Allegheny County Mortality Report

Transcription

1 2012 Allegheny County Mortality Report Bureau of Assessment, Statistics & Epidemiology Allegheny County Health Department 542 4th Ave., Pittsburgh, PA 15219

2 2012 Allegheny County Mortality Report A publication of the ALLEGHENY COUNTY HEALTH DEPARTMENT Karen Hacker, MD, MPH, Director Report prepared July 2015 by Bureau of Assessment, Statistics, & Epidemiology Maya Reed McDaniel, Intern University of Pittsburgh John M. Kokenda, Statistical Analyst Michelle Kurta, Epidemiology Research Associate Allegheny County Health Department Page ii

3 PREFACE The 2012 Allegheny County Mortality Report presents final mortality data for 2012 on cause of death, death rates, infant mortality, infant mortality rates, and premature mortality. Included for comparison are selected mortality statistics for the United States, Pennsylvania and each of the 130 municipalities that comprise Allegheny County. All mortality data seen in this report are compiled directly from death certificates through a cooperative agreement with the Pennsylvania Department of Health. This cooperative agreement requires the following disclaimer: These data were supplied by the State Health Data Center, Pennsylvania Department of Health, Harrisburg, Pennsylvania. The Pennsylvania Department of Health specifically disclaims responsibility for any analyses, interpretations or conclusions. The International Classification of Disease, Tenth Revisions (ICD-10) classifies each death into specific causes. Select causes of death have been included in this report, statistical data for smaller geographical areas or other causes of death are available upon request. Data compiled in this report are based on 100-percent of known death certificates filed for Allegheny County residents, regardless of where the death occurred. Where measures are comparable, Allegheny County rates are compared to Healthy People 2020 goals set forth by the U.S. Department of Health and Human Services for certain public health improvements. To help attain these goals, the Allegheny County Health Department s Plan for a Healthier Allegheny (PHA is a guide for health improvement for the next 3 to5 years. The five priority areas identified for the PHA are: Access, Chronic Disease Health Risk Behaviors, Environment, Maternal and Child Health, Mental Health and Substance Use Disorders. Health equity, which encompasses the social determinants of health and special populations, is an important cross-cutting theme that is being addressed across all five priority areas. With regard to health equity, data suggest that Allegheny County has both geographic and racial health disparities. These are apparent in this report. As seen in Table 25, there were 2,650 years of potential life lost due to homicides among black males within the county. By comparison, there were 355 years lost among white males. Geographic differences can be found in Table 55, which compares the ageadjusted death rates for many causes of death across all 130 of Allegheny County s municipalities. Some of the highest total death rates are found in the Mon Valley, including Homestead, McKeesport, Millvale, Duquesne, and Clairton, with adjusted death rates over 1,000/100,000, compared to a U.S. rate of 810 and an overall county rate of 764. Please address all questions, comments, or suggestions to: Bureau of Assessment, Statistics & Epidemiology Allegheny County Health Department 542 4th Avenue Pittsburgh, Pennsylvania (412) Allegheny County Health Department Page iii

4 TABLE OF CONTENTS Section Page Report Highlights and Illustrations 1-17 Total Deaths 1 Deaths by Race 2 Deaths by Sex 4 Infant Mortality 6 Neonatal Mortality 7 Post-neonatal Mortality 7 Leading Causes of Death and Select Discussions 9 Diseases of the Heart 11 Malignant Neoplasms 12 Accidents 13 Accidental Poisoning and Exposure to Noxious Substances 14 Diabetes Mellitus 15 Assault (homicide) Mortality Report Tables Technical Notes Allegheny County Health Department iv

5 Figure Guide Page Figure 1: Age-adjusted Death Rates: Allegheny County, PA Figure 2: Median Age of Death 1 Allegheny County, Pa: 2012 Figure 3: Leading Causes of Death, Numbers: Allegheny County, PA Figure 4: Age-adjusted Death Rates by Race: Allegheny County, PA Figure 5: Leading Causes of Mortality : Whites 3 Allegheny County, Pa Figure 6: Leading Causes of Mortality : Blacks 3 Allegheny County, Pa Figure 7: Age-adjusted Death Rates by Sex: Allegheny County, PA Figure 8: Leading Causes of Mortality : Males 5 Allegheny County, Pa Figure 9: Leading Causes of Mortality : Females 5 Allegheny County, Pa Figure 10: Median Age at Death: Allegheny County, PA Figure 11: Infant Mortality Rate: Race 6 Allegheny County, Pa: Figure 12: Neonatal Mortality Rate: Race 7 Allegheny County, Pa: Figure 13: Post- Neonatal Mortality Rate: Race 7 Allegheny County, Pa: Figure 14: Leading Causes of Mortality 9 Allegheny County, Pa: 2012 Figure 15: Leading causes of mortality ranked by number of deaths 10 Figure 16: Age-Adjusted Death Rates - Diseases of the Heart 11 Allegheny County, Pa: Figure 17: Age-Adjusted Death Rates - Diseases of Heart 11 Allegheny County, Pa 2012 Figure 18: Age-Adjusted Death Rates - Malignant Neoplasms 12 Allegheny County, Pa: Figure 19: Malignant Neoplasm Deaths by Site 12 Allegheny County, Pa 2012 Figure 20: Age-Adjusted Death Rates - Accidents 13 Allegheny County, Pa: Figure 21: Accidental Deaths by Type 14 Allegheny County, Pa 2012 Figure 22: 2012 Accidental Poisoning & Exposure to Noxious Substances By Specific Category 14 Figure 23: Age- Adjusted Death Rates - Accidental Poisoning & Exposure to Noxious Substances 15 Allegheny County, Pa: Figure 24: Age-Adjusted Death Rates - Diabetes Mellitus 16 Allegheny County, Pa: Figure 25: Age-Adjusted Death Rates - Homicide 16 Allegheny County, Pa: Figure 26: Homicide Deaths by Race and Sex 17 Allegheny County, Pa 2012 Allegheny County Health Department v

6 Table Guide Page Table 1. TOTAL DEATHS, INFANT DEATHS and DEATH RATES 19 Table 2. INFANT MORTALITY Numbers and Rate by Race 20 Table 3. NEONTAL INFANT MORTALITY Numbers and Rates by Race 21 Table 4. POST-NEONATAL INFANT MORTALITY Number and Rates by Race 22 Table 5. Leading Causes of Death, Numbers: ALL GROUPS 23 Table 6. Leading Causes of Death, Numbers: WHITES 24 Table 7. Leading Causes of Death, Numbers: BLACKS 25 Table 8. Leading Causes of Death, Numbers: MALES 26 Table 9. Leading Causes of Death, Numbers: FEMALES 27 Table 10. Leading Causes of Death, Numbers: WHITE MALES 28 Table 11. Leading Causes of Death, Numbers: WHITE FEMALES 29 Table 12. Leading Causes of Death, Numbers: BLACK MALES 30 Table 13. Leading Causes of Death, Numbers: BLACK FEMALES 31 Table 14. Leading Causes of Death, Age Adjusted Rates: ALL GROUPS 32 Table 15. Leading Causes of Death, Age Adjusted Rates: WHITE 33 Table 16. Leading Causes of Death, Age Adjusted Rates: BLACK 34 Table 17. Leading Causes of Death, Age Adjusted Rates: MALES 35 Table 18. Leading Causes of Death, Age Adjusted Rates: FEMALE 36 Table 19. Leading Causes of Death, Age Adjusted Rates: WHITE MALES 37 Table 20. Leading Causes of Death, Age Adjusted Rates: WHITE FEMALES 38 Table 21. Leading Causes of Death, Age Adjusted Rates: BLACK MALES 39 Table 22. Leading Causes of Death, Age Adjusted Rates: BLACK FEMALES 40 Table 23. Leading Causes of Death, NUMBERS: RACE and SEX 41 Table 24. Leading Causes of Death (Ranked by Numbers): RACE and SEX 42 Table 25. Leading Causes of Death: Years of Potential Life Lost: RACE and SEX 43 Table 26. Leading Causes of Death (Ranked by Years of Potential Life Lost): RACE and SEX 44 Table 27. Leading Causes of Death, Years of Potential Life Lost Ratios 45 Table 28. Leading Causes, Median Age At Death: Race and Sex 46 Table 29. Leading Causes, Oldest Median Age At Death Rank: Race and Sex 47 Table 30. Leading Causes of Death, Numbers: AGE GROUP <15 48 Table 31. Leading Causes of Death, Numbers: AGE GROUP Table 32. Leading Causes of Death, Numbers: AGE GROUP Table 33. Leading Causes of Death, Numbers: AGE GROUP Table 34. Leading Causes of Death, Numbers: AGE GROUP Table 35. Leading Causes of Death, Numbers: AGE GROUP Table 36. Leading Causes of Death, Numbers: AGE GROUP Table 37. Leading Causes of Death, Numbers: AGE GROUP Table 38. Leading Causes of Death, Age Specific Rates: AGE GROUP <1 56 Table 39. Leading Causes of Death, Age Specific Rates: AGE GROUP Allegheny County Health Department vi

7 Table Guide (continued) Page Table 40. Leading Causes of Death, Age Specific Rates: AGE GROUP Table 42. Leading Causes of Death, Age Specific Rates: AGE GROUP Table 43. Leading Causes of Death, Age Specific Rates: AGE GROUP Table 44. Leading Causes of Death, Age Specific Rates: AGE GROUP Table 45. Leading Causes of Death, Age Specific Rates: AGE GROUP Table 46. Leading Causes of Death, Age Specific Rates: AGE GROUP Table 47. Leading Causes of Death, Age Specific Rates: AGE GROUP Table 48. Leading Cause of Death, Ratio of Age-Adjusted Rates: BLACK v. WHITE Ratios 65 Table 49. Leading Cause of Death, Ratio of Age - Adjusted Rates: Male v. Female Ratios 66 Table 50. All Causes of Death, Numbers: AGE, RACE, and SEX 67 Table 51. Selected Causes of Death, Numbers: Race and Sex Allegheny County, PA Table 52. Selected Causes of Death, Age-adjusted Rates: Race and Sex Allegheny County, PA Table 53. Selected Causes of Death, Numbers: Race and Sex Allegheny County, PA Table 54. Selected Causes of Death, Age-adjusted Rates: Race and Sex Allegheny County, PA Table 55. Selected Death Statistics for the United States, Pennsylvania, Allegheny County and it's Municipalities, 2012 Allegheny County Health Department vii

8 2012 Allegheny County Mortality Report REPORT HIGHLIGHTS & ILLUSTRATIONS

9 Total Deaths There were 13,318 total deaths in Allegheny County during 2012, a small decrease from the 13,690 total deaths in The crude death rate decreased slightly from 11.2 per 1,000 population in 2011 to 10.9 in The ageadjusted rate also decreased slightly from per 100,000 U.S Standard Million Population (this standard is to be assumed for ageadjusted rates out of Rate per 100,000 U. S.2000 Standard Million population 1, , ,000.0 Figure 1: Age-adjusted Death Rates: Allegheny County, PA ,000 throughout the report- see Technical Note) in 2011 to in This rate was higher than that of the state of Pennsylvania (749.4) but lower than the national rate (810.2).The median age of death in Allegheny County for 2012 was 80.3 years, a slight decrease from 2011 (80.4 years) Figure 2: Median Age of Death Allegheny County, Pa: 2012 Allegheny County Health Department Page 1

10 Figure 3: Leading Causes of Death, Numbers: Allegheny County, PA ,500 3,000 2,500 2,000 1,500 1, Deaths by Race Due to the demographics of Allegheny County, race is restricted to individuals identified as white or black and the sexes male and female (see Technical Notes). In 2012, there were 11,569 deaths among the white population of Allegheny County for an age-adjusted rate of per 100,000, a decrease from 2011 (757.7). The median age of death for the Rate per 100,000 U. S.2000 Standard Million Population Figure 4: Age-adjusted Death Rates by Race: Allegheny County, PA , , , , , white population also increased slightly from 2011 (81.3) to 2012 (81.4). In 2012 there were 1,573 deaths among the black population, a small increase from 2011 (1,529). The age-adjusted rate of 1,001.4 increased from that of 2011 (975.0). The median age at death among the black population, 70.4 years, represented an entire year decrease from 71.4 years in White Black All Races Allegheny County Health Department 2

11 Diabetes mellitus 3% Alzheimer's disease 3% Cerebrovascular disease 5% Chronic lower respiratory diseases 5% Accidents (unintentional injuries) 5% Influenza and Pneumonia 2% Malignant neoplasms 23% Nephritis, nephrotic syndrome and nephrosis 2% All other causes 21% Other leading causes 5% Diseases of heart 25% Figure 5: Leading Causes of Mortality : Whites Allegheny County, Pa Intentional self-harm 1% Chronic liver disease and cirrhosis 1% Parkinson's disease 1% Septicemia 1% Pneumonitis due to solids and liquids 1% Assault(homicide) <1% Nephritis, nephrotic syndrome and nephrosis 2% Diabetes mellitus 4% Cerebrovascular disease 5% Chronic lower respiratory diseases 3% Accidents (unintentional injuries) 5% Malignant neoplasms 25% Assault(homicide) 5% All other causes 21% Other leading causes 9% Diseases of heart 23% Figure 6: Leading Causes of Mortality : Blacks Allegheny County, Pa Septicemia 2% Influenza and Pneumonia 2% Parkinson's disease <1% Intentional self-harm 1% Alzheimer's disease 2% Chronic liver disease and cirrhosis 1% Pneumoniti s due to solids and liquids 1% Allegheny County Health Department 3

12 It is evident that there continues to be a large disparity between white and black mortality in Allegheny County for The age-adjusted mortality rate among the white population (727.4) was 27.4% lower than that of the black population (1,001.4), and the median age at death for whites (81.4 years) was 11 years greater than that for blacks (70.4 years). Deaths by Sex There were a total of 6,210 deaths among males in Allegheny County during 2012 for an ageadjusted rate of per 100,000 males, a decrease from 2011 (955.0). The median age at death for males remained steady at 77.0 years from 2011 to Among females, there were 7,108 deaths in 2012; a decrease from the 7,219 deaths among females in The age-adjusted mortality rate of per 100,000 females in 2012 represents a decrease from in The median age at death for females in 2012 was 83.4 years, a slight drop from 83.6 years in Rate per 100,000 U. S Standard Million Population Figure 7: Age-adjusted Death Rates by Sex: Allegheny County, PA , , , , , Male Female Both Sexes There are observable differences in the mortality experience between males and females in Allegheny County for The age-adjusted rate of for males was 41.2% higher than that of females (650.3). Also, the median age at death for males (77.0 years) was 6.4 years less than that for females (83.4 years). Allegheny County Health Department 4

13 Influenza and Pneumonia 2% Chronic lower respiratory diseases 4% Accidents (unintentional injuries) 6% Cerebrovascular disease 4% Diabete s mellitus 3% Nephritis, nephrotic syndrome and nephrosis 2% Intentiona l selfharm 2% All other causes 17% Figure 8: Leading Causes of Mortality : Males Allegheny County, Pa Chronic liver disease and cirrhosis 2% Pneumonitis due to solids and liquids 1% Assault(homicide) 1% Malignant neoplasms 25% Other leading causes 8% Diseases of heart 26% Parkinson's disease 1% Septicemia 1% Alzheimer's disease 2% Cerebrovascular disease 6% Chronic lower respiratory diseases 5% Accidents (unintentional injuries) 4% Alzheimer's disease 4% Diabetes mellitus 3% Malignant neoplasms 22% Figure 9: Leading Causes of Mortality : Females Allegheny County, Pa All other causes 24% Other leading causes 9% Diseases of heart 24% Nephritis, nephrotic syndrome and nephrosis 2% Parkinson's disease 1% Septicemia 2% Intentional self-harm <1% Chronic liver disease and cirrhosis 1% Influenza and Pneumonia 2% Pneumonitis due to solids and liquids 1% Assault(homicide) <1% Allegheny County Health Department 5

14 Infant Mortality Median Age at Death Figure 10: Median Age at Death: Allegheny County, PA White Male White Female Black Male Black Female All Race/ Sex The number of infant deaths in Allegheny County decreased slightly from 80 in 2011 to 77 in There were 35 infant deaths among the white population and 27 among the black population, with the remaining 15 deaths being of another or unknown race. The total infant mortality rate decreased 3.3% from 6.1 in 2011 to 5.9 in 2012 (deaths per 1,000 live births). The 2012 infant mortality rate for Allegheny Rate per 1,000 Live Births Figure 11: Infant Mortality Rate: Race Allegheny County, Pa: County was lower than that of both the state (7.0 deaths per 1,000 live births) and the nation (6.0 deaths per 1,000 live births). White Black HP 2020 Goal Although the total infant mortality rate decreased slightly, there are significant differences between racial groups in Allegheny County with regards to infant mortality. The white population had a stable infant mortality rate of 3.7 from 2011 to In contrast, the black population had an infant mortality rate of 10.3 in 2012, a 23.1% decrease from 2011 (13.4). Additionally, the black infant mortality rate (10.3) is more than 2.7 times greater than the white rate (3.7). The Healthy People 2020 Objectives are a collection of health-related goals set forth by the U.S. Department of Health and Human Allegheny County Health Department 6

15 Services, with the aim to improve various measures of health by the year The Healthy People infant mortality goal of 6.0 deaths per 1,000 live births (Maternal, Infant, and Child Health Objective 1.3) has been met by the white population rate in recent years, but had still not been attained by the black population rate as of Neonatal Mortality Neonatal deaths are infant deaths that occur within the first 28 days of life. Allegheny County had a total of 59 neonatal deaths for a rate of 4.5 deaths per 1,000 live births in 2012; a slight increase from 2011, when there were 55 neonatal deaths for a rate of 4.2. Much like the trend for overall infant mortality, there remained a large gap in neonatal mortality between white and black populations. The black neonatal mortality rate of 6.9 was over twice as great as that of the white rate at 2.9. Neonatal mortality for the white population remained stable at 2.9 deaths per 1,000 live births between 2011 and The black population rate experienced a 25.0% decrease from 9.2 in Rate per 1,000 Live Births Figure 12: Neonatal Mortality Rate: Race Allegheny County, Pa: to 6.9 in 2012 (deaths per 1,000 live births). The Healthy People 2020 Objectives set a goal of 4.1 deaths per 1,000 live births (Maternal, Infant, and Child Health Objective 1.4); a goal which had been met by the white population rate, but not the black rate. White Black HP 2020 Goal Post neonatal Mortality Infant deaths that occur between 28 days and 1 year of life are classified as post-neonatal deaths. A total of 18 post-neonatal deaths occurred in Allegheny County during 2012, resulting in a rate of 1.4 deaths per 1,000 live births; a 26.3% decrease from 2011 (1.9). In 2012, there were 8 post-neonatal deaths among the white population for a rate of 0.9. By contrast, there were 9 post- Rate per 1,000 Live Births Figure 13: Post- Neonatal Mortality Rate: Race Allegheny County, Pa: White Black HP 2020 Goal Allegheny County Health Department 7

16 neonatal deaths among the black population for a rate of 3.4 (per 1,000 live births), and 1 death of a post-neonate belonging to another or an unspecified race. There was an increase of 12.5% in the post-neonatal mortality rate for the white population between 2012 (0.9) and 2011 (0.8). Conversely, there was an approximately 19% decrease in the post- neonatal mortality rate for the black population between 2011 (4.2) and 2012 (3.4). The Healthy People 2020 Objective of 2.0 deaths per 1,000 live births had been met by the white population rate, but had not quite yet been reached by the black population rate (Maternal, Infant, and Child Health Objective 1.5). Allegheny County Health Department 8

17 Leading Causes of Death and Select Discussions Figure 14: Leading Causes of Mortality Allegheny County, Pa: 2012 Septicemia 1% Nephrtitis, nephrotic syndrome and nephrosis 2% Influenza and Pneumonia 2% Diabetes mellitus 3% other 26% Alzheimer's disease 3% Cerebrovascular disease 5% Chronic lower respiratory diseases 5% Diseases of the heart 25% Malignant neoplasms 23% Accidents (unintentional injuries) 5% Diseases of the heart followed by malignant neoplasms (cancers) were the two leading causes of death among Allegheny County Residents for 2012, accounting for just under half of all deaths. Accidents (3 rd ), chronic lower respiratory disease (4 th ), and cerebrovascular disease (5 th ) concluded the top five causes of mortality. The 6 th leading cause of death for 2012 was Alzheimer s disease, followed by diabetes mellitus (7 th ), influenza and pneumonia (8 th ), nephritis, nephrotic syndrome and nephrosis (9 th ), and septicemia (10 th ) rounded out the top ten. The top ten causes of death accounted for almost 74% of all deaths in Allegheny County during Parkinson s disease (11 th ), intentional self- harm (12 th ), chronic liver disease and cirrhosis (13 th ), pneumonitis due to solids and liquids (14 th ), and homicide (15 th ) concluded the top 15 leading causes of death in Allegheny County Health Department 9

18 Figure 15: Leading causes of mortality ranked by number of deaths Rank White Male White Female Black Male Black Female 1st Diseases of the heart Diseases of the heart Diseases of the heart Malignant Neoplasm 2nd Malignant Neoplasm Malignant Neoplasm Malignant Neoplasm Diseases of the heart 3rd Accidents (unintentional injuries) Cerebrovascular disease Assault (homicide) Cerebrovascular disease 4th Chronic lower respiratory diseases Chronic lower respiratory diseases Accidents (unintentional injuries) Diabetes mellitus 5th Cerebrovascular disease Alzheimer's disease Cerebrovascular disease Chronic lower respiratory diseases 6th Influenza and Pneumonia Accidents (unintentional injuries) Chronic lower respiratory diseases Accidents (unintentional injuries) 7th Diabetes mellitus Diabetes mellitus Diabetes mellitus Nephritis, nephrotic syndrome and nephrosis 8th Nephritis, nephrotic syndrome and nephrosis Influenza and Pneumonia Nephritis, nephrotic syndrome and nephrosis Alzheimer's disease 9th Intentional self-harm Nephritis, nephrotic syndrome and nephrosis Influenza and Pneumonia Septicemia 10th Alzheimer's disease Septicemia Septicemia Influenza and Pneumonia Allegheny County Health Department 10

19 Diseases of the Heart Diseases of the heart accounted for 3,308 deaths, or 24.8% of all deaths, in Allegheny County during The age-adjusted rate of (per 100,000 standardized population) was higher than that of the state (175.2), but lower than that of the nation (191.0). Diseases of the heart were the #1 cause of death when calculated across the total Rate per 100,000 U.S Standard Million Population Figure 16: Age-Adjusted Death Rates - Diseases of the Heart Allegheny County, Pa: population. Age-adjusted rates in 2012 were highest among black males (312.0), followed by white males (222.0) and black females (176.9), and lowest among white females (139.0). White Male White Female Black Males Black Females About three fourths of all deaths due to diseases of the heart occurred in those age 75 and older. The male to female ratio of age- adjusted rates of deaths from diseases of the heart was 1.6 to 1 (233.3 v 144.2) and the black to white ratio was 1.4 to 1 (233.0 v 173.5). The median age of death from diseases of the heart increased slightly from 82.7 years in 2011 to 83.1 years in Figure 17: Age-Adjusted Death Rates - Diseases of Heart Allegheny County, Pa 2012 Rate per 100,000 U.S Standard Million Population White Male White Female Black Male Black Female Allegheny County Health Department 11

20 Malignant Neoplasms Malignant neoplasms, more commonly referred to as cancers, were the second leading cause of death among residents of Allegheny County. Malignant neoplasms caused 3,095 deaths in 2012 and accounted for 23.2% of all deaths for county residents. The ageadjusted cancer mortality rate of per 100,000 standardized population is higher than that for diseases of the heart (181.4). The county s rate Rate per 100,000 U.S Standard Million Population Figure 18: Age-Adjusted Death Rates - Malignant Neoplasms Allegheny County, Pa: falls between that of the state (173.8) and the nation (185.6). Based on age-adjusted rates, males were more likely to die of malignant neoplasms than females (ratio of 1.4 to 1) and, likewise, blacks were more likely than whites to die of malignant neoplasms (ratio of 1.4 to 1). Cancer of the trachea, bronchus and lung accounted for 28.4% of all cancer deaths in 2012 (879). These respiratory system cancers were the leading cause of cancer deaths among all race/sex groups. For males, prostate cancer (153 deaths) was the second leading cause of cancer deaths with an age-adjusted rate of 22.6 per 100,000. The rate for black males (58.1) was nearly three times that Lymphoid, hematopoietic and related tissue 9% Figure 19: Malignant Neoplasm Deaths by Site Allegheny County, Pa 2012 Breast 7% All other 36% Trachea, bronchus and lung 28% White Male White Female Black Male Black Female HP 2020 Goal Colon, rectum and anus Pancreas 8% 7% Prostate 5% of white males (19.9). Among females, the second leading cause of cancer deaths was cancer of the breast (199 deaths) with an age-adjusted rate of 20.9 per 100,000. The rate for black females (25.9) was Allegheny County Health Department 12

21 about 1.3 times greater than that of white females (20.2). All aforementioned demographic groups, with the exception of white females, still maintained higher rates of malignant neoplasm deaths than the Healthy People 2020 Objective of cancer deaths per 100,000 standardized population (Cancer Objective 1). Accidents With 661 deaths, accidents were ranked as the 3 rd leading cause of death in Allegheny County during Accidental deaths resulted in an age-adjusted rate of 45.6 per 100,000, which was greater than that of both the state (43.7) and the nation (40.7). Based on numbers of deaths, accidents were the leading cause of death Rate per 100,000 U.S Standard Million Population Figure 20: Age-Adjusted Death Rates - Accidents Allegheny County, Pa: White Male for those aged 15 and under as well as those aged Those who were 85 years and older had an accidental death rate (384.4 per 100,000 population) at least 2.7 times higher than any other age group (NOTE: The second highest rate of belonged to those aged 75-84). The rate of accidental deaths among males is nearly twice that of females. This is reflected in the fact that, while both white and black females had surpassed the Healthy People 2020 Objective of 36.4 unintentional injury deaths per 100,000 (Injury and Violence Prevention Objective 11), neither white males nor black males have done so in recent years. Accidents accounted for the third youngest median age at death with 56.6 years. White Female Black Male Black Female HP 2020 Goal The ICD-10 coding system (International Classification of Disease, 10 th revision- see Technical Notes) further breaks down accidents, with the top three types of accidents being ranked as follows : 1 st accidental poisoning and exposure to noxious substances (270 deaths), 2 nd - falls (210 deaths), and 3 rd - transport accidents (90). County residents who were over the age of 85 accounted for 47.6% (100) of all fall-related deaths with an age-specific rate (284.8) over three times that of the next age group with the highest fall rate (i.e., those aged had an age-specific rate of 86.2). These often preventable deaths among the elderly are of particular concern in Allegheny County, since it has a higher percentage of elderly individuals when compared to state and national demographics (U.S. Census Bureau, 2010 Census of Population). Allegheny County Health Department 13

22 Accidental exposure to smoke, fire and flames 2% Other and Water, air, and space transport <1% Accidental drowning and submersion 1% unspecified accidents 12% Figure 21: Accidental Deaths by Type Allegheny County, Pa 2012 Falls 32% Accidental poisoning and exposure to noxious substances 41% Motor vehicle accidents 12% Accidental Poisonings and Exposure to Noxious Substances This subcategory of accidental deaths accounted for 270 (2%) of the total deaths in This section is of specific concern in Allegheny County, as it includes accidental deaths as a result of overdoses related to both legal and illicit drugs. The ICD-10 classifications associated with this category are X40-X49, with X40-X44 accounting for accidental poisonings due to drugs, medicants and biological substances, X45 accounting for accidental poisonings due to alcohol, X46 accounting for accidental poisonings due to Figure 22: 2012 Accidental Poisoning & Exposure to Noxious Substances By Specific Category 3% 1% 96% Accidental poisoning by and exposure to drugs, medicants and, biologicals Accidental poisoning by and exposure to alcohol Accidental poisoning by and exposure to other gases and vapors Allegheny County Health Department 14

23 organic substances and related vapors, X47 accounting for other gases and vapors, and X48 and X49 accounting for accidental poisonings due to pesticides and unspecified substances, respectively. Only those causes listed in Figure 22 occurred in 2012, with accidental poisonings due to drugs, medicants, and biological substances accounting for 96%. The highest age-adjusted rates were seen among black males (35.4 per 100,000 standardized population), followed by white males (26.9), white female (18.6) and, lastly, black females (11.4). Men accounted for a higher age-adjusted rate of accidental poisoning and exposure than did women, with a ratio of 1.6 to 1 (27.0 v 16.9); a trend that has been constant for a majority of the past decade (with the exception of 2006). Whites also accounted for higher age-adjusted rates than blacks with a ratio of 1.04 to 1 (22.7 v 21.8); a trend that was not seen prior to The median age of death as a result of accidental poisoning and exposure to noxious substances was 41.6 years of age. Rate per 100,000 U.S Standard Million Population Figure 23: Age- Adjusted Death Rates - Accidental Poisoning & Exposure to Noxious Substances Allegheny County, Pa: White Male White Female Black Male Black Female All Race/ Sex Diabetes Mellitus With 358 deaths, accounting for 2.7% of all deaths in 2012, diabetes mellitus (more simply known as diabetes) ranked 7 th as a leading cause of death for county residents. Diabetes mellitus had an age-adjusted rate of 20.7 per 100,000 standardized population in 2012, which was lower than that of both the state (22.0) and the nation (23.6). The highest age-adjusted rates were found among black males (37.3), while the lowest were found among white females (16.9). Stark differences were noticed between races, with the black rate (37.6) having been more than twice that of the white rate (18.5) in Those who died from diabetes mellitus had a median age of death of Allegheny County Health Department 15

24 Rate per 100,000 U.S Standard Million Population Figure 24: Age-Adjusted Death Rates - Diabetes Mellitus Allegheny County, Pa: White Male White Female Black Male Black Female Assault (homicide) The 15 th leading cause of death in 2012, assault (homicide), accounted for 95 (0.7%) of all deaths among Allegheny County residents, with an age-adjusted rate of 8.6 per 100,000.The highest age-specific rates are seen among black males at 78.1, while the lowest rates were among white females at 1.1 (per 100,000 population). Rate per 100,000 U.S Standard Million Population Figure 25: Age-Adjusted Death Rates - Homicide Allegheny County, Pa: White Male White Female Black Male Black Female HP 2020 Goal Allegheny County Health Department 16

25 Significant differences can be seen among race and sex categories, with males having an ageadjusted rate 7.9 times that of females (14.3 v 1.8), and with blacks having a rate 23.5 times that of whites (39.9 v 1.7). These rates differ by such large factors mainly due to the fact that 74.7% of all homicide victims were black males. With a median age at death of 23.3, deaths due to assaults yielded the youngest median age at death in 2012, when compared to the other leading causes (i.e., the second youngest was intentional self-harm at 46.9 years of age). The Healthy People 2020 Objective of 5.5 homicides per 100,000 (Injury and Violence Prevention Objective 29) had been achieved by both white males and white females, but by neither black males nor black females, as of Figure 26: Homicide Deaths by Race and Sex Allegheny County, Pa 2012 Black Female 7% White Male 13% White Female 5% Black Male 75% Allegheny County Health Department 17

26 2012 Mortality Report Tables Allegheny County Health Department 18

27 TABLE 1. TOTAL DEATHS, INFANT DEATHS and DEATH RATES ALLEGHENY COUNTY, PA , 1975, 1980, 1985, Number Year Total Deaths Infant Deaths Crude Death Rate (1) Infant Death Rate (2) 2012* 13, , , , , , , , , , , , , , , , , , , , , , , , , , , (1) Per 1,000 Population (2) Per 1,000 Live Births Rates Allegheny County Health Department 19

28 Table 2. INFANT MORTALITY NUMBERS and RATES by RACE ALLEGHENY COUNTY, PA , 1975, 1980, 1985, Year Total White Black Non White Number Rate (1) Number Rate (2) Number Rate Number Rate 2012* n.a. n.a n.a. n.a n.a. n.a n.a. n.a (1) Per 1,000 Live Births Infant Death: Age at death under 1 year. (2) Per 1,000 Live Births of Mother s Racial Group n.a. Indicates data not available Allegheny County Health Department 20

29 Table 3. NEONTAL INFANT MORTALITY NUMBERS and RATES by RACE ALLEGHENY COUNTY, PA , 1975, 1980, 1985, Year Total White Black Non White Number Rate (1) Number Rate (2) Number Rate (2) Number Rate (2) 2012* n.a. n.a n.a. n.a n.a. n.a. n.a. n.a. n.a. n.a n.a. n.a. n.a. n.a. n.a. n.a. (1) Per 1,000 Live Births Neonatal Death: Death occurring between 0 and 27 days after birth (2) Per 1,000 Live Births of Mother s Racial Group n.a. Indicates data not available Allegheny County Health Department 21

30 Table 4. POST-NEONATAL INFANT MORTALITY NUMBERS and RATES by RACE ALLEGHENY COUNTY, PA , 1975, 1980, 1985, Year Total White Black Non White Number Rate (1) Number Rate (2) Number Rate (2) Number Rate (2) 2012* n.a. n.a n.a. n.a n.a. n.a. n.a. n.a. n.a. n.a n.a. n.a. n.a. n.a. n.a. n.a. (1) Per 1,000 Live Births Post-Neonatal Death: Death occurring between 28 and 364 days after birth (2) Per 1,000 Live Births of Mother s Racial Group n.a. Indicates data not available Allegheny County Health Department 22

31 Table 5. Leading Causes of Death, Numbers: ALL GROUPS ALLEGHENY COUNTY, PA , 1975, 1980, 1985, 1990, 1995, 2000, 2005, 2010, 2012 Cause of Death Diseases of heart 3,308 3,336 4,221 4,706 5,252 5,480 6,450 7,101 7,259 7,529 Malignant neoplasms 3,095 3,107 3,498 3,625 3,846 3,971 3,679 3,672 3,630 3,226 Accidents (unintentional injuries) Chronic lower respiratory diseases Cerebrovascular disease , ,008 1,220 1,510 1,700 Alzheimer's disease n.a. n.a. Diabetes mellitus Influenza and Pneumonia Nephritis, nephrotic syndrome and nephrosis Septicemia Parkinson's disease n.a. n.a. Intentional self-harm(suicide) Chronic liver disease and cirrhosis Pneumonitis due to solids and liquids n.a. n.a. n.a. n.a. n.a. n.a. Assault(homicide) All other causes 2,801 2,642 2,495 2,216 2,194 1,924 1,694 1,687 1,767 2,183 Total all causes 13,318 13,280 14,771 15,053 15,316 15,269 15,542 16,450 16,605 17,393 n.a. Indicates data not available Allegheny County Health Department 23

32 Table 6. Leading Causes of Death, Numbers: WHITES ALLEGHENY COUNTY, PA , 1975, 1980, 1985, 1990, 1995, 2000, 2005, 2010, 2012 Cause of Death Diseases of heart 2,905 2,928 3,759 4,208 4,763 5,007 5,848 6,454 6,688 6,928 Malignant neoplasms 2,671 2,697 3,104 3,279 3,470 3,559 3,283 3,280 3,109 2,919 Accidents (unintentional injuries) Chronic lower respiratory diseases Cerebrovascular disease ,090 1,344 1,512 Alzheimer's disease n.a. n.a. Diabetes mellitus Influenza and Pneumonia Nephritis, nephrotic syndrome and nephrosis Septicemia Parkinson's disease n.a. n.a. Intentional self-harm Chronic liver disease and cirrhosis Pneumonitis due to solids and liquids n.a. n.a. n.a. n.a. n.a. n.a. Assault(homicide) All other causes 2,423 2,294 2,177 1,933 1,889 1,680 1,477 1,479 1,572 1,863 Total all causes 11,569 11,544 12,983 13,233 13,622 13,597 13,863 14,682 14,974 15,536 n.a. Indicates data not available Allegheny County Health Department 24

33 Table 7. Leading Causes of Death, Numbers: BLACKS ALLEGHENY COUNTY, PA , 1975, 1980, 1985, 1990, 1995, 2000, 2005, 2010, 2012 Cause of Death * 1980* 1975* 1970* Diseases of heart Malignant neoplasms Accidents (unintentional injuries) Chronic lower respiratory diseases Cerebrovascular disease Alzheimer's disease n.a. n.a. Diabetes mellitus Influenza and Pneumonia Nephritis, nephrotic syndrome and nephrosis Septicemia Parkinson's disease n.a. n.a. Intentional self-harm Chronic liver disease and cirrhosis Pneumonitis due to solids and liquids n.a. n.a. n.a. n.a. n.a. n.a. Assault(homicide) All other causes Total all causes 1,573 1,630 1,736 1,774 1,648 1,636 1,674 1,755 1,625 1,836 n.a. Indicates data not available * For years 1988 and prior, nonwhite death counts were used as an estimate for black. Allegheny County Health Department 25

34 Table 8. Leading Causes of Death, Numbers: MALES ALLEGHENY COUNTY, PA , 1975, 1980, 1985, 1990, 1995, 2000, 2005, 2010, 2012 Cause of Death Diseases of heart 1,596 1,662 1,932 2,185 2,511 2,684 3,191 3,751 3,888 4,211 Malignant neoplasms 1,540 1,522 1,764 1,793 1,916 2,056 1,959 2,024 1,835 1,773 Accidents (unintentional injuries) Chronic lower respiratory diseases Cerebrovascular disease Alzheimer's disease n.a. n.a. Diabetes mellitus Influenza and Pneumonia Nephritis, nephrotic syndrome and nephrosis Septicemia Parkinson's disease n.a. n.a. Intentional self-harm Chronic liver disease and cirrhosis Pneumonitis due to solids and liquids n.a. n.a. n.a. n.a. n.a. n.a. Assault(homicide) All other causes 1,075 1, , ,159 Total all causes 6,210 6,346 6,770 6,945 7,428 7,561 7,882 8,808 8,970 9,575 n.a. Indicates data not available Allegheny County Health Department 26

35 Table 9. Leading Causes of Death, Numbers: FEMALES ALLEGHENY COUNTY, PA , 1975, 1980, 1985, 1990, 1995, 2000, 2005, 2010, 2012 Cause of Death Diseases of heart 1,712 1,674 2,289 2,521 2,741 2,796 3,259 3,350 3,371 3,318 Malignant neoplasms 1,555 1,585 1,734 1,832 1,930 1,915 1,720 1,648 1,595 1,453 Accidents (unintentional injuries) Chronic lower respiratory diseases Cerebrovascular disease Alzheimer's disease n.a. n.a. Diabetes mellitus Influenza and Pneumonia Nephritis, nephrotic syndrome and nephrosis Septicemia Parkinson's disease n.a. n.a. Intentional self-harm Chronic liver disease and cirrhosis Pneumonitis due to solids and liquids n.a. n.a. n.a. n.a. n.a. n.a. Assault(homicide) All other causes 1,726 1,542 1,525 1,289 1, ,024 Total all causes 7,108 6,934 8,001 8,108 7,888 7,708 7,660 7,642 7,635 7,818 n.a. Indicates data not available Allegheny County Health Department 27

36 Table 10. Leading Causes of Death, Numbers: WHITE MALES ALLEGHENY COUNTY, PA , 1975, 1980, 1985, 1990, 1995, 2000, 2005, 2010, 2012 Cause of Death Diseases of heart 1,381 1,461 1,696 1,936 2,272 2,430 2,876 3,407 3,564 3,852 Malignant neoplasms 1,338 1,323 1,564 1,587 1,705 1,824 1,735 1,784 1,637 1,596 Accidents (unintentional injuries) Chronic lower respiratory diseases Cerebrovascular disease Alzheimer's disease n.a. n.a. Diabetes mellitus Influenza and Pneumonia Nephritis, nephrotic syndrome and nephrosis Septicemia Parkinson's disease n.a. n.a. Intentional self-harm Chronic liver disease and cirrhosis Pneumonitis due to solids and liquids n.a. n.a. n.a. n.a. n.a. n.a. Assault(homicide) All other causes Total all causes 5,326 5,461 5,846 6,032 6,529 6,664 6,961 7,785 8,010 8,507 n.a. Indicates data not available Allegheny County Health Department 28

37 Table 11. Leading Causes of Death, Numbers: WHITE FEMALES ALLEGHENY COUNTY, PA , 1975, 1980, 1985, 1990, 1995, 2000, 2005, 2010, 2012 Cause of Death Diseases of heart 1,524 1,467 2,063 2,272 2,491 2,577 2,972 3,047 3,124 3,076 Malignant neoplasms 1,333 1,374 1,540 1,632 1,765 1,735 1,548 1,496 1,472 1,323 Accidents (unintentional injuries) Chronic lower respiratory diseases Cerebrovascular disease Alzheimer's disease n.a. n.a. Diabetes mellitus Influenza and Pneumonia Nephritis, nephrotic syndrome and nephrosis Septicemia Parkinson's disease n.a. n.a. Intentional self-harm Chronic liver disease and cirrhosis Pneumonitis due to solids and liquids n.a. n.a. n.a. n.a. n.a. n.a. Assault(homicide) All other causes 1,517 1,344 1,352 1,135 1, Total all causes 6,243 6,083 7,137 7,201 7,093 6,932 6,902 6,897 6,964 7,029 n.a. Indicates data not available Allegheny County Health Department 29

38 Table 12. Leading Causes of Death, Numbers: BLACK MALES ALLEGHENY COUNTY, PA , 1975, 1980, 1985, 1990, 1995, 2000, 2005, 2010, 2012 Cause of Death * 1980* 1975* 1970* Diseases of heart Malignant neoplasms Accidents (unintentional injuries) Chronic lower respiratory diseases Cerebrovascular disease Alzheimer's disease n.a. n.a. Diabetes mellitus Influenza and Pneumonia Nephritis, nephrotic syndrome and nephrosis Septicemia Parkinson's disease n.a. n.a. Intentional self-harm Chronic liver disease and cirrhosis Pneumonitis due to solids and liquids n.a. n.a. n.a. n.a. n.a. n.a. Assault(homicide) All other causes Total all causes , ,054 n.a. Indicates data not available * For years 1988 and prior, nonwhite death counts were used as an estimate for black. Allegheny County Health Department 30