Preventing Chronic Disease | The Contributions of Selected Diseases to Disparities in Death Rates and Years of Life Lost for Racial/Ethnic Minorities in the United States, 1999–2010 - CDC

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Preventing Chronic Disease | The Contributions of Selected Diseases to Disparities in Death Rates and Years of Life Lost for Racial/Ethnic Minorities in the United States, 1999–2010 - CDC

The Contributions of Selected Diseases to Disparities in Death Rates and Years of Life Lost for Racial/Ethnic Minorities in the United States, 1999–2010

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• Abstract
• Introduction
• Methods
• Results
• Discussion
• Acknowledgments
• Author Information
• References
• Tables
• Appendix

George Howard, DrPH; Frederick Peace, MS; Virginia J. Howard, PhD

Suggested citation for this article: Howard G, Peace F, Howard VJ. The Contributions of Selected Diseases to Disparities in Death Rates and Years of Life Lost for Racial/Ethnic Minorities in the United States, 1999–2010. Prev Chronic Dis 2014;11:140138. DOI:http://dx.doi.org/10.5888/pcd11.140138.

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Abstract

Introduction
Differences in risk for death from diseases and other causes among racial/ethnic groups likely contributed to the limited improvement in the state of health in the United States in the last few decades. The objective of this study was to identify causes of death that are the largest contributors to health disparities among racial/ethnic groups.

Methods
Using data from WONDER system, we measured the relative (age-adjusted mortality ratio [AAMR]) and absolute (difference in years of life lost [dYLL]) differences in mortality risk between the non-Hispanic white population and the black, Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander populations for the 25 leading causes of death.

Results
Many causes contributed to disparities between non-Hispanic whites and blacks, led by assault (AAMR, 7.56; dYLL, 4.5 million). Malignant neoplasms were the second largest absolute contributor (dYLL, 3.8 million) to black–white disparities; we also found substantial relative and absolute differences for several cardiovascular diseases. Only assault, diabetes, and diseases of the liver contributed substantially to disparities between non-Hispanic whites and Hispanics (AAMR ≥ 1.65; dYLL ≥ 325,000). Many causes of death, led by assault (AAMR, 3.25; dYLL, 98,000), contributed to disparities between non-Hispanic whites and American Indians/Alaska Natives; Asian/Pacific Islanders did not have a higher risk than non-Hispanic whites for death from any disease.

Conclusion
Assault was a substantial contributor to disparities in mortality among non-Asian racial/ethnic minority populations. Research and intervention resources need to target diseases (such as diabetes and diseases of the liver) that affect certain racial/ethnic populations.

Acknowledgments

This work was supported by cooperative agreement no. U01 NS041588 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Services; and by the Sankofa Health Initiative, an intramural organization at University of Alabama at Birmingham.

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Author Information

Corresponding Author: George Howard, DrPH, Professor, Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL 35294-0022. Telephone: 205-934-4905. E-mail: ghoward@uab.edu.

Author Affiliations: Frederick Peace, Virginia J. Howard, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.

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References

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