Differences in the Health Status Among Ethnic Groups Arizona, 1999 Public Health Services Bureau of Public Health Statistics Office of Epidemiology and Statistics ~ Leadership for a Healthy Arizona ~ Jane Dee Hull, Governor State of Arizona Catherine R. Eden, Director Arizona Department of Health Services OFFICE OF EPIDEMIOLOGY AND STATISTICS BUREAU OF PUBLIC HEALTH STATISTICS ARIZONA DEPARTMENT OF HEALTH SERVICES 2700 North 3rd Street, Room 4075 Phoenix, Arizona 85004 Phone: 602/542-1216; FAX: 602/542-2940 http://www.hs.state.az.us/plan/index.htm This publication can be made available in alternative format. Please contact the Office of Epidemiology and Statistics at 602/542-1216 (voice) or call 1-800-367-8939 (TDD). Permission to quote from or reproduce materials from this publication is granted when due acknowledgment is made. Differences in the Health Status Among Ethnic Groups, Arizona, 1999 by Christopher K. Mrela, Ph.D., Assistant Registrar of Vital Statistics Trentham Coe, Senior Research Data Analyst January 2001 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 Differences in the Health Status Among Ethnic Groups, Arizona, 1999 Table of Contents Purpose....................................................................................................... 1 Demographic Profile of Arizona Ethnic Diversity ......................................... 1 Methods ...................................................................................................... 2 Key Findings ............................................................................................... 2 FIGURES .................................................................................................. 5 1. 2. 3. 4. 5. 6. 7. 8. 9. Teen Pregnancies ............................................................................ 7 Maternal Lifestyle and Health Characteristics ................................ 13 Utilization of Prenatal Care Services.............................................. 25 Newborn's Health .......................................................................... 31 Mortality from Natural Causes ....................................................... 43 Mortality from Injuries .................................................................. 65 Age-Specific Mortality.................................................................... 75 Patterns of Premature Mortality .................................................... 81 The Incidence of Reportable Diseases ........................................... 87 RATES AND RATIOS FOR 1999 ..................................................... 95 SCORES IN 1999 .............................................................................. 101 RANKING ORDER IN 1999 ............................................................ 107 COMPARATIVE RATES AND RATIOS FOR 1995, 1997 AND 1999 .......................................................... 113 DATA SOURCES AND DEFINITIONS .......................................... 121 Sources of Data....................................................................................... 123 Definitions .............................................................................................. 123 Terms Related to Reproductive Health .................................... 123 Terms Related to Mortality...................................................... 124 Medical Terms Used on the Birth Certificate............................ 125 POPULATION DENOMINATORS ................................................... 127 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 PURPOSE The report Differences in the Health Status Among Ethnic Groups, Arizona, 1999 is the update* of population-level data about differences in the relative health of five ethnic groups residing in Arizona: White non-Hispanics, Hispanics, Blacks (or African-Americans), American Indians and Asians (Asian or Pacific Islanders). The report compares the relative standing of ethnic groups on 67 indicators or measures of health status. The indicators are presented in a series of simple, self-explanatory bar charts and organized around 9 major subject areas: (1) TEEN PREGNANCIES, (2) MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS, (3) UTILIZATION OF PRENATAL CARE SERVICES, (4) NEWBORN'S HEALTH, (5) MORTALITY FROM NATURAL CAUSES (CHRONIC OR INFECTIOUS DISEASES), (6) MORTALITY FROM INJURIES, (7) AGE-SPECIFIC MORTALITY, (8) PATTERNS OF PREMATURE MORTALITY and (9) THE INCIDENCE OF REPORTABLE DISEASES. The report also provides scores and rankings of ethnic groups on each of the 67 health status measures. The comparisons of rates and ratios, as well as scores and rankings are intended to give some sense of the inequalities in the health status among ethnic groups in our State and to stimulate viable initiatives to improve the health of all Arizonans. DEMOGRAPHIC PROFILE OF ARIZONA'S ETHNIC DIVERSITY In 1999, the White non-Hispanic group in Arizona made up 67.4 percent of the total population statewide, while racial and ethnic minority groups accounted for 32.6 percent. The White non-Hispanic population increased by 64.1 percent from 1980 to 1999, while Arizona's minority population more than doubled from 697,000 in 1980 to 1,607,000 in 1999 (See p.127: Population Denominators, Population by Ethnic Group, Arizona Residents, 1980, 1990 and 1999). The fastest growing ethnic minority groups in Arizona between 1980 and 1999 were Asian (an increase of 322 percent), followed by Hispanic (139 percent), Black (138 percent) and American Indian (72.2 percent). Compared with the White non-Hispanic majority, the ethnic minority groups have had greater percentages of people younger than 25 years (48.6 vs. 29.9 percent). In contrast, people aged 65 years and older accounted for 17.9 percent of White non-Hispanics, but only 5.9 percent of all ethnic minority groups combined. ____________________________________ * Prior editions of this report were published for the 1995 and 1997 data years. This report uses the same methodology as 1997 edition, so that all scores and ranks are directly comparable. In addition, all rates and ratios are comparable for 1995, 1997 and 1999 (see p. 113 Comparative Rates and Ratios for 1995, 1997 and 1999). DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 2 METHODS The 67 indicators presented in this report are individual measures of the various dimensions or facets of health status. By calculating overall scores and rankings it is possible to provide a summary measure representing a relative standing of each ethnic group on a broad range of health status issues. Scores indicate the percentage an ethnic group is above or below the statewide average. Each score is calculated as follows: THE VALUE OF A RATE OR RATIO IN A SPECIFIED GROUP SCORE = - 1.0 X 100 THE AVERAGE VALUE OF A RATE OR RATIO FOR THE STATE Scores may have positive (+) or negative (-) values. The above formula produces a score of 0.0 for a group with the same value as the statewide average. A negative score indicates better than average standing on an indicator. The age-adjusted mortality rates presented in section 5 and section 6 of this report were computed by the direct method, i.e. by applying the age-specific death rates to the standard population distributed by age. The total U.S. population as enumerated in 1940 was selected as the standard. KEY FINDINGS In 1999, as in 1997, Arizona's Asian residents ranked best among ethnic groups in the overall health status, followed by White non-Hispanics, Hispanics, American Indians and Blacks. BLACKS Average rank: 4.1* Average score: +60.5** Arizona Black residents had the lowest rank of overall health status because they ranked 5th of 4th among the five ethnic groups on 49 of 67 measures (see Figure A). High infant mortality rate, high ratios of low birthweight and very low birthweight births, high incidence of many reportable diseases, high mortality rates for almost all of the leading causes of death and high rate of premature death all lowered the ranking for this population group. However, Blacks experienced an improvement in overall score from 71.9 in 1997 to 60.5 in 1999. This decrease in scores reflects substantial declines in age-adjusted mortality rates for HIV infection (which dropped 50.3 percent between 1997 and 1999), septicemia (44.5 percent), alcoholism (41 percent), firearm-related injuries (23.5 percent) and cancer (13.2 percent). _____________________________________ * The average rank based on all 67 measurements (the sum of the ranks divided by 67 measurements. Ranks range between 1 = the highest rank of health indicators and 5 = the lowest rank of health indicators). See section RATES AND RATIOS, p.95. ** The average score based on all 67 measurements (the sum of all scores divided by 67 measurements). See section SCORES, p.101. DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 3 AMERICAN INDIANS Average rank: 3.8 Average score: +61.0 In 1999, American Indians in Arizona had the highest average score among all groups, but second lowest rank of overall health status. They ranked 5th or 4th less often than Blacks (39 times on 67 indicators, Figure A), but they exceeded the statewide averages by a wider margin than any other group (Figure B). American Indians ranked poorly on measures of maternal lifestyle and health as well as in utilization of prenatal care. High infant mortality, alcoholism, diabetes, motor vehicle accidents and mortality from unintentional injuries contributed to the premature death rate. This resulted in the second lowest ranking of American Indians in the relative healthiness among racial and ethnic groups in Arizona. HISPANICS Average rank: 3.0 Average score: +7.1 In 1999, as in 1997, Hispanics achieved a 3rd place health ranking, with a score only slightly higher than that of White non-Hispanics. Hispanics ranked in the middle of five groups on 23 of 67 measures of health. They ranked worse than average in poor utilization of early prenatal care, high teen pregnancy rates and high premature mortality. They ranked better than average with low suicide mortality rate, low mortality from unintentional injuries, low alcohol and tobacco use among women giving birth and in total mortality. WHITE NON-HISPANICS Average rank: 2.6 Average score: -9.2 White non-Hispanics ranked second best in the relative healthiness among ethnic groups in Arizona. They ranked No.1 or No.2 on 37 of 67 measures of health, including low teen pregnancy rates, high utilization of prenatal care and low premature mortality. However, in the use of tobacco among women giving birth and in mortality rates for chronic obstructive pulmonary disease, lung cancer and Alzheimer’s disease, White non-Hispanics ranked worst among ethnic groups. ASIANS Average rank: 1.5 Average score: -46.3 Many factors contributed to Asians' No.1 relative health ranking. They ranked best or second best among ethnic groups on 63 of 67 indicators, including measures of maternal lifestyle and health, cause-and-age-specific mortality and in low incidence of reportable diseases. Asians ranked second best in utilization of prenatal care services and second with a low rate of premature death. The average score of Arizona Asian residents improved from –42.8 in 1997 to -46.3 in 1999. DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 4 Figure A Number of Times Each Group Ranked Better Than Average, Average, and Worst Than Average on 67 Indicators, Arizona, 1999 Black American Indian 4 14 49 14 Hispanic 15 21 White non-Hispanic 38 23 23 37 12 Asian 18 63 Better than Average (ranks 1 or 2) 13 Average (rank 3) Worst than Average (ranks 4 or 5) Figure B Average Scores in 1999 (A score is a percent above or below the average for all Arizona residents. A negative score indicates better than average standing on an indicator.) 90.0 Black 75.0 60.5 60.0 American Indian 61.0 45.0 30.0 Hispanic 7.1 15.0 AVERAGE FOR ALL ARIZONANS 0.0 -15.0 -9.2 -30.0 White non-Hispanic -45.0 -60.0 -75.0 -90.0 -46.3 Asian DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 5 FIGURES DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 7 1. Teen Pregnancies Females 19 and Younger Females 14 and Younger Females 15-17 Years Old Females 18-19 Years Old DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 9 Pregnancies Among Females Aged 19 and Younger 1-1 66.1 Hispanic 40.8 Black 36.1 ALL ARIZONANS 33.1 American Indian 21.0 White non-Hispanic 16.3 Asian 0.0 20.0 40.0 60.0 80.0 Number of pregnancies per 1,000 females aged 19 or younger DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 10 Pregnancies Among Females 14 and Younger 1-2 1.6 Hispanic Black 1.5 American Indian 1.5 0.9 ALL ARIZONANS 0.5 Asian 0.4 White non-Hispanic 0.0 0.4 0.8 1.2 1.6 2.0 Number of pregnancies per 1,000 females 10-14 years old DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 11 1-3 Pregnancies Among Females 15-17 Years Old 80.4 Hispanic 47.7 Black ALL ARIZONANS 40.2 American Indian 39.5 White non-Hispanic Asian 0.0 20.4 11.2 15.0 30.0 45.0 60.0 75.0 90.0 Number of pregnancies per 1,000 females 15-17 years old DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 12 1-4 Pregnancies Among Females 18-19 Years Old 215.5 Hispanic 141.4 Black American Indian 124.5 ALL ARIZONANS 122.7 74.6 White non-Hispanic 67.9 Asian 0.0 55.0 110.0 165.0 220.0 Number of pregnancies per 1,000 females 18-19 years old DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 13 2. Maternal Lifestyle and Health Characteristics Unmarried Mothers Tobacco Use During Pregnancy Alcohol Use During Pregnancy The Incidence of Chronic Hypertension Dysfunctional Labor The Incidence of Anemia During Pregnancy The Incidence of Diabetes The Incidence of Pregnancy-Associated Hypertension The Incidence of Genital Herpes Maternal Weight Gain of Less Than 21 Pounds DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 15 2-1 Unmarried Mothers 69.2 American Indian 64.0 Black 50.3 Hispanic 38.8 ALL ARIZONANS White non-Hispanic Asian 0.0 24.8 18.1 15.0 30.0 45.0 Per 100 live births 60.0 75.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 16 2-2 Tobacco Use During Pregnancy 11.7 White non-Hispanic 10.4 Black 7.3 ALL ARIZONANS American Indian Asian Hispanic 0.0 3.5 2.9 2.5 2.5 5.0 7.5 Per 100 live births 10.0 12.5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 17 2-3 Alcohol Use During Pregnancy 3.0 American Indian 1.7 Black 1.3 White non-Hispanic ALL ARIZONANS 0.5 Hispanic 0.5 Asian 0.5 0.0 0.7 1.4 2.1 Per 100 live births 2.8 3.5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 18 The Incidence of Chronic Hypertension in Women Giving Birth 2-4 0.9 American Indian 0.8 Black ALL ARIZONANS 0.3 White non-Hispanic 0.3 Asian 0.2 Hispanic 0.2 0.0 0.3 0.6 Per 100 live births 0.9 1.2 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 19 2-5 Dysfunctional Labor 1.5 American Indian 1.3 Asian 1.1 Black 1.0 White non-Hispanic 0.9 ALL ARIZONANS Hispanic 0.0 0.6 0.5 0.9 Per 100 live births 1.4 1.8 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 21 2-6 The Incidence of Anemia During Pregnancy 5.1 American Indian 2.7 Black 2.3 White non-Hispanic ALL ARIZONANS 2.1 Asian 1.4 Hispanic 1.3 0.0 1.0 2.0 3.0 Per 100 live births 4.0 5.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 21 2-7 The Incidence of Diabetes During Pregnancy 6.6 American Indian 3.6 Asian ALL ARIZONANS 2.2 Black 1.9 Hispanic 1.9 White non-Hispanic 0.0 1.7 1.5 3.0 4.5 Per 100 live births 6.0 7.5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 22 2-8 The Incidence of Pregnancy-Associated Hypertension 5.6 American Indian 3.4 White non-Hispanic ALL ARIZONANS 2.8 Black 2.7 Asian Hispanic 0.0 2.3 1.8 1.3 2.6 3.9 Per 100 live births 5.2 6.5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 23 2-9 The Incidence of Genital Herpes During Pregnancy 1.1 White non-Hispanic ALL ARIZONANS 0.7 Black 0.7 American Indian 0.3 Asian 0.3 Hispanic 0.0 0.2 0.2 0.4 0.6 0.8 Per 100 live births 1.0 1.2 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 24 2-10 Maternal Weight Gain of Less Than 21 Pounds 29.3 American Indian Black Hispanic ALL ARIZONANS Asian White non-Hispanic 0.0 22.3 20.4 19.2 17.4 16.5 10.0 20.0 Per 100 live births 30.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 25 3. Utilization of Prenatal Care Services Early Prenatal Care Five or More Prenatal Visits No Prenatal Care DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 27 3-1 Early Prenatal Care 84.7 White non-Hispanic 81.5 Asian 74.1 ALL ARIZONANS 71.1 Black 64.1 American Indian 62.7 Hispanic 50.0 60.0 70.0 80.0 90.0 Women giving birth who received prenatal care in the first trimester of pregnancy per 100 live births in specified group DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 28 3-2 Five or More Prenatal Visits White non-Hispanic 93.3 Asian 92.6 88.4 ALL ARIZONANS 84.5 American Indian Hispanic 83.4 Black 83.3 70.0 80.0 90.0 100.0 Women giving birth who had five or more prenatal visits per 100 live births in specified group DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 29 3-3 No Prenatal Care 3.9 Hispanic 2.4 American Indian 2.2 ALL ARIZONANS 1.9 Black Asian 0.9 White non-Hispanic 0.8 0.0 1.5 3.0 Women giving birth who received no prenatal care per 100 live births in specified group 4.5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 31 4. Newborn’s Health The Incidence of Hyaline Membrane Disease Newborn Intensive Care The Incidence of Low-Birthweight Births The Incidence of Very Low-Birthweight Births The Incidence of Congenital Anomalies (Birth Defects) Infant Mortality Sudden Infant Death Syndrome Mortality of Infants from Low-Birthweight/ Short Gestation Neonatal Mortality Postneonatal Mortality DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 33 4-1 The Incidence of Hyaline Membrane Disease* 0.7 White non-Hispanic 0.5 ALL ARIZONANS Asian 0.3 Black 0.3 American Indian 0.2 Hispanic 0.2 0.0 0.2 0.3 0.5 0.6 0.8 0.9 Per 100 live births in specified group * A disorder primarily of prematurity, manifested clinically by respiratory distress and pathologically by pulmonary hyaline membranes and incomplete expansion of the lungs at birth. DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 34 4-2 The Incidence of Newborn Intensive Care 9.3 Black 6.9 Hispanic ALL ARIZONANS 6.6 White non-Hispanic 6.6 5.5 Asian 4.8 American Indian 0.0 2.0 4.0 6.0 8.0 Per 100 live births in specified group 10.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 35 4-3 The Incidence of Low-Birthweight Births 12.0 Black 8.2 Asian American Indian 7.6 ALL ARIZONANS 7.0 Hispanic 6.9 White non-Hispanic 6.7 0.0 3.5 7.0 10.5 Number of infants weighing less than 2,500 grams per 100 live births in specified group 14.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 36 4-4 The Incidence of Very Low-Birthweight Births 2.6 Black American Indian 1.4 ALL ARIZONANS 1.2 White non-Hispanic 1.2 Hispanic Asian 0.0 1.1 1.0 1.0 2.0 Number of infants weighing less than 1,500 grams per 100 live births in specified group 3.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 37 4-5 The Incidence of Congenital Anomalies (Birth Defects) 2.9 American Indian ALL ARIZONANS 1.3 White non-Hispanic 1.3 Black Asian Hispanic 0.0 1.2 1.0 0.9 1.0 2.0 Per 100 live births in specified group 3.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 38 4-6 Infant Mortality 13.8 Black 8.5 American Indian 7.2 Hispanic 6.8 ALL ARIZONANS 5.7 White non-Hispanic Asian 0.0 2.2 3.5 7.0 10.5 14.0 Per 1,000 live births in specified child's ethnic group DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 39 Infant Mortality from SIDS* 4-7 1.3 Black 0.9 American Indian ALL ARIZONANS Hispanic White non-Hispanic Asian 0.0 0.5 0.4 0.3 0.0 0.4 0.8 1.2 1.6 Per 1,000 live births in specified child's ethnic group * Sudden Infant Death Syndrome. DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 40 Infant Mortality from Low Birthweight/ Short Gestation 4-8 1.6 Black 0.9 Hispanic 0.8 ALL ARIZONANS White non-Hispanic 0.6 0.0 American Indian 0.0 Asian 0.0 0.6 1.2 1.8 Per 1,000 live births in specified child's ethnic group 2.4 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 41 4-9 Neonatal Mortality 8.2 Black 5.0 American Indian Hispanic 4.6 ALL ARIZONANS 4.5 4.2 White non-Hispanic Asian 0.0 1.3 1.5 3.0 4.5 6.0 7.5 Per 1,000 live births in specified child's ethnic group 9.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 42 4-10 Postneonatal Mortality 5.6 Black 3.5 American Indian 2.6 Hispanic 2.3 ALL ARIZONANS White non-Hispanic Asian 0.0 1.5 0.9 2.0 4.0 Per 1,000 live births in specified child's ethnic group 6.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 43 5. Mortality from Natural Causes Mortality from Cardiovascular Diseases Mortality from Diseases of the Heart Mortality from Coronary Heart Disease Mortality from Cerebrovascular Disease Mortality from Chronic Obstructive Pulmonary Disease Mortality from Malignant Neoplasms Mortality from Lung Cancer Mortality from Breast Cancer Mortality from Cervical Cancer Mortality from Colorectal Cancer Mortality from Prostate Cancer Mortality from Pneumonia & Influenza Mortality from Diabetes Mortality from Infectious & Parasitic Diseases (excluding HIV Infection) Mortality from HIV Infection Mortality from Septicemia Mortality from Alzheimer's Disease Mortality from Nephritis, Nephrotic Syndrome & Nephrosis Mortality from Alcoholism Mortality from All Causes DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 45 5-1 Mortality from Cardiovascular Diseases 192.3 Black White non-Hispanic 164.0 ALL ARIZONANS 161.4 152.7 American Indian 131.8 Hispanic Asian 65.7 40.0 80.0 120.0 160.0 200.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 46 5-2 Mortality from Diseases of the Heart 142.4 Black White non-Hispanic 123.8 ALL ARIZONANS 120.9 114.8 American Indian 94.7 Hispanic 37.6 Asian 0.0 30.0 60.0 90.0 120.0 150.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 47 5-3 Mortality from Coronary Heart Disease 107.6 White non-Hispanic 101.7 Black 97.6 ALL ARIZONANS 77.0 American Indian 72.2 Hispanic 27.9 Asian 0.0 30.0 60.0 90.0 120.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 48 5-4 Mortality from Cerebrovascular Disease 31.1 Black ALL ARIZONANS 25.9 White non-Hispanic 25.5 Hispanic 24.7 American Indian 24.1 16.2 Asian 0.0 7.0 14.0 21.0 28.0 35.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 49 Mortality from Chronic Obstructive Pulmonary Disease 5-5 30.5 White non-Hispanic 27.8 ALL ARIZONANS 21.9 Black 11.4 American Indian 10.2 Hispanic 7.1 Asian 0.0 8.0 16.0 24.0 32.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 50 5-6 Mortality from Malignant Neoplasms 122.3 Black 118.4 White non-Hispanic 113.1 ALL ARIZONANS 82.6 Hispanic 78.1 American Indian 53.3 Asian 0.0 25.0 50.0 75.0 100.0 125.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 51 5-7 Mortality from Lung Cancer 36.0 White non-Hispanic 32.3 ALL ARIZONANS 25.9 Black 14.2 Hispanic 11.5 Asian 8.0 American Indian 0.0 8.0 16.0 24.0 32.0 40.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 52 5-8 Mortality from Breast Cancer 24.8 Black 18.3 White non-Hispanic 17.1 ALL ARIZONANS Hispanic 10.7 American Indian 8.4 Asian 8.0 0.0 10.0 20.0 30.0 Number of deaths per 100,000 females in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 53 5-9 Mortality from Cervical Cancer 3.1 Black Hispanic ALL ARIZONANS White non-Hispanic 2.3 1.7 1.6 0.0 American Indian 0.0 Asian 0.0 0.9 1.8 2.7 3.6 Number of deaths per 100,000 females in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 54 5-10 Mortality from Colorectal Cancer 14.9 Black 10.3 White non-Hispanic 10.0 ALL ARIZONANS 8.2 Hispanic Asian American Indian 0.0 4.4 1.9 4.0 8.0 12.0 16.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 55 5-11 Mortality from Prostate Cancer 15.3 Black White non-Hispanic 12.1 ALL ARIZONANS 11.7 8.4 Hispanic 6.0 American Indian 4.8 Asian 0.0 4.5 9.0 13.5 18.0 Number of deaths per 100,000 males in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 56 5-12 Mortality from Pneumonia & Influenza 35.4 American Indian Black 20.0 ALL ARIZONANS 19.7 White non-Hispanic 19.4 15.0 Hispanic 8.4 Asian 0.0 10.0 20.0 30.0 40.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 57 5-13 Mortality from Diabetes 63.7 American Indian 26.1 Hispanic 23.1 Black ALL ARIZONANS White non-Hispanic Asian 0.0 13.5 10.1 7.0 13.0 26.0 39.0 52.0 65.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 58 5-14 Mortality from Infectious & Parasitic Diseases (excluding HIV Infection) 23.6 American Indian Black Hispanic 11.4 10.6 ALL ARIZONANS 8.2 Asian 7.9 White non-Hispanic 0.0 6.9 5.0 10.0 15.0 20.0 25.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 59 5-15 Mortality from HIV Infection 8.1 Black 4.0 Hispanic 3.6 American Indian 2.9 ALL ARIZONANS White non-Hispanic Asian 0.0 2.4 1.0 1.5 3.0 4.5 6.0 7.5 9.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 60 5-16 Mortality from Septicemia 16.9 American Indian 6.6 Black 5.9 Hispanic 4.3 ALL ARIZONANS 3.6 White non-Hispanic 1.9 Asian 0.0 4.5 9.0 13.5 18.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 61 5-17 Mortality from Alzheimer's Disease 5.8 White non-Hispanic 5.5 ALL ARIZONANS 5.0 Black 3.7 Hispanic American Indian Asian 0.0 1.4 1.0 1.3 2.6 3.9 5.2 6.5 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 62 Mortality from Nephritis, Nephrotic Syndrome and Nephrosis 5-18 14.9 American Indian 12.1 Black 6.7 Hispanic ALL ARIZONANS White non-Hispanic Asian 0.0 5.0 4.3 3.1 4.0 8.0 12.0 16.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 63 5-19 Mortality from Alcoholism 40.5 American Indian 6.9 ALL ARIZONANS Hispanic 6.4 White non-Hispanic 5.7 3.6 Black 1.0 Asian 0.0 7.0 14.0 21.0 28.0 35.0 42.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 64 5-20 Mortality from All Causes 747.2 American Indian 586.1 Black ALL ARIZONANS 507.1 White non-Hispanic 492.2 447.1 Hispanic Asian 0.0 210.2 200.0 400.0 600.0 800.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 65 6. Mortality from Injuries Mortality from Unintentional Injuries Mortality from Motor Vehicle-Related Injuries Mortality from Fall-Related Injuries Drowning Mortality Firearm-Related Mortality Drug-Related Mortality Suicide Mortality Homicide Mortality DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 67 6-1 Mortality from Unintentional Injuries 121.5 American Indian 44.5 Hispanic 39.8 ALL ARIZONANS Black 35.2 White non-Hispanic 32.1 20.0 Asian 0.0 25.0 50.0 75.0 100.0 125.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 68 6-2 Mortality from Motor Vehicle-Related Injuries 71.5 American Indian Hispanic ALL ARIZONANS Black 25.1 19.7 17.1 Asian 14.3 White non-Hispanic 13.8 0.0 15.0 30.0 45.0 60.0 75.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 69 6-3 Mortality from Fall-Related Injuries 9.7 American Indian 4.8 ALL ARIZONANS White non-Hispanic 4.4 Hispanic 4.4 2.6 Black 1.9 Asian 0.0 2.5 5.0 7.5 10.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 70 6-4 Drowning Mortality 5.3 American Indian ALL ARIZONANS 1.7 Black 1.7 White non-Hispanic 1.6 Hispanic 1.3 0.0 Asian 0.0 2.0 4.0 6.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 71 6-5 Firearm-Related Mortality 29.0 Black 22.6 Hispanic 16.9 ALL ARIZONANS 14.8 White non-Hispanic 13.2 American Indian 6.6 Asian 0.0 8.0 16.0 24.0 Number of deaths per 100,000 persons in specified group (crude-death rate) 32.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 72 6-6 Drug-Related Mortality 16.5 Black 11.6 White non-Hispanic 11.0 ALL ARIZONANS Hispanic 9.3 American Indian 9.1 2.8 Asian 0.0 3.5 7.0 10.5 14.0 Number of deaths per 100,000 persons in specified group (crude death rate) 17.5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 73 6-7 Suicide Mortality 18.2 American Indian 15.1 White non-Hispanic 14.6 ALL ARIZONANS Black 10.6 Hispanic 10.6 6.4 Asian 0.0 4.0 8.0 12.0 16.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) 20.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 74 6-8 Homicide Mortality 25.5 Black 21.9 American Indian 18.6 Hispanic 10.0 ALL ARIZONANS Asian 4.9 White non-Hispanic 4.8 0.0 7.0 14.0 21.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 1940 standard population) 28.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 75 7. AGE-SPECIFIC MORTALITY Mortality Among Children 1-14 Years Old Mortality Among Adolescents and Young Adults 15-24 Years Old Mortality Among Adults 25-64 Years Old DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 77 7-1 Mortality of Children 1-14 Years Old 50.1 American Indian 36.6 Black 26.9 Hispanic 24.1 ALL ARIZONANS White non-Hispanic Asian 0.0 17.4 8.8 11.0 22.0 33.0 44.0 Number of deaths per 100,000 children 1-14 years old in specified ethnic group 55.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 78 7-2 Mortality of Adolescents and Young Adults 15-24 Years Old 195.9 American Indian 150.3 Black 123.8 Hispanic ALL ARIZONANS White non-Hispanic Asian 0.0 96.0 66.6 56.2 40.0 80.0 120.0 160.0 Number of deaths per 100,000 persons 15-24 years old in specified ethnic group 200.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 79 7-3 Mortality among Adults 25-64 Years Old 666.8 American Indian Black 429.7 ALL ARIZONANS 375.6 White non-Hispanic 373.3 Hispanic 318.9 Asian 306.3 0.0 150.0 300.0 450.0 600.0 Number of deaths per 100,000 persons 25-64 years old in specified ethnic group 750.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 81 8. Patterns of Premature Mortality Average Age At Death From All Causes Among Arizona Residents Average Age At Death From All Causes Among Arizona Males Average Age At Death From All Causes Among Arizona Females Percent of Total Deaths Before Expected Years of Life Reached DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 83 8-1 Average Age At Death From All Causes Among Arizona Residents In 1999 74.1 Whitenon-Hispanic 71.7 ALL ARIZONANS Asians Black Hispanic American Indian 40.0 63.9 60.5 59.2 55.7 60.0 80.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 84 8-2 Average Age At Death From All Causes Among Arizona Males In 1999 71.5 White non-Hispanic 68.8 ALL ARIZONANS 62.3 Asians Black Hispanic American Indian 40.0 57.8 56.2 51.8 60.0 80.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 85 8-3 Average Age At Death From All Causes Among Arizona Females In 1999 77.0 White non-Hispanic 74.9 ALL ARIZONANS Asians 65.5 Black 63.9 Hispanic 63.3 American Indian 40.0 60.6 60.0 80.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 86 8-4 Percent of Total Deaths Before and After Expected Years of Life Reached* BEFORE White non-Hispanic ALL ARIZONANS Asian Black Hispanic American Indian 47.4% 51.8% 67.0% AFTER 52.6% 48.2% 33.0% 70.7% 29.3% 71.7% 28.3% 76.9% 23.1% *Percent deaths in specified group in Arizona in 1999 before and after expected years of life at birth or life expectancy of 76.7 years for all U.S. residents. DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 87 9. The Incidence of Reportable Diseases Incidence Rates of Syphilis Incidence Rates of Gonorrhea Incidence Rates of Chlamydia Incidence Rates of Genital Herpes Incidence Rates of AIDS DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 89 9-1 Incidence Rates of Early Syphilis 61.9 Black 21.1 Hispanic ALL ARIZONANS American Indian 10.2 9.1 3.9 White non-Hispanic 2.8 Asian 0.0 13.0 26.0 39.0 52.0 65.0 Number of cases reported in 1999 per 100,000 population in specified group Source: Arizona Department of Health Services, Bureau of Epidemiology and Disease Control, Office of HIV/STD Services DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 90 Incidence Rates of Gonorrhea 9-2 512.5 Black Hispanic ALL ARIZONANS American Indian 154.2 86.8 81.5 32.5 White non-Hispanic 10.4 Asian 0.0 110.0 220.0 330.0 440.0 550.0 Number of cases reported in 1999 per 100,000 population in specified group Source: Arizona Department of Health Services, Bureau of Epidemiology and Disease Control, Office of HIV/STD Services DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 91 Incidence Rates of Chlamydia 9-3 643.7 American Indian 635.2 635.2 Black 408.9 Hispanic ALL ARIZONANS 643.7 241.0 408.9 241.0 88.5 White non-Hispanic 70.8 Asian 0.0 250.0 500.0 750.0 Number of cases reported in 1999 per 100,000 population in specified group Source: Arizona Department of Health Services, Bureau of Epidemiology and Disease Control, Office of HIV/STD Services DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 92 9-4 Incidence Rates of Genital Herpes 41.5 Black American Indian ALL ARIZONANS Hispanic White non-Hispanic 24.5 19.7 19.2 12.8 2.8 Asian 0.0 9.0 18.0 27.0 36.0 45.0 Number of cases reported in 1999 per 100,000 population in specified group Source: Arizona Department of Health Services, Bureau of Epidemiology and Disease Control, Office of HIV/STD Services DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 93 9-5 Incidence Rates of AIDS 25.6 Black Hispanic American Indian ALL ARIZONANS White non-Hispanic 8.9 8.3 6.8 5.3 0 Asian 0.0 7.0 14.0 21.0 28.0 Number of cases reported in 1999 per 100,000 population in specified group Source: Arizona Department of Health Services, Bureau of Epidemiology and Disease Control, Office of HIV/STD Services DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 95 RATES AND RATIOS FOR 1999 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 97 RATES AND RATIOS 1. TEEN PREGNANCIES 66.1 40.8 33.1 16.3 1-2 Pregnancies among females 14 and younger 0.9 0.4 1.6 1.5 1.5 0.5 1-3 Pregnancies among females 1517 years old 40.2 20.4 80.4 47.7 39.5 11.2 1-4 Pregnancies among females 1819 years old 122.7 74.6 215.5 141.4 124.5 67.9 Black or African American American Indian Figure number Asian or Pacific Islander 21.0 American Indian 36.1 Black or African American Pregnancies among females 19 and younger Hispanic White nonHispanic 1-1 Indicator ALL ARIZONA RESIDENTS (Number of pregnancies per 1,000 females in specified age group) 2. MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS Unmarried mothers Tobacco use Alcohol use Chronic hypertension Dysfunctional labor Anemia during pregnancy Diabetes during pregnancy Pregnancy-associated hypertension Genital herpes during pregnancy Weight gain of less than 21 pounds 24.8 11.7 1.3 0.3 1.0 2.3 1.7 3.4 1.1 16.5 50.3 2.5 0.5 0.2 0.6 1.3 1.9 1.8 0.2 20.4 64.0 10.4 1.7 0.8 1.1 2.7 1.9 2.7 0.7 22.3 69.2 3.5 3.0 0.9 1.5 5.1 6.6 5.6 0.3 29.3 Asian or Pacific Islander 38.8 7.3 0.5 0.3 0.9 2.1 2.2 2.8 0.7 19.2 Hispanic White nonHispanic 2-1 2-2 2-3 2-4 2-5 2-6 2-7 2-8 2-9 2-10 ALL ARIZONA RESIDENTS Figure number Indicator (All ratios are per 100 live births) 18.1 2.9 0.5 0.2 1.3 1.4 3.6 2.3 0.3 17.4 3. UTILIZATION OF PRENATAL CARE SERVICES 3-1 3-2 3-3 Early prenatal care Five or more prenatal visits No prenatal care 74.1 88.4 2.2 84.7 93.3 0.8 62.7 83.4 3.9 71.1 83.3 1.9 64.1 84.5 2.4 Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic ALL ARIZONA RESIDENTS Indicator Figure number (Per 100 live births) 81.5 92.6 0.9 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 98 4. NEWBORN'S HEALTH Black or African American American Indian Asian or Pacific Islander Hyaline membrane disease 0.5 0.7 0.2 0.3 0.2 0.3 4-2 Newborn intensive care 6.6 6.6 6.9 9.3 4.8 5.5 4-3 Low-birthweight 7.0 6.7 6.9 12.0 7.6 8.2 4-4 Very low-birthweight 1.2 1.2 1.2 2.5 1.4 1.0 4-5 Congenital anomalies 1.3 1.3 0.9 1.2 2.9 1.0 4-6 Infant mortality 6.8 5.7 7.2 13.8 8.5 2.2 4-7 Sudden Infant Death Syndrome (SIDS) 0.5 0.3 0.4 1.3 0.9 .0 4-8 Mortality of infants from low birthweight/short gestation 0.8 0.6 0.9 1.6 .0 .0 4-9 Neonatal mortality 4.5 4.2 4.6 8.2 5.0 1.3 Postneonatal mortality 2.3 1.5 2.6 5.6 3.5 0.9 Figure number 4-10 Hispanic White nonHispanic 4-1 Indicator ALL ARIZONA RESIDENTS (Infant, neonatal and postneonatal rates are per 1,000 live births. All other indicators are expressed per 100 live births). 5. MORTALITY FROM NATURAL CAUSES (chronic or infectious diseases) American Indian 161.4 164.0 131.8 192.3 152.7 65.7 5-2 Diseases of the Heart 120.9 123.8 94.7 142.4 114.8 37.6 5-3 Coronary Heart Disease 97.6 101.7 72.2 107.6 77.0 27.9 5-4 Cerebrovascular Disease 25.9 25.5 24.7 31.1 24.1 16.2 5-5 Chronic Obstructive Pulmonary Disease 27.8 30.5 10.2 21.9 11.4 7.1 5-6 Malignant Neoplasms (cancer) 113.1 118.4 82.6 122.3 78.1 53.3 5-7 Lung Cancer 32.3 36.0 14.2 25.9 8.0 11.5 5-8 Breast Cancer 17.1 18.3 10.7 24.8 8.4 8.0 5-9 Cervical Cancer Figure number Asian or Pacific Islander Black or African American Cardiovascular Diseases White nonHispanic 5-1 Indicator Hispanic ALL ARIZONA RESIDENTS (Number of deaths per 100,000 population age-adjusted to 1940 standard) 1.7 1.6 2.3 3.1 .0 .0 5-10 Colorectal Cancer 10.0 10.3 8.2 14.9 4.4 1.9 5-11 Prostate Cancer 11.7 12.1 8.4 15.3 6.0 4.8 5-12 Pneumonia and influenza 19.7 19.4 15.0 20.0 35.4 8.4 5-13 Diabetes 13.5 10.1 26.1 23.1 63.7 7.0 5-14 Infectious & Parasitic Diseases (excluding HIV Infection) 8.2 6.9 10.6 11.4 23.6 7.9 5-15 HIV Infection 2.9 2.4 4.0 8.1 3.6 1.0 5-16 Septicemia 4.3 3.6 5.9 6.6 16.9 1.9 5-17 Alzheimer's Disease 5.5 5.8 3.7 5.0 1.4 1.0 5-18 Nephritis, Nephrotic Syndrome & Nephrosis 5.0 4.3 6.7 12.1 14.9 3.1 5-19 Alcoholism 5-20 Total mortality from all causes 6.9 5.7 6.4 3.6 40.5 1.0 507.1 492.2 447.1 586.1 747.2 210.2 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 99 6. MORTALITY FROM INJURIES Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number Indicator ALL ARIZONA RESIDENTS (Number of deaths per 100,000 population age-adjusted to 1940 standard) 39.8 32.1 44.5 35.2 121.5 20.0 6-2 Motor vehicle-related injuries 19.7 13.8 25.1 17.1 71.5 14.3 6-3 Fall-related injuries 4.8 4.4 4.4 2.6 9.7 1.9 6-4 Drowning mortality 1.7 1.6 1.3 1.7 5.3 .0 6-5 Firearm-related deaths* 16.9 14.8 22.6 29.0 13.2 6.6 6-6 Drug-related deaths* 11.0 11.6 9.3 16.5 9.1 2.8 6-7 Suicide 14.6 15.1 10.6 10.6 18.2 6.4 6-8 Homicide 10.0 4.8 18.6 25.5 21.9 4.9 American Indian Unintentional injuries Black or African American 6-1 * Crude death rates (number of deaths per 100,000 population in specified group) 7. AGE-SPECIFIC MORTALITY Mortality of children 1-14 years old 24.1 17.4 26.9 36.6 50.1 8.8 7-2 Mortality of adolescents and young adults 15-24 years old 96.0 66.6 123.8 150.3 195.9 56.2 7-3 Mortality of adults 25-64 years old 375.6 373.3 318.9 429.7 666.8 306.3 American Indian Asian or Pacific Islander Asian or Pacific Islander 7-1 Black or African American Hispanic White nonHispanic ALL ARIZONA RESIDENTS Indicator Figure number (Number of deaths per 100,000 persons in specified group) Average age at death from all causes 71.7 74.1 59.2 60.5 55.7 63.9 8-2 Average age at death from all causes among males 68.8 71.5 56.2 57.8 51.8 62.3 8-3 Average age at death from all causes among females 74.9 77.0 63.3 63.9 60.6 65.5 8-4 Percent of total deaths before expected years of life reached 51.8 47.4 71.7 70.7 76.9 67.0 Hispanic Indicator 8-1 White nonHispanic Figure number ALL ARIZONA RESIDENTS 8. PREMATURE MORTALITY 9. REPORTABLE DISEASES Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic ALL ARIZONA RESIDENTS Indicator Figure number (Number of cases per 100,000 persons in specified group) 9-1 Incidence of early syphilis 10.2 3.9 21.1 61.9 9.1 2.8 9-2 Incidence of gonorrhea 86.8 32.5 154.2 512.5 81.5 10.4 9-3 Incidence of chlamydia 241.0 88.5 408.9 635.2 643.7 70.8 19.7 12.8 19.2 41.5 24.5 2.8 6.8 5.3 8.9 25.6 8.3 .0 9-4 Incidence of genital herpes 9-5 Incidence of AIDS DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 101 SCORES IN 1999 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 103 SCORES (A score is the percent above or below the average rate or ratio for all Arizona residents. A negative score indicates better than average standing on an indicator.) American Indian -41.8 83.1 13.0 -8.3 -54.8 Pregnancies among females 14 and younger -55.6 77.8 66.7 66.7 -44.4 1-3 Pregnancies among females 15-17 years old -49.3 100.0 18.7 -1.7 -72.1 1-4 Pregnancies among females 18-19 years old -39.2 75.6 15.2 1.5 -44.7 -185.9 336.5 113.6 58.2 -216.0 -46.5 84.1 28.4 14.6 -54.0 TOTAL SCORE AVERAGE SCORE Asian or Pacific Islander Pregnancies among females 19 and younger 1-2 Hispanic Indicator 1-1 White nonHispanic Figure number Black or African American 1. TEEN PREGNANCIES 2-1 Unmarried mothers 2-2 Tobacco use 2-3 Alcohol use 2-4 Chronic hypertension 2-5 Dysfunctional labor 2-6 Anemia during pregnancy 2-7 Diabetes during pregnancy 2-8 Pregnancy-associated hypertension 2-9 Genital herpes during pregnancy Weight gain of less than 21 pounds TOTAL SCORE 2-10 AVERAGE SCORE Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number Indicator 2. MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS -36.1 29.6 64.9 78.4 -53.4 60.3 -65.8 42.5 -52.1 -60.3 160.0 .0 240.0 500.0 .0 .0 -33.3 166.7 200.0 -33.3 11.1 -33.3 22.2 66.7 44.4 9.5 -38.1 28.6 142.9 -33.3 -22.7 -13.6 -13.6 200.0 63.6 21.4 -35.7 -3.6 100.0 -17.9 57.1 -71.4 .0 -57.1 -57.1 -14.1 6.3 16.1 52.6 -9.4 246.5 -255.3 563.8 1231.4 -156.7 24.7 -25.5 56.4 123.1 -15.7 3-1 Early prenatal care 3-2 Five or more prenatal visits 3-3 Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number Indicator 3. UTILIZATION OF PRENATAL CARE SERVICES -14.3 15.4 4.0 13.5 -10.0 -5.5 5.7 5.8 4.4 -4.8 No prenatal care -63.6 77.3 -13.6 9.1 -59.1 TOTAL SCORE -83.4 98.4 -3.8 27.0 -73.9 AVERAGE SCORE -27.8 32.8 -1.3 9.0 -24.6 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 104 4-1 Hyaline membrane disease 4-2 Newborn intensive care 4-3 Low birthweight 4-4 Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number Indicator 4. NEWBORN'S HEALTH 40.0 -60.0 -40.0 -60.0 -40.0 .0 4.5 40.9 -27.3 -16.7 -4.3 -1.4 71.4 8.6 17.1 Very low birthweight .0 .0 108.3 16.7 -16.7 4-5 Congenital anomalies .0 -30.8 -7.7 123.1 -23.1 4-6 Infant mortality -16.2 5.9 102.9 25.0 -67.6 4-7 Sudden Infant Death Syndrome (SIDS) -40.0 -20.0 160.0 80.0 -100.0 4-8 Mortality of infants from low birthweight/ short gestation -25.0 12.5 100.0 -100.0 -100.0 4-9 Neonatal mortality -6.7 2.2 82.2 11.1 -71.1 4-10 Postneonatal mortality -34.8 13.0 143.5 52.2 -60.9 TOTAL SCORE -87.0 -74.1 761.5 129.4 -479.0 -8.7 -7.4 76.2 12.9 -47.9 AVERAGE SCORE Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number Indicator 5. MORTALITY FROM NATURAL CAUSES (chronic or infectious diseases) 5-1 Cardiovascular Diseases 1.6 -18.3 19.1 -5.4 -59.3 5-2 Diseases of the Heart 2.4 -21.7 17.8 -5.0 -68.9 5-3 Coronary Heart Disease 4.2 -26.0 10.2 -21.1 -71.4 5-4 Cerebrovascular Disease -1.5 -4.6 20.1 -6.9 -37.5 5-5 Chronic Obstructive Pulmonary Disease 9.7 -63.3 -21.2 -59.0 -74.5 5-6 Malignant Neoplasms (cancer) 4.7 -27.0 8.1 -30.9 -52.9 5-7 Lung Cancer 11.5 -56.0 -19.8 -75.2 -64.4 5-8 Breast Cancer 7.0 -37.4 45.0 -50.9 -53.2 5-9 Cervical Cancer -5.9 35.3 82.4 -100.0 -100.0 5-10 Colorectal Cancer 3.0 -18.0 49.0 -56.0 -81.0 5-11 Prostate Cancer 3.4 -28.2 30.8 -48.7 -59.0 5-12 Pneumonia and influenza -1.5 -23.9 1.5 79.7 -57.4 5-13 Diabetes -25.2 93.3 71.1 371.9 -48.1 5-14 Infectious & Parasitic Diseases (excluding HIV Infection) -15.9 29.3 39.0 187.8 -3.7 5-15 HIV Infection -17.2 37.9 179.3 24.1 -65.5 5-16 Septicemia -16.3 37.2 53.5 293.0 -55.8 5-17 Alzheimer's Disease 5.5 -32.7 -9.1 -74.5 -81.8 5-18 Nephritis, Nephrotic Syndrome & Nephrosis -14.0 34.0 142.0 198.0 -38.0 5-19 Alcoholism -17.4 -7.2 -47.8 487.0 -85.5 5-20 Total mortality from all causes TOTAL SCORE AVERAGE SCORE -2.9 -11.8 15.6 47.3 -58.5 -64.8 -109.1 686.6 1155.2 -1216.4 -3.2 -5.5 34.3 57.8 -60.8 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 105 Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number Indicator 6. MORTALITY FROM INJURIES 6-1 Unintentional injuries -19.3 11.8 -11.6 205.3 -49.7 6-2 Motor vehicle-related injuries -29.9 27.4 -13.2 262.9 -27.4 6-3 Fall-related injuries -8.3 -8.3 -45.8 102.1 -60.4 6-4 6-5 Drowning mortality Firearm-related deaths* -5.9 -23.5 .0 211.8 -100.0 -12.4 33.7 71.6 -21.9 -60.9 6-6 Drug-related deaths* 5.5 -15.5 50.0 -17.3 -74.5 6-7 Suicide 3.4 -27.4 -27.4 24.7 -56.2 6.8 Homicide -52.0 86.0 155.0 119.0 -51.0 -118.9 84.2 178.6 886.6 -480.1 -14.9 10.5 22.3 110.8 -60.0 TOTAL SCORE AVERAGE SCORE Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number Indicator 7. AGE-SPECIFIC MORTALITY 7-1 Mortality of children 1-14 years old -27.8 11.6 51.9 107.9 -63.5 7-2 Mortality of adolescents and young adults 15-24 years old -30.6 29.0 56.6 104.1 -41.5 7-3 Mortality of adults 25-64 years old -.6 -15.1 14.4 77.5 -18.5 TOTAL SCORE -59.0 25.5 122.9 289.5 -123.5 AVERAGE SCORE -19.7 8.5 41.0 96.5 -41.2 Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number Indicator 8. PREMATURE MORTALITY 8-1 Average age at death from all causes -3.3 17.4 15.6 22.3 10.9 8-2 Average age at death from all causes among males -3.9 18.3 16.0 24.7 9.4 8-3 Average age at death from all causes among females -2.8 15.5 14.7 19.1 12.6 8-4 Percent of total deaths before expected years of life reached -8.5 38.4 36.5 48.5 29.3 -18.5 89.6 82.8 114.6 62.2 -4.6 22.4 20.7 28.7 15.6 TOTAL SCORE AVERAGE SCORE DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 106 Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number Indicator 9. REPORTABLE DISEASES 9-1 Incidence of early syphilis -61.8 106.9 506.9 -10.8 -72.5 9-2 Incidence of gonorrhea -62.6 77.6 490.4 -6.1 -88.0 9-3 Incidence of chlamydia -63.3 69.7 163.6 167.1 -70.6 9-4 Incidence of genital herpes -35.0 -2.5 110.7 24.4 -85.8 9-5 Incidence of AIDS -22.1 30.9 276.5 22.1 -100.0 -244.8 282.6 1548.1 196.7 -416.9 -49.0 56.5 309.6 39.3 -83.4 TOTAL SCORE AVERAGE SCORE SUM OF ALL SCORES FOR 67 INDICATORS AVERAGE OF ALL SCORES FOR 67 INDICATORS Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic OVERALL HEALTH STATUS (ALL 67 INDICATORS) -615.8 478.3 4,054.1 4,088.6 -3,100.3 -9.2 7.1 60.5 61.0 -46.3 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 107 RANKING ORDER IN 1999 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 109 RANK ORDER (A rank is the ordering of each ethnic group according to score.) 1 = RANKS BEST AMONG ETHNIC GROUP 5 = RANKS WORST AMONG ETHNIC GROUPS Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number Indicator 1. TEEN PREGNANCIES 1-1 Pregnancies among females 19 and younger 2 5 4 3 1 1-2 Pregnancies among females 14 and younger 1 5 3.5 3.5 2 1-3 Pregnancies among females 15-17 years old 2 5 4 3 1 1-4 Pregnancies among females 18-19 years old 2 5 4 3 1 SUM OF RANKS 7.0 20.0 15.5 12.5 5.0 AVERAGE RANK 1.8 5.0 3.9 3.1 1.3 Alcohol use 2-4 Chronic hypertension 2-5 2-6 Asian or Pacific Islander Tobacco use 2-3 3 4 5 5 1 4 3 2 3 1.5 4 5 1.5 3 1.5 4 5 1.5 Dysfunctional labor 2 1 3 5 4 Anemia during pregnancy 3 1 4 5 2 2-7 Diabetes during pregnancy 1 2.5 2.5 5 4 2-8 Pregnancy-associated hypertension 4 1 3 5 2 2-9 Genital herpes during pregnancy 5 1 4 2.5 2.5 Weight gain of less than 21 pounds 1 3 4 5 2 SUM OF RANKS 29.0 16.5 36.5 45.5 22.5 AVERAGE RANK 2.9 1.7 3.7 4.6 2.3 2-10 2 American Indian 2-2 Black or African American Unmarried mothers Hispanic Indicator 2-1 White nonHispanic Figure number 2. MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS 1 Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number Indicator 3. UTILIZATION OF PRENATAL CARE SERVICES 3-1 Early prenatal care 1 5 3 4 2 3-2 Five or more prenatal visits 1 4 5 3 2 3-3 No prenatal care 1 5 3 4 2 SUM OF RANKS 3.0 14.0 11.0 11.0 6.0 AVERAGE RANK 1.0 4.7 3.7 3.7 2.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 110 Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number INDICATOR 4. NEWBORN'S HEALTH 4-1 Hyaline membrane disease 5 1.5 3.5 1.5 3.5 4-2 Newborn intensive care 3 4 5 1 2 4-3 Low birthweight 1 2 5 3 4 4-4 Very low birthweight 2.5 2.5 5 4 1 4-5 Congenital anomalies 4 1 3 5 2 4-6 Infant mortality 2 3 5 4 1 4-7 Sudden Infant Death Syndrome (SIDS) 2 3 5 4 1 4-8 Mortality of infants from low birthweight/ short gestation 3 4 5 1.5 1.5 4-9 Neonatal mortality 2 3 5 4 1 Postneonatal mortality 2 3 5 4 1 SUM OF RANKS 26.5 27.0 46.5 32.0 19.0 AVERAGE RANK 2.7 2.7 4.7 3.2 1.9 4-10 5-1 Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number INDICATOR 5. MORTALITY FROM NATURAL CAUSES (chronic or infectious diseases) Cardiovascular Diseases 4 2 5 3 1 5-2 Diseases of the Heart 4 2 5 3 1 5-3 Coronary Heart Disease 4 2 5 3 1 5-4 Cerebrovascular Disease 4 3 5 2 1 5-5 Chronic Obstructive Pulmonary Disease 5 2 4 3 1 5-6 Malignant Neoplasms (cancer) 4 3 5 2 1 5-7 Lung Cancer 5 3 4 1 2 5-8 Breast Cancer 4 3 5 2 1 5-9 Cervical Cancer 3 4 5 1.5 1.5 5-10 Colorectal Cancer 4 3 5 2 1 5-11 Prostate Cancer 4 3 5 2 1 5-12 Pneumonia and influenza 3 2 4 5 1 5-13 Diabetes 2 4 3 5 1 5-14 Infectious & Parasitic Diseases (excluding HIV Infection) 1 3 4 5 2 5-15 HIV Infection 2 4 5 3 1 5-16 Septicemia 2 3 4 5 1 5-17 Alzheimer's Disease 5 3 4 2 1 5-18 Nephritis, Nephrotic Syndrome & Nephrosis 2 3 4 5 1 5-19 Alcoholism 3 4 2 5 1 5-20 Total mortality from all causes 3 2 4 5 1 SUM OF RANKS 68.0 58.0 87.0 64.5 22.5 AVERAGE RANK 3.4 2.9 4.4 3.2 1.1 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 111 Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number INDICATOR 6. MORTALITY FROM INJURIES 6-1 Unintentional injuries 2 4 3 5 1 6-2 Motor vehicle-related injuries 1 4 3 5 2 6-3 Fall-related injuries 3.5 3.5 2 5 1 6-4 Drowning mortality 3 2 4 5 1 6-5 Firearm-related deaths 3 4 5 2 1 6-6 Drug-related deaths 4 3 5 2 1 6-7 Suicide 4 2.5 2.5 5 1 6-8 Homicide 1 3 5 4 2 SUM OF RANKS 21.5 26.5 29.5 33.0 10.0 AVERAGE RANK 2.7 3.3 3.7 4.1 1.3 Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number INDICATOR 7. AGE-SPECIFIC MORTALITY 7-1 Mortality of children 1-14 years old 2 3 4 5 1 7-2 Mortality of adolescents and young adults 15-24 years old 2 3 4 5 1 7-3 Mortality among adults 25-64 years old 3 2 4 5 1 SUM OF RANKS 7.0 8.0 12.0 15.0 3.0 AVERAGE RANK 2.3 2.7 4.0 5.0 1.0 Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic Figure number INDICATOR 8. PREMATURE MORTALITY 8-1 Average age at death from all causes 1 4 3 5 2 8-2 Average age at death from all causes among males 1 4 3 5 2 8-3 Average age at death from all causes among females 1 4 3 5 2 8-4 Percent of total deaths before expected years of life reached 1 4 3 5 2 SUM OF RANKS 4.0 16.0 12.0 20.0 8.0 AVERAGE RANK 1.0 4.0 3.0 5.0 2.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 112 Asian or Pacific Islander American Indian Black or African American Hispanic Incidence of early syphilis 2 4 5 3 1 9-2 Incidence of gonorrhea 2 4 5 3 1 9-3 Incidence of chlamydia 2 3 4 5 1 9-4 Incidence of genital herpes 2 3 5 4 1 9-5 Incidence of AIDS 2 4 5 3 1 SUM OF RANKS 10.0 18.0 24.0 18.0 5.0 AVERAGE RANK 2.0 3.6 4.8 3.6 1.0 Black or African American White nonHispanic 9-1 Hispanic Figure number INDICATOR 9. REPORTABLE DISEASES SUM OF ALL RANKS FOR 67 MEASUREMENTS AVERAGE RANK BASED ON 67 MEASUREMENTS Asian or Pacific Islander American Indian White nonHispanic OVERALL HEALTH STATUS (ALL 67 INDICATORS) 176.0 204.0 274.0 251.5 101.0 2.6 3.0 4.1 3.8 1.5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 113 COMPARATIVE RATES AND RATIOS FOR 1995, 1997 AND 1999 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 115 COMPARATIVE RATES AND RATIOS FOR 1995, 1997 AND 1999 1. TEEN PREGNANCIES Pregnancies among females 14 and younger 1-3 Pregnancies among females 15-17 years old 1-4 Pregnancies among females 18-19 years old 66.1 67.9 67.3 1.6 1.9 3.7 80.4 86.3 101.5 215.5 218.9 214.0 40.8 41.7 75.9 1.5 1.1 3.1 47.7 49.8 59.4 141.4 146.2 149.1 33.1 34.4 54.7 1.5 0.8 1.9 39.5 45.9 54.9 124.5 125.1 148.6 Asian or Pacific Islander 21.0 24.6 38.9 0.4 0.5 0.9 20.4 25.2 34.8 74.6 86.3 104.1 Hispanic 36.1 38.0 49.7 0.9 1.0 2.2 40.2 44.6 61.1 122.7 128.4 129.5 American Indian 1-2 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 Black or African American Pregnancies among females 19 and younger White nonHispanic 1-1 ALL ARIZONA RESIDENTS Year Figure number Indicator (Number of pregnancies per 1,000 females in specified age group) 16.3 15.8 0.5 0.8 0.6 11.2 17.8 19.0 67.9 56.6 68.0 2. MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS 2-2 Tobacco use 2-3 Alcohol use 2-4 Chronic hypertension 2-5 Dysfunctional labor 2-6 Anemia during pregnancy 2-7 Diabetes during pregnancy 2-8 Pregnancy-associated hypertension 2-9 Genital herpes during pregnancy 2-10 Weight gain of less than 21 pounds 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 50.3 48.3 50.0 2.5 3.1 4.5 0.5 0.7 1.1 0.2 0.3 0.4 0.6 0.3 0.8 1.3 1.1 1.4 1.9 2.2 2.5 1.8 1.8 1.9 0.2 0.2 0.6 20.4 22.1 19.0 64.0 64.8 63.4 10.4 11.6 15.5 1.7 2.1 3.4 0.8 0.8 0.7 1.1 0.8 1.3 2.7 1.7 2.2 1.9 1.8 1.8 2.7 2.7 1.5 0.7 0.6 0.7 22.3 22.1 21.1 69.2 68.4 67.5 3.5 4.2 4.9 3.0 3.3 3.8 0.9 1.2 1.3 1.5 1.2 2.3 5.1 4.4 4.1 6.6 7.5 6.5 5.6 5.3 4.8 0.3 0.4 1.8 29.3 27.0 27.1 Asian or Pacific Islander American Indian 24.8 24.7 25.7 11.7 13.2 16.8 1.3 1.4 2.2 0.3 0.4 0.4 1.0 0.4 1.5 2.3 1.3 1.3 1.7 2.2 2.0 3.4 2.8 2.5 1.1 1.0 0.5 16.5 15.1 13.8 Black or African American 38.8 37.7 38.2 7.3 8.5 11.4 0.5 1.3 1.9 0.3 0.4 0.5 0.9 0.4 1.3 2.1 1.4 1.6 2.2 2.5 2.5 2.8 2.6 2.4 0.7 0.6 0.9 19.2 18.8 16.8 Hispanic White nonHispanic Unmarried mothers ALL ARIZONA RESIDENTS 2-1 Year Figure number Indicator (All ratios are per 100 live births) 18.1 18.5 19.8 2.9 2.9 4.6 0.5 0.2 0.4 0.2 0.4 0.2 1.3 0.4 2.1 1.4 1.4 0.9 3.6 1.9 3.1 2.3 1.6 1.3 0.3 0.4 0.4 17.4 15.2 16.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 116 3. UTILIZATION OF PRENATAL CARE SERVICES Early prenatal care 62.7 71.1 64.1 81.5 1997 74.4 84.3 63.9 69.4 60.0 81.6 1995 70.7 80.0 59.2 67.0 57.0 77.4 3-2 Five or more prenatal visits 1999 88.4 93.3 83.4 83.3 84.5 92.6 1997 91.6 95.6 87.8 87.7 84.5 95.6 1995 87.3 91.1 82.9 80.7 83.3 89.3 3-3 No prenatal care 1999 2.2 0.8 3.9 1.9 2.4 0.9 1997 1.8 0.7 3.0 3.0 2.4 0.6 1995 1.6 0.8 2.7 1.8 2.6 0.8 Hispanic Asian or Pacific Islander 84.7 American Indian 74.1 Year Figure number 3-1 Black or African American White nonHispanic 1999 Indicator ALL ARIZONA RESIDENTS (Per 100 live births) 4. NEWBORN'S HEALTH 4-2 Newborn intensive care 4-3 Low birthweight 4-4 Very low birthweight 4-5 Congenital anomalies 4-6 Infant mortality 4-7 Sudden Infant Death Syndrome (SIDS) 4-8 Mortality of infants from low birthweight/short gestation 4-9 Neonatal mortality 4-10 Postneonatal mortality 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 0.2 0.3 0.1 6.9 6.8 6.3 6.9 6.6 6.6 1.2 1.1 1.2 0.9 1.4 1.9 7.2 7.3 6.6 0.4 0.4 0.5 0.9 0.7 0.7 4.6 5.0 4.7 2.6 2.3 1.9 0.3 0.5 0.1 9.3 10.7 9.9 12.0 13.6 13.3 2.5 2.6 2.6 1.2 2.2 2.0 13.8 10.4 12.8 1.3 0.9 3.7 1.6 2.0 1.3 8.2 6.9 6.7 5.6 3.5 6.1 0.2 0.3 0.1 4.8 4.5 4.0 7.6 6.6 6.2 1.4 1.1 0.9 2.9 2.5 2.8 8.5 8.4 9.7 0.9 1.2 2.0 .0 0.8 0.6 5.0 3.4 3.8 3.5 5.0 6.0 Asian or Pacific Islander American Indian 0.7 0.9 0.3 6.6 6.4 5.3 6.7 6.7 6.7 1.2 1.2 1.1 1.3 1.4 1.5 5.7 6.7 7.8 0.3 0.6 1.1 0.6 0.5 0.7 4.2 4.1 5.1 1.5 2.6 2.7 Black or African American 0.5 0.6 0.2 6.6 6.6 5.7 7.0 6.9 6.8 1.2 1.2 1.2 1.3 1.5 1.7 6.8 7.2 7.6 0.5 0.6 1.0 0.8 0.7 0.7 4.5 4.5 4.8 2.3 2.7 2.8 Hispanic White nonHispanic Hyaline membrane disease ALL ARIZONA RESIDENTS 4-1 Year Figure number Indicator (Infant, neonatal and postneonatal rates are per 1,000 live births. All other indicators are expressed per 100 live births). 0.3 1.2 0.1 5.5 6.2 5.3 8.2 7.6 6.3 1.0 1.0 1.1 1.0 1.5 1.9 2.2 3.9 2.2 .0 0.6 0.7 .0 0.6 0.1 1.3 3.2 1.5 0.9 0.7 0.7 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 117 5. MORTALITY FROM NATURAL CAUSES (chronic or infectious diseases) 5-1 Cardiovascular Diseases 5-2 Diseases of the Heart 5-3 Coronary Heart Disease 5-4 Cerebrovascular Disease 5-5 Chronic Obstructive Pulmonary Disease 5-6 Malignant Neoplasms (cancer) 5-7 Lung Cancer 5-8 Breast Cancer 5-9 Cervical Cancer 5-10 Colorectal Cancer 5-11 Prostate Cancer 5-12 Pneumonia and influenza 5-13 Diabetes 5-14 Infectious & Parasitic Diseases (excluding HIV Infection) 5-15 HIV Infection 5-16 Septicemia 5-17 Alzheimer's Disease 5-18 Nephritis, Nephrotic Syndrome and Nephrosis 5-19 Alcoholism 5-20 Total mortality from all causes 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 161.4 166.9 180.2 120.9 126.6 150.1 97.6 102.2 111.0 25.9 29.2 28.0 27.8 28.9 26.1 113.1 116.5 126.3 32.3 32.2 34.1 17.1 19.3 17.2 1.7 1.7 2.4 10.0 10.7 11.5 11.7 14.2 17.5 19.7 16.1 17.2 13.5 13.1 10.9 8.2 8.8 6.0 2.9 4.2 8.6 4.3 4.5 4.1 5.5 4.8 4.1 5.0 4.1 4.2 6.9 7.9 8.9 507.1 518.1 546.1 164.0 179.2 188.1 123.8 136.6 152.3 101.7 112.2 120.7 25.5 30.8 27.7 30.5 33.7 28.9 118.4 127.3 131.1 36.0 36.9 37.7 18.3 21.0 18.2 1.6 1.6 2.2 10.3 11.7 12.3 12.1 16.0 17.6 19.4 16.6 16.5 10.1 10.1 8.5 6.9 8.0 4.9 2.4 3.9 9.1 3.6 4.2 3.1 5.8 5.5 5.0 4.3 4.1 3.8 5.7 6.9 6.6 492.2 533.1 537.2 131.8 149.8 169.1 94.7 108.3 125.8 72.2 81.0 103.1 24.7 31.3 25.3 10.2 11.5 11.7 82.6 89.1 100.0 14.2 14.9 18.2 10.7 16.0 13.2 2.3 2.4 3.7 8.2 7.7 7.8 8.4 10.8 17.5 15.0 15.4 15.4 26.1 26.0 20.6 10.6 10.3 7.7 4.0 4.7 6.8 5.9 5.5 5.3 3.7 3.7 2.7 6.7 5.5 5.4 6.4 8.0 10.4 447.1 470.6 478.8 192.3 201.3 236.7 142.4 155.8 217.8 107.6 105.2 133.0 31.1 34.0 41.3 21.9 24.5 24.3 122.3 140.9 164.3 25.9 44.7 49.6 24.8 26.8 21.4 3.1 2.4 2.7 14.9 14.0 15.9 15.3 28.6 27.5 20.0 20.6 22.0 23.1 27.8 23.0 11.4 18.8 12.2 8.1 16.3 17.7 6.6 11.9 6.5 5.0 3.4 2.3 12.1 7.0 10.5 3.6 6.1 9.0 586.1 651.1 767.3 152.7 162.5 166.4 114.8 126.5 129.3 77.0 88.2 79.0 24.1 25.1 29.7 11.4 11.1 10.7 78.1 88.2 81.8 8.0 8.5 11.0 8.4 6.4 7.3 .0 4.1 4.1 4.4 5.6 8.7 6.0 5.4 15.7 35.4 36.4 40.5 63.7 62.1 48.1 23.6 27.0 23.3 3.6 4.2 3.1 16.9 14.7 17.4 1.4 0.6 1.8 14.9 8.3 11.1 40.5 33.8 49.7 747.2 766.0 755.3 Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic ALL ARIZONA RESIDENTS Year Figure number Indicator (Number of deaths per 100,000 population age-adjusted to 1940 standard) 65.7 73.3 100.0 37.6 52.8 79.6 27.9 41.9 54.1 16.2 14.1 26.0 7.1 9.3 9.7 53.3 49.5 89.5 11.5 12.2 18.1 8.0 1.7 23.5 .0 .0 2.4 1.9 7.0 9.2 4.8 6.6 7.9 8.4 1.4 10.5 7.0 14.5 7.6 7.9 6.1 4.9 1.0 0.9 1.8 1.9 0.0 4.9 1.0 0.0 0.0 3.1 1.4 0.0 1.0 0.0 1.2 210.2 224.9 323.5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 118 6. MORTALITY FROM INJURIES 6-2 Motor vehicle-related injuries 6-3 Fall-related injuries 6-4 Drowning mortality 6-5 Firearm-related deaths* 6-6 Drug-related deaths* 6-7 Suicide 6-8 Homicide 44.5 40.3 39.8 25.1 21.9 23.4 4.4 4.7 3.6 1.3 1.3 2.9 22.6 24.5 28.9 9.3 6.9 5.6 10.6 9.8 10.6 18.6 20.2 15.3 35.2 44.4 42.5 17.1 21.2 19.7 2.6 2.5 0.8 1.7 3.7 2.4 29.0 37.9 43.2 16.5 14.5 9.1 10.6 12.4 12.4 25.5 29.9 35.9 121.5 146.0 136.8 71.5 84.3 83.3 9.7 10.3 9.7 5.3 7.0 3.1 13.2 17.9 16.4 9.1 8.8 5.1 18.2 21.3 20.8 21.9 20.2 22.4 Asian or Pacific Islander American Indian 32.1 36.8 36.1 13.8 17.2 20.1 4.4 4.8 3.4 1.6 1.8 2.4 14.8 17.9 22.0 11.6 9.4 6.9 15.1 19.2 19.6 4.8 5.4 6.5 Black or African American 39.8 41.5 41.4 19.7 21.0 23.7 4.8 4.7 3.5 1.7 2.0 2.6 16.9 19.6 24.1 11.0 8.8 6.5 14.6 16.9 18.2 10.0 11.1 10.2 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995** 1999 1997 1995 1999 1997 1995 Hispanic White nonHispanic Unintentional Injuries ALL ARIZONA RESIDENTS 6-1 Year Figure number Indicator (Number of deaths per 100,000 population age-adjusted to 1940 standard) 20.0 16.5 22.1 14.3 9.1 14.6 1.9 1.4 1.4 0.0 0.0 2.3 6.6 7.7 6.2 2.8 2.2 1.5 6.4 13.1 6.3 4.9 5.1 5.1 * Crude death rates (number of deaths per 100,000 population in specified group). ** Average annual rates for 1985-1995. 7. AGE-SPECIFIC MORTALITY 7-2 Mortality of adolescents and young adults 15-24 years old 7-3 Mortality among adults 25-64 years old 1999 1997 1995 1999 1997 1995 1999 1997 1995 26.9 36.3 32.0 123.8 129.5 116.7 318.9 298.3 310.5 36.6 40.4 60.9 150.3 170.7 167.3 429.7 470.0 547.0 50.1 39.2 72.2 195.9 243.9 257.1 666.8 714.9 660.4 Asian or Pacific Islander American Indian 17.4 27.5 34.2 66.6 91.1 103.7 373.3 394.9 405.0 Black or African American 24.1 33.1 35.9 96.0 115.3 139.4 375.6 379.7 420.0 Hispanic White nonHispanic Mortality of children 1-14 years old ALL ARIZONA RESIDENTS 7-1 Year Indicator Figure number (Number of deaths per 100,000 persons in specified group) 8.8 23.7 54.9 56.2 49.0 45.4 306.3 126.5 153.9 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 119 8-1 Average age at death from all causes 8-2 Average age at death from all causes among males 8-3 Average age at death from all causes among females 8-4 Percent of total deaths before expected years of life reached 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 71.7 71.0 68.5 68.8 67.5 65.2 74.9 74.9 72.4 51.8 53.6 54.0 74.1 73.1 71.0 71.5 70.1 68.2 77.0 76.3 74.2 47.4 49.9 50.2 59.2 61.3 57.4 56.2 57.2 53.1 63.3 67.4 63.6 71.7 69.6 70.5 60.5 61.9 67.4 57.8 57.6 53.7 63.9 67.7 62.9 70.7 71.2 72.0 55.7 55.4 52.2 51.8 51.2 48.2 60.6 61.4 57.8 76.9 79.9 78.6 Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic ALL ARIZONA RESIDENTS Year Indicator Figure number 8. PREMATURE MORTALITY 63.9 64.2 63.8 62.3 61.4 63.1 65.5 68.0 64.6 67.0 68.5 65.1 9. REPORTABLE DISEASES 9-1 Incidence of early syphilis 9-2 Incidence of gonorrhea 9-3 Incidence of chlamydia 9-4 Incidence of genital herpes 9-5 Incidence of AIDS 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 1999 1997 1995 10.2 7.2 3.8 86.8 82.6 91.8 241.0 234.2 240.3 19.7 29.9 51.2 6.8 6.7 11.3 3.9 2.3 0.8 32.5 30.0 39.5 88.5 85.5 98.7 12.8 18.9 31.6 5.3 5.6 12.2 21.1 13.4 10.6 154.2 125.6 164.4 408.9 388.5 476.2 19.2 25.6 49.4 8.9 9.8 8.6 61.9 73.4 45.1 512.5 639.9 992.8 635.2 523.5 870.3 41.5 67.7 119.8 25.6 18.9 24.8 9.1 2.8 2.9 81.5 55.8 91.7 643.7 635.5 708.3 24.5 29.5 31.9 8.3 4.0 3.0 Asian or Pacific Islander American Indian Black or African American Hispanic White nonHispanic ALL ARIZONA RESIDENTS Year Indicator Figure number (Number of cases per 100,000 persons in specified group) 2.8 1.1 3.6 10.4 18.7 25.5 70.8 76.9 83.6 2.8 8.8 23.6 .0 1.1 3.3 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 121 DATA SOURCES AND DEFINITIONS DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 123 SOURCES OF DATA Information on births and deaths is compiled from the original documents (i.e., certificates of live births and certificates of death) filed with the Arizona Department of Health Services. Information on induced terminations of pregnancy (abortions) performed on Arizona women is compiled from reports sent to the Arizona Department of Health Services by facilities within but not outside the state. Pregnancies are the sum of live births, spontaneous terminations of pregnancy (fetal deaths or still births) and induced terminations of pregnancy (abortions). Data on morbidity, levels of disease and disability in the population, are obtained for certain infectious diseases that must be reported by law. The ADHS Epidemiology and Disease Control Services conducts surveillance and monitoring of these reportable diseases and provided data for section 9 in this report. In order to obtain population denominators by ethnic group, used to calculate rates for 1999, the 1999 percentages of population breakdowns by race/ethnicity for Arizona from the U.S. Bureau of the Census (Detailed State Projection Data Files: 1995 to 2025, available on the Web at http://www.census.gov/population/www/projections/stproj.html ) were applied to official population estimates prepared by the Population Statistics Unit of the Arizona Department of Economic Security. Almost all figures are based on rates and ratios published in the 1999 Arizona Health Status and Vital Statistics annual report. DEFINITIONS Terms Related to Reproductive Health ABORTION RATE - NUMBER OF REPORTED ABORTIONS TO FEMALES OF ALL AGES DURING A CALENDAR YEAR PER 1,000 FEMALES OF CHILDBEARING AGE (15-44 YEARS). ABORTION RATIO - NUMBER OF ABORTIONS REPORTED DURING A PERIOD PER 1,000 LIVE BIRTHS OCCURRING DURING THE SAME PERIOD. BIRTH OR LIVE BIRTH - THE COMPLETE EXPULSION OR EXTRACTION FROM ITS MOTHER OF A PRODUCT OF HUMAN CONCEPTION, IRRESPECTIVE OF THE DURATION OF PREGNANCY WHICH, AFTER SUCH EXPULSION OR EXTRACTION, BREATHS OR SHOWS ANY OTHER EVIDENCE OF LIFE SUCH AS BEATING OF THE HEART, PULSATION OF THE UMBILICAL CORD OR DEFINITE MOVEMENT OF VOLUNTARY MUSCLES, WHETHER OR NOT THE UMBILICAL CORD HAS BEEN CUT OR THE PLACENTA IS ATTACHED. BIRTH WEIGHT - THE WEIGHT OF A NEONATE DETERMINED IMMEDIATELY AFTER DELIVERY OR AS SOON THEREAFTER AS POSSIBLE. INFANT DEATH - ANY DEATH AT ANY TIME FROM BIRTH UP TO, BUT NOT INCLUDING, THE FIRST YEAR OF AGE (364 DAYS, 23 HOURS, 59 MINUTES FROM THE MOMENT OF BIRTH). LOW-BIRTHWEIGHT - PRIOR TO 1990: ANY NEONATE WHOSE WEIGHT AT BIRTH IS 2,500 GRAMS OR BEGINNING IN 1990: ANY NEONATE WEIGHING LESS THAN 2,500 GRAMS AT BIRTH (LESS THAN 5 POUNDS 8 OUNCES). LESS. NEONATAL DEATH - DEATH OF A LIVEBORN NEONATE BEFORE THE NEONATE BECOMES 28 DAYS OLD (UP TO AND INCLUDING 27 DAYS, 23 HOURS, 59 MINUTES FROM THE MOMENT OF BIRTH). DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 124 POSTNEONATAL DEATH - ANY DEATH OF A LIVEBORN INFANT AT LEAST 28 DAYS OF AGE BUT UNDER ONE YEAR OF AGE. VERY LOW-BIRTHWEIGHT - ANY NEONATE WHOSE WEIGHT AT BIRTH IS 1,500 GRAMS OR LESS (LESS THAN 3 POUNDS 5 OUNCES). TERMS RELATED TO MORTALITY AGE-ADJUSTED MORTALITY RATES - BECAUSE MORTALITY FROM MOST CAUSES OF DEATH OCCURS PREDOMINATELY AMONG THE ELDERLY, A POPULATION GROUP WITH A LARGER PROPORTION OF OLDER PERSONS WOULD HAVE A HIGHER MORTALITY RATE. THE "AGE-ADJUSTMENT" REMOVES THE EFFECT OF THE AGE DIFFERENCES AMONG SUB-POPULATIONS BY PLACING THEM ALL IN A POPULATION WITH A STANDARD AGE DISTRIBUTION. AGE-SPECIFIC MORTALITY - NUMBER OF DEATHS IN A SPECIFIC AGE GROUP DURING A CALENDAR YEAR. CAUSE OF DEATH - FOR THE PURPOSE OF NATIONAL MORTALITY STATISTICS, EVERY DEATH IS ATTRIBUTED TO ONE UNDERLYING CONDITION, BASED ON INFORMATION REPORTED ON THE DEATH CERTIFICATE AND UTILIZING THE INTERNATIONAL RULES FOR SELECTING THE UNDERLYING CAUSE OF DEATH FROM THE REPORTED CONDITIONS. CAUSE-SPECIFIC MORTALITY - NUMBER OF DEATHS FROM A SPECIFIED CAUSE DURING A CALENDAR YEAR. CLASSIFICATION OF CAUSE OF DEATH - THE CAUSE OF DEATH USED IN THIS REPORT IS THE UNDERLYING CAUSE CLASSIFIED ACCORDING TO THE INTERNATIONAL CLASSIFICATION OF DISEASES, INJURIES AND CAUSES OF DEATH. LISTED BELOW ARE CATEGORIES AND INTERNATIONAL CLASSIFICATION OF DISEASES (ICD) CODES FOR SELECTED CAUSES OF MORTALITY PRESENTED IN THIS REPORT. ALCOHOLISM: 291, 303, 571.0-571.3 ALZHEIMER'S DISEASE: 331.0 BREAST CANCER IN WOMEN: 174 CARDIOVASCULAR DISEASE: 390-448 CEREBROVASCULAR DISEASE (STROKE): 430-438 CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD): 490-496 CIRRHOSIS: 571 COLORECTAL CANCER: 153.0-154.3, 154.8, 159.0 CORONARY HEART DISEASE: 410-414, 402, 429.2 DIABETES MELLITUS: 250 DISEASE OF HEART: 390-398, 402, 404-429 DROWNING: E830, E832, E910 DRUG-RELATED DEATHS: 292, 304, 305.2-305.9, E850-E858, E950.0-E950.5, E962.0, 980.0E980.5 FALL-RELATED DEATHS: E880-E888 FIREARM-RELATED DEATHS: E922.0-E922.3, E922.8-E922.9, E955.0-E955.4, E965.0-E965.4, E970, E985.0-E985.4 HIV INFECTION: 042-044 HOMICIDE AND LEGAL INTERVENTION: E960-E978 INFECTIOUS AND PARASITIC DISEASES: 001-139 INJURIES NOT RELATED TO MOTOR VEHICLES: E800-E807, E826-E949; INJURIES, UNINTENTIONAL: E800-E949 MALIGNANT NEOPLASMS (CANCERS): 140-208 MOTOR VEHICLE-RELATED INJURIES: E810-E825 NEPHRITIS, NEPHROTIC SYNDROME AND NEPHROSIS: 580-589 PNEUMONIA & INFLUENZA: 480-487 SEPTICEMIA: 038 SUICIDE : E950-E959 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 125 Medical Terms Used on the Birth Certificate MEDICAL RISK FACTORS FOR THIS PREGNANCY ANEMIA - HEMOGLOBIN LEVEL OF LESS THAN 10.0 G/DL DURING PREGNANCY OR HEMATOCRIT OF LESS THAN 30 PERCENT DURING PREGNANCY. CARDIAC DISEASE - DISEASE OF THE HEART. ACUTE OR CHRONIC LUNG DISEASE - DISEASE OF THE LUNGS DURING PREGNANCY. DIABETES - METABOLIC DISORDER CHARACTERIZED BY EXCESSIVE DISCHARGE OF URINE AND PERSISTENT THIRST; INCLUDES JUVENILE ONSET, ADULT ONSET AND GESTATIONAL DIABETES DURING PREGNANCY. GENITAL HERPES - INFECTION OF THE SKIN OF THE GENITAL AREA BY HERPES SIMPLEX VIRUS. HYDRAMNIOS/OLIGOHYDRAMNIOS (OLIGOHYDRAMNIOS) OF AMNIOTIC FLUID. ANY NOTICEABLE EXCESS (HYDRAMNIOS) OR LACK HEMOGLOBINOPATHY - A BLOOD DISORDER CAUSED BY ALTERATION IN THE GENETICALLY DETERMINED MOLECULAR STRUCTURE OF HEMOGLOBIN (FOR EXAMPLE, SICKLE CELL ANEMIA). HYPERTENSION, CHRONIC - BLOOD PRESSURE PERSISTENTLY GREATER THAN 140/90, DIAGNOSED PRIOR 20TH WEEK OF GESTATION. TO ONSET OF PREGNANCY OR BEFORE THE HYPERTENSION, PREGNANCY-ASSOCIATED - AN INCREASE IN BLOOD PRESSURE OF AT LEAST 30 MM HG SYSTOLIC OR 15 MM HG DIASTOLIC ON TWO MEASUREMENTS TAKEN 6 HOURS APART AFTER THE 20TH WEEK OF GESTATION. ECLAMPSIA - THE OCCURRENCE OF CONVULSIONS AND/OR COMA UNRELATED TO OTHER CEREBRAL CONDITIONS IN WOMEN WITH SIGNS AND SYMPTOMS OF PREECLAMPSIA. INCOMPETENT CERVIX - CHARACTERIZED BY PAINLESS DILATION OF THE CERVIX IN THE SECOND TRIMESTER OR EARLY IN THE THIRD TRIMESTER OF PREGNANCY, WITH PREMATURE EXPULSION OF MEMBRANES THOUGH CERVIX AND BALLOONING OF THE MEMBRANES INTO VAGINA, FOLLOWED BY RUPTURE OF THE MEMBRANE AND SUBSEQUENT EXPULSION OF THE FETUS. PREVIOUS INFANT 4,000+ GRAMS - THE BIRTHWEIGHT OF A PREVIOUS LIVE-BORN CHILD WAS OVER 4,000 GRAMS (8LBS.14OZ.). PREVIOUS PRETERM OR SMALL-FOR-GESTATIONAL-AGE-INFANT - PREVIOUS BIRTH OF AN INFANT PRIOR 37 COMPLETED WEEKS OF GESTATION) OR OF AN INFANT WEIGHING LESS THAN THE 10TH PERCENTILE FOR GESTATIONAL AGE USING A STANDARD WEIGHT FOR AGE CHART. RENAL DISEASE - KIDNEY DISEASE. TO TERM (BEFORE RH SENSITIZATION - THE PROCESS OR STATE OF BECOMING SENSITIZED TO THE RH FACTOR AS WHEN AN RH-NEGATIVE WOMAN IS PREGNANT WITH AN RH-POSITIVE FETUS. UTERINE BLEEDING - ANY CLINICALLY SIGNIFICANT BLEEDING DURING THE PREGNANCY TAKING INTO CONSIDERATION THE STAGE OF PREGNANCY; ANY SECOND OR THIRD TRIMESTER BLEEDING OR THIRD TRIMESTER BLEEDING OF THE UTERUS PRIOR TO THE ONSET OF LABOR. DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 126 COMPLICATIONS OF LABOR AND/OR DELIVERY FEBRILE - A FEVER GREATER THAN 100 DEGREES F. OR 38 DEGREES C. OCCURRING DURING LABOR AND/OR DELIVERY. MECONIUM, MODERATE/HEAVY - MECONIUM CONSISTS OF UNDIGESTED DEBRIS FROM SWALLOWED AMNIOTIC FLUID, VARIOUS PRODUCTS OF SECRETION AND SHEDDING BY THE GASTROINTESTINAL TRACT, MODERATE TO HEAVY AMOUNTS OF MECONIUM IN THE AMNIOTIC FLUID NOTED DURING LABOR AND/OR DELIVERY. MECONIUM ASPIRATION SYNDROME - ASPIRATION OF MECONIUM BY THE FETUS OR NEWBORN, AFFECTING THE LOWER RESPIRATORY SYSTEM. ASSISTED VENTILATION (LESS THAN 30 MINUTES) - A MECHANICAL METHOD OF ASSISTING RESPIRATION FOR NEWBORNS WITH RESPIRATORY FAILURE. PREMATURE RUPTURE OF MEMBRANES (MORE THAN 12 HOURS) - RUPTURE OF MEMBRANES AT ANY 12 HOURS BEFORE THE ONSET OF LABOR. TIME DURING PREGNANCY AND MORE THAN ABRUPTIO PLACENTA - PREMATURE SEPARATION OF NORMALLY IMPLANTED PLACENTA FROM THE UTERUS. PLACENTA PREVIA - IMPLANTATION OF THE PLACENTA OVER OR NEAR THE INTERNAL OPENING OF THE CERVIX. OTHER EXCESSIVE BLEEDING - THE LOSS OF SIGNIFICANT AMOUNT OF BLOOD FROM CONDITIONS OTHER THAN ABRUPTIO PLACENTA OR PLACENTA PREVIA. SEIZURES DURING LABOR - MATERNAL SEIZURES OCCURRING DURING LABOR FROM ANY CAUSE . ABNORMAL CONDITIONS OF THE NEWBORN ANEMIA - HEMOGLOBIN LEVEL OF LESS THAN 13.0 G/DL OR A HEMATOCRIT OF LESS THAN 39 PERCENT. BIRTH INJURY - IMPAIRMENT OF THE INFANT'S BODY FUNCTION OR STRUCTURE DUE TO ADVERSE INFLUENCES THAT OCCURRED AT BIRTH. FETAL ALCOHOL SYNDROME - A SYNDROME OF ALTERED PRENATAL GROWTH AND DEVELOPMENT OCCURRING IN INFANTS BORN OF WOMEN WHO CONSUMED EXCESSIVE AMOUNTS OF ALCOHOL DURING PREGNANCY. HYALINE MEMBRANE DISEASE/RDS - A DISORDER PRIMARILY OF PREMATURITY, MANIFESTED CLINICALLY BY RESPIRATORY DISTRESS AND PATHOLOGICALLY BY PULMONARY HYALINE MEMBRANES AND INCOMPLETE EXPANSION OF THE LUNGS AT BIRTH. ASSISTED VENTILATION (30 MINUTES OR MORE) - NEWBORN PLACED ON ASSISTED VENTILATION FOR 30 MINUTES OR LONGER. SEIZURES - A SEIZURE OF ANY ETIOLOGY. DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 127 POPULATION DENOMINATORS POPULATION BY ETHNIC GROUP, ARIZONA RESIDENTS, 1980, 1990 AND 1999 (Numbers rounded to nearest thousand) American Indian 1980 1990 1997 203.0 265.2 5.4% Asian 25.0 55.0 105.5 2.1% Black 74.0 110.0 176.1 3.6% 444.0 688.0 1,060.2 21.5% Non-Hispanic white 2,021.0 2,608.0 3,317.3 67.4% TOTAL 2,718.0 3,665.0 4,924.3 100.0% Hispanic Note: Data for 1980 and 1990 are the census counts. In order to obtain population denominators by ethnic group, used to calculate rates for 1999, the 1999 percentages of population breakdowns by race/ethnicity for Arizona from the U.S. Bureau of the Census (Detailed State Projection Data Files: 1995 to 2025, available on the Web at http://www.census.gov/population/www/projections/stproj.html ) were applied to official population estimates prepared by the Population Statistics Unit of the Arizona Department of Economic Security. 129 154.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 Ethnic group % of total population in 1999 ESTIMATED POPULATION BY AGE GROUP, GENDER AND RACE/ETHNICITY, ARIZONA, 1999 Age group Total 5-14 15-24 25-34 35-44 45-54 55-64 65+ WHITE NON-HISPANIC 39,260 153,949 404,166 393,674 447,460 521,438 444,958 318,471 593,920 3,317,297 ---Male 20,131 79,670 218,156 214,651 232,904 257,423 217,629 151,806 265,903 1,658,274 ---Female 19,129 74,279 186,010 179,023 214,556 264,015 227,329 166,665 328,017 1,659,023 HISPANIC 25,154 91,961 219,993 186,577 182,878 148,296 92,660 51,621 61,058 1,060,197 ---Male 12,833 46,854 112,176 94,465 93,760 75,342 45,721 24,230 26,287 531,668 ---Female 12,320 45,106 107,817 92,112 89,118 72,954 46,939 27,391 34,771 528,529 BLACK 3,388 12,539 31,195 28,604 30,341 29,416 18,050 10,356 12,239 176,128 ---Male 1,719 6,376 15,992 14,562 15,831 15,595 9,343 5,006 5,355 89,779 ---Female 1,668 6,163 15,203 14,043 14,510 13,822 8,706 5,350 6,885 86,349 AMERICAN INDIAN 6,501 23,681 62,192 47,977 42,510 34,237 21,579 12,310 14,208 265,195 ---Male 3,256 11,942 31,016 23,883 20,924 16,503 9,944 5,459 5,753 128,679 ---Female 3,245 11,739 31,176 24,094 21,586 17,735 11,635 6,851 8,455 136,516 ASIAN 1,710 6,493 16,346 16,020 21,072 17,848 12,040 6,868 7,137 105,533 ---Male 863 3,296 8,392 7,960 10,241 8,380 5,156 2,908 2,857 50,053 ---Female 847 3,197 7,955 8,059 10,831 9,467 6,884 3,960 4,280 55,480 ALL GROUPS 76,012 288,622 733,892 672,852 724,261 751,236 589,287 399,626 688,562 4,924,350 ---Male 38,802 148,138 385,732 355,521 373,660 373,243 287,793 189,409 306,155 2,458,453 ---Female 37,210 140,484 348,160 317,331 350,601 377,993 301,494 210,217 382,407 2,465,897 Note: The 1999 percentages of population breakdowns by race/ethnicity and single year of age from the U.S. Bureau of the Census were applied to official population estimates prepared by DES Population Statistics Unit and released on 8/12/1999. 130 1-4 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 1999 <1 Our Web site at http://www.hs.state.az.us/plan/ohpes.htm provides instantaneous access to a wide range of statistical information about health status and use of health care in Arizona. The Arizona Health Status and Vital Statistics annual report examines trends in natality, mortality and morbidity towards established health objectives. Additional data can be found in the special reports and studies focused on differences in the health status by ethnic group, suicide mortality, unintentional injury mortality among children and adolescents, firearm-related fatalities, unintentional drowning deaths, drug-related mortality, teenage pregnancy and abortion practices in Arizona. The Monthly Vital Statistics Bulletin has the most up to date information on births, deaths, marriages and divorces. Office of Epidemiology and Statistics Bureau of Public Health Statistics Public Health Services ARIZONA DEPARTMENT OF HEALTH SERVICES