DIFFERENCES IN THE HEALTH STATUS AMONG RACIAL/ETHNIC GROUPS ARIZONA, 2013 Public Health Services Bureau of Public Health Statistics Population Health and Vital Statistics Section ~ Health and Wellness for all Arizonans ~ Douglas A. Ducey, Governor State of Arizona Cory Nelson, Interim Director Arizona Department of Health Services POPULATION HEALTH 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 Racial/Ethnic Groups, Arizona, 2013 BY NICHOLAS J. BISHOP, PH.D., ARIZONA VITAL STATISTICIAN SANHITA GUPTA, VITAL STATISTICS HEALTH MANAGEMENT ANALYST CLARE TORRES, SENIOR HEALTH DATA ANALYST March 2015 _____________________________________________________________________________________________ Acknowledgment Grateful acknowledgement is made to S. Robert Bailey for reviewing the typescript. _________________________________________________________________ Differences in Health Status among Racial/Ethnic Groups, Arizona, 2013 Table of Contents Purpose ................................................................................................................................ 1 Demographic Profile of Arizona’s Racial/Ethnic Diversity ............................................................... 1 Methods ................................................................................................................................ 4 Key Findings .......................................................................................................................... 5 Comparison of Scores by Race/Ethnicity in 1997, 1999, 2001, 2003, 2005, 2007, 2009, 2011, and 2013 ................................................................................................................. 5 Number of Times Each Group Ranked Better Than Average, Average, And Worse Than Average on 69 Indicators, Arizona, 2013................................................. 5 Average Scores in 2013 ....................................................................................................... 6 Comparative Age-Adjusted Mortality Rates for the Five Leading Causes of Death By Race/Ethnicity in 2013 ........................................................................................... 8 Risk Profiles ........................................................................................................................... 8 Risk Profile of Asian or Pacific Islander ................................................................................ 9 Risk Profile of White non-Hispanic .................................................................................... 10 Risk Profile of Hispanic or Latino ...................................................................................... 11 Risk Profile of American Indian or Alaska Native ................................................................. 12 Risk Profile of Black or African American ............................................................................ 13 COMPARATIVE MEASURES OF HEALTH STATUS BY RACE/ETHNICITY IN 2013 .................... 15 1. 2. 3. 4. 5. 6. 7. 8. 9. Teen Pregnancies.................................................................................................... 17 Maternal Lifestyle and Health Characteristics .............................................................. 23 Utilization of Prenatal Care Services .......................................................................... 35 Newborn's Health ................................................................................................... 41 Mortality from Natural Causes................................................................................... 55 Mortality from Injuries ............................................................................................. 77 Age-Specific Mortality .............................................................................................. 89 Patterns of Premature Mortality ................................................................................ 95 The Incidence of Reportable Diseases ...................................................................... 101 COMPARATIVE RATES AND RATIOS FOR 2003 – 2013 ...................................................... 109 SCORES IN 2013 .............................................................................................................. 127 RANK ORDER IN 2013...................................................................................................... 133 DATA SOURCES AND DEFINITIONS .................................................................................. 139 Sources of Data ........................................................................................................... 141 Definitions .................................................................................................................. 141 Terms Related to Mortality ............................................................................................ 146 POPULATION DENOMINATORS ........................................................................................ 147 PURPOSE Differences in Health Status among Racial/Ethnic Groups, Arizona, 2013 is drawn upon information reported to the Department (see Source of Data on page 139). The report provides population-level data concerning differences in the health of five racial/ethnic groups residing in Arizona: White non-Hispanics, Hispanics or Latinos, Blacks or AfricanAmericans, American Indians or Alaska Natives, and Asians or Pacific Islanders including Hawaiians. The report compares the relative standing of racial/ethnic groups on 69 indicators (prior to the 2013 report there were 70 indicators) or measures of health status. The indicators are presented in a series of simple, self-explanatory bar charts and are 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 AND 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 racial/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 2013 while the tabulated values also are available in the Rates and Ratios in 2013 and Comparative Rates and Ratios for 2003-2013 sections of the report. The report also provides comparative risk profiles, as well as scores and rankings of racial/ethnic groups on each of the 69 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 racial/ethnic groups in our State and to stimulate viable initiatives to improve the health of all Arizonans. DEMOGRAPHIC PROFILE OF ARIZONA'S RACIAL/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 6,581,054 Arizona residents in 2013, approximately 3,842,190 (58.4 percent) were White non-Hispanic, 1,961,135 (29.8 percent) were Hispanic or Latino, and 309,035 (4.7 percent) were American Indian or Alaska Natives. Blacks or African Americans accounted for 269,384 or (4.1 percent) of the State’s population. Asians or Pacific Islanders, the smallest racial/ethnic group, represented 3.0 percent of the total population (199,310 people). It is important to note that the population denominators for 2013 are not exact enumerations of the State’s residents in different racial/ethnic, gender, or age group categories. These denominators are extrapolations, which use past experience, and are not adjusted for the impact of economic and legal factors, which were previously absent. The most severe economic recession in 80 years obviously is one of these factors. The high rate of foreclosures, many built but vacant houses, high unemployment, the collapse of the home construction business, etc. have impacted not only vital events (such as the number of resident births) but also in-and-out migration. Implementation of the employer-sanction law on January 1st, 2008 (a penalty on employers hiring illegal immigrants), and a widespread practice of e-verify (checking the legal-residence status of those seeking employment) affected Hispanics or Latinos, the second largest group of Arizona’s residents. These recent events have shaped the racial/ethnic distribution of Arizona’s population, meaning projections used to estimate the State’s population that were not able to take these factors into account contain some bias, generally reflecting larger populations, especially of Hispanics or Latinos, than those actually residing in Arizona. Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 1 Racial/ethnic minority groups have greater percentages of people younger than 25 years (45.7 percent) when compared with White non-Hispanics (27.3 percent). In contrast, people aged 65 years and older accounted for 21.0 percent of White non-Hispanics, but only 6.3 percent of all racial/ethnic minority groups combined. Among Arizonans less than 25 years old in 2013, more than half (54.4 percent) were a race/ethnicity other than White non-Hispanic. Among Arizona’s adults 65 years old or older, eight out of ten (82.3 percent) were White non-Hispanic (Table A). Table A. POPULATION BY AGE GROUP AND RACE/ETHNICITY, ARIZONA, 2013 Other than White non-Hispanica POPULATION BY AGE GROUP IN 2013 White nonHispanic Total < 25 years 2,301,786 1,048,985 1,252,801 940,213 110,101 138,755 63,732 Percent 35.0% 27.3% 45.7% 47.9% 40.9% 44.9% 32.0% 3,298,140 1,985,982 1,312,158 907,876 139,660 147,072 117,550 50.1% 51.7% 47.9% 46.3% 51.8% 47.6% 59.0% 981,128 807,224 173,905 113,046 19,623 23,208 18,028 14.9% 21.0% 6.3% 5.8% 7.3% 7.5% 9.0% 6,581,054 3,842,190 2,738,864 1,961,135 269,384 309,035 199,310 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 25-64 years Percent 65+ years Percent b Total, all ages Percent Hispanic or Latino Black or African American American Indian or Alaska Native All groups Asian or Pacific Islander Mortality patterns by age group in Arizona show similar contrasts between race/ethnicity groups. In 2013, the elderly (65 years and older) comprised 76.9 percent of the total mortality among White non-Hispanics, compared to 41.7 percent among American Indians, 53.0 percent among Blacks, 56.2 percent among Hispanics, and 71.9 percent among Asians. In 2013, only 1.4 percent of White non-Hispanics who died were less than 25 years old. In comparison, 7.8 percent of individuals who were of a racial/ethnic group other than White non-Hispanic died before reaching 25 years of age. Table B. MORTALITY BY AGE GROUP AND RACE/ETHNICITY, ARIZONA, 2013 Other than White non-Hispanica MORTALITY BY AGE GROUP IN 2013 < 25 years All groups 1,365 Percent 25-64 years Percent 65+ years Percent b White nonHispanic Hispanic or Latino Total 558 807 Black or African American American Indian or Alaska Native Asian or Pacific Islander 504 117 165 21 2.7% 1.4% 7.8% 8.0% 7.3% 8.4% 3.9% 12,564 8,574 3,990 2,255 631 974 130 25.2% 21.7% 38.4% 35.8% 39.6% 49.8% 24.2% 36,000 30,411 5,589 3,541 845 816 387 72.1% 76.9% 53.8% 56.2% 53.0% 41.7% 71.9% Total, all ages 49,929 39,543 10,386 6,300 1,593 1,955 538 Percent 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% a Note: Includes groups other than Hispanic, Black, American Indian, and Asian; b Includes unknown age; Source: The 2013 death certificate file for Arizona residents. In 2013, the absolute majority of deaths of American Indians (58.2 percent) and Black (46.9 percent) residents of Arizona occurred before the age of 65 years, compared to 23.1 percent among White non-Hispanics. Graphic representations of the contrasting patterns in age-specific mortality and in the age composition of the population are provided below: 2 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Percent distribution of population by age group and race/ethnicity, Arizona, 2013 Percent distribution of deaths by age group and race/ethnicity, Arizona, 2013 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 3 METHODS The 69 indicators presented in this report are individual measures of various dimensions or facets of health status. By calculating overall scores and rankings it is possible to provide a summary measure representing the relative standing of each racial/ethnic group across a broad range of health status issues. Scores indicate the percentage points a racial/ethnic group falls 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 worse than average standing on an indicator.* It is important to note that the unit of analysis in this report is the racial/ethnic group. The aggregate measures of health status (such as teen pregnancy rate, infant mortality rate, mortality rate for drug-induced deaths, the incidence of lowbirthweight, etc.) apply to groups and not individuals. In addition, this is a study of the relative, not absolute, healthiness of racial/ethnic groups. The highest ranking group is not problem-free, it is comparatively better. 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 2003-2013 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 editions of this report prior to 2001. 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 analysis 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. Beginning with the 2005 edition of the report, the median age at death replaced the arithmetic mean age at death as one of the measures of premature mortality (indicators 8-1, 8-2, and 8-3). The median age is higher than the arithmetic mean age in negatively skewed distributions.** Prior editions of this report were published biennially from 1995 to 2011. This report uses the same methodology as the 1997 through 2011 editions, so that average scores and average ranks (but not mortality rates published before 2000) are directly comparable. ________________________________ *For consistency, the signs + and - for scores indicating the median age at death as higher or lower than the statewide average were reversed (indicators 8-1, 8-2, 8-3). Otherwise, a higher-than-average median age at death would indicate worse than average standing on this indicator. ** A comparison of the median with the mean age at death in Arizona by race/ethnicity, gender, and year for 2003-2013 is available in Table 2D-1 of “Arizona Health Status and Vital Statistics 2013” report at http://www.azdhs.gov/plan/report/ahs/ahs2013/2d1.pdf 4 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 KEY FINDINGS The overall inequity between the groups, as measured by the range of score values from the lowest (the most favorable standing among the groups, for 2013 Asian or Pacific Islander at -36.9), to the highest (the least favorable standing, for 2013 Blacks at 53.2), increased from 81.7 in 2011 to 90.1 points in 2013 (Figure A). From 2011 to 2013, Asians and Hispanics continued to experience favorable change among the racial/ethnic groups, meaning that the average scores decreased. American Indians and Blacks show an increase in their average scores. (Figure A). The shift in average score for White non-Hispanics was trivial. Figure A Comparison of Average Scores by Race/Ethnicity in 1997, 1999, 2001, 2003, 2005, 2007, 2009, 2011, and 2013 In 2013, as in prior years, Arizona's Asian residents ranked highest among racial/ethnic groups in 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 69 Indicators, Arizona 2013 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 5 Figure C Average Scores in 2013 (A score is the percent above or below the average for all Arizona residents. A negative score reflects better than average standing on an indicator.) ASIANS or PACIFIC ISLANDERS Average rank: 1.7* Total score: -2,542.8 Average score: -36.9** In 2013, Asian residents of Arizona ranked best or second best among all racial/ethnic groups on 57 of 69 indicators, including low incidence of drug or alcohol induced deaths, low postneonatal mortality, and low mortality from reportable diseases, chronic diseases, and injuries. The total mortality rate of 413.4 deaths per 100,000 Asian or Pacific Islander residents of the State was the lowest rate among all racial/ethnic groups. Asians’ median age at death was the second highest among the racial/ethnic groups in Arizona in 2013. The 2013 average score of -36.9 for Asian residents was slightly better than their average score of -33.1 in 2011 and indicates Asians’ health status remained stable in relation to the health of other racial/ethnic groups. __________ *The average rank based on all 69 measurements (the sum of the ranks divided by 69 measurements. Ranks range between 1 = the highest rank of health indicators and 5 = the lowest rank of health indicators). **The average score based on all 69 measurements (the sum of all scores divided by 69 measurements). See section SCORES IN 2013. 6 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 WHITE NON-HISPANICS Average rank: 2.6 Total score: -629.3 Average score: -10.0 White non-Hispanics ranked second best in relative healthiness among racial/ethnic groups in Arizona. They ranked 1st or 2nd on 38 of 69 measures of health, including low teen pregnancy rates, high utilization of prenatal care, and low premature mortality. White non-Hispanics continued to rank worse than all other racial/ethnic groups in mortality due to chronic lower respiratory diseases, drug-induced deaths, and suicide. The overall score of -10.0 in 2013, was similar to their overall score of -10.4 in 2011. The total mortality rate of 693.7 deaths per 100,000 in 2013 was lower than the total mortality rate of 741.5 in 2011. HISPANICS or LATINOS Average rank: 2.8 Total score: 46.0 Average score: 0.7 In 2013 Hispanics retained a 3rd place health ranking. The average score of Hispanics decreased from a peak of 14.8 in 2005, 3.1 in 2011, to 0.7 in 2013. Hispanics ranked best or second best on 25 indicators in 2013, an increase from 19 indicators in 2011 and the same as in 2009. They ranked worse than average with diabetes, high teen pregnancy rates, low utilization of prenatal care, and cervical cancer. They ranked better than average with low alcohol and tobacco use among women giving birth, low incidence of death due to chronic lower respiratory diseases, and a low suicide mortality rate. Comparative Rates and Ratios for 2003-2013 provides a detailed picture of changes over time for all of the 69 measures. AMERICAN INDIANS or ALASKA NATIVES Average rank: 3.8 Total score: 3,579.0 Average score: 51.9 In 2013, American Indians in Arizona had the second highest average score among all groups and second poorest rank of overall health status. They ranked 4th or 5th on 43 of the 69 health indicators (Figure B) and they exceeded the statewide averages by a wider margin than any other group except Blacks (Figure C). American Indians had relatively poor values on a number of health indicators including incidence of alcohol use during pregnancy, infant mortality, chronic liver disease and cirrhosis, diabetes, motor vehicle accidents, and mortality from unintentional injuries, contributing to a high premature death rate. American Indians also ranked poorly on measures of maternal lifestyle and health, as well as in utilization of prenatal care. In 2013, compared to White non-Hispanics, American Indian residents of Arizona were on-average 19 years younger at time of death. BLACKS or AFRICAN AMERICANS Average rank: 4.1 Total score: 3,668.2 Average score: 53.2 Compared to the average score of 87.0 for Arizona Black or African American residents in 2001, their scores from 2003 2013 were substantially lower. Despite this improvement, Blacks or African Americans had the lowest rank of overall health status because they ranked 4th or 5th among the five racial/ethnic groups on 52 of 69 measures (see Figure B). High mortality among children and middle-aged adults, high ratios of low birthweight and preterm births, high incidence of many reportable diseases, high mortality rates for almost all of the leading causes of death, and a 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 from cervical cancer, chronic liver disease and cirrhosis, and fall-related injuries. They also had low rates of diabetes during pregnancy and no prenatal care. Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 7 COMPARATIVE CAUSE-SPECIFIC In 2013, cancer was the leading cause of death for three of the five racial/ethnic groups in Arizona: Asians or Pacific Islanders, Hispanics or Latinos and White non-Hispanics (Figure D). Diseases of the heart were the number one cause among American Indian or Alaska Natives and Blacks or African Americans. Unintentional injury was the third leading cause of death only for American Indians but came in 4th for Hispanics or Latinos and White non-Hispanics. For Asians, stroke was the 3rd leading cause of death and 4th for Blacks in 2013. Diabetes was among the top five causes of death among American Indians, Blacks, and Hispanics. While Alzheimer’s disease was the fifth leading cause of death among Asians, Blacks, and White non-Hispanics in 2011, in 2013 it remained 5th for Asians, Hispanics, and White non-Hispanics. Chronic liver disease and cirrhosis continued to be the fifth leading cause of death specific to American Indians. Chronic lower respiratory diseases were the third leading cause of death for White non-Hispanics, 4th for Asians and 5th for Blacks. Figure D Comparative Age-Adjusted Mortality Rates for the Five Leading Causes of Death by Race/Ethnicity in Arizona in 2013 Rank Asian or Pacific Islander Am erican Indian or Alaska Native Black or African Am erican Hispanic or Latino White nonHispanic 1 Cancer 100.1 Diseases of heart 122.9 Diseases of heart 200.5 Cancer 129.8 Cancer 154.3 2 Diseases of heart 82.5 Cancer 118.2 Cancer 190.4 Diseases of heart 116.1 Diseases of heart 147.6 3 Stroke 30.7 Unintentional injury 104.5 Diabetes 60.2 Diabetes 40.7 Chronic low er respiratory diseases 49.3 4 Chronic low er respiratory diseases 19.4 Diabetes 65.7 Stroke 54.4 Unintentional injury 38.5 Unintentional injury 47.9 5 Alzheim er's disease 18.2 Chronic liver disease and cirrhosis 62.0 Chronic low er respiratory diseases 46.7 Alzheim er's disease 35.6 Alzheim er's disease 33.4 COMPARATIVE RATES AND RATIOS FOR 2003 and 2013 The 138 bar charts provide both a snapshot of differences between the racial/ethnic groups in Arizona in 2013, as well as a measure of change since 2003. More detailed comparisons over time are available in a special section of the report (Comparative Rates and Ratios for 2003 – 2013) that documents specific changes by year from 2003 through 2013 on the 69 health status measures by racial/ethnic group. RISK PROFILES Risk profiles presented on the following pages summarize how each racial/ethnic group compares to the State average for the entire set of measures of health status. These profiles use scores developed to describe the level of each of the 69 measures for each racial/ethnic group relative to the average level for all groups. The profiles visually describe the betterthan-average and worse-than-average clusters of health status characteristics for each racial/ethnic group. 8 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Risk Profile of Asians or Pacific Islanders (Percent above or below the State mean) BETTER THAN AVERAGE 5‐15 4‐8 6‐6 6‐7 1‐3 9‐2 2‐2 4‐10 5‐14 9‐3 6‐1 4‐7 7‐4 6‐9 5‐9 1‐1 2‐1 7‐3 9‐1 6‐5 1‐4 9‐4 6‐8 4‐9 5‐5 6‐3 4‐11 2‐3 3‐3 4‐1 6‐2 2‐9 5‐17 5‐8 5‐3 5‐2 7‐1 5‐20 5‐7 3‐2 5‐6 5‐1 7‐2 4‐6 2‐4 3‐1 1‐2 5‐13 5‐16 5‐12 2‐10 2‐8 5‐10 8‐4 2‐6 4‐3 4‐5 8‐1 8‐2 5‐11 8‐3 4‐2 2‐5 5‐4 4‐4 5‐18 6‐4 2‐7 5‐19 WORSE THAN AVERAGE HIV disease Sudden Infant Death Syndrome (SIDS) Drug‐induced deaths Alcohol‐induced deaths Pregnancies among females 15‐17 years old Incidence of gonorrhea Tobacco use during pregnancy Neonatal mortality Chronic liver disease and cirrhosis Incidence of chlamydia Unintentional injuries Infant mortality Mortality among middle‐age adults 45‐64 years old Assault (homicide) Cervical cancer Pregnancies among females 19 and younger Unmarried mothers Mortality among young adults 20‐44 years old Incidence of early syphilis Injury by firearms Pregnancies among females 18‐19 years old Incidence of HIV/AIDS Intentional self‐harm (suicide) Mortality of infants from low birthweight/short gestation Chronic lower respiratory diseases Fall‐related injuries Postneonatal mortality Alcohol use during pregnancy No prenatal care Hyaline membrane disease Motor vehicle‐related injuries Genital herpes during pregnancy Alzheimer's disease Breast cancer Coronary heart disease Diseases of the heart Mortality among children 1‐14 years old Total mortality from all causes Lung cancer Fewer than five prenatal visits Malignant neoplasms (cancer) Cardiovascular diseases Mortality among adolescents 15‐19 years old Incidence of congenital anomalies (birth defects) Chronic hypertension No care in the 1st trimester Pregnancies among females 14 and younger Diabetes Septicemia Influenza and pneumonia Weight gain of less than 21 pounds Pregnancy associated hypertension Colorectal cancer Percent of total deaths before expected years of life reached Anemia during pregnancy Born too early (preterm or < 37 weeks) Born too small: very low‐birthweight (<1,500 grams) Median age at death from all causes Median age at death from all causes among males Prostate cancer Median age at death from all causes among females Newborn intensive care Dysfunctional labor Cerebrovascular disease Born too small: low‐birthweight (<2,500 grams) Nephritis, nephrotic syndrome and nephrosis (kidney disease) Drowning mortality Diabetes during pregnancy Essential (primary) hypertension) hypertension AVERAGE FOR ALL RESIDENTS Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 9 Risk Profile of White non-Hispanics (Percent above or below the State mean) BETTER THAN AVERAGE 1‐2 9‐3 9‐2 1‐3 3‐3 1‐1 1‐4 3‐2 4‐9 2‐1 3‐1 6‐9 9‐4 9‐1 4‐10 2‐10 2‐7 5‐13 4‐7 5‐15 7‐1 5‐14 2‐6 6‐7 5‐9 2‐5 6‐2 4‐11 4‐5 5‐19 5‐18 4‐4 4‐3 7‐2 5‐16 5‐12 5‐4 8‐2 8‐1 8‐3 5‐11 7‐3 6‐4 4‐8 4‐6 4‐2 2‐4 2‐3 5‐17 5‐10 5‐20 5‐1 6‐3 5‐8 5‐3 5‐6 5‐2 6‐1 2‐8 7‐4 8‐4 5‐7 5‐5 6‐5 6‐8 6‐6 2‐9 4‐1 2‐2 WORSE THAN AVERAGE Pregnancies among females 14 and younger Incidence of chlamydia Incidence of gonorrhea Pregnancies among females 15‐17 years old younger No prenatal care Pregnancies among females 19 and Pregnancies among females 18‐19 years old Fewer than five prenatal visits Mortality of infants from low birthweight/short gestation Unmarried mothers No care in the 1st trimester Assault (homicide) Incidence of HIV/AIDS Incidence of early syphilis Neonatal mortality Weight gain of less than 21 pounds Diabetes during pregnancy Diabetes Infant mortality HIV disease Mortality among children 1‐14 years old Chronic liver disease and cirrhosis Anemia during pregnancy Alcohol‐induced deaths Cervical cancer Dysfunctional labor Motor vehicle‐related injuries Postneonatal mortality Born too small: very low‐birthweight (<1,500 grams) Essential (primary) hypertension Nephritis, nephrotic syndrome and nephrosis (kidney disease) Born too small: low‐birthweight (<2,500 grams) Born too early (preterm or < 37 weeks) Mortality among adolescents 15‐19 years old Septicemia Influenza and pneumonia Cerebrovascular disease Median age at death from all causes among males Median age at death from all causes Median age at death from all causes among females Prostate cancer Mortality among young adults 20‐44 years old Drowning mortality Sudden Infant Death Syndrome (SIDS) Incidence of congenital anomalies (birth defects) Newborn intensive care Chronic hypertension Alcohol use during pregnancy Alzheimer's disease Colorectal cancer Total mortality from all causes Cardiovascular diseases Fall‐related injuries Breast cancer Coronary heart disease Malignant neoplasms (cancer) Diseases of the heart Unintentional injuries Pregnancy associated hypertension Mortality among middle‐age adults 45‐64 years old Percent of total deaths before expected years of life reached Lung cancer Chronic lower respiratory diseases Injury by firearms Intentional self‐harm (suicide) Drug‐induced deaths Genital herpes during pregnancy Hyaline membrane disease Tobacco use during pregnancy AVERAGE FOR ALL RESIDENTS 10 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Risk Profile of Hispanics or Latinos (Percent above or below the State mean) BETTER THAN AVERAGE 2‐2 5‐5 6‐8 2‐3 4‐8 6‐6 5‐7 6‐5 2‐9 7‐4 8‐4 7‐3 6‐7 5‐2 6‐1 5‐3 4‐11 5‐18 5‐15 7‐2 5‐1 5‐6 2‐8 7‐1 5‐20 6‐4 5‐10 5‐11 9‐2 5‐8 4‐4 2‐6 4‐2 6‐9 6‐3 2‐4 2‐5 4‐5 6‐2 4‐3 5‐4 4‐7 2‐7 5‐17 8‐3 5‐12 8‐1 9‐3 8‐2 4‐6 9‐4 5‐14 5‐19 4‐10 2‐10 9‐1 2‐1 5‐16 3‐1 4‐9 1‐1 3‐2 1‐4 1‐3 1‐2 4‐1 3‐3 5‐13 5‐9 WORSE THAN AVERAGE Tobacco use during pregnancy Chronic lower respiratory diseases Intentional self‐harm (suicide) Alcohol use during pregnancy Sudden Infant Death Syndrome (SIDS) Drug‐induced deaths Lung cancer Injury by firearms Genital herpes during pregnancy Mortality among middle‐age adults 45‐64 years old Percent of total deaths before expected years of life reached Mortality among young adults 20‐44 years old Alcohol‐induced deaths Diseases of the heart Unintentional injuries Coronary heart disease Postneonatal mortality Nephritis, nephrotic syndrome and nephrosis (kidney disease) HIV disease Mortality among adolescents 15‐19 years old Cardiovascular diseases Malignant neoplasms (cancer) Pregnancy associated hypertension Mortality among children 1‐14 years old Total mortality from all causes Drowning mortality Colorectal cancer Prostate cancer Incidence of gonorrhea Breast cancer Born too small: low‐birthweight (<2,500 grams) Anemia during pregnancy Newborn intensive care Assault (homicide) Fall‐related injuries Chronic hypertension Dysfunctional labor Born too small: very low‐birthweight (<1,500 grams) Motor vehicle‐related injuries Born too early (preterm or < 37 weeks) Cerebrovascular disease Infant mortality Diabetes during pregnancy Alzheimer's disease Median age at death from all causes among females Influenza and pneumonia Median age at death from all causes Incidence of chlamydia Median age at death from all causes among males Incidence of congenital anomalies (birth defects) Incidence of HIV/AIDS Chronic liver disease and cirrhosis Essential (primary) hypertension Neonatal mortality Weight gain of less than 21 pounds Incidence of early syphilis Unmarried mothers Septicemia No care in the 1st trimester Mortality of infants from low birthweight/short gestation Pregnancies among females 19 and younger Fewer than five prenatal visits Pregnancies among females 18‐19 years old Pregnancies among females 15‐17 years old Pregnancies among females 14 and younger Hyaline membrane disease No prenatal care Diabetes Cervical cancer AVERAGE FOR ALL RESIDENTS Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 11 Risk Profile of American Indians or Alaska Natives (Percent above or below the State mean) BETTER THAN AVERAGE 5‐7 5‐5 5‐17 4‐1 8‐4 5‐8 2‐9. 2‐2 4‐9 4‐2 5‐6 5‐4 5‐10 5‐9 5‐3 6‐3 5‐2 5‐1 4‐5 6‐5 4‐8 4‐4 4‐3 4‐10 5‐11 6‐6 4‐6 8‐3 6‐4 8‐1 4‐7 8‐2 2‐4 9‐1 6‐8 5‐20 5‐19 2‐10 2‐8 5‐15 9‐4 2‐6 1‐2 1‐4 7‐4 4‐11 2‐5 1‐1 3‐1 3‐3 1‐3 2‐1 2‐7 6‐1 7‐2 9‐2 3‐2 5‐16 5‐12 9‐3 7‐1 7‐3 2‐3 6‐2 5‐13 5‐18 6‐9 5‐14 6‐7 WORSE THAN AVERAGE Lung cancer Chronic lower respiratory diseases Alzheimer's disease Hyaline membrane disease Percent of total deaths before expected years of life reached Breast cancer Genital herpes during pregnancy Tobacco use Mortality of infants from low birthweight/short gestation Newborn intensive care Malignant neoplasms (cancer) Cerebrovascular disease Colorectal cancer Cervical cancer Coronary heart disease Fall‐related injuries Diseases of the heart Cardiovascular diseases Born too small: very low‐birthweight (<1,500 grams) Injury by firearms Sudden Infant Death Syndrome (SIDS) Born too small: low‐birthweight (<2,500 grams) Born too early (preterm or < 37 weeks) Neonatal mortality Prostate cancer Drug‐induced deaths Incidence of congenital anomalies (birth defects) Median age at death from all causes among females Drowning mortality Median age at death from all causes Infant mortality Median age at death from all causes among males Chronic hypertension Incidence of early syphilis Intentional self‐harm (suicide) Total mortality from all causes Essential (primary) hypertension Weight gain of less than 21 pounds Pregnancy associated hypertension HIV disease Incidence of HIV/AIDS Anemia during pregnancy Pregnancies among females 14 and younger Pregnancies among females 18‐19 years old Mortality among middle‐age adults 45‐64 years old Postneonatal mortality Dysfunctional labor Pregnancies among females 19 and younger No care in the 1st trimester No prenatal care Pregnancies among females 15‐17 years old Unmarried mothers Diabetes during pregnancy Unintentional injuries Mortality among adolescents 15‐19 years old Incidence of gonorrhea Fewer than five prenatal visits Septicemia Influenza and pneumonia Incidence of chlamydia Mortality among children 1‐14 years old Mortality among young adults 20‐44 years old Alcohol use during pregnancy Motor vehicle‐related injuries Diabetes Nephritis, nephrotic syndrome and nephrosis (kidney disease) Assault (homicide) Chronic liver disease and cirrhosis Alcohol‐induced deaths AVERAGE FOR ALL RESIDENTS 12 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Risk Profile of Blacks or African Americans (Percent above or below the State mean) BETTER THAN AVERAGE 6‐8 6‐7 5‐14 5‐9 6‐4 8‐4 6‐3 6‐6 2‐7 3‐3 6‐1 2‐5 5‐5 6‐2 8‐3 5‐7 5‐8 2‐8 8‐1 2‐10 8‐2 1‐3 3‐1 3‐2 5‐12 6‐5 7‐3 5‐17 7‐4 5‐6 1‐4 4‐6 1‐1 4‐3 5‐20 4‐2 5‐2 7‐2 2‐1 5‐11 2‐2 5‐3 5‐1 2‐3 4‐1 5‐16 7‐1 5‐10 4‐4 2‐4 2‐9 2‐6 1‐2 4‐5 9‐3 5‐4 5‐19 5‐18 4‐11 4‐10 4‐7 4‐9 5‐13 6‐9 9‐1 4‐8 9‐2 9‐4 5‐15 WORSE THAN AVERAGE Intentional self‐harm (suicide) Alcohol‐induced deaths Chronic liver disease and cirrhosis Cervical cancer Drowning mortality Percent of total deaths before expected years of life reached Fall‐related injuries Drug‐induced deaths Diabetes during pregnancy No prenatal care Unintentional injuries Dysfunctional labor Chronic lower respiratory diseases Motor vehicle‐related injuries Median age at death from all causes among females Lung cancer Breast cancer Pregnancy associated hypertension Median age at death from all causes Weight gain of less than 21 pounds Median age at death from all causes among males Pregnancies among females 15‐17 years old No care in the 1st trimester Fewer than five prenatal visits Influenza and pneumonia Injury by firearms Mortality among young adults 20‐44 years old Alzheimer's disease Mortality among middle‐age adults 45‐64 years old Malignant neoplasms (cancer) Pregnancies among females 18‐19 years old Incidence of congenital anomalies (birth defects) Pregnancies among females 19 and younger Born too early (preterm or < 37 weeks) Total mortality from all causes Newborn intensive care Diseases of the heart Mortality among adolescents 15‐19 years old Unmarried mothers Prostate cancer Tobacco use during pregnancy Coronary heart disease Cardiovascular diseases Alcohol use during pregnancy Hyaline membrane disease Septicemia Mortality among children 1‐14 years old Colorectal cancer Born too small: low‐birthweight (<2,500 grams) Chronic hypertension Genital herpes during pregnancy Anemia during pregnancy Pregnancies among females 14 and younger Born too small: very low‐birthweight (<1,500 grams) Incidence of chlamydia Cerebrovascular disease Essential (primary) hypertension Nephritis, nephrotic syndrome and nephrosis (kidney disease) Postneonatal mortality Neonatal mortality Infant mortality Mortality of infants from low birthweight/short gestation Diabetes Assault (homicide) Incidence of early syphilis Sudden Infant Death Syndrome (SIDS) Incidence of gonorrhea Incidence of HIV/AIDS HIV disease AVERAGE FOR ALL RESIDENTS Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 13 COMPARATIVE MEASURES OF HEALTH STATUS BY RACE/ETHNICITY IN 2013 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 15 1 Teen Pregnancies 1-1 Pregnancies Among Females 19 or Younger 1-2 Pregnancies Among Females 14 or Younger 1-3 Pregnancies Among Females 15-17 Years Old 1-4 Pregnancies Among Females 18-19 Years Old Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 17 1-1 PREGNANCIES AMONG FEMALES 19 OR YOUNGER 2013 Note: Number of pregnancies per 1,000 females 10-19 years old in specified group. 2003 Note: Number of pregnancies per 1,000 females 10-19 years old in specified group. COMPARATIVE RATES FOR 2003 AND 2013 Rate per 1,000 females by race/ethnicity Year 2003 2013 % change from 2003 34.5 19.2 18.2 9.8 57.5 25.0 45.4 25.1 American Indian or Alaska Native 39.9 29.7 -44.3 -46.2 -56.5 -44.7 -25.6 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 19.2 6.8 -64.6 19 1-2 PREGNANCIES AMONG FEMALES 14 OR YOUNGER 2013 Note: Number of pregnancies per 1,000 females 10-14 years old in specified group. 2003 Note: Number of pregnancies per 1,000 females 10-14 years old in specified group. COMPARATIVE RATES FOR 2003 AND 2013 Rate per 1,000 females by race/ethnicity Year 2003 2013 % change from 2003 20 1.4 0.4 0.4 0.1 2.6 0.6 1.2 0.7 American Indian or Alaska Native 2.5 0.6 -71.4 -75.0 -76.9 -41.7 -76.0 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 0.6 0.3 -50.0 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 1-3 PREGNANCIES AMONG FEMALES 15-17 YEARS OLD 2013 Note: Number of pregnancies per 1,000 females 15-17 years old in specified group. 2003 Note: Number of pregnancies per 1,000 females 15-17 years old in specified group. COMPARATIVE RATES FOR 2003 AND 2013 Rate per 1,000 females by race/ethnicity Year 2003 2013 % change from 2003 41.6 18.0 17.5 7.1 76.5 25.9 59.8 20.9 American Indian or Alaska Native 52.0 31.5 -56.7 -59.4 -66.1 -65.1 -39.4 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 22.0 3.7 -83.2 21 1-4 PREGNANCIES AMONG FEMALES 18-19 YEARS OLD 2013 Note: Number of pregnancies per 1,000 females 18-19 years old in specified group. 2003 Note: Number of pregnancies per 1,000 females 18-19 years old in specified group. COMPARATIVE RATES FOR 2003 AND 2013 Rate per 1,000 females by race/ethnicity Year 2003 2013 % change from 2003 22 108.2 64.8 62.9 34.0 172.7 87.4 147.5 82.9 American Indian or Alaska Native 134.2 98.0 -40.1 -45.9 -49.4 -43.8 -27.0 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 52.1 25.5 -51.1 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 2 Maternal Lifestyle and Health Characteristics 2-1 Unmarried Mothers 2-2 Tobacco Use during Pregnancy 2-3 Alcohol Use during Pregnancy 2-4 The Incidence of Chronic Hypertension 2-5 Dysfunctional Labor 2-6 The Incidence of Anemia During Pregnancy 2-7 The Incidence of Diabetes 2-8 The Incidence of Pregnancy-Associated Hypertension 2-9 The Incidence of Genital Herpes 2-10 Maternal Weight Gain of Less Than 21 Pounds Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 23 2-1 UNMARRIED MOTHERS 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 41.2 45.1 25.1 30.3 52.7 57.1 62.7 63.7 American Indian or Alaska Native 72.4 79.2 9.5 20.7 8.3 1.6 9.4 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 16.3 16.0 -1.8 25 2-2 TOBACCO USE DURING PREGNANCY 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 26 5.8 4.4 9.4 7.0 2.1 1.8 8.7 6.5 American Indian or Alaska Native 3.2 2.9 -24.1 -25.5 -14.3 -25.3 -9.4 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 2.8 1.1 -60.7 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 2-3 ALCOHOL USE DURING PREGNANCY 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 0.9 0.4 1.1 0.4 0.4 0.2 1.3 0.6 American Indian or Alaska Native 2.4 1.1 -55.6 -63.6 -50.0 -53.8 -54.2 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 0.5 0.2 -60.0 27 2-4 CHRONIC HYPERTENSION 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 28 0.3 1.1 0.4 1.1 0.2 1.1 0.5 1.8 American Indian or Alaska Native 0.7 1.4 266.7 175.0 450.0 260.0 100.0 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 0.3 0.8 166.7 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 2-5 DYSFUNCTIONAL LABOR 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 0.8 1.7 0.9 1.5 0.5 1.7 0.8 1.7 American Indian or Alaska Native 2.4 2.6 112.5 66.7 240.0 112.5 8.3 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 0.6 1.8 200.0 29 2-6 ANEMIA DURING PREGNANCY 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 30 2.0 4.7 2.3 4.1 1.2 4.6 2.8 8.1 American Indian or Alaska Native 5.5 7.0 135.0 78.3 283.3 189.3 27.3 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 1.7 4.5 164.7 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 2-7 DIABETES DURING PREGNANCY 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 2.1 5.7 1.8 4.4 1.8 6.1 2.2 5.0 American Indian or Alaska Native 6.0 11.1 171.4 144.4 238.9 127.3 85.0 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 3.0 9.7 223.3 31 2-8 PREGNANCY-ASSOCIATED HYPERTENSION 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 32 2.8 5.6 3.4 5.9 1.9 4.9 2.7 6.4 American Indian or Alaska Native 5.7 7.4 100.0 73.5 157.9 137.0 29.8 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 1.9 4.9 157.9 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 2-9 GENITAL HERPES DURING PREGNANCY 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 0.6 1.1 1.0 1.4 0.2 0.8 1.0 1.8 American Indian or Alaska Native 0.5 0.7 83.3 40.0 300.0 80.0 40.0 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 0.5 0.6 20.0 33 2-10 WEIGHT GAIN OF LESS THAN 21 POUNDS 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 34 19.7 27.6 14.5 20.7 22.9 33.9 23.3 31.7 American Indian or Alaska Native 31.9 36.3 40.1 42.8 48.0 36.1 13.8 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 16.0 23.9 49.4 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 3 Utilization of Prenatal Care Services 3-1 No Care in the 1st Trimester 3-2 Fewer Than Five Prenatal Visits 3-3 No Prenatal Care Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 35 3-1 NO CARE IN THE 1ST TRIMESTER 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 24.4 18.7 13.2 12.6 34.2 23.8 24.3 21.8 American Indian or Alaska Native 31.2 31.3 -23.4 -4.5 -30.4 -10.3 0.3 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 15.8 13.6 -13.9 37 3-2 FEWER THAN 5 PRENATAL VISITS 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 38 7.2 5.1 2.9 2.8 10.4 6.8 7.6 6.0 American Indian or Alaska Native 11.8 11.9 -29.2 -3.4 -34.6 -21.1 0.8 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 4.5 3.3 -26.7 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 3-3 NO PRENATAL CARE 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 2.9 1.4 0.6 0.7 4.8 2.1 3.5 1.3 American Indian or Alaska Native 2.4 2.4 -51.7 16.7 -56.3 -62.9 0.0 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 1.6 0.7 -56.3 39 4 Newborn’s Health 4-1 The Incidence of Hyaline Membrane Disease 4-2 Newborn Intensive Care 4-3 Born Too Early (Preterm or <37 Weeks) 4-4 The Incidence of Low-Birthweight Births 4-5 The Incidence of Very Low-Birthweight Births 4-6 The Incidence of Congenital Anomalies (Birth Defects) 4-7 Infant Mortality 4-8 Sudden Infant Death Syndrome 4-9 Mortality of Infants from Low-Birthweight/ Short Gestation 4-10 Neonatal Mortality 4-11 Postneonatal Mortality Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 41 4-1 INCIDENCE OF HYALINE MEMBRANE DISEASE 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 0.3 0.2 0.5 0.3 0.2 0.3 0.2 0.3 American Indian or Alaska Native 0.3 0.1 -33.3 -40.0 50.0 50.0 -66.7 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 0.3 0.1 -66.7 43 4-2 INCIDENCE OF NEWBORN INTENSIVE CARE 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 44 5.4 5.3 6.2 5.3 4.7 5.2 7.0 7.2 American Indian or Alaska Native 4.2 4.1 -1.9 -14.5 10.6 2.9 -2.4 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 5.6 5.5 -1.8 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 4-3 BORN TOO EARLY (PRETERM OF <37 WEEKS) 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 10.5 9.0 11.0 8.4 9.8 9.3 14.4 11.8 American Indian or Alaska Native 9.8 9.7 -14.3 -23.6 -5.1 -18.1 -1.0 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 10.8 8.9 -17.6 45 4-4 BORN TOO SMALL: LOW BIRTHWEIGHT (<2,500 GRAMS) 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 46 7.1 6.9 6.9 6.4 6.9 6.6 11.7 11.1 American Indian or Alaska Native 6.8 7.2 -2.8 -7.2 -4.3 -5.1 5.9 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 8.5 7.9 -7.1 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 4-5 BORN TOO SMALL: VERY LOW BIRTHWEIGHT (<1,500 GRAMS) 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 1.1 1.1 1.1 1.0 1.1 1.1 2.2 2.0 American Indian or Alaska Native 0.9 1.0 0.0 -9.1 0.0 -9.1 11.1 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 1.5 1.1 -26.7 47 4-6 INCIDENCE OF CONGENITAL ANOMALIES (BIRTH DEFECTS) 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 100 births by race/ethnicity Year 2003 2013 % change from 2003 48 1.0 0.7 1.0 0.7 1.0 0.8 1.0 0.9 American Indian or Alaska Native 1.3 0.8 -30.0 -30.0 -20.0 -10.0 -38.5 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 1.0 0.5 -50.0 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 4-7 INFANT MORTALITY 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 1,000 births by race/ethnicity Year 2003 2013 % change from 2003 6.5 5.3 5.4 4.2 7.0 5.6 15.9 12.5 American Indian or Alaska Native 7.5 6.6 -18.5 -22.2 -20.0 -21.4 -12.0 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 4.4 1.7 -61.4 49 4-8 SUDDEN INFANT DEATH SYNDROME (SIDS) 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 1,000 births by race/ethnicity Year 2003 2013 % change from 2003 50 0.3 0.2 0.3 0.2 0.3 0.1 0.7 0.6 American Indian or Alaska Native 0.3 0.2 -33.3 -33.3 -66.7 -14.3 -33.3 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 0.0 0.0 NA Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 4-9 MORTALITY OF INFANTS FROM LOW BIRTHWEIGHT/SHORT GESTATION 2013 Note: Per 100 live births. 2003 Note: Per 100 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 1,000 births by race/ethnicity Year 2003 2013 % change from 2003 0.9 0.7 0.6 0.4 1.1 0.9 3.6 1.7 American Indian or Alaska Native 0.9 0.5 -22.2 -33.3 -18.2 -52.8 -44.4 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 0.4 0.3 -25.0 51 4-10 NEONATAL MORTALITY 2013 Note: Number of deaths per 1,000 live births. 2003 Note: Number of deaths per 1,000 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 1,000 births by race/ethnicity Year 2003 2013 % change from 2003 52 4.3 3.4 3.7 2.5 4.9 4.0 10.3 8.0 American Indian or Alaska Native 3.1 3.7 -20.9 -32.4 -18.4 -22.3 19.4 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 2.0 0.9 -55.0 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 4-11 POSTNEONATAL MORTALITY 2013 Note: Number of deaths per 1,000 live births. 2003 Note: Number of deaths per 1,000 live births. COMPARATIVE RATES FOR 2003 AND 2013 Per 1,000 births by race/ethnicity Year 2003 2013 % change from 2003 2.2 1.9 1.7 1.7 2.1 1.6 5.6 4.4 American Indian or Alaska Native 4.4 2.9 -13.6 0.0 -23.8 -21.4 -34.1 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 2.4 0.9 -62.5 53 5 Mortality from Natural Causes 5-1 5-2 5-3 5-4 5-5 5-6 5-7 5-8 5-9 5-10 5-11 5-12 5-13 5-14 5-15 5-16 5-17 5-18 Cardiovascular Disease Diseases of the Heart Coronary Heart Disease Cerebrovascular Disease Chronic Lower Respiratory Disease Malignant Neoplasms Lung Cancer Breast Cancer Cervical Cancer Colorectal Cancer Prostate Cancer Influenza and Pneumonia Diabetes Chronic Liver Disease and Cirrhosis HIV Disease Septicemia Alzheimer's Disease Nephritis, Nephrotic Syndrome, & Nephrosis (kidney disease) 5-19 Essential (primary) Hypertension 5-20 Mortality from All Causes Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 55 5-1 CARDIOVASCULAR DISEASE 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 258.4 187.7 257.2 190.9 278.2 161.9 390.1 280.2 American Indian or Alaska Native 188.6 164.2 -27.4 -25.8 -41.8 -28.2 -12.9 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 145.3 133.6 -8.1 57 5-2 DISEASES OF THE HEART 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 58 197.1 143.0 197.7 147.6 198.5 116.1 299.4 200.5 American Indian or Alaska Native 141.9 122.9 -27.4 -25.3 -41.5 -33.0 -13.4 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 97.6 82.5 -15.5 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 5-3 CORONARY HEART DISEASE 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 156.6 110.0 157.8 113.3 154.4 91.6 245.7 164.0 American Indian or Alaska Native 100.7 92.7 -29.8 -28.2 -40.7 -33.3 -7.9 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 75.5 63.4 -16.0 59 5-4 CEREBROVASCULAR DISEASE 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 60 43.9 28.2 41.7 27.1 61.9 29.7 69.0 54.4 American Indian or Alaska Native 36.4 23.4 -35.8 -35.0 -52.0 -21.2 -35.7 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 35.9 30.7 -14.5 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 5-5 CHRONIC LOWER RESPIRATORY DISEASE 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 45.4 44.5 48.3 49.3 28.7 20.9 30.3 46.7 American Indian or Alaska Native 19.4 15.5 -2.0 2.1 -27.2 54.1 -20.1 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 15.5 19.4 25.2 61 5-6 MALIGNANT NEOPLASM (CANCER) 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 62 169.4 149.6 171.2 154.3 168.5 129.8 218.5 190.4 American Indian or Alaska Native 120.7 118.2 -11.7 -9.9 -23.0 -12.9 -2.1 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 132.9 100.1 -24.7 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 5-7 LUNG CANCER 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 47.4 36.4 50.6 40.2 33.5 22.1 59.4 40.5 American Indian or Alaska Native 13.2 10.0 -23.2 -20.6 -34.0 -31.8 -24.2 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 21.9 22.9 4.6 63 5-8 BREAST CANCER 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 females by race/ethnicity Year 2003 2013 % change from 2003 64 22.1 20.7 22.3 21.3 18.9 19.7 41.2 23.3 American Indian or Alaska Native 16.4 13.1 -6.3 -4.5 4.2 -43.4 -20.1 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 19.6 11.4 -41.8 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 5-9 CERVICAL CANCER 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 females by race/ethnicity Year 2003 2013 % change from 2003 2.2 2.4 1.0 2.1 1.8 4.4 6.8 1.5 American Indian or Alaska Native 4.2 2.0 9.1 110.0 144.4 -77.9 -52.4 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 10.5 0.8 -92.4 65 5-10 COLORECTAL CANCER 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 66 17.9 13.6 17.9 13.7 21.2 12.5 26.3 21.7 American Indian or Alaska Native 6.3 11.3 -24.0 -23.5 -41.0 -17.5 79.4 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 3.0 12.1 303.3 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 5-11 PROSTATE CANCER 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 males by race/ethnicity Year 2003 2013 % change from 2003 25.1 18.2 25.2 18.0 22.4 17.0 41.2 26.7 American Indian or Alaska Native 21.0 19.9 -27.5 -28.6 -24.1 -35.2 -5.2 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 7.6 18.5 143.4 67 5-12 INFLUENZA AND PNEUMONIA 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 68 23.4 10.0 21.8 9.6 27.9 10.9 30.4 11.9 American Indian or Alaska Native 58.9 24.7 -57.3 -56.0 -60.9 -60.9 -58.1 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 16.4 8.0 -51.2 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 5-13 DIABETES 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 20.3 23.6 16.5 18.6 39.1 40.7 53.6 60.2 American Indian or Alaska Native 55.8 65.7 16.3 12.7 4.1 12.3 17.7 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 15.7 17.9 14.0 69 5-14 CHRONIC LIVER DISEASE AND CIRRHOSIS 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 70 11.5 14.5 9.7 12.6 17.6 16.7 3.5 6.8 American Indian or Alaska Native 38.8 62.0 26.1 29.9 -5.1 94.3 59.8 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 3.3 3.9 18.2 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 5-15 HIV DISEASE 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 3.2 1.4 2.8 1.2 4.3 1.2 8.1 5.9 American Indian or Alaska Native 3.6 1.9 -56.3 -57.1 -72.1 -27.2 -47.2 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 1.7 0.0 -100.0 71 5-16 SEPTICEMIA 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 72 8.4 4.8 7.1 4.5 12.6 6.1 11.3 7.4 American Indian or Alaska Native 25.8 11.4 -42.9 -36.6 -51.6 -34.5 -55.8 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 6.8 3.8 -44.1 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 5-17 ALZHEIMER’S DISEASE 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 32.5 33.2 33.4 33.4 28.2 35.6 43.3 41.3 American Indian or Alaska Native 5.6 16.0 2.2 0.0 26.2 -4.6 185.7 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 11.4 18.2 59.6 73 5-18 NEPHRITIS, NEPHROTIC SYNDROME, AND NEPHROSIS 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 74 10.1 5.3 8.4 4.9 18.4 4.5 20.9 12.2 American Indian or Alaska Native 24.7 15.8 -47.5 -41.7 -75.5 -41.6 -36.0 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 16.0 6.2 -61.3 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 5-19 ESSENTIAL (PRIMARY) HYPERTENSION 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 6.3 9.7 6.0 8.9 7.9 11.4 14.5 21.3 American Indian or Alaska Native 5.4 12.7 54.0 48.3 44.3 46.9 135.2 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 9.4 17.0 80.9 75 5-20 TOTAL MORTALITY FROM ALL CAUSES 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 76 784.0 687.8 764.9 693.7 839.5 615.6 1048.6 918.5 American Indian or Alaska Native 900.7 887.0 -12.3 -9.3 -26.7 -12.4 -1.5 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 497.2 413.4 -16.9 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 6 Mortality from Injuries 6-1 Unintentional Injuries 6-2 Motor Vehicle-Related Injuries 6-3 Fall-Related Injuries 6-4 Drowning 6-5 Injury by Firearms 6-6 Drug-Induced 6-7 Alcohol-Induced 6-8 Intentional Self-Harm (suicide) 6-9 Assault (homicide) Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 77 6-1 UNINTENTIONAL INJURIES 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 44.8 46.3 40.9 47.9 44.7 38.5 52.4 43.3 American Indian or Alaska Native 108.6 104.5 3.3 17.1 -13.9 -17.4 -3.8 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 25.3 13.4 -47.0 79 6-2 MOTOR VEHICLE-RELATED INJURIES 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 80 18.0 11.4 14.6 10.2 21.3 11.4 15.2 12.0 American Indian or Alaska Native 59.0 31.7 -36.7 -30.1 -46.5 -21.1 -46.3 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 11.8 5.8 -50.8 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 6-3 FALL-RELATED INJURIES 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 8.8 12.1 9.0 12.4 5.5 12.0 6.3 8.8 American Indian or Alaska Native 12.7 10.3 37.5 37.8 118.2 39.7 -18.9 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 7.5 5.7 -24.0 81 6-4 DROWNING 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 82 1.5 1.1 1.3 1.1 1.5 1.0 2.7 0.7 American Indian or Alaska Native 2.5 1.3 -26.7 -15.4 -33.3 -74.1 -48.0 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 0.5 1.5 200.0 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 6-5 FIREARM-RELATED 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 14.8 14.1 12.7 15.8 15.7 8.6 23.2 17.0 American Indian or Alaska Native 15.6 13.0 -4.7 24.4 -45.2 -26.7 -16.7 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 1.8 5.1 183.3 83 6-6 DRUG-INDUCED 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 84 12.0 16.9 12.8 21.2 10.5 9.9 23.5 13.5 American Indian or Alaska Native 8.5 18.7 40.8 65.6 -5.7 -42.6 120.0 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 0.0 0.4 NA Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 6-7 ALCOHOL-INDUCED 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 10.1 15.7 8.3 13.7 10.2 12.5 6.8 7.1 American Indian or Alaska Native 49.3 84.7 55.4 65.1 22.5 4.4 71.8 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 0.0 2.0 NA 85 6-8 INTENTIONAL SELF-HARM (SUICIDE) 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 86 14.6 17.0 16.4 20.8 8.2 8.4 11.3 6.7 American Indian or Alaska Native 15.2 21.9 16.4 26.8 2.4 -40.7 44.1 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 6.0 7.0 16.7 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 6-9 ASSAULT (HOMICIDE) 2013 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). 2003 Note: Number of deaths per 100,000 population (age-adjusted to the 2000 standard). COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 8.3 5.9 3.7 4.0 14.7 5.8 24.9 15.4 American Indian or Alaska Native 18.8 17.7 -28.9 8.1 -60.5 -38.2 -5.9 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 5.4 1.9 -64.8 87 7 Age-Specific Mortality 7-1 Children 1-14 Years Old 7-2 Adolescents 15-19 Years Old 7-3 Young Adults 20-44 Years Old 7-4 Middle-Age Adults 45-64 Years Old Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 89 7-1 CHILDREN 1-14 YEARS OLD 2013 Note: Number of deaths per 100,000 children 1-14 years. 2003 Note: Number of deaths per 100,000 children 1-14 years. COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 children 1-14 years old by race/ethnicity Year 2003 2013 % change from 2003 24.3 19.8 21.8 17.1 22.1 17.7 42.5 30.9 American Indian or Alaska Native 45.3 49.2 -18.5 -21.6 -19.9 -27.3 8.6 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 9.2 11.5 25.0 91 7-2 ADOLESCENTS 15-19 YEARS OLD 2013 Note: Number of deaths per 100,000 adolescents 15-19 years. 2003 Note: Number of deaths per 100,000 adolescents 15-19 years. COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 adolescents 15-19 years old by race/ethnicity Year 2003 2013 % change from 2003 92 75.4 45.5 51.6 42.5 87.5 39.1 89.5 64.1 American Indian or Alaska Native 196.2 103.1 -39.7 -17.6 -55.3 -28.4 -47.5 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 36.2 32.4 -10.5 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 7-3 YOUNG ADULTS 20-44 YEARS OLD 2013 Note: Number of deaths per 100,000 young adults 20-44 years. 2003 Note: Number of deaths per 100,000 young adults 20-44 years. COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 young adults 20-44 years old by race/ethnicity Year 2003 2013 % change from 2003 151.1 143.5 139.6 143.2 139.1 112.6 220.4 174.2 American Indian or Alaska Native 345.8 390.8 -5.0 2.6 -19.1 -21.0 13.0 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 56.8 51.3 -9.7 93 7-4 MIDDLE-AGE ADULTS 45-64 YEARS OLD 2013 Note: Number of deaths per 100,000 middle-age adults 45-64 years. 2003 Note: Number of deaths per 100,000 middle-age adults 45-64 years. COMPARATIVE RATES FOR 2003 AND 2013 Number of deaths per 100,000 middle-age adults 45-64 years old by race/ethnicity Year 2003 2013 % change from 2003 94 653.7 620.7 651.1 661.0 593.5 461.2 909.7 788.7 American Indian or Alaska Native 914.9 943.5 -5.0 1.5 -22.3 -13.3 3.1 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 292.2 199.0 -31.9 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 8 Patterns of Premature Mortality 8-1 Median Age at Death from All Causes among Arizona Residents 8-2 Median Age at Death from All Causes among Arizona Males 8-3 Median Age at Death from All Causes among Arizona Females 8-4 Percent of Total Deaths before Expected Years of Life Reached Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 95 8-1 MEDIAN AGE AT DEATH FROM ALL CAUSES 2013 2003 MEDIAN AGE AT DEATH IN 2003 AND 2013 By race/ethnicity Year 2003 2013 % change from 2003 76.0 77.0 78.0 79.0 66.0 69.0 66.0 66.0 American Indian or Alaska Native 56.0 60.0 1.3 1.3 4.5 0.0 7.1 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 70.0 76.0 8.6 97 8-2 MEDIAN AGE AT DEATH FROM ALL CAUSES AMONG MALES 2013 2003 MEDIAN AGE AT DEATH AMONG MALES IN 2003 AND 2013 By race/ethnicity Year 2003 2013 % change from 2003 98 73.0 74.0 75.0 76.0 60.0 64.0 60.0 63.0 American Indian or Alaska Native 51.0 55.0 1.4 1.3 6.7 5.0 7.8 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 70.0 73.0 4.3 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 8-3 MEDIAN AGE AT DEATH FROM ALL CAUSES AMONG FEMALES 2013 2003 MEDIAN AGE AT DEATH AMONG FEMALES IN 2003 AND 2013 By race/ethnicity Year 2003 2013 % change from 2003 80.0 81.0 81.0 82.0 72.0 75.0 71.0 73.0 American Indian or Alaska Native 65.0 67.0 1.3 1.2 4.2 2.8 3.1 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 71.0 78.0 9.9 99 8-4 PERCENT OF TOTAL DEATHS BEFORE EXPECTED YEARS OF LIFE REACHED 2013 2003 DEATHS BEFORE EXPECTED YEARS OF LIFE REACHED IN 2003 AND 2013 By race/ethnicity Year 2003 2013 % change from 2003 100 50.8 54.6 46.1 50.1 70.0 67.1 70.6 72.8 American Indian or Alaska Native 78.4 76.7 7.5 8.7 -4.1 3.1 -2.2 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 65.7 58.9 -10.4 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 9 The Incidence of Reportable Diseases 9-1 Rates of Early Syphilis 9-2 Rates of Gonorrhea 9-3 Rates of Chlamydia 9-4 Rates of HIV/AIDS Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 101 9-1 RATES OF EARLY SYPHILIS 2013 2003 COMPARATIVE RATES FOR 2003 AND 2013 Number of reported cases per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 7.4 7.5 4.2 5.3 9.7 9.3 18.2 19.9 American Indian or Alaska Native 20.1 9.6 1.4 26.2 -4.1 9.3 -52.2 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 0.9 2.7 200.0 103 9-2 RATES OF GONORRHEA 2013 2003 COMPARATIVE RATES FOR 2003 AND 2013 Number of reported cases per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 104 63.5 98.2 33.4 37.4 71.4 92.7 359.7 351.0 American Indian or Alaska Native 103.1 224.6 54.6 12.0 29.8 -2.4 117.8 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 15.3 23.2 51.6 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 9-3 RATES OF CHLAMYDIA 2013 2003 COMPARATIVE RATES FOR 2003 AND 2013 Number of reported cases per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 227.1 466.6 100.7 149.3 329.1 518.0 537.6 848.9 American Indian or Alaska Native 623.9 1158.2 105.5 48.3 57.4 57.9 85.6 All groups White nonHispanic Hispanic or Latino Black or African American Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander 86.4 129.3 49.7 105 9-4 RATES OF HIV/AIDS 2013 2003 COMPARATIVE RATES FOR 2003 AND 2013 Number of reported HIV/AIDS cases per 100,000 population by race/ethnicity Year 2003 2013 % change from 2003 106 11.3 11.1 11.4 7.8 7.4 12.7 42.5 44.9 American Indian or Alaska Native 11.3 16.2 -1.8 -31.6 71.6 5.6 43.4 All groups White nonHispanic Hispanic or Latino Black or African American Asian or Pacific Islander 4.2 4.5 7.1 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 COMPARATIVE RATES AND RATIOS FOR 2003-2013 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 107 COMPARATIVE RATES AND RATIOS FOR 2003 – 2013 1. TEEN PREGNANCIES (Number of pregnancies per 1,000 females in specified age group) Indicator ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander Figure 1-1. - Pregnancies among females 19 and younger 2013 19.2 9.8 25.0 25.1 29.7 6.8 2012 21.6 10.7 28.0 26.2 33.6 7.5 2011 23.0 11.8 30.2 24.9 29.2 9.1 2010 24.7 15.9 33.8 29.5 37.0 9.9 2009 28.0 15.6 43.5 33.3 34.7 11.6 2008 31.6 17.5 49.4 37.7 35.5 13.5 2007 34.4 19.0 55.3 36.1 39.1 15.3 2006 34.1 18.9 56.0 32.6 36.2 12.9 2005 32.7 15.8 55.5 43.5 40.8 16.2 2004 34.6 17.7 59.2 44.2 39.7 19.3 2003 34.5 18.2 57.5 45.4 39.9 19.2 Figure 1-2. - Pregnancies among females 14 and younger 2013 0.4 0.1 0.6 0.7 0.6 0.3 2012 0.5 0.1 0.6 0.8 0.5 0.2 2011 0.7 0.2 0.9 0.9 0.8 0.5 2010 0.7 0.3 0.9 1.1 1.2 0.2 2009 0.7 0.3 1.1 0.8 1.0 0.5 2008 1.0 0.3 1.7 1.6 1.4 0.5 2007 1.5 0.9 1.9 2.3 2.0 0.7 2006 1.1 0.4 1.9 1.4 1.1 0.8 2005 1.1 0.3 2.2 1.6 1.5 0.3 2004 1.1 0.3 2.3 1.6 1.4 0.6 2003 1.4 0.4 2.6 1.2 2.5 0.6 Figure 1-3. - Pregnancies among females 15-17 years old 2013 18.0 7.1 25.9 20.9 31.5 3.7 2012 21.8 9.0 31.6 26.2 32.2 5.6 2011 22.1 9.6 31.8 22.3 28.8 7.2 2010 25.5 12.9 38.9 27.3 40.5 8.3 2009 28.5 12.3 51.3 31.6 36.9 8.2 2008 34.6 14.9 62.7 37.2 38.1 11.6 2007 36.9 15.6 68.5 36.9 42.4 12.0 2006 39.0 17.2 72.7 36.1 41.5 13.0 2005 39.1 14.9 72.9 51.6 55.0 16.2 2004 42.0 16.9 79.7 53.0 53.2 20.2 2003 41.6 17.5 76.5 59.8 52.0 22.0 Figure 1-4. - Pregnancies among females 18-19 years old 2013 64.8 34.0 87.4 82.9 98.0 25.5 2012 70.2 35.6 93.8 81.2 110.7 26.6 2011 77.2 40.8 104.0 84.0 94.2 32.7 2010 80.8 53.9 112.6 97.0 111.0 35.5 2009 102.5 59.6 164.2 141.7 114.0 48.7 2008 111.3 65.3 177.2 155.7 115.2 53.5 2007 121.4 70.3 201.2 144.1 124.9 62.2 2006 115.6 68.6 188.1 118.1 119.8 45.0 2005 103.6 55.1 168.9 144.8 137.0 47.6 2004 108.7 61.2 177.4 149.8 134.2 55.0 2003 108.2 62.9 172.7 147.5 134.2 52.1 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 109 2. MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS (All ratios are per 100 live births) Indicator ALL ARIZONA RESIDENTS White nonHispanic Figure 2-1. - Unmarried mothers 2013 45.1 2012 45.2 2011 44.3 2010 44.7 2009 45.2 2008 45.1 2007 45.0 2006 43.9 2005 42.8 2004 41.9 2003 41.2 Figure 2-2. - Tobacco use during pregnancy 2013 4.4 2012 4.2 2011 4.3 2010 4.7 2009 4.8 2008 4.9 2007 4.7 2006 5.1 2005 5.4 2004 5.8 2003 5.8 Figure 2-3. - Alcohol use during pregnancy 2013 0.4 2012 0.5 2011 0.5 2010 0.5 2009 0.5 2008 0.5 2007 0.6 2006 0.6 2005 0.8 2004 0.5 2003 0.9 Figure 2-4. - Chronic hypertension 2013 1.1 2012 0.9 2011 0.8 2010 0.9 2009 0.8 2008 0.8 2007 0.6 2006 0.6 2005 0.4 2004 0.4 2003 0.3 Figure 2-5. - Dysfunctional labor 2013 1.7 2012 1.7 2011 1.6 2010 1.9 2009 1.6 2008 1.4 2007 1.1 2006 1.0 2005 1.2 2004 0.9 2003 0.8 110 Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 30.3 30.4 29.5 29.9 29.7 29.5 28.4 27.7 26.1 24.8 25.1 57.1 57.2 56.6 56.2 56.9 56.5 56.7 55.4 54.3 53.9 52.7 63.7 64.8 63.6 63.1 62.7 62.6 61.9 62.3 61.9 62.0 62.7 79.2 78.5 77.1 77.7 76.9 75.8 75.9 74.8 72.9 73.1 72.4 16.0 17.3 17.3 17.4 15.8 17.4 17.6 16.2 17.0 15.8 16.3 7.0 6.7 6.7 7.5 8.0 8.4 8.3 8.8 9.3 9.4 9.4 1.8 1.6 1.6 1.7 1.8 1.6 1.6 1.8 1.9 2.1 2.1 6.5 6.4 6.7 6.9 7.0 7.3 6.8 7.2 7.7 9.0 8.7 2.9 2.3 2.4 2.5 2.6 2.8 3.1 3.6 3.4 3.7 3.2 1.1 1.0 1.5 1.7 1.7 1.6 1.9 1.8 2.2 2.4 2.8 0.4 0.5 0.6 0.5 0.6 0.7 0.7 0.8 1.1 0.6 1.1 0.2 0.3 0.2 0.2 0.4 0.4 0.2 0.3 0.3 0.2 0.4 0.6 0.3 0.6 0.8 0.6 0.5 0.6 0.6 0.7 0.4 1.3 1.1 1.5 1.5 1.9 1.4 1.3 1.8 1.9 2.2 1.4 2.4 0.2 0.3 0.4 0.4 0.2 0.4 0.2 0.4 0.4 0.3 0.5 1.1 0.9 0.8 0.9 0.8 0.8 0.6 0.6 0.5 0.4 0.4 1.1 0.8 0.7 0.6 0.6 0.6 0.5 0.4 0.3 0.2 0.2 1.8 1.4 1.7 1.8 1.6 1.7 1.1 1.0 1.0 0.4 0.5 1.4 1.4 1.2 1.5 1.6 1.4 1.5 1.4 1.0 0.8 0.7 0.8 1.0 0.6 0.6 0.9 0.4 0.5 0.5 0.5 0.4 0.3 1.5 1.6 1.6 2.1 1.8 1.4 1.2 1.1 1.4 1.0 0.9 1.7 1.6 1.3 1.4 1.2 1.1 0.8 0.6 0.8 0.6 0.5 1.7 2.0 1.5 2.1 1.5 1.8 1.1 1.0 1.0 0.8 0.8 2.6 2.7 3.3 2.6 2.5 3.3 2.9 2.5 3.0 2.9 2.4 1.8 2.4 1.8 2.3 2.5 1.4 1.3 1.4 1.5 1.0 0.6 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 2. MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS (continued) (All ratios are per 100 live births) Indicator ALL ARIZONA RESIDENTS White nonHispanic Figure 2-6. - Anemia during pregnancy 2013 4.7 2012 4.5 2011 3.6 2010 3.8 2009 3.6 2008 3.9 2007 3.0 2006 2.0 2005 2.0 2004 2.2 2003 2.0 Figure 2-7. - Diabetes during pregnancy 2013 5.7 2012 5.1 2011 4.6 2010 4.2 2009 3.9 2008 3.9 2007 3.4 2006 3.2 2005 3.0 2004 2.5 2003 2.1 Figure 2-8. - Pregnancy-associated hypertension 2013 5.6 2012 4.5 2011 4.2 2010 3.9 2009 3.6 2008 3.5 2007 3.1 2006 2.9 2005 3.1 2004 2.9 2003 2.8 Figure 2-9. - Genital herpes during pregnancy 2013 1.1 2012 1.1 2011 1.0 2010 1.0 2009 1.0 2008 1.0 2007 0.7 2006 0.7 2005 0.7 2004 0.7 2003 0.6 Figure 2-10. - Weight gain of less than 21 pounds 2013 27.6 2012 26.4 2011 26.4 2010 26.8 2009 26.9 2008 25.9 2007 25.3 2006 25.5 2005 24.4 2004 20.6 2003 19.7 Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 4.1 3.8 3.7 4.0 3.7 4.3 3.3 1.7 2.0 2.4 2.3 4.6 4.3 2.8 3.0 2.6 2.9 2.0 1.6 1.5 1.5 1.2 8.1 7.2 5.9 6.2 6.0 6.3 4.3 2.3 3.5 2.5 2.8 7.0 8.1 6.0 6.0 7.2 7.2 6.8 6.6 5.6 5.5 5.5 4.5 3.6 2.6 3.5 3.0 3.4 2.4 1.5 1.6 1.5 1.7 4.4 3.7 3.4 3.2 3.0 2.9 2.7 2.5 2.2 2.0 1.8 6.1 5.8 5.1 4.5 4.0 4.1 3.3 3.2 2.9 2.1 1.8 5.0 4.3 3.8 3.4 2.9 2.9 3.0 2.7 2.3 1.9 2.2 11.1 9.9 9.3 7.8 8.2 8.2 8.0 7.2 8.2 7.6 6.0 9.7 7.9 7.5 6.8 6.1 6.8 5.9 4.5 4.7 3.9 3.0 5.9 4.7 4.5 4.1 4.2 4.0 3.7 3.3 3.8 3.6 3.4 4.9 4.0 3.5 3.3 2.7 2.7 2.2 2.1 2.1 1.9 1.9 6.4 4.9 5.2 4.6 4.3 4.5 3.5 3.5 3.0 2.8 2.7 7.4 6.5 6.3 6.1 5.5 5.9 5.8 5.9 5.8 5.4 5.7 4.9 3.8 3.1 3.2 2.5 3.0 2.4 1.8 2.4 2.3 1.9 1.4 1.4 1.4 1.4 1.5 1.5 1.2 1.1 1.2 1.2 1.0 0.8 0.7 0.6 0.6 0.6 0.5 0.3 0.3 0.3 0.3 0.2 1.8 2.0 1.5 1.7 1.2 1.3 0.8 1.0 1.1 0.8 1.0 0.7 0.8 0.7 0.7 0.6 0.9 0.5 0.4 0.5 0.4 0.5 0.6 0.9 0.8 0.7 0.6 0.6 0.5 0.4 0.7 0.4 0.5 20.7 19.7 20.1 20.0 19.7 18.6 18.1 18.5 16.9 15.1 14.5 33.9 32.4 32.2 32.7 33.1 32.3 31.2 31.3 30.1 24.3 22.9 31.7 30.5 30.0 31.3 31.0 27.2 27.5 28.2 27.9 23.4 23.3 36.3 35.9 35.6 35.2 34.6 32.9 31.9 33.4 32.4 28.5 31.9 23.9 23.6 22.5 23.1 21.8 20.3 19.4 21.0 18.7 18.4 16.0 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 111 3. UTILIZATION OF PRENATAL CARE SERVICES (Per 100 live births) Indicator ALL ARIZONA RESIDENTS White nonHispanic Figure 3-1. - No care in the 1 st trimester 2013 18.7 2012 17.4 2011 18.3 2010 18.1 2009 19.7 2008 20.6 2007 22.4 2006 22.3 2005 22.3 2004 23.7 2003 24.4 Figure 3-2. - Fewer than five prenatal visits 2013 5.1 2012 4.8 2011 5.0 2010 4.9 2009 5.3 2008 5.4 2007 6.0 2006 6.4 2005 6.5 2004 7.4 2003 7.2 Figure 3-3. - No prenatal care 2013 1.4 2012 1.2 2011 1.6 2010 1.6 2009 1.8 2008 1.8 2007 2.2 2006 2.4 2005 2.3 2004 2.8 2003 2.9 4. Black or African American American Indian or Alaska Native Asian or Pacific Islander 12.6 11.6 12.0 11.8 12.1 12.7 13.5 13.1 12.3 12.7 13.2 23.8 21.8 23.5 23.4 25.9 26.6 29.5 29.9 30.5 33.0 34.2 21.8 20.1 19.6 18.4 19.7 22.4 23.2 22.6 24.4 24.2 24.3 31.3 31.8 31.4 30.6 34.0 34.9 34.1 34.1 32.1 31.0 31.2 13.6 12.9 13.5 11.9 11.9 13.6 13.5 13.9 13.7 15.3 15.8 2.8 2.6 2.3 2.3 2.5 2.7 3.0 2.9 2.8 2.8 2.9 6.8 6.4 6.9 6.8 7.4 6.9 8.1 8.8 19.2 11.0 10.4 6.0 5.6 5.6 5.8 5.3 5.8 7.1 6.4 13.4 7.9 7.6 11.9 11.1 11.5 11.0 10.7 12.4 12.0 13.2 12.6 12.1 11.8 3.3 3.1 3.3 3.1 3.4 3.7 3.3 3.2 3.5 4.4 4.5 0.7 0.6 0.6 0.6 0.7 0.7 0.9 0.9 0.8 0.7 0.6 2.1 1.9 2.5 2.6 2.9 2.5 3.2 3.6 6.7 4.5 4.8 1.3 1.1 1.6 1.7 1.6 2.1 2.7 2.3 4.4 3.3 3.5 2.4 2.0 2.5 2.3 2.1 3.1 3.2 3.5 3.0 3.0 2.4 0.7 0.7 1.0 1.2 1.3 1.3 1.5 1.2 1.0 1.5 1.6 NEWBORN'S HEALTH (Infant, neonatal and postneonatal rates are per 1,000 live births. All other indicators are expressed per 100 live births). Indicator ALL ARIZONA RESIDENTS Figure 4-1. - Hyaline membrane disease 2013 0.2 2012 0.2 2011 0.3 112 Hispanic or Latino White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 0.3 0.2 0.3 0.3 0.2 0.3 0.3 0.3 0.4 0.1 0.1 0.2 0.1 0.3 0.1 2010 0.4 0.5 0.4 0.8 0.2 0.3 2009 0.5 0.6 0.4 0.7 0.2 0.3 2008 0.5 0.7 0.4 0.4 0.3 0.6 2007 0.4 0.5 0.2 0.6 0.2 0.4 2006 0.2 0.3 0.2 0.4 0.3 0.2 2005 0.3 0.4 0.1 0.5 0.3 0.2 2004 0.3 0.4 0.2 0.3 0.4 0.3 2003 0.3 0.5 0.2 0.2 0.3 0.3 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 4. NEWBORN'S HEALTH (continued) (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 or Latino Figure 4-2. - Newborn intensive care 2013 5.3 5.3 2012 4.9 4.7 2011 5.4 5.6 2010 6.2 6.3 2009 6.2 6.5 2008 6.0 6.5 2007 5.1 5.7 2006 5.1 5.7 2005 5.7 6.5 2004 5.7 6.4 2003 5.4 6.2 Figure 4-3. - Born too early (preterm or <37 weeks) 2013 9.0 8.4 2012 9.2 8.7 2011 9.3 9.1 2010 9.7 9.3 2009 10.0 9.9 2008 10.2 10.1 2007 10.3 10.4 2006 10.6 10.5 2005 10.7 10.9 2004 11.0 11.4 2003 10.5 11.0 Figure 4-4. - Born too small: low-birthweight (<2,500 grams) 2013 6.9 6.4 2012 6.9 6.5 2011 7.0 6.7 2010 7.1 6.7 2009 7.1 6.9 2008 7.1 6.9 2007 7.1 7.1 2006 7.1 6.7 2005 6.9 6.9 2004 7.2 7.2 2003 7.1 6.9 Figure 4-5. - Born too small: very low-birthweight (<1,500 grams) 2013 1.1 1.0 2012 1.2 1.0 2011 1.2 1.1 2010 1.1 0.9 2009 1.2 1.1 2008 1.2 1.1 2007 1.2 1.1 2006 1.2 1.1 2005 1.2 1.1 2004 1.2 1.1 2003 1.1 1.1 Figure 4-6. - Incidence of congenital anomalies (birth defects) 2013 0.7 0.7 2012 0.8 0.8 2011 1.1 1.1 2010 0.6 0.6 2009 0.6 0.7 2008 0.9 0.9 2007 0.8 0.9 2006 0.9 0.9 2005 1.0 1.0 2004 1.0 1.0 2003 1.0 1.0 Black or African American American Indian or Alaska Native Asian or Pacific Islander 5.2 4.9 5.2 5.8 5.8 5.4 4.5 4.4 5.1 5.2 4.7 7.2 6.9 7.5 8.1 9.2 7.6 7.3 7.0 7.4 7.2 7.0 4.1 4.2 4.3 5.6 4.7 4.9 4.5 4.8 5.1 4.4 4.2 5.5 4.1 5.2 6.0 6.2 6.7 4.9 4.9 5.4 5.8 5.6 9.3 9.4 9.1 9.5 9.7 9.9 9.8 10.1 10.1 10.3 9.8 11.8 11.9 12.7 12.3 14.4 14.0 14.9 14.5 16.4 14.4 14.4 9.7 9.7 9.0 10.7 9.6 9.8 10.4 11.7 10.6 10.9 9.8 8.9 8.4 9.0 10.0 10.0 10.0 9.6 10.4 10.2 11.0 10.8 6.6 6.8 6.4 6.8 6.6 6.7 6.6 6.9 6.4 6.8 6.9 11.1 11.7 12.5 11.4 12.8 11.7 12.8 12.7 12.6 11.6 11.7 7.2 6.7 6.9 7.0 6.4 6.7 6.6 7.4 7.3 7.2 6.8 7.9 7.2 8.3 8.5 8.8 9.1 8.0 8.5 8.0 8.0 8.5 1.1 1.1 1.1 1.1 1.1 1.1 1.2 1.2 1.2 1.2 1.1 2.0 2.3 2.5 2.6 2.8 2.6 2.6 2.3 2.5 2.5 2.2 1.0 1.1 1.3 1.2 0.9 1.1 1.0 1.1 1.1 0.9 0.9 1.1 0.8 1.1 1.4 1.5 1.5 1.0 1.1 1.2 1.1 1.5 0.8 0.8 1.1 0.7 0.6 0.9 0.7 0.8 0.9 1.0 1.0 0.9 0.7 1.0 0.6 0.7 0.8 0.7 0.8 0.9 0.6 1.0 0.8 0.9 1.4 0.6 0.8 0.9 1.4 1.2 1.5 1.6 1.3 0.5 0.8 0.8 0.5 0.4 0.7 0.8 0.5 1.2 0.7 1.0 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 113 4. NEWBORN'S HEALTH (continued) (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 or Latino Figure 4-7. - Infant mortality 2013 5.3 4.2 5.6 2012 5.8 4.0 7.1 2011 5.9 4.5 7.1 2010 6.0 3.9 6.8 2009 5.9 4.8 5.6 2008 6.3 5.1 5.9 2007 6.8 5.6 7.4 2006 6.3 5.4 6.6 2005 6.8 6.2 7.0 2004 6.7 5.4 7.7 2003 6.5 5.4 7.0 Figure 4-8. - Sudden Infant Death Syndrome (SIDS) 2013 0.2 0.2 0.1 2012 0.2 0.1 0.1 2011 0.3 0.2 0.3 2010 0.4 0.3 0.3 2009 0.5 0.3 0.4 2008 0.2 0.1 0.1 2007 0.4 0.5 0.3 2006 0.4 0.5 0.2 2005 0.3 0.3 0.3 2004 0.3 0.3 0.3 2003 0.3 0.3 0.3 Figure 4-9. - Mortality of infants from low birthweight/short gestation 2013 0.7 0.4 0.9 2012 0.7 0.5 1.1 2011 0.7 0.5 0.8 2010 0.7 0.3 1.0 2009 1.1 0.8 1.3 2008 0.9 0.6 0.8 2007 0.9 0.5 1.2 2006 0.9 0.6 1.1 2005 0.8 0.5 1.2 2004 0.9 0.7 1.1 2003 0.9 0.6 1.1 Figure 4-10. - Neonatal mortality 2013 3.4 2.5 4.0 2012 3.9 2.6 5.1 2011 3.9 3.1 4.7 2010 3.8 2.5 4.5 2009 3.9 3.2 3.9 2008 4.2 3.3 4.1 2007 4.7 3.8 5.2 2006 4.3 3.7 4.7 2005 4.4 4.1 4.9 2004 4.5 3.9 5.1 2003 4.3 3.7 4.9 Figure 4-11. - Postneonatal mortality 2013 1.9 1.7 1.6 2012 1.9 1.4 2.0 2011 2.0 1.3 2.4 2010 2.2 1.4 2.3 2009 2.0 1.6 1.7 2008 2.1 1.8 1.8 2007 2.2 1.8 2.2 2006 2.0 1.7 1.9 2005 2.4 2.1 2.1 2004 2.2 1.4 2.6 2003 2.2 1.7 2.1 114 Black or African American American Indian or Alaska Native Asian or Pacific Islander 12.5 11.0 7.3 11.1 17.1 17.7 15.1 16.8 12.8 12.1 15.9 6.6 7.4 7.4 8.1 8.4 8.2 8.1 6.4 8.3 7.2 7.5 1.7 3.3 2.9 3.9 3.8 7.9 3.2 2.2 5.3 3.8 4.4 0.6 0.4 0.5 0.5 1.8 0.9 1.0 0.8 0.6 0.6 0.7 0.2 0.2 0.3 0.9 0.8 0.6 0.6 0.3 0.6 0.0 0.3 0.0 0.3 0.0 0.3 0.3 0.3 0.0 0.3 0.7 0.0 0.0 1.7 0.5 1.1 2.5 3.0 3.5 2.4 2.6 1.2 2.2 3.6 0.5 0.2 1.2 1.0 0.5 0.6 0.8 1.1 0.5 0.5 0.9 0.3 0.0 0.6 0.0 0.6 2.0 0.9 0.6 0.0 0.0 0.4 8.0 7.2 4.6 7.4 10.5 11.9 10.3 9.6 5.5 7.8 10.3 3.7 3.8 3.3 3.8 4.2 4.6 4.2 4.0 4.3 3.4 3.1 0.9 1.9 2.9 3.3 2.9 6.4 2.6 1.0 3.2 2.7 2.0 4.4 3.8 2.7 3.7 6.6 5.8 4.8 7.2 7.3 4.4 5.6 2.9 3.6 4.1 4.3 4.2 3.6 3.9 2.4 4.0 3.8 4.4 0.9 1.4 0.0 0.6 0.9 1.5 0.6 1.2 2.1 1.1 2.4 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 5. MORTALITY FROM NATURAL CAUSES - Chronic or infectious diseases (Number of deaths per 100,000 population age-adjusted to 2000 standard) Indicator ALL ARIZONA RESIDENTS White nonHispanic Figure 5-1. - Cardiovascular diseases 2013 187.7 2012 193.3 2011 201.0 2010 188.6 2009 188.8 2008 194.1 2007 194.4 2006 216.4 2005 245.7 2004 248.5 2003 258.4 Figure 5-2. - Diseases of the heart 2013 143.0 2012 145.8 2011 152.7 2010 143.3 2009 145.9 2008 149.3 2007 149.5 2006 166.1 2005 186.9 2004 186.7 2003 197.1 Figure 5-3. - Coronary heart disease 2013 110.0 2012 112.7 2011 120.3 2010 112.9 2009 115.9 2008 118.3 2007 115.0 2006 130.2 2005 147.9 2004 148.7 2003 156.6 Figure 5-4. - Cerebrovascular disease 2013 28.2 2012 29.9 2011 30.6 2010 30.7 2009 28.9 2008 30.3 2007 30.6 2006 34.8 2005 40.6 2004 43.6 2003 43.9 Figure 5-5. - Chronic lower respiratory diseases 2013 44.5 2012 44.2 2011 45.9 2010 42.6 2009 40.5 2008 42.2 2007 39.2 2006 44.3 2005 46.8 2004 41.9 2003 45.4 Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 190.9 195.1 212.6 188.8 188.3 196.3 196.9 218.2 241.3 243.1 257.2 161.9 176.2 193.4 172.4 179.8 184.8 179.8 203.2 266.1 284.1 278.2 280.2 284.0 266.1 258.5 245.7 219.6 225.9 310.3 343.3 372.5 390.1 164.2 168.3 149.2 183.2 164.2 150.4 155.0 167.0 235.6 214.6 188.6 133.6 134.7 122.4 130.0 150.8 121.4 108.9 136.2 243.0 200.3 145.3 147.6 150.0 164.3 145.4 147.5 153.1 153.2 168.8 185.2 184.9 197.7 116.1 123.4 137.4 121.3 130.5 132.0 131.5 149.8 189.6 197.6 198.5 200.5 190.5 174.0 177.7 171.3 161.7 171.3 231.9 250.3 258.5 299.4 122.9 122.7 111.1 135.9 125.8 114.6 115.2 129.4 179.1 166.9 141.9 82.5 87.9 77.0 86.8 96.7 71.8 58.6 94.7 159.8 135.3 97.6 113.3 115.9 130.6 114.5 117.3 121.8 118.0 132.3 147.3 147.3 157.8 91.6 95.5 106.0 96.3 103.7 103.3 101.7 117.3 147.1 158.2 154.4 164.0 156.1 142.7 159.3 137.3 131.9 136.6 190.1 211.4 207.5 245.7 92.7 88.9 79.6 98.6 94.6 83.2 84.6 97.6 133.7 137.5 100.7 63.4 80.5 61.0 75.6 81.0 61.5 47.9 86.2 113.7 120.6 75.5 27.1 28.1 30.4 29.4 27.5 29.2 29.7 34.1 38.8 41.4 41.7 29.7 35.5 34.9 35.1 33.8 33.6 34.9 37.3 51.0 61.3 61.9 54.4 56.0 56.5 53.5 42.8 40.0 34.1 58.2 66.0 71.5 69.0 23.4 27.1 29.7 29.8 24.7 23.5 22.0 27.0 32.3 27.5 36.4 30.7 30.9 29.1 26.0 39.2 36.2 37.7 18.4 64.6 45.1 35.9 49.3 49.4 55.3 47.1 45.0 46.9 43.7 49.2 49.6 45.1 48.3 20.9 20.3 19.5 18.6 16.4 20.5 18.8 18.3 31.6 22.7 28.7 46.7 35.0 34.8 27.4 26.8 26.0 18.7 27.3 43.9 24.9 30.3 15.5 18.0 14.4 21.7 19.2 15.8 13.0 8.4 12.0 10.8 19.4 19.4 14.7 17.2 12.0 18.0 13.7 7.5 9.9 17.9 21.6 15.5 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 115 5. MORTALITY FROM NATURAL CAUSES - Chronic or infectious diseases (continued) (Number of deaths per 100,000 population age-adjusted to 2000 standard) Indicator ALL ARIZONA RESIDENTS White nonHispanic Figure 5-6. - Malignant neoplasms (cancer) 2013 149.6 2012 149.8 2011 151.3 2010 150.5 2009 147.2 2008 145.5 2007 148.0 2006 154.7 2005 161.8 2004 164.7 2003 169.4 Figure 5-7. - Lung cancer 2013 36.4 2012 37.7 2011 37.8 2010 38.1 2009 39.0 2008 38.5 2007 38.2 2006 42.7 2005 43.0 2004 45.4 2003 47.4 Figure 5-8. - Breast cancer (female) 2013 20.7 2012 19.2 2011 19.7 2010 19.2 2009 19.2 2008 19.8 2007 20.1 2006 21.6 2005 20.7 2004 21.4 2003 22.1 Figure 5-9. - Cervical cancer 2013 2.4 2012 2.0 2011 2.1 2010 2.0 2009 1.8 2008 1.8 2007 1.9 2006 1.7 2005 2.1 2004 2.2 2003 2.2 Figure 5-10. - Colorectal cancer 2013 13.6 2012 13.1 2011 13.4 2010 13.8 2009 12.9 2008 13.1 2007 14.4 2006 14.6 2005 15.4 2004 15.3 2003 17.9 116 Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 154.3 155.6 170.3 155.6 151.1 150.4 154.6 162.8 162.4 165.4 171.2 129.8 127.2 136.3 126.2 128.4 123.8 118.6 124.7 165.9 161.6 168.5 190.4 180.1 167.1 182.6 153.1 149.2 153.4 163.5 217.9 227.7 218.5 118.2 100.8 100.8 106.4 113.3 106.7 113.9 83.1 122.2 139.3 120.7 100.1 100.5 116.6 96.2 108.1 104.4 84.2 82.0 112.7 111.0 132.9 40.2 41.5 46.7 41.7 42.7 42.3 42.4 47.4 45.9 48.2 50.6 22.1 22.0 22.9 20.6 23.7 20.0 20.5 21.4 29.0 29.4 33.5 40.5 43.0 36.6 36.6 38.7 37.1 39.6 45.9 53.0 61.4 59.4 10.0 9.3 7.9 7.5 10.0 11.2 9.9 4.7 6.5 17.3 13.2 22.9 20.9 20.8 22,.1 26.6 32.7 21.5 18.4 19.7 21.5 21.9 21.3 20.0 20.8 19.9 19.8 20.6 20.5 23.2 20.5 21.4 22.3 19.7 14.8 12.2 18.5 16.4 15.1 16.9 14.0 19.8 18.0 18.9 23.3 30.3 24.1 25.8 30.7 38.0 23.9 25.7 35.7 32.2 41.2 13.1 8.6 7.5 8.2 11.6 11.6 16.2 6.9 14.9 18.4 16.4 11.4 15.3 15.6 12.9 5.9 7.1 11.3 7.5 17.3 35.2 19.6 2.1 1.8 1.6 1.6 1.5 1.3 1.6 1.4 1.8 1.6 1.0 4.4 1.8 3.7 2.8 2.1 3.3 3.2 2.4 4.1 5.0 1.8 1.5 4.4 2.4 1.8 2.2 3.3 2.3 2.7 1.4 2.8 6.8 2.0 2.8 3.1 5.0 4.1 4.8 2.3 5.8 3.4 2.0 4.2 0.8 2.5 3.0 3.5 2.9 0.0 1.2 1.2 4.6 3.6 10.5 13.7 13.4 14.4 13.9 12.9 13.2 15.0 15.1 15.2 15.5 17.9 12.5 12.2 13.6 13.5 13.8 13.2 12.0 14.2 17.6 13.1 21.2 21.7 20.5 20.2 21.9 14.1 16.4 15.7 14.9 27.0 27.3 26.3 11.3 7.1 9.9 12.4 8.5 11.1 8.0 4.7 7.5 9.3 6.3 12.1 9.8 14.3 10.3 13.8 8.6 9.4 6.5 12.5 11.0 3.0 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 5. MORTALITY FROM NATURAL CAUSES - Chronic or Infectious Diseases (continued) (Number of deaths per 100,000 population age-adjusted to 2000 standard) Indicator Figure 5-11. 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 Figure 5-12. 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 Figure 5-13. 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 Figure 5-14. 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 Figure 5-15. 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander Prostate cancer 18.2 18.9 19.8 19.1 18.4 19.1 18.9 20.1 23.8 24.0 25.1 Influenza and pneumonia 10.0 9.1 9.7 10.9 14.6 15.6 12.9 18.4 22.3 20.1 23.4 Diabetes 23.6 23.5 24.8 20.1 15.7 17.0 17.0 18.9 20.1 20.7 20.3 Chronic liver disease and cirrhosis 14.5 13.6 13.4 12.3 12.2 11.7 11.3 11.4 12.7 11.1 11.5 HIV disease 1.4 1.5 1.6 1.6 1.6 1.8 1.7 2.3 2.4 2.8 3.2 18.0 18.8 19.5 18.4 18.2 18.9 19.5 19.2 23.5 22.6 25.2 17.0 22.0 20.6 23.9 20.0 20.3 15.8 25.9 30.6 35.0 22.4 26.7 26.7 24.1 35.2 28.9 20.5 23.6 34.9 20.4 54.6 41.2 19.9 12.4 17.1 21.6 16.4 14.7 16.6 16.9 23.5 31.2 21.0 18.5 9.8 5.0 12.6 2.1 25.5 19.4 24.0 5.1 6.1 7.6 9.6 8.7 9.3 10.3 13.0 14.6 12.3 17.7 20.5 19.4 21.8 10.9 9.0 12.0 9.8 15.5 18.3 14.4 20.0 26.5 20.7 27.9 11.9 8.7 8.1 9.2 14.3 12.4 13.0 18.1 21.6 12.0 30.4 24.7 30.0 28.4 33.2 42.7 36.3 34.3 32.8 72.0 32.7 58.9 8.0 4.5 9.1 8.0 16.3 13.5 7.4 21.7 17.5 10.5 16.4 18.6 18.3 21.6 15.2 12.2 13.8 13.7 15.2 15.5 16.8 16.5 40.7 40.8 41.7 37.3 28.1 29.1 30.8 40.4 46.0 43.5 39.1 60.2 49.4 57.8 50.0 31.1 30.8 30.3 43.9 55.2 44.8 53.6 65.7 80.2 61.3 79.3 54.2 50.8 51.1 43.9 69.9 59.0 55.8 17.9 27.6 23.3 11.7 16.2 16.1 5.1 10.9 17.8 30.0 15.7 12.6 11.4 12.0 9.7 9.5 10.0 9.6 9.6 10.7 8.4 9.7 16.7 16.9 18.9 15.5 18.7 15.4 16.3 15.5 19.4 18.6 17.6 6.8 10.9 6.6 8.0 3.1 7.5 5.9 7.2 12.8 6.7 3.5 62.0 59.2 43.6 64.6 54.0 40.7 36.8 43.6 51.2 51.0 38.8 3.9 2.6 4.2 0.5 3.1 1.8 3.2 3.1 4.9 3.8 3.3 1.2 1.3 1.2 1.3 1.0 1.5 1.3 2.1 2.0 2.3 2.8 1.2 1.4 1.7 1.7 2.1 1.9 1.7 2.3 2.5 3.1 4.3 5.9 4.5 5.4 5.7 8.9 4.9 6.0 7.2 9.2 14.6 8.1 1.9 2.0 2.0 1.9 3.7 2.2 3.6 1.8 3.1 3.5 3.6 0.0 1.4 1.2 0.5 0.0 0.6 0.4 0.6 0.5 0.8 1.7 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 117 5. MORTALITY FROM NATURAL CAUSES - Chronic or Infectious Diseases (continued) (Number of deaths per 100,000 population age-adjusted to 2000 standard) Indicator Figure 5-16. 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 Figure 5-17. 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 Figure 5-18. 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 Figure 5-19. 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 Figure 5-20. 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 118 ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander Septicemia 4.8 4.5 4.7 7.4 7.7 7.9 8.1 8.6 8.4 8.0 8.4 4.5 4.2 4.2 7.5 6.5 6.7 7.0 7.7 7.3 6.6 7.1 6.1 3.8 6.4 7.8 8.0 11.0 10.4 11.0 13.0 14.4 12.6 7.4 6.3 6.4 4.4 13.2 10.9 14.7 14.6 18.2 16.0 11.3 11.4 15.8 16.5 8.1 31.4 20.6 17.8 17.3 18.2 21.5 25.8 3.8 4.4 3.2 1.4 9.2 7.1 10.9 5.5 6.2 4.6 6.8 41.3 38.5 54.7 46.7 29.6 42.5 29.8 28.8 42.7 42.8 43.3 16.0 12.0 18.1 14.9 10.9 8.5 10.3 15.3 16.2 8.0 5.6 18.2 31.3 21.0 32.2 18.1 18.4 12.9 8.3 30.2 17.1 11.4 12.2 17.0 10.0 16.5 16.2 9.8 19.1 9.8 19.8 26.6 20.9 15.8 15.5 15.3 19.9 19.6 23.5 20.6 23.3 31.4 30.2 24.7 6.2 3.2 8.6 3.8 1.5 5.3 5.0 5.2 9.2 16.0 16.0 21.3 28.3 29.4 17.6 22.0 12.3 12.7 12.9 15.6 27.0 14.5 12.7 14.6 6.9 16.3 7.0 6.7 11.2 8.5 15.8 13.2 5.4 17.0 11.3 9.8 3.8 10.6 5.0 7.3 14.1 6.8 6.0 9.4 918.5 886.5 833.6 835.0 736.8 710.7 719.2 885.1 1053.1 1021.7 1048.6 887.0 843.8 765.5 891.8 823.5 766.3 752.5 744.5 1006.6 879.2 900.7 413.4 440.1 436.7 424.1 472.8 427.0 356.3 393.4 629.5 557.5 497.2 Alzheimer's disease 33.2 33.4 35.6 31.1 31.6 29.5 35.2 36.3 30.9 35.1 35.5 32.6 29.5 30.4 26.9 29.8 30.6 26.3 29.6 30.9 24.1 33.4 34.7 28.0 32.7 33.0 31.3 31.3 32.0 26.6 32.5 33.4 28.2 Nephritis, nephrotic syndrome and nephrosis (kidney disease) 5.3 4.9 4.5 6.2 5.3 8.7 6.0 5.4 8.8 7.6 6.3 10.7 7.7 6.2 14.1 7.1 5.6 13.2 7.6 6.0 13.1 8.8 7.4 14.2 10.4 8.5 22.5 11.0 8.9 21.5 10.1 8.4 18.4 Essential (primary) hypertension 9.7 8.9 11.4 10.4 9.7 10.8 10.8 10.5 12.9 6.3 5.4 6.3 6.8 6.1 9.0 6.9 6.4 9.5 5.7 5.3 5.6 6.7 6.1 8.3 6.8 5.9 13.2 7.3 6.2 11.9 6.3 6.0 7.9 Total mortality from all causes 687.8 693.7 615.6 687.2 693.1 616.2 699.6 741.5 656.4 679.9 674.4 612.0 653.2 647.3 614.9 659.6 660.1 606.9 663.2 665.1 603.7 727.3 728.5 685.6 772.5 744.6 849.2 757.3 734.6 834.0 784.0 764.9 839.5 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 6. MORTALITY FROM INJURIES (Number of deaths per 100,000 population age-adjusted to 2000 standard) Indicator ALL ARIZONA RESIDENTS Figure 6-1. - Unintentional injuries 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 Figure 6-2. - Motor vehicle-related 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 Figure 6-3. - Fall-related injuries 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 Figure 6-4. - Drowning mortality 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 Figure 6-5. - Injury by firearms 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 46.3 42.4 45.5 43.8 43.1 44.7 46.6 51.2 51.1 46.0 44.8 injuries 11.4 11.4 12.1 11.1 11.6 13.6 16.2 19.6 18.9 18.1 18.0 White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander 47.9 43.3 46.9 45.5 43.3 45.4 44.9 48.7 46.2 43.3 40.9 38.5 33.9 38.9 33.7 35.3 34.2 40.6 52.4 54.8 48.9 44.7 43.3 38.2 41.6 36.0 36.5 43.1 48.1 54.8 64.3 45.9 52.4 104.5 94.8 100.6 99.2 92.6 92.6 95.0 97.2 117.8 103.9 108.6 13.4 21.0 19.7 24.6 24.5 23.7 20.3 19.8 34.2 21.2 25.3 10.2 10.0 10.4 9.2 10.1 12.0 13.1 16.6 15.0 15.3 14.6 11.4 10.6 11.7 11.1 10.6 13.1 17.6 21.9 22.7 23.2 21.3 12.0 10.1 11.7 10.8 12.4 11.5 13.6 15.3 24.9 14.8 15.2 31.7 37.8 44.2 41.7 36.9 41.9 49.0 56.9 62.6 54.1 59.0 5.8 4.9 6.8 5.5 6.5 4.4 9.9 5.9 10.2 11.3 11.8 12.1 11.2 11.6 11.5 10.4 10.8 10.6 11.3 12.0 9.6 8.8 12.4 11.5 12.0 11.9 10.5 11.0 10.9 11.3 11.9 9.5 9.0 12.0 9.1 10.5 8.0 9.9 8.6 7.5 12.0 12.1 8.7 5.5 8.8 6.6 8.9 2.3 3.8 7.1 7.0 7.1 6.5 8.8 6.3 10.3 13.2 15.8 17.5 15.3 13.4 9.7 9.9 10.4 14.9 12.7 5.7 5.2 6.4 8.8 10.8 8.7 5.6 7.4 15.0 3.3 7.5 1.1 1.3 1.3 1.3 1.5 1.2 1.3 1.5 1.4 1.8 1.5 1.1 1.3 1.3 1.5 1.3 1.0 1.3 1.0 1.1 1.6 1.3 1.0 0.8 1.0 0.7 1.4 1.1 1.2 1.9 1.3 1.6 1.5 0.7 2.4 2.6 0.4 2.0 2.4 2.7 2.3 2.9 4.1 2.7 1.3 2.9 2.2 3.0 3.7 1.9 2.5 1.5 3.4 3.0 2.5 1.5 2.8 2.0 2.5 1.6 2.0 0.6 2.5 3.2 1.7 0.5 14.1 13.8 14.7 14.2 12.8 13.5 14.4 15.4 15.2 15.0 14.8 15.8 15.7 16.3 15.3 13.0 12.6 13.3 13.9 12.0 13.2 12.7 8.6 8.2 10.8 9.9 10.4 12.1 14.9 15.6 18.4 16.8 15.7 17.0 15.5 16.2 15.5 16.0 22.4 25.1 21.5 23.4 23.7 23.2 13.0 12.6 9.2 11.7 8.3 7.6 7.6 8.0 15.6 12.6 15.6 5.1 5.3 2.4 6.9 4.4 4.6 3.1 2.9 7.5 1.4 1.8 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 119 6. MORTALITY FROM INJURIES (continued) (Number of deaths per 100,000 population age-adjusted to 2000 standard) Indicator ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander Figure 6-6. - Drug-induced deaths 2013 16.9 21.2 9.9 13.5 18.7 2012 16.3 20.6 9.0 17.6 13.4 2.8 2011 16.8 21.6 10.9 12.6 9.6 1.8 2010 17.6 22.2 10.2 14.6 12.5 2.2 2009 16.8 20.6 9.9 14.8 13.2 1.8 2008 14.9 18.7 6.8 17.9 10.9 3.3 2007 15.1 18.5 8.7 19.7 8.7 2.9 2006 15.1 17.5 10.4 24.6 10.6 5.1 2005 13.8 14.8 10.6 28.4 12.4 2.1 2004 13.3 14.7 9.4 14.7 14.5 0.8 2003 12.0 Figure 6-7. - Alcohol-induced deaths 12.8 10.5 23.5 8.5 0.0 2013 15.7 13.7 12.5 7.1 84.7 2.0 2012 14.2 12.0 12.8 9.6 78.6 2.5 2011 14.3 12.5 14.3 6.0 64.1 1.9 2010 14.1 12.0 11.0 7.3 84.8 0.0 2009 12.0 10.0 10.1 7.0 62.1 2.8 2008 11.8 10.6 9.2 7.3 54.3 1.8 2007 11.1 9.4 11.8 6.9 49.3 2.5 2006 10.3 8.7 10.2 5.8 48.1 0.7 2005 11.2 9.9 11.0 6.7 51.1 7.2 2004 10.0 8.0 9.8 7.3 55.4 3.8 8.3 10.2 6.8 49.3 0.0 2003 10.1 Figure 6-8. - Intentional self-harm (suicide) 2013 17.0 20.8 8.4 6.7 21.9 7.0 2012 16.2 20.2 6.8 10.0 17.9 5.7 2011 17.2 22.0 8.1 9.1 14.9 5.3 2010 16.7 20.6 7.4 6.4 18.7 6.8 2009 16.1 18.4 9.0 10.5 15.9 9.9 2008 14.8 17.6 6.5 7.5 13.5 9.9 2007 15.4 18.7 9.2 6.2 9.8 6.1 2006 15.4 17.8 8.2 8.3 13.7 8.4 2005 15.4 16.6 10.5 3.3 17.5 11.7 2004 14.9 16.6 9.8 12.1 17.0 4.0 14.6 16.4 8.2 11.3 15.2 6.0 2013 5.9 4.0 5.8 15.4 17.7 1.9 2012 5.9 4.3 6.1 14.5 17.3 2.0 2011 6.1 3.5 7.9 16.5 11.9 3.9 2010 6.5 3.8 8.0 15.4 18.0 4.1 2009 5.5 3.2 8.1 14.2 13.2 0.9 2008 7.1 3.7 10.6 20.7 12.8 3.2 2007 7.7 3.9 12.0 23.4 13.1 2.6 2006 8.5 4.6 13.0 19.6 13.2 2.4 2005 8.2 3.5 14.6 27.4 14.0 5.1 2004 8.2 4.8 13.6 22.3 14.7 1.4 2003 8.3 3.7 14.7 24.9 18.8 5.4 2003 Figure 6-9. - Assault (homicide) 120 0.4 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 7. AGE-SPECIFIC MORTALITY (Number of deaths per 100,000 persons in specified group) Indicator ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander Figure 7-1. - Mortality among children 1-14 years old 2013 19.8 17.1 17.7 30.9 49.2 11.5 2012 19.4 14.9 16.5 37.7 57.4 23.8 2011 17.5 15.4 16.4 32.4 21.9 10.6 2010 18.9 18.3 17.2 18.8 30.5 32.6 2009 20.2 15.0 21.9 28.5 35.6 22.9 2008 19.7 14.6 21.0 39.3 29.4 17.2 2007 19.5 14.2 22.1 29.1 34.3 17.5 2006 21.5 18.2 23.5 20.2 33.3 22.0 2005 22.7 17.4 26.3 35.7 33.4 18.7 2004 20.4 17.2 21.0 39.2 32.1 9.7 2003 24.3 21.8 22.1 42.5 45.3 9.2 Figure 7-2. - Mortality among adolescents 15-19 years old 2013 45.5 42.5 39.1 64.1 103.1 32.4 2012 47.1 46.1 37.7 55.8 107.9 50.0 2011 49.7 45.8 44.1 39.8 114.2 15.2 2010 47.7 39.7 43.1 59.4 115.3 32.7 2009 55.9 44.7 62.2 49.2 102.6 44.4 2008 65.7 47.7 80.0 85.6 111.8 35.8 2007 76.9 66.1 83.9 91.5 124.4 18.1 2006 93.8 72.4 103.0 127.1 188.6 29.1 2005 80.1 68.6 89.2 88.7 137.0 24.6 2004 80.8 64.9 91.1 150.9 134.5 25.4 2003 75.4 51.6 87.5 89.5 196.2 36.2 Figure 7-3. - Mortality among young adults 20-44 years old 2013 143.5 143.2 112.6 174.2 390.8 51.3 2012 135.0 140.6 98.3 171.0 351.4 43.7 2011 133.6 136.0 102.4 152.4 276.5 46.1 2010 131.8 133.4 96.9 142.1 358.1 55.5 2009 123.0 120.4 95.7 185.6 332.1 50.5 2008 123.0 119.4 98.2 190.9 287.0 52.2 2007 138.2 132.3 123.3 193.9 291.3 50.3 2006 147.5 142.7 132.9 177.3 305.1 64.1 2005 140.9 122.1 140.7 227.3 348.3 61.3 2004 141.0 130.8 134.0 209.0 293.3 59.7 2003 151.1 139.6 139.1 220.4 345.8 56.8 Figure 7-4. - Mortality among middle-age adults 45-64 years old 2013 620.7 661.0 461.2 788.7 943.5 199.0 2012 607.6 637.5 466.9 786.8 880.3 295.4 2011 595.0 611.6 473.9 759.3 726.8 319.3 2010 587.2 594.6 448.9 772.0 978.8 282.1 2009 590.0 593.9 488.5 808.8 846.9 302.0 2008 591.8 609.7 445.9 843.0 832.3 301.5 2007 582.8 593.4 494.0 833.6 737.5 272.9 2006 614.6 638.3 477.3 872.5 775.4 194.3 2005 673.1 654.2 631.6 1103.8 1077.0 313.1 2004 649.1 633.9 592.2 1032.2 1019.2 375.8 2003 653.7 651.1 593.5 909.7 914.9 292.2 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 121 8. PREMATURE MORTALITY Indicator ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander Figure 8-1. - Median age at death from all causes 2013 77.0 79.0 69.0 66.0 60.0 76.0 2012 77.0 78.0 68.0 65.0 59.0 73.0 2011 77.0 79.0 68.0 66.0 60.0 72.0 2010 77.0 79.0 68.0 65.0 58.0 71.0 2009 76.0 78.0 67.0 64.0 59.0 74.0 2008 77.0 78.0 68.0 62.0 59.0 70.0 2007 76.0 78.0 64.0 62.0 59.0 70.0 2006 76.0 78.0 65.0 63.0 57.0 73.0 2005 77.0 79.0 65.0 64.0 59.0 72.0 2004 76.0 78.0 65.0 64.0 58.0 69.0 2003 76.0 78.0 66.0 66.0 56.0 70.0 Figure 8-2. - Median age at death from all causes among males 2013 74.0 76.0 64.0 63.0 55.0 73.0 2012 73.0 75.0 64.0 63.0 55.0 68.0 2011 73.0 76.0 63.0 64.0 54.0 69.0 2010 73.0 75.0 63.0 63.0 53.0 70.0 2009 73.0 75.0 63.0 60.0 54.0 69.0 2008 73.0 76.0 62.0 59.0 54.0 67.5 2007 73.0 75.0 59.0 57.0 54.0 64.0 2006 73.0 75.0 59.0 59.0 52.0 71.5 2005 74.0 76.0 61.0 58.0 54.0 71.0 2004 73.0 75.0 60.0 59.0 53.0 68.0 2003 73.0 75.0 60.0 60.0 51.0 70.0 Figure 8-3. - Median age at death from all causes among females 2013 81.0 82.0 75.0 73.0 67.0 78.0 2012 80.0 82.0 74.0 69.0 65.0 78.0 2011 81.0 82.0 75.0 69.0 67.0 75.0 2010 80.0 82.0 74.0 69.0 65.0 74.0 2009 80.0 81.0 72.0 68.0 66.0 77.0 2008 80.0 81.0 74.0 67.0 67.0 73.0 2007 80.0 81.0 71.0 70.0 67.0 73.0 2006 80.0 81.0 73.0 70.0 65.0 73.0 2005 80.0 81.0 71.0 71.0 66.0 73.0 2004 80.0 81.0 72.0 70.0 64.0 70.0 2003 80.0 81.0 72.0 71.0 65.0 71.0 58.9 Figure 8-4. - Percent of total deaths before expected years of life reached 122 2013 54.6 50.1 67.1 72.8 76.7 2012 55.0 50.9 68.4 74.4 78.7 62.3 2011 53.8 49.6 67.4 74.4 77.7 66.3 2010 54.5 49.9 68.7 73.4 79.6 65.1 2009 52.5 48.0 68.0 73.0 76.4 60.6 2008 52.4 48.0 67.6 74.7 76.5 66.4 2007 52.6 47.7 71.6 73.3 75.8 64.9 2006 52.7 48.2 70.8 73.9 77.4 61.0 2005 52.7 47.9 71.3 75.1 78.4 65.1 2004 53.0 48.3 71.5 74.3 80.3 64.3 2003 50.8 46.1 70.0 70.6 78.4 65.7 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 9. REPORTABLE DISEASES (Number of cases per 100,000 persons in specified group) Indicator ALL ARIZONA RESIDENTS White nonHispanic Hispanic or Latino Black or African American American Indian or Alaska Native Asian or Pacific Islander Figure 9-1. - Incidence of early syphilis 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 Figure 9-2. - Incidence of gonorrhea 7.5 5.4 7.2 6.2 6.5 8.8 8.8 6.2 5.1 6.5 7.4 5.3 3.9 4.8 3.8 4.4 5.8 4.2 3.5 2.9 3.1 4.2 9.3 6.3 10.3 7.4 9.3 11.1 7.8 7.6 8.6 9.6 9.7 19.9 12.2 23.8 15.1 11.1 19.8 17.0 14.9 16.5 16.6 18.2 9.6 9.1 10.5 12.4 11.6 16.1 30.5 8.4 10.6 14.9 20.1 2.7 3.2 1.8 2.3 1.7 4.1 3.5 1.2 2.6 0.9 0.9 2013 98.2 2012 89.4 2011 71.4 2010 50.8 2009 49.3 2008 52.8 2007 78.7 2006 95.3 2005 81.9 2004 70.1 2003 63.5 Figure 9-3. - Incidence of chlamydia 2013 466.6 2012 466.5 2011 457.6 2010 420.2 2009 394.2 2008 379.0 2007 386.6 2006 386.0 2005 352.0 2004 289.2 2003 227.1 Figure 9-4. - Incidence of HIV/AIDS 2013 11.1 2012 9.9 2011 9.2 2010 9.8 2009 10.2 2008 11.4 2007 12.7 2006 12.5 2005 12.8 2004 10.9 2003 11.3 37.4 31.0 28.9 21.5 19.0 21.0 33.1 44.0 31.5 32.5 33.4 92.7 89.8 67.1 52.0 46.4 49.5 60.4 81.6 95.0 84.6 71.4 351.0 380.6 415.7 305.7 316.0 256.8 345.6 382.4 395.7 376.8 359.7 224.6 185.7 162.8 85.1 50.0 73.3 94.4 125.7 142.6 142.7 103.1 23.2 25.1 19.9 11.1 11.5 9.9 13.5 13.6 14.6 12.3 15.3 149.3 148.7 186.8 174.8 156.3 130.9 142.5 150.1 121.9 115.7 100.7 518.0 540.1 533.0 494.2 471.5 413.3 346.1 406.9 468.5 413.6 329.1 848.9 884.3 1146.4 1148.5 926.9 778.6 722.7 634.2 778.1 676.8 537.6 1158.2 1096.9 1129.6 1042.2 679.3 739.8 641.6 676.8 827.6 872.7 623.9 129.3 106.8 132.5 157.8 150.6 100.3 91.3 95.7 99.7 110.6 86.4 7.8 6.7 6.4 8.4 7.4 9.6 9.8 9.3 10.1 8.2 11.4 12.7 11.0 11.4 10.9 13.2 12.9 15.8 15.5 16.0 13.9 7.4 44.9 40.3 29.9 21.6 28.0 31.1 35.5 48.8 41.6 45.3 42.5 16.2 15.1 11.4 12.8 11.0 10.2 8.3 8.1 15.1 10.3 11.3 4.5 8.3 8.0 5.8 5.7 6.4 8.8 6.2 6.9 7.1 4.2 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 123 SCORES IN 2013 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 125 SCORES IN 2013 (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). 1. TEEN PREGNANCIES Figure No. Indicator American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native 1-1 Pregnancies among females 19 and younger -49.0 30.2 30.7 54.7 1-2 Pregnancies among females 14 and younger -75.0 50.0 75.0 50.0 -64.6 -25.0 1-3 Pregnancies among females 15-17 years old -60.6 43.9 16.1 75.0 -79.4 1-4 Pregnancies among females 18-19 years old TOTAL SCORE AVERAGE SCORE -47.5 -232.1 -58.0 34.9 159.0 39.8 27.9 149.7 37.4 51.2 230.9 57.7 -60.6 -229.6 -57.4 2. MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS Figure No. Indicator American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native 2-1 Unmarried mothers 2-2 Tobacco use during pregnancy -32.8 26.6 41.2 75.6 -64.5 59.1 -59.1 47.7 -34.1 -75.0 2-3 2-4 Alcohol use during pregnancy 0.0 -50.0 50.0 175.0 -50.0 Chronic hypertension 0.0 0.0 63.6 27.3 -27.3 2-5 Dysfunctional labor -11.8 2-6 Anemia during pregnancy -12.8 0.0 0.0 52.9 5.9 -2.1 72.3 48.9 -4.3 2-7 Diabetes during pregnancy -22.8 2-8 Pregnancy associated hypertension 5.4 7.0 -12.3 94.7 70.2 -12.5 14.3 32.1 -12.5 2-9 Genital herpes during pregnancy 27.3 2-10 Weight gain of less than 21 pounds TOTAL SCORE AVERAGE SCORE -25.0 -13.4 -1.3 -27.3 63.6 -36.4 -45.5 22.8 -94.6 -9.5 14.9 355.3 35.5 31.5 467.5 46.8 -13.4 -216.4 -21.6 3. UTILIZATION OF PRENATAL CARE SERVICES Figure No. Indicator American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native 3-1 No care in the 1st trimester -32.6 27.3 16.6 67.4 -27.3 3-2 Fewer than five prenatal visits -45.1 33.3 17.6 133.3 -35.3 3-3 No prenatal care -50.0 -127.7 -42.6 50.0 110.6 36.9 -7.1 27.1 9.0 71.4 272.1 90.7 -50.0 -112.6 -37.5 TOTAL SCORE AVERAGE SCORE 4. NEWBORN'S HEALTH Figure No. Indicator 4-1 Hyaline membrane disease 4-2 Newborn intensive care 4-3 American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native 50.0 50.0 50.0 -50.0 0.0 -1.9 35.8 -22.6 3.8 Born too early (preterm or < 37 weeks) -6.7 3.3 31.1 7.8 -1.1 4-4 Born too small: low-birthweight (<2,500 grams) -7.2 -4.3 60.9 4.3 14.5 4-5 Born too small: very low-birthweight (<1,500 grams) -9.1 0.0 81.8 -9.1 0.0 4-6 Incidence of congenital anomalies (birth defects) 0.0 14.3 28.6 14.3 -28.6 4-7 Infant mortality -20.8 5.7 135.8 24.5 -67.9 4-8 Sudden Infant Death Syndrome (SIDS) 0.0 -50.0 200.0 0.0 -100.0 4-9 Mortality of infants from low birthweight/short gestation -42.9 28.6 142.9 -28.6 -57.1 4-10 Neonatal mortality -26.5 17.6 135.3 8.8 -73.5 4-11 Postneonatal mortality -10.5 -73.7 -6.7 -15.8 47.5 4.3 131.6 1033.8 94.0 52.6 2.0 0.2 -52.6 -412.5 -37.5 TOTAL SCORE AVERAGE SCORE Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 -50.0 127 5. MORTALITY FROM NATURAL CAUSES - Chronic or infectious diseases Figure No. American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native Indicator 5-1 Cardiovascular diseases 1.7 -13.7 49.3 -12.5 -28.8 5-2 Diseases of the heart 3.2 -18.8 40.2 -14.1 -42.3 5-3 Coronary heart disease 3.0 -16.7 49.1 -15.7 -42.4 5-4 Cerebrovascular disease -3.9 5.3 92.9 -17.0 8.9 5-5 Chronic lower respiratory diseases 10.8 -53.0 4.9 -65.2 -56.4 5-6 Malignant neoplasms (cancer) 5-7 Lung cancer 5-8 Breast cancer 5-9 Cervical cancer 5-10 Colorectal cancer 5-11 Prostate cancer 5-12 Influenza and pneumonia 5-13 5-14 3.1 -13.2 27.3 -21.0 -33.1 10.4 -39.3 11.3 -72.5 -37.1 2.9 -4.8 12.6 -36.7 -44.9 -12.5 83.3 -37.5 -16.7 -66.7 0.7 -8.1 59.6 -16.9 -11.0 -1.1 -6.6 46.7 9.3 1.6 -4.0 9.0 19.0 147.0 -20.0 Diabetes -21.2 72.5 155.1 178.4 -24.2 Chronic liver disease and cirrhosis -13.1 15.2 -53.1 327.6 -73.1 5-15 HIV disease -14.3 -14.3 321.4 35.7 -100.0 5-16 Septicemia -6.3 27.1 54.2 137.5 -20.8 5-17 0.6 7.2 24.4 -51.8 -45.2 -7.5 -15.1 130.2 198.1 17.0 5-19 Alzheimer's disease Nephritis, nephrotic syndrome and nephrosis (kidney disease) Essential (primary) hypertension -8.2 17.5 119.6 30.9 75.3 5-20 Total mortality from all causes 0.9 -10.5 33.5 29.0 -39.9 -54.8 23.0 1160.7 753.4 -583.1 -2.7 1.2 58.0 37.7 -29.2 5-18 TOTAL SCORE AVERAGE SCORE 6. MORTALITY FROM INJURIES Figure No. American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native Indicator 6-1 Unintentional injuries 6-2 Motor vehicle-related injuries 6-3 Fall-related injuries 6-4 Drowning mortality 6-5 Injury by firearms 6-6 Drug-induced deaths 6-7 Alcohol-induced deaths 6-8 Intentional self-harm (suicide) 6-9 Assault (homicide) TOTAL SCORE AVERAGE SCORE 3.5 -16.8 -6.5 125.7 -10.5 0.0 5.3 178.1 -71.1 -49.1 2.5 -0.8 -27.3 -14.9 -52.9 0.0 -9.1 -36.4 18.2 36.4 12.1 -39.0 20.6 -7.8 -63.8 25.4 -41.4 -20.1 10.7 -97.6 -12.7 -20.4 -54.8 439.5 -87.3 -58.8 22.4 -50.6 -60.6 28.8 -32.2 -1.7 161.0 200.0 -67.8 10.5 -179.8 -18.8 978.3 -512.0 1.2 -20.0 -2.1 108.7 -56.9 7. AGE-SPECIFIC MORTALITY Figure No. Indicator 7-1 Mortality among children 1-14 years old -13.6 -10.6 56.1 148.5 7-2 Mortality among adolescents 15-19 years old -6.6 -14.1 40.9 126.6 -28.8 7-3 Mortality among young adults 20-44 years old -0.2 -21.5 21.4 172.3 -64.3 7-4 Mortality among middle-age adults 45-64 years old TOTAL SCORE AVERAGE SCORE 128 American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native -41.9 6.5 -25.7 27.1 52.0 -67.9 -13.9 -71.9 145.5 499.4 -202.9 -3.5 -18.0 36.4 124.9 -50.7 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 8. PREMATURE MORTALITY Figure No. Indicator American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native 8-1 Median age at death from all causes -2.6 10.4 14.3 22.1 8-2 Median age at death from all causes among males -2.7 13.5 14.9 25.7 1.3 1.4 8-3 Median age at death from all causes among females -1.2 7.4 9.9 17.3 3.7 8-4 Percent of total deaths before expected years of life reached 8.2 -22.9 -33.3 -40.5 -7.9 TOTAL SCORE 1.7 8.4 5.8 24.6 -1.5 AVERAGE SCORE 0.4 2.1 1.5 6.2 -0.4 9. REPORTABLE DISEASES - (Number of cases per 100,000 [persons in specified group) Figure No. Indicator American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native 9-1 Incidence of early syphilis -29.3 24.0 165.3 28.0 9-2 Incidence of gonorrhea -61.9 -5.6 257.4 128.7 -76.4 9-3 Incidence of chlamydia -68.0 11.0 81.9 148.2 -72.3 9-4 Incidence of HIV/HIV/AIDS TOTAL SCORE -64.0 -29.7 14.4 304.5 45.9 -59.5 -188.9 43.8 809.1 350.8 -272.2 -47.2 11.0 202.3 87.7 -68.1 AVERAGE SCORE OVERALL HEALTH STATUS (ALL 69 INDICATORS) American Black or Asian or White Hispanic Indian or African Pacific nonor Latino Alaska American Islander Hispanic Native TOTAL SCORE -692.3 46.0 3668.2 3579.0 -2542.8 -10.0 0.7 53.2 51.9 -36.9 AVERAGE SCORE Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 129 RANK ORDER IN 2013 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 131 RANK ORDER IN 2013 (A rank is the ordering of each race/ethnic group according to score). 1 = RANKS BEST AMONG RACE/ETHNIC GROUPS 5 = RANKS WORST AMONG RACE/ETHNIC GROUPS 1. TEEN PREGNANCIES Figure No. 1-1 1-2 1-3 1-4 Indicator Pregnancies Pregnancies Pregnancies Pregnancies among among among among American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native females 19 and younger females 14 and younger females 15-17 years old females 18-19 years old SUM OF RANKS AVERAGE RANK 2.0 1.0 2.0 2.0 7.0 1.8 3.0 3.5 4.0 4.0 14.5 3.6 4.0 5.0 3.0 3.0 15.0 3.8 5.0 3.5 5.0 5.0 18.5 4.6 1.0 2.0 1.0 1.0 5.0 1.3 2. MATERNAL LIFESTYLE AND HEALTH CHARACTERISTICS Figure No. 2-1 2-2 2-3 2-4 2-5 2-6 2-7 2-8 2-9 2-10 Indicator American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native Unmarried mothers Tobacco use during pregnancy Alcohol use during pregnancy Chronic hypertension Dysfunctional labor Anemia during pregnancy Diabetes during pregnancy Pregnancy associated hypertension Genital herpes during pregnancy Weight gain of less than 21 pounds SUM OF RANKS AVERAGE RANK 2.0 5.0 3.0 2.5 1.0 1.0 1.0 3.0 4.0 1.0 23.5 2.4 3.0 2.0 1.5 2.5 2.5 3.0 3.0 1.5 3.0 4.0 26.0 2.6 4.0 4.0 4.0 5.0 2.5 5.0 2.0 4.0 5.0 3.0 38.5 3.9 5.0 3.0 5.0 4.0 5.0 4.0 5.0 5.0 2.0 5.0 43.0 4.3 1.0 1.0 1.5 1.0 4.0 2.0 4.0 1.5 1.0 2.0 19.0 1.9 3. UTILIZATION OF PRENATAL CARE SERVICES Figure No. 3-1 3-2 3-3 Indicator American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native No care in the 1st trimester Fewer than five prenatal visits No prenatal care SUM OF RANKS AVERAGE RANK 1.0 1.0 1.5 3.5 1.2 4.0 4.0 4.0 12.0 4.0 3.0 3.0 3.0 9.0 3.0 5.0 5.0 5.0 15.0 5.0 2.0 2.0 1.5 5.5 1.8 4. NEWBORN'S HEALTH Figure No. 4-1 4-2 4-3 4-4 4-5 4-6 4-7 4-8 4-9 4-10 4-11 Indicator American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native Hyaline membrane disease Newborn intensive care Born too early (preterm or < 37 weeks) Born too small: low-birthweight (<2,500 grams) Born too small: very low-birthweight (<1,500 grams) Incidence of congenital anomalies (birth defects) Infant mortality Sudden Infant Death Syndrome (SIDS) Mortality of infants from low birthweight/short gestation Neonatal mortality Postneonatal mortality SUM OF RANKS AVERAGE RANK Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 4.0 3.0 1.0 1.0 1.5 2.0 2.0 3.5 2.0 2.0 3.0 25.0 2.3 4.0 2.0 3.0 2.0 3.5 3.5 3.0 2.0 4.0 4.0 2.0 33.0 3.0 4.0 5.0 5.0 5.0 5.0 5.0 5.0 5.0 5.0 5.0 5.0 54.0 4.9 1.5 1.0 4.0 3.0 1.5 3.5 4.0 3.5 3.0 3.0 4.0 32.0 2.9 1.5 4.0 2.0 4.0 3.5 1.0 1.0 1.0 1.0 1.0 1.0 21.0 1.9 133 5. MORTALITY FROM NATURAL CAUSES - Chronic or infectious diseases Figure No. American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native Indicator 5-1 Cardiovascular diseases 4.0 2.0 5.0 3.0 1.0 5-2 Diseases of the heart 4.0 2.0 5.0 3.0 1.0 5-3 Coronary heart disease 4.0 2.0 5.0 3.0 1.0 5-4 Cerebrovascular disease 2.0 3.0 5.0 1.0 4.0 5-5 Chronic lower respiratory diseases 5.0 3.0 4.0 1.0 2.0 5-6 Malignant neoplasms (cancer) 4.0 3.0 5.0 2.0 1.0 5-7 Lung cancer 4.0 2.0 5.0 1.0 3.0 5-8 Breast cancer 4.0 3.0 5.0 2.0 1.0 5-9 Cervical cancer 4.0 5.0 2.0 3.0 1.0 5-10 Colorectal cancer 4.0 3.0 5.0 1.0 2.0 5-11 Prostate cancer 2.0 1.0 5.0 4.0 3.0 5-12 Influenza and pneumonia 2.0 3.0 4.0 5.0 1.0 5-13 Diabetes 2.0 3.0 4.0 5.0 1.0 5-14 Chronic liver disease and cirrhosis 3.0 4.0 2.0 5.0 1.0 5-15 HIV disease 2.5 2.5 5.0 4.0 1.0 5-16 Septicemia 2.0 3.0 4.0 5.0 1.0 5-17 3.0 4.0 5.0 1.0 2.0 2.0 1.0 4.0 5.0 3.0 5-19 Alzheimer's disease Nephritis, nephrotic syndrome and nephrosis (kidney disease) Essential (primary) hypertension 1.0 2.0 5.0 3.0 4.0 5-20 Total mortality from all causes 3.0 2.0 5.0 4.0 1.0 SUM OF RANKS 61.5 53.5 89.0 61.0 35.0 AVERAGE RANK 3.1 2.7 4.5 3.1 1.8 5-18 6. MORTALITY FROM INJURIES Figure No. American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native Indicator 6-1 Unintentional injuries 4.0 2.0 3.0 5.0 6-2 Motor vehicle-related injuries 2.0 3.0 4.0 5.0 1.0 1.0 6-3 Fall-related injuries 5.0 4.0 2.0 3.0 1.0 6-4 Drowning mortality 3.0 2.0 1.0 4.0 5.0 6-5 Injury by firearms 4.0 2.0 5.0 3.0 1.0 6-6 Drug-induced deaths 5.0 2.0 3.0 4.0 1.0 6-7 Alcohol-induced deaths 4.0 3.0 2.0 5.0 1.0 6-8 Intentional self-harm (suicide) 4.0 3.0 1.0 5.0 2.0 6-9 Assault (homicide) 2.0 3.0 4.0 5.0 1.0 SUM OF RANKS 33.0 24.0 25.0 39.0 14.0 AVERAGE RANK 3.7 2.7 2.8 4.3 1.6 7. AGE-SPECIFIC MORTALITY Figure No. 134 American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native Indicator 7-1 Mortality among children 1-14 years old 2.0 3.0 4.0 5.0 7-2 Mortality among adolescents 15-19 years old 3.0 2.0 4.0 5.0 1.0 1.0 7-3 Mortality among young adults 20-44 years old 3.0 2.0 4.0 5.0 1.0 7-4 Mortality among middle-age adults 45-64 years old 3.0 2.0 4.0 5.0 1.0 SUM OF RANKS 11.0 9.0 16.0 20.0 4.0 AVERAGE RANK 2.8 2.3 4.0 5.0 1.0 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 8. PREMATURE MORTALITY Figure No. Indicator American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native 8-1 Median age at death from all causes 1.0 3.0 4.0 5.0 2.0 8-2 Median age at death from all causes among males 1.0 3.0 4.0 5.0 2.0 8-3 Median age at death from all causes among females 1.0 3.0 4.0 5.0 2.0 8-4 Percent of total deaths before expected years of life reached 5.0 3.0 2.0 1.0 4.0 SUM OF RANKS 8.0 12.0 14.0 16.0 10.0 AVERAGE RANK 2.0 3.0 3.5 4.0 2.5 9. REPORTABLE DISEASES - (Number of cases per 100,000 persons in specified group) Figure No. Indicator American Black or White Asian or Hispanic Indian or African nonPacific or Latino Alaska American Hispanic Islander Native 9-1 Incidence of early syphilis 2.0 3.0 5.0 4.0 9-2 Incidence of gonorrhea 2.0 3.0 5.0 4.0 1.0 1.0 9-3 Incidence of chlamydia 2.0 3.0 4.0 5.0 1.0 9-4 Incidence of HIV/AIDS 2.0 3.0 5.0 4.0 1.0 SUM OF RANKS 8.0 12.0 19.0 17.0 4.0 AVERAGE RANK 2.0 3.0 4.8 4.3 1.0 OVERALL HEALTH STATUS (ALL 69 INDICATORS) American Black or Asian or White Hispanic Indian or African Pacific nonor Latino Alaska American Islander Hispanic Native SUM OF ALL RANKS FOR 69 MEASUREMENTS AVERAGE RANKS BASED ON 69 MEASUREMENTS Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 180.5 196.0 279.5 261.5 117.5 2.6 2.8 4.1 3.8 1.7 135 DATA SOURCES AND DEFINITIONS Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 137 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 and 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 conduct surveillance and monitoring of these reportable diseases and provided data for section 9 in this report. Population denominators for Arizona residents, used to calculate rates for 2013 and other intercensal years, utilize the best available data sources. They are described in detail at http://www.azdhs.gov/plan/ . Almost all figures are based on rates and ratios published in the 2013 Arizona Health Status and Vital Statistics report and available online at http://www.azdhs.gov/plan/ DEFINITIONS Figure number 1. TEEN PREGNANCIES Indicator 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 Definitions Indicator 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). 2-5 Dysfunctional labor Failure to progress in a normal pattern of labor (the number of cases per 100 births). Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 139 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 Definition 4-1 Incidence of hyaline membrane disease The number of cases of hyaline membrane disease per 100 births. Hyaline membrane disease is 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 4-5 140 Indicator 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 is 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 is 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 is 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 is 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. 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. Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 4-10 Neonatal mortality The number of neonatal deaths per 1,000 live births. Neonatal death is death of a live born 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 is any death of a live born 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 100,000 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. Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 141 Figure number 6. MORTALITY FROM INJURIES 142 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. Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 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. 7-2 Mortality of adolescents 15-19 years old The number of deaths per 100,000 adolescents 15-19 years old. 7-3 Mortality of young adults 20-44 years old The number of deaths per 100,000 young adults 20-44 years old. 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. Figure number 8. PREMATURE MORTALITY Indicators 8-1 Median age at death from all causes The median age (the age in the middle) of death for Arizonans. 8-2 Median age at death from all causes among males The median age (the age in the middle) of death for Arizona males. 8-3 Median age at death from all causes among females The median age (the age in the middle) of death for Arizona females. 8-4 Percent of total deaths before expected years of life reached The number of deaths before reaching the life expectancy of all U.S. residents 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. Incidence of HIV/AIDS Number of reported new cases of HIV/AIDS per 100,000 population. The estimated incidence of HIV/AIDS includes the sum of new HIV cases and new AIDS cases which were not diagnosed as HIV positive in any prior calendar year. The cases of persons who were diagnosed with both HIV and AIDS in the same calendar year are counted only as AIDS to avoid double counting. 9-4 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 143 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 A 2013 population B 2013 deaths C Age-specific rates Age-adjusted 2000 standard rate for 2013 in 2013 D E F (C/B)*100000 D*E <1 89,196 447 501.1 .013818 6.9 1-4 351,077 131 37.3 .055317 2.1 5-14 924,150 121 13.1 .145565 1.9 15-24 937,362 663 70.7 .138646 9.8 25-34 868,888 1,081 124.4 .135573 16.9 35-44 834,554 1,585 189.9 .162613 30.9 45-54 834,992 3,418 409.3 .134834 55.2 55-64 759,706 6,480 853.0 .087247 74.4 65-74 566,812 9,091 1603.9 .066037 105.9 179.6 75-84 301,956 12,091 4004.2 .044842 85+ 112,360 14,801 13172.8 .015508 204.3 6,581,054 49,929 TOTAL ∑ =687.8 All ages 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. 144 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 POPULATION DENOMINATORS Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 145 POPULATION BY RACE/ETHNICITY: ARIZONA RESIDENTS, 1993, 2003 AND 2013 Racial/ethnic group 1993 2003 2013 Percent increase from 1993 to 2013 All Groups 4,065,441 5,629,870 6,581,054 61.9 White Non-Hispanic 2,825,508 3,608,747 3,842,190 36.0 Hispanic or Latino 795,157 1,424,357 1,961,135 146.6 Black or African American 133,252 185,786 269,384 102.2 American Indian or Alaska Native 237,276 292,753 309,035 30.2 74,248 118,227 199,310 168.4 Asian or Pacific Islander Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 147 148 Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013 Asian or Pacific Islander American Indian or Alaska Native Black or African American Hispanic or Latino White nonHispanic All groups 1,556 1,460 Male Female 2,870 Female 3,016 3,008 Male Total 5,878 1,946 Female Total 2,049 Male 18,320 Female 3,995 19,107 Male Total 37,427 18,873 Female Total 20,007 Male 43,469 Female 38,880 45,727 Male Total 89,196 Total <1 5,225 5,379 10,603 10,980 11,314 22,294 7,888 8,192 16,080 72,570 75,995 148,565 75,266 78,269 153,535 171,929 179,148 351,077 1-4 12,233 12,061 24,294 27,235 27,668 54,903 20,342 21,795 42,137 192,685 201,768 394,453 199,525 208,838 408,363 452,021 472,129 924,150 5-14 12,361 13,458 25,819 27,196 28,485 55,681 22,216 25,673 47,889 172,303 187,465 359,767 216,442 231,764 448,207 450,518 486,844 937,362 15-24 16,728 16,663 33,391 22,797 23,541 46,338 18,725 22,783 41,507 144,774 153,216 297,989 219,958 229,704 449,662 422,981 445,906 868,888 25-34 19,476 17,440 36,916 19,114 18,342 37,456 17,423 20,505 37,928 135,562 133,664 269,225 221,382 231,646 453,028 412,958 421,596 834,554 35-44 14,787 12,558 27,345 19,278 17,321 36,599 16,576 18,560 35,136 104,751 103,356 208,108 264,900 262,904 527,804 420,292 414,700 834,992 45-54 11,746 8,152 19,898 14,545 12,133 26,678 12,421 12,666 25,088 68,869 63,684 132,554 291,067 264,421 555,488 398,648 361,058 759,706 55-64 6,926 4,621 11,548 7,902 6,388 14,290 6,594 5,975 12,569 37,837 32,000 69,838 240,720 217,849 458,569 299,979 266,833 566,812 65-74 3,101 2,082 5,183 3,910 2,799 6,708 3,068 2,472 5,539 18,645 14,224 32,869 133,695 117,962 251,656 162,418 139,537 301,956 75-84 ESTIMATED POPULATION BY AGE GROUP, GENDER AND RACE/ETHNICITY, ARIZONA, 2013 844 453 1,297 1,443 767 2,210 1,050 465 1,516 6,575 3,764 10,339 60,868 36,131 96,999 70,780 41,580 112,360 85+ 104,887 94,424 199,310 157,270 151,765 309,035 128,249 141,134 269,384 972,892 988,243 1,961,135 1,942,697 1,899,494 3,842,190 3,305,994 3,275,060 6,581,054 Total Our Web site at http://www.azdhs.gov/plan provides access to a wide range of statistical information about the health status of Arizonans. The Arizona Health Status and Vital Statistics annual report examines trends in natality, mortality, and morbidity towards established health objectives. In addition to the print and original online versions, the 2013 report is made available as a mobile-friendly e-book. Additional reports and studies include Advance Vital Statistics by County of Residence, Injury Mortality among Arizona Residents (accidents, suicides, homicides, legal intervention, firearm-related fatalities, drug-related deaths, drowning deaths, falls among Arizonans 65 years or older), Hospital Inpatient and Emergency Room Statistics (first-listed diagnosis, procedures, mental disorders, asthma, diabetes, influenza and pneumonia, and substance abuse), Community Vital Statistics, Teenage Pregnancy, Differences in Health Status Among Racial/Ethnic Groups, and Health Status Profile of American Indians in Arizona. Population Health and Vital Statistics Section Bureau of Public Health Statistics ARIZONA DEPARTMENT OF HEALTH SERVICES