J 2. North Carolina State LiDrary
STUDIES
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Doa
A SPECIAL REPORT SERIES BY THE N.C. DEPARTMENT OF HUMAN RESOURCES, DIVISION OF
HEALTH SERVICES, STATE CENTER FOR HEALTH STATISTICS, P.O. BOX 2091, RALEIGH, N.C. 27602
No. 18
ji^^^
o \9S0 August I9B0
WIDE GAPS IN MORTALITY RISK:
COMPARISONS AMONG RACE-SEX GROUPS
ACROSS TIME AND SPACE DIMENSIONS
Effective May 1, 1980, the State Center for Health Statistics was created.
Accordingly y our special-study monograph series has a new name—SCES STUDIES replacing
the former PHSB STUDIES. In the future, we hope to be more prolific than in the recent
past, and as always, we welcome your suggestions for improvement. Now to the subject
at hand . . .
For many conditions contributing to death, prevention is possible and chances of
survival are good when cases are diagnosed and treated at an early stage. Hence,
through the analysis of risk patterns among population groups, public health programs
can play a major role in reducing morbidity and mortality by concentrating their efforts
on those groups at greatest risk.
As discussed in a prior publication on leading causes of mortality in North
Carolina (1), certain causes of death are associated with wide gaps between the sexes
and between races with males and nonwhites experiencing substantially higher death
rates than their female and white counterparts. In particular, the publication reveals
the following recent patterns in North Carolina:
- Male death rates approach or exceed twice the female rates for 8
major causes: acute myocardial infarction, lung cancer, chronic
obstructive lung diseases, motor vehicle and other accidents,
cirrhosis, suicide and homicide.
- Nonwhite death rates approach or exceed twice the white rates for
6 causes: cancer of the stomach, cervix, prostate; hypertension;
nephr i t i s/nephrosis and homicide.
Differential age structures can account for mortality differences since, obviously,
an older population will experience more deaths and hence higher death rates unless we
adjust for age. Thus, in order to identify those race-sex groups most in need of
particular kinds of service, the present effort examines age-adjusted rates for major
underlying causes of death. Rates for race-sex groups within health service areas
(HSA's), North Carolina and the United States for each year 1973-77 allow for trending
over time (final 1978 U.S. data are not available). In addition, rates for the period
197^-78 are computed for race-sex groups at the county, MSA and state levels. Due to
the high costs involved, comparable data for a prior time period have not been generated.
Consistent with procedures of the National Center for Health Statistics (2), all
rates are adjusted by the direct method using ten-year age intervals and the 19^0 Census
of the total U.S. population as the standard. This allows for comparisons across race-sex
groups, years and geographical areas. All U.S. data are final mortality statistics
published annually by the National Center for Health Statistics as in reference 2.