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Health Disparities in Massachusetts: Data and Trends

Health Disparities in Massachusetts: Data and Trends. Disparities Council June 16, 2008. Racial Disparities in Health Indicators. Fair or Poor Self-Perceived Health Status, MA 1993-2007. Percentages are age adjusted to 2000 US population

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Health Disparities in Massachusetts: Data and Trends

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  1. Health Disparities in Massachusetts: Data and Trends Disparities Council June 16, 2008

  2. Racial Disparities in Health Indicators

  3. Fair or Poor Self-Perceived Health Status, MA 1993-2007 Percentages are age adjusted to 2000 US population Time trend in prevalence is shown when it is significant p<=0.05 source: MA BRFSS

  4. Poor Self-Perceived Mental Health, MA 1993-2007 Percentages are age adjusted to 2000 US population Time trend in prevalence is shown when it is significant p<=0.05 source: MA BRFSS

  5. Overweight or Obese, MA 1990-2007 * * * Percentages are age adjusted to 2000 US population Time trend in prevalence is shown when it is significant p<=0.05 source: MA BRFSS

  6. Diabetes, MA 1990-2007 * * Percentages are age adjusted to 2000 US population Time trend in prevalence is shown when it is significant p<=0.05 source: MA BRFSS

  7. Current Smokers, MA 1990-2007 * Percentages are age adjusted to 2000 US population Time trend in prevalence is shown when it is significant p<=0.05 source: MA BRFSS

  8. Binge Drinkers, MA 1990-2007 Percentages are age adjusted to 2000 US population Time trend in prevalence is shown when it is significant p<=0.05 source: MA BRFSS

  9. Had mammography in the past two years , MA 1992-2007 * * Percentages are age adjusted to 2000 US population Time trend in prevalence is shown when it is significant p<=0.05 source: MA BRFSS

  10. Racial Disparities in Birth Outcome Indicators

  11. Ratio of Rates Used to Compare Outcomes of Blacks1, Hispanics, And Asians1 to that of Whites1 Interpretation of ratio of rates and of its trend over time • Values of ratio of rates • <1 rates are lower than that of whites • =1 rates are equal to that of whites • >1 rates are higher than that of whites • Where the observed ratio crosses the Y axis, it indicates the magnitude of the gap between a particular race and Whites, for a given outcome. • When the Annual Percent Change (APC) is statistically different from 0 (p<0.05) and: • APC<0, this indicates that the gap (or ratio) is decreasing • APC=0, this indicates that the gap (or ratio) is stable • APC>0, this indicates that the gap (or ratio) is increasing 1. non-Hispanics

  12. Interpretation of ratio of rates and APC for Adverse Outcomes Interpretation of ratio of rates and APC for adverse outcomes Values of ratio of rates <1, better off than whites (B) =1, rates are equal to that of whites (E) >1, worse off than whites (W) Values of the Annual Percent Change (APC) If statistically different from 0 (p<0.05) and: APC<0, indicates that the racial disparity/gap is improving APC=0, indicates that the racial disparity/gap remains stable APC>0, indicates that the racial disparity/gap is worsening

  13. Worse Off Better Off Ratio of Teen Birth Rate by RaceCompared to White non-HispanicsMassachusetts Births 1996-2006 -2.4% * APC Hispanics -4.7% *APC Blacks Asians -2.5% * APC * Statistically significantly different from 0(p ≤0.05) APC = Annual Percentage Change

  14. Worse Off Better Off Ratio of Infant Mortality Rate by RaceCompared to White non-HispanicsMassachusetts Births 1996-2006 1.0% APC Blacks 3.5% * APC Hispanics Asians 1.9% APC * Statistically significantly different from 0(p ≤0.05) APC = Annual Percentage Change

  15. Worse Off Better Off Ratio of Cesarean Rates by RaceCompared to White non-HispanicsMassachusetts Births 1996-2006 -0.5% APC Blacks Asians 1.4% * APC -0.7% * APC Hispanics * Statistically significantly different from 0(p ≤0.05) APC = Annual Percentage Change

  16. Worse Off Better Off Ratio of Gestational Diabetes Mellitus by RaceCompared to White non-HispanicsMassachusetts Births 1996-2006 Asians -0.3% APC -3.2% APC Blacks Hispanics -1.0% APC * Statistically significantly different from 0(p ≤0.05) APC = Annual Percentage Change

  17. Worse Off Better Off Ratio of Singleton Low Birth Weight Rate by RaceCompared to White non-HispanicsMassachusetts Births 1996-2006 -1.4% *APC Blacks -1.0% * APC Hispanics Asians -1.4% APC * Statistically significantly different from 0(p ≤0.05) APC = Annual Percentage Change

  18. Worse Off Better Off Ratio of Smoking During Pregnancy Rate by RaceCompared to White non-HispanicsMassachusetts Births 1996-2006 -1.1% * APC Blacks -3.5% * APC Hispanics Asians 4.8% * APC * Statistically significantly different from 0(p ≤0.05) APC = Annual Percentage Change

  19. Better Off Worse Off Ratio of Adequate Prenatal Care (APNC) by RaceCompared to White non-HispanicsMassachusetts Births 1996-2006 Asians 0.3%* APC 0.6% * APC Hispanics 0.3% APC Blacks * Statistically significantly different from 0(p ≤0.05) APC = Annual Percentage Change

  20. Better Off Worse Off Ratio of Breastfeeding Rate by RaceCompared to White non-HispanicsMassachusetts Births 1996-2006 Asians 0.5% * APC 0.5% * APC Hispanics 1.1% * APC Blacks * Statistically significantly different from 0(p ≤0.05) APC = Annual Percentage Change

  21. Summary of Racial Disparities in Selected Birth Outcomes

  22. Racial Disparities in Incidence of Selected Cancers

  23. Worse Off Better Off Ratio of Colorectal Cancer Incidence by RaceCompared to White non-HispanicsMassachusetts Births 1996-2005 -1.1% APC Blacks 4.0% * APC Hispanics Asians -0.9% APC * Statistically significantly different from 0(p ≤0.05) APC = Annual Percentage Change

  24. Worse Off Better Off Ratio of Prostate Cancer Incidence by RaceCompared to White non-HispanicsMassachusetts Births 1996-2005 -1.0% APC Blacks 3.4% * APC Hispanics Asians -1.1% APC * Statistically significantly different from 0(p ≤0.05) APC = Annual Percentage Change

  25. Worse Off Better Off Ratio of Female Breast Cancer Mortality RatesCompared to White non-Hispanics Massachusetts: 1996-2006 Blacks to Whites + 1.7% APC Hispanics to Whites + 5.0%* APC Asians to Whites * Statistically Significant(p ≤.05) APC = Annual Percentage Change

  26. Worse Off Better Off Ratio of Lung Cancer Mortality RatesCompared to White non-Hispanics Massachusetts: 1996-2006 Blacks to Whites - 0.5% APC Asians to Whites - 1.5% APC Hispanics to Whites -1.4% APC * Statistically Significant(p ≤.05) APC = Annual Percentage Change

  27. Worse Off Better Off Ratio of Liver Cancer Incidence by RaceCompared to White non-HispanicsMassachusetts Births 1996-2005 Asians -5.0% * APC 4.7% APC Hispanics 2.3% APC Blacks * Statistically significantly different from 0(p ≤0.05) APC = Annual Percentage Change

  28. Worse Off Better Off Ratio of Stomach Cancer Incidence by RaceCompared to White non-HispanicsMassachusetts Births 1996-2005 Hispanics 0.4% APC 0.1% APC Blacks Asians -2.9% APC * Statistically significantly different from 0(p ≤0.05) APC = Annual Percentage Change

  29. Summary of Racial Disparities in Incidence of Selected Cancers W racial group is worse off than Whites E racial group has an equal rate than Whites B racial group is better of than Whites

  30. Disparities in Mortality in Massachusetts

  31. Note Regarding Mortality Rates for Hispanics, Asians and Native Americans • There are limitations to data from death certificates: there is an undercount of Hispanics, Asians, and Native Americans which may result in artificially low mortality rates

  32. All Cause Mortality Age-Adjusted Death Rates: 1994-2004 Adjusted Estimate Underestimate Rates are per 100,000 population. Age-adjusted to the 2000 US standard population

  33. Worse Off Better Off Ratio of All Cause Mortality RatesCompared to White non-Hispanics Massachusetts: 1996-2006 Blacks to Whites - 1.5%* APC Hispanics to Whites - 1.0%* APC Asians to Whites + 10.9%* APC * Statistically Significant(p ≤.05) APC = Annual Percentage Change

  34. Worse Off Better Off Ratio of Heart Disease Mortality RatesCompared to White non-Hispanics Massachusetts: 1996-2006 Blacks to Whites + 0.3% APC - 1.9% APC Hispanics to Whites Asians to Whites + 15.0% APC + 1.7% APC - 1.5% APC * Statistically Significant(p ≤.05) APC = Annual Percentage Change

  35. Worse Off Better Off Ratio of Diabetes Mortality RatesCompared to White non-Hispanics Massachusetts: 1996-2006 Blacks to Whites + 0.04% APC Hispanics to Whites + 3.8% APC * Statistically Significant(p ≤.05) APC = Annual Percentage Change

  36. Worse Off Better Off Ratio of Asthma Mortality Rates Compared to White non-Hispanics Massachusetts: 1996-2006 Blacks to Whites + 3.0% APC Hispanics to Whites * Statistically Significant(p ≤.05) APC = Annual Percentage Change

  37. Worse Off Better Off Ratio of Suicides RatesCompared to White non-Hispanics Massachusetts: 1996-2006 Blacks to Whites - 0.3% APC Hispanics to Whites - 3.6% APC * Statistically Significant(p ≤.05) APC = Annual Percentage Change

  38. Worse Off Better Off Ratio of Homicide Rates Compared to White non-Hispanics Massachusetts: 1996-2006 Blacks to Whites + 2.3%* APC Hispanics to Whites -0.3% APC * Statistically Significant(p ≤.05) APC = Annual Percentage Change

  39. Worse Off Better Off Ratio of HIV/AIDS Mortality RatesCompared to White non-Hispanics Massachusetts: 1996-2006 Blacks to Whites - 0.8% APC Hispanics to Whites - 0.7% APC * Statistically Significant(p ≤.05) APC = Annual Percentage Change

  40. Worse Off Better Off Ratio of Premature Mortality RatesCompared to White non-Hispanics Massachusetts: 1996-2006 Blacks to Whites - 2.2%* APC Hispanics to Whites + 4.8%* APC - 3.9% APC Asians to Whites - 2.7%* APC * Statistically Significant(p ≤.05) APC = Annual Percentage Change

  41. Worse Off Better Off Ratio of Mortality Rates for Causes Amenable to Health Care Compared to White non-Hispanics Massachusetts: 2000 and 2006 * Statistically higher than 2000 rate (p<0.O5)

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