Health Outcomes of Western NC Compared to Eastern NC Relating to Race & Ethnicity

1. Health Outcomes of Western NC Compared to Eastern NC Relating to Race & Ethnicity • Casey Mullen • Kirsten Dickson • Amanda Marshall

2. Who? What? Where? A comparative display of statistics on health outcomes by race and/or ethnicity for Eastern NC as compared with Western NC

3. Location • We started off comparing the Eastern Counties of • Pitt • Halifax • Carteret • And the Western Counties of • Henderson • Ashe • Burke • However, we found our sample was better represented when just comparing Eastern NC to Western NC

4. Comparison Groups • X variable= the independent variable • In our case the independent variable was due to race & ethnicity • White • Black • Hispanic

5. Measures • Y variable= dependent variable • Had to do with the annual mortality rate from the health outcomes of 2010 due to… • Heart disease • All types of cancers • COPD • Stroke

6. What Does This Mean? • Theory • The specific population of mortality from each disease (D.V.) depends on the race and ethnicity (I.V.) of those diagnosed with these diseases and upon which region they live in (East vs. West) in North Carolina

7. Understanding the Slope • Correlation • Two random variables are positively correlated if high values of one are likely to be associated with high values of the other (upward slope to the right corner of the graph) • They are negatively correlated if high values of one are likely to be associated with low values of the other (downward slope to the right) • If there is no correlation then the two variables simply do not affect one another and share no relation (straight line on the graph) • So, how well can we predict one from the other?

8. What Does This Mean? • Therefore, if one race has a positive correlation with a particular mortality rate, then that race is more strongly associated with dying from that disease or vice versa

9. Western Region • Independent variable (x)- Percent white • Dependent variable (y)- One year Mortality rate of heart disease (2010 count) • Correlation- Negative/ weak • Thus, the higher the value of the sum of people dying from heart disease annually in the Western Region of North Carolina, then the lower the percentage of white people will be of dying from this disease (versus their black and Hispanic counterparts)

10. Western Region • Independent variable (x)- percent black • Dependent variable (y)- One year Mortality rate of heart disease (2010 count) • Correlation- Positive/ strong • Thus, the larger the sum of people dying of heart disease (in the west), then the more likely those dying were to be black

11. Western Region • Independent variable (x)- Percent Hispanic • Dependent variable (y)- One year Mortality rate of heart disease (2010 count) • Correlation- Positive • Similar to blacks in the western region of NC, more Hispanics are positively associated with mortality from this disease than whites

12. Summary • Blacks and Hispanics are more strongly associated with death due to heart disease than whites in the Western Region of North Carolina

13. Eastern Region • Independent variable (x)- Percent white • Dependent variable (y)- One year Mortality rate of heart disease • Correlation- Negative (almost flat as if no correlation were present)

14. Eastern Region • Independent variable (x)- Percent black • Dependent variable (y)- One year Mortality rate of heart disease • Correlation- Negative

15. Eastern Region • Independent variable (x)- Percent Hispanic • Dependent variable (y)- One year Mortality rate of heart disease • Correlation- Positive

16. In Sum • Whites and blacks are less associated with death due to heart disease than Hispanics are in the Eastern portion of North Carolina

17. Western Region • I.V.- White • D.V.- One year mortality, all cancers • Correlation- Negative

18. Western Region • I.V.- Black • D.V.- One year mortality, all cancers • Correlation- Positive

19. Western Region • I.V.- Hispanic • D.V.- One year mortality, all cancers • Correlation- Positive

20. Eastern Region • I.V.- White • D.V.- One year mortality, all cancers • Correlation- Negative

21. Eastern Region • I.V.- Black • D.V.- One year mortality, all cancers • Correlation- Positive

22. Eastern Region • I.V.- Hispanic • D.V.- One year mortality, all cancers • Correlation- Positive

23. Summary • Whites are more weakly assoc. with death due to cancers in the West and the East than blacks and Hispanics

24. Western Region • I.V.- White • D.V.- One year mortality, COPD • Correlation- Negative

25. Western Region • I.V.- Black • D.V.- One year mortality COPD • Correlation- Positive

26. Western Region • I.V.- Hispanic • D.V.- One year mortality COPD • Correlation- Positive

27. Summary • Whites are less associated with death due to COPD in the Western Region of NC than blacks and Hispanics

28. Eastern Region • I.V.- White • D.V.- One year mortality, COPD • Correlation- Negative

29. Eastern Region • I.V.- Black • D.V.- One year mortality, COPD • Correlation- Negative

30. Eastern Region • I.V.- Hispanic • D.V.- One year mortality, COPD • Correlation- Positive

31. Summary • Hispanics are more strongly associated with death due to COPD than whites and blacks in the East part of NC

32. Western Region • I.V.- White • D.V.- One year mortality rate, Stroke • Correlation- Negative

33. Western Region • I.V.- Black • D.V.- One year mortality rate, Stroke • Correlation- Positive

34. Western Region • I.V.- Hispanic • D.V.- One year mortality rate, Stroke • Correlation- Positive

35. Summary • Hispanics and blacks from the Western portion of NC are more highly associated with mortality from stroke than whites are

36. Eastern Region • I.V.- White • D.V.- One year mortality rate, Stroke • Correlation- None

37. Eastern Region • I.V.- Black • D.V.- One year mortality rate, Stroke • Correlation- Negative

38. Eastern Region • I.V.- Hispanic • D.V.- One year mortality rate, Stroke • Correlation- Positive

39. In Sum • Whites show no correlation is evident between their race and its effects on the mortality rate of stroke in the East • Blacks show a weak correlation • While Hispanics show a strong correlation

40. Overview of SES • Both African Americans and Hispanics, as a whole, have lower income, lower educational level, and higher unemployment rates than Whites • Both minority groups also have higher percentages of people who don’t have current health insurance, couldn’t see a doctor due to cost, or who had no personal doctor when compared to their white counterparts • These things contribute to higher rates of health problems

41. Blacks & Hispanics • Less likely than whites to get the recommended level of physical activity or to engage in any leisure time activity • Less likely to consume recommended amount of fruits and vegetables each day

42. Hispanics • Top 3 causes of death • Cancer • Motor vehicle injuries • Heart disease

43. Hispanics Continued • Higher percentages reported of fair or poor health when compared to whites or blacks • Less likely to report diabetes, high blood pressure, or asthma than whites or blacks • In reality, Hispanics are worse off than whites, but better off than blacks

44. Blacks • Top 4 diseases among African Americans • Heart Disease • Cancer • Stroke • Diabetes • Higher rates of obesity when compared to whites

45. Blacks Continued • Heart Disease • African Americans are 30% more likely to die from heart disease than whites • Cancer • Substantially higher rates of prostate cancer compared to whites • Higher rates of colon/rectum and cervical cancer

46. Steps should be considered in developing policies to eliminate racial and ethnic disparities:[ • Consistentracial and ethnic data collection by health care providers • Effective evaluation of disparities-reduction programs • Minimum standards for culturally and linguistically competent health services • Greater minority representation within the health care workforce • Establishment or enhancement of government offices of minority health • Expanded access to services for all ethnic and racial groups • Involvement of all health system representatives in minority health improvement efforts

47. How can we generate these changes? • Interpreter services • Recruitment • Specialized Training • Use of Community Health Workers • Culturally competent health promotion • Including family and/or community members • Immersion into another culture • Administrative and Organizational accommodations