DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS ARIZONA, 2003 Public Health Services Bureau of Public Health Statistics Health Status and Vital Statistics Section ~ Leadership for a Healthy Arizona ~ Janet Napolitano, Governor State of Arizona Catherine R. Eden, Director Arizona Department of Health Services Health Status and Vital Statistics Section BUREAU OF PUBLIC HEALTH STATISTICS ARIZONA DEPARTMENT OF HEALTH SERVICES 150 North 18th Avenue, Suite 550 Phoenix, Arizona 85007 Phone: 602/542-7333; FAX: 602/542-2940 www.azdhs.gov/plan This publication can be made available in alternative format. Please contact the Bureau of Public Health Statistics at 602/542-7333 (voice) or call 1-800-367-8939 (TDD). The Arizona Department of Health Services is an Equal Employment Opportunity Agency. 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, 2003 BY CHRISTOPHER K. MRELA, PH.D., ASSISTANT REGISTRAR OF VITAL STATISTICS November 2004 Acknowledgment Grateful acknowledgement is made to Richard S. Porter for reviewing the typescript. Our appreciation to Roberta Durfee for proofreading the report. Differences in the Health Status Among Ethnic Groups, Arizona, 2003 Table of Contents Purpose................................................................................................................................. 1 Demographic Profile of Arizona’s Ethnic Diversity ................................................................ 2 Methods ................................................................................................................................ 3 Key Findings ......................................................................................................................... 4 Comparison of Scores by Race/Ethnicity in 1997, 1999, 2001 and 2003 ........................... 4 Number of Times Each Group Ranked Better Than Average, Average, And Worse Than Average on 70 Indicators, Arizona, 2003 ........................................ 4 Average Scores in 2003..................................................................................................... 5 Risk Profiles ...................................................................................................................... 6 Risk Profile of Asians...................................................................................................... 7 Risk Profile of White non-Hispanics................................................................................ 8 Risk Profile of Hispanics ................................................................................................. 9 Risk Profile of American Indians .................................................................................. 10 Risk Profile of Blacks or African Americans .................................................................. 11 COMPARATIVE MEASURES OF HEALTH STATUS BY RACE/ETHNICITY IN 2003.................... 13 1. 2. 3. 4. 5. 6. 7. 8. 9. Teen Pregnancies .................................................................................................. 15 Maternal Lifestyle and Health Characteristics ....................................................... 21 Utilization of Prenatal Care Services ..................................................................... 33 Newborn's Health.................................................................................................. 39 Mortality from Natural Causes............................................................................... 53 Mortality from Injuries.......................................................................................... 75 Age-Specific Mortality ........................................................................................... 87 Patterns of Premature Mortality............................................................................ 93 The Incidence of Reportable Diseases................................................................... 99 RATES AND RATIOS FOR 2003 .......................................................................................... 105 SCORES IN 2003 ............................................................................................................... 113 RANKING ORDER IN 2003 ................................................................................................. 121 COMPARATIVE RATES AND RATIOS FOR 2000 – 2003....................................................... 129 DATA SOURCES AND DEFINITIONS ................................................................................... 141 Sources of Data .......................................................................................................... 143 Definitions.................................................................................................................. 143 Terms Related to Mortality ......................................................................................... 148 POPULATION DENOMINATORS.......................................................................................... 151 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 PURPOSE The report Differences in the Health Status Among Ethnic Groups, Arizona, 2003 is the update* of population-level data about differences in the relative health of five ethnic groups residing in Arizona: White non-Hispanics, Hispanics or Latinos, Blacks or African-Americans, American Indians or Alaska Natives and Asians or Pacific Islanders including Hawaiians. The report compares the relative standing of ethnic groups on 70 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. Each bar chart visually describes how the race/ethnic group compares to other groups and the overall State level for each indicator. These graphic representations are found in Comparative Measures of Health Status by Race/Ethnicity in 2003 while the tabulated values also are available in the Rates and Ratios for 2003 section of the report. The report also provides comparative risk profiles, as well as scores and rankings of ethnic groups on each of the 70 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 health status among ethnic groups in our State and to stimulate viable initiatives to improve the health of all Arizonans. ____________________________________ * Prior editions of this report were published for the 1995, 1997, 1999, and 2001 data years. This report uses the same methodology as the 1997, 1999, and 2001 editions, so that average scores and average ranks (but not mortality rates) are directly comparable. 1 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 DEMOGRAPHIC PROFILE OF ARIZONA'S ETHNIC DIVERSITY The racial and ethnic composition of the population has important consequences for the State’s health status because many measures of disease and disability differ significantly by race and ethnicity. Among the estimated 5,629,870 Arizona residents in 2003, 3,608,747 (64.1 percent) were White nonHispanic, 1,424,357 (25.3 percent) were Hispanic or Latino, and 292,753 (5.2 percent) were American Indian or Alaska Natives. Blacks or African Americans accounted for 185,786 or 3.3 percent of the State’s population. Asians or Pacific Islanders, the smallest race group, represented 2.1 percent of the total population (118,227 people). The White non-Hispanic population increased by 38.4 percent from 1990 to 2003, while Arizona saw a 91.1 percent increase in its minority population (See p.127: Population Denominators, Population by Race/Ethnic Group: Arizona Residents, 1990, 2000 and 2003). Both the Asian and Hispanic ethnic minority groups in Arizona more than doubled in size since 1990. The Black or African American population increased by 68.1 percent while the American Indian population increased by 43.8 percent from 1990 to 2003. Compared with the White non-Hispanics, the racial/ethnic minority groups have had greater percentages of people younger than 25 years (49.0 vs. 29.1 percent). In contrast, people aged 65 years and older accounted for 17.7 percent of White non-Hispanics, but only 4.6 percent of all ethnic minority groups combined: POPULATION BY AGE GROUP IN 2003 (in thousands): All groups White nonHispanic Total Other than White non-Hispanic* American Black or Indian or African Alaska American Native Hispanic or Latino Asian or Pacific Islander < 25 years 2063.2 1051.0 1011.7 739.3 80.8 149.9 41.7 Percent 36.6% 29.1% 49.0% 51.9% 43.5% 51.2% 35.3% 2833.0 1920.2 913.7 624.1 93.6 127.0 69.0 50.3% 53.2% 44.3% 43.8% 50.4% 43.4% 58.4% 25-64 years Percent 65+ years Percent Total, all ages** Percent 732.7 637.0 95.6 61.0 11.3 15.8 7.5 13.0% 17.7% 4.6% 4.3% 6.1% 5.4% 6.3% 5629.9 100% 3608.7 100.0% 2021.1 100.0% 1424.4 100.% 185.8 100.0% 292.7 100.0% 118.2 100.0% Source: In order to obtain the 2003 population denominators, the 2000 percentages of population breakdowns (or census shares) by race/ethnicity, age group and gender were applied to total state population estimates released by the Arizona Department of Economic Security on 12/11/2003. Similar to the differences in the age composition is the contrasting pattern of proportional mortality by age group. In 2003, the elderly (65 years and older) comprised 77.0 percent of the total mortality among White non-Hispanics, compared to 40.2 percent among American Indians, 52.5 percent among Blacks, 51.8 percent among Hispanics, and 60.2 percent among Asians. One out of fifty White nonHispanics who died in 2003 was less than 25 years old (1.8 percent). In contrast, persons younger than 25 years of age accounted for one out of every eight (12.6 percent) deaths among Arizona ethnic minorities: MORTALITY BY AGE GROUP IN 2003: All groups White nonHispanic Total Other than White non-Hispanic * American Black or Hispanic or Indian or African Latino Alaska American Native < 25 years 1630 639 989 659 106 205 19 Percent 3.8% 1.8% 12.6% 13.4% 9.3% 13.4% 6.6% 25-64 years Percent 65+ years Percent Total, all ages** Percent 10331 7375 2935 1699 432 708 96 24.1% 21.1% 37.3% 34.6% 38.0% 46.4% 33.2% 30815 26873 3933 2547 598 614 174 71.9% 77.0% 50.0% 51.8% 52.5% 40.2% 60.2% 42830 100.0% 34906 100.0% 7868 100.0% *Includes other groups than Hispanic, Black, American Indian and Asian. **Includes unknown age. Source: the 2003 death certificate file for Arizona residents 2 Asian or Pacific Islander 4914 100.0% 1138 100.0% 1527 100.0% 289 100.0% DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 METHODS The 70 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. A positive score indicates wore than average standing on an indicator. It is important to note that the unit of analysis in this report is the race/ethnic group. The aggregate measures of health status (such as teen pregnancy rate, infant mortality rate, mortality rate for druginduced deaths or the incidence of low-birthweight, etc.) apply to groups and not individuals. The rates and ratios presented in sections 1-4 and 7-9 of Comparative Measures of Health Status by Race/Ethnicity and Rates and Ratios for 2003 are directly comparable to the previously published rates and ratios for 1995, 1997, and 1999. However, the cause-specific mortality rates in section 5 and section 6 CANNOT BE compared to cause-specific mortality rates published in prior editions of this report. This is because beginning with the 2000 data year in Arizona (1999 nationally) two major changes have occurred that affect the computation of mortality rates and analyses of mortality data over time. First, a new revision of the International Classification of Diseases (ICD), used to classify causes of death, was implemented. The Tenth Revision (ICD-10) has replaced the Ninth Revision (ICD-9), which was in effect since 1979. Second, a new population standard for the age adjustment of mortality rates has replaced the standard based on the 1940 population and used since 1943. The new set of age-adjustment weights uses the projected year 2000 U.S. population as a standard. Both changes have profound effects on the comparability of mortality data and continuity in statistical trends. Age-adjusted rates can only be compared to other age-adjusted rates that use the same population standard. In this report, ALL age-adjusted mortality rates are based on the (new) 2000 standard, and they CANNOT BE compared to rates using the 1940 standard population. This is because the age structures of the 1940 and year 2000 populations differ. From 1940 to 2000 the U.S. population “aged” considerably. The age-adjusted rates based on the year 2000 standard are different because the year 2000 population standard, which has an older age structure, gives more weight than the 1940 standard to death rates at older ages where mortality is higher. Breaks in comparability of mortality statistics effective with deaths occurring in 2000 also result from the implementation of ICD-10. ICD-10 is far more detailed than ICD-9, with about 8,000 categories compared with about 5,000 categories. ICD-10 uses alphanumeric codes compared with numeric codes in ICD-9. Some of the coding rules and rules for selecting the underlying cause of death have been changed. Moreover, cause-of-death titles have been changed and the cause-of-death categories regrouped. For example, the ICD-9 category “chronic obstructive pulmonary diseases (COPD)” was replaced by the ICD-10 category “chronic lower respiratory diseases (CLRD)”. Unlike COPD, CLRD excludes allergic alveolitis and pneumonitis due to inhaled organic dust. Conversely, over 55 percent more deaths are classified to Alzheimer’s disease in ICD-10 than ICD-9. Almost all of this increase comes from deaths classified in ICD-9 as Presenile dementia but reclassified in ICD-10 to Alzheimer’s disease. The statistical consequences of the new standard and of the new revision of the ICD were discussed in greater detail in the year 2000 edition of the Arizona Health Status and Vital Statistics report (see http://www.hs.state.az.us/plan/report/ahs/ahs2000/pdf/093_094text2.pdf ) 3 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 KEY FINDINGS The inequity between the groups, as measured by the range of score values from the lowest (the most favorable standing among the groups) to the highest (the least favorable standing), narrowed from 117.2 points in 2001 to 93.9 in 2003 (Figure A). The average score for Blacks improved from 87.0 in 2001 to 64.3 in 2003. Compared to a score of 69.9 in 2001, the average score for American Indians also declined to 56.0 in 2003. Simultaneously Asians had their worst average score in 2003, compared to their average scores in 1997, 1999 and 2001 (Figure A). Figure A Comparison of Scores by Race/Ethnicity in 1997, 1999, 2001 and 2003 90.0 WORSE THAN AVERAGE 75.0 Black 60.0 American Indian 45.0 30.0 Hispanic 15.0 Average for all Arizonans 0.0 BETTER THAN AVERAGE -15.0 White non-Hispanic -30.0 Asian -45.0 -60.0 -75.0 -90.0 1997 1999 2001 American Indian 54.7 61.0 69.9 2003 56.0 Asian -42.8 -46.3 -30.2 -29.6 64.3 Black 71.9 60.5 87.0 Hispanic 4.8 7.1 8.2 8.2 White non-Hispanic -7.4 -9.2 -9.8 -10.5 Difference between the highest and the lowest score 114.7 107.3 117.2 93.9 In 2003, as in 2001, 1999 and 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 (Figure B). Figure B Number of Times Each Group Ranked Better Than Average, Average, and Worse Than Average on 70 Indicators, Arizona, 2003 Asian White non-Hispanic American Indian 19 6 39 12 53 11 Better than average (ranks 1 or 2) 4 22 26 22 5 19 12 39 Hispanic Black 7 58 Average (rank 3) Worse than average (ranks 4 or 5) DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 The average scores based on all 70 measurements ranged from –29.6 for Asians to 64.3 for Blacks (Figure C). The scores for White non-Hispanics (-10.5) and Hispanics (8.2) differed little from the statewide average. The score of 56.0 for American Indians was the second highest among the racial/ethnic groups in Arizona. Figue C Average Scores in 2003 (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.) Asian -29.6 White non-Hispanic -10.5 Hispanic 8.2 American Indian 56.0 Black 64.3 -100.0 -80.0 -60.0 -40.0 BETTER THAN AVERAGE ASIANS or PACIFIC ISLANDERS Average rank: 1.8* -20.0 0.0 20.0 AVERAGE FOR ALL ARIZONANS 40.0 60.0 80.0 100.0 WORSE THAN AVERAGE Average score: -29.6** Many factors contributed to Asians' No.1 relative health ranking. They ranked best or second best among ethnic groups on 58 of 70 indicators, including measures of maternal lifestyle and health, cause-and-age-specific mortality and in low incidence of reportable diseases. Asians ranked best on measures of newborn’s health and second best in utilization of prenatal care services. Asians also had the lowest risk of injury mortality in accidents, as well as self-inflicted injuries in suicide. WHITE NON-HISPANICS Average rank: 2.6 Average score: -10.5 White non-Hispanics ranked second best in the relative healthiness among ethnic groups in Arizona. They ranked No.1 or No.2 on 39 of 70 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 lower respiratory diseases and suicide, White non-Hispanics ranked worst among ethnic groups. __________ *The average rank based on all 70 measurements (the sum of the ranks divided by 70 measurements. Ranks range between 1 = the highest rank of health indicators and 5 = the lowest rank of health indicators). See section RATES AND RATIOS FOR 2003, p.95. **The average score based on all 70 measurements (the sum of all scores divided by 70 measurements). See section SCORES IN 2003, p.101. 5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 HISPANICS or LATINOS Average rank: 3.0 Average score: +8.2 In 2003, as in 2001, 1999 and 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 26 of 70 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 alcohol and tobacco use among women giving birth, low incidence of preterm births and postneonatal mortality. AMERICAN INDIANS or ALASKA NATIVES Average rank: 3.6 Average score: +56.0 In 2003, American Indians in Arizona had the second highest average score among all groups and second lowest rank of overall health status. They ranked 5th or 4th 39 times on 70 indicators (Figure B), and they exceeded the statewide averages by a wider margin than any other group except Blacks (Figure C). American Indians ranked poorly on measures of maternal lifestyle and health as well as in utilization of prenatal care. High incidence of birth defects and 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. BLACKS or AFRICAN AMERICANS Average rank: 4.1 Average score: +64.3 Arizona Black or African American residents had the lowest rank of overall health status because they ranked 5th or 4th among the five ethnic groups on 53 of 70 measures (see Figure B). 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 or African Americans ranked better than average with low mortality rates for alcohol-induced causes (including chronic liver disease and cirrhosis) and fall-related injuries. In 2003, the average age at death from all causes among Black females (65.3 years) was the second best among ethnic groups. COMPARATIVE RATES AND RATIOS FOR 2000 – 2003 The seventy bar charts provide a snapshot of differences between the ethnic groups in Arizona in 2003. For the convenience of the readers, these inter-group comparisons for a single point in time are supplemented by comparisons over time in a special section of the report (Comparative Rates and Ratios for 2000 – 2003), which documents the race/ethnicity-specific changes since 2000 through 2003 on the 70 health status measures. RISK PROFILES Risk profiles presented on the following pages summarize how each race/ethnic group compares to the State average for the entire set of measures of health status. These profiles use scores, which were developed to describe the level of each of the 70 measures for each race/ethnic group in comparison to the average level for all groups. The profiles visually describe the better-than-average and worse than-average clusters of health status characteristics for each race/ethnic group. 6 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Risk Profile of Asians (percent above or below the State mean) BETTER THAN AVERAGE 4-8.Sudden Infant Death Syndrome (SIDS) 6-6.Drug-induced deaths 6-7.Alcohol-induced deaths 6-5.Injury by firearms 9-1.Incidence of early syphilis 5-10.Colorectal cancer 9-2.Incidence of gonorrhea 5-14.Chronic liver disease and cirrhosis 5-11.Prostate cancer 6-4.Drowning mortality 5-5.Chronic lower respiratory diseases 5-17.Alzheimer's disease 9-5.Incidence of AIDS 7-3.Mortality of young adults 20-44 years 7-1.Mortality of children 1-14 years 9-3.Incidence of chlamydia 2-1.Unmarried mothers 6-8.Intentional self-harm (suicide) 1-2.Pregnancies among females 14 and younger 4-9.Mortality of infants from low birthweight 7-4.Mortality of middle-aged adults 45-64 years 5-7.Lung cancer 4-10.Neonatal mortality 9-4.Incidence of genital herpes 7-2.Mortality of adolescents 15-19 years 1-4.Pregnancies among females 18-19 years 5-3.Coronary heart disease 2-2.Tobacco use during pregnancy 5-2.Diseases of the heart 1-3.Pregnancies among females 15-17 years 5-15.HIV disease 3-3.No prenatal care 2-3.Alcohol use during pregnancy 1-1.Pregnancies among females 19 and younger 5-1.Cardiovascular disease 6-1.Unintentional injuries 3-2.Fewer than five prenatal visit 5-20.Total mortality from all causes 3-1.No care in the 1st trimester 6-9.Assault (homicide) 6-2.Motor vehicle-related injuries 4-7.Infant mortality 2-8.Pregnancy-associated hypertension 5-12.Influenza and pneumonia 2-5.Dysfunctional labor 5-13.Diabetes 5-6.Malignant neoplasm (cancer) 5-16.Septicemia 2-10.Weight gain of less than 21 pounds 5-4.Cerebrovascular disease 2-9.Genital herpes during pregnancy 2-6.Anemia during pregnancy 6-3.Fall-related injuries 5-8.Breast cancer 2-4.Chronic hypertension 4-1.Incidence of hyaline membrane 4-6.Incidence of congenital anomal 4-3.Born too early (preterm or < 37 weeks) 4-2.Incidence of newborn intensive 8-2.Average age at death among males 4-11.Postneonatal mortality 8-1.Average age at death from all causes 8-3.Average age at death among females 4-4.Born too small: <2,500 grams 8-4.Deaths before expected years of life reached 4-5.Born too small: <1,500 grams 2-7.Diabetes during pregnancy 5-19.Essential (primary) hypertension 5-18.Nephritis, nephrotic syndrome and nephrosis 5-9.Cervical cancer WORSE THAN AVERAGE -100.0 -100.0 -100.0 -87.8 -87.8 -83.2 -75.9 -71.3 -69.7 -66.7 -65.9 -64.9 -62.8 -62.4 -62.1 -62.0 -60.4 -58.9 -57.1 -55.6 -55.3 -53.8 -53.5 -53.1 -52.0 -51.8 -51.8 -51.7 -50.5 -47.1 -46.9 -44.8 -44.4 -44.4 -43.8 -43.5 -37.5 -36.6 -35.2 -34.9 -34.4 -32.3 -32.1 -29.9 -25.0 -22.7 -21.5 -19.0 -18.8 -18.2 -16.7 -15.0 -14.8 -11.3 0.0 0.0 0.0 2.9 3.7 8.8 9.1 10.9 13.4 19.7 29.3 36.4 42.9 49.2 58.4 377.3 -500.0 0.0 -250.0 500.0 250.0 AVERAGE FOR ALL RESIDENTS 7 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Risk Profile of White non-Hispanics (percent above or below the State mean) BETTER THAN AVERAGE 3-3.No prenatal care 1-2.Pregnancies among females 14 and younger 3-2.Fewer than five prenatal visit 1-3.Pregnancies among females 15-17 years 9-3.Incidence of chlamydia 6-9.Assault (homicide) 5-9.Cervical cancer 9-2.Incidence of gonorrhea 1-1.Pregnancies among females 19 and younger 3-1.No care in the 1st trimester 9-1.Incidence of early syphilis 1-4.Pregnancies among females 18-19 years 2-1.Unmarried mothers 4-9.Mortality of infants from low birthweight 7-2.Mortality of adolescents 15-19 years 9-4.Incidence of genital herpes 2-10.Weight gain of less than 21 pounds 4-11.Postneonatal mortality 6-2.Motor vehicle-related injuries 5-13.Diabetes 6-7.Alcohol-induced deaths 4-7.Infant mortality 5-18.Nephritis, nephrotic syndrome and nephrosis 5-14.Chronic liver disease and cirrhosis 5-16.Septicemia 2-7.Diabetes during pregnancy 6-5.Injury by firearms 4-10.Neonatal mortality 6-4.Drowning mortality 5-15.HIV disease 7-1.Mortality of children 1-14 years 8-4.Deaths before expected years of life reached 6-1.Unintentional injuries 7-3.Mortality of young adults 20-44 years 5-12.Influenza and pneumonia 5-4.Cerebrovascular disease 5-19.Essential (primary) hypertension 8-3.Average age at death among females 8-1.Average age at death from all causes 8-2.Average age at death among males 4-4.Born too small: <2,500 grams 5-20.Total mortality from all causes 5-1.Cardiovascular disease 7-4.Mortality of middle-aged adults 45-64 years 4-8.Sudden Infant Death Syndrome (SIDS) 5-10.Colorectal cancer 4-6.Incidence of congenital anomal 4-5.Born too small: <1,500 grams 5-2.Diseases of the heart 5-11.Prostate cancer 5-3.Coronary heart disease 9-5.Incidence of AIDS 5-8.Breast cancer 5-6.Malignant neoplasm (cancer) 6-3.Fall-related injuries 5-17.Alzheimer's disease 4-3.Born too early (preterm or < 37 weeks) 5-5.Chronic lower respiratory diseases 6-6.Drug-induced deaths 5-7.Lung cancer 6-8.Intentional self-harm (suicide) 2-5.Dysfunctional labor 4-2.Incidence of newborn intensive 2-6.Anemia during pregnancy 2-8.Pregnancy-associated hypertension 2-3.Alcohol use during pregnancy 2-4.Chronic hypertension 2-2.Tobacco use during pregnancy 2-9.Genital herpes during pregnancy 4-1.Incidence of hyaline membrane WORSE THAN AVERAGE -79.3 -71.4 -59.7 -57.9 -55.7 -55.4 -54.5 -47.4 -47.3 -45.9 -43.2 -41.9 -39.1 -33.3 -31.6 -27.2 -26.4 -22.7 -18.9 -18.7 -17.8 -16.9 -16.8 -15.7 -15.5 -14.3 -14.2 -14.0 -13.3 -12.5 -10.3 -9.3 -8.7 -7.6 -6.8 -5.0 -4.8 -3.1 -3.0 -2.9 -2.8 -2.4 -0.5 -0.4 0.0 0.0 0.0 0.0 0.3 0.4 0.8 0.9 0.9 1.1 2.3 2.8 4.8 6.4 6.7 6.8 12.3 12.5 14.8 15.0 21.4 22.2 33.3 62.1 66.7 66.7 -500.0 0.0 -250.0 AVERAGE FOR ALL RESIDENTS 8 500.0 250.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Risk Profile of Hispanics (percent above or below the State mean) BETTER THAN AVERAGE 2-9.Genital herpes during pregnancy 2-2.Tobacco use during pregnancy 2-3.Alcohol use during pregnancy 6-8.Intentional self-harm (suicide) 2-6.Anemia during pregnancy 6-3.Fall-related injuries 2-5.Dysfunctional labor 5-5.Chronic lower respiratory diseases 9-5.Incidence of AIDS 2-4.Chronic hypertension 4-1.Incidence of hyaline membrane 2-8.Pregnancy-associated hypertension 5-7.Lung cancer 5-9.Cervical cancer 5-8.Breast cancer 2-7.Diabetes during pregnancy 5-17.Alzheimer's disease 4-2.Incidence of newborn intensive 6-6.Drug-induced deaths 9-4.Incidence of genital herpes 5-11.Prostate cancer 7-4.Mortality of middle-aged adults 45-64 years 7-1.Mortality of children 1-14 years 7-3.Mortality of young adults 20-44 years 4-3.Born too early (preterm or < 37 weeks) 4-11.Postneonatal mortality 4-4.Born too small: <2,500 grams 5-3.Coronary heart disease 5-6.Malignant neoplasm (cancer) 6-1.Unintentional injuries 6-4.Drowning mortality 4-8.Sudden Infant Death Syndrome (SIDS) 4-6.Incidence of congenital anomal 4-5.Born too small: <1,500 grams 5-2.Diseases of the heart 6-7.Alcohol-induced deaths 6-5.Injury by firearms 5-20.Total mortality from all causes 5-1.Cardiovascular disease 4-7.Infant mortality 9-2.Incidence of gonorrhea 4-10.Neonatal mortality 8-3.Average age at death among females 7-2.Mortality of adolescents 15-19 years 2-10.Weight gain of less than 21 pounds 8-1.Average age at death from all causes 8-2.Average age at death among males 6-2.Motor vehicle-related injuries 5-10.Colorectal cancer 5-12.Influenza and pneumonia 4-9.Mortality of infants from low birthweight 5-19.Essential (primary) hypertension 2-1.Unmarried mothers 9-1.Incidence of early syphilis 5-15.HIV disease 8-4.Deaths before expected years of life reached 3-1.No care in the 1st trimester 5-4.Cerebrovascular disease 3-2.Fewer than five prenatal visit 9-3.Incidence of chlamydia 5-16.Septicemia 5-14.Chronic liver disease and cirrhosis 1-4.Pregnancies among females 18-19 years 3-3.No prenatal care 1-1.Pregnancies among females 19 and younger 6-9.Assault (homicide) 5-18.Nephritis, nephrotic syndrome and nephrosis 1-3.Pregnancies among females 15-17 years 1-2.Pregnancies among females 14 and younger 5-13.Diabetes WORSE THAN AVERAGE -66.7 -63.8 -55.6 -43.8 -40.0 -37.5 -37.5 -36.8 -34.5 -33.3 -33.3 -32.1 -29.3 -18.2 -14.5 -14.3 -13.2 -13.0 -12.5 -11.7 -10.8 -9.2 -9.1 -7.9 -6.7 -4.5 -2.8 -1.4 -0.5 -0.2 0.0 0.0 0.0 0.0 0.7 1.0 6.1 7.1 7.7 7.7 12.4 14.0 14.2 16.0 16.2 16.3 17.4 18.3 18.4 19.2 22.2 25.4 27.9 31.1 34.4 37.8 40.2 41.0 44.4 44.9 50.0 53.0 59.6 65.5 66.6 77.1 82.2 83.9 85.7 92.6 -500.0 0.0 -250.0 500.0 250.0 AVERAGE FOR ALL RESIDENTS 9 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Risk Profile of American Indians (percent above or below the State mean) BETTER THAN AVERAGE 5-17.Alzheimer's disease 5-7.Lung cancer 5-10.Colorectal cancer 5-5.Chronic lower respiratory diseases 2-2.Tobacco use during pregnancy 5-3.Coronary heart disease 6-6.Drug-induced deaths 5-6.Malignant neoplasm (cancer) 5-2.Diseases of the heart 4-10.Neonatal mortality 5-1.Cardiovascular disease 5-8.Breast cancer 4-2.Incidence of newborn intensive 4-5.Born too small: <1,500 grams 3-3.No prenatal care 5-4.Cerebrovascular disease 2-9.Genital herpes during pregnancy 5-11.Prostate cancer 5-19.Essential (primary) hypertension 4-3.Born too early (preterm or < 37 weeks) 4-4.Born too small: <2,500 grams 9-5.Incidence of AIDS 4-1.Incidence of hyaline membrane 4-8.Sudden Infant Death Syndrome (SIDS) 4-9.Mortality of infants from low birthweight 6-8.Intentional self-harm (suicide) 6-5.Injury by firearms 5-15.HIV disease 5-20.Total mortality from all causes 4-7.Infant mortality 1-1.Pregnancies among females 19 and younger 8-3.Average age at death among females 1-4.Pregnancies among females 18-19 years 8-1.Average age at death from all causes 1-3.Pregnancies among females 15-17 years 8-2.Average age at death among males 3-1.No care in the 1st trimester 4-6.Incidence of congenital anomal 7-4.Mortality of middle-aged adults 45-64 years 6-3.Fall-related injuries 8-4.Deaths before expected years of life reached 2-10.Weight gain of less than 21 pounds 9-2.Incidence of gonorrhea 3-2.Fewer than five prenatal visit 6-4.Drowning mortality 2-1.Unmarried mothers 1-2.Pregnancies among females 14 and younger 7-1.Mortality of children 1-14 years 9-4.Incidence of genital herpes 5-9.Cervical cancer 4-11.Postneonatal mortality 2-8.Pregnancy-associated hypertension 6-9.Assault (homicide) 7-3.Mortality of young adults 20-44 years 2-4.Chronic hypertension 6-1.Unintentional injuries 5-18.Nephritis, nephrotic syndrome and nephrosis 5-12.Influenza and pneumonia 7-2.Mortality of adolescents 15-19 years 2-3.Alcohol use during pregnancy 9-1.Incidence of early syphilis 9-3.Incidence of chlamydia 5-13.Diabetes 2-6.Anemia during pregnancy 2-7.Diabetes during pregnancy 2-5.Dysfunctional labor 5-16.Septicemia 6-2.Motor vehicle-related injuries 5-14.Chronic liver disease and cirrhosis 6-7.Alcohol-induced deaths WORSE THAN AVERAGE -82.8 -72.2 -64.8 -57.3 -44.8 -35.7 -29.2 -28.7 -28.0 -27.9 -27.0 -25.8 -22.2 -18.2 -17.2 -17.1 -16.7 -16.3 -14.3 -6.7 -4.2 0.0 0.0 0.0 0.0 4.1 5.4 12.5 14.9 15.4 15.6 19.6 24.0 24.2 25.0 27.7 27.9 30.0 40.0 44.3 54.3 61.9 62.4 63.9 66.7 75.7 78.6 86.4 87.7 90.9 100.0 103.6 126.5 128.9 133.3 142.4 144.6 151.7 160.2 166.7 171.6 174.7 174.9 175.0 185.7 200.0 207.1 227.8 237.4 388.1 -500.0 0.0 -250.0 AVERAGE FOR ALL RESIDENTS 10 500.0 250.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Risk Profile of Blacks or African Americans (percent above or below the State mean) BETTER THAN AVERAGE 5-14.Chronic liver disease and cirrhosis 4-1.Incidence of hyaline membrane 5-5.Chronic lower respiratory diseases 6-7.Alcohol-induced deaths 6-3.Fall-related injuries 6-8.Intentional self-harm (suicide) 6-2.Motor vehicle-related injuries 1-2.Pregnancies among females 14 and younger 2-8.Pregnancy-associated hypertension 3-1.No care in the 1st trimester 4-6.Incidence of congenital anomal 2-5.Dysfunctional labor 2-7.Diabetes during pregnancy 3-2.Fewer than five prenatal visit 8-3.Average age at death among females 8-1.Average age at death from all causes 8-2.Average age at death among males 6-1.Unintentional injuries 2-10.Weight gain of less than 21 pounds 7-2.Mortality of adolescents 15-19 years 3-3.No prenatal care 5-7.Lung cancer 5-6.Malignant neoplasm (cancer) 4-2.Incidence of newborn intensive 5-12.Influenza and pneumonia 1-1.Pregnancies among females 19 and younger 5-17.Alzheimer's disease 5-20.Total mortality from all causes 5-16.Septicemia 1-4.Pregnancies among females 18-19 years 4-3.Born too early (preterm or < 37 weeks) 8-4.Deaths before expected years of life reached 7-4.Mortality of middle-aged adults 45-64 years 2-6.Anemia during pregnancy 9-4.Incidence of genital herpes 1-3.Pregnancies among females 15-17 years 2-3.Alcohol use during pregnancy 7-3.Mortality of young adults 20-44 years 5-10.Colorectal cancer 2-2.Tobacco use during pregnancy 5-1.Cardiovascular disease 5-2.Diseases of the heart 2-1.Unmarried mothers 6-5.Injury by firearms 5-3.Coronary heart disease 5-4.Cerebrovascular disease 5-11.Prostate cancer 4-4.Born too small: <2,500 grams 2-9.Genital herpes during pregnancy 2-4.Chronic hypertension 7-1.Mortality of children 1-14 years 6-4.Drowning mortality 5-8.Breast cancer 6-6.Drug-induced deaths 4-5.Born too small: <1,500 grams 5-18.Nephritis, nephrotic syndrome and nephrosis 5-19.Essential (primary) hypertension 4-8.Sudden Infant Death Syndrome (SIDS) 9-3.Incidence of chlamydia 4-10.Neonatal mortality 4-7.Infant mortality 9-1.Incidence of early syphilis 5-15.HIV disease 4-11.Postneonatal mortality 5-13.Diabetes 6-9.Assault (homicide) 5-9.Cervical cancer 9-5.Incidence of AIDS 4-9.Mortality of infants from low birthweight 9-2.Incidence of gonorrhea WORSE THAN AVERAGE -69.6 -33.3 -33.3 -32.7 -28.4 -22.6 -15.6 -14.3 -3.6 -0.4 0.0 0.0 4.8 5.6 13.0 13.6 13.8 17.0 18.3 18.7 20.7 25.3 29.0 29.6 29.9 31.6 33.2 33.7 34.5 36.3 37.1 39.0 39.2 40.0 42.6 43.7 44.4 45.9 46.9 50.0 51.0 51.9 52.2 56.8 56.9 57.2 64.1 64.8 66.7 66.7 74.9 80.0 86.4 95.8 100.0 106.9 130.2 133.3 136.7 139.5 144.6 145.9 153.1 154.5 164.0 200.0 209.1 276.1 300.0 466.5 -500.0 0.0 -250.0 500.0 250.0 AVERAGE FOR ALL RESIDENTS 11 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 COMPARATIVE MEASURES OF HEALTH STATUS BY RACE/ETHNICITY IN 2003 13 14 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 1. Teen Pregnancies Pregnancies Among Females 19 and Younger Pregnancies Among Females 14 and Younger Pregnancies Among Females 15-17 Years Old Pregnancies Among Females 18-19 Years Old 15 16 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Pregnancies Among Females Aged 19 and Younger 1-1 57.5 Hispanic 45.4 Black 39.9 American Indian 34.5 ALL ARIZONANS 19.2 Asian 18.2 White non-Hispanic 0.0 13.0 26.0 39.0 52.0 65.0 Number of pregnancies per 1,000 females aged 19 or younger COMPARATIVE RATES FOR 2000 AND 2003: 1-1 PREGNANCIES AMONG FEMALES 19 Year 2000 2003 % change from 2000 All groups 39.5 34.5 -12.7 OR YOUNGER Rate per 1,000 females by race/ethnicity: White Black or American nonHispanic African Indian Hispanic American 25.2 60.9 51.9 41.3 18.2 57.5 45.4 39.9 -27.8 -5.6 -12.5 -3.4 Asian or Pacific Islander 21.3 19.2 -9.9 17 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Pregnancies Among Females 14 and Younger 1-2 2.6 Hispanic 2.5 American Indian 1.4 ALL ARIZONANS 1.2 Black 1.3 0.6 Asian 0.4 White non-Hispanic 0.0 0.6 1.2 1.8 2.4 3.0 Number of pregnancies per 1,000 females 10-14 years old COMPARATIVE RATES FOR 2000 AND 2003: 1-2 PREGNANCIES AMONG FEMALES 14 Year 2000 2003 % change from 2000 18 All groups 1.5 1.4 -6.7 AND YOUNGER Rate per 1,000 females by race/ethnicity: White Black or American nonHispanic African Indian Hispanic American 0.7 2.7 2.4 1.6 0.4 2.6 1.2 2.5 -42.9 -3.7 -50.0 56.3 Asian or Pacific Islander 0.3 0.6 100.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 1-3 Pregnancies Among Females 15-17 Years Old 76.5 Hispanic 59.8 Black 52.0 American Indian 41.6 ALL ARIZONANS 22.0 Asian 17.5 White non-Hispanic 0.0 15.0 30.0 45.0 60.0 75.0 90.0 Number of pregnancies per 1,000 females 15-17 years old COMPARATIVE RATES FOR 2000 AND 2003: 1-3 PREGNANCIES AMONG FEMALES 15-17 Year 2000 2003 % change from 2000 All groups 48.1 41.6 -13.5 YEARS OLD Rate per 1,000 females by race/ethnicity: White Black or American nonHispanic African Indian Hispanic American 25.1 84.0 64.2 52.1 17.5 76.5 59.8 52.0 -30.3 -8.9 -6.9 -0.2 Asian or Pacific Islander 21.4 22.0 2.8 19 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 1-4 Pregnancies Among Females 18-19 Years Old 172.7 Hispanic 147.5 Black 134.2 American Indian 108.2 ALL ARIZONANS 62.9 White non-Hispanic 52.1 Asian 0.0 50.0 100.0 150.0 200.0 Number of pregnancies per 1,000 females 18-19 years old COMPARATIVE RATES FOR 2000 AND 2003: 1-4 PREGNANCIES AMONG FEMALES 18-19 Year 2000 2003 % change from 2000 20 All groups 123.6 108.2 -12.5 YEARS OLD Rate per 1,000 females by race/ethnicity: White Black or American nonHispanic African Indian Hispanic American 85.0 178.4 171.7 144.4 62.9 172.7 147.5 134.2 -26.0 -3.2 -14.1 -7.1 Asian or Pacific Islander 62.4 52.1 -16.5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 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 21 22 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 2-1 Unmarried Mothers 72.4 American Indian 62.7 Black 52.7 Hispanic 41.2 ALL ARIZONANS 25.1 White non-Hispanic 16.3 Asian 0.0 15.0 30.0 45.0 60.0 75.0 Per 100 live births COMPARATIVE RATES FOR 2000 AND 2003: 2-1 UNMARRIED MOTHERS Year 2000 2003 % change from 2000 All groups 39.3 41.2 4.8 White nonHispanic 24.8 25.1 1.2 Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 51.4 62.2 68.5 52.7 62.7 72.4 2.5 0.8 5.7 Asian or Pacific Islander 15.1 16.3 7.9 23 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 2-2 Tobacco Use During Pregnancy 9.4 White non-Hispanic 8.7 Black 5.8 ALL ARIZONANS American Indian Asian Hispanic 0.0 3.2 2.7 2.1 2.5 5.0 7.5 10.0 12.5 Per 100 live births COMPARATIVE RATES FOR 2000 AND 2003: 2-2 TOBACCO USE Year 2000 2003 % change from 2000 24 6.8 5.8 White nonHispanic 11.0 9.4 -14.7 -14.5 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 2.4 11.0 3.5 2.1 8.7 3.2 -12.5 -20.9 -8.5 Asian or Pacific Islander 2.5 2.8 12.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 2-3 Alcohol Use During Pregnancy 2.4 American Indian 1.3 Black 1.1 White non-Hispanic 0.9 ALL ARIZONANS Asian Hispanic 0.0 0.5 0.4 0.6 1.2 1.8 2.4 3.0 Per 100 live births COMPARATIVE RATES FOR 2000 AND 2003: 2-3 ALCOHOL USE Year 2000 2003 % change from 2000 1.0 0.9 White nonHispanic 1.3 1.1 -10.0 -15.4 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 0.6 1.6 2.3 0.4 1.3 2.4 -33.3 -18.8 4.3 Asian or Pacific Islander 0.6 0.5 -16.7 25 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 The Incidence of Chronic Hypertension in Women Giving Birth 2-4 0.7 American Indian 0.5 Black 0.4 White non-Hispanic ALL ARIZONANS Asian Hispanic 0.3 0.3 0.2 0.0 0.3 0.6 0.9 Per 100 live births COMPARATIVE RATES FOR 2000 AND 2003: 2-4 CHRONIC HYPERTENSION Year 2000 2003 % change from 2000 26 0.4 0.3 White nonHispanic 0.4 0.4 -25.0 0.0 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 0.2 0.7 1.3 0.2 0.5 0.7 0.0 -28.6 -46.2 Asian or Pacific Islander 0.3 0.3 0.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 2-5 Dysfunctional Labor 2.4 American Indian White non-Hispanic ALL ARIZONANS Black Asian Hispanic 0.9 0.8 0.8 0.6 0.5 0.0 0.7 1.4 2.1 2.8 Per 100 live births COMPARATIVE RATES FOR 2000 AND 2003: 2-5 DYSFUNCTIONAL LABOR Year 2000 2003 % change from 2000 0.8 0.8 White nonHispanic 0.8 0.9 0.0 12.5 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 0.5 0.7 2.2 0.5 0.8 2.4 0.0 14.2 9.1 Asian or Pacific Islander 0.8 0.6 -25.0 27 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 2-6 The Incidence of Anemia During Pregnancy 5.5 American Indian 2.8 Black 2.3 White non-Hispanic ALL ARIZONANS Asian Hispanic 0.0 2.0 1.7 1.2 1.0 2.0 3.0 4.0 5.0 6.0 Per 100 live births COMPARATIVE RATES FOR 2000 AND 2003: 2-6 ANEMIA DURING PREGNANCY Year 2000 2003 % change from 2000 28 1.7 2.0 White nonHispanic 1.7 2.3 17.6 35.3 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 1.1 2.0 4.8 1.2 2.8 5.5 9.1 40.0 14.6 Asian or Pacific Islander 1.1 1.7 54.5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 2-7 The Incidence of Diabetes During Pregnancy 6.0 American Indian 3.0 Asian 2.2 Black 2.1 ALL ARIZONANS 1.8 Hispanic 1.8 White non-Hispanic 0.0 1.3 2.6 3.9 5.2 6.5 Per 100 live births COMPARATIVE RATES FOR 2000 AND 2003: 2-7 DIABETES DURING PREGNANCY Year 2000 2003 % change from 2000 2.3 2.1 White nonHispanic 1.9 1.8 -8.7 -5.3 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 2.0 1.8 6.7 1.8 2.2 6.0 10.0 22.2 -10.4 Asian or Pacific Islander 3.1 3.0 -3.2 29 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 2-8 The Incidence of Pregnancy-Associated Hypertension 5.7 American Indian 3.4 White non-Hispanic ALL ARIZONANS Black Asian Hispanic 0.0 2.8 2.7 1.9 1.9 1.3 2.6 3.9 5.2 6.5 Per 100 live births COMPARATIVE RATES FOR 2000 AND 2003: 2-8 PREGNANCY-ASSOCIATED HYPERTENSION Year 2000 2003 % change from 2000 30 3.0 2.8 White nonHispanic 3.6 3.4 -6.7 -5.6 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 2.0 2.9 5.6 1.9 2.7 5.7 -5.0 -6.9 1.8 Asian or Pacific Islander 2.3 1.9 -17.4 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 2-9 The Incidence of Genital Herpes During Pregnancy 1.0 White non-Hispanic 1.0 Black 0.6 ALL ARIZONANS 0.5 Asian 0.5 American Indian Hispanic 0.0 0.2 0.3 0.6 0.9 1.2 1.5 Per 100 live births COMPARATIVE RATES FOR 2000 AND 2003: 2-9 GENITAL HERPES DURING PREGNANCY Year 2000 2003 % change from 2000 0.7 0.6 White nonHispanic 1.2 1.0 -14.3 -16.7 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 0.2 0.7 0.3 0.2 1.0 0.5 0.0 42.9 0.7 Asian or Pacific Islander 0.5 0.5 0.0 31 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 2-10 Maternal Weight Gain of Less Than 21 Pounds 31.9 American Indian 23.3 Black 22.9 Hispanic 19.7 ALL ARIZONANS Asian White non-Hispanic 0.0 16.0 14.5 7.0 14.0 21.0 28.0 35.0 Per 100 live births COMPARATIVE RATES FOR 2000 AND 2003: 2-10 WEIGHT GAIN OF LESS THAN 21 Year 2000 2003 % change from 2000 32 19.1 19.7 White nonHispanic 15.4 14.5 3.1 -5.8 All groups POUNDS Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 21.3 22.4 30.4 22.9 23.3 31.9 7.5 4.0 4.9 Asian or Pacific Islander 16.7 16.0 -4.2 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 3. Utilization of Prenatal Care Services No Care in the 1st Trimester Fewer Than Five Prenatal Visits No Prenatal Care 33 34 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 No Care in the 1st Trimester 3-1 34.2 Hispanic 31.2 American Indian 24.4 ALL ARIZONANS 24.3 Black 15.8 Asian 13.2 White non-Hispanic 0.0 8.0 16.0 24.0 32.0 40.0 Women giving birth who received no prenatal care in the first trimester of pregnancy per 100 live births in specified group COMPARATIVE RATES FOR 2000 AND 2003: 3-1 NO CARE IN THE 1ST TRIMESTER Year 2000 2003 % change from 2000 25.0 24.4 White nonHispanic 14.0 13.2 -2.4 -5.7 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 36.5 28.9 34.2 34.2 24.3 31.2 -6.3 -15.9 -8.8 Asian or Pacific Islander 15.0 15.8 5.3 35 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 3-2 Fewer than Five Prenatal Visits 11.8 American Indian 10.4 Hispanic 7.6 Black 7.2 ALL ARIZONANS 4.5 Asian 2.9 White non-Hispanic 0.0 3.0 6.0 9.0 12.0 15.0 Women giving birth who had fewer than five prenatal visits per 100 live births in specified group COMPARATIVE RATES FOR 2000 AND 2003: 3-2 FEWER THAN FIVE PRENATAL VISITS Year 2000 2003 % change from 2000 36 6.7 7.2 White nonHispanic 2.8 2.9 7.5 3.6 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 10.5 6.6 12.5 10.4 7.6 11.8 -0.9 15.2 -5.6 Asian or Pacific Islander 3.3 4.5 36.4 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 3-3 No Prenatal Care 4.8 Hispanic 3.5 Black 2.9 ALL ARIZONANS 2.4 American Indian 1.6 Asian 0.6 White non-Hispanic 0.0 1.5 3.0 4.5 6.0 Women giving birth who received no prenatal care per 100 live births in specified group COMPARATIVE RATES FOR 2000 AND 2003: 3-3 NO PRENATAL CARE Year 2000 2003 % change from 2000 2.1 2.9 White nonHispanic 0.7 0.6 38.1 -14.3 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 3.6 2.4 2.4 4.8 3.5 2.4 33.3 45.8 0.0 Asian or Pacific Islander 0.9 1.6 77.8 37 38 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 4. Newborn’s Health The Incidence of Hyaline Membrane Disease Newborn Intensive Care Born Too Early (Preterm or < 37 Weeks) 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 39 40 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 4-1 The Incidence of Hyaline Membrane Disease* 0.5 White non-Hispanic ALL ARIZONANS 0.3 American Indian 0.3 0.3 Asian Hispanic Black 0.0 0.2 0.2 0.1 0.2 0.3 0.4 0.5 0.6 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. COMPARATIVE RATES FOR 2000 AND 2003: 4-1 HYALINE MEMBRANE DISEASE REPORTED Year 2000 2003 % change from 2000 0.3 0.3 White nonHispanic 0.4 0.5 0.0 25.0 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 0.2 0.6 0.2 0.2 0.2 0.3 0.0 -66.7 50.0 Asian or Pacific Islander 0.3 0.3 0.0 41 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 4-2 The Incidence of Newborn Intensive Care 7.0 Black 6.2 White non-Hispanic 5.6 Asian 5.4 ALL ARIZONANS 4.7 Hispanic 4.2 American Indian 0.0 2.0 4.0 6.0 8.0 Per 100 live births in specified group COMPARATIVE RATES FOR 2000 AND 2003: 4-2 ADMITTED TO NEWBORN INTENSIVE CARE Year 2000 2003 % change from 2000 42 5.8 5.4 White nonHispanic 5.5 6.2 -6.9 12.7 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 6.3 9.3 4.6 4.7 7.0 4.2 -25.4 -24.7 -8.7 Asian or Pacific Islander 4.3 5.6 30.2 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 4-3 Born Too Early (Preterm or < 37 Weeks) 14.4 Black 11.0 White non-Hispanic 10.8 Asian 10.5 ALL ARIZONANS 9.8 American Indian 9.8 Hispanic 0.0 4.0 8.0 12.0 16.0 Number of infants born berfore 37 completed weeks of gestation per 100 live births in specified group COMPARATIVE RATES FOR 2000 AND 2003: 4-3 BORN TOO EARLY (PRETERM OR < 37 Year 2000 2003 % change from 2000 10.3 10.5 White nonHispanic 10.5 11.0 1.9 4.8 All groups WEEKS) Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 9.8 14.9 9.4 9.8 14.4 9.8 0.0 -3.4 4.3 Asian or Pacific Islander 9.3 10.8 16.1 43 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Born Too Small: Low-Birthweight 4-4 11.7 Black 8.5 Asian ALL ARIZONANS 7.1 White non-Hispanic 6.9 6.9 Hispanic 6.8 American Indian 0.0 2.5 5.0 7.5 10.0 12.5 Number of infants weighing less than 2,500 grams per 100 live births in specified group COMPARATIVE RATES FOR 2000 AND 2003: 4-4 BORN TOO SMALL: Year 2000 2003 % change from 2000 44 LOW-BIRTHWEIGHT 7.0 7.1 White nonHispanic 7.0 6.9 1.4 1.4 All groups (<2,500 GRAMS) Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 6.7 13.0 6.7 6.9 11.7 6.8 2.9 -10.0 1.5 Asian or Pacific Islander 7.6 8.5 11.8 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 4-5 Born Too Small: Very Low-Birthweight 2.2 Black 1.5 Asian 1.1 Hispanic White non-Hispanic 1.1 ALL ARIZONANS 1.1 0.9 American Indian 0.0 0.5 1.0 1.5 2.0 2.5 Infants weighing less than 1,500 grams at birth per 100 live births in specified group COMPARATIVE RATES FOR 2000 AND 2003: 4-5 BORN TOO SMALL: Year 2000 2003 % change from 2000 VERY LOW-BIRTHWEIGHT 1.2 1.1 White nonHispanic 1.1 1.1 -8.3 0.0 All groups (<1,500 GRAMS) Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 1.1 2.6 1.4 1.1 2.2 0.9 0.0 -15.4 -35.7 Asian or Pacific Islander 1.2 1.5 25.0 45 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 The Incidence of Congenital Anomalies 4-6 1.3 American Indian 1.0 ALL ARIZONANS 1.0 Asian 1.0 Black 1.0 Hispanic 1.0 White non-Hispanic 0.0 0.3 0.6 0.9 1.2 1.5 Congenital anomalies (birth defects) per 1,000 live births in specified group COMPARATIVE RATES FOR 2000 AND 2003: 4-6 THE INCIDENCE OF CONGENITAL ANOMALIES Year 2000 2003 % change from 2000 46 1.3 1.0 White nonHispanic 1.5 1.0 -23.1 -33.3 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 0.9 1.1 1.9 1.0 1.0 1.3 11.1 -9.1 -31.6 Asian or Pacific Islander 0.8 1.0 25.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 4-7 Infant Mortality 15.9 Black 7.5 American Indian 7.0 Hispanic 6.5 ALL ARIZONANS 5.4 White non-Hispanic 4.4 Asian 0.0 4.5 9.0 13.5 18.0 Number of infant deaths per 1,000 live births in specified group COMPARATIVE RATES FOR 2000 AND 2003: 4-7 INFANT MORTALITY Year 2000 2003 % change from 2000 6.7 6.5 White nonHispanic 6.1 5.4 -3.0 -11.5 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 6.3 17.8 9.6 7.0 15.9 7.5 11.1 -10.7 -21.9 Asian or Pacific Islander 4.9 4.4 -10.2 47 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Infant Mortality from SIDS* 4-8 0.7 Black ALL ARIZONANS 0.3 American Indian 0.3 White non-Hispanic 0.3 0.3 Hispanic 0.0 Asian 0.0 0.2 0.4 0.6 0.8 1.0 Per 1,000 live births in specified mother's ethnic group * Sudden Infant Death Syndrome. COMPARATIVE RATES FOR 2000 AND 2003: 4-8 SUDDEN INFANT DEATH SYNDROME (SIDS) 2000 2003 0.3 0.3 White nonHispanic 0.3 0.3 % change from 2000 0.0 0.0 Year 48 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 0.2 0.7 0.7 0.3 0.7 0.3 50.0 0.0 -57.1 Asian or Pacific Islander 0.0 0.0 0.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Mortality of Infants from Low Birthweight/Short Gestation 4-9 3.6 Black 1.1 Hispanic ALL ARIZONANS 0.9 American Indian 0.9 0.6 White non-Hispanic 0.4 Asian 0.0 0.9 1.8 2.7 3.6 4.5 Number of infant deaths from low birthweight/short gestation per 1,000 live births in specified group COMPARATIVE RATES FOR 2000 AND 2003: 4-9 MORTALITY OF INFANTS FROM LOW BIRTHWEIGHT/SHORT GESTATION Year 2000 2003 % change from 2000 0.6 0.9 White nonHispanic 0.4 0.6 50.0 50.0 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 0.9 2.5 0.9 1.1 3.6 0.9 22.2 44.0 0.0 Asian or Pacific Islander 0.0 0.4 N/A 49 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 4-10 Neonatal Mortality 10.3 Black 4.9 Hispanic 4.3 ALL ARIZONANS 3.7 White nonHispanic 3.1 American Indian 2.0 Asian 0.0 3.0 6.0 9.0 12.0 Number of neonatal deaths per 1,000 live births in specified group COMPARATIVE RATES FOR 2000 AND 2003: 4-10 NEONATAL MORTALITY 2000 2003 4.3 4.3 White nonHispanic 3.8 3.7 % change from 2000 0.0 -2.6 Year 50 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 4.2 9.8 6.4 4.9 10.3 3.1 16.7 5.1 -51.6 Asian or Pacific Islander 2.0 2.0 0.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 4-11 Postneonatal Mortality 5.6 Black 4.4 American Indian 2.4 Asian 2.2 ALL ARIZONANS 2.1 Hispanic 1.7 White non-Hispanic 0.0 1.5 3.0 4.5 6.0 7.5 Number of postneonatal deaths per 1,000 live births in specified group COMPARATIVE RATES FOR 2000 AND 2003: 4-11 POSTNEONATAL MORTALITY Year 2000 2003 % change from 2000 2.4 2.2 White nonHispanic 2.3 1.7 -8.3 -26.1 All groups Per 100 births by race/ethnicity: Black or American Hispanic African Indian American 2.0 8.0 3.2 2.1 5.6 4.4 5.0 -30.0 37.5 Asian or Pacific Islander 2.0 2.4 20.0 51 52 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 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 Lower Respiratory Diseases 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 Influenza and Pneumonia Mortality from Diabetes Mortality from Chronic Liver Disease and Cirrhosis Mortality from HIV Disease Mortality from Septicemia Mortality from Alzheimer's Disease Mortality from Nephritis, Nephrotic Syndrome & Nephrosis (kidney disease) Mortality from Essential (primary) Hypertension Mortality from All Causes 53 54 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 5-1. Mortality from Cardiovascular Diseases 390.1 Black 278.2 Hispanic ALL ARIZONANS 258.4 White non-Hispanic 257.2 188.6 American Indian 145.3 Asian 0.0 90.0 180.0 270.0 360.0 450.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-1 CARDIOVASCULAR DISEASE Year 2000 2003 % change from 2000 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 276.1 276.0 273.6 411.5 257.5 190.6 258.4 257.2 278.2 390.1 188.6 145.3 -6.4 -6.8 1.7 -5.2 -26.8 -23.8 55 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Mortality from Diseases of the Heart 5-2. 299.4 Black 198.5 Hispanic White non-Hispanic 197.9 ALL ARIZONANS 197.1 141.9 American Indian 97.6 Asian 0.0 80.0 160.0 240.0 320.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-2 DISEASES OF THE HEART Year 2000 2003 % change from 2000 56 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 206.1 207.2 204.7 289.5 183.8 132.3 197.1 197.9 198.5 299.4 141.9 97.6 -4.4 -4.5 -3.0 3.4 -22.8 -26.2 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Mortality from Coronary Heart Disease 5-3 White non-Hispanic 157.8 ALL ARIZONANS 156.6 156.4 Black 154.4 Hispanic 100.7 American Indian 75.5 Asian 0.0 45.0 90.0 135.0 180.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-3 CORONARY HEART DISEASE Year 2000 2003 % change from 2000 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 160.4 162.4 154.7 225.1 124.4 107.4 156.6 157.8 154.4 245.7 100.7 75.5 -2.4 -2.8 -0.2 9.2 -19.1 -29.7 57 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Mortality from Cerebrovascular Disease 5-4 69.0 Black 61.9 Hispanic 43.9 ALL ARIZONANS 41.7 White non-Hispanic 36.4 American Indian 35.9 Asian 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 the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-4 CEREBROVASCULAR DISEASE Year 2000 2003 % change from 2000 58 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 51.7 50.8 51.2 82.4 55.3 46.1 43.9 41.7 61.9 69.0 36.4 35.9 -15.1 -17.9 20.9 -16.3 -34.2 -22.1 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 5-5 Mortality from Chronic Lower Respiratory Diseases * 48.3 White non-Hispanic 45.4 ALL ARIZONANS 30.3 Black 28.7 Hispanic American Indian Asian 0.0 19.4 15.5 10.0 20.0 30.0 40.0 50.0 60.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) * This ICD-10 title corresponds to Chronic obstructive pulmonary diseases in ICD-9. COMPARATIVE RATES FOR 2000 AND 2003: 5-5 CHRONIC LOWER RESPIRATORY DISEASES Year 2000 2003 % change from 2000 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 47.4 51.1 24.4 30.4 21.9 12.7 45.4 48.3 28.7 30.3 19.4 15.5 -4.2 -5.5 17.6 -0.3 -11.4 22.0 59 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 5-6. Mortality from Malignant Neoplasms 218.5 Black White non-Hispanic 171.2 ALL ARIZONANS 169.4 168.5 Hispanic Asian American Indian 0.0 132.9 121.7 50.0 100.0 150.0 200.0 250.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-6 MALIGNANT NEOPLASM (CANCER) Year 2000 2003 % change from 2000 60 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 170.4 174.8 156.9 216.1 123.0 103.4 169.4 171.2 168.5 218.5 120.7 132.9 -0.6 -2.1 7.4 1.1 -1.9 28.5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Mortality from Lung Cancer 5-7 59.4 Black 50.6 White non-Hispanic 47.4 ALL ARIZONANS 33.5 Hispanic 21.9 Asian 13.2 American Indian 0.0 13.0 26.0 39.0 52.0 65.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-7 LUNG CANCER Year 2000 2003 % change from 2000 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 46.1 49.1 31.6 65.8 8.9 29.6 47.4 50.6 33.5 59.4 13.2 21.9 2.8 3.1 6.0 -9.7 48.3 -26.0 61 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Mortality from Breast Cancer 5-8. 41.2 Black White non-Hispanic 22.3 ALL ARIZONANS 22.1 19.6 Asian 18.9 Hispanic 16.4 American Indian 0.0 10.0 20.0 30.0 40.0 50.0 Number of deaths per 100,000 females in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-8 BREAST CANCER Year 2000 2003 % change from 2000 62 All groups 25.4 22.1 -13.0 Number of deaths per 100,000 females by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or American nonHispanic African Pacific Indian Hispanic American Islander 26.2 20.7 29.5 12.1 12.8 22.3 18.9 41.2 16.4 19.6 -14.9 -8.7 39.7 35.5 53.1 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Mortality from Cervical Cancer 5-9. 10.5 Asian 6.8 Black 4.2 American Indian 2.2 ALL ARIZONANS 1.8 Hispanic 1.0 White non-Hispanic 0.0 3.0 6.0 9.0 12.0 Number of deaths per 100,000 females in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-9 CERVICAL CANCER Year 2000 2003 % change from 2000 All groups 3.0 2.2 -26.7 Number of deaths per 100,000 females by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or American nonHispanic African Pacific Indian Hispanic American Islander 2.5 3.7 7.6 10.1 3.5 1.0 1.8 6.8 4.2 10.5 -60.0 -51.4 -10.5 -58.4 200.0 63 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 5-10 Mortality from Colorectal Cancer 26.3 Black 21.2 Hispanic 17.9 ALL ARIZONANS 17.9 White non-Hispanic 6.3 American Indian 3.0 Asian 0.0 6.0 12.0 18.0 24.0 30.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-10 COLORECTAL CANCER Year 2000 2003 % change from 2000 64 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 17.0 17.4 16.4 16.3 8.2 6.6 17.9 17.9 21.2 26.3 6.3 3.0 5.3 2.9 29.3 61.3 -23.2 -54.5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Mortality from Prostate Cancer 5-11 41.2 Black White non-Hispanic 25.2 ALL ARIZONANS 25.1 22.4 Hispanic 21.0 American Indian 7.6 Asian 0.0 9.0 18.0 27.0 36.0 45.0 Number of deaths per 100,000 males in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-11 PROSTATE CANCER Year 2000 2003 % change from 2000 All groups 28.4 25.1 -11.6 Number of deaths per 100,000 males by race/ethnicity (age-adjusted to the 2000 standard) White Black or American nonHispanic African Indian Hispanic American 28.0 30.0 74.8 27.1 25.2 22.4 41.2 21.0 -10.0 -25.3 -44.9 -22.5 Asian or Pacific Islander 8.9 7.6 -14.6 65 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 5-12. Mortality from Influenza and Pneumonia 58.9 American Indian 30.4 Black 27.9 Hispanic ALL ARIZONANS White non-Hispanic Asian 0.0 23.4 21.8 16.4 10.0 20.0 30.0 40.0 50.0 60.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-12 INFLUENZA AND PNEUMONIA Year 2000 66 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 24.4 23.3 30.1 26.9 48.2 11.9 2003 23.4 21.8 27.9 30.4 58.9 16.4 % change from 2000 -4.1 -6.4 -7.3 13.0 22.2 37.8 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 5-13 Mortality from Diabetes 55.8 American Indian 53.6 Black 39.1 Hispanic 20.3 ALL ARIZONANS 16.5 White non-Hispanic 15.7 Asian 0.0 13.0 26.0 39.0 52.0 65.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-13 DIABETES Year 2000 2003 % change from 2000 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 19.0 14.9 41.1 46.0 74.6 19.5 20.3 16.5 39.1 53.6 55.8 15.7 6.8 10.7 -4.9 16.5 -25.2 -19.5 67 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Mortality from Chronic Liver Disease and Cirrhosis 5-14 38.8 American Indian 17.6 Hispanic 11.5 ALL ARIZONANS 9.7 White non-Hispanic Black Asian 3.5 3.3 0.0 9.0 18.0 27.0 36.0 45.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-14 CHRONIC LIVER DISEASE AND CIRRHOSIS Year 2000 2003 % change from 2000 68 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 12.8 10.4 15.8 6.6 61.7 4.1 11.5 9.7 17.6 3.5 38.8 3.3 -10.2 -6.7 11.4 -47.0 -37.1 -19.5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 5-15 Mortality from HIV Disease 8.1 Black 4.3 Hispanic 3.6 American Indian ALL ARIZONANS White non-Hispanic Asian 0.0 3.2 2.8 1.7 2.5 5.0 7.5 10.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-15 HIV Year 2000 2003 % change from 2000 DISEASE Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 3.2 3.1 3.4 9.6 1.8 .0 3.2 2.8 4.3 8.1 3.6 1.7 0.0 -9.7 26.5 -15.6 100.0 0.0 69 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Mortality from Septicemia 5-16 25.8 American Indian Hispanic Black ALL ARIZONANS White non-Hispanic Asian 0.0 12.6 11.3 8.4 7.1 6.8 6.0 12.0 18.0 24.0 30.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-16 SEPTICEMIA Year 2000 2003 % change from 2000 70 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 6.7 6.0 9.9 6.2 21.5 1.3 8.4 7.1 12.6 11.3 25.8 6.8 25.4 18.3 27.3 82.3 20.0 423.1 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 5-17 Mortality from Alzheimer's Disease 43.3 Black White non-Hispanic 33.4 ALL ARIZONANS 32.5 28.2 Hispanic Asian American Indian 11.4 5.6 0.0 10.0 20.0 30.0 40.0 50.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-17 ALZHEIMER'S DISEASE Year 2000 2003 % change from 2000 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 21.8 22.5 18.9 20.5 7.2 7.8 32.5 33.4 28.2 43.3 5.6 11.4 49.1 48.4 49.2 110.7 -22.2 46.2 71 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 5-18 Mortality from Nephritis, Nephrotic Syndrome and Nephrosis (kidney disease) 24.7 American Indian 20.9 Black 18.4 Hispanic 16.0 Asian 10.1 ALL ARIZONANS 8.4 White non-Hispanic 0.0 6.0 12.0 18.0 24.0 30.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-18 NEPHRITIS, NEPHROTIC SYNDROME AND NEPHROSIS (KIDNEY DISEASE) Year 2000 2003 % change from 2000 72 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 11.7 10.1 22.1 26.9 22.6 5.0 10.1 8.4 18.4 20.9 24.7 16.0 -13.7 -16.8 -16.7 -22.3 9.3 220.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 5-19 Mortality from Essential (primary) Hypertension 14.5 Black 9.4 Asian 7.9 Hispanic ALL ARIZONANS 6.3 White non-Hispanic 6.0 5.4 American Indian 0.0 4.0 8.0 12.0 16.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-19 ESSENTIAL (PRIMARY) Year 2000 2003 % change from 2000 HYPERTENSION Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 5.6 5.2 7.3 11.2 10.8 5.8 6.3 6.0 7.9 14.5 5.4 9.4 12.5 15.4 8.2 29.5 -50.0 62.1 73 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Mortality from All Causes 5-20 1048.6 Black 900.7 American Indian 839.5 Hispanic ALL ARIZONANS 784.0 White non-Hispanic 764.9 497.2 Asian 0.0 200.0 400.0 600.0 800.0 1000.0 1200.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 5-20 TOTAL MORTALITY FROM ALL CAUSES Year 2000 2003 % change from 2000 74 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 785.6 776.6 769.9 1057.5 1011.4 504.1 784.0 764.9 839.5 1048.6 900.7 497.2 -0.2 -1.5 9.0 -0.8 -10.9 -1.4 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 6. Mortality from Injuries Mortality from Unintentional Injuries Mortality from Motor Vehicle-Related Injuries Mortality from Fall-Related Injuries Drowning Mortality Mortality from Injury by Firearms Drug-Induced Deaths Alcohol-Induced Deaths Intentional Self-Harm (suicide) Assault (homicide) 75 76 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Mortality from Unintentional Injuries 6-1. 108.6 American Indian 52.4 Black 44.8 ALL ARIZONANS 44.7 Hispanic 40.9 White non-Hispanic 25.3 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 the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 6-1 UNINTENTIONAL INJURIES Year 2000 2003 % change from 2000 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 41.1 36.9 41.6 49.7 113.1 24.1 44.8 40.9 44.7 52.4 108.6 25.3 9.0 10.8 7.5 5.4 -4.0 5.0 77 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Mortality from Motor Vehicle-Related Injuries 6-2 59.0 American Indian 21.3 Hispanic 18.0 ALL ARIZONANS 15.2 Black 14.6 White non-Hispanic 11.8 Asian 0.0 13.0 26.0 39.0 52.0 65.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 6-2 MOTOR VEHICLE-RELATED INJURIES Year 2000 2003 % change from 2000 78 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 17.5 13.8 18.2 19.3 74.2 15.3 18.0 14.6 21.3 15.2 59.0 11.8 2.9 5.8 17.0 -21.2 -20.5 -22.9 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Mortality from Fall-Related Injuries 6-3 12.7 American Indian White non-Hispanic 9.0 ALL ARIZONANS 8.8 7.5 Asian 6.3 Black 5.5 Hispanic 0.0 3.5 7.0 10.5 14.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 6-3 FALL-RELATED INJURIES Year 2000 2003 % change from 2000 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 7.6 7.6 8.9 5.2 6.0 3.9 8.8 9.0 5.5 6.3 12.7 7.5 15.8 18.4 -38.2 21.2 111.7 92.3 79 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 6-4 Drowning Mortality 2.7 Black 2.5 American Indian 1.5 ALL ARIZONANS 1.5 Hispanic 1.3 White non-Hispanic 0.5 Asian 0.0 0.8 1.6 2.4 3.2 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 6-4 DROWNING MORTALITY Year 2000 2003 % change from 2000 80 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 1.7 1.6 1.2 3.3 3.8 1.1 1.5 1.3 1.5 2.7 2.5 .5 -11.8 -18.8 25.0 -18.2 -34.2 -54.5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 6-5 Mortality from Injury by Firearms 23.2 Black 15.7 Hispanic 15.6 American Indian 14.8 ALL ARIZONANS 12.7 White non-Hispanic Asian 1.8 0.0 5.0 10.0 15.0 20.0 25.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 6-5 INJURY BY FIREARMS Year 2000 2003 % change from 2000 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 15.3 13.9 14.9 25.7 12.2 11.1 14.8 12.7 15.7 23.2 15.6 1.8 -3.3 -8.6 5.4 -9.7 27.9 -83.8 81 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 6-6 Drug-Induced Deaths 23.5 Black 12.8 White non-Hispanic 12.0 ALL ARIZONANS 10.5 Hispanic American Indian 8.5 0.0 Asian 0.0 5.0 10.0 15.0 20.0 25.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 6-6 DRUG-INDUCED DEATHS Year 2000 2003 % change from 2000 82 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 6.8 7.3 5.0 9.6 6.7 .0 12.0 12.8 10.5 23.5 8.5 .0 76.5 75.3 110.0 144.8 26.9 0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 6-7 Alcohol-Induced Deaths 49.3 American Indian Hispanic ALL ARIZONANS White non-Hispanic Black 10.2 10.1 8.3 6.8 0.0 Asian 0.0 11.0 22.0 33.0 44.0 55.0 Number of deaths per 100,000 persons in specified group (age-adjusted to the 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 6-7 ALCOHOL-INDUCED DEATHS Year 2000 2003 % change from 2000 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 8.7 6.8 8.6 6.1 56.1 1.3 10.1 8.3 10.2 6.8 49.3 .0 16.1 22.1 18.6 11.5 -12.1 -100.0 83 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 6-8 Intentional Self-Harm (suicide) 16.4 White non-Hispanic 15.2 American Indian 14.6 ALL ARIZONANS 11.3 Black Hispanic Asian 0.0 8.2 6.0 4.0 8.0 12.0 16.0 20.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 6-8 INTENTIONAL SELF-HARM (SUICIDE) Year 2000 2003 % change from 2000 84 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 14.6 16.7 7.2 6.5 16.2 5.7 14.6 16.4 8.2 11.3 15.2 6.0 0.0 -1.8 13.9 73.8 -6.2 5.3 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 6-9 Assault (homicide) 24.9 Black 18.8 American Indian 14.7 Hispanic 8.3 ALL ARIZONANS Asian White non-Hispanic 5.4 3.7 0.0 5.0 10.0 15.0 20.0 25.0 Number of deaths per 100,000 persons in specified group (age-adjusted to 2000 standard) COMPARATIVE RATES FOR 2000 AND 2003: 6-9 ASSAULT (HOMICIDE) Year 2000 Number of deaths per 100,000 population by race/ethnicity (age-adjusted to the 2000 standard) White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 7.6 3.9 13.0 22.7 14.9 7.6 2003 8.3 3.7 14.7 24.9 18.8 5.4 % change from 2000 9.2 -5.1 13.1 9.7 26.2 -28.9 85 86 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 7. AGE-SPECIFIC MORTALITY Mortality of Children 1-14 Years Old Mortality of Adolescents 15-19 Years Old Mortality of Young Adults 20-44 Years Old Mortality of Middle-Aged Adults 45-64 Years Old 87 88 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 7-1 Mortality of Children 1-14 Years Old 45.3 American Indian 42.5 Black 24.3 ALL ARIZONANS 22.1 Hispanic 21.8 White non-Hispanic 9.2 Asian 0.0 10.0 20.0 30.0 40.0 50.0 Number of deaths per 100,000 children 1-14 years old in specified ethnic group COMPARATIVE RATES FOR 2000 AND 2003: 7-1 MORTALITY OF CHILDREN 1-14 Year All groups 2000 2003 25.3 24.3 % change from 2000 -3.9 YEARS OLD Number of deaths per 100,000 population 1-14 years old by race/ethnicity White Black or American nonHispanic African Indian Hispanic American 20.8 27.4 37.2 48.2 21.8 22.1 42.5 45.3 4.8 -19.3 14.2 -0.06 Asian or Pacific Islander 22.0 9.2 -58.9 89 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 7-2 Mortality of Adolescents 15-19 Years Old 196.2 American Indian 89.5 Black 87.5 Hispanic 75.4 ALL ARIZONANS 51.6 White non-Hispanic 36.2 Asian 0.0 60.0 120.0 180.0 240.0 Number of deaths per 100,000 adolescents 15-19 years old in specified ethnic group COMPARATIVE RATES FOR 2000 AND 2003: 7-2 MORTALITY OF ADOLESCENTS 15-19 Year 90 All groups 2000 2003 78.9 75.4 % change from 2000 -4.4 YEARS OLD Number of deaths per 100,000 population 15-19 years old by race/ethnicity White Black or American nonHispanic African Indian Hispanic American 68.6 74.0 149.5 171.2 51.6 87.5 89.5 196.2 -24.8 18.2 -40.1 14.6 Asian or Pacific Islander 0.0 36.2 0.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 7-3 Mortality of Young Adults 20-44 Years Old 345.8 American Indian 220.4 Black 151.1 ALL ARIZONANS 139.1 Hispanic 139.6 White non-Hispanic 56.8 Asian 0.0 100.0 200.0 300.0 400.0 Number of deaths per 100,000 young adults 20-44 years old in specified ethnic group COMPARATIVE RATES FOR 2000 AND 2003: 7-3 MORTALITY AMONG YOUNG ADULTS 20-44 Year 2000 2003 % change from 2000 All groups 156.5 151.1 -3.5 YEARS OLD Number of deaths per 100,000 population 20-44 years old by race/ethnicity White Black or American Hispanic nonAfrican Indian Hispanic American 173.1 136.3 212.3 403.1 139.6 139.1 220.4 345.8 -19.4 2.1 3.8 -14.2 Asian or Pacific Islander 93.3 56.8 -39.1 91 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 7-4 Mortality of Middle-Aged Adults 45-64 Years Old 914.9 American Indian 909.7 Black ALL ARIZONANS 653.7 White non-Hispanic 651.1 593.5 Hispanic 292.2 Asian 0.0 200.0 400.0 600.0 800.0 1000.0 Number of deaths per 100,000 middle-aged adults 45-64 years old in specified ethnic group COMPARATIVE RATES FOR 2000 AND 2003: 7-4 MORTALITY AMONG MIDDLE-AGED ADULTS 45-64 Year 2000 2003 % change from 2000 92 All groups 633.9 653.7 3.1 YEARS OLD Number of deaths per 100,000 population 45-64 years old by race/ethnicity White Black or American nonHispanic African Indian Hispanic American 636.8 540.5 929.9 994.2 651.1 593.5 909.7 914.9 2.2 9.8 -2.2 -7.9 Asian or Pacific Islander 276.1 292.2 5.8 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 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 and After Expected Years of Life Reached 93 94 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 8-1 Average Age At Death From All Causes Among Arizona Residents 74.4 White non-Hispanic 72.2 ALL ARIZONANS 64.3 Asians 62.4 Black 60.4 Hispanic 54.7 American Indian 0.0 20.0 40.0 60.0 80.0 COMPARATIVE RATES FOR 2000 AND 2003: 8-1 AVERAGE AGE AT DEATH FROM ALL CAUSES Year 2000 2003 % change from 2000 All groups 71.6 72.2 0.8 White nonHispanic 73.9 74.4 0.7 By race/ethnicity Black or Hispanic African American 59.2 60.8 60.4 62.4 2.0 2.6 American Indian 55.4 54.7 -1.3 Asian or Pacific Islander 62.3 64.3 3.2 95 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 8-2 Average Age At Death From All Causes Among Arizona Males 71.6 White non-Hispanic 69.6 ALL ARIZONANS 63.5 Asians 60.0 Black 57.5 Hispanic 50.3 American Indian 0.0 20.0 40.0 60.0 80.0 COMPARATIVE RATES FOR 2000 AND 2003: 8-2 AVERAGE AGE AT DEATH FROM ALL CAUSES AMONG MALES Year 2000 2003 % change from 2000 96 68.7 69.6 White nonHispanic 70.9 71.6 1.3 1.0 All groups By race/ethnicity Black or Hispanic African American 55.8 56.8 57.5 60.0 3.0 5.6 51.6 50.3 Asian or Pacific Islander 61.6 63.5 -2.5 3.1 American Indian DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 8-3 Average Age At Death From All Causes Among Arizona Females 77.4 White non-Hispanic 75.1 ALL ARIZONANS 65.3 Black 65.0 Asians 64.4 Hispanic 60.4 American Indian 0.0 20.0 40.0 60.0 80.0 COMPARATIVE RATES FOR 2000 AND 2003: 8-3 AVERAGE AGE AT DEATH FROM ALL CAUSES AMONG FEMALES Year 2000 2003 % change from 2000 74.9 75.1 White nonHispanic 77.0 77.4 0.3 0.5 All groups By race/ethnicity Black or Hispanic African American 63.7 65.8 64.4 65.3 1.1 -0.8 60.4 60.4 Asian or Pacific Islander 63.0 65.0 0.0 3.2 American Indian 97 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 8-4 Percent of Total Deaths Before and After Expected Years of Life Reached* BEFORE White non-Hispanic AFTER 53.9% 46.1% ALL ARIZONANS 50.8% 65.7% Asian 49.2% 34.3% Hispanic 70.0% 30.0% Black 70.6% 29.4% American Indian 21.6% 78.4% *Percent deaths in specified group in Arizona in 2003 before and after expected years of life at birth or life expectancy of 77.4 years for all U.S. residents in 2002. COMPARATIVE RATES FOR 2000 AND 2003: 8-4 PERCENT OF TOTAL DEATHS BEFORE EXPECTED YEARS OF LIFE REACHED Year 2000 2003 % change from 2000 98 51.6 50.8 White nonHispanic 47.3 46.1 -1.6 -2.5 All groups By race/ethnicity Black or Hispanic African American 70.5 69.3 70.0 70.6 -0.7 1.9 78.7 78.4 Asian or Pacific Islander 69.6 65.7 -0.4 -5.6 American Indian DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 9. The Incidence of Reportable Diseases Incidence Rates of Early Syphilis Incidence Rates of Gonorrhea Incidence Rates of Chlamydia Incidence Rates of Genital Herpes Incidence Rates of HIV/AIDS 99 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Incidence Rates of Early Syphilis 9-1 20.1 American Indian 18.2 Black 9.7 Hispanic 7.4 ALL ARIZONANS 4.2 White non-Hispanic Asian 0.9 0.0 7.0 14.0 21.0 Number of cases reported in 2003 per 100,000 population in specified group Source: Arizona Department of Health Services, Bureau of Epidemiology and Disease Control, Office of HIV/STD/HCV Services COMPARATIVE RATES FOR 2000 AND 2003: 9-1 INCIDENCE OF EARLY SYPHILIS Year 2000 2003 % change from 2000 100 Number of reported cases per 100,000 population by race/ethnicity White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 8.5 3.2 15.4 60.4 12.1 3.0 0.9 7.4 4.2 9.7 18.2 20.1 -12.9 31.3 -37.0 -69.9 66.1 -70.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Incidence Rates of Gonorrhea 9-2 359.7 Black 103.1 American Indian 71.4 Hispanic 63.5 ALL ARIZONANS 33.4 White non-Hispanic Asian 15.3 0.0 100.0 200.0 300.0 400.0 Number of cases reported in 2001 per 100,000 population in specified group Source: Arizona Department of Health Services, Bureau of Epidemiology and Disease Control, Office of HIV/STD/HCV Services COMPARATIVE RATES FOR 2000 AND 2003: 9-2 INCIDENCE OF GONORRHEA Year 2000 2003 % change from 2000 Number of reported cases per 100,000 population by race/ethnicity White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 80.0 29.5 111.8 630.8 105.1 22.2 15.3 63.5 33.4 71.4 359.7 103.1 -20.6 13.2 -36.1 -43.0 -1.9 -31.1 101 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Incidence Rates of Chlamydia 9-3 623.9 American Indian 537.6 Black 329.1 Hispanic 227.1 ALL ARIZONANS 100.7 White non-Hispanic 86.4 Asian 0.0 130.0 260.0 390.0 520.0 650.0 Number of cases reported in 2003 per 100,000 population in specified group Source: Arizona Department of Health Services, Bureau of Epidemiology and Disease Control, Office of HIV/STD/HCV Services COMPARATIVE RATES FOR 2000 AND 2003: 9-3 INCIDENCE OF CHLAMYDIA Year 2000 2003 % change from 2000 102 Number of reported cases per 100,000 population by race/ethnicity White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 243.9 96.7 350.3 686.2 844.1 89.9 86.4 227.1 100.7 329.1 537.6 623.9 -6.9 4.1 -6.1 -21.7 -26.1 -3.9 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Incidence Rates of Genital Herpes 9-4 30.4 American Indian 23.1 Black 16.2 ALL ARIZONANS 14.3 Hispanic 11.8 White non-Hispanic 7.6 Asian 0.0 12.0 24.0 36.0 Number of cases reported in 2003 per 100,000 population in specified group Source: Arizona Department of Health Services, Bureau of Epidemiology and Disease Control, Office of HIV/STD/HCV Services COMPARATIVE RATES FOR 2000 AND 2003: 9-4 INCIDENCE OF GENITAL HERPES Year 2000 2003 % change from 2000 Number of reported cases per 100,000 population by race/ethnicity White Black or Asian or All American nonHispanic African Pacific groups Indian Hispanic American Islander 21.8 15.8 17.1 47.8 33.6 7.1 7.6 16.2 11.8 14.3 23.1 30.4 -25.7 -25.3 -16.4 -51.7 -9.5 7.0 103 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Incidence Rates of HIV/AIDS 9-5 42.5 Black 11.4 White non-Hispanic 11.3 ALL ARIZONANS 11.3 American Indian 7.4 Hispanic 4.2 Asian 0.0 12.0 24.0 36.0 48.0 Number of cases reported in 2003 per 100,000 population in specified group Source: Arizona Department of Health Services, Bureau of Epidemiology and Disease Control, Office of HIV/STD/HCV Services COMPARATIVE RATES FOR 2000 AND 2003: 9-5 INCIDENCE OF HIV/AIDS Year 2000 2003 % change from 2000 104 Number of reported cases per 100,000 population by race/ethnicity White Black or Asian or American nonHispanic African Pacific Indian Hispanic American Islander 6.9 6.4 7.3 23.3 9.0 5.0 4.2 11.3 11.4 7.4 42.5 11.3 All groups 63.8 78.1 1.4 82.4 25.6 -16.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 RATES AND RATIOS FOR 2003 105 106 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 RATES AND RATIOS FOR 2003 1. TEEN PREGNANCIES Figure number (Number of pregnancies per 1,000 females in specified age group) Indicator All Arizona Residents White nonHispanic Hispanic Black or African American American Indian Asian or Pacific Islander 1-1 Pregnancies among females 19 and younger 34.5 18.2 57.5 45.4 39.9 19.2 1-2 Pregnancies among females 14 and younger 1.4 0.4 2.6 1.2 2.5 0.6 1-3 Pregnancies among females 15-17 years old 41.6 17.5 76.5 59.8 52.0 22.0 1-4 Pregnancies among females 18-19 years old 108.2 62.9 172.7 147.5 134.2 52.1 2. MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS Figure number (All ratios are per 100 live births) Indicator All Arizona Residents White nonHispanic Hispanic Black or African American American Indian Asian or Pacific Islander 2-1 Unmarried mothers 41.2 25.1 52.7 62.7 72.4 16.3 2-2 Tobacco use during pregnancy 5.8 9.4 2.1 8.7 3.2 2.8 2-3 Alcohol use during pregnancy 0.9 1.1 0.4 1.3 2.4 0.5 2-4 Chronic hypertension 0.3 0.4 0.2 0.5 0.7 0.3 2-5 Dysfunctional labor 0.8 0.9 0.5 0.8 2.4 0.6 2-6 Anemia during pregnancy 2.0 2.3 1.2 2.8 5.5 1.7 2-7 Diabetes during pregnancy 2.1 1.8 1.8 2.2 6.0 3.0 2-8 Pregnancyassociated hypertension 2.8 3.4 1.9 2.7 5.7 1.9 2-9 Genital herpes during pregnancy 0.6 1.0 0.2 1.0 0.5 0.5 2-10 Weight gain of less than 21 pounds 19.7 14.5 22.9 23.3 31.9 16.0 107 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 3. UTILIZATION OF PRENATAL CARE SERVICES Figure number (Per 100 live births) Indicator 3-1 No care in the 1st trimester 3-2 3-3 All Arizona residents White nonHispanic Hispanic Black or African American American Indian Asian or Pacific Islander 24.4 13.2 34.2 24.3 31.2 15.8 Fewer than five prenatal visits 7.2 2.9 10.4 7.6 11.8 4.5 No prenatal care 2.9 0.6 4.8 3.5 2.4 1.6 4. NEWBORN'S HEALTH Figure number (Infant, neonatal and postneonatal rates are per 1,000 live births. All other indicators are expressed per 100 live births). Indicator All Arizona residents White nonHispanic Hispanic Black or African American American Indian Asian or Pacific Islander 4-1 Incidence of hyaline membrane disease 0.3 0.5 0.2 0.2 0.3 0.3 4-2 Incidence of newborn intensive care 5.4 6.2 4.7 7.0 4.2 5.6 4-3 Born too early (preterm or < 37 weeks) 10.5 11.0 9.8 14.4 9.8 10.8 4-4 Born too small: low-birthweight (<2,500 grams) 7.1 6.9 6.9 11.7 6.8 8.5 4-5 Born too small: very lowbirthweight (<1,500 grams) 1.1 1.1 1.1 2.2 0.9 1.5 4-6 Incidence of congenital anomalies (birth defects) 1.0 1.0 1.0 1.0 1.3 1.0 4-7 Infant mortality 6.5 5.4 7.0 15.9 7.5 4.4 4-8 Sudden Infant Death Syndrome (SIDS) 0.3 0.3 0.3 0.7 0.3 0.0 4-9 Mortality of infants from low birthweight/short gestation 0.9 0.6 1.1 3.6 0.9 0.4 4-10 Neonatal mortality 4.3 3.7 4.9 10.3 3.1 2.0 4-11 Postneonatal mortality 2.2 1.7 2.1 5.6 4.4 2.4 108 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 5. MORTALITY FROM NATURAL CAUSES (chronic or infectious diseases) Figure number (Number of deaths per 100,000 population age-adjusted to 2000 standard. The causes of death are classified by the Tenth Revision of the International Classification of Diseases or ICD-10). Indicator All arizona residents White nonHispanic Hispanic Black or African American American Indian Asian or Pacific Islander 5-1 Cardiovascular disease 258.4 257.2 278.2 390.1 188.6 145.3 5-2 Diseases of the heart 197.1 197.7 198.5 299.4 141.9 97.6 5-3 Coronary heart disease 156.6 157.8 154.4 245.7 100.7 75.5 5-4 Cerebrovascular disease 43.9 41.7 61.9 69.0 36.4 35.9 5-5 Chronic lower respiratory diseases 45.4 48.3 28.7 30.3 19.4 15.5 5-6 Malignant neoplasm (cancer) 169.4 171.2 168.5 218.5 120.7 132.9 5-7 Lung cancer 47.4 50.6 33.5 59.4 13.2 21.9 5-8 Breast cancer 22.1 22.3 18.9 41.2 16.4 19.6 5-9 Cervical cancer 2.2 1.0 1.8 6.8 4.2 10.5 5-10 Colorectal cancer 17.9 17.9 21.2 26.3 6.3 3.0 5-11 Prostate cancer 25.1 25.2 22.4 41.2 21.0 7.6 5-12 Influenza and pneumonia 23.4 21.8 27.9 30.4 58.9 16.4 5-13 Diabetes 20.3 16.5 39.1 53.6 55.8 15.7 5-14 Chronic liver disease and cirrhosis 11.5 9.7 17.6 3.5 38.8 3.3 5-15 HIV disease 3.2 2.8 4.3 8.1 3.6 1.7 5-16 Septicemia 8.4 7.1 12.6 11.3 25.8 6.8 5-17 Alzheimer's disease 32.5 33.4 28.2 43.3 5.6 11.4 10.1 8.4 18.4 20.9 24.7 16.0 6.3 6.0 7.9 14.5 5.4 9.4 784.0 764.9 839.5 1048.6 900.7 497.2 5-18 5-19 5-20 Nephritis, nephrotic syndrome and nephrosis (kidney disease) Essential (primary) hypertension Total mortality from all causes 109 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 6. MORTALITY FROM INJURIES Figure number (Number of deaths per 100,000 population age-adjusted to 2000 standard. The causes of death are classified by the Tenth Revision of the International Classification of Diseases or ICD-10. Drug-induced deaths include accidental, suicidal and homicidal poisoning by drugs, but also disorders due to use of psychoactive substances. Alcohol-induced deaths include accidental, suicidal and homicidal poisoning by drugs, but also disorders due to use of alcohol.) All Arizona residents Indicator White nonHispanic Hispanic Black or African American American Indian Asian or Pacific Islander 6-1 6-1. Unintentional injuries 44.8 40.9 44.7 52.4 108.6 25.3 6-2 6-2. Motor vehiclerelated injuries 18.0 14.6 21.3 15.2 59.0 11.8 6-3 6-3. Fall-related injuries 8.8 9.0 5.5 6.3 12.7 7.5 6-4 6-4. Drowning mortality 1.5 1.3 1.5 2.7 2.5 .5 6-5 6-5. Injury by firearms 14.8 12.7 15.7 23.2 15.6 1.8 6-6 6-6. Drug-induced deaths 12.0 12.8 10.5 23.5 8.5 .0 6-7 6-7. Alcoholinduced deaths 10.1 8.3 10.2 6.8 49.3 .0 6.8 6-8. Intentional self-harm (suicide) 14.6 16.4 8.2 11.3 15.2 6.0 6-9 Assault (homicide) 8.3 3.7 14.7 24.9 18.8 5.4 7. AGE-SPECIFIC MORTALITY Figure number (Number of deaths per 100,000 persons in specified group) Indicators All Arizona Residents White nonHispanic Hispanic Black or African American American Indian Asian or Pacific Islander 7-1 Mortality of children 1-14 years old 24.3 21.8 22.1 42.5 45.3 9.2 7-2 Mortality of adolescents 15-19 years old 75.4 51.6 87.5 89.5 196.2 36.2 7-3 Mortality of young adults 20-44 years old 151.1 139.6 139.1 220.4 345.8 56.8 7-4 Mortality of middleaged adults 45-64 years old 653.7 651.1 593.5 909.7 914.9 292.2 110 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Figure number 8. PREMATURE MORTALITY Indicators All Arizona residents White nonHispanic Hispanic Black or African American American Indian Asian or Pacific Islander 8-1 Average age at death from all causes 72.2 74.4 60.4 62.4 54.7 64.3 8-2 Average age at death from all causes among males 69.6 71.6 57.5 60.0 50.3 63.5 8-3 Average age at death from all causes among females 75.1 77.4 64.4 65.3 60.4 65.0 8-4 Percent of total deaths before expected years of life reached 50.8 46.1 70.0 70.6 78.4 65.7 Hispanic Black or African American American Indian 9. REPORTABLE DISEASES Figure number (Number of cases per 100,000 persons in specified group) Indicators 9-1 Incidence of early syphilis 9-2 All Arizona residents White nonHispanic Asian or Pacific Islander 7.4 4.2 9.7 18.2 20.1 0.9 Incidence of gonorrhea 63.5 33.4 71.4 359.7 103.1 15.3 9-3 Incidence of chlamydia 227.1 100.7 329.1 537.6 623.9 86.4 9-4 Incidence of genital herpes 16.2 11.8 14.3 23.1 30.4 7.6 9-5 Incidence of HIV/AIDS 11.3 11.4 7.4 42.5 11.3 4.2 111 112 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 SCORES IN 2003 113 114 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 SCORES IN 2003 (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). Figure number 1. TEEN PREGNANCIES Indicator White nonHispanic Hispanic Black or African American American Indian Asian or Pacific Islander 1-1 Pregnancies among females 19 and younger -47.3 66.6 31.6 15.6 -44.4 1-2 Pregnancies among females 14 and younger -71.4 85.7 -14.3 78.6 -57.1 1-3 Pregnancies among females 15-17 years old -57.9 83.9 43.7 25.0 -47.1 1-4 Pregnancies among females 18-19 years old -41.9 59.6 36.3 24.0 -51.8 -218.5 295.8 97.3 143.2 -200.5 -54.6 74.0 24.3 35.8 -50.1 TOTAL SCORE AVERAGE SCORE Figure number 2. MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS Indicator White nonHispanic Hispanic Black or African American American Indian Asian or Pacific Islander 2-1 Unmarried mothers -39.1 27.9 52.2 75.7 -60.4 2-2 Tobacco use during pregnancy 62.1 -63.8 50.0 -44.8 -51.7 2-3 Alcohol use during pregnancy 22.2 -55.6 44.4 166.7 -44.4 2-4 Chronic hypertension 33.3 -33.3 66.7 133.3 .0 2-5 Dysfunctional labor 12.5 -37.5 .0 200.0 -25.0 2-6 Anemia during pregnancy 15.0 -40.0 40.0 175.0 -15.0 2-7 Diabetes during pregnancy -14.3 -14.3 4.8 185.7 42.9 2-8 Pregnancy-associated hypertension 21.4 -32.1 -3.6 103.6 -32.1 2-9 Genital herpes during pregnancy 66.7 -66.7 66.7 -16.7 -16.7 2-10 Weight gain of less than 21 pounds -26.4 16.2 18.3 61.9 -18.8 153.5 -299.1 339.4 1040.4 -221.3 15.3 -29.9 33.9 104.0 -22.1 TOTAL SCORE AVERAGE SCORE 115 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Figure number 3. UTILIZATION OF PRENATAL CARE SERVICES Indicator White nonHispanic Hispanic Black or African American American Indian Asian or Pacific Islander 3-1 No care in the 1st trimester -45.9 40.2 -.4 27.9 -35.2 3-2 Fewer than five prenatal visits -59.7 44.4 5.6 63.9 -37.5 3-3 No prenatal care -79.3 65.5 20.7 -17.2 -44.8 -184.9 150.1 25.8 74.5 -117.6 -61.6 50.0 8.6 24.8 -39.2 TOTAL SCORE AVERAGE SCORE Figure number 4. NEWBORN'S HEALTH Indicator Hispanic Black or African American American Indian Asian or Pacific Islander 4-1 Incidence of hyaline membrane disease 66.7 -33.3 -33.3 .0 .0 4-2 Incidence of newborn intensive care 14.8 -13.0 29.6 -22.2 3.7 4-3 Born too early (preterm or < 37 weeks) 4.8 -6.7 37.1 -6.7 2.9 4-4 Born too small: lowbirthweight (<2,500 grams) -2.8 -2.8 64.8 -4.2 19.7 4-5 Born too small: very lowbirthweight (<1,500 grams) .0 .0 100.0 -18.2 36.4 4-6 Incidence of congenital anomalies .0 .0 .0 30.0 .0 4-7 Infant mortality -16.9 7.7 144.6 15.4 -32.3 4-8 Sudden Infant Death Syndrome (SIDS) .0 .0 133.3 .0 -100.0 4-9 Mortality of infants from low birthweight/ short gestation -33.3 22.2 300.0 .0 -55.6 4-10 Neonatal mortality -14.0 14.0 139.5 -27.9 -53.5 4-11 Postneonatal mortality -22.7 -4.5 154.5 100.0 9.1 -3.5 -16.5 1070.3 66.2 -169.6 -.3 -1.5 97.3 6.0 -15.4 TOTAL SCORE AVERAGE SCORE 116 White nonHispanic DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Figure number 5. MORTALITY FROM NATURAL CAUSES (chronic or infectious diseases) Indicator 5-1 Cardiovascular disease 5-2 White nonHispanic Hispanic Black or African American American Indian Asian or Pacific Islander -.5 7.7 51.0 -27.0 -43.8 Diseases of the heart .3 .7 51.9 -28.0 -50.5 5-3 Coronary heart disease .8 -1.4 56.9 -35.7 -51.8 5-4 Cerebrovascular disease -5.0 41.0 57.2 -17.1 -18.2 5-5 Chronic lower respiratory diseases 6.4 -36.8 -33.3 -57.3 -65.9 5-6 Malignant neoplasm (cancer) 1.1 -.5 29.0 -28.7 -21.5 5-7 Lung cancer 6.8 -29.3 25.3 -72.2 -53.8 5-8 Breast cancer .9 -14.5 86.4 -25.8 -11.3 5-9 Cervical cancer -54.5 -18.2 209.1 90.9 377.3 5-10 Colorectal cancer .0 18.4 46.9 -64.8 -83.2 5-11 Prostate cancer .4 -10.8 64.1 -16.3 -69.7 5-12 Influenza and pneumonia -6.8 19.2 29.9 151.7 -29.9 5-13 Diabetes -18.7 92.6 164.0 174.9 -22.7 5-14 Chronic liver disease and cirrhosis -15.7 53.0 -69.6 237.4 -71.3 5-15 HIV disease -12.5 34.4 153.1 12.5 -46.9 5-16 Septicemia -15.5 50.0 34.5 207.1 -19.0 5-17 Alzheimer's disease 2.8 -13.2 33.2 -82.8 -64.9 -16.8 82.2 106.9 144.6 58.4 -4.8 25.4 130.2 -14.3 49.2 Total mortality from all causes -2.4 7.1 33.7 14.9 -36.6 TOTAL SCORE -2.4 7.1 33.7 14.9 -36.6 -136.3 314.1 1294.4 578.9 -312.7 5-18 5-19 5-20 Nephritis, nephrotic syndrome and nephrosis (kidney disease) Essential (primary) hypertension AVERAGE SCORE 117 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Figure number 6. MORTALITY FROM INJURIES 6-1 Indicator White nonHispanic Unintentional injuries Hispanic Black or African American American Indian Asian or Pacific Islander -8.7 -.2 17.0 142.4 -43.5 -18.9 18.3 -15.6 227.8 -34.4 6-2 Motor vehicle-related injuries 6-3 Fall-related injuries 2.3 -37.5 -28.4 44.3 -14.8 6-4 Drowning mortality -13.3 .0 80.0 66.7 -66.7 6-5 Injury by firearms -14.2 6.1 56.8 5.4 -87.8 6-6 Drug-induced deaths 6.7 -12.5 95.8 -29.2 -100.0 6-7 Alcohol-induced deaths -17.8 1.0 -32.7 388.1 -100.0 6-8 Intentional self-harm (suicide) 12.3 -43.8 -22.6 4.1 -58.9 6-9 Assault (homicide) -55.4 77.1 200.0 126.5 -34.9 -107.1 8.5 350.3 976.1 -541.1 -11.9 .9 38.9 108.5 -60.1 TOTAL SCORE AVERAGE SCORE Figure number 7. AGE-SPECIFIC MORTALITY 118 Indicators White nonHispanic Hispanic Black or African American American Indian Asian or Pacific Islander 7-1 Mortality of children 1-14 years old -10.3 -9.1 74.9 86.4 -62.1 7-2 Mortality of adolescents 15-19 years old -31.6 16.0 18.7 160.2 -52.0 7-3 Mortality of young adults 20-44 years old -7.6 -7.9 45.9 128.9 -62.4 7-4 Mortality of middle-aged adults 45-64 years old -.4 -9.2 39.2 40.0 -55.3 TOTAL SCORE -49.9 -10.2 178.6 415.4 -231.8 AVERAGE SCORE -12.5 -2.5 44.7 103.9 -58.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Figure number 8. PREMATURE MORTALITY 8-1 8-2 8-3 8-4 Indicators Average age at death from all causes Average age at death from all causes among males Average age at death from all causes among females Percent of total deaths before expected years of life reached TOTAL SCORE AVERAGE SCORE White nonHispanic Hispanic Black or African American American Indian Asian or Pacific Islander -3.0 16.3 13.6 24.2 10.9 -2.9 17.4 13.8 27.7 8.8 -3.1 14.2 13.0 19.6 13.4 -9.3 37.8 39.0 54.3 29.3 -18.3 85.7 79.4 125.8 62.4 -4.6 21.4 19.9 31.5 15.6 9. REPORTABLE DISEASES Figure number (Number of cases per 100,000 persons in specified group) Indicators White nonHispanic Hispanic Black or African American American Indian Asian or Pacific Islander 9-1 Incidence of early syphilis -43.2 31.1 145.9 171.6 -87.8 9-2 Incidence of gonorrhea -47.4 12.4 466.5 62.4 -75.9 9-3 Incidence of chlamydia -55.7 44.9 136.7 174.7 -62.0 9-4 Incidence of genital herpes -27.2 -11.7 42.6 87.7 -53.1 9-5 Incidence of HIV/AIDS .9 -34.5 276.1 .0 -62.8 -172.6 42.2 1067.8 496.4 -341.6 -34.5 8.4 213.6 99.3 -68.3 TOTAL SCORE AVERAGE SCORE OVERALL HEALTH STATUS (ALL 70 INDICATORS) White nonHispanic SUM OF ALL SCORES FOR 70 INDICATORS AVERAGE OF ALL SCORES FOR 70 INDICATORS Hispanic Black or African American American Indian Asian or Pacific Islander -737.6 570.7 4503.5 3917.0 -2073.9 -10.5 8.2 64.3 56.0 -29.6 119 120 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 RANKING ORDER IN 2003 121 122 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 RANK ORDER IN 2003 (A rank is the ordering of each ethnic group according to score). 1 = RANKS BEST AMONG ETHNIC GROUPS 5 = RANKS WORST AMONG ETHNIC GROUPS Figure number 1. TEEN PREGNANCIES Indicator White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 1-1 Pregnancies among females 19 and younger 1 5 4 3 2 1-2 Pregnancies among females 14 and younger 1 5 3 4 2 1-3 Pregnancies among females 15-17 years old 1 5 4 3 2 1-4 Pregnancies among females 18-19 years old 2 5 4 3 1 SUM OF RANKS 5.0 20.0 15.0 13.0 7.0 AVERAGE RANK 1.3 4.0 3.8 3.3 1.8 Figure number 2. MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS Indicator White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 2-1 Unmarried mothers 2 3 4 5 1 2-2 Tobacco use during pregnancy 5 1 4 3 2 2-3 Alcohol use during pregnancy 3 1 4 5 2 2-4 Chronic hypertension 3 1 4 5 2 2-5 Dysfunctional labor 4 1 3 5 2 3 1 4 5 2 1.5 1.5 3 5 4 2-6 2-7 Anemia during pregnancy Diabetes during pregnancy 2-8 Pregnancy-associated hypertension 4 1.5 3 5 1.5 2-9 Genital herpes during pregnancy 4.5 1 4.5 2.5 2.5 2-10 Weight gain of less than 21 pounds 1 3 4 5 2 SUM OF RANKS 31.0 15.0 37.5 45.5 21.0 AVERAGE RANK 3.1 1.5 3.8 4.6 2.1 123 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Figure number 3. UTILIZATION OF PRENATAL CARE SERVICES Indicator White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 3-1 No care in the 1st trimester 1 5 3 4 2 3-2 Fewer than five prenatal visits 1 4 3 5 2 3-3 No prenatal care 1 5 4 3 2 SUM OF RANKS 3.0 14.0 10.0 12.0 6.0 AVERAGE RANK 1.0 4.7 3.3 4.0 2.0 Figure number 4. NEWBORN'S HEALTH 124 Indicator White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 4-1 Incidence of hyaline membrane disease 5 1.5 1.5 3.5 3.5 4-2 Incidence of newborn intensive care 4 2 5 1 3 4-3 Born too early (preterm or < 37 weeks) 4 1.5 5 1.5 3 4-4 Born too small: lowbirthweight (<2,500 grams) 2.5 2.5 5 1 4 4-5 Born too small: very lowbirthweight (<1,500 grams) 2.5 2.5 5 1 4 4-6 Incidence of congenital anomalies (birth defects) 2.5 2.5 2.5 5 2.5 4-7 Infant mortality 2 3 5 4 1 4-8 Sudden Infant Death Syndrome (SIDS) 3 3 5 3 1 4-9 Mortality of infants from low birthweight/ short gestation 2 4 5 3 1 4-10 Neonatal mortality 3 4 5 2 1 4-11 Postneonatal mortality 1 2 5 4 3 SUM OF RANKS 31.5 28.5 49.0 29.0 27.0 AVERAGE RANK 2.9 2.6 4.5 2.6 2.5 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Figure number 5. MORTALITY FROM NATURAL CAUSES (chronic or infectious diseases) Indicator White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 5-1 Cardiovascular disease 3 4 5 2 1 5-2 Diseases of the heart 3 4 5 2 1 5-3 Coronary heart disease 4 3 5 2 1 5-4 Cerebrovascular disease 3 4 5 2 1 5-5 Chronic lower respiratory diseases 5 3 4 2 1 5-6 Malignant neoplasm (cancer) 4 3 5 1 2 5-7 Lung cancer 4 3 5 1 2 5-8 Breast cancer 4 2 5 1 3 5-9 Cervical cancer 1 2 4 3 5 5-10 Colorectal cancer 3 4 5 2 1 5-11 Prostate cancer 4 3 5 2 1 5-12 Influenza and pneumonia 2 3 4 5 1 5-13 Diabetes 2 3 4 5 1 5-14 Chronic liver disease and cirrhosis 3 4 2 5 1 5-15 HIV disease 2 4 5 3 1 5-16 Septicemia 2 4 3 5 1 5-17 Alzheimer's disease 4 3 5 1 2 1 3 4 5 2 2 3 5 1 4 2 3 5 4 1 SUM OF RANKS 58.0 65.0 90.0 54.0 33.0 AVERAGE RANK 2.9 3.3 4.5 2.7 1.7 5-18 5-19 5-20 Nephritis, nephrotic syndrome and nephrosis (kidney disease) Essential (primary) hypertension Total mortality from all causes 125 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Figure number 6. MORTALITY FROM INJURIES Indicator White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 6-1 Unintentional injuries 2 3 4 5 1 6-2 Motor vehicle-related injuries 2 4 3 5 1 6-3 Fall-related injuries 4 1 2 5 3 6-4 Drowning mortality 2 3 5 4 1 6-5 Injury by firearms 2 4 5 3 1 6-6 Drug-induced deaths 4 3 5 2 1 6-7 Alcohol-induced deaths 3 4 2 5 1 6-8 Intentional self-harm (suicide) 5 2 3 4 1 6-9 Assault (homicide) 1 3 5 4 2 SUM OF RANKS 25.0 27.0 34.0 37.0 12.0 AVERAGE RANK 2.8 3.0 3.8 4.1 1.3 Black or African American American Indian or Alaska Native Figure number 7. AGE-SPECIFIC MORTALITY 126 Indicators White nonHispanic Hispanic or Latino Asian or Pacific Islander 7-1 Mortality of children 1-14 years old 2 3 4 5 1 7-2 Mortality of adolescents 15-19 years old 2 3 4 5 1 7-3 Mortality of young adults 20-44 years old 3 2 4 5 1 7-4 Mortality of middle-aged adults 45-64 years old 3 2 4 5 1 SUM OF RANKS 10.0 10.0 16.0 20.0 4.0 AVERAGE RANK 2.5 2.5 4.0 5.0 1.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Figure number 8. PREMATURE MORTALITY 8-1 8-2 8-3 8-4 Indicators Average age at death from all causes White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 1 4 3 5 2 1 4 3 5 2 1 4 2 5 3 1 3 4 5 2 SUM OF RANKS 4.0 15.0 12.0 20.0 9.0 AVERAGE RANK 1.0 3.8 3.0 5.0 2.3 Average age at death from all causes among males Average age at death from all causes among females Percent of total deaths before expected years of life reached 9. REPORTABLE DISEASES Figure number (Number of cases per 100,000 persons in specified group) Indicators White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 9-1 Incidence of early syphilis 2 3 4 5 1 9-2 Incidence of gonorrhea 2 3 5 4 1 9-3 Incidence of chlamydia 2 3 4 5 1 9-4 Incidence of genital herpes 2 3 4 5 1 9-5 Incidence of HIV/AIDS 4 2 5 3 1 SUM OF RANKS 12.0 14.0 22.0 22.0 5.0 AVERAGE RANK 2.4 2.8 4.4 4.4 1.0 OVERALL HEALTH STATUS (ALL 70 INDICATORS) White nonHispanic SUM OF ALL RANKS FOR 70 MEASUREMENTS AVERAGE RANKS BASED ON 70 MEASUREMENTS Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 179.5 208.5 285.5 252.5 124.0 2.6 3.0 4.1 3.6 1.8 127 128 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 COMPARATIVE RATES AND RATIOS, 2000 – 2003 129 130 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 COMPARATIVE RATES AND RATIOS FOR 2000 - 2003 2. TEEN PREGNANCIES (Number of pregnancies per 1,000 females in specified age group) Indicator Figure no. ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 1-1. Pregnancies among females 19 and younger 2003 34.5 18.2 57.5 45.4 39.9 19.2 2002 35.2 20.1 57.6 42.5 36.6 19.1 2001 36.0 21.1 59.1 45.1 36.7 20.3 2000 39.5 25.2 60.9 51.9 41.3 21.3 1-2. Pregnancies among females 14 and younger 2003 1.4 0.4 2.6 1.2 2.5 0.6 2002 1.3 0.4 2.5 2.4 1.3 0.3 2001 1.3 0.5 2.5 2.2 1.4 0.0 2000 1.5 0.7 2.7 2.4 1.6 0.3 2003 41.6 17.5 76.5 59.8 52.0 22.0 2002 42.2 20.2 77.0 47.0 45.1 14.6 2001 43.2 20.8 79.7 57.5 43.5 22.8 48.1 1-4. Pregnancies among females 18-19 years old 25.1 84.0 64.2 52.1 21.4 1-3. Pregnancies among females 15-17 years old 2000 2003 108.2 62.9 172.7 147.5 134.2 52.1 2002 111.2 67.9 172.8 148.0 130.1 61.6 2001 113.2 71.7 176.0 146.4 133.4 57.1 2000 123.6 85.0 178.4 171.7 144.4 62.4 Black or African American American Indian or Alaska Native 2. MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS (All ratios are per 100 live births) Indicator Figure no. 2-1. Unmarried mothers 2003 ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Asian or Pacific Islander 41.2 25.1 52.7 62.7 72.4 16.3 2002 40.2 25.0 52.2 61.8 69.7 15.5 2001 39.4 24.5 51.0 64.2 70.1 17.0 2000 39.3 24.8 51.4 62.2 68.5 15.1 2002 5.8 6.3 9.4 10.7 2.1 2.1 8.7 9.7 3.2 3.3 2.8 2.3 2001 6.8 11.0 2.4 10.7 4.0 2.7 2000 6.8 11.0 2.4 11.0 3.5 2.5 2-3. Alcohol use during pregnancy 2003 0.9 1.1 0.4 1.3 2.4 0.5 2002 0.9 1.0 0.4 1.2 2.6 0.2 2001 0.9 1.0 0.5 1.6 2.6 0.4 2000 1.0 1.3 0.6 1.6 2.3 0.6 2-2. Tobacco use during pregnancy 2003 2-4. Chronic hypertension 2003 0.3 0.4 0.2 0.5 0.7 0.3 2002 0.4 0.4 0.2 0.7 0.8 0.2 2001 0.4 0.4 0.2 0.7 1.3 0.2 2000 0.4 0.4 0.2 0.7 1.3 0.3 131 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Indicator Figure no. 2-5. Dysfunctional labor 2003 ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 0.8 0.9 0.5 0.8 2.4 0.6 2002 1.0 1.1 0.7 1.2 2.7 1.3 2001 1.2 1.4 0.6 1.2 3.0 1.7 2000 0.8 0.8 0.5 0.7 2.2 0.8 2-6. Anemia during pregnancy 2003 2.0 2.3 1.2 2.8 5.5 1.7 2002 1.8 1.9 1.1 2.7 5.1 1.1 2001 1.6 1.5 1.0 1.7 6.0 1.6 2000 1.7 1.7 1.1 2.0 4.8 1.1 2-7. Diabetes during pregnancy 2003 2.1 1.8 1.8 2.2 6.0 3.0 2002 2.3 1.9 2.2 2.0 6.5 2.9 2001 2.2 1.8 2.0 1.8 6.2 3.9 2000 2.3 1.9 2.0 1.8 6.7 3.1 2-8. Pregnancy-associated hypertension 2003 2.8 3.4 1.9 2.7 5.7 1.9 2002 2.5 3.0 1.7 2.5 4.6 1.5 2001 2.6 3.1 1.7 2.4 5.7 1.8 2000 3.0 3.6 2.0 2.9 5.6 2.3 2-9. Genital herpes during pregnancy 2003 0.6 1.0 0.2 1.0 0.5 0.5 2002 0.7 1.1 0.2 1.2 0.3 0.4 2001 0.8 1.3 0.3 1.2 0.3 0.7 2000 0.7 1.2 0.2 0.7 0.3 0.5 2-10. Weight gain of less than 21 pounds 2003 19.7 14.5 22.9 23.3 31.9 16.0 2002 19.3 15.4 22.1 19.3 28.2 16.3 2001 18.5 14.9 20.9 21.3 28.8 16.0 2000 19.1 15.4 21.3 22.4 30.4 16.7 3. UTILIZATION OF PRENATAL CARE SERVICES (Per 100 live births) Asian or Pacific Islander ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native 2003 24.4 13.2 34.2 24.3 31.2 15.8 2002 24.3 13.5 34.4 24.8 35.6 15.7 2001 24.5 13.8 34.7 26.2 35.4 17.3 2000 25.0 14.0 36.5 28.9 34.2 15.0 2003 7.2 2.9 10.4 7.6 11.8 4.5 2002 6.6 2.9 9.9 6.0 12.4 3.3 2001 9.4 5.1 13.2 11.8 14.5 5.4 2000 6.7 2.8 10.5 6.6 12.5 3.3 Indicator Figure No. 3-1. No care in the 1st trimester 3-2. Fewer than five prenatal visits 132 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 3. UTILIZATION OF PRENATAL CARE SERVICES (continued) (Per 100 live births) 3-3. No prenatal care 2003 2.9 0.6 4.8 3.5 2.4 1.6 2002 2.2 0.7 3.8 1.7 2.6 1.1 2001 1.9 0.6 3.2 1.6 1.9 1.1 2000 2.1 0.7 3.6 2.4 2.4 0.9 4. NEWBORN'S HEALTH (Infant, neonatal and postneonatal rates are per 1,000 live births. All other indicators are expressed per 100 live births). ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native 2003 0.3 0.5 0.2 0.2 0.3 0.3 2002 0.5 0.7 0.3 0.5 0.4 0.8 2001 0.3 0.4 0.2 0.5 0.4 0.3 2000 0.3 0.4 0.2 0.6 0.2 0.3 2003 5.4 6.2 4.7 7.0 4.2 5.6 2002 5.6 6.3 5.0 7.2 4.8 5.7 2001 5.7 5.9 5.4 9.0 4.6 5.6 2000 5.8 5.5 6.3 9.3 4.6 4.3 2003 10.5 11.0 9.8 14.4 9.8 10.8 2002 10.0 10.5 9.4 14.0 9.6 11.0 2001 9.9 10.1 9.4 14.8 10.1 9.8 2000 10.3 10.5 9.8 14.9 9.4 9.3 2003 7.1 6.9 6.9 11.7 6.8 8.5 2002 6.8 6.7 6.4 11.9 6.5 8.6 2001 7.0 6.7 6.7 13.7 7.3 7.7 2000 7.0 4-5. Born too small: very low-birthweight (<1,500 grams) 7.0 6.7 13.0 6.7 7.6 Indicator Figure no. Asian or Pacific Islander 4-1. Hyaline membrane disease 4-2. Newborn intensive care 4-3. Born too early (preterm or < 37 weeks) 4-4. Born too small: low-birthweight (<2,500 grams) 2003 1.1 1.1 1.1 2.2 0.9 1.5 2002 1.1 1.2 1.0 2.5 0.9 1.2 2001 1.1 1.0 1.0 2.7 1.0 0.9 2000 1.2 1.1 1.1 2.6 1.4 1.2 2003 1.0 1.0 1.0 1.0 1.3 1.0 2002 1.3 1.4 1.1 1.2 2.2 0.9 2001 1.3 1.4 1.1 1.4 1.9 1.3 2000 1.3 1.5 0.9 1.1 1.9 0.8 2003 6.5 5.4 7.0 15.9 7.5 4.4 2002 6.3 5.9 6.6 13.1 7.0 4.0 2001 6.9 5.7 6.7 22.7 10.7 3.8 2000 6.7 6.1 6.3 17.8 9.6 4.9 4-6. Incidence of congenital anomalies (birth defects) 4-7. Infant mortality 133 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 4. NEWBORN'S HEALTH (Infant, neonatal and postneonatal rates are per 1,000 live births. All other indicators are expressed per 100 live births). ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native 2003 0.3 0.3 0.3 0.7 0.3 0.0 2002 0.4 0.4 0.3 2.2 0.4 0.0 2001 0.4 0.4 0.2 2.9 0.4 0.0 2000 0.3 4-9. Mortality of infants from low birthweight/short gestation 0.3 0.2 0.7 0.7 0.0 Indicator Figure no. Asian or Pacific Islander 4-8. Sudden Infant Death Syndrome (SIDS) 2003 0.9 0.6 1.1 3.6 0.9 0.4 2002 1.1 0.9 1.3 2.6 0.7 0.0 2001 0.9 0.6 1.1 4.0 0.4 0.0 2000 0.6 0.4 0.9 2.5 0.9 0.0 2003 4.3 3.7 4.9 10.3 3.1 2.0 2002 4.1 3.9 4.6 5.8 3.6 3.1 2001 4.5 4.0 4.5 15.0 4.1 2.4 2000 4.3 3.8 4.2 9.8 6.4 2.0 2003 2.2 1.7 2.1 5.6 4.4 2.4 2002 2.2 2.0 2.0 7.3 3.4 .9 2001 2.4 1.7 2.2 7.7 6.6 1.4 2000 2.4 2.3 2.0 8.0 3.2 2.0 4-10. Neonatal mortality 4-11. Postneonatal mortality 5. MORTALITY FROM NATURAL CAUSES (chronic or infectious diseases) (Number of deaths per 100,000 population age-adjusted to 2000 standard) Indicator Figure no. ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islande r 5-1. Cardiovascular Diseases 2003 258.4 257.2 278.2 390.1 188.6 145.3 2002 265.5 266.1 276.3 329.8 216.2 218.4 2001 267.3 265.8 281.4 388.1 234.1 184.3 2000 276.1 276.0 273.6 411.5 257.5 190.6 2003 197.1 197.7 198.5 299.4 141.9 97.6 2002 201.0 203.0 201.2 237.0 164.0 145.6 2001 201.7 202.1 206.1 273.6 177.7 116.1 2000 206.1 207.2 204.7 289.5 183.8 132.3 5-2. Diseases of the Heart 134 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 5. MORTALITY FROM NATURAL CAUSES (chronic or infectious diseases, continued) (Number of deaths per 100,000 population age-adjusted to 2000 standard) Indicator Figure no. ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 5-3. Coronary Heart Disease 2003 156.6 157.8 154.4 245.7 100.7 75.5 2002 159.5 161.7 159.4 181.2 119.5 104.4 2001 149.3 149.8 159.7 196.9 116.4 80.7 2000 160.4 162.4 154.7 225.1 124.4 107.4 2003 43.9 41.7 61.9 69.0 36.4 35.9 2002 47.0 45.9 53.9 69.6 39.4 57.6 2001 47.7 46.2 55.4 79.6 44.3 51.1 2000 51.7 50.8 51.2 82.4 55.3 46.1 2003 45.4 48.3 28.7 30.3 19.4 15.5 2002 47.0 50.4 25.2 38.3 22.3 24.5 2001 46.9 51.0 17.7 37.9 26.8 21.4 2000 47.4 51.1 24.4 30.4 21.9 12.7 2003 169.4 171.2 168.5 218.5 120.7 132.9 2002 168.6 172.4 156.3 222.7 117.6 116.5 2001 169.2 173.1 155.6 213.0 121.7 147.0 2000 170.4 174.8 156.9 216.1 123.0 103.4 2003 47.4 50.6 33.5 59.4 13.2 21.9 2002 46.6 50.1 27.7 61.2 13.1 24.7 2001 44.5 47.6 29.2 55.7 9.8 41.7 2000 46.1 49.1 31.6 65.8 8.9 29.6 2003 22.1 22.3 18.9 41.2 16.4 19.6 2002 22.2 22.5 18.7 42.3 9.6 17.7 2001 23.6 24.7 17.5 55.8 11.7 12.7 2000 25.4 26.2 20.7 29.5 12.1 12.8 2003 2.2 1.0 1.8 6.8 4.2 10.5 2002 2.2 1.9 3.7 2.0 4.7 2.0 2001 2.8 2.5 3.9 3.5 5.4 .0 2000 3.0 2.5 3.7 7.6 10.1 3.5 2003 17.9 17.9 21.2 26.3 6.3 3.0 2002 16.5 16.9 16.2 26.4 9.1 9.7 2001 16.7 16.9 16.6 27.4 7.2 10.6 2000 17.0 17.4 16.4 16.3 8.2 6.6 5-4. Cerebrovascular Disease 5-5. Chronic lower respiratory diseases 5-6. Malignant neoplasms (cancer) 5-7. Lung Cancer 5-8. Breast Cancer 5-9. Cervical Cancer 5-10. Colorectal Cancer 135 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 5. MORTALITY FROM NATURAL CAUSES (chronic or infectious diseases, continued) (Number of deaths per 100,000 population age-adjusted to 2000 standard) Indicator Figure no. ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islande r 7.6 5-11.Prostate Cancer 2003 25.1 25.2 22.4 41.2 21.0 2002 24.8 24.1 35.3 48.6 12.5 8.4 2001 24.3 24.1 26.3 45.0 14.0 24.2 2000 28.4 28.0 30.0 74.8 27.1 8.9 2003 23.4 21.8 27.9 30.4 58.9 16.4 2002 25.0 24.3 26.1 29.2 51.7 13.2 2001 21.9 21.3 26.1 14.8 43.0 15.0 2000 24.4 23.3 30.1 26.9 48.2 11.9 2003 20.3 16.5 39.1 53.6 55.8 15.7 2002 22.3 18.0 45.6 41.0 80.8 21.9 2001 19.9 15.4 42.9 55.7 72.8 14.8 2000 19.0 14.9 41.1 46.0 74.6 19.5 2003 11.5 9.7 17.6 3.5 38.8 3.3 2002 12.1 9.9 21.6 9.8 40.5 5.3 2001 12.3 10.6 17.4 11.7 39.1 4.0 2000 12.8 10.4 15.8 6.6 61.7 4.1 2003 3.2 2.8 4.3 8.1 3.6 1.7 2002 3.1 2.5 3.2 14.3 5.5 0.0 2001 3.1 2.6 3.2 11.2 5.5 1.1 2000 3.2 3.1 3.4 9.6 1.8 .0 5-12. Pneumonia and influenza 5-13. Diabetes 5-14. Chronic liver disease and cirrhosis 5-15. HIV Disease 5-16. Septicemia 2003 8.4 7.1 12.6 11.3 25.8 6.8 2002 8.3 7.3 10.5 14.8 23.4 0.0 2001 7.2 6.0 10.7 13.6 21.8 3.2 2000 6.7 6.0 9.9 6.2 21.5 1.3 2003 32.5 33.4 28.2 43.3 5.6 11.4 2002 28.0 28.9 24.7 25.1 8.8 17.4 2001 22.5 23.5 14.7 21.5 12.7 14.6 22.5 18.9 20.5 7.2 7.8 8.4 18.4 20.9 24.7 16.0 5-17. Alzheimer's Disease 2000 21.8 5-18. Nephritis, Nephrotic Syndrome and Nephrosis (kidney disease) 2003 10.1 2002 11.3 136 9.7 21.6 20.8 25.8 4.7 2001 12.0 9.9 22.6 23.5 33.5 8.4 2000 11.7 10.1 22.1 26.9 22.6 5.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 5. MORTALITY FROM NATURAL CAUSES (chronic or infectious diseases, continued) (Number of deaths per 100,000 population age-adjusted to 2000 standard) Indicator Figure no. ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islande r 9.4 5-19. Essential (primary) hypertension 2003 6.3 6.0 7.9 14.5 5.4 2002 5.6 5.4 7.3 12.5 4.9 5.1 2001 5.9 5.5 8.7 13.8 3.4 11.8 2000 5.6 5.2 7.3 11.2 10.8 5.8 5-20. Total mortality from all causes 2003 784.0 764.9 839.5 1048.6 900.7 497.2 2002 796.4 786.7 811.1 951.5 975.1 560.4 2001 791.2 778.1 787.6 1050.6 1010.5 560.7 2000 785.6 776.6 769.9 1057.5 1011.4 504.1 Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islande r 6. MORTALITY FROM INJURIES (Number of deaths per 100,000 population age-adjusted to 2000 standard) Indicator Figure no. ALL ARIZONA RESIDENTS White nonHispanic 6-1. Unintentional injuries 2003 44.8 40.9 44.7 52.4 108.6 25.3 2002 45.2 41.5 45.5 44.0 111.0 15.5 2001 46.6 42.5 45.6 52.6 112.7 29.9 2000 41.1 36.9 41.6 49.7 113.1 24.1 6-2. Motor vehicle-related injuries 2003 18.0 14.6 21.3 15.2 59.0 11.8 2002 18.5 14.7 21.1 11.9 65.9 10.1 2001 17.2 13.5 18.2 19.1 63.2 8.6 2000 17.5 13.8 18.2 19.3 74.2 15.3 2003 8.8 9.0 5.5 6.3 12.7 7.5 2002 8.6 8.7 6.6 4.9 12.9 2.7 2001 8.9 8.9 7.8 8.8 11.3 8.3 2000 7.6 7.6 8.9 5.2 6.0 3.9 2003 1.5 1.3 1.5 2.7 2.5 .5 2002 1.2 1.3 1.2 0.5 1.3 1.9 2001 1.6 1.8 1.3 1.5 1.2 4.0 2000 1.7 1.6 1.2 3.3 3.8 1.1 2003 14.8 12.7 15.7 23.2 15.6 1.8 2002 17.3 16.2 17.0 19.1 14.6 5.8 2001 15.5 13.9 15.8 25.3 11.8 9.0 2000 15.3 13.9 14.9 25.7 12.2 11.1 6-3. Fall-related injuries 6-4. Drowning mortality 6-5. Injury by firearms 137 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 6. MORTALITY FROM INJURIES (continued) (Number of deaths per 100,000 population age-adjusted to 2000 standard) Indicator Figure no. ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islande r 6-6. Drug-induced deaths 2003 12.0 12.8 10.5 23.5 8.5 .0 2002 12.2 13.1 9.8 19.8 13.1 0.0 2001 11.3 12.4 9.4 13.8 9.3 .9 2000 6.8 7.3 5.0 9.6 6.7 .0 6-7. Alcohol-induced deaths 2003 10.1 8.3 10.2 6.8 49.3 .0 2002 9.3 8.2 9.9 10.3 39.4 0.9 2001 8.4 6.8 9.1 7.9 41.5 1.1 8.7 6.8 8.6 6.1 56.1 1.3 2003 14.6 16.4 8.2 11.3 15.2 6.0 2002 15.9 18.3 8.3 6.2 17.9 4.1 2001 11.5 12.8 5.9 9.2 15.4 9.4 2000 14.6 16.7 7.2 6.5 16.2 5.7 2003 8.3 3.7 14.7 24.9 18.8 5.4 2002 8.6 4.4 15.1 21.3 20.3 3.3 2001 8.7 4.3 15.5 22.2 17.2 4.9 2000 7.6 3.9 13.0 22.7 14.9 7.6 2000 6-8. Intentional self-harm (Suicide) 6-9. Assault (Homicide) 7. AGE-SPECIFIC MORTALITY (Number of deaths per 100,000 persons in specified group) Asian or Pacific Islander Black or African American American Indian or Alaska Native 22.1 42.5 45.3 9.2 18.3 25.0 32.6 55.8 15.5 23.9 26.3 43.2 71.0 31.9 20.8 27.4 37.2 48.2 22.0 36.2 ALL ARIZONA RESIDENTS White nonHispanic 2003 24.3 21.8 2002 23.7 2001 28.8 Indicators Figure no. Hispanic or Latino 7-1. Mortality of children 1-14 years old 2000 25.3 7-2. Mortality of adolescents and young adults 15-19 years old 138 2003 75.4 51.6 87.5 89.5 196.2 2002 83.2 64.8 93.8 107.5 195.8 24.3 2001 86.6 70.2 82.7 73.2 265.2 61.9 2000 78.9 68.6 74.0 149.5 171.2 0.0 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 7. AGE-SPECIFIC MORTALITY (continued) (Number of deaths per 100,000 persons in specified group) Asian or Pacific Islander Black or African American American Indian or Alaska Native 139.1 220.4 345.8 56.8 143.4 148.5 212.3 350.3 48.6 145.2 147.5 250.1 373.2 60.6 156.5 173.1 136.3 212.3 403.1 93.3 2003 653.7 651.1 593.5 909.7 914.9 292.2 2002 654.8 656.7 588.5 878.8 1025.6 258.9 2001 632.1 631.9 545.9 996.1 981.4 312.2 2000 633.9 636.8 540.5 929.9 994.2 276.1 ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native ALL ARIZONA RESIDENTS White nonHispanic 2003 151.1 139.6 2002 154.7 2001 158.2 2000 Indicators Figure no. Hispanic or Latino 7-3. Mortality among adults 20-44 years old 7-4. Mortality among adults 45-65 years old 8. PREMATURE MORTALITY Indicators Figure no. 8-1. Average age at death from all causes 2003 Asian or Pacific Islander 72.2 74.4 60.4 62.4 54.7 64.3 2002 71.5 74.3 58.6 60.9 55.8 67.4 2001 71.2 74.2 58.4 59.1 54.3 63.9 71.6 8-2. Average age at death from all causes among males 2003 69.6 2002 68.1 73.9 59.2 60.8 55.4 62.3 71.6 57.5 60.0 50.3 63.5 71.3 54.9 56.9 52.5 64.2 67.9 71.2 54.8 55.6 50.1 61.6 68.7 8-3. Average age at death from all causes among females 2003 70.9 55.8 56.8 51.6 61.6 2000 2001 2000 2002 75.3 77.5 63.9 66.4 60.4 71.1 2001 75.0 77.3 63.4 63.2 60.0 66.0 77.0 63.7 65.8 60.4 63.0 46.1 70.0 70.6 78.4 65.7 45.6 70.3 71.7 78.3 59.8 2000 74.9 8-4. Percent of total deaths before expected years of life reached 2003 50.8 2002 50.2 2001 51.0 46.2 71.2 73.0 79.1 69.9 2000 51.6 47.3 70.5 69.3 78.7 69.6 139 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 9. REPORTABLE DISEASES (Number of cases per 100,000 persons in specified group) Asian or Pacific Islander Hispanic or Latino Black or African American American Indian or Alaska Native 4.2 9.7 18.2 20.1 0.9 2.5 12.6 40.2 16.1 0.9 8.4 2.6 16.6 52.4 15.1 0.0 8.5 3.2 15.4 60.4 12.1 3.0 2003 63.5 33.4 71.4 359.7 103.1 15.3 2002 68.9 30.5 98.6 432.0 107.7 11.3 2001 73.9 32.4 99.7 558.5 115.5 10.8 2000 80.0 29.5 111.8 630.8 105.1 22.2 2003 227.1 100.7 329.1 537.6 623.9 86.4 2002 272.2 113.2 453.3 700.0 716.9 104.7 2001 270.4 116.5 466.4 756.7 738.9 113.7 2000 243.9 96.7 350.3 686.2 844.1 89.9 16.2 11.8 14.3 23.1 30.4 7.6 ALL ARIZONA RESIDENTS White nonHispanic 2003 7.4 2002 7.3 2001 2000 Indicators Figure no. 9-1. Incidence of early syphilis 9-2. Incidence of gonorrhea 9-3. Incidence of chlamydia 9-4. Incidence of genital herpes 2003 2002 21.0 16.2 19.7 45.0 35.9 7.67 2001 22.1 17.7 23.8 43.3 27.9 13.7 2000 21.8 15.8 17.1 47.8 33.6 7.1 2003 11.3 11.4 7.4 42.5 11.3 4.2 2002 8.1 6.7 8.5 33.0 10.9 2.8 2001 7.0 6.4 6.3 29.4 6.8 3.9 2000 6.9 6.4 7.3 23.3 9.0 5.0 9-5. Incidence of HIV/HIV/AIDS 140 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 DATA SOURCES AND DEFINITIONS 141 142 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 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 stillbirths) 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 the 2003 population denominators, the 2000 percentages of population breakdowns (or census shares) by race/ethnicity, age group and gender were applied to total state population estimates released by the Arizona Department of Economic Security on 12/11/03 (http://www.workforce.az.gov/admin/uploadedPublications/1003_EEC-03.pdf). The total for all groups includes racial/ethnic groups other than White non-Hispanic, Hispanic, Black, American Indian and Asian Almost all figures are based on rates and ratios published in the 2003 Arizona Health Status and Vital Statistics report and available online at http://www.azdhs.gov/plan/report/ahs/index.htm. Figure number 1. TEEN PREGNANCIES Indicator DEFINITIONS Definitions 1-1 Pregnancies among females 19 and younger The sum of live births, fetal deaths, and abortions per 1,000 females aged 19 or younger. 1-2 Pregnancies among females 14 and younger The sum of live births, fetal deaths, and abortions per 1,000 females aged 14 or younger. 1-3 Pregnancies among females 15-17 years old The sum of live births, fetal deaths, and abortions per 1,000 females aged 15-17 years. 1-4 Pregnancies among females 18-19 years old The sum of live births, fetal deaths, and abortions per 1,000 females aged 18-19 years. Figure number 2. MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS Indicator Definitions 2-1 Unmarried mothers The number of births to unmarried mothers per 100 births. 2-2 Tobacco use during pregnancy The number of mothers giving birth who self-reported tobacco use during pregnancy per 100 births. 2-3 Alcohol use during pregnancy The number of mothers giving birth who self-reported alcohol use during pregnancy per 100 births. 2-4 Chronic hypertension Blood pressure persistently greater than 140/90, diagnosed prior to onset of pregnancy or before the 20th week of gestation (the number of cases per 100 births). 143 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 2-5 Dysfunctional labor Failure to progress in a normal pattern of labor (the number of cases per 100 births). 2-6 Anemia during pregnancy Hemoglobin level of less than 10.0 g/dL during pregnancy, or hematocrit of less than 30 percent during pregnancy (the number of cases per 100 births). 2-7 Diabetes during pregnancy 2-8 Pregnancy-associated hypertension 2-9 Genital herpes during pregnancy Infection of the skin of the genital area by herpes simplex virus (the number of cases per 100 births). 2-10 Weight gain of less than 21 pounds The number of women giving birth who gained less than 21 pounds per 100 births. Metabolic disorder characterized by excessive discharge of urine and persistent thirst; includes juvenile onset, adult onset and gestational diabetes during pregnancy (the number of cases per 100 births). 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 (the number of cases per 100 births). Figure number 3. UTILIZATION OF PRENATAL CARE SERVICES Indicator Definition 3-1 No care in the 1st trimester The number of mothers giving birth who received no prenatal care in the 1st trimester of pregnancy per 100 births. 3-2 Fewer than five prenatal visits The number of mothers giving birth who had fewer than five prenatal visits during pregnancy per 100 births. 3-3 No prenatal care The number of mothers giving birth who received no prenatal care during pregnancy per 100 births. Figure number 4. NEWBORN'S HEALTH Indicator Definition 4-1 Incidence of hyaline membrane disease The number of cases of hyaline membrane disease per 100 births. Hyaline membrane disease = a disorder primarily of prematurity, manifested clinically by respiratory distress and pathologically by pulmonary hyaline membranes and incomplete expansion of the lungs at birth. 4-2 Incidence of newborn intensive care The number of babies admitted to Newborn Intensive Care units per 100 births. 4-3 Born too early (preterm or < 37 weeks) 4-4 4-5 Born too small: lowbirthweight (<2,500 grams) Born too small: very lowbirthweight (<1,500 grams) The number of births before 37 weeks of gestation per 100 births. Preterm = any neonate whose birth occurs through the end of the last day of the 37th week (259th day), following onset of the last menstrual period. The number of newborns weighing less than 2,500 grams per 100 births. Lowbirthweight = any neonate weighing less than 2,500 grams at birth (less than 5 pounds 8 ounces). The number of newborns weighing less than 1,500 grams per 100 births. Very lowbirthweight = any neonate whose weight at birth is 1,500 grams or less (less than 3 pounds 5 ounces). 4-6 Incidence of congenital anomalies (birth defects) The numbers of babies born with birth defects per 100 births. 4-7 Infant mortality The number of infant deaths per 1,000 live births. 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). 4-8 Sudden Infant Death Syndrome (SIDS) The number of infant deaths from Sudden Infant Death Syndrome (ICD-10 code R95) per 1,000 live births. 144 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 4-9 Mortality of infants from low birthweight/short gestation The number of infant deaths from low- birthweight/short gestation (ICD-10 code P07) per 1,000 live births. 4-10 Neonatal mortality The number of neonatal deaths per 1,000 live births. 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). 4-11 Postneonatal mortality The number of postneonatal deaths per 1,000 live births. Postneonatal death = any death of a liveborn infant at least 28 days of age but less than one year of age. Figure number 5. MORTALITY FROM NATURAL CAUSES (chronic or infectious diseases) Indicator Definition 5-1 Cardiovascular disease The number of deaths from cardiovascular diseases (ICD-10 codes I00-I78) per 100,000 age-adjusted population. 5-2 Diseases of the heart The number of deaths from disease of the heart (ICD-10 codes I00–I09, I11, I13, I20–I51) per 100,000 age-adjusted population. 5-3 Coronary heart disease The number of deaths from coronary heart disease (ICD-10 codes I200-I259 and I110 – I119) per 100,000 age-adjusted population. 5-4 Cerebrovascular disease The number of deaths from cerebrovascular disease (ICD-10 codes I60–I69) per 100,000 age-adjusted population. 5-5 Chronic lower respiratory diseases The number of deaths from chronic lower respiratory diseases (ICD-10 codes J40– J47) per 100,000 age-adjusted population. 5-6 Malignant neoplasm (cancer) The number of deaths from cancer (ICD-10 codes C00–C97) per 100,000 ageadjusted population. 5-7 Lung cancer The number of deaths from lung cancer (ICD-10 codes C33–C34) per 100,000 ageadjusted population. 5-8 Breast cancer The number of deaths from breast cancer (ICD-10 code C50) per 100,00 ageadjusted female population. 5-9 Cervical cancer The number of deaths from cervical cancer (ICD-10 code C53) per 100,000 ageadjusted female population. 5-10 Colorectal cancer The number of deaths from colorectal cancer (ICD-10 codes C18–C21) per 100,000 age-adjusted population. 5-11 Prostate cancer The number of deaths from prostate cancer (ICD-10 code C61) per 100,000 ageadjusted male population. 5-12 Influenza and pneumonia The number of deaths from influenza and pneumonia (ICD-10 codes J10–J18) per 100,000 age-adjusted population. 5-13 Diabetes The number of deaths from diabetes (ICD-10 codes E10–E14) per 100,000 ageadjusted population. 5-14 Chronic liver disease and cirrhosis The number of deaths from chronic liver disease and cirrhosis (ICD-10 codes K70, K73–K74) per 100,000 age-adjusted population. 5-15 HIV disease The number of deaths from HIV disease (ICD-10 codes B20-B24) per 100,000 ageadjusted population. 5-16 Septicemia The number of deaths from septicemia (ICD-10 codes A40-A41) per 100,000 ageadjusted population. 5-17 Alzheimer's disease The number of deaths from Alzheimer’s disease (ICD-10 code G30) per 100,000 age-adjusted population. 5-18 Nephritis, nephrotic syndrome and nephrosis (kidney disease) The number of deaths from nephritis, nephritic syndrome and nephrosis (ICD-10 codes N00–N07, N17–N19,N25–N27) per 100,000 age-adjusted population. 5-19 Essential (primary) hypertension The number of deaths from essential (primary) hypertension (ICD-10 codes I10, I12) per 100,000 age-adjusted population. 5-20 Total mortality from all causes Total number of deaths from all causes per 100,000 age-adjusted population. 145 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Figure number 6. MORTALITY FROM INJURIES Indicator Definition 6-1 Unintentional injuries The number of deaths from unintentional injuries in accidents (ICD-10 codes V01– X59, Y85–Y86) per 100,000 age-adjusted population. 6-2 Motor vehicle-related injuries The number of deaths from motor vehicle-related injuries (ICD-10 codes V02–V04, V09.0, V09.2, V12–V14, V19.0–V19.2, V19.4–V19.6,V20–V79, V80.3–V80.5, V81.0– V81.1, V82.0–V82.1, V83–V86, V87.0–V87.8, V88.0–V88.8, V89.0, V89.2) per 100,000 age-adjusted population. 6-3 Fall-related injuries The number of deaths from fall-related injuries (ICD-10 codes W00-W19) per 100,000 age-adjusted population. 6-4 Drowning mortality The number of deaths due to accidental drowning and submersion (ICD-10 codes W65-W74) per 100,000 age-adjusted population. The number of deaths by firearms (ICD-10 codes W32–W34, X72–X74, X93–X95, Y22–Y24, Y35.0) per 100,000 age-adjusted population. Causes of death attributable to firearm mortality include accidental discharge of firearms, intentional self-harm (suicide) by discharge of firearms, assault (homicide) by discharge of firearms, discharge of firearms, undetermined intent; and legal intervention involving firearm discharge. Deaths from injury by firearms exclude deaths due to explosives and other causes indirectly related to firearms. The number of drug-induced deaths (ICD-10 codes F11.0–F11.5, F11.7–F11.9, F12.0–F12.5, F12.7–F12.9, F13.0–F13.5, F13.7–F13.9, F14.0–F14.5, F14.7–F14.9, F15.0–F15.5, F15.7–F15.9, F16.0–F16.5, F16.7–F16.9, F17.0, F17.3–F17.5, F17.7– F17.9, F18.0–F18.5, F18.7–F18.9, F19.0–F19.5, F19.7–F19.9, X40–X44, X60–X64, X85, Y10–Y14) per 100,000 age-adjusted population. Causes of death attributable to drug-induced mortality include selected codes from the ICD-10 title Mental and behavioral disorders due to psychoactive substance use, accidental poisoning by and exposure to drugs, medicaments and biological substances; intentional self-poisoning (suicide) by and exposure to drugs; assault (homicide) by drugs, medicaments and biological substances; and poisoning by and exposure to drugs, medicaments and biological substances, undetermined intent. Drug-induced causes exclude accidents, homicides, and other causes indirectly related to drug use. Also excluded are newborn deaths associated with mother’s drug use. The number of alcohol-induced deaths (ICD-10 codes F10, G31.2, G62.1, I42.6, K29.2, K70, R78.0, X45, X65, Y15) per 100,000 age-adjusted population. Causes of death attributable to alcohol-induced mortality include mental and behavioral disorders due to alcohol use, degeneration of nervous system due to alcohol, alcoholic polyneuropathy, alcoholic cardiomyopathy, alcoholic gastritis, alcoholic liver disease, finding of alcohol in blood, accidental poisoning by and exposure to alcohol, intentional self-poisoning by and exposure to alcohol; and poisoning by and exposure to alcohol, undetermined intent. Alcohol-induced causes exclude accidents, homicides, and other causes indirectly related to alcohol use. 6-5 Injury by firearms 6-6 Drug-induced deaths 6-7 Alcohol-induced deaths 6-8 Intentional self-harm (suicide) The number of deaths due to intentional self-harm (ICD-10 codes X60-X84, Y87.0) per 100,000 age-adjusted population. 6-9 Assault (homicide) The number of homicides (ICD-10 codes X85-X09, Y87.1) per 100,000 age-adjusted population. 146 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 Figure number 7. AGE-SPECIFIC MORTALITY Indicators Definition 7-1 Mortality of children 1-14 years old The number of deaths per 100,000 children 1-14 years old in 2003 7-2 Mortality of adolescents 15-19 years old The number of deaths per 100,000 adolescents 15-19 years old in 2003 7-3 Mortality of young adults 20-44 years old The number of deaths per 100,000 young adults 20-44 years old in 2003 7-4 Mortality of middle-aged adults 45-64 years old The number of deaths per 100,000 middle-aged adults 45-64 years old in 2003 Figure number 8. PREMATURE MORTALITY Indicators 8-1 Average age at death from all causes The average age of Arizonans who died in 2003. 8-2 Average age at death from all causes among males The average age of Arizona males who died in 2003. 8-3 Average age at death from all causes among females The average age of Arizona females who died in 2003. 8-4 Percent of total deaths before expected years of life reached The number of deaths before reaching 76.9 years (the life expectancy of all U.S. residents in 2003) per 100 deaths. Figure number 9. REPORTABLE DISEASES Indicators 9-1 Incidence of early syphilis Number of reported cases of early syphilis per 100,000 population. 9-2 Incidence of gonorrhea Number of reported cases of gonorrhea per 100,000 population. 9-3 Incidence of chlamydia Number of reported cases of chlamydia per 100,000 population. 9-4 Incidence of genital herpes Number of reported cases of genital herpes per 100,000 population. 9-5 Incidence of HIV/AIDS Number of reported new cases of HIV/HIV/AIDS per 100,000 population. 147 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 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 (or in the same population over time) by placing them all in a population with a standard age distribution. All age-adjusted mortality rates in this report were computed by the direct method, that is by weighting the age-specific rates for a given year by the age distribution of a standard population. The weighted age-specific rates are then added to produce the summary rate for all ages combined. Beginning with the 2000 data year, a new population standard for the age adjustment of mortality rates has replaced the standard based on the 1940 population and used since 1943. The new standard uses the age composition of the 2000 U.S. projected population. The standard is expressed in terms of a “standard million”: the relative distribution of the 2000 population of the United States totaling 1 million in 10-year age groups: Age group 2003 population 2003 deaths A B C <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ All ages 84959 334668 842137 801422 815839 843932 688912 485263 399131 258415 75192 5629870 586 135 151 758 881 1775 3174 4501 7396 12465 10954 42830 Age-specific rates in 2003 D (C/B)*100000 689.7 40.3 17.9 94.6 108.0 210.3 460.7 927.5 1853.0 4823.6 14568.0 760.8 2000 standard E .013818 .055317 .145565 .138646 .135573 .162613 .134834 .087247 .066037 .044842 .015508 TOTAL Ageadjusted rate for 2003 F D*E 9.5 2.2 2.6 13.1 14.6 34.2 62.1 80.9 122.4 216.3 225.9 784.0 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 causes of death - The cause of death used in this report is the underlying cause classified according to the International Classification of Diseases (ICD). Beginning with the 2000 data year in Arizona (1999 nationally), a new revision of the International Classification of Diseases was implemented. The Tenth Revision (ICD-10) has replaced the Ninth Revision (ICD-9), which was in effect since 1979. The measures of comparison between ICD-9 and ICD-10 – the “comparability ratios” – for the causes of death shown in this report are available on the Arizona Vital Statistics web site at http://www.azdhs.gov/plan/report/ahs/ahs2000/pdf/452_455codn.pdf 148 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 POPULATION DENOMINATORS 149 150 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 POPULATION BY RACE/ETHNIC GROUP: ARIZONA RESIDENTS, 1990, 2000 AND 2003 (Numbers rounded to nearest thousand) Ethnic group American Indian or Alaska Native 1990 2000 2003 % of total population in 2003 203,527 255,879 292,753 5.2 55,026 98,969 118,227 2.1 Black or African American 110,524 158,873 185,786 3.3 Hispanic or Latino 688,338 1,295,617 1,424,357 25.3 White Non-Hispanic 2,607,633 3,274,258 3,608,747 64.1 TOTAL 3,665,228 5,130,632 5,629,870 100.0 Asian or Pacific Islander Note: Data for 1990 and 2000 are the census counts. In order to obtain the 2003 population denominators, the 2000 percentages of population breakdowns (or census shares) by race/ethnicity, age group and gender were applied to total state population estimates released by the Department of Economic Security on 12/11/03. 151 DIFFERENCES IN THE HEALTH STATUS AMONG ETHNIC GROUPS, ARIZONA, 2003 ESTIMATED POPULATION BY AGE GROUP, GENDER AND RACE/ETHNICITY, ARIZONA, 2003 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Total 5,768 23,015 67,402 53,685 42,414 40,975 27,569 16,044 9,767 4,527 1,587 292,753 Male 2,869 11,627 34,024 27,061 20,967 19,547 12,908 7,287 4,285 1,871 588 143,034 Female 2,899 11,388 33,378 26,624 21,447 21,428 14,661 8,757 5,482 2,656 999 149,719 1,492 6,568 15,162 18,474 25,172 20,981 14,732 8,196 5,119 1,858 473 118,227 Male 742 3,243 7,751 9,700 12,382 9,566 5,985 3,414 2,029 761 205 55,778 Female 750 3,325 7,411 8,774 12,790 11,415 8,747 4,782 3,090 1,097 268 62,449 3,135 12,681 34,405 30,598 30,654 31,511 20,316 11,122 6,890 3,320 1,154 185,786 Male 1,644 6,475 17,578 16,552 16,944 17,266 10,912 5,546 3,242 1,337 368 97,864 Female 1,491 6,206 16,827 14,046 13,710 14,245 9,404 5,576 3,648 1,983 786 87,922 35,437 133,070 296,008 274,744 254,600 191,725 115,998 61,762 38,553 17,764 Male 18,154 68,024 151,417 147,971 136,584 99,789 58,394 29,453 17,492 7,438 1,604 736,320 Female 17,283 65,046 144,591 126,773 118,016 91,936 57,604 32,309 21,061 10,326 3,092 688,037 American Indian or Alaska Native Asian Black or African American Hispanic or Latino White Non-Hispanic 4,696 1,424,357 39,127 159,334 429,160 423,921 462,999 558,740 510,297 388,139 338,802 230,946 67,282 3,608,747 Male 20,037 81,866 220,726 217,482 238,421 280,573 249,496 185,105 161,292 100,028 22,491 1,777,517 Female 19,090 77,468 208,434 206,439 224,578 278,167 260,801 203,034 177,510 130,918 44,791 1,831,230 Total 84,959 334,668 842,137 801,422 815,839 843,932 688,912 485,263 399,131 258,415 75,192 5,629,870 Male 43,446 171,235 431,496 418,766 425,298 426,741 337,695 230,805 188,340 111,435 25,256 2,810,513 Female 41,513 163,433 410,641 382,656 390,541 417,191 351,217 254,458 210,791 146,980 49,936 2,819,357 NOTE: In order to obtain the 2003 population denominators, the 2000 percentages of population breakdowns (or census shares) by race/ethnicity, age group and gender were applied to total state population estimates released by the Department of Economic Security on 12/11/03. 152 Our Web site at http://www.azdhs.gov/plan provides instantaneous access to a wide range of statistical information about health status of Arizonans. The Arizona Health Status and Vital Statistics annual report examines trends in natality, mortality and morbidity towards established health objectives. Additional reports and studies include Differences in Health Status by Ethnic Group, Advance Vital Statistics by County of Residence, Mortality from Alzheimer's Disease, Injury Mortality among Arizona Residents (accidents, suicides, homicides, legal intervention, firearm-related fatalities, drug-related deaths, drowning deaths), Community Vital Statistics, Teenage Pregnancy, Selected Characteristics of Newborns and Mothers Giving Birth by Census Tract in Maricopa County, Pima County and South Phoenix Area, Health Status Profile of American Indians in Arizona and Deaths from Exposure to Excessive Natural Heat Occurring in Arizona. Health Status and Vital Statistics Section Bureau of Public Health Statistics Public Health Services ARIZONA DEPARTMENT OF HEALTH SERVICES