Massachusetts Deaths 2006

1
Massachusetts Deaths 2006

• Isabel A. Cáceres, Epidemiologist
• Massachusetts Department of Public Health
• Bureau of Health Information, Statistics,
• Research, and Evaluation
• Division of Research and Epidemiology

April 2008
2
Causes of Death Massachusetts 1842-2006
3
Outline

• Highlights
• Selected Causes of Death
• Cancer
• Heart Disease
• Diabetes
• Injury Poisonings and Falls
• Disparities in Mortality
• Single Mortality Measures
• Summary

4
Highlights

• Trends
• Comparisons with U.S.
• Leading Causes of death

5
On An Average Day, in Massachusetts, in 2006
53,293 Total deaths in 2006
37 Cancer
lt1 HIV/AIDS (15 per month)
1 Infant Death
35 Heart Disease
On an average day 146 deaths
8 Injury
3 Diabetes
8 Stroke
4 Alzheimers
7 CL Respiratory
6
Life Expectancy at BirthMassachusetts vs. U.S.
1900-20061
Massachusetts
United States
1 2006 U.S. data was not available at the time of
this release, 2005 US data used.
7
Overall Mortality Rates Massachusetts and U.S.
1994-20061
? 1.3 APC
United States
Massachusetts
? 1.2 APC
? 2.6 APC
Rates are per 100,000 population. Age-adjusted
to the 2000 US standard population
Statistically significant (plt0.05) APC
Annual Percent Change
Rates are per 100,000 population. Age-adjusted
to the 2000 US standard population.
1 2005 Data. 2006 U.S. Data was not available at
the time of this release
8
Leading Causes of Death Massachusetts 2006
Cancer 25
Other 22.5
Septicemia 1.7
Diabetes 2.1
Nephritis 2.6
Alzheimers 2.9
Heart Disease 24
Pneumonia Influenza 3.3
Chronic Lower Respiratory Disease 4.7

• In 2006
• 13,375 cancer deaths
• 12,891 heart disease deaths

Stroke 5.4
Injury 5.5
9
Ranking of Leading Causes of Death by Race and
EthnicityMassachusetts 2006
White1 Asian1 Black1 Hispanic
Cancer 1 1 1 1
Heart Disease 2 2 2 2
Injuries (all combined) 4 4 3 3
Stroke 3 3 4 4
CLRD2 5 5 7 12
Influenza Pneumonia 6 7 11 11
Alzheimers Disease 7 9 13 14
Diabetes 9 8 5 5
HIV/AIDS 24 26 10 6

Homicide 28 21 7 10
Suicide 15 8 17 16
1 Non-Hispanic, 2 Chronic Lower Respiratory
Disease
Note The lower the number the higher the rank
10
Leading Causes of Death by Age Massachusetts
2006
of Total in Total
Age Leading Cause Age Group
Deaths 1-14 Injuries 33 124 15-24
Injuries 69 471 25-44 Injuries 44
1,953 45-64 Cancer 38
8,660 65-74 Cancer 40
7,572 75-84 Cancer 27 15,333
85 Heart Disease 31 18,811
11
Changes in Mortality RatesMassachusetts 2000
and 2006
CAUSE Rate Rate Change
CAUSE 2000 2006 Change
Cancer 206.1 186.3 ?10
Heart Disease 216.7 168.8 ?22
Injuries 35.9 42.5 ?18
Stroke 50.9 37.4 ?27
Chronic Lower Respiratory Disease 41.8 34.5 ?17
Diabetes 19.6 15.3 ?22
Alzheimers Disease 19.5 19.3 ? 1
Statistically higher than 2000 rate
(plt0.05) Statistically lower than 2000 rate
(plt0.05)
Rates are per 100,000 population. Age-adjusted
to the 2000 US standard population.

12
Selected Causes of Death

• Cancer
• Heart Disease
• Diabetes
• Injury

13
Cancer Mortality Rates Massachusetts and U.S.
1994-20061
? 1.8 APC
Massachusetts
United States
? 1.0 APC
? 1.7 APC
Rates are per 100,000 population. Age-adjusted
to the 2000 US standard population
Statistically significant (plt0.05) APC
Annual Percent Change
1 2005 Data. 2006 U.S. Data was not available at
the time of this release
14
Mortality Rates of Most Common Types of Cancer
Death by Gender Massachusetts 2006

Statistically higher than female rates
(plt0.05)
Rates are per 100,000 population. Age-adjusted
to the 2000 US standard population
15
Heart Disease Mortality Rates Massachusetts and
U.S. 1994-20061
? 2.5 APC
United States
? 4.1 APC
Massachusetts
? 3.7 APC
Rates are per 100,000 population. Age-adjusted
to the 2000 US standard population
Statistically significant (plt0.05) APC
Annual Percent Change
1 2005 Data. 2006 U.S. Data was not available at
the time of this release
16
Number of Heart Disease Deathsby Age and
GenderMassachusetts 2006
17
Diabetes-Related DeathsMassachusetts 1999-2006
? 7.5 APC
Statistically significant (plt0.05) APC
Annual Percent Change
18
Injury Deaths
19
Causes of Injury Deaths Massachusetts 2006
Total Injuries 2,910
Other 18
Firearm 7
Hanging, Suffocation,, or Strangulation
10
Motor Vehicle-related 16
Falls 15
20
Leading Causes of Injury DeathsMassachusetts
2000 and 2006
Rate CAUSE
2000 2006 Change
Poisonings 9.0
14.9 ?66 Motor vehicle-related 7.6
7.1 ?7 Falls
3.2 5.7 ?78
Hanging/Suffocation 4.0 4.2 ?
5 Firearm Deaths 2.7 3.2
?19
Statistically higher than 2000 rate (plt0.05)
Rates are per 100,000 population. Age-adjusted
to the 2000 US standard population.

21
Poisoning Deaths Where Opioids Are
MentionedMassachusetts 2000-2006
Total Poisoning Deaths
? 6.7 APC
Opioid-mentioned Agent
? 7.3 APC
Statistically significant (plt0.05) APC
Annual Percent Change
22
Fall Related Mortality RatesMassachusetts
1999-2006
Statistically higher than 2005 rate (plt0.05)
Rates are per 100,000 population. Age-adjusted
to the 2000 US standard population
23
Fall Related Mortality RatesAges 15-64 and 65
Massachusetts 1994-2006
? 6.3 APC
? 0.7 APC
Statistically significant (plt0.05) APC
Annual Percent Change
Rates are per 100,000 population ages 65 and
15-64 respectively.
24
Suicide and Homicide Rates Massachusetts
1994-2006
? 1.9 APC
? 5.7 APC
? 16.4 APC
Statistically significant (plt0.05) APC
Annual Percent Change
Rates are per 100,000 population. Age-adjusted
to the 2000 US standard population.
25
Disparities in Mortality
26
Diabetes Mortality Rates by Race and
EthnicityMassachusetts 2006



N1,127
N969
N91
N13
N51
Statistically higher than state rate
(plt0.05) Statistically lower than state rate
(plt0.05)
Rates are per 100,000 population. Age-adjusted
to the 2000 US standard population
27
Mortality Rates by Education and Race/Ethnicity,
Adults 25-64 Years1Massachusetts 2006



Statistically higher than those with 13 yrs of
education (plt0..05)
Rates are per 100,000 population. Age-adjusted
to the 2000 US standard population
1Uses 2000 Population Estimates
28
Homicide Rates by Race and Ethnicity
Massachusetts 1994-2006
Rates are per 100,000 population. Age-adjusted
to the 2000 US standard population
29
Single Mortality Measures for Improving Health

• Premature Mortality
• Mortality Amenable to Health Care

30
Premature Mortality Rates by Race and Hispanic
EthnicityMassachusetts 2006


Statistically higher than state rate
(plt0.05) Statistically lower than state rate
(plt0.05)
Rates are per 100,000 population. Age-adjusted
to the 2000 US standard population persons ages
0-74
31
Premature Mortality Rates (PMR) by Community
Health Network Area Massachusetts 2006
32
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
• Potentially useful tool to assess
• Performance of health care systems and
• Track changes over time1
• Originally developed in U.S. in 1970s adopted
  and updated by many researchers especially in
  Europe2

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
33
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

34
Percent Deaths Amenable to Health Care
Massachusetts 2006
All Deaths
Deaths to Persons Ages 0-74
Deaths Amenable to Health Care 28
Deaths Amenable to Health Care 10
35
Mortality Rates for Causes Amenable to Health
Care by GenderMassachusetts 2000 and 2006



Statistically lower than 2000 rate (plt0.05)
Rates are per 100,000 population. Age-adjusted
to the 2000 US standard population persons ages
0-74
36
Mortality Rates for Causes Amenable to Health
Care by Race and EthnicityMassachusetts 2000
and 2006


Statistically lower than 2000 rate (plt0.05)
Rates are per 100,000 population. Age-adjusted
to the 2000 US standard population persons ages
0-74
37
Summary
38
Summary Massachusetts Deaths 2006

• The Massachusetts death rate was the lowest on
  record
• Massachusetts compared favorably to the U.S.
• Life expectancy reached a record high
• Cancer is the leading cause of mortality in MA
• Cancer and heart disease death rates continued to
  decline

39
Summary (continued)

• Increase in poisonings and fall deaths in 2006
• Two out of 3 poisoning deaths are related to
  opioids
• Increasing trend in homicide rates
• Disparities persist by
• gender
• race and ethnicity
• education
• geography

40
How Can You Access This Information?

• Hard Copies [phone]
• TDD/TTY [phone]
• MDPH Website http//www.mass.gov/dph/resep
• MassCHIP Website
  http//masschip.state.ma.us (DPHs
  Internet-based public health information service)