February 2024 2021 Health Status Report: Mesa Maricopa County Department of Public Health Division of Epidemiology and Informatics Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2023 0 Table of Contents Table 1. Crude Hospitalization Rates (per 100,000), by Race/Ethnicity, for Select Morbidities— Maricopa County, 2021 ........................................................................................................................ 2 Table 2. Crude Emergency Department Visit Rates (per 100,000), by Race/Ethnicity, for Select Morbidities—Maricopa County, 2021 .................................................................................................. 3 Table 3. Crude Hospitalization Rates (per 100,000), by Sex, for Select Morbidities—Maricopa County, 2021 ......................................................................................................................................... 4 Table 4. Crude Emergency Department Visit Rates (per 100,000), by Sex, for Select Morbidities— Maricopa County, 2021 ........................................................................................................................ 5 Table 5. Crude Hospitalization Rates (per 100,000), by 5-year Age Groups, for Select Morbidities—Maricopa County, 2021 .................................................................................................. 6 Table 6. Crude Emergency Department Visit Rates (per 100,000), by 5-year Age Groups, for Select Morbidities—Maricopa County, 2021 ....................................................................................... 7 Table 7. Crude Death Rates (per 100,000), by Race/Ethnicity, for Select Morbidities—Maricopa County, 2021 ......................................................................................................................................... 8 Table 8. Crude Death Rates (per 100,000), by Sex, for Select Morbidities—Maricopa County, 2021 ....................................................................................................................................................... 9 Table 9. Crude Death Rates (per 100,000), by 5-year Age Group, for Select Diseases—Maricopa County, 2021 .......................................................................................................................................10 Figure 1. Top 10 Reasons for Hospitalizations—Maricopa County, 2017–2021...........................11 Figure 2. Top 10 Reasons for ED Visits—Maricopa County, 2017–2021 .......................................12 Figure 3. Top 10 Causes for Deaths—Maricopa County, 2016–2021 ............................................13 Table 10. Crude Rate (per 1,000) of Select Birth Indicators, by Race/Ethnicity— Maricopa County, 2021 .....................................................................................................................................................14 Table 11. Crude Rates (per 100,000) of Select Infectious Diseases, by Sex— Maricopa County, 2021 .....................................................................................................................................................15 Technical Notes..................................................................................................................................16 Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 1 Table 1. Crude Hospitalization Rates (per 100,000), by Race/Ethnicity, for Select Morbidities—Mesa, 2021 MORBIDITY Alzheimer’s Disease Arthritis Asthma CHRONIC DISEASES Cardiovascular Disease Chronic Obstructive Pulmonary Disease Diabetes Liver Disease Stroke Lung Cancer CANCER 1 Breast Cancer Prostate Cancer Schizophrenic Disorders MENTAL HEALTH DISORDERS Mood Disorders Drug-induced Disorders All Mental Health Disorders Alcohol-related Drug Overdose SUBSTANCE ABUSE AND OTHER INJURY Opioid-related Violence-related Motor Vehicle Crash Suicide Falls Heat Related INFECTIOUS DISEASE Influenza/Pneumonia RACE/ETHNICITY White 5.6 7.0 20.9 1320.4 74.1 175.7 * 302.0 * 10.8 8.7 141.5 954.7 169.9 998.3 35.3 * 18.2 15.8 95.8 32.9 293.4 * 132.7 Hispanic/ African Latinx American/Black American Indian Asian OVERALL * * 34.4 483.1 16.1 154.2 * 115.5 * * * 114.7 562.0 111.8 596.4 * * 109.2 1669.6 95.5 332.1 * 418.5 * * * 423.1 1396.7 177.4 1492.2 0.0 0.0 * 584.7 0.0 314.8 * 143.9 0.0 0.0 0.0 179.9 1601.2 710.6 1655.1 0.0 0.0 * 1084.4 70.5 141.1 * 220.4 * * * 114.6 678.8 70.5 687.7 5.0 5.8 31.3 1249.8 66.1 201.1 86.8 289.1 34.0 9.6 9.3 164.1 990.9 185.0 1038.9 13.2 * 10.2 21.2 59.9 23.4 85.5 * 58.5 68.2 * 50.0 72.8 131.9 36.4 145.6 * 195.6 143.9 * * * 99.0 * 134.9 0.0 72.0 52.9 * * * 97.0 * 185.1 0.0 105.8 38.0 64.3 19.1 22.5 100.3 34.6 260.0 6.6 129.2 1 Breast cancer rates are per 100,000 females; prostate cancer rates are per 100,000 males. * Denotes indicators with a count of 5 or less Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 2 Table 2. Crude Emergency Department Visit Rates (per 100,000), by Race/Ethnicity, for Select Morbidities—Mesa, 2021 MORBIDITY Hispanic/Latinx African American/Black American Indian * * 0.0 0.0 0.0 4.4 Arthritis 32.9 31.4 81.9 54.0 61.7 39.6 Asthma Cardiovascular Disease 173.3 1115.5 274.1 540.1 1246.5 1801.6 233.9 548.7 176.3 1128.5 270.6 1109.6 Chronic Obstructive Pulmonary Disease 174.1 68.7 268.4 54.0 123.4 165.8 Diabetes 193.1 * 215.6 * 573.2 * 440.8 * 176.3 244.7 * * * * * * 45.2 54.9 Lung Cancer 4.8 * 4.6 3.0 0.0 0.0 0.0 * Breast Cancer 0.0 0.0 0.0 2.4 Prostate Cancer * 0.0 0.0 0.0 0.0 * Schizophrenic Disorders * * * * * 57.3 Mood Disorders 579.4 445.8 1328.4 2365.8 387.9 682.7 Drug-induced Disorders 401.0 320.1 941.7 2230.8 211.6 489.2 All Mental Health Disorders 667.3 1815.2 2806.5 581.9 973.0 Alcohol-related 835.4 11.5 * 205.7 277.5 81.0 188.9 * Drug Overdose 6.6 193.7 123.4 13.5 230.0 62.3 75.3 91.0 99.0 61.7 76.8 144.7 218.5 568.7 638.7 105.8 211.8 Suicide 519.2 122.8 586.1 90.6 1478.6 118.3 602.7 188.9 670.0 61.7 652.9 129.2 Falls 2028.7 1333.1 2097.3 1538.2 1322.4 2057.7 Heat Related 26.2 20.5 72.8 63.0 0.0 29.9 Influenza/Pneumonia 252.5 310.6 632.4 296.8 343.8 319.0 Alzheimer’s Disease CHRONIC DISEASES Liver Disease Stroke CANCER 1 MENTAL HEALTH DISORDERS Opioid-related SUBSTANCE ABUSE AND OTHER Violence-related INJURY Motor Vehicle Crash Infectious Disease RACE/ETHNICITY White Asian OVERALL 1 Breast cancer rates are per 100,000 females; prostate cancer rates are per 100,000 males. * Denotes indicators with a count of 5 or less Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 3 Table 3. Crude Hospitalization Rates (per 100,000), by Sex, for Select Morbidities— Mesa, 2021 MORBIDITY CHRONIC DISEASES CANCER 1 MENTAL HEALTH DISORDERS SUBSTANCE ABUSE AND OTHER INJURY INFECTIOUS DISEASE SEX Male Female OVERALL Alzheimer’s Disease 4.9 5.2 5.0 Arthritis 6.9 4.8 5.8 Asthma 30.0 32.6 31.3 1394.1 1108.2 1249.8 Chronic Obstructive Pulmonary Disease 56.0 76.0 66.1 Diabetes 240.5 162.4 201.1 Liver Disease 87.2 86.4 86.8 Stroke 304.2 274.3 289.1 Lung Cancer 28.8 39.0 34.0 Breast Cancer - 9.6 9.6 Prostate Cancer 9.3 - 9.3 Schizophrenic Disorders 217.4 111.9 164.1 Mood Disorders 1080.1 902.8 990.9 Drug-induced Disorders 259.2 112.3 185.0 All Mental Health Disorders 1123.5 955.4 1038.9 Alcohol-related 51.5 24.7 38.0 Drug Overdose 61.7 66.9 64.3 Opioid-related 22.7 15.5 19.1 Violence-related 34.5 10.8 22.5 Motor Vehicle Crash 131.0 70.1 100.3 Suicide 30.8 38.2 34.6 Falls 213.8 305.3 260.0 Heat Related 11.0 2.4 6.6 Influenza/Pneumonia 122.5 135.7 129.2 Cardiovascular Disease 1 Breast cancer rates are per 100,000 females; prostate cancer rates are per 100,000 males. * Denotes indicators with a count of 5 or less Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 4 Table 4. Crude Emergency Department Visit Rates (per 100,000), by Sex, for Select Morbidities—Mesa, 2021 MORBIDITY CHRONIC DISEASES CANCER 1 MENTAL HEALTH DISORDERS SUBSTANCE ABUSE AND OTHER INJURY INFECTIOUS DISEASE SEX Male Female OVERALL Alzheimer’s Disease 4.1 4.8 4.4 Arthritis 56.4 23.1 39.6 Asthma 255.5 285.4 270.6 Cardiovascular Disease 1114.2 1104.7 1109.6 Chronic Obstructive Pulmonary Disease 153.3 177.9 165.8 Diabetes 271.8 218.2 244.7 Liver Disease 38.1 52.2 45.2 Stroke 50.3 59.3 54.9 Lung Cancer 3.7 5.6 4.6 Breast Cancer - 2.4 2.4 Prostate Cancer * - * Schizophrenic Disorders 64.1 50.6 57.3 Mood Disorders 857.9 510.3 682.7 Drug-induced Disorders 674.5 306.9 489.2 All Mental Health Disorders 1122.7 825.6 973.0 Alcohol-related 16.2 10.8 13.5 Drug Overdose 226.3 233.7 230.0 Opioid-related 106.7 47.4 76.8 Violence-related 238.9 185.1 211.8 Motor Vehicle Crash 654.7 650.9 652.9 Suicide 84.8 172.8 129.2 Falls 1808.2 2302.5 2057.7 Heat Related 43.0 17.1 29.9 Influenza/Pneumonia 314.8 323.2 319.0 1 Breast cancer rates are per 100,000 females; prostate cancer rates are per 100,000 males. * Denotes indicators with a count of 5 or less Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 5 Table 5. Crude Hospitalization Rates (per 100,000), by Age Group, for Select Morbidities—Mesa, 2021 MORBIDITY CHRONIC DISEASES 25–44 45–64 65+ OVERALL 0.0 0.0 * Arthritis 0.0 0.0 * * * 26.7 5.0 5.8 Asthma 14.2 31.6 0.0 21.1 297.2 Chronic Obstructive Pulmonary Disease 80.3 29.1 0.0 * 23.4 1570.4 * 13.4 4803.5 * 31.3 1249.8 66.1 Diabetes 36.1 123.3 * * 6.0 * Lung Cancer 0.0 341.0 165.7 342.7 * 349.9 156.7 1171.1 * 201.1 86.8 289.1 * 150.0 79.4 52.4 0.0 Breast Cancer 0.0 0.0 0.0 0.0 8.9 0.0 13.5 21.5 22.3 29.4 34.0 9.6 9.3 Drug-induced Disorders 8.0 341.3 0.0 214.9 1732.2 145.4 287.0 1570.3 351.1 220.4 936.2 249.9 30.4 317.1 71.7 164.1 990.9 185.0 All Mental Health Disorders 400.6 1857.1 Alcohol-related * * Drug Overdose 34.1 1611.8 59.7 59.0 * 964.8 65.9 77.2 * 330.4 29.2 53.5 * 1038.9 38.0 64.3 Cardiovascular Disease Prostate Cancer MENTAL HEALTH DISORDERS 15–24 0.0 Stroke CANCER 1–14 Alzheimer’s Disease Liver Disease 1 AGE GROUP Schizophrenic Disorders Mood Disorders SUBSTANCE Opioid-related ABUSE AND Violence-related OTHER Motor Vehicle Crash INJURY * 113.8 * 21.1 * 41.1 * 34.2 * 12.2 * 4.9 22.5 * Suicide 22.1 91.7 27.7 35.6 15.8 100.3 34.6 Falls 38.2 0.0 23.7 56.1 * * 182.2 10.4 1159.0 17.0 260.0 6.6 37.1 19.0 40.8 137.1 461.6 129.2 Heat Related INFECTIOUS Influenza/Pneumonia DISEASE 19.1 1 Breast cancer rates are per 100,000 females; prostate cancer rates are per 100,000 males. * Denotes indicators with a count of 5 or less Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 6 Table 6. Crude Emergency Department Visit Rates (per 100,000), by Age Group, for Select Morbidities—Mesa, 2021 MORBIDITY CHRONIC DISEASES 25–44 45–64 65+ 0.0 0.0 * Arthritis 0.0 * * Asthma 410.6 76.3 350.9 183.3 13.1 34.1 23.7 105.9 * OVERALL * * * 4.4 39.6 340.1 547.0 158.8 1566.9 80.2 3370.0 270.6 1109.6 249.9 414.7 * * 511.5 396.0 * * 165.8 244.7 0.0 64.1 228.0 * * 0.0 7.8 17.0 45.2 54.9 4.6 0.0 0.0 * * 2.4 * * * * 0.0 0.0 * * * * 57.3 130.5 25.1 287.1 942.0 559.5 1433.5 1089.6 875.5 1532.4 802.6 640.3 1022.1 304.9 140.9 447.1 682.7 489.2 973.0 Alcohol-related * * 166.7 9.0 504.2 166.0 20.0 151.0 39.9 * Drug Overdose 24.0 299.4 150.8 91.1 18.2 13.5 230.0 76.8 107.4 230.9 93.4 360.4 1335.5 406.2 365.6 919.9 144.9 158.8 577.8 63.3 41.3 298.9 25.5 211.8 652.9 129.2 Heat Related 2217.6 7.0 1077.9 33.2 1029.2 48.8 1593.8 27.8 4982.1 26.7 2057.7 29.9 Influenza/Pneumonia 307.2 289.2 279.7 328.8 408.2 319.0 Cardiovascular Disease Chronic Obstructive Pulmonary Disease Stroke Lung Cancer Breast Cancer Prostate Cancer Schizophrenic Disorders Mood Disorders Drug-induced Disorders All Mental Health Disorders Opioid-related SUBSTANCE ABUSE AND Violence-related OTHER INJURY Motor Vehicle Crash Suicide Falls NFECTIOUS DISEASE 15–24 0.0 Liver Disease MENTAL HEALTH DISORDERS 1–14 Alzheimer’s Disease Diabetes CANCER 1 AGE GROUP * 0.0 0.0 0.0 0.0 * 1 Breast cancer rates are per 100,000 females; prostate cancer rates are per 100,000 males. * Denotes indicators with a count of 5 or less Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 7 Table 7. Crude Death Rates (per 100,000), by Race/Ethnicity, for Select Morbidities—Mesa, 2021 RACE/ETHNICITY MORBIDITY Asian OVERALL * 0.0 * 46.4 1.6 * * 0.0 0.0 1.6 Cardiovascular Disease 241.0 62.1 127.4 202.8 210.4 Chronic Obstructive Pulmonary Disease 59.9 * 7.3 * * 63.0 0.0 * 48.4 * * * 40.4 * * 27.1 * * 179.9 * * Stroke 23.3 * * 46.6 Lung Cancer 43.1 12.4 45.5 * * 39.2 * * 27.1 Diabetes Liver Disease CANCER American Indian * Asthma 1 African American/Black * Alzheimer’s Disease CHRONIC DISEASES White Hispanic/Latinx Breast Cancer 31.9 8.7 * Prostate Cancer * * 0.0 0.0 18.7 Alcohol-related 20.6 34.8 197.9 * 38.2 * 27.3 * 0.0 Drug Overdose 21.9 * * 37.8 * * * * * 27.9 2.94 6.58 31.8 * 0.0 5.2 7.3 * * * 10.7 22.5 8.8 * * * 20.7 * * * 0.0 0.0 14.9 13.9 5.1 * 0.0 * 12.5 SUBSTANCE Opioid-related ABUSE AND Violence-related OTHER Motor Vehicle Crash INJURY Suicide Falls INFECTIOUS Influenza/Pneumonia DISEASE 10.4 1 Breast cancer rates are per 100,000 females; prostate cancer rates are per 100,000 males. * Denotes indicators with a count of 5 or less Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 8 Table 8. Crude Death Rates (per 100,000), by Sex, for Select Morbidities— Mesa, 2021 MORBIDITY CHRONIC DISEASES CANCER 1 SUBSTANCE ABUSE AND OTHER INJURY INFECTIOUS DISEASE SEX Male Female OVERALL Alzheimer’s Disease 28.0 64.5 46.4 Asthma 2.4 0.0 1.6 Cardiovascular Disease 230.4 190.7 210.4 Chronic Obstructive Pulmonary Disease 42.6 54.1 48.4 Diabetes 48.3 32.6 40.4 Liver Disease 30.8 23.5 27.1 Stroke 41.0 52.2 46.6 Lung Cancer 39.3 39.0 39.2 Breast Cancer - 27.1 27.1 Prostate Cancer 18.7 - 18.7 Alcohol-related 52.7 23.9 38.2 Drug Overdose 56.4 19.5 37.8 Opioid-related (excluding heroin) 41.8 14.3 27.9 Violence-related 9.3 2.4 5.8 Motor Vehicle Crash 13.8 7.6 10.7 Suicide 32.0 9.6 20.7 Falls 12.2 17.5 14.9 Influenza/Pneumonia 13.8 11.2 12.5 1 Breast cancer rates are per 100,000 females; prostate cancer rates are per 100,000 males. * Denotes indicators with a count of 5 or less Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 9 Table 9. Crude Death Rates (per 100,000), by Age Group, for Select Diseases— Mesa, 2021 MORBIDITY AGE GROUP 1–14 15–24 25–44 45–64 Alzheimer’s Disease 0.0 0.0 0.0 Asthma 0.0 0.0 * * * Chronic Obstructive Pulmonary Disease 0.0 Diabetes 65+ OVERALL 5.2 * 273.3 * 46.4 110.2 1086.1 210.4 0.0 16.0 0.0 26.9 255.1 48.4 0.0 * * 46.9 173.7 40.4 * * 47.7 45.0 27.1 Stroke 0.0 0.0 29.1 * * * 46.6 Lung Cancer 0.0 0.0 0.0 42.5 177.4 39.2 Breast Cancer 0.0 0.0 * * * 27.1 Prostate Cancer 0.0 0.0 0.0 * * 18.7 Alcohol-related 0.0 * * 78.1 52.2 38.2 Drug Overdose 0.0 31.6 75.0 48.6 10.9 37.8 SUBSTANCE Opioid-related ABUSE AND Violence-Related OTHER Motor Vehicle Crash INJURY 0.0 30.0 57.5 19.0 8.0 7.3 * 27.9 * 30.4 * * * * * * 10.7 Suicide 0.0 27.9 20.7 0.0 23.3 * 30.4 Falls 20.6 0.0 * * 14.9 INFECTIOUS Influenza/Pneumonia DISEASE 0.0 * * 12.2 55.9 12.5 CHRONIC DISEASES Cardiovascular Disease Liver Disease CANCER 1 1.6 5.8 1 Breast cancer rates are per 100,000 females; prostate cancer rates are per 100,000 males. * Denotes indicators with a count of 5 or less Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 10 Figure 1. Top 101 Reasons for Hospitalizations— Mesa, 2021 Rank Reason for Hospitalization 1 Cardiovascular Disease 2 Bacterial Infection 3 All Mental Health Related Conditions 4 COVID 19 5 Injuries 6 Complications of Surgical and Medical Care 7 Stroke 8 All Cancer 9 Intestinal Diseases 10 Diabetes 1 Pregnancy and early life care were not considered part of this analysis. Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 11 Figure 2. Top 10 Reasons 1 for ED Visits— Mesa, 2021 Rank Reason for ED Visit 1 Injuries 2 Digestive and Abdominal Issues 3 Respiratory and Circulatory Issues 4 COVID-19 5 Acute Upper Respiratory Infections 6 Cardiovascular Disease 7 All Mental Health Related Conditions 8 Diseases of the Urinary System 9 Disease of the Intestines 10 Infections of the Skin 1 The top 10 excluded the “General Symptoms and Signs” reasons for ED visit. Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 12 Figure 3. Top 10 Causes for Deaths— Mesa, 2021 Rank Cause of Death 1 Heart Disease 2 All Cancer 3 COVID 19 4 Unintentional Injuries 5 Chronic Lower Respiratory Diseases 6 Stroke 7 Alzheimer Disease 8 Diabetes 9 Chronic Liver Disease 10 Suicide Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 13 Table 10. Crude Rate (per 1,000) of Select Birth Indicators 1, by Race/Ethnicity— Mesa, 2021 INDICATOR RACE/ETHNICITY African American/ American Black Indian White Hispanic/ Latinx Low birth weight 70.9 70.4 134.9 85.7 118.3 75.6 Pre-term infants 98.9 91.5 121.7 128.6 139.8 99.2 Infant mortality 4.8 6.7 * 0.0 * 6.0 Teen pregnancy 21.3 65.5 39.5 * * 38.9 Asian OVERALL 1 Rates for each indicator were calculated per 1,000 live births. * Denotes indicators with a count of 5 or less Note: See technical notes for more detailed description information on each birth indicator. Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 14 Table 11. Crude Rates (per 100,000) of Select Infectious Diseases 1, by Sex— Mesa, 2021 SEX DISEASE VACCINE PREVENTABLE DISEASES CENTRAL NERVOUS SYSTEM ENTERICS MYCOSIS ZOONOSES/ VECTORBORNE HEPATITIDES OTHER SEXUALLY TRANSMITTED DISEASES Male H. influenzae, Invasive Disease Pertussis Aseptic Meningitis, Viral Encephalitis, Viral Meningococcal Invasive Disease Amebiasis Campylobacteriosis Cryptosporidiosis E. coli, Shiga Toxin-Producing Giardiasis Listeriosis Norovirus Paratyphoid Fever Salmonellosis Shigellosis Typhoid Fever Coccidioidomycosis Brucellosis Dengue Malaria St. Louis Encephalitis Virus West Nile Virus Hepatitis A Hepatitis B 3 Legionellosis MRSA RSV Streptococcal Group A, Invasive Streptococcal Group B, Invasive 4 Streptococcus pneumoniae, Invasive Tuberculosis Vibrio Infection Yersiniosis Gonorrhea Syphilis – Primary and Secondary Syphilis – All Others Chlamydia HIV/AIDS5 2 0.0 0.0 0.0 * 0.0 * 14.2 * * * 0.0 2.8 0.0 8.9 4.9 * 172 * 0.0 0.0 0.0 37.7 0.0 11.8 * 21.9 66.9 14.6 * 12.2 * 0.0 0.0 263.6 30.0 71.4 348.4 * Female 0.0 0.0 0.0 * 0.0 * 10.7 0.0 * * 0.0 9.2 0.0 7.6 2.4 0.0 190.3 * * 0.0 0.0 22.7 0.0 11.1 * 14.7 63.7 10.3 0.0 7.6 * * * 195.9 9.6 31.4 648.5 * OVERALL 0.0 0.0 0.0 * 0.0 * 12.5 * 2.4 1.4 0.0 6.0 0.0 8.2 3.6 * 181.2 * * 0.0 0.0 30.1 0.0 11.5 2.0 18.3 65.3 12.5 * 9.8 1.8 * * 229.6 19.7 51.2 500.2 6.2 1 Rates were calculated using total confirmed and probable cases. 2 Includes only H. influenzae Type B cases. 3 Includes only acute cases of Hepatitis B. 4 Streptococcal Group B Invasive disease is only reportable for cases in infants under 90 days. 5 HIV and Aids were combined starting in 2021 * Denotes indicators with a count of 5 or less Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 15 Technical Notes Calculating Rates Rates were calculated for this report using the 5-year population statistics for 2021, available from the United States Census. While we stratified rates by age for many of the indicators presented in this report, only crude rates were calculated for overall county rates, with no adjustment for age. Ageadjusting can remove the effect of a disproportionately large population of young or old individuals being affected by a certain morbidity or disease. Indicators where the count is 5 or less are recorded as *. Data Sources Hospital Discharge Data Hospital Discharge Data (HDD) are submitted by Arizona Hospitals to Arizona Department of Health Services (ADHS). Data are submitted by half years, with the first half (January 1 – June 30) due August 15 of the same year and the second half (July 1 – December 31) due by February 15th of the following year. ADHS then prepares the data for public release and the data are released between 3 and 6 months after collection. These datasets only contain hospitalizations from facilities within the state of Arizona. Hospitalizations of Maricopa Residents that occur outside of Arizona are not captured. Both inpatient and emergency department (ED) visits are included in this dataset and are analyzed separately. These datasets also only contain data for Maricopa County residents that are seen at a facility within the State of Arizona. Also federal facilities such as Veterans Affairs or Indian Health Services are not included in the data set which will affect disease rates among American Indians. Hospitalization Discharges represent the number of discharges from facilities within Arizona during a calendar year and are not unique patients. Therefore, if a person is hospitalized multiple times in a calendar year, that person will be represented multiple times in the dataset. Most hospitals bill under the “72-hour rule”. This means that if a patient comes into the ER and is admitted as an inpatient within a 72-hour period, the visit is bundled into one account for billing. In the data this patient would show up as an IP record. There are a few exceptions that will do “split billing”, specifically with Critical Access Hospitals and with some insurance carriers. These cases will show up in both the ED and IP. All data are calculated utilizing the rules of the International Classification of Disease, 10th Revision (ICD-10). Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 16 Mortality Data All data on mortality statistics are from death certificates included in the Arizona Department of Health Services (ADHS) final annual files. The data presented in this report include Maricopa County residents only. This includes Maricopa County residents who died in Maricopa County and residents who died elsewhere. Non-Maricopa County residents who died in Maricopa County are not included. Unless otherwise noted, all deaths are attributed to one underlying condition, based on death certificate information, using the rules of the International Classification of Diseases, 10th Revision (ICD-10). Causes of death are classified by ICD-10 codes. Although other causes may have contributed to death, the underlying cause of death is the cause that began the disease process that resulted in death. The underlying causes of death shown in this report were selected to align with reports MCDPH has created for hospital and FQHC partners. The number for certain cause of death in this report could be different from other reports generated from our office due to different initiatives or protocols set for that specific cause of death. Birth Data Birth statistics are from birth certificates included in the ADHS final annual files. The data presented in this report include births to mothers whose county of residence is Maricopa County. This may include births that did not occur in Maricopa County. Also included are some births that occurred outside of Arizona to mothers who reside in Arizona but whose county and city of residence is unknown. National Center for Health Statistics rules state that if a birth does not occur in the state of residency and the county and city are unknown, the city of residency is assigned to the largest city in the state of residency. Infant mortality statistics are from unlinked data or the number of infant deaths in a given year. The infant mortality rate is defined by the number of deaths per 1,000 live births. Teen pregnancy is the rate of live births to females under the age of 20 years. Pre-term birth is defined as 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. Finally, low birthweight is defined as any neonate weighing less than 2,500 grams at birth (less than 5 pounds 8 ounces). Infectious Disease Data The data presented in this report include communicable diseases among residents of Maricopa County. This includes Maricopa County residents who acquired a disease in Maricopa County and residents who acquired a disease elsewhere. Non-Maricopa County residents are not included, even if they acquired a disease in Maricopa County. Other reports may show different morbidity rates because they include non-residents Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 17 who acquired disease in Maricopa County, or they exclude residents who were exposed outside of the county. For example, residents were reported with malaria in 2019, but all these individuals acquired malaria outside of Maricopa County. All data on communicable diseases are new cases of reportable diseases from the ADHS final annual files. There are several exceptions: data on gonorrhea, chlamydia, and syphilis are from MCDPH data files. Data on tuberculosis, STDs, HIV, and AIDS may differ from other reports published by MCDPH and ADHS. Data on these diseases are in databases that may have been updated during the time between reports. The data for this report were acquired on August 9, 2023. Communicable disease data include only confirmed and probable cases. Data can be classified by date of onset, date of diagnosis, or date of report to the health department. All diseases/conditions listed in this report are classified by the date of report to the health department. The only exceptions are HIV and AIDS which are classified by the date of diagnosis. Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 18 Definitions of Morbidities Below is a brief description of indicators, not including infectious diseases, and the corresponding ICD codes. Indicator Description Alzheimer’s Disease Alzheimer’s Disease HDD ICD Codes 1 Mortality ICD Codes 2 G30 G30 Arthritis Rheumatoid arthritis, osteoarthritis in different regions of the body, gout, arthritis due to infections or parasites, and a variety of other joint and connective tissue disorders A54, A52, D481, D690, E79, G83, G54, G57, G63, G83, I01, I67, I73, M00, M1A, M3, M02, M05, M06, M11, M15, M16, M17, M18, M19, M21, M25, M60, M66, M67, M75, M76, M77, R26, R29, 716, 7281, 729 Not applicable Asthma Mild intermittent and persistent asthma, moderate persistent asthma, severe asthma, and unspecified asthma J45 J45 Cardiovascular Disease Hypertensive diseases, ischemic heart diseases, pulmonary heart diseases and other forms of heart diseases I00–I99, I09, I110, I13, I50, 398, 402, 404, 428 I00–I09, I11, I13, I20–I51 Chronic Obstructive Pulmonary Disease COPD, and includes emphysema, chronic bronchitis J41, J42, J43, J44, J47 J449 Diabetes Diabetes Mellitus Type 1 and 2, other specified diabetes mellitus E08–E13, PQI0, 250 E149, N40 Liver Disease Alcoholic liver disease, toxic liver disease, hepatic failure, cirrhosis of the live, and other diseases of the liver K70–K77 K70, K73–K74 Stroke Cerebral infarction, nontraumatic subarachnoid hemorrhage, and other cerebrovascular diseases I60–I69 I60–I69 Lung Cancer Cancer of lung and bronchus, malignant neoplasm of trachea, Kaposi’s sarcoma of unspecified lung, secondary malignant neoplasm of respiratory organ C33, C34, C464, C78, D02 C33–C34 1 Simplified for purposes of this report; not all subcategories may have been used. 2 Simplified for purposes of this report; not all subcategories may have been used. Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 19 Breast Cancer Malignant neoplasm of breast, secondary malignant neoplasm of breast Prostate Cancer Malignant neoplasm of prostate Schizophrenic Disorders C50, C79 C50, C79 C61 C61 Schizophrenia, schizotypal, and delusional disorders F20–F29 Not applicable Mood Disorders Mood disorders, depression, and bipolar disorders F30–F39 Not applicable Drug-Induced Disorders Mental and behavioral disorders due to psychoactive substance abuse F10–F19 Not applicable All Mental Health Disorders All mental disorders including, schizophrenic disorders, mood disorders, drug-induced disorders, personality disorders, intellectual disabilities, and other unspecified mental disorders F01–F99 Not applicable Alcohol-Related Alcohol use (specified and unspecified), alcohol-induced Cushing’s syndrome, E244, F100-F109, G621, G312, G721, I426, K292, K700-K704, K709, K860, O354, P043, Q860, R780, T510, T511, X45, Y15, X65 E244, F100-F109, G621, G312, G721, I426, K292, K700-K704, K709, K860, O354, P043, Q860, R780, T510, T511, X45, Y15, X65 Drug Overdose Drug overdose (unintentional) T400, T401, T402, T403, T404 T400, T401, T402, T403, T404 Opioid-Related Opioid-related, not including heroine T400, T402, T403, T404, T406, F424 T400, T402, T403, T404, T406, F424 Violence-Related Injury from assault X92–Y09, S00 - T88 X85–X90, X92–X99, Y20– Y24, Y26–Y29 Motor Vehicle Crash Motor vehicle crash, injury to occupant, pedestrian-related crash, injury to a pedal cyclist, injury to a motor cyclist Suicide Intentional self-harm, including multiple methods of inflicting self-injury Falls Falls including from slipping, stumbling, or otherwise unspecified Influenza/ Pneumonia Influenza and pneumonia V00–V89, E810, E811, E812, E813, E814, E815, E816, E817, E818, E819 V00–V29, V79, V80, V81, V82, V83, V87, V88, V89, X71–X83 U03, X60, X84, X87 W00-W19, X80, Y01, Y30 W00-W19 J09–J18 J10–J18 Maricopa County • Department of Public Health • Division of Epidemiology and Informatics • February 2024 20