Montgomery County, Maryland, residents have better health outcomes in a number of areas when compared to national or state data, according to a report released Friday.

Findings from the report show that the leading causes of death in the county are cancer, heart disease, accidents and lower respiratory disease.

While heart disease mortality decreased, the report states that emergency room use related to heart disease increased, and that African American and Hispanic residents had the highest rate of emergency room visits.

In Montgomery County, visits to emergency rooms due to substance abuse increased, along with the mortality rate. Non-Hispanic white residents and those between ages 18 and 34 had the highest rate of such visits.

The county’s acting health officer, Dr. James Bridgers, said in a statement from the county, “Montgomery County fares better than state and national averages for many health bench marks, such as life expectancy, but the data also suggests several concerning trends in access and utilization of care services.”

The county’s Department of Health and Human Services compiled information over a period of nine years, from 2010 to 2018.