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Presentation: Massachusetts Deaths 2007 (PPT 1.2MB)

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Massachusetts Deaths 2007
Bruce Cohen, PhD
Massachusetts Department of Public Health
Bureau of Health Information, Statistics,
Research, and Evaluation
Division of Research and Epidemiology
Registry of Vital Records and Statistics
April 2009
Causes of Death
Massachusetts: 1842-2007
60%
50%
Infectious
Disease
Percent of Total Deaths
Heart Disease
40%
30%
20%
Cancer
10%
1842
1848
1854
1860
1866
1872
1878
1884
1890
1896
1902
1908
1914
1920
1926
1932
1938
1944
1950
1956
1962
1968
1974
1980
1986
1992
1998
2007
0%
Injuries
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Outline
• Highlights
• Selected Causes of Death
-
Cancer
Heart Disease
Diabetes
HIV/AIDS
Injury
• Race, Education and Mortality
• Applications of Mortality Data
• Summary
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
HIGHLIGHTS
On An Average Day in Massachusetts
1 Infant
death
36 Cancer
35 Heart Disease
3 Diabetes
144 DEATHS
5 Alzheimer’s
8 Injury
6 CLRD
7 Stroke
52,690
Total deaths in 2007
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Life Expectancy at Birth
Massachusetts vs. U.S.1: 1900-2007
90
Life Expectancy in Years
Massachusetts
80
80.2
78.1
United States
70
60
50 47.3
40
1900 1910 1920 1930 1940 1950 1960 1970 1980 1987 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
1
2007 U.S. data was not available at the time of this release, 2006 U.S. data used.
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Overall Mortality Rates
Massachusetts and U.S.1 : 1994-2007
1,000
Deaths per 100,000
920.0
900
United States
868.2
- 1.9%* APC
800
776.4
Massachusetts
700
- 2.4%*
APC
704.4
600
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population.
1
* Statistically significant (p<0.05)
APC= Annual Percent Change
2006 Data. 2007 U.S. Data was not available at the time of this release
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Percentage Difference in Mortality Rates
Massachusetts vs. U.S.1: 2007
50%
Nephritis*
% difference
30%
10%
25%
Heart
Diabetes*
Homicide*
Infant Disease*
Cancer*
Suicide*
Mortality*
Overall*
-1%
-10%
-9%
-17%
-30%
-29%
-29%
-27%
Higher than US
-50%
-52%
Lower than US
-70%
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population.
1
*Statistically Significant (p ≤ .05)
2006 Data. 2007 U.S. Data was not available at the time of this release
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Leading Causes of Death
Massachusetts: 2007
Other
23.4%
Cancer
24.6%
Septicemia
1.7%
Diabetes
2.3%
Nephritis
Heart
Disease
24.2%
2.6%
Alzheimer’s
3.2%
Pneumonia
& Influenza
2.9%
Chronic Lower
Respiratory Stroke
Disease
5.1%
Injury
4.4%
In 2007:
•12,961 cancer deaths
•12,735 heart disease deaths
5.6%
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Ranking of Leading Causes of Death
by Race and Ethnicity
Massachusetts: 2007
White1
Black1
Asian1
Hispanic
(N=48,.518)
(N=2,211)
(N=610)
(N=1,264)
Cancer
1
1
1
1
Heart Disease
2
2
2
2
Stroke
3
6
3
5
CLRD2
4
9
6
16
Unintentional Injuries
5
5
5
3
Alzheimer’s Disease
6
14
14
15
Influenza & Pneumonia
7
15
4
17
Nephritis
8
3
8
9
Diabetes
9
4
7
4
HIV/AIDS
29
8
--
8
Homicide
30
7
21
7
Note: The lower the number the higher the rank
1 Non-Hispanic, 2 Chronic
Lower Respiratory Disease
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Leading Causes of Death by Age
Massachusetts: 2007
Age
Leading Cause
% of Total in
Age Group
Total
Deaths
1-14 Injuries
32%
128
15-24 Injuries
72%
505
25-44 Injuries
44%
2,023
45-64 Cancer
37%
8,560
65-74 Cancer
40%
7,494
75-84 Cancer
27%
14,781
30%
18,816
85+
Heart Disease
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Changes in Mortality Rates
Massachusetts: 2000 and 2007
Rate
Cause
Cancer
Heart Disease
Stroke
Chronic Lower
Respiratory Disease
All Injuries
Alzheimer’s Disease
Nephritis
Diabetes
All Diabetes-related
2000
% Change
2007
206.1
216.7
50.9
179.0 *
166.0 *
35.0 *
пѓІ13%
пѓІ23%
пѓІ31%
41.8
35.9
19.5
17.6
19.6
61.5
31.5
42.5
20.9
17.9
16.5
52.9
пѓІ25%
пѓ±18%
пѓ± 7%
пѓ± 2%
пѓІ16%
пѓІ14%
*
*
*
*
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population. * Statistically different than 2000 rate (p<0.05)
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
SELECTED CAUSES OF DEATH
Cancer Mortality Rates
Massachusetts and U.S. : 1994-20071
250
Deaths per 100,000
226.0
Massachusetts
200
212.4
United States
179.0
180.8
150
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Year
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population
1
2006 Data. 2007 U.S. Data was not available at the time of this release
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Female Breast Cancer Mortality Rates
Massachusetts: 1994-2007
40
35
Deaths per 100,000
35.4
- 4%* APC
30
25
20
20.4
15
1994
1995
1996
1997
1998
1999
2000
2001
2002
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population
2003
2004
2005
2006
2007
* Statistically significant (p<0.05)
APC= Annual Percent Change
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Heart Disease Mortality Rates
Massachusetts and U.S.: 1994-20071
310
300.2
290
United States
Deaths per 100,000
270
250
261.5
230
Massachusetts
210
199.4
190
170
166.0
150
130
1994
1995
1996
1997
1998
1999
2000
2001
2002
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population
2006 Data. 2007 U.S. Data was not available at the time of this release
1
2003
2004
2005
2006
2007
* Statistically significant (p<0.05)
APC= Annual Percent Change
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Number of Heart Disease Deaths
by Age and Gender
Massachusetts: 2007
7,000
6,622
6,112
Number of Deaths
6,000
Males
Females
5,000
3,780
4,000
3,000
1,804 1,750 1,913
2,000
1,000
202 79
995
742
456
150
307
556
0
< 45
45-54
55-64
65-74
75-84
85+
Total
Ages
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Diabetes-Related Deaths
Massachusetts: 2007
All Diabetes-related
N=3,899
Underlying Cause
Contributing Cause
(Looking at all other 15
conditions mentioned on
death certificates)
N=2,683
(Disease or injury which
initiated the train of events
leading directly to death, or
the circumstances of the
accident or violence which
produced the fatal injury)1
N=1,216
1
World Health Organization. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision.
2d ed. Geneva: World Health Organization. 2004.
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Diabetes Mortality Rates
by Race and Ethnicity
Massachusetts: 2007
37.4 *
Deaths per 100,000
40
28.2 *
30
20
16.5
15.5
9.9 *
10
0
Whites
N=1,041
Blacks
N=96
Asians
Hispanics
Total
N=15
N=62
N=1,216
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population
* Statistically different than state rate (p<0.05)
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Number of HIV/AIDS Deaths
Massachusetts: 1987-2007
1,200
998
Number of Deaths
1,000
Highly Active
Antiretroviral Therapy
HAART
800
648
600
400
241
277
200
143
0
1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Percent of HIV/AIDS Deaths by Age Group
Massachusetts: 1994-2007
100%
90%
80%
Percent of HIV/AIDS Deaths
80%
73%
Less than 45 years
70%
60%
50%
40%
30%
45+ years
20%
10%
27%
20%
0%
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
2007
Injury Deaths
Causes of Injury Deaths
Massachusetts: 2007
Total Injuries = 2,967
Other
18%
Poisonings
33%
Firearm
8%
66% Opioids
18% Alcohol
16% Other (gases,
vapor, NSAIDS, etc)
Suffocation, Hanging
or Strangulation
11%
Motor Vehicle-related
15%
Falls
16%
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Number of Poisoning Deaths
Where Opioids Are Mentioned
Massachusetts: 2000-2007
1,000
Number of deaths
750
574
500
487
637
637
2006
2007
544
475
449
363
250
0
2000
2001
2002
2004
2003
2005
Year
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Unintentional Fall Mortality Rates
Persons Ages 65+
Massachusetts and U.S.: 1994-2007
50
Ages 65+, Deaths per 100,000
43.0
42.3
United States1
40
30
22.1
20
15.8
Massachusetts
10
0
1994
1995
1996
1997
Rates are per 100,000 population ages 65+.
1998
1999
2000
2001
2002
1
2003
2004
2005
2006
2007
Available from URL: www.cdc.gov/ncipc/wisqars
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Intentional Injury Deaths by Cause
Massachusetts: 2007
Other
(n=55)
Other
(n=37)
Cut/Pierce
(n=33)
Firearm
(n=113)
Homicide
(n=183)
Suicide
(n=504)
Firearm
(n=112)
Hanging
(n=220)
Poisoning
(n=117)
N= 687 deaths
(183 homicides)
(504
suicides)
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Suicides by Gender and by Age
Massachusetts: 2007
159
160
141
Number of Deaths
140
Female
Male
120
100
80
60
48
43
34
40
24
20
11
7
6
16
13
0
0
15-24
25-44
45-64
65-74
75-84
85+
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Suicide Rates by Gender
Massachusetts: 1994-2007
16
Deaths per 100,000
14
13.6
12.4
12
Males
10
8.1
8
- 3%* APC
7.5
Massachusetts
6
4
2
3.5
Females
3.0
0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population.
* Statistically significant (p<0.05)
APC= Annual Percent Change
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Child Homicides (Ages 1-14)
Massachusetts: 1997-2007
18
16
16
Number of Deaths
14
12
11
10
8
8
6
7
5
7
5
4
5
4
4
3
2
0
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
2007
Race, Education, and Mortality
Mortality Rates by Education and
Race/Ethnicity, Adults 25-64 Years1
Massachusetts: 2007
Deaths per 100,000
800
600
High School or Less
13+ Education
727.3 *
533.7 *
467.7*
400
358.5
231.0
200
181.0
0
Whites
Blacks
Hispanics
* Statistically higher than those with 13+ yrs of education (p<0..05)
1Uses 2000 Population Estimates
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Mortality Rates by Race/Ethnicity
Adults 25-64 Years1 with 13+Years of Education
Massachusetts: 2007
Deaths per 100,000
600
400
358.5 *
231.0
200
181.0
0
Whites
Blacks
Hispanics
* Statistically higher than the rate for whites (p<0..05)
1Uses 2000 Population Estimates
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Applications of Mortality Data
Premature Mortality Rate (PMR)1
• Definition
– deaths before age 75, age-adjusted to the 2000 US standard
population under 75 years of age
• Focus
– two-thirds of deaths to persons ages 75+
– majority of deaths to persons age 75+ are due to chronic
conditions associated with aging
– deaths to persons less than 75 years may be preventable
• Value
– excellent measure to reflect the health status of a population
– used as a health status indicator that can be used to focus
prevention initiatives and target programs
1
Age-adjusted to the 2000 US standard population under 75 years of age.
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Premature Mortality Rates
by Race and Hispanic Ethnicity
Massachusetts: 2007
Deaths per 100,000
600
428.3 *
400
293.5
200
277.4
295.4
Hispanics
Total
141.3 *
0
Whites
Blacks
Asians
(*) Statistically different from State (p ≤.05)
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population persons ages 0-74
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Premature Mortality Rates (PMR) by
Community Health Network Area (CHNA)
Massachusetts: 2007
Massachusetts PMR= 295.4
12
11
10
2
13
9
16 14
15
1
17
3
7
8
19
18
21
4
20
5
6
22
23
2007 PMR by CHNA
24
Significantly higher than state rate
Not significantly different from state rate
Significantly lower than state rate
CHNA PMR
1. Community Health Network of Berkshire = 331.0
2. Upper Valley Health Web-Franklin County = 303.5
3. Partnership for Health in Hampshire County = 319.1
4. The Community Health Connection = 384.3
5. Community Health Network of Southern Worcester County = 335.9
6. Community Partners for Health = 290.2
7. Community Health Network of Greater Metro West = 238.6
8. Community Wellness Coalition = 355.6
9. Fitchburg/Gardner Community Health Network = 322.6
10. Greater Lowell Community Health Network = 350.9
11. Greater Lawrence Community Health Network = 281.9
12. Greater Haverhill Community Health Network = 331.3
13. Community Health Network North = 267.4
25
26
27
14. North Shore Community Health Network = 316.5
15. Greater Woburn/Concord/Littleton Community Health Network = 192.0
16. North Suburban Health Alliance = 285.6
17. Greater Cambridge/Somerville Community Health Network = 232.7
18. West Suburban Health Network = 210.6
19. Alliance for Community Health = 358.4
20. Blue Hills Community Health Alliance = 298.4
21. Hampshire County Partnership = 351.5
22. Greater Brockton Community Health Network = 366.6
23. South Shore Community Partners in Prevention = 284.9
24. Greater Attleboro-Taunton Health & Education Response = 354
25. Partners for a Healthier Community = 378.9
26. Greater New Bedford Health & Human Services Coalition = 343.5
27. Cape Cod & Islands Community Health Network = 295.9
Rates are per 100,000 persons under 75 years of age, age-adjusted to the 2000 US standard population and are calculated using MDPH
population
estimates
foryears
2005,ofwhich
are the most
available at the sub-state level by age groups.
Rates per 100,000
population
under 75
age; age-adjusted
to up-to-date
the 2000 USestimates
standard population.
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Mortality Amenable to Health Care
 Definition: Deaths for persons ages 0-74
from certain causes that should not occur in
the presence of timely and effective health
care1,2
 Value: A useful tool to assess
 Performance of health care systems and
 Track changes over time1
1
Nolte E and McKee CM. Measuring The Health of Nations: Updating An Earlier Analysis. Health Affairs 2008; Vol 27,
Number 1: 58-71; Jan/Feb 2008.
2 Nolte E and McKee CM . Does Health Care Save Lives? Avoidable Mortality Revisited. The Nullfield Trust. 2004.
London, England
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Mortality Causes
Amenable to Health Care
Causes considered as amenable to health care:
– Amenable to secondary prevention
• where screening and treatment are effective;
– for example colorectal, breast, cervical, and skin cancer
– Amenable to improved treatment and medical care:
• that require direct medical and/or surgical intervention
– for example appendicitis and hypertension
• that rely on efficient medical care delivery
– accurate and timely diagnosis, transport, and treatment
• that respond to antibiotic treatments and immunizations
– infectious diseases
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Percent Deaths Amenable to Health Care
Massachusetts: 2007
All Deaths
Deaths to Persons
Ages 0-74
Amenable
10% Deaths
Amenable
Deaths
28%
90%
72%
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Mortality Rates for Causes
Amenable to Health Care by Race/Ethnicity
Massachusetts: 2000 and 2007
2000
2007
160
Deaths per 100,000
142.9
122.9
120
105.4
103.6
80.5
80.8 **
82.1 **
80
64.5
53.1
40.6
40
0
Whites
Blacks
Asians
Hispanics
Total
** Statistically lower than 2000 rate (p<0.05)
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population persons ages 0-74
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
SUMMARY
Summary
пѓ�
The Massachusetts death rate was the lowest on record
пѓ�
Life expectancy reached an all-time high
пѓ�
Massachusetts continues to compare favorably with the
U.S.
пѓ�
Cancer remained the leading cause of death followed by
heart disease. As in previous years, cancer and heart
disease accounted for almost half of all deaths
пѓ�
Death rates for chronic lower respiratory disease, overall
cancer, and female breast cancer declined from 2006
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Summary (continued)
пѓ� Lowest annual number of HIV/AIDS deaths in
Massachusetts
пѓ� Almost Вѕ of HIV/AIDS deaths occurred among persons 45+ years
пѓ� Poisoning deaths, the leading cause of injury deaths,
were stable from 2006 to 2007
пѓ� Two out of 3 poisoning deaths were associated with opioids
пѓ� Suicide rates had leveled off since 2002 but increased
for men from 2006 to 2007
пѓ� Continued increasing trend in unintentional fall-related
deaths
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
Summary (continued)
Disparities Persist:
• The cancer death rate for men was 46% higher than
the rate for women
• Blacks had the highest premature mortality rate,
1.5 times the rate of whites
• The death rate for those with less education was
almost 3 times higher than the rate for those with more
education
• Springfield, Lowell, Fall River, Taunton, Worcester, and
New Bedford had the highest premature mortality
rates
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
How to Access the Death Report and Data
To access the 2007 Report:
•Hard Copies: (617) 740-2670
•TDD/TTY:
(617) 624-6001
•DPH Website:
http:// mass.gov/dph/bhsre/resep/resep.htm#birth
To access Death data via MassCHIP (DPH’s Internet
based public health information service):
•Website: http://masschip.state.ma.us
•Telephone: 1-888-MASCHIP (Mass only)
(617) 624-5629
Source: Massachusetts Department of Public Health, Bureau of Health Information, Statistics, Research, and Evaluation
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