Congestive Heart Failure in Metro Philadelphia
Based on our research, there were approximately 1,335 heart failure deaths in the greater Philadelphia metropolitan area in 2016. This includes 360 deaths in the City of Philadelphia, and 162 deaths in Delaware county, which is part of the Philadelphia core-based statistical area.
While three was plenty of available data that could help answer this request, interpreting it correctly and making the correct assumptions was key to ensuring a correct answer.
Defining Congestive Heart Failure Deaths
In the data sources we used, congestive heart failure was not separated from other forms of heart failure. This is due to ICD-10 coding practices, where a high level code (I50) is for all heart failure deaths, and lower level codes delineate specific types of heart failure. In the data and discussion of heart failure by the American Heart Association, heart failure is consistently addressed as one disease without anything specific about congestive heart failure. We have followed this convention in our research, and believe that heart failure overall is a reasonable proxy for congestive heart failure.
Defining Metro Philadelphia
Your request asked for statistics for Metro Philadelphia, and this can be interpreted multiple ways. Based on the availability of data, we chose to present data for Philadelphia county, which represents the City of Philadelphia. In addition, we are able to present data for the Philadelphia core-based statistical area, which consists of Philadelphia and Delaware counties. Finally, we present information for the Philadelphia-Reading-Camden, PA-NJ-DE-MD combined statistical area, which represents all of Metropolitan Philadelphia and encompasses area in four different states. All three of these geographic breakdowns were based on the census definitions for the respective geographies.
Data was available from the Pennsylvania Department of Health on deaths from diseases of the heart by county for 2016. This was used to produce the estimates for the City of Philadelphia and the Philadelphia core-based statistical area. However, because the Philadelphia-Reading-Camden, PA-NJ-DE-MD combined statistical area encompasses parts of four states, gathering county by county data was beyond the scope of a single Wonder request. Therefore, we used the Census estimate of the population and the overall heart failure mortality rate to estimate heart failure deaths in Metro Philadelphia.
Estimates for the City of Philadelphia and the Philadelphia core-based statistical area use age-specific rates of heart failure death, as heart failure death is not evenly distributed across the population by age. We were unable to estimate this way for all of Metro Philadelphia, and therefore use the overall age-adjusted mortality rate for the U.S. Population as the basis for our estimates. It should be noted that if the age distribution of the metro area differs substantially from the age distribution of the entire U.S., this estimate will be less accurate than a fully age-adjusted estimate.
The full calculations for the age adjusted estimates are available in this Google Document. It shows the following steps.
1. First, age-specific rates of the percentage of disease of the heart deaths that were caused by heart failure were calculated using the 2014 Deaths data from the CDC.
2. Next, those age-specific rates were applied to the actual death data by county from the Pennsylvania Department of Health to arrive at a final estimate.
To produce an estimate for the entire metro region, we multiplied the national rate for heart failure deaths per 100,000 by the population of Metro Philadelphia.
Total Heart Failure Deaths = Population / 100,000 * Mortality Rate per 100,000
Total Heart Failure Deaths = 7,179,357 / 100,000 * 18.6 = 1,335
Checks with other sources
To confirm the data this was based on was accurate, we checked the statistics put out by the American Heart Association about heart failure deaths. In their detailed statistics on heart failure, they use the same source we used for national estimates — Deaths: Final Data for 2014 from the CDC.
While pre-compiled data on congestive heart failure deaths in Metro Philadelphia was not available, we were able to triangulate reasonable estimates of heart failure deaths for three levels of geography that should answer the question.