disorders

V450 V4500 V4501 V4502 V4509 V533 V5331 V5332 V5339 4260 42610 42611 42612 42613 4262 4263 4264 42650 42651 42652 42653 42654 4266 4267 42681 42689 4269

106   Cardiac dysrhythmias

4270 4271 4272 42731 42732 42760 42761 42769 42781 42789 4279 7850 7851

107   Cardiac arrest and ventricular fibrillation

42741 42742 4275

108   Congestive heart failure, nonhypertensive

39891 4280 4281 42820 42821 42822 42823 42830 42831 42832 42833 42840 42841 42842 42843 4289

The amount that the hospital charges for inpatient hospitalizations for residents of the area (state, region, county) who were admitted for heart disease. The charges do not necessarily represent the cost to the hospital of providing the care nor do they represent the amount actually collected by the hospital for providing the care.

The days of care (length of stay) in the hospital for residents of the area (state, region, county) who were admitted for heart disease.

Resident hospital emergency room visits with a principal diagnosis of heart disease. This includes acute myocardial infarction (heart attack), rheumatic heart disease, hypertensive heart disease, pulmonary embolism, various valve disorders, cardiomyopathy, atrial fibrillation, and congestive heart failure, chest pain, tachycardia, heart palpitations, meningococcal carditis, cocksackie carditis, problems with transplanted heart valves and cardiac devices (pacemaker, etc). International Classification of Diseases (ICD-9-CM) codes according to the Clinical Classifications Software (CCS) categories:

96   Heart valve disorders

V422 V433 3940 3941 3942 3949 3950 3951 3952 3959 3960 3961 3962 3963 3968 3969 3970 3971 3979 4240 4241 4242 4243 42490 42491 42499 7852 7853

97   Peri , endo , and myocarditis, cardiomyopathy (except that caused by tuberculosis or sexually transmitted disease)

03282 03640 03641 03642 03643 07420 07421 07422 07423 11281 11503 11504 11513 11514 11593 11594 1303 3910 3911 3912 3918 3919 3920 393 3980 39890 39899 4200 42090 42091 42099 4210 4211 4219 4220 42290 42291 42292 42293 42299 4230 4231 4232 4238 4239 4250 4251 4252 4253 4254 4255 4257 4258 4259 4290

100   Acute myocardial infarction

4100 41000 41001 41002 4101 41010 41011 41012 4102 41020 41021 41022 4103 41030 41031 41032 4104 41040 41041 41042 4105 41050 41051 41052 4106 41060 41061 41062 4107 41070 41071 41072 4108 41080 41081 41082 4109 41090 41091 41092

101   Coronary atherosclerosis and other heart disease

V4581 V4582 4110 4111 4118 41181 41189 412 4130 4131 4139 4140 41400 41401 41403 41406 4148 4149

102   Nonspecific chest pain

78650 78651 78659

103   Pulmonary heart disease

4150 4151 41519 4160 4161 4168 4169 4170 4171 4178 4179

104   Other and ill defined heart disease

41410 41411 41412 41419 4291 4292 4293 4295 4296 42971 42979 42981 42982 42989 4299

105   Conduction disorders

V450 V4500 V4501 V4502 V4509 V533 V5331 V5332 V5339 4260 42610 42611 42612 42613 4262 4263 4264 42650 42651 42652 42653 42654 4266 4267 42681 42689 4269

106   Cardiac dysrhythmias

4270 4271 4272 42731 42732 42760 42761 42769 42781 42789 4279 7850 7851

107   Cardiac arrest and ventricular fibrillation

42741 42742 4275

108   Congestive heart failure, nonhypertensive

39891 4280 4281 42820 42821 42822 42823 42830 42831 42832 42833 42840 42841 42842 42843 4289

Resident hospitalizations with a principal diagnosis of acute myocardial infarction. An acute myocardial infarction (AMI) is death of tissue in heart muscle due to an interruption in the blood supply. An AMI or "heart attack," is usually caused by a blood clot obstructing a coronary artery.
International Classification of Diseases (ICD-9-CM) code 410.

Resident visits to a hospital emergency room with a principal diagnosis of acute myocardial infarction. An acute myocardial infarction (AMI) is death of tissue in heart muscle due to an interruption in the blood supply. An AMI or "heart attack," is usually caused by a blood clot obstructing a coronary artery.
International Classification of Diseases (ICD-9-CM) code 410.

Resident hospitalizations with a principal diagnosis indicating myocardial infarction with ST-segment elevation. A STEMI heart attack is one for which the electrocardiogram shows ST-segment elevation, usually in association with an acutely blocked coronary artery. A STEMI is one type of heart attack that is a potentially lethal condition for which specific therapies, administered rapidly, reduce mortality and disability. The more time that passes before blood flow is restored, the more damage that is done to the heart muscle.
Classification of Diseases (ICD-9-CM) codes 410.0-410.6, 410.8

The amount that the hospital charges for inpatient hospitalizations for residents of the area (state, region, county) admitted for acute myocardial infarction with ST-segment elevation. The charges do not necessarily represent the cost to the hospital of providing the care nor do they represent the amount actually collected by the hospital for providing the care.

The days of care (length of stay) in the hospital for residents of the area (state, region, county) admitted for acute myocardial infarction with ST-segment elevation.

Discharge Status: Home: Discharged to home or self care-routine discharge.
Discharge Status: Rehabilitation: Discharged to a rehabilitation facility. This is not coded by all hospitals and is probably underreported.
Discharge Status: Other LTC Facility: Discharged to an intermediate care facility, skilled nursing facility, or long term care hospital.
Discharge Status: Died: Patient died in the facility.

Resident visits to a hospital emergency room with a principal diagnosis indicating myocardial infarction with ST-segment elevation. A STEMI heart attack is one for which the electrocardiogram shows ST-segment elevation, usually in association with an acutely blocked coronary artery. A STEMI is one type of heart attack that is a potentially lethal condition for which specific therapies, administered rapidly, reduce mortality and disability. The more time that passes before blood flow is restored, the more damage that is done to the heart muscle.
International Classification of Diseases (ICD-9-CM) codes 410.0-410.6, 410.8

Resident hospitalizations with a principal diagnosis indicating myocardial infarction without ST-segment elevation. An NSTEMI is a type of heart attack caused by a partially blocked blood supply to a portion of the heart. While serious, this type of heart attack is not considered as dangerous as a STEMI heart attack, where an artery in the heart is completely blocking blood flow to a portion of the heart. This form of heart attack does not result in an elevation of the 'ST segment' of the electrocardiogram.
International Classification of Diseases (ICD-9-CM) code 410.7.

The amount that the hospital charges for inpatient hospitalizations for residents of the area (state, region, county) admitted for acute myocardial infarction without ST-segment elevation. The charges do not necessarily represent the cost to the hospital of providing the care nor do they represent the amount actually collected by the hospital for providing the care.

The days of care (length of stay) in the hospital for residents of the area (state, region, county) admitted for acute myocardial infarction without ST-segment elevation.

Discharge Status: Home: Discharged to home or self care-routine discharge.
Discharge Status: Rehabilitation: Discharged to a rehabilitation facility. This is not coded by all hospitals and is probably underreported.
Discharge Status: Other LTC Facility: Discharged to an intermediate care facility, skilled nursing facility, or long term care hospital.
Discharge Status: Died: Patient died in the facility.

Resident visits to a hospital emergency room with a principal diagnosis indicating myocardial infarction without ST-segment elevation. An NSTEMI is a type of heart attack caused by a partially blocked blood supply to a portion of the heart. While serious, this type of heart attack is not considered as dangerous as a STEMI heart attack, where an artery in the heart is completely blocking blood flow to a portion of the heart. The NSTEMI form of heart attack does not result in an elevation of the 'ST segment' of the electrocardiogram.
International Classification of Diseases (ICD-9-CM) codes 410.7.