Wide gaps in mortality risk: comparisons among race - sex groups across time and space dimensions

n. a Doc. 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 0 August 1980 o'-"4 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, our special-study monograph series has a new name — SCHS 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; nephritis/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 1 973 — 77 allow for trending over time (final 1978 U.S. data are not available). In addition, rates for the period 197A-78 are computed for race-sex groups at the county, HSA 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.