Most physicians and epidemiologists agree that rheumatic heart disease is not distributed uniformly throughout the United States. Thoroughly reliable data on this problem may not become available until the development of some specific diagnostic test that would permit detection of mild or subclinical cases. In the meantime efforts have been made to estimate the distribution of this disease by (a) the use of rheumatic heart disease mortality statistics1 and (b) conclusions drawn from morbidity studies in certain segments of the population, such as school children2 or military personnel.3
Attempts to check the findings of one method by those of the other, for any given locality, have not been reported, but on one point there seems to be general agreement between the results of the various mortality studies and morbidity reports for this disease, namely, that the Rocky Mountain states have an undue amount of rheumatic fever. The
Maresh GJ, Dodge HJ, Lichty JA. INCIDENCE OF HEART DISEASE AMONG COLORADO SCHOOL CHILDREN: A STATE-WIDE STUDY. JAMA. 1952;149(9):802–805. doi:10.1001/jama.1952.02930260004002
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