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Health Disparities in MA Council for the Elimination of Racial and Ethnic Disparities

Health Disparities in MA Council for the Elimination of Racial and Ethnic Disparities. Racial and Ethnic Disparities in Health Outcomes Are Seen Consistently in Massachusetts.

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Health Disparities in MA Council for the Elimination of Racial and Ethnic Disparities

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  1. Health Disparities in MACouncil for the Elimination of Racial and Ethnic Disparities

  2. Racial and Ethnic Disparities in Health Outcomes Are Seen Consistently in Massachusetts • Such disparities are particularly apparent in premature or excessive death rates for cancer, HIV, diabetes and asthma and in higher hospitalizations rates for many diseases and conditions • Disparities are seen across the Commonwealth – in all corners of the State • The causes of these disparities are multiple, including poverty, lack of acess to care and racism, discrimination and the legacy of slavery

  3. Race and Ethnic Breakdown of PopulationCentral Region and Massachusetts: 2005 Central Region Massachusetts * Non-Hispanics American Indian* 0.3% American Indian* 0.2% Asian* 3.3% Asian* 4.9% Hispanic 7.3% Hispanic 7.9% Black* 3.2% Black* 6.0% White* 86.0% White* 81.0% Population Total = 806,015 Population Total = 6,349,097 Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program

  4. Race and Ethnic Breakdown of PopulationWorcester and Massachusetts: 2005 * Non-Hispanics Worcester Massachusetts Population Total = 172,648 Population Total = 6,349,097 Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program

  5. Spanish Spoken at Home Central Region: 2000 Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program

  6. Examples of Racial and Ethnic Disparities

  7. Diabetes

  8. Source: MDPH, Bureau of Health Information, Statistics, Research and Evaluation, Health Survey Program Prevalence of Diabetes in Massachusetts Varies Significantly by Race/Ethnicity

  9. Diabetes Hospital Discharges, 2003-2005 Source: Division of Health Care Finance and Policy, Inpatient Hospital Discharge Database

  10. Mortality Rates are Much Higher for Blacks and Hispanics Source: MDPH, Bureau of Health Information, Statistics, Research and Evaluation, Health Survey Program

  11. Diabetes Mortality Rates, 2003-2005 Source: MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program

  12. N=368 N=238 N=274 N=211 N=277 N=379 N=1,830 N=1,485 GDM by Race and Hispanic EthnicityMassachusetts: 2000 vs. 2006 * * * Statistically higher than 2000 rate (p<0.05)

  13. Asthma

  14. Age-Adjusted Asthma ED Visits and Hospitalizations by Race/Ethnicity 2003-2005 Source: MDPH, Bureau of Health Information, Statistics, Research and Evaluation, Health Survey Program

  15. Age-Adjusted Asthma Mortality, 2003-2005 Source: MDPH, Bureau of Health Information, Statistics, Research and Evaluation, Health Survey Program

  16. Cancer

  17. Age-Adjusted Cancer Incidence, MA Males, 2000-2004 Source: MDPH, MA Cancer Registry

  18. Age-Adjusted Cancer Incidence, MA Females, 2000-2004 Source: MDPH, MA Cancer Registry

  19. Birth outcomes

  20. IMR by Race & Hispanic Ethnicity Massachusetts: 1990-2006 Black Non-Hispanic Hispanic White Non-Hispanic Source: MDPH, Bureau of Health Information, Statistics, Research and Evaluation, Health Survey Program

  21. HIV

  22. People Diagnosed with HIV Infection by Gender and Race/Ethnicity: Massachusetts, 2004-2006 Data Source: MDPH HIV/AIDS Surveillance Program, Data as of 11/1/07

  23. Females Diagnosed with HIV Infection by Race/Ethnicity and Place of Birth: Massachusetts,2004-2006 1 1 97% of people diagnosed with HIV infection from 2004-2006 that were born in a US Dependency were born in Puerto Rico; NH=Non-Hispanic; Data Source: MDPH HIV/AIDS Surveillance Program, Data as of 11/1/07

  24. Percentage of HIV Cases Among 13-24 Year Olds, by Race/Ethnicity: 1999–20061 Black NH Hispanic White NH Other 1 2006 Data are preliminary; Data Source: MDPH HIV/AIDS Surveillance Program; Data as of 11/1/07

  25. People Diagnosed with HIV Infection by Age at Diagnosis & Race/Ethnicity: Massachusetts, 2003-2005 Data Source: MDPH HIV/AIDS Surveillance Program, Data as of 7/06

  26. Violence in Massachusetts

  27. Gun Violence in Boston Homicides & Non-Fatal Shootings(1990 - PRESENT) # of Shootings Year DATA SOURCE: Councilor Ross (5.06 Presentation)

  28. Nonfatal Gunshot Injuries by Race/Ethnicity Boston, 2003-2005 Combined Black Bostonians are 24% of total population and 74% of victims of gunshots DATA SOURCE: Weapon-related injuries, Massachusetts Department of Public Health, Weapon-Related Injury Surveillance System DATA ANALYSIS: Boston Public Health Commission Research Office

  29. Disparities Are Seen Across the Commonwealth

  30. Diabetes Hospital Discharge Rate by Race/EthnicityWestern RegionandMassachusetts: 2003-2005 * * Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than state Age-adjusted to the 2000 US standard population.Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Inpatient Hospital Discharge Database

  31. Diabetes Death Rate by Race/EthnicityCentral Region and Massachusetts: 2003-2005 * Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state Age-adjusted to the 2000 US standard population. Source: Preliminary 2005 MA Death file, Registry of Vital Records MDPH, Health Information, Statistics, Research and Evaluation Bureau, Research & Epidemiology Program

  32. NA NA NA NA Diabetes Hospital Discharge Rate by Race/EthnicityBerkshires, Pittsfield & Massachusetts: 2003-2005 * * * Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than state Age-adjusted to the 2000 US standard population.Source: Division of Health Care Finance and Policy. Calendar Year 2003-2005. Inpatient Hospital Discharge Database

  33. Infant Mortality Rates by Race/Ethnicity Western Region and Massachusetts: 2002-2005 State Overall: 4.9 NA NA= Calculations based on less than 5 events are excluded ^ = Non-Hispanic (*) Statistically different from State (p ≤.05) Source: MDPH, Bureau of Health Information, Statistics, Research, & Evaluation Bureau, Division of Research & Epidemiology

  34. HIV/AIDS Death Rate by Race/EthnicityWestern Region and Massachusetts: 2003-2005 * NA Statistically different from State (p ≤.05) Red (*) = Statistically worse; Green (**) = Statistically better than state Age-adjusted to the 2000 US standard population. Source: MDPH, Health Information, Statistics, Research & Evaluation Bureau, Research & Epidemiology Program

  35. Asthma Emergency Department Visit Rates Children Ages 0-14 Western Region and Massachusetts: 2005 * ** Statistically different from State (p ≤.05) Red (*) = Statistically higher; Green (**) = Statistically lower Age-adjusted to the 2000 US standard population. Source: Division of Health Care Finance and Policy. Calendar Year 2005. Emergency Department Visits

  36. The Health Profiles of Each Racial and Ethnic Group and Sub-group are Different

  37. Cesarean Rate by Maternal Ethnicity1,Massachusetts 2006 * * * * * * ** ** ** ** ** ** ** ** ** ** * Statistically higher than state rate (p ≤.05) ** Statistically lower than state rate (p<.05) 1 Only ethnic groups statistically different from the state rate are included

  38. What are the contributing factors? Social and economic determinants of health matter

  39. Substantial Variation in Diabetes Rates by Household Income <$25,000 3+ fold variation $75,000 + Source: NEHI/Boston Foundation: Boston Paradox

  40. Diabetes by Education, 2006 Statistically different from state (p ≤.05)– Red (*) Statistically worse than state- Green (**) statistically better than state Source: MDPH, Bureau of Health Information, Statistics, Research and Evaluation, Health Survey Program

  41. The Experience of Racism and Discrimination Boston Adults Who Report Having Been Treated Worse Than People of Other Races At Work During the Previous Year, By Race/Ethnicity Boston Adults Who Report Having Been Treated Worse Than People of Other Races When Seeking Health Care During the Previous Year, By Race/Ethnicity Note: Data about Asian residents not shown due to inadequate sample size SOURCE: Behavioral Risk Factor Surveillance System, Massachusetts Department of Public Health and Boston Public Health Commission

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