Death Chapter 13: Death

Transcription

1 Death 0-0 Chapter : Death 97

2 0-0 Health of Boston Death The increase in life expectancy over the last century has been remarkable. In the 900s, infant mortality was so high that the average life expectancy was not much more than 0 years (). Today, the life expectancy in the United States is 78.7 years (). This increase is mostly due to improvements in infant survival with important shifts in the leading causes of death from infectious disease to chronic conditions which cause death later in life (). Vaccines against smallpox, polio, and major childhood killers like measles, as well as better living standards, cleaner drinking water, and more nutritious diets have significantly reduced the number of serious infections in the United States (). In earlier time periods, the risk of death from infection was high at every age and only a small proportion of people reached old age. Today, most people live past middle age, and death is highly concentrated among older individuals (). Over the last decade in the United States, increases in life expectancy have varied by race/ethnicity and gender, with the largest increase (6%) among Black males to 7. years. Life expectancy increased % among Black females to 78. years; % among White males to 76.6 years; and % among White females to 8. years. Despite higher percent (or relative) gains in life expectancy among Black males and females, racial inequities in absolute life span persist the Black U.S. population dies.8 years younger, on average, than the White U.S. population. This difference is explained by a higher death rate from heart disease, cancer, homicide, diabetes, and perinatal conditions within the Black U.S. population compared with the White U.S. population (). These differences in mortality rates by racial group underscore the importance of efforts to examine health delivery and public health systems with a health equity focus. Today, all people in older age groups, regardless of race/ethnicity, are living longer. The most recent research shows life expectancy continuing to increase for people over the age of 80 (). These gains in life expectancy for the oldest among us raise questions about how we plan for an aging population as families and as a society (). 98

3 Life Expectancy in Years Death Figure. Life Expectancy by Gender and Race/Ethnicity, Boston Female Male Asian Black Latino White DATA SOURCE: Boston Resident Deaths, Massachusetts Department of Public Health During the period of 008-0, the life expectancy for a Boston resident was 80. years. For females the life expectancy was 8.8 per 00,000; it was 77. for males. For Asian residents the rate was 87., for Black residents it was 77.0, for Latino residents it was 86. and for White residents the rate was 79. per 00,

4 0-0 Health of Boston Figure. All-Cause Mortality by Gender and Race/Ethnicity*, 0 Boston Female The age-adjusted all-cause mortality rate for Boston residents in 0 was 686. deaths per 00,000. Females had a lower mortality rate than males with 8.7 deaths per 00,000 versus 87. for males. The mortality rate for Asian residents (80.) and Latino residents (96.) was lower than that of White residents (79.). There was no statistical difference in the all-cause mortality rate between Black and White residents. Male 87. Asian 80. Black 77.8 Latino 96. White 79. *Age-adjusted rates ,000 Deaths per 00,000 Residents DATA SOURCE: Boston Resident Deaths, Massachusetts Department of Public Health 00

5 Deaths per 00,000 Residents Death 0-0 In 0, Boston residents ages 6 years and over had,00 Figure. All-Cause Mortality by Age, 0,. an all-cause mortality rate of. per,000 00,000. The rate for residents under year of age was. per 00,000., < yr -9 yrs 0-7 yrs 8- yrs - yrs yrs 6+ yrs DATA SOURCE: Boston Resident Deaths, Massachusetts Department of Public Health Figure. Top Five Leading Causes of Death by Year* (80.) s of the 80 (.0) 7 (.) 7 (0.7) (0.) 9 (78.0) s of the 797 (.0) 9 (.) 6 (0.6) 8 (.6) 9 (8.6) s of the 78 (9.0) 8 (.6) 6 (7.9) 8 (8.7) 90 (7.) s of the 69 (8.6) 8 (.) 7 (8.7) 9 (6.0) 996 (86.) s of the 709 (.) 89 (.) 8 (.0) (.) *Age-adjusted rates per 00,000 deaths DATA SOURCE: Boston Resident Deaths, Massachusetts Department of Public Health was the leading cause of death for Boston residents from 008 to 0. s of the heart was the second leading cause of death during these years. 0

6 0-0 Health of Boston Figure. Top Five Leading Causes of Death by Gender and Year* Females (.7) s of the 0 (6.6) 0 (0.) 8 (6.6) 8 (.) 8 (.9) s of the 9 (7.6) 9 (7.6) 8 (.6) 78 (.0) 6 (0.) s of the 7 (09.9) 07 (.) 8 (6.6) 8 (.) 8 (8.) s of the 8 (9.8) 88 (8.) 79 (.0) 7 (0.) 9 (9.0) s of the 8 (0.) (.9) 8 (.0) 7 (.) Males (.0) s of the 8 (8.8) 09 (.) 70 (6.) 70 (6.) 87 (9.8) s of the 0 (98.) (.) 68 (6.0) Nephritis/ Nephrosis 9 (0.6) 86 (6.) s of the 7 (78.6) 97 (8.0) 7 (8.0) 6 (7.) 77 (.6) s of the 7 (78.) 7 (.9) 60 (9.0) 9 (0.) 0 (6.) s of the 6 (66.) (7.9) 70 (.) Diabetes 7 (.9) *Age-adjusted rates per 00,000 deaths DATA SOURCE: Boston Resident Deaths, Massachusetts Department of Public Health and heart disease remained the top two leading causes of death for both males and females from 008 to 0. For males, in 0, the top five leading causes of death in order were: cancer, diseases of the heart, other injuries, cerebrovascular and diabetes. For females, in 0, the top five leading causes of death in order were: cancer, diseases of the heart, cerebrovascular, Alzheimer's and. 0

7 Death 0-0 Figure.6 Top Five Leading Causes of Death by Race/Ethnicity and Year* Asian Residents (.8) 8 (07.8) 6 (6.7) (8.7) 66 (.9) s of the s of the s of the s of the s of the (.) (76.8) (.) (.) (.6) (9.) 8 (.0) Pneumonia/ Influenza 7 (6.9) (9.) Pneumonia/ Influenza 9 (.9) Diabetes 6 (.8) (.7) 7 (6.) Essential Hypertension and Hypertensive Renal 6 (.0) (7.0) (6.7) Nephritis/ Nephrosis 9 (0.) (.) 0 (.) 0 (0.) Black Residents (09.6) s of the 09 (8.) 8 (.6) 8 (.0) (.) 9 (86.6) s of the 96 (7.) 9 (7.) 6 (0.) Nephritis/ Nephrosis (7.) 70 (0.8) s of the 8 (6.7) (.9) 9 (.9) 8 (9.0) 9 (08.9) s of the 69 (0.6) Diabetes 9 (.) 8 (.) 7 (7.0) 69 (09.) s of the 9 (.9) (.7) Diabetes (9.) 0 (9.6) *Age-adjusted rates per 00,000 deaths Continued on next page. 0

8 0-0 Health of Boston Latino Residents (88.6) 6 (.) 60 (.) 68 (7.) 8 (.6) s of the s of the s of the s of the s of the 6 (8.) (6.) 8 (76.9) (97.) (80.) 6 (.) (9.) Nephritis/ Nephrosis (7.) 9 (.0) (0.6) Perinatal 8 (6.0) 7 (0.0) (.) (.) 0 (.9) (8.9) 9 (6.9) (.7) (7.9) Diabetes (.9) White Residents (9.) s of the (6.8) 6 (0.6) 07 (.8) 0 (0.9) 8 (97.) s of the (68.7) (7.9) 97 (.0) 97 (8.8) 7 (88.6) s of the 99 (.7) 8 (9.) 0 (.) 99 (.) 7 (80.) s of the (.) 7 (0.8) 0 (7.) 8 (6.) 68 (00.0) s of the (.9) 8 (0.8) 0 (.6) 9 (.9) *Age-adjusted rates per 00,000 deaths NOTES: Rates based on counts <0 should be interpreted with caution. DATA SOURCE: Boston Resident Deaths, Massachusetts Department of Public Health In Boston, cancer and diseases of the heart remained the top two leading causes of death for all racial/ethnic groups presented from 008 to 0. For Asian residents, in 0, the top five leading causes of death in order were: cancer, diseases of the heart, cerebrovascular,, and other injuries. For Black residents, in 0, the top five leading causes of death in order were: cancer, diseases of the heart, cerebrovascular disease, diabetes, and other injuries. For Latino residents, in 0, the top five leading causes of death in order were: cancer, diseases of the heart, cerebrovascular, other injuries, and diabetes. For White residents, in 0, the top five leading causes of death in order were: cancer diseases of the heart, other injuries, cerebrovascular disease, and. 0

9 Death 0-0 Figure.7 Top Five Leading Causes of Death by Age < yr -9 yrs 0-7 yrs Perinatal (,8.) 7 (.) 6 (8.) Congenital Anomalies Congenital Anomalies 6 (67.0) 6 (.) (.) * (9.6) * * * * * * * 0 8- yrs - yrs -6 yrs 6+ yrs (7.6) 7 (.6) Suicide 6 (.8) * (.) 0 (9.6) s of the 8 (.7) (0.) 7 (08.8) s of the (09.) 7 (.6) Chronic Liver 8 (9.) 678 (,079.9) s of the 7 (8.) 6 (6.) (80.0) * Suicide (6.8) Diabetes (9.) 07 (70.) *Not calculated, n< NOTE: Rates based on counts <0 should be interpreted with caution. DATA SOURCE: Boston Resident Deaths, Massachusetts Department of Public Health In Boston from 008-0, the leading cause of death for those under year of age was due to conditions originating in the perinatal period, with a rate of,8. per 00,000 residents under year of age. For those -9 years of age, the top cause of death was cancer, with a rate of.. For residents between the ages of 0-7 the leading cause of death was homicide (8.) in this same period. In 0, the leading cause of death for residents 8- years of age was homicide (7.6). For those - years of age, the leading cause of death was other injuries (.). The leading cause of death for residents ages -6 and 6 years and over was cancer, with a rate of 08.8 and,079.9 respectively. 0

10 Years of Potential Life Lost per 00,000 residents 0-0 Health of Boston Figure.8 Years of Potential Life Lost by Gender and Race/Ethnicity*, ,000 9,0 7,00,000,00,78,07 7,6,86,,6 0 Boston Female Male Asian Black Latino White *Age-adjusted rates DATA SOURCE: Boston Resident Deaths, Massachusetts Department of Public Health For 008-0, there were,78 years of potential life lost on average annually per 00,000 Boston residents. There were,07 years of potential life lost on average annually per 00,000 female residents and 7,6 years of potential life lost on average annually per 00,000 male residents. There were,86 years of potential life lost on average annually per 00,000 Asian residents, 9,0 years of potential life lost on average annually per 00,000 Black residents,,6 years of potential life lost on average annually per 00,000 Latino residents, and, years of potential life lost on average annually per 00,000 White residents. 06

11 Death 0-0 References. Bell, F. C. and Miller, M. L. Life Tables for the United States Social Security Area s.l. : Social Security Administration, Deaths: Final Data for 00. Murphy, S. L., Xu, J. and Kochanek, K. D., Hyattsville : National Center for Health Statistics, 0, Vol. 6.. National Institute on Aging. Living Longer. Global Health and Aging. [Online] October 0. [Cited: February 7, 0.] Kochanek, K. D., Arias, E. and Anderson, R. N. How Did Cause of Death Contribute to Racial Differences in Life Expectancy in the United States in 00? NCHS Data Brief. [Online] July 0. [Cited: February 7, 0.] 07