It does seem like quite an outlier. I found another article that mentions it and splits it by county. http://socialcapitalreview.org/washington-tops-u-s-in-12-yea...

It looks like a problem in the western part of the state, but I don't see any suggestion of why that is.

*Correction: Meant county instead of country.

This definitely deserves some kind of investigation. There's probably something to learn from such high levels of difference in very close counties : http://socialcapitalreview.org/wp-content/uploads/2013/03/Sc...

As a resident of Washington the first thing that comes to mind is the difference in climate between the west and east. The eastern part of the state is mostly semi-arid, nearly desert in some areas.

I've heard we also have one of the highest rates of multiple sclerosis in the US, but I'm having a hard time finding good data on that.

It could also be something innocent, like a large treatment center or palliative care facility.

That is, unless the data is meticulously groomed to report the patients' county/state of origin.

I contacted Dr Doraiswamy (a well known Alzheimer specialist) and he could not think of any other reason than "higher rate of APoE4 genotype due to greater Scandinavian heritage". He also suggested this could be coming from the way the death ratio is calculated "ie the denominator of deaths to all other causes is lower due to better diet".

I'll see what I can find.

You mean by county, I presume.

I would also be interested in county data, if only because upstate New York and New York City are essentially two completely different places :P