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Health Disparities in MA Council for the Elimination of Racial and Ethnic Disparities

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Nonfatal Gunshot Injuries by Race/Ethnicity. Boston, 2003-2005 Combined ... and 74% of victims of gunshots. Disparities Are Seen Across the Commonwealth. 31 ... – PowerPoint PPT presentation

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Title: Health Disparities in MA Council for the Elimination of Racial and Ethnic Disparities


1
Health Disparities in MACouncil for the
Elimination of Racial and Ethnic Disparities

2
Racial and Ethnic Disparities in Health Outcomes
Are Seen Consistently in Massachusetts
  • Such disparities are particularly apparent in
    premature or excessive death rates for cancer,
    HIV, diabetes and asthma and in higher
    hospitalizations rates for many diseases and
    conditions
  • Disparities are seen across the Commonwealth in
    all corners of the State
  • The causes of these disparities are multiple,
    including poverty, lack of acess to care and
    racism, discrimination and the legacy of slavery

3
Race and Ethnic Breakdown of PopulationCentral
Region and Massachusetts 2005
Central Region
Massachusetts
Non-Hispanics
American Indian
0.3
American Indian
0.2
Asian 3.3
Asian 4.9
Hispanic 7.3
Hispanic 7.9
Black 3.2
Black 6.0
White 86.0
White 81.0
Population Total 806,015
Population Total 6,349,097
Source MDPH, Health Information, Statistics,
Research and Evaluation Bureau, Research
Epidemiology Program
4
Race and Ethnic Breakdown of PopulationWorcester
and Massachusetts 2005
Non-Hispanics
Worcester
Massachusetts
Population Total 6,349,097
Population Total 172,648
Source MDPH, Health Information, Statistics,
Research and Evaluation Bureau, Research
Epidemiology Program
5
Spanish Spoken at Home Central Region 2000
Source MDPH, Health Information, Statistics,
Research and Evaluation Bureau, Research
Epidemiology Program
6
  • Examples of Racial and Ethnic Disparities

7
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8
  • Diabetes

9
Prevalence of Diabetes in Massachusetts Varies
Significantly by Race/Ethnicity


10
Diabetes Hospital Discharges, 2003-2005
Source Division of Health Care Finance and
Policy, Inpatient Hospital Discharge Database
11
Mortality Rates are Much Higher for Blacks and
Hispanics
Source MDPH, Bureau of Health Information,
Statistics, Research and Evaluation, Health
Survey Program
12
Diabetes Mortality Rates, 2003-2005
Source MDPH, Health Information, Statistics,
Research and Evaluation Bureau, Research
Epidemiology Program
13
GDM by Race and Hispanic EthnicityMassachusetts
2000 vs. 2006


Statistically higher than 2000 rate (plt0.05)
14
  • Asthma

15
Age-Adjusted Asthma ED Visits and
Hospitalizations by Race/Ethnicity 2003-2005
Source MDPH, Bureau of Health Information,
Statistics, Research and Evaluation, Health
Survey Program
16
Age-Adjusted Asthma Mortality, 2003-2005
Source MDPH, Bureau of Health Information,
Statistics, Research and Evaluation, Health
Survey Program
17
  • Cancer

18
Age-Adjusted Cancer Incidence, MA Males,
2000-2004
Source MDPH, MA Cancer Registry
19
Age-Adjusted Cancer Incidence, MA Females,
2000-2004
Source MDPH, MA Cancer Registry
20
  • Birth outcomes

21
IMR by Race Hispanic Ethnicity Massachusetts
1990-2006
Black Non-Hispanic
Hispanic
White Non-Hispanic
Source MDPH, Bureau of Health Information,
Statistics, Research and Evaluation, Health
Survey Program
22
  • HIV

23
People Diagnosed with HIV Infection by Gender and
Race/Ethnicity Massachusetts, 2004-2006
Data Source MDPH HIV/AIDS Surveillance Program,
Data as of 11/1/07
24
Females Diagnosed with HIV Infection by
Race/Ethnicity and Place of Birth
Massachusetts,2004-2006
1
1 97 of people diagnosed with HIV infection
from 2004-2006 that were born in a US Dependency
were born in Puerto Rico NHNon-Hispanic Data
Source MDPH HIV/AIDS Surveillance Program, Data
as of 11/1/07
25
Percentage of HIV Cases Among 13-24 Year Olds, by
Race/Ethnicity 199920061
Black NH
Hispanic
White NH
Other
1
2006 Data are preliminary Data Source MDPH
HIV/AIDS Surveillance Program Data as of 11/1/07
26
People Diagnosed with HIV Infection by Age at
Diagnosis Race/Ethnicity Massachusetts,
2003-2005
Data Source MDPH HIV/AIDS Surveillance Program,
Data as of 7/06
27
Violence in Massachusetts
28
Gun Violence in Boston Homicides Non-Fatal
Shootings(1990 - PRESENT)
of Shootings
Year
DATA SOURCE Councilor Ross (5.06 Presentation)
29
Nonfatal Gunshot Injuries by Race/Ethnicity
Boston, 2003-2005 Combined
Black Bostonians are 24 of total population and
74 of victims of gunshots
DATA SOURCE Weapon-related injuries,
Massachusetts Department of Public Health,
Weapon-Related Injury Surveillance System DATA
ANALYSIS Boston Public Health Commission
Research Office
30
  • Disparities Are Seen Across the Commonwealth

31
Diabetes Hospital Discharge Rate by
Race/EthnicityWestern Region and Massachusetts
2003-2005


Statistically different from State (p .05) Red
() Statistically worse Green ()
Statistically better than state
Age-adjusted to the 2000 US standard population.

Source Division of
Health Care Finance and Policy. Calendar Year
2003-2005. Inpatient Hospital Discharge Database
32
Diabetes Death Rate by Race/EthnicityCentral
Region and Massachusetts 2003-2005

Statistically different from state (p .05) Red
() Statistically worse than state- Green ()
statistically better than state
Age-adjusted to the 2000 US standard population.


Source Preliminary 2005 MA
Death file, Registry of Vital Records MDPH,
Health Information, Statistics, Research and
Evaluation Bureau, Research Epidemiology
Program
33
Diabetes Hospital Discharge Rate by
Race/EthnicityBerkshires, Pittsfield
Massachusetts 2003-2005



Statistically different from State (p .05) Red
() Statistically worse Green ()
Statistically better than state
Age-adjusted to the 2000 US standard population.

Source Division of
Health Care Finance and Policy. Calendar Year
2003-2005. Inpatient Hospital Discharge Database
34
Infant Mortality Rates by Race/Ethnicity
Western Region and Massachusetts 2002-2005
State Overall 4.9
NA
NA Calculations based on less than 5 events are
excluded
Non-Hispanic
() Statistically different from State (p .05)
Source MDPH, Bureau of Health Information,
Statistics, Research, Evaluation Bureau,
Division of Research Epidemiology
35
HIV/AIDS Death Rate by Race/EthnicityWestern
Region and Massachusetts 2003-2005

NA
Statistically different from State (p .05) Red
() Statistically worse Green ()
Statistically better than state
Age-adjusted to the 2000 US standard population.


Source MDPH, Health
Information, Statistics, Research Evaluation
Bureau, Research Epidemiology Program
36
Asthma Emergency Department Visit Rates Children
Ages 0-14 Western Region and Massachusetts 2005


Statistically different from State (p .05) Red
() Statistically higher Green ()
Statistically lower
Age-adjusted to the 2000 US standard
population. Source Division of Health Care
Finance and Policy. Calendar Year 2005. Emergency
Department Visits
37
  • The Health Profiles of Each Racial and Ethnic
    Group and Sub-group are Different

38
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39
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40
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41
Cesarean Rate by Maternal Ethnicity1,Massachusetts
2006
















Statistically higher than state rate (p
.05) Statistically lower than state rate
(plt.05)
1 Only ethnic groups statistically different from
the state rate are included
42
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43
  • What are the contributing factors?
  • Social and economic determinants of health matter

44
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45
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46
Substantial Variation in Diabetes Rates by
Household Income
lt25,000
3 fold variation
75,000
Source NEHI/Boston Foundation Boston Paradox
47
Diabetes by Education, 2006
Statistically different from state (p .05) Red
() Statistically worse than state- Green ()
statistically better than state
Source MDPH, Bureau of Health Information,
Statistics, Research and Evaluation, Health
Survey Program
48
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49
The Experience of Racism and Discrimination
Boston Adults Who Report Having Been Treated
Worse Than People of Other Races At Work During
the Previous Year, By Race/Ethnicity
Boston Adults Who Report Having Been Treated
Worse Than People of Other Races When Seeking
Health Care During the Previous Year, By
Race/Ethnicity
Note Data about Asian residents not shown due to
inadequate sample size SOURCE Behavioral Risk
Factor Surveillance System, Massachusetts
Department of Public Health and Boston Public
Health Commission
50
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51
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