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States with highest population-based death rates - what's going on out west? Posts from 2009

JimO

Well-known member
I wonder if there are any sequences from South Dakota, New Mexico, Wyoming, Arizona, Alaska, Utah, or Nevada indicating D225G? Doesn't it seem odd that South Dakota has double to triple the death rate of most other states?

Deaths per million residents

South Dakota 26.1
New Mexico 20.2
Wyoming 18.8
Arizona 17.8
Alaska 16.0
Utah 14.3
Nevada 13.8
Montana 12.4
California 11.6
Puerto Rico 11.4
Colorado 11.1
Rhode Island 10.5
Washington 10.5
 
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Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

For further consideration -

The combined population of Arizona, Nevada, New Mexico, South Dakota, Utah, and Wyoming is 15.16M. The combined confirmed H1N1 deaths are 262. This results in a population-based rate of 17.3 deaths per million (the highest in the world). This is far higher than Ukraine, Norway, or any of the nations in the Southern Hemisphere, and we still face the peak flu season in 6 to 8 weeks.

Another curious point - these states are not nearly as densely populated as California or states east of the Mississippi, where one would expect more deaths, based on population. These are largely pre-vaccination impacts and I'm not aware of Tamiflu shortages in these states, so there is no obvious cause that I can see.

Based on the data, I am quite concerned that something is going on in the Western U.S. and I hope people who know a lot more about this than I do are paying attention.
 
Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

I wonder if their school calendars might have something to do with it. I wonder if states that went back earlier than we did in the East or which have more year-round schedules have higher death rates.
 
Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

In post #2 above JimO poses an interesting question. Why are H1N1 deaths so high in western US states when adjusting for the size of the population? He also notes that many of the states have low population densities. Below is a population density map for the US with JimO's deaths rates per million residents (from post #1) plotted. He is correct that the highest rates of H1N1 deaths occur in states with some of the lowest population densities. This is counterintuitive. The expectation is that states with higher population densities would have more cases of H1N1 because of easier transmission and, along with higher infection rates, higher rates of death. Whether there are some demographic factors in the western states that are playing a role in high death rates is unknown because of the lack of publicly available information about individuals who have died from H1N1 in the USA.

H1N1 deaths  by Population and Density 20091128.png
Population density map source:http://upload.wikimedia.org/wikipedia/commons/7/78/USA_states_population_density_map.PNG
 
Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

I can think of two differences: drier climate in the West, and a higher percentage of certain ethnic/racial groups that might possibly be more susceptible (I remember there was some speculation about that at the beginning of the pandemic, but don't know if it was actually researched, perhaps not because of touchy political issues).
 
Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

This is a sociological guess about transmission. I lived in Utah for 6 years, which is possibly over 60% Mormon. Nevada and Wyoming are also very high in LDS populations. I will respectfully note that although they are more spread out, they come together often during the week for worship and social activities. However, this guess doesn't seem to explain S.Dakota and New Mexico.
 
Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

I can think of two differences: drier climate in the West, and a higher percentage of certain ethnic/racial groups that might possibly be more susceptible (I remember there was some speculation about that at the beginning of the pandemic, but don't know if it was actually researched, perhaps not because of touchy political issues).


Hippocrates, welcome to Flutrackers.

Yes, there is some evidence that H1N1 differentially affects some ethnic groups more than others. But that probably doesn't explain the high death rate in South Dakota (the highest in the USA). According to the US Census, about 87% of the state's population is self-identified as "White", making it a fairly homogeneous state for such a high death rate.

Below is a link to the US Census maps for all states and shows the percentage population that self-identifies as "White". Many of the states that have a diverse population do not have high death rates.

http://factfinder.census.gov/servle..._2008_3YR_G00_&-_MapEvent=displayBy&-_dBy=040
 
Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

Welcome to FT Hippocrates. :)

.
 
Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

I can think of two differences: drier climate in the West, and a higher percentage of certain ethnic/racial groups that might possibly be more susceptible (I remember there was some speculation about that at the beginning of the pandemic, but don't know if it was actually researched, perhaps not because of touchy political issues).
The drier climate is a good point. The virus has also persisted in some of those states over the summer. Thanks for posting and welcome. It's good to have you here.
 
Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

Although methemoglobin is continually produced in humans, an enzyme in the human body reduces methemoglobin to hemoglobin. In most individuals, methemoglobin is rapidly converted back to hemoglobin. Typically, less than 1 percent of the total circulating hemoglobin in a healthy adult is present in the form of methemoglobin. Infants, however, have a low concentration (about 60 percent of the adult concentration) of the reducing enzyme, as do some older individuals with an enzyme deficiency. In these people, methemoglobin is not converted to hemoglobin as readily.
Methemoglobinemia Case Histories

Cases of infant methemoglobinemia have been reported in the United States. The majority of reported cases were in infants under the age of four months and who were fed milk formulas prepared with contaminated well water. A Nebraska survey of physicians reported in the Nebraska Medical Journal in 1981 indicated at least eight cases of infant methemoglobinemia were treated in Nebraska between 1973 and 1978. More recently, two infants with methemoglobinemia were identified by the South Dakota Department of Health. The private well water was found to have a nitrate-nitrogen concentration of 150 mg/l in one instance and 54 mg/l in the other. In Colorado, a case of methemoglobinemia involved an infant ingesting water containing 13.3 mg/l nitrate-nitrogen. No cases have been identified with water at or below the MCL of 10 mg/l nitrate-nitrogen.
http://www.p2pays.org/ref/20/19714.htm

The drier climate is a good point.
Jimo - with drier climate comes a worsening of water conditions.

www.state.sd.us/doa/das/news_S97.pdf+%22south+dakota%22+drinking+water+nitrate&hl=en&gl=nz&sig=AHIEtbQAGc1ZL7of2DQK3xp2AH-BMomjqQ
Water flowing from saline seeps has been found to carry high concentrations of naturally occuring nitrate, sulphate and selenium
This might well be the problem around Utah. Many areas have saline in the drinking waterfrom ancient sea beds, salt water intrusion from the sea when aquifers are stressed and where there are oil wells brackish water is sometimes pumped into the earth? contaminating the local aquifers.Salt in the drinking water appears to be causing an increase in severity of symptoms.

The bottom line is we have to identify the correlating environmental factors if it is not a mutation problem.

And - remiss of me - welcome Hippocrates.
 
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Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

I wonder if there are any sequences from South Dakota, New Mexico, Wyoming, Arizona, Alaska, Utah, or Nevada indicating D225G? Doesn't it seem odd that South Dakota has double to triple the death rate of most other states?

Deaths per million residents

South Dakota 26.1
New Mexico 20.2
Wyoming 18.8
Arizona 17.8
Alaska 16.0
Utah 14.3
Nevada 13.8
Montana 12.4
California 11.6
Puerto Rico 11.4
Colorado 11.1
Rhode Island 10.5
Washington 10.5

In comparision, the highest rates in Scotland (and likely also highest of Europe) are found in

Borders 26.69
Fife 16.58
Ayrshire & Arran 16.32
Greater Glasgow & Clyde 15.07

Highest rates of Norway are seen in

Innlandet (Hedmark & Oppland) : 13.35
Oslo & Akershus : 9.07
 
Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

Celvin what table is this ? here in the Borders I think we only had 3 deaths and 2 of those were a mum and baby..?
 
Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

hello ming

Borders, of course has a relatively small population - mid-year 2008 the number of inhabitants stood at 112 400

3 H1N1 deaths brings Borders to the highest death rate in Europe, if we compare regional data

Celvin11
 
Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

I wonder if there are any sequences from South Dakota, New Mexico, Wyoming, Arizona, Alaska, Utah, or Nevada indicating D225G? Doesn't it seem odd that South Dakota has double to triple the death rate of most other states?

Deaths per million residents

South Dakota 26.1
New Mexico 20.2
Wyoming 18.8
Arizona 17.8
Alaska 16.0
Utah 14.3
Nevada 13.8
Montana 12.4
California 11.6
Puerto Rico 11.4
Colorado 11.1
Rhode Island 10.5
Washington 10.5

Fog of War?

You have likely seen the odd story about MEs are catching H1N1 deaths in postmortem.

Perhaps MEs and docs in these sleepy areas have the luxury of doing a more exact job of IDing H1N1 in the living and then in the dead. (Am guessing its more the first than the last unless there is data to support that)

Whereas the intense crush of inner city hospitals, the sheer mass of cases of all sorts of disease conditions makes for a statistical skew as you see above.

(as well as many many uninsured who may not even go to the hosp and then are not caught in postmortems)

Just throwing these confounding factors into the conversation.
 
Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

Fog of War?

You have likely seen the odd story about MEs are catching H1N1 deaths in postmortem.

Perhaps MEs and docs in these sleepy areas have the luxury of doing a more exact job of IDing H1N1 in the living and then in the dead. (Am guessing its more the first than the last unless there is data to support that)

Whereas the intense crush of inner city hospitals, the sheer mass of cases of all sorts of disease conditions makes for a statistical skew as you see above.

(as well as many many uninsured who may not even go to the hosp and then are not caught in postmortems)

Just throwing these confounding factors into the conversation.

There may be some truth in Nika's observations. Public health official in the western USA may be doing a better job communicating with local doctors and hospitals to get accurate H1N1 death counts. As noted in the map below some of these states have a lower death rate per 100,000 individuals than other parts of the country. Whether these overall lower rates allow better identification of cause of death is open to debate.

USA Death Rates.png

map source: http://www.statehealthfacts.org/comparemaptable.jsp?cat=2&ind=58
 
Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

Probably coincidental but, the top 5 states also may have the highest percent of Native Americans.
 
Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

Probably coincidental but, the top 5 states also may have the highest percent of Native Americans.

Yes, but my cursory review of the demographics of deaths in these states does not indicate a high percentage of Native American deaths. Perhaps JimO or someone else tabulating the deaths can comment.
 
Re: States with highest population-based death rates - what's going on out west?

Re: States with highest population-based death rates - what's going on out west?

Yes, but my cursory review of the demographics of deaths in these states does not indicate a high percentage of Native American deaths. Perhaps JimO or someone else tabulating the deaths can comment.
I don't have much information on ethnicity. I will try to look into this in the coming week. The next couple of days will be very busy because most public health offices were closed Thursday and Friday and very little media coverage has been seen since Wednesday. After the dust settles, I should have time to look into this for states where the information is available.
 
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