Racial and ethnic health disparities in North Carolina : report card

              Racial and Ethnic Health Disparities in North Carolina REPORT CARD 2010 OFFICE OF MINORITY HEALTH AND HEALTH DISPARITIES AND STATE CENTER FOR HEALTH STATISTICS NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES Racial and Ethnic Health Disparities
in North Carolina
Report Card
2010
Office of Minority Health and Health Disparities
and
State Center for Health Statistics
North Carolina Department of Health and Human Services
North Carolina Division of Public Health Acknowledgements
Barbara Pullen- Smith, North Carolina Office of Minority Health and Health Disparities ( OMHHD), Kathleen Jones- Vessey, State Center for Health Statistics ( SCHS), and Camillia Easley ( CDC Prevention Specialist, Chronic Disease and Injury Section) in partnership developed this Racial and Ethnic Disparities in North Carolina Report Card 2010 with valuable contributions from many staff members of the State Center for Health Statistics, especially Don Akin, Matt Avery, Sidney Evans,
Ann Farmer, and Donna Miles.
Appreciation is given for the professional insight and contributions from the program staff of the OMHHD.
A special appreciation is given to Barbara Pullen- Smith, director of the OMHHD, for being instrumental in providing leadership to help move the Call to Action vision forward to eliminate the health status gaps between racial and ethnic minorities and other underserved populations in North Carolina. The OMHHD leadership encourages the state of North Carolina to hold itself accountable and monitor progress toward eliminating the health status gaps. Racial and Ethnic Health Disparities Report Card 2010 — June 2010
Office of Minority Health and Health Disparities and State Center for Health Statistics 3
Racial and Ethnic Health Disparities in North Carolina
Report Card 2010
The Purpose:
This Racial and Ethnic Health Disparities in North Carolina Report Card 2010 is a useful tool that shows leading health indicators for broad racial and ethnic population groups for North Carolina, supporting data for those health indicators, and a letter grade that ranks the health status of those groups. This Report Card is put together to inform and help guide those with the will to eliminate health disparities.
The Report Card is a tool that:
■ measures and helps monitor the state’s progress towards eliminating the health status gap between racial and ethnic minorities and the white population.
■ provides current data that can be used by community- based organizations, faith- based organizations, tribal governments and communities, local health departments, state agencies and organizations, legislators, and local businesses to help guide and make plans for efforts to provide services and outreach to help specific groups and communities with health status gaps.
■ can be used to inform key decision makers about eliminating health disparities through policy reform and systems change.
According to America’s Health Rankings ™ , North Carolina ranks 37th in the country in 2009.1 The health status ranking of North Carolina in the nation is closely tied to the health status of minorities and other underserved population groups. Although data are presented by race and ethnicity to describe health status gaps, race/ ethnicity by itself is not a cause of a health condition or health status.
About the Data:
This Health Disparities Report Card contains data from different sources. The key indicators were chosen because of the relationship to health and health disparities and based on availability of data. The symbol ♦ is used in this report for indicators where reliable rates could not be calculated due to inadequate data or small number of events. In some cases this may indicate where improved data collection is needed. For the 2010 Report Card, all rates presented by race/ ethnicity are mutually exclusive categories. Therefore, rates and figures presented here will differ from earlier Report Cards. Note: Some data show percentages, e. g., from the North Carolina Behavioral Risk Factor Surveillance System ( BRFSS), while other data show rates per 100,000 population, e. g., mortality data.
1 United Health Foundation. America’s Health Rankings ™ : North Carolina. 2009. Available at:
www. americashealthrankings. org/ StateRanking. aspx. Racial and Ethnic Health Disparities Report Card 2010 — June 2010
4 Office of Minority Health and Health Disparities and State Center for Health Statistics
Disparity Ratios and Grades:
This Racial and Ethnic Health Disparities Report Card uses ratios to compare race and ethnic groups in North Carolina. These ratios are a measure in one group divided by the measure in the white group. The ratios show areas with the greatest health disparities, areas with growing disparities, and disparity areas that are improving.
Letter grades ranging from “ A” for very good to “ F” for failing were given to each racial or ethnic minority group in North Carolina as compared to the measures of the white population of North Carolina.
Here is an example.
The 2004��� 2008 prostate cancer death rate shown for African Americans ( 59.1) was divided by the prostate cancer death rate for whites ( 21.3): 59.1 ÷ 21.3 = 2.8. This ratio shows the prostate cancer death rate for African Americans was 2.8 times higher than the rate for the white population. By following the disparity ratio grading scale below, the ratio of 2.8 receives a grade of “ D.”
These grades do not consider trends in the data or the ranking of North Carolina relative to the United States, so a grade of “ A” or “ B” could still mean that improvement is needed. In this Report Card, the health status of the white population is not graded. The white population is used as a point of comparison to determine the disparity ratio and the grade for the minority population groups because whites are the majority population in North Carolina and because they often have the best health outcomes. Comparing the different minority groups to the white majority population does not mean that whites are setting a “ gold standard.” The white population also has major health issues that need to be addressed.
The following grading scale was used in assigning the letter grades. ( This grading scale was reversed for the social and economic well- being indicator “ median family income.”)
Disparity Ratio and Grades:
A = 0.0– 0.5
B = 0.6– 1.0
C = 1.1– 1.9
D = 2.0– 2.9
F = 3.0 or greater
With some indicators, the rates have improved from the baseline years to the current rates. But the grades for those rates may not show an improvement because the disparity still exists.
In cases where the minority rates are better than the white comparison rate, the disparity ratio was not utilized, and the grade is reported as an “ A.”
In cases where racial/ ethnic groups have a very small number of reported events, their rates/ percentages are statistically unstable. In these cases, you will see the symbol ♦ indicating that reliable rates could not be calculated for this indicator due to an inadequate or small number of events. Racial and Ethnic Health Disparities Report Card 2010 — June 2010
Office of Minority Health and Health Disparities and State Center for Health Statistics 5
Social and Economic Well- Being
Indicators
Baseline Measure
Ratio to Whites
Grade
Updated Measure
Ratio to Whites
Grade
Percent of children under 18 years of age
living below the Federal Poverty Level1
2004
2008
All
21.9
19.9
White
13.1
1.0
11.3
1.0
African American/ Black
38.2
2.3
D
33.4
3.0
F
American Indian
34.5
2.6
D
28.3
2.5
D
Asian/ Pacific Islander
7.4
0.6
A §
12.8
1.1
C
Hispanic/ Latino
36.8
2.8
D
34.3
3.0
F
Percent of families living below the Federal Poverty Level1
2004
2008
All
12.1
10.9
White
7.5
1.0
6.7
1.0
African American/ Black
25.2
3.4
F
21.3
3.2
F
American Indian
19.4
2.6
D
21.2
3.2
F
Asian/ Pacific Islander
6.5
0.9
A §
8.0
1.2
C
Hispanic/ Latino
25.6
3.4
F
24.8
3.7
F
Percent of single parent families1
2004
2008
All
26.3
25.9
White
17.2
1.0
17.8
1.0
African American/ Black
54.8
3.2
F
52.8
3.0
F
American Indian
38.9
2.3
D
36.6
2.1
D
Asian/ Pacific Islander
17.4
1.0
B
12.7
0.7
A §
Hispanic/ Latino
39.0
2.3
D
32.9
1.8
C
Median family income ($) 1*
2004
2008
All
47,112
56,588
White
52,991
1.0
64,879
1.0
African American/ Black
30,463
0.6
D
37,897
0.6
D
American Indian
33,841
0.6
D
40,849
0.6
D
Asian/ Pacific Islander
61,592
1.2
A §
69,277
1.1
A §
Hispanic/ Latino
30,589
0.6
D
33,814
0.5
F
Dropout Rates2
2005– 2006
2007– 2008
All
5.0
5.0
White
4.4
1.0
4.3
1.0
African American/ Black
5.6
1.3
C
6.0
1.4
C
American Indian
8.4
1.9
C
7.0
1.6
C
Asian/ Pacific Islander
2.7
0.6
A §
2.2
0.5
A §
Hispanic/ Latino
8.7
2.0
D
6.9
1.6
C
Percentage Not Owning a Home (%) 1
2004
2008
All
31.0
31.8
White
24.2
1.0
24.2
1.0
African American/ Black
46.1
1.9
C
50.7
2.1
D
American Indian
29.0
1.2
C
30.9
1.3
C
Asian/ Pacific Islander
40.6
1.7
C
37.2
1.5
C
Hispanic/ Latino
69.0
2.9
D
58.4
2.4
D
1. U. S. Census Bureau; American Community Survey, 2004 and 2008 Summary Tables; generated by SCHS staff; using American FactFinder; ( Accessed January 22, 2010) Available at: http:// factfinder. census. gov/ home/ saff/ main. html?_ lang= en.
2. North Carolina State Board of Education, Department of Public Instruction, Program Monitoring and Support. Dropout Reports: 2005- 06 & 2007– 08. ( Accessed November 25, 2009) Available at: www. ncpublicschools. org/ research/ dropout/ reports. The dropout rate represents the number of students in grades 9– 12 dropping out in one year, divided by a measure of the total number of students in grades 9– 12. A dropout is defined by State Board policy ( HSP- Q- 001) as “ any student who leaves school for any reason before graduation or completion of a program of studies without transferring to secondary school.” For reporting purposes, a dropout is a student who was enrolled at some time during the previous school year, but who was not enrolled on day 20 of the current school year.
* For median family income, a higher ratio indicates a better income, therefore the grading scale was reversed, such that: 0.0– 0.5= F; 0.6– 1.0= D; 1.1– 1.9= C; 2.0– 2.9= B; and 3.0 or greater= A.
§ The rate for this race/ ethnicity is better than the white comparison rate, therefore the disparity ratio is not utilized and the grade is reported as an “ A.” Racial and Ethnic Health Disparities Report Card 2010 — June 2010
6 Office of Minority Health and Health Disparities and State Center for Health Statistics
Maternal and Infant Health
Indicators
Baseline
Measure
Ratio to Whites
Grade
Updated
Measure
Ratio to Whites
Grade
Number of infant deaths per 1,000 live births ( Infant Mortality Rate) 1
( Healthy People 2010 Goal = 4.5)
1999– 2003
2004– 2008
All
8.4
8.4
White
6.3
1.0
6.2
1.0
African American/ Black
15.0
2.4
D
15.1
2.4
D
American Indian
11.0
1.7
C
13.2
2.1
D
Asian/ Pacific Islander
5.4
0.9
A §
5.9
1.0
A §
Hispanic/ Latina
6.1
1.0
A §
6.3
1.0
B
Percent of births that were low birthweight (< 2,500 grams) 2
( Healthy People 2010 Goal = 5.0)
1999– 2003
2004– 2008
All
8.9
9.1
White
7.5
1.0
7.8
1.0
African American/ Black
13.9
1.9
C
14.4
1.8
C
American Indian
10.8
1.4
C
10.7
1.4
C
Asian/ Pacific Islander
7.9
1.1
C
8.5
1.1
C
Hispanic/ Latina
6.2
0.8
A §
6.3
0.8
A §
Percent of women with late prenatal care
( after 1st trimester or no prenatal care) 2 ( Healthy People 2010 Goal = 10.0 percent)
1999– 2003
2004– 2008
All
15.3
16.9
White
9.0
1.0
10.3
1.0
African American/ Black
23.8
2.6
D
23.7
2.3
D
American Indian
22.2
2.5
D
20.9
2.0
D
Asian/ Pacific Islander
15.8
1.8
C
14.6
1.4
C
Hispanic/ Latina
30.1
3.3
F
30.5
3.0
F
Percent of women who smoked during
pregnancy2
1999– 2003
2004– 2008
All
13.6
11.5
White
17.1
1.0
15.0
1.0
African American/ Black
11.0
0.6
A §
10.4
0.7
A §
American Indian
25.0
1.5
C
24.1
1.6
C
Asian/ Pacific Islander
2.3
0.1
A §
2.1
0.1
A §
Hispanic/ Latina
1.5
0.1
A §
1.2
0.1
A §
1. North Carolina Division of Public Health, State Center for Health Statistics. North Carolina resident matched live birth/ death certificates 1999– 2008 [ Electronic data files]. Raleigh, NC: State Center for Health Statistics [ Producer].
2. North Carolina Division of Public Health, State Center for Health Statistics. North Carolina resident live birth certificates 1999– 2008 [ Electronic data files]. Raleigh, NC: State Center for Health Statistics [ Producer].
§ The rate for this race/ ethnicity is better than the white comparison rate, therefore the disparity ratio is not utilized and the grade is reported as an “ A.” Racial and Ethnic Health Disparities Report Card 2010 — June 2010
Office of Minority Health and Health Disparities and State Center for Health Statistics 7
Adult Health
Indicators
Baseline Measure
Ratio to Whites
Grade
Updated Measure
Ratio to Whites
Grade
Percent of adults ages 18– 64 with no health insurance1
2003– 2005
2006– 2008
All
21.0
21.3
White
14.8
1.0
14.2
1.0
African American/ Black
22.5
1.5
C
23.1
1.6
C
American Indian
27.9
1.9
C
28.3
2.0
D
Asian/ Pacific Islander
18.7
1.3
C
16.7
1.2
C
Hispanic/ Latino
65.3
4.4
F
65.0
4.6
F
Percent of adults who could not see a doctor in the previous 12 months due to cost1
2003– 2005
2006– 2008
All
15.7
16.5
White
13.1
1.0
13.5
1.0
African American/ Black
20.7
1.6
C
20.6
1.5
C
American Indian
28.3
2.2
D
25.3
1.9
C
Asian/ Pacific Islander
17.6
1.3
C
15.7
1.2
C
Hispanic/ Latino
24.8
1.9
C
29.1
2.2
D
Percent of adults who did not visit a dentist in the past year1
2002 & 2004
2006 & 2008
All
32.4
33.8
White
27.9
1.0
28.6
1.0
African American/ Black
40.8
1.5
C
41.6
1.5
C
American Indian
42.2
1.5
C
41.8
1.5
C
Asian/ Pacific Islander
33.7
1.2
C
30.4
1.1
C
Hispanic/ Latino
56.4
2.0
D
57.0
2.0
D
Percent of adults in fair or poor health1
2003– 2005
2006– 2008
All
19.0
18.1
White
16.8
1.0
15.7
1.0
African American/ Black
23.2
1.4
C
21.6
1.4
C
American Indian
25.0
1.5
C
27.5
1.8
C
Asian/ Pacific Islander
8.0
0.5
A §
8.6
0.5
A §
Hispanic/ Latino
30.0
1.8
C
29.1
1.9
C
1. North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System Survey Data 2003– 2008. Raleigh, NC: State Center for Health Statistics [ Producer]. www. schs. state. nc. us/ SCHS/ brfss.
* Note: BRFSS is an ongoing, monthly telephone survey, which collects data from randomly selected, non- institutionalized North Carolina adults in households with telephones. The survey collects information on a broad array of health topics including insurance status, access to care,
disability, chronic conditions, and health behaviors.
§ The rate for this race/ ethnicity is better than the white comparison rate, therefore the disparity ratio is not utilized and the grade is reported as an “ A.” Racial and Ethnic Health Disparities Report Card 2010 — June 2010
8 Office of Minority Health and Health Disparities and State Center for Health Statistics
Adult Health ( continued)
Indicators
Baseline Measure
Ratio to Whites
Grade
Updated Measure
Ratio to Whites
Grade
Heart disease deaths per 100,000 population2 ( Healthy People 2010 Goal= 166.0)
1999– 2003
2004– 2008
All
245.6
197.9
White
237.3
1.0
192.6
1.0
African American/ Black
293.5
1.2
C
236.0
1.2
C
American Indian
295.1
1.2
C
207.7
1.1
C
Asian/ Pacific Islander
75.0
0.3
A §
73.9
0.4
A §
Hispanic/ Latino
86.6
0.4
A §
66.4
0.3
A §
Stroke deaths per 100,000 population2
( Healthy people 2010 Goal= 48.0)
1999– 2003
2004– 2008
All
71.5
53.1
White
66.8
1.0
49.2
1.0
African American/ Black
95.4
1.4
C
73.5
1.5
C
American Indian
74.7
1.1
C
54.6
1.1
C
Asian/ Pacific Islander
42.2
0.6
A §
32.7
0.7
A §
Hispanic/ Latino
32.4
0.5
A §
20.5
0.4
A §
Diabetes deaths per 100,000 population ( All Mentions) 2 ( Healthy People 2010 Goal= 45.0)
1999– 2003
2004– 2008
All
97.5
93.7
White
82.4
1.0
80.2
1.0
African American/ Black
173.5
2.1
D
163.8
2.0
D
American Indian
158.0
1.9
C
138.0
1.7
C
Asian/ Pacific Islander
41.4
0.5
A §
36.3
0.5
A §
Hispanic/ Latino
47.3
0.6
A §
45.9
0.6
A §
Kidney disease deaths per 100,000
population2
1999– 2003
2004– 2008
All
17.1
18.4
White
13.6
1.0
14.8
1.0
African American/ Black
34.8
2.6
D
36.5
2.5
D
American Indian
21.6
1.6
C
23.5
1.6
C
Asian/ Pacific Islander
11.5
0.8
A §
10.8
0.7
A §
Hispanic/ Latino
4.9
0.4
A §
8.7
0.6
A §
Chronic lower respiratory disease deaths
per 100,000 population2
1999– 2003
2004– 2008
All
47.1
46.9
White
50.8
1.0
51.1
1.0
African American/ Black
31.5
0.6
A §
30.4
0.6
A §
American Indian
40.6
0.8
A §
30.1
0.6
A §
Asian/ Pacific Islander
♦
♦
♦
7.5
0.1
A §
Hispanic/ Latino
9.4
0.2
A §
11.4
0.2
A §
2. North Carolina Division of Public Health, State Center for Health Statistics. North Carolina resident death certificates 1999– 2008 [ Electronic data files]. Raleigh, NC: State Center for Health Statistics [ Producer].
* Note: Surname matching was used to enhance identification of Hispanic/ Latino deaths. Age- adjusted by the direct method using the 2000 U. S.
population as the standard ( except the child 0– 17 death rate).
§ The rate for this race/ ethnicity is better than the white comparison rate, therefore the disparity ratio is not utilized and the grade is reported as an “ A.”
♦ A reliable rate could not be calculated for this indicator due to a small number of events (< 20 cases), therefore no grade is presented. Racial and Ethnic Health Disparities Report Card 2010 — June 2010
Office of Minority Health and Health Disparities and State Center for Health Statistics 9
Adult Health ( continued)
Indicators
Baseline Measure
Ratio to Whites
Grade
Updated Measure
Ratio to Whites
Grade
HIV disease deaths per 100,000 population2 ( Healthy People 2010 Goal= 0.7)
1999– 2003
2004– 2008
All
5.6
4.4
White
1.5
1.0
1.2
1.0
African American/ Black
21.1
14.1
F
16.5
13.8
F
American Indian
♦
♦
♦
♦
♦
♦
Asian/ Pacific Islander
♦
♦
♦
♦
♦
♦
Hispanic/ Latino
4.1
2.7
D
2.7
2.3
D
Prostate cancer deaths per 100,000 male
population2 ( Healthy People 2010 Goal= 28.8)
1999– 2003
2004– 2008
All
33.2
26.5
White
26.2
1.0
21.3
1.0
African American/ Black
74.9
2.9
D
59.1
2.8
D
American Indian
43.8
1.7
C
31.4
1.5
C
Asian/ Pacific Islander
♦
♦
♦
♦
♦
♦
Hispanic/ Latino
♦
♦
♦
8.7
0.4
A §
Lung cancer deaths per 100,000 population2 ( Healthy People 2010 Goal= 44.9)
1999– 2003
2004– 2008
All
60.0
58.2
White
60.7
1.0
59.7
1.0
African American/ Black
60.7
1.0
A §
56.6
0.9
A §
American Indian
46.9
0.8
A §
57.3
1.0
A §
Asian/ Pacific Islander
20.0
0.3
A §
19.7
0.3
A §
Hispanic/ Latino
19.5
0.3
A §
15.1
0.3
A §
Colorectal cancer deaths per 100,000
population2 ( Healthy People 2010 Goal= 13.9)
1999– 2003
2004– 2008
All
19.5
17.0
White
18.3
1.0
15.9
1.0
African American/ Black
26.1
1.4
C
23.7
1.5
C
American Indian
12.9
0.7
A §
11.8
0.7
A §
Asian/ Pacific Islander
8.9
0.5
A §
8.8
0.6
A §
Hispanic/ Latino
9.8
0.5
A §
6.9
0.4
A §
Breast cancer deaths per 100,000 female population2 ( Healthy People 2010 Goal= 22.3)
1999– 2003
2004– 2008
All
25.4
24.4
White
23.6
1.0
22.7
1.0
African American/ Black
33.8
1.4
C
33.0
1.5
C
American Indian
25.8
1.1
C
20.8
0.9
A §
Asian/ Pacific Islander
8.3
0.4
A §
8.8
0.4
A §
Hispanic/ Latino
12.5
0.5
A §
9.4
0.4
A §
2. North Carolina Division of Public Health, State Center for Health Statistics. North Carolina resident death certificates 1999– 2008 [ Electronic data files]. Raleigh, NC: State Center for Health Statistics [ Producer].
* Note: Surname matching was used to enhance identification of Hispanic/ Latino deaths. Age- adjusted by the direct method using the 2000 U. S. population as the standard ( except the child 0– 17 death rate).
§ The rate for this race/ ethnicity is better than the white comparison rate, therefore the disparity ratio is not utilized and the grade is reported as an “ A.”
♦ A reliable rate could not be calculated for this indicator due to a small number of events (< 20 cases), therefore no grade is presented. Racial and Ethnic Health Disparities Report Card 2010 — June 2010
10 Office of Minority Health and Health Disparities and State Center for Health Statistics
Communicable Diseases
Indicators
Baseline Measure
Ratio to Whites
Grade
Updated Measure
Ratio to Whites
Grade
Diagnosed Adult/ Adolescent ( Ages 13+) HIV cases per 100,000 population1
1999– 2003
2004– 2008
All
22.5
24.3
White
7.4
1.0
9.0
1.0
African American/ Black
75.1
10.1
F
74.4
8.3
F
American Indian
18.8
2.5
D
16.0
1.8
C
Asian/ Pacific Islander
♦
♦
♦
♦
♦
♦
Hispanic/ Latino
25.3
3.4
F
33.6
3.7
F
Early Syphilis cases ( Primary, Secondary & Early Latent) per 100,000 population1 ( Healthy People 2010 Goal= 0.2)
1999– 2003
2004– 2008
All
10.4
5.9
White
2.4
1.0
2.2
1.0
African American/ Black
34.3
14.3
F
18.4
8.4
F
American Indian
50.1
20.9
F
4.5
2.0
D
Asian/ Pacific Islander
♦
♦
♦
♦
♦
♦
Hispanic/ Latino
12.4
5.2
F
5.2
2.4
D
Gonorrhea cases per 100,000 population1 ( Healthy People 2010 Goal= 19.0)
1999– 2003
2004– 2008
All
206.4
178.6
White
40.4
1.0
40.0
1.0
African American/ Black
781.5
19.3
F
604.3
15.1
F
American Indian
182.5
4.5
F
191.4
4.8
F
Asian/ Pacific Islander
♦
♦
♦
♦
♦
♦
Hispanic/ Latino
94.3
2.3
D
68.1
1.7
C
Chlamydia cases per 100,000 population1 ( Healthy People 2010 Goal= 3.0)
1999– 2003
2004– 2008
All
285.3
365.7
White
104.2
1.0
127.6
1.0
African American/ Black
860.0
8.3
F
982.1
7.7
F
American Indian
332.7
3.2
F
396.0
3.1
F
Asian/ Pacific Islander
♦
♦
♦
♦
♦
♦
Hispanic/ Latino
369.3
3.5
F
395.8
3.1
F
1. North Carolina Division of Public Health, HIV/ STD Prevention and Care Branch. North Carolina resident HIV/ STD Surveillance Data 1999– 2008 [ Electronic data files]. Raleigh, NC: HIV/ STD Prevention and Care Branch [ Producer].
♦ A reliable rate could not be calculated for this indicator due to a small number of events (< 20 cases), therefore no grade is presented. Racial and Ethnic Health Disparities Report Card 2010 — June 2010
Office of Minority Health and Health Disparities and State Center for Health Statistics 11
Violence and Injuries
Indicators
Baseline Measure
Ratio to Whites
Grade
Updated Measure
Ratio to Whites
Grade
Homicide deaths per 100,000 population1 ( Healthy People 2010 Goal= 3.0)
1999– 2003
2004– 2008
All
7.5
7.3
White
3.8
1.0
3.6
1.0
African American/ Black
16.8
4.4
F
16.4
4.6
F
American Indian
18.6
4.9
F
20.4
5.7
F
Asian/ Pacific Islander
4.0
1.1
C
3.8
1.1
C
Hispanic/ Latino
13.0
3.4
F
10.3
2.9
D
Suicide deaths per 100,000 population1 ( Healthy People 2010 Goal= 5.0)
1999– 2003
2004– 2008
All
11.5
11.9
White
13.5
1.0
14.4
1.0
African American/ Black
5.5
0.4
A §
5.0
0.3
A §
American Indian
7.0
0.5
A §
9.5
0.7
A §
Asian/ Pacific Islander
6.0
0.4
A §
6.5
0.5
A §
Hispanic/ Latino
4.1
0.3
A §
5.6
0.4
A §
Unintentional motor vehicle crash deaths per 100,000 population1
( Healthy People 2010 Goal= 9.2)
1999– 2003
2004– 2008
All
19.6
18.7
White
18.3
1.0
18.1
1.0
African American/ Black
20.5
1.1
C
18.0
1.0
A ��
American Indian
41.5
2.3
D
39.0
2.2
D
Asian/ Pacific Islander
12.1
0.7
A §
7.6
0.4
A §
Hispanic/ Latino
30.4
1.7
C
24.1
1.3
C
Other unintentional injury deaths per 100,000 population1
1999– 2003
2004– 2008
All
23.8
28.2
White
24.2
1.0
30.9
1.0
African American/ Black
22.9
0.9
A §
21.8
0.7
A §
American Indian
22.2
0.9
A §
30.9
1.0
A §
Asian/ Pacific Islander
9.5
0.4
A §
7.4
0.2
A §
Hispanic/ Latino
17.0
0.7
A §
13.4
0.4
A §
1. North Carolina Division of Public Health, State Center for Health Statistics. North Carolina resident death certificates 1999– 2008 [ Electronic data files]. Raleigh, NC: State Center for Health Statistics [ Producer].
* Note: Surname matching was used to enhance identification of Hispanic/ Latino deaths. Age- adjusted by the direct method using the 2000 U. S. population as the standard ( except the child 0– 17 death rate).
§ The rate for this race/ ethnicity is better than the white comparison rate, therefore the disparity ratio is not utilized and the grade is reported as an “ A.” Racial and Ethnic Health Disparities Report Card 2010 — June 2010
12 Office of Minority Health and Health Disparities and State Center for Health Statistics
Child and Adolescent Health
Indicators
Baseline Measure
Ratio to Whites
Grade
Updated Measure
Ratio to Whites
Grade
Deaths of children 1 to 17 years per 100,000 population1
1999– 2003
2004– 2008
All
29.0
26.4
White
26.8
1.0
23.7
1.0
African American/ Black
33.1
1.2
C
33.1
1.4
C
American Indian
44.7
1.7
C
40.9
1.7
C
Asian/ Pacific Islander
18.3
0.7
A §
13.9
0.6
A §
Hispanic/ Latino
32.0
1.2
C
25.7
1.1
C
Pregnancies to teens ages 15– 19 per 1,000 female population2
1999– 2003
2004– 2008
All
71.3
64.5
White
51.9
1.0
43.9
1.0
African American/ Black
97.3
1.9
C
86.9
2.0
D
American Indian
91.5
1.8
C
85.7
2.0
D
Asian/ Pacific Islander
60.9
1.2
C
41.6
0.9
A §
Hispanic/ Latino
175.5
3.4
F
173.2
3.9
F
Percent of high school students who smoked cigarettes on one or more of the past 30 days3 ( Healthy People 2010 Goal= 16.0)
2003
2007
All
24.8
22.5
White
28.4
1.0
26.7
1.0
African American/ Black
15.4
0.5
A §
14.8
0.6
A §
American Indian
♦
♦
♦
♦
♦
♦
Asian/ Pacific Islander
♦
♦
♦
♦
♦
♦
Hispanic/ Latino
23.3
0.8
A §
20.2
0.8
A §
Percent of high school students who drank
alcohol in the past 30 days3
2003
2007
All
39.4
37.7
White
43.6
1.0
43.0
1.0
African American/ Black
30.3
0.7
A §
27.2
0.6
A §
American Indian
♦
♦
♦
♦
♦
♦
Asian/ Pacific Islander
♦
♦
♦
♦
♦
♦
Hispanic/ Latino
33.0
0.8
A §
38.7
0.9
A §
1. North Carolina Division of Public Health, State Center for Health Statistics. North Carolina resident death certificates 1999– 2008 [ Electronic data files]. Raleigh, NC: State Center for Health Statistics [ Producer].
* Note: Surname matching was used to enhance identification of Hispanic/ Latino deaths. Age- adjusted by the direct method using the 2000 U. S. population as the standard ( except the child 0– 17 death rate).
2. North Carolina Division of Public Health, State Center for Health Statistics. North Carolina resident live birth/ fetal death/ abortion certificates 1999– 2008 [ Electronic data files]. Raleigh, NC: State Center for Health Statistics [ Producer].
3. North Carolina Department of Public Instruction and the Department of Health and Human Services, Healthy Schools Initiative, Youth Risk Behavior Survey ( YRBS). NC YRBS High School Reports 2003 & 2007: www. nchealthyschools. org/ data/ yrbs.
§ The rate for this race/ ethnicity is better than the white comparison rate, therefore the disparity ratio is not utilized and the grade is reported as an “ A.”
♦ A reliable rate could not be calculated for this indicator due to a small number of events (< 20 cases), therefore no grade is presented. Racial and Ethnic Health Disparities Report Card 2010 — June 2010
Office of Minority Health and Health Disparities and State Center for Health Statistics 13
Child and Adolescent Health ( continued)
Indicators
Baseline Measure
Ratio to Whites
Grade
Updated Measure
Ratio to Whites
Grade
Percent of low income children under age 18 who are obese ( BMI >= 95 percentile) 4 ( Healthy People 2010 Goal= 5.0)
2004
2008
All
17.0
17.5
White
17.3
1.0
17.7
1.0
African American/ Black
15.8
0.9
A §
15.7
0.9
A §
American Indian
17.5
1.0
B
19.0
1.1
C
Asian/ Pacific Islander
19.6
1.1
C
16.1
0.9
A §
Hispanic/ Latino
21.3
1.2
C
22.7
1.3
C
Percent of children under age 18 who have ever been diagnosed with asthma5
2005
2008
All
17.8
14.2
White
16.8
1.0
13.7
1.0
African American/ Black
20.7
1.2
C
18.6
1.4
C
American Indian
♦
♦
♦
♦
♦
♦
Asian/ Pacific Islander
♦
♦
♦
♦
♦
♦
Hispanic/ Latino
15.6
0.9
A §
10.1
0.7
A §
Percent of children under age 18 who do not have a regular dentist5
2005
2008
All
25.5
20.7
White
22.2
1.0
17.4
1.0
African American/ Black
28.0
1.3
C
23.8
1.4
C
American Indian
♦
♦
♦
♦
♦
♦
Asian/ Pacific Islander
♦
♦
♦
♦
♦
♦
Hispanic/ Latino
51.7
2.3
D
29.6
1.7
C
Percent of children under age 18 who did not have health insurance at some point during the past 12 months5
2005
2008
All
11.6
11.3
White
9.6
1.0
8.0
1.0
African American/ Black
12.4
1.3
C
12.3
1.5
C
American Indian
♦
♦
♦
♦
♦
♦
Asian/ Pacific Islander
♦
♦
♦
♦
♦
♦
Hispanic/ Latino
39.0
4.1
F
25.8
3.2
F
4. North Carolina Nutrition and Physical Activity Surveillance System ( NC- NPASS) includes data on children seen in North Carolina public health sponsored WIC and child health clinics and some school based health centers. Percentiles were based on the CDC/ NCHS Year 2000 Body Mass Index ( BMI) Reference. NC NPASS Tables showing Overweight by age, Hispanicity, and gender: 2004 & 2008: www. eatsmartmovemorenc. com/ Data/ ChildAndYouthData. html.
5. North Carolina Division of Public Health, State Center for Health Statistics, North Carolina Child Health Assessment and Monitoring Program ( CHAMP). North Carolina CHAMP data 2005 & 2008 [ Electronic data files]. Raleigh, NC: State Center for Health Statistics [ Producer]. www. schs. state. nc. us/ SCHS/ champ.
§ The rate for this race/ ethnicity is better than the white comparison rate, therefore the disparity ratio is not utilized and the grade is reported as an “ A.”
♦ A reliable rate could not be calculated for this indicator due to a small number of events (< 20 cases), therefore no grade is presented. Racial and Ethnic Health Disparities Report Card 2010 — June 2010
14 Office of Minority Health and Health Disparities and State Center for Health Statistics
Risk Behaviors and Health Promotion
Indicators
Baseline Measure
Ratio to Whites
Grade
Updated Measure
Ratio to Whites
Grade
Percent of adults who do not eat 5 or more fruits and vegetables a day1
2002 & 2003
2005 & 2007
All
76.6
77.9
White
74.5
1.0
76.2
1.0
African American/ Black
81.1
1.1
C
82.2
1.1
C
American Indian
81.4
1.1
C
79.2
1.0
B
Asian/ Pacific Islander
69.7
0.9
A §
75.0
1.0
A §
Hispanic/ Latino
87.8
1.2
C
84.5
1.1
C
Percent of adults who engage in no leisure time physically activity1
( Healthy People 2010 Goal= 20.0%)
2003– 2005
2006– 2008
All
25.3
24.2
White
21.7
1.0
21.3
1.0
African American/ Black
31.5
1.5
C
29.4
1.4
C
American Indian
31.0
1.4
C
35.4
1.7
C
Asian/ Pacific Islander
22.6
1.0
B
20.7
1.0
A §
Hispanic/ Latino
44.3
2.0
D
37.3
1.8
C
Percent of adults 18+ who are overweight or obese ( BMI > 25 kg/ m2) 1
2003– 2005
2006– 2008
All
62.3
64.4
White
59.8
1.0
62.3
1.0
African American/ Black
73.8
1.2
C
74.9
1.2
C
American Indian
69.2
1.2
C
68.6
1.1
C
Asian/ Pacific Islander
33.1
0.6
A §
35.5
0.6
A §
Hispanic/ Latino
62.8
1.1
C
63.5
1.0
B
Percent of adults with high blood pressure1 ( Healthy People 2010 Goal= 16.0%)
2003 & 2004
2005 & 2007
All
29.7
30.4
White
29.6
1.0
29.9
1.0
African American/ Black
38.0
1.3
C
42.4
1.4
C
American Indian
36.3
1.2
C
33.3
1.1
C
Asian/ Pacific Islander
7.6
0.3
A §
15.7
0.5
A §
Hispanic/ Latino
8.8
0.3
A §
13.3
0.4
A §
Percent of adults who smoke1
( Healthy People 2010 Goal= 12.0%)
2003– 2005
2006– 2008
All
23.3
21.9
White
23.8
1.0
22.2
1.0
African American/ Black
23.0
1.0
A §
22.4
1.0
B
American Indian
35.3
1.5
C
36.4
1.6
C
Asian/ Pacific Islander
11.9
0.5
A §
14.6
0.7
A §
Hispanic/ Latino
17.5
0.7
A §
16.3
0.7
A §
1. North Carolina Division of Public Health, State Center for Health Statistics. North Carolina Behavioral Risk Factor Surveillance System Survey Data 2003– 2008. Raleigh, NC: State Center for Health Statistics [ Producer]. www. schs. state. nc. us/ SCHS/ brfss.
* Note: BRFSS is an ongoing, monthly telephone survey, which collects data from randomly selected, non- institutionalized North Carolina adults in households with telephones. The survey collects information on a broad array of health topics including insurance status, access to care,
disability, chronic conditions, and health behaviors.
§ The rate for this race/ ethnicity is better than the white comparison rate, therefore the disparity ratio is not utilized and the grade is reported as an “ A.” Racial and Ethnic Health Disparities Report Card 2010 — June 2010
Office of Minority Health and Health Disparities and State Center for Health Statistics 15
Glossary of Terms Used in this Document
Baseline Measure: A number, rate, or measure to be used as a starting point, a base or foundation.
BRFSS: The Behavioral Risk Factor Surveillance System is an ongoing, monthly telephone survey which collects data from randomly selected North Carolina adults in households with telephones.
Data: Information or numbers collected and used to present facts.
Disparity: Person( s) or group( s) not being equal in age, rank, health, etc.; gaps, unequal, unfair.
Disparity Ratios: A measure or number for a race or ethnic group compared to the measure of another group.
Grades: The use of a “ letter grade” of A, B, C, D or F to show the health status of race or ethnic groups in North Carolina.
Health Disparities: The major differences or inequalities in health that exist between whites and racial/ ethnic minorities.
Healthy People 2010: A federal initiative and report that states the goals and objectives needed to improve the health and quality of life for individuals and communities.
Leading Health Indicators: The major public health concerns in the United States; chosen based on their ability to motivate action.
Mortality Rate: The number of deaths in proportion to a population.
Updated Measure: The latest available number, rate, or measure to be used as a comparison with the Baseline Measure. State of North Carolina  Beverly Eaves Perdue, Governor Department of Health and Human Services  Lanier M. Cansler, Secretary Division of Public Health  Jeffrey P. Engel, State Health Director Office of Minority Health and Health Disparities Barbara Pullen- Smith, Director www. ncminorityhealth. org State Center for Health Statistics Karen L. Knight, Director www. schs. state. nc. us/ SCHS The Department of Health and Human Services does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in employment or the provision of services. 06/ 10 June 2010