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Massachusetts Deaths 2007. Bruce Cohen, PhD Massachusetts Department of Public Health Bureau of Health Information, Statistics, Research, and Evaluation Division of Research and Epidemiology Registry of Vital Records and Statistics April 2009. Causes of Death Massachusetts: 1842-2007.
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Massachusetts Deaths 2007 Bruce Cohen, PhD Massachusetts Department of Public Health Bureau of Health Information, Statistics, Research, and Evaluation Division of Research and Epidemiology Registry of Vital Records and Statistics April 2009
Outline • Highlights • Selected Causes of Death • Cancer • Heart Disease • Diabetes • HIV/AIDS • Injury • Race, Education and Mortality • Applications of Mortality Data • Summary
36 Cancer 1 Infant death 35 Heart Disease 3 Diabetes 144 DEATHS 5 Alzheimer’s 8 Injury 7 Stroke 6 CLRD On An Average Day in Massachusetts 52,690 Total deaths in 2007
Life Expectancy at BirthMassachusetts vs. U.S.1: 1900-2007 Massachusetts United States 1 2007 U.S. data was not available at the time of this release, 2006 U.S. data used.
Overall Mortality Rates Massachusetts and U.S.1 : 1994-2007 United States - 1.9%* APC Massachusetts - 2.4%* APC * Statistically significant (p<0.05) APC= Annual Percent Change Rates are per 100,000 population. Age-adjusted to the 2000 US standard population. 1 2006 Data. 2007 U.S. Data was not available at the time of this release
Higher than US Lower than US Percentage Difference in Mortality Rates Massachusetts vs. U.S.1: 2007 Nephritis* Diabetes* Homicide* Heart Disease* Infant Mortality* Cancer* Overall* Suicide* % difference Rates are per 100,000 population. Age-adjusted to the 2000 US standard population. *Statistically Significant (p ≤ .05) 1 2006 Data. 2007 U.S. Data was not available at the time of this release
Leading Causes of Death Massachusetts: 2007 Other 23.4% Cancer 24.6% Septicemia 1.7% Diabetes 2.3% Nephritis 2.6% Heart Disease 24.2% Alzheimer’s 3.2% Pneumonia & Influenza 2.9% • In 2007: • 12,961 cancer deaths • 12,735 heart disease deaths Chronic Lower Respiratory Disease 4.4% Stroke 5.1% Injury 5.6%
Ranking of Leading Causes of Death by Race and EthnicityMassachusetts: 2007 1 Non-Hispanic, 2Chronic Lower Respiratory Disease Note: The lower the number the higher the rank
Leading Causes of Death by Age Massachusetts: 2007 % of Total in Total AgeLeading CauseAge GroupDeaths 1-14Injuries 32% 128 15-24Injuries 72% 505 25-44Injuries 44% 2,023 45-64Cancer 37% 8,560 65-74Cancer 40% 7,494 75-84Cancer 27% 14,781 85+Heart Disease 30% 18,816
Changes in Mortality RatesMassachusetts: 2000 and 2007 Rates are per 100,000 population. Age-adjusted to the 2000 US standard population. *Statistically different than 2000 rate (p<0.05)
Cancer Mortality Rates Massachusetts and U.S. : 1994-20071 Massachusetts United States Rates are per 100,000 population. Age-adjusted to the 2000 US standard population 1 2006 Data. 2007 U.S. Data was not available at the time of this release
Female Breast Cancer Mortality Rates Massachusetts: 1994-2007 - 4%* APC Rates are per 100,000 population. Age-adjusted to the 2000 US standard population * Statistically significant (p<0.05) APC= Annual Percent Change
Heart Disease Mortality Rates Massachusetts and U.S.: 1994-20071 United States Massachusetts Rates are per 100,000 population. Age-adjusted to the 2000 US standard population * Statistically significant (p<0.05) APC= Annual Percent Change 1 2006 Data. 2007 U.S. Data was not available at the time of this release
Number of Heart Disease Deathsby Age and GenderMassachusetts: 2007
Diabetes-Related DeathsMassachusetts: 2007 All Diabetes-related N=3,899 Underlying Cause(Disease or injury which initiated the train of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury)1 N=1,216 Contributing Cause(Looking at all other 15 conditions mentioned on death certificates) N=2,683 1 World Health Organization. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision. 2d ed. Geneva: World Health Organization. 2004.
Diabetes Mortality Rates by Race and EthnicityMassachusetts: 2007 * * * N=1,216 N=1,041 N=96 N=15 N=62 Rates are per 100,000 population. Age-adjusted to the 2000 US standard population * Statistically different than state rate (p<0.05)
Number of HIV/AIDS Deaths Massachusetts: 1987-2007 Highly Active Antiretroviral Therapy HAART
Percent of HIV/AIDS Deaths by Age GroupMassachusetts: 1994-2007 Less than 45 years 45+ years
Poisonings 33% Causes of Injury Deaths Massachusetts: 2007 Total Injuries = 2,967 Other 18% 66% Opioids 18% Alcohol 16% Other (gases, vapor, NSAIDS, etc) Firearm 8% Suffocation, Hanging or Strangulation 11% Falls 16% Motor Vehicle-related 15%
Number of Poisoning Deaths Where Opioids Are MentionedMassachusetts: 2000-2007
Unintentional Fall Mortality RatesPersons Ages 65+Massachusetts and U.S.: 1994-2007 United States1 Massachusetts Rates are per 100,000 population ages 65+. 1 Available from URL: www.cdc.gov/ncipc/wisqars
Intentional Injury Deaths by Cause Massachusetts: 2007 Other (n=55) Other (n=37) Suicide (n=504) Homicide (n=183) Firearm (n=112) Hanging (n=220) Firearm (n=113) Cut/Pierce (n=33) Poisoning (n=117) N= 687 deaths (183 homicides) (504 suicides)
- 3%* APC Suicide Rates by GenderMassachusetts: 1994-2007 Males Massachusetts Females * Statistically significant (p<0.05) APC= Annual Percent Change Rates are per 100,000 population. Age-adjusted to the 2000 US standard population.
Mortality Rates by Education and Race/Ethnicity, Adults 25-64 Years1Massachusetts: 2007 * * * * Statistically higher than those with 13+ yrs of education (p<0..05) Rates are per 100,000 population. Age-adjusted to the 2000 US standard population 1Uses 2000 Population Estimates
Mortality Rates by Race/EthnicityAdults 25-64 Years1 with 13+Years of EducationMassachusetts: 2007 * * Statistically higher than the rate for whites (p<0..05) Rates are per 100,000 population. Age-adjusted to the 2000 US standard population 1Uses 2000 Population Estimates
Premature Mortality Rate (PMR)1 • Definition • deaths before age 75, age-adjusted to the 2000 US standard population under 75 years of age • Focus • two-thirds of deaths to persons ages 75+ • majority of deaths to persons age 75+ are due to chronic conditions associated with aging • deaths to persons less than 75 years may be preventable • Value • excellent measure to reflect the health status of a population • used as a health status indicator that can be used to focus prevention initiatives and target programs 1 Age-adjusted to the 2000 US standard population under 75 years of age.
Premature Mortality Rates by Race and Hispanic EthnicityMassachusetts: 2007 * * (*) Statistically different from State (p ≤.05) Rates are per 100,000 population. Age-adjusted to the 2000 US standard population persons ages 0-74
Premature Mortality Rates (PMR) by Community Health Network Area (CHNA) Massachusetts: 2007
Mortality Amenable to Health Care • Definition: Deaths for persons ages 0-74 from certain causes that should not occur in the presence of timely and effective health care1,2 • Value: A useful tool to assess • Performance of health care systems and • Track changes over time1 1 Nolte E and McKee CM. Measuring The Health of Nations: Updating An Earlier Analysis. Health Affairs 2008; Vol 27, Number 1: 58-71; Jan/Feb 2008. 2 Nolte E and McKee CM . Does Health Care Save Lives? Avoidable Mortality Revisited. The Nullfield Trust. 2004. London, England
Mortality Causes Amenable to Health Care Causes considered as amenable to health care: • Amenable to secondary prevention • where screening and treatment are effective; • for example colorectal, breast, cervical, and skin cancer • Amenable to improved treatment and medical care: • that require direct medical and/or surgical intervention • for example appendicitis and hypertension • that rely on efficient medical care delivery • accurate and timely diagnosis, transport, and treatment • that respond to antibiotic treatments and immunizations • infectious diseases
Percent Deaths Amenable to Health Care Massachusetts: 2007 All Deaths Deaths to Persons Ages 0-74 Amenable Deaths Amenable Deaths
Mortality Rates for Causes Amenable to Health Care by Race/EthnicityMassachusetts: 2000 and 2007 ** ** ** Statistically lower than 2000 rate (p<0.05) Rates are per 100,000 population. Age-adjusted to the 2000 US standard population persons ages 0-74
Summary • The Massachusetts death rate was the lowest on record • Life expectancy reached an all-time high • Massachusetts continues to compare favorably with the U.S. • Cancer remained the leading cause of death followed by heart disease. As in previous years, cancer and heart disease accounted for almost half of all deaths • Death rates for chronic lower respiratory disease, overall cancer, and female breast cancer declined from 2006
Summary (continued) • Lowest annual number of HIV/AIDS deaths in Massachusetts • Almost ¾ of HIV/AIDS deaths occurred among persons 45+ years • Poisoning deaths, the leading cause of injury deaths, were stable from 2006 to 2007 • Two out of 3 poisoning deaths were associated with opioids • Suicide rates had leveled off since 2002 but increased for men from 2006 to 2007 • Continued increasing trend in unintentional fall-related deaths
Summary (continued) Disparities Persist: • The cancer death rate for men was 46% higher than the rate for women • Blacks had the highest premature mortality rate, 1.5 times the rate of whites • The death rate for those with less education was almost 3 times higher than the rate for those with more education • Springfield, Lowell, Fall River, Taunton, Worcester, and New Bedford had the highest premature mortality rates
How to Access the Death Report and Data • To access the 2007 Report: • Hard Copies: (617) 740-2670 • TDD/TTY: (617) 624-6001 • DPH Website: • http:// mass.gov/dph/bhsre/resep/resep.htm#birth • To access Death data via MassCHIP (DPH’s Internet based public health information service): • Website: http://masschip.state.ma.us • Telephone: 1-888-MASCHIP (Mass only) • (617) 624-5629