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Substate Regional Life Expectancy for Local Health Assessment in Illinois

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Regional Life Tables: The Illinois Experience. Population requirements (county level) ... Regional Life Tables: The Illinois Experience ... – PowerPoint PPT presentation

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Title: Substate Regional Life Expectancy for Local Health Assessment in Illinois


1
Sub-state Regional Life Expectancy for Local
Health Assessment in Illinois
  • 29 September, 2004
  • AI Conference Atlanta, GA
  • Mark Flotow
  • Illinois Center for Health Statistics, IDPH

2
Life Expectancy for Local Health Assessment
What this presentation will cover - life
expectancy as part of local health assessment -
how life expectancy is derived (inputs, outputs,
etc.) - considerations of how life expectancy
can be derived for meaningful sub-state
areas Two parts to this presentation I. Life
expectancy as a health measure II. Application
in Illinois
3
Life Expectancy as a Health Measure
Serves as a summary measure of the impact of
mortality - standardized - comparisons easily
understood (even if hypothetical) - covers all
age groups - used as basis for decision making
assessments, grants, etc. Characteristics -
based on life table calculations - hypothetical
the if factor
4
Life Expectancy as a Health Measure
Application and use - for large geographies,
like nation and state - can be by sex/race
category/ethnicity - often coincides with
decennial censuses, especially as demographic
detail increases - life expectancy at birth is
the most widely-cited value, but
life expectancy at other ages also part of the
life table output
5
Life Tables What You Need To Know
Key terms and definitions - abridged versus
complete life table - period versus cohort life
table - most common type is abridged period life
table - life expectancy lifetime remaining at
the beginning of the age interval Inputs -
deaths by age group - population by the same age
groups
6
Life Tables What You Need To Know
Outputs and Results - age-specific death
rates - converts the mortality experiences into
hypothetical person- years lived that in turn
are calculated as life expectancy for each age
group - life expectancy often expressed to the
nearest tenth of a year Shortcomings - accuracy
of inputs detailed population and death data -
death and population characteristics must match
this especially can be problematic for race and
ethnicity categories
7
Life Tables What You Need To Know
Shortcomings (more) - deaths need to be
representative of the period and the population
to avoid skewed results - representative-ness
data smoothing - small numbers issues gt
chance fluctuation effects on results gt with
young age groups (sometimes) gt with small
geographies (almost always)
8
Small Population/Geography Considerations
Aggregation (to address small numbers issues) -
time years of deaths - geography demographic
basis - geography outcome basis - geography
regional basis - demographic characteristics
(combine sexes, race categories) Smoothing of
mortality data Minimum numbers of
deaths Interpretation
9
Regional Life Tables The Illinois Experience
Population requirements (county level) -
decennial census data by age - no other
demographic characteristics Mortality
requirements - three-year aggregation of deaths
surrounding the census year - a minimum
three-year total of 1,000 deaths
10
Regional Life Tables The Illinois Experience
Aggregating counties to meet mortality
requirements - stand-alone counties (the ideal)
39 (out of 102) - remaining 63 counties
combined into 20 regions Basis for the 20
regions - median household income (2000 census
data) - infant mortality rate (1994-2002
average) - age structure (lt25 years, 25-44,
45-64, 65 2000 census) - age-adjusted death
rates all causes, diseases of heart
and malignant neoplasms - migration (MSA
considerations) - local health department
boundaries
11
Median Household Income by County, 1999
Median household income (in dollars)
46,000 68,000
40,000 46,000
36,000 40,000
32,000 36,000
24,000 32,000
12
Nine-Year Average Infant Mortality Rate, 1994-2002
Infant Mortality Rate (per 1,000 births)
8.4 12.2
7.0 8.2
6.0 6.9
3.8 5.9
No rate less than 10 deaths
13
County Population Age 65 Years or Older, 2000
Percentage age 65 years
17.8 - 21.0
16.6 - 17.7
15.4 - 16.5
13.4 - 15.3
8.0 - 13.3
14
Age-adjusted Death Rates for All Causes 1999-2001
Rates per 100,000 population
940 - 1,067
890 - 939
860 - 889
825 - 859
714 - 824
15
Regional Life Tables The Illinois Experience
Life table construction - abridged age 0, 1-4,
5-9, 10-14, . . . 75-79, 80-84, 85 - both
sexes, all race categories combined i.e., total
population - unsmoothed mortality data gt
looked for irregularities among the age
groups gt previously, smoothing had up to a .03
year difference in life expectancy at birth
for regional life tables (1989-1991) - 2000
census data (MARS data for 1990) - same life
table method for calculation of abridged life
tables as used at the state level
16
Life Expectancy at Birth 1979-1981
Life expectancy in years
75.7 76.5
75.0 75.5
74.6 74.9
73.9 74.5
71.5 73.8
17
Life Expectancy at Birth 1989-1991
Life expectancy in years
77.2 77.9
76.5 77.1
76.2 76.3
75.5 76.1
73.0 75.4
18
Life Expectancy at Birth 1999-2001
Life expectancy in years
78.3 79.7
77.6 78.2
77.1 77.5
76.2 76.9
73.9 76.1
19
Life Expectancy at Birth
1979-1981
1989-1991
20
Implications for Assessment
Availability of information - Illinois Project
for the Local Assessment of Needs (IPLAN) -
state health department Web site - Illinois
Vital Statistics Basic Research Series
publication Interpretation and comparison -
with other time periods - with other
geographies Use with other health indicators -
mortality rates, average age at death, YPLL,
morbidity data, etc.
21
Future Directions
Sub-populations - by sex or race categories -
for (large) cities Non-decennial census years -
for larger areas or groups of counties Decrement
life tables - to examine the effects of specific
causes or means of death Data distribution -
correlated data with the distribution of life
expectancy
22
Summary
  • Life expectancy at birth, from life tables, is a
    much-in-demand general
  • summary of health
  • With certain standards and guidelines, such
    measures can be
  • constructed for sub-state areas
  • In Illinois, larger individual counties and the
    additional 20 aggregated
  • county regions held up well over time as stable,
    meaningful
  • analytical units
  • Life expectancy at birth can be a useful
    starting point for local
  • assessment of health needs

23
Contact information Mark Flotow Illinois
Center for Health Statistics Illinois Department
of Public Health 525 West Jefferson
Street Springfield, IL 62761 Telephone (217)
785-1064 Fax (217) 785-4308 E-mail
mflotow_at_idph.state.il.us
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