How people die in SLO County: Stroke, drugs, suicide

jlamb@thetribunenews.comMay 16, 2013 

Coroner's investigators Jeff Nichols, left, and Stuart MacDonald prepare to perform an autopsy at the Los Osos Valley Mortuary.


San Luis Obispo County has the highest rate of stroke death in California and an above-average incidence of drug-induced deaths but is among the healthiest counties for mortality relating to heart disease and the flu.

But fewer people on average die here of diabetes, Alzheimer’s disease and homicide than in most of the state’s 58 counties.

Those results are the highlights of a report recently released by the California Department of Public Health and the Conference of Local Health Officers. Since 1993 the County Health Status Profiles has annually taken a selection of health indicators — this year’s looked at the 2005-11 period — and painted a picture of what people die of across the state (per every 100,000 people).

Most of San Luis Obispo County’s death rates align with other affluent counties in the state, but not all: For instance, suicide rates here are among the highest in the state and chronic lower respiratory disease deaths are above the state average.

But geographically based mortality rates, wherever they rank, do not always foretell a person’s likeliness to die of a certain disease, said San Luis Obispo County’s epidemiologist, Ann McDowell. She has not read the state’s latest report but closely tracks the county’s health and mortality.

While these mortality rates can help reveal the health of the county’s population now, McDowell warns that dying of a disease does not mean a person didn’t have other implicating factors, and, she added, causes of death are often multifaceted. Heredity, lifestyle and environment can all play a role.

“I have read a lot of death certificates in this county, and I can tell you some are incomplete,” she said. Still, she added, “By and large we have a pretty healthy county. For the most part, people make good lifestyle choices here.”

Here’s a closer look at the report’s findings. (Rankings are from best to worst. So the No. 1 county in a particular category is the most healthy, No. 58 the least):


San Luis Obispo County has the highest rate of stroke-related deaths in the state — 56.6 per 100,000 people, whereas the state average is 38.1. The county’s stroke death rates are similar to counties in the Central Valley rather than the Bay Area or the Los Angeles area as is the case for many of San Luis Obispo’s other death rates.

“We have a healthy population, but living longer means chronic diseases,” said McDowell. Therefore, she said, high stroke rates can mask the fact that people live with other diseases, too.

Drug-induced death

The county’s rate of drug-induced death — 14.5 per 100,000 people — is higher than the state’s 10.9. San Luis Obispo County ranks 36th, which is akin to counties as different as San Diego, Merced and Sonoma. McDowell, who is concerned about drug deaths, said they are mostly caused by prescription drug abuse and accidents. “I am constantly concerned with the unintentional drug death in the county.”


San Luis Obispo County ranks 38th in the state for suicides with a rate of 16.3 per 100,000 people compared to the state’s 10.2. But McDowell warns this is not all it seems. Many of the suicides in the county are visitors committing suicide rather than locals, which artificially raises the local rate.

Chronic lower respiratory disease

The county’s 37.8 rate of respiratory disease is only slightly higher than the state’s 37.5 rate. The county ranks 23rd. But McDowell pointed out that this may be partly caused by the large number of retirees who move here. Environmental factors not present here — air pollution, for instance — may have been worse in the counties where retirees used to live and that exposure impacted their lungs.

Alzheimer’s disease, heart disease, diabetes and influenza/pneumonia

San Luis Obispo County has rates among the lowest 20 counties for all of these diseases: 18th lowest for Alzheimer’s or a rate of 23.7 per 100,000 people; 14th lowest for diabetes with a rate of 13.5; and seventh for coronary heart disease with a rate of 90.5. The county has the eighth lowest rate of death from the flu and pneumonia, at 11.0. McDowell said these low rates are most likely because of the relatively healthy lifestyle choices made here.

All cancers

While the county ranks among the lowest in the state in cancer death rates — the 20th lowest — McDowell says that San Luis Obispo County also ranks among the highest for invasive cancer. It’s just that here the disease is caught and treated more often, so it doesn’t show up as a major cause of death, she said. But low death rates mask the extremely high rate of cancer here. “I can’t explain the rates,” McDowell said.

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