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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 Disparities Council June 16, 2008
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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)