healthy gente 2010: history and health measures sam notzon national center for health statistics
TRANSCRIPT
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Healthy Gente 2010: History and Health Measures
Sam NotzonSam NotzonNational Center for Health StatisticsNational Center for Health Statistics
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Topics to Cover:
Background informationBackground information
Statistical considerationsStatistical considerations History of Healthy GenteHistory of Healthy Gente Health measuresHealth measures
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Dangers of Statistical Analysis:
In a recent study of the effects of a In a recent study of the effects of a new chicken food:new chicken food:
33.3% gained weight;33.3% gained weight; 33.3% lost weight;33.3% lost weight; the other chicken ran away.the other chicken ran away.
(Source: anonymous reporter)(Source: anonymous reporter)
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Statistical Issues:
Small number problemSmall number problem
Racial and ethnic identificationRacial and ethnic identification
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U.S. Counties Included in Border Region
2000 Population
55.1 million
6.6 million
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Population trends in U.S.-Mexico border 1970-2020
2.73.4
4.5
6.4
7.3
8.3
3.1
4.3
5.5
6.6
7.9
9.4
1
2
3
4
5
6
7
8
9
10
1970 1980 1990 2000 2010 2020
Mexico borderU.S. border
Population in millions
Projections
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*Persons of Hispanic/Latino origin may be any race.Source: Census 2000 Summary File 1, U.S.Bureau of the Census.
0.7 3.7
69.1
12.612.1
0
20
40
60
80
Distribution of the population by specified race/ethnicity: United States, 2000
Black/African American,non-Hispanic
American Indian/Alaska Native,non-Hispanic
Hispanic/Latino*
White, non-Hispanic Asian/Native Hawaiianand Other Pacific Islander,
non-Hispanic
Percent
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42.1
32.4
32.0
25.3
19.7
17.1
16.8
15.1
13.3
12.3
12.6
0 10 20 30 40
United States
New Mexico
California
Texas
Arizona
Nevada
Colorado
Florida
New York
New Jersey
Illinois
Percent of population that is Hispanic/Latino:United States and ten States with largestproportion of Hispanic/Latino residents, 2000
Source: Census 2000 Summary File 1, U.S.Bureau of the Census. Percent
Selected States
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Source: Census 2000 Summary File 1, U.S.Bureau of the Census.
2.0
2.5
4.1
0
1
2
3
4
American Indian/Alaskan Native population, 1990 and 2000
2000AIANOr
Combination
1990 2000AIANalone
Number in millions
(+25%)
(+ 110%)
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SocioeconomicDifferentials
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Percent with education less than 9 years,United States 2000
0
5
10
15
20
25
30
35
USA State Border .
Per
cent NHWhite
HispanicAIAN
Source: 2000 Census, United States
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Percent with education less than 9 years,United States 2000
0
5
10
15
20
25
30
35
USA State Border
Per
cent
0
5
10
15
NHWhite
Hispanic
AIAN
Ratio
Source: 2000 Census, United States.
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Percent with no telephone access,United States 2000
Projections
0
1
2
3
4
5
6
USA State Border
0
1
2
3
4
5
NHWhite
Hispanic
Ratio
Source: 2000 Census, United States.
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Per capita income, United States 1999
Projections
0
5000
10000
15000
20000
25000
30000
35000
USA State Border
0
1
2
3
NHWhite
Hispanic
Ratio
Source: 2000 Census, United States.
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Health Disparities
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Medically Underserved Border Counties, 1998
Underserved Border Counties Entire County
Portion
Not Underserved
Source: HRSA.
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Death rates by cause, US border counties, 2000
0
100
200
300
400
500
600
700
800
900
Total Heart Cancer Stroke
NHWhiteHispanic
Source: NCHS/CDC.
Rate per 100,000
Note: Rates are age-adjusted to the US 2000 population.
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Death rates by cause, US border counties, 2000
0
10
20
30
40
50
NHWhite
Hispanic
Source: NCHS/CDC.
Rate per 100,000
Note: Rates are age-adjusted to the US 2000 population.
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Communicable Diseases, US border
Disease rates by ethnicity not currently Disease rates by ethnicity not currently available, but Hispanic excesses have been available, but Hispanic excesses have been documented for:documented for: Hepatitis AHepatitis A BrucellosisBrucellosis ShigellosisShigellosis TuberculosisTuberculosis OthersOthers
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US-Mexico Border Health Commission:
Healthy Border/Healthy Gente Program
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Healthy Border/Healthy Gente Program Timeline:
1998: First meeting of Design Team and birth of 1998: First meeting of Design Team and birth of Healthy Gente conceptHealthy Gente concept
Jan. 2000: US Section Commissioners appointedJan. 2000: US Section Commissioners appointed Jan. 2000: HG objectives finalized, presented at Jan. 2000: HG objectives finalized, presented at
launch conference for Healthy People 2010launch conference for Healthy People 2010 Nov. 2000: HG workshop, S. Padre IslandNov. 2000: HG workshop, S. Padre Island Mar. 2001: Second meeting of Commission; US & Mar. 2001: Second meeting of Commission; US &
Mexico agree to Healthy Border ProgramMexico agree to Healthy Border Program
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Healthy Border/Healthy Gente Program
Program of health education and health promotionProgram of health education and health promotion Establishes priority health objectives for the Establishes priority health objectives for the
border regionborder region Healthy Healthy GenteGente Program based on U.S. Healthy Program based on U.S. Healthy
People 2010 ProgramPeople 2010 Program Healthy Border Program combines Healthy Healthy Border Program combines Healthy GenteGente
objectives with Mexico’s objectives with Mexico’s Indicadores de Indicadores de ResultadosResultados Program Program
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Healthy Border/Healthy Gente Objectives
Focus attention on key health issuesFocus attention on key health issues Improve allocation of health resourcesImprove allocation of health resources Coordinate public and private actionCoordinate public and private action Inspire ownership of objectivesInspire ownership of objectives Achieve objectives through:Achieve objectives through:
coordinated program activitiescoordinated program activities community projectscommunity projects
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Selection Criteria
Key health issues for borderKey health issues for border Measurable objectivesMeasurable objectives Limited numberLimited number Compatible with federal and state Compatible with federal and state
objectivesobjectives
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Healthy Border/Healthy Gente Program
25 Healthy 25 Healthy Gente Gente objectivesobjectives
20 Healthy Border objectives20 Healthy Border objectives
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Access to Care
25 percent reduction in persons lacking access to primary care provider in underserved areas
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Medically Underserved Border Counties
Underserved Border Counties Entire County
Portion
Not Underserved
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Cancer
Reduce breast cancer death rate by 20 Reduce breast cancer death rate by 20 percentpercent
Reduce cervical cancer death rate by Reduce cervical cancer death rate by 30 percent30 percent
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Breast Cancer1998-2000
0.0 5.0 10.0 15.0 20.0 25.0 30.0Rate per 100,000 population
USABDR-TOTBDR-TXBDR-AZBDR-NMBDR-CAAZ-YMTX-HITX-MKTX-CMNM-DACA-SD
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Border Breast Cancer Death Rates
0
5
10
15
20
25
30per 100,000 population
20%
Healthy GenteGoal
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Diabetes
Reduce diabetes death rate by 10 Reduce diabetes death rate by 10 percentpercent
Reduce hospital admissions for Reduce hospital admissions for diabetes by 25 percent diabetes by 25 percent
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Diabetes Mortality1998-2000
0 5 10 15 20 25 30 35 40 45 50 55 60Rate per 100,000
USABDR-TOTBDR-TXBDR-NMBDR-AZBDR-CATX-MKTX-ELAZ-SCTX-CMCA-IMCA-SD
Source: NCHS, CDC; age-adjusted to US 2000 population
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Border Diabetes Death Rate
0
5
10
15
20
25
30per 100,000 population
10%
“Healthy Gente” Goal
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Environment
All countries will meet or exceed EPA air quality standards All households will be connected to public
sewage systems or septic tanks Reduce hospitalization for acute pesticide poisoning by 25 percent
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Border Counties and EPA Air Quality Standards
In Compliance
Not in Compliance
Compliance Status
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HIV
Reduce adolescent and adult HIV cases Reduce adolescent and adult HIV cases by 50 percent by 50 percent
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Border HIV+ Incidence Rate
0
1
2
3
4
5
6
7
8
9
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
per 100,000 population
50%
“Healthy Gente” Goal
Source: State Health Departments of Arizona, New Mexico, Texas.
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Immunizations and Infectious Diseases
Reduce incidence of hepatitis A and Reduce incidence of hepatitis A and hepatitis B by 50 percenthepatitis B by 50 percent
Reduce incidence of tuberculosis by 50 Reduce incidence of tuberculosis by 50 percentpercent
Raise and maintain immunization Raise and maintain immunization coverage rate at 90 percentcoverage rate at 90 percent
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Border Hepatitis A and B Rates
05
1015202530354045
Hepatitis A
Hepatitis B
per 100,000 population
50%
“Healthy Gente” Goal
Source: State Health Departments of Arizona, California, New Mexico, Texas.
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Injury/Violence Prevention
Reduce motor vehicle crash deaths by 25 percent
Reduce childhood death rate due to unintentional injuries by 30 percent
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Motor Vehicle Crash Deaths1998-2000
0 5 10 15 20 25 30Rate per 100,000
USA
BDR-TOT
BDR-NM
BDR-AZ
BDR-TX
BDR-CA
CA-IM
AZ-YM
TX-HI
CA-SD
TX-WB
Source: NCHS, CDC; rates age-adjusted to US 2000 population
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Border Motor Vehicle Death Rate
0
2
4
6
8
10
12
14
16per 100,000 population
25%
“Healthy Gente” Goal
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Maternal and Child Health
Reduce infant mortality rate by 15 percent. Reduce infant mortality rate due to all birth
defects by 30 percent Raise first trimester prenatal care initiation to 85
percent Reduce young teen pregnancy rate by 33 percent
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Initiation of Prenatal Carein First Trimester, 2000
0 20 40 60 80 100Percentage
USABDR-TOTBDR-CABDR-AZBDR-NMBDR-TXCA-SDTX-VVAZ-PMTX-WBTX-HINM-LU
Source: NCHS, CDC
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Border Prenatal Care in First Trimester
4045505560657075808590
percent “Healthy Gente”
Goal
Source: NCHS/CDC.
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Mental Health
Reduce suicide death rate by 15 Reduce suicide death rate by 15 percentpercent
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Suicide Mortality1998-2000
0 5 10 15 20Rate per 100,000
USABDR-TOTBDR-NMBDR-AZBDR-CABDR-TXAZ-PMAZ-YMNM-DACA-IMTX-VVTX-HI
Source: NCHS, CDC; rates are age-adjusted to the US 2000 population.
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Border Suicide Death Rate
0
2
4
6
8
10
12
14per 100,000 population
15%
“Healthy Gente” Goal
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Nutrition and Overweight
Reduce the proportion of adults who Reduce the proportion of adults who are obese to 15 percentare obese to 15 percent
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Proportion Obese,1988-94
Source: NCHS, CDC
0 10 20 30 40 50
White
Black
M-A
Border M-A
Total
WomenMen
Percent
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Oral Health
75 percent of population served by flouridated community water systems
75 percent of children and adults use oral health care system each year
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Respiratory Diseases
Reduce asthma hospitalization rate by Reduce asthma hospitalization rate by 40 percent40 percent
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Substance Abuse
Reduce the number of alcohol-related motor vehicle crash deaths by 50 percent
Increase to 89 percent the proportion of teenagers not using alcohol or any illicit drugs in past 30 days
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Alcohol-Related Motor Vehicle Crash Deaths, 1998
Source: NHTSA, DOT.
36.6
44.2
54.0
31.6
45.6
35.6
52.5
49.2
47.1
44.7
38.6
0 10 20 30 40 50 60
Percentage
USA
BDR-TOT
BDR-NM
BDR-AZ
BDR-TX
BDR-CA
AZ-YL
CA-IM
TX-HI
TX-WB
CA-SD
BAC 0.01+Alcohol Related
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BAC 0.01+ Border Alcohol-Related Motor Vehicle Crash
0.00
10.00
20.00
30.00
40.00
50.00
60.00
50%Percentage
“Healthy Gente” Goal
Percent
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Tobacco Use
Reduce teen and adult tobacco use by Reduce teen and adult tobacco use by one-thirdone-third
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Cigarette Use in Past MonthAdolescents 12-17 Years of Age, USA
0
5
10
15
20
25
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
Percent
Source: SAMHSA
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Additional Statistical Resources
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Additional Statistical Resources
Hospitalization/morbidity data: Asthma, diabetes: Hospital discharge data files from each state Pesticide poisoning: State poison control centers
Risk factor information (obesity, smoking, drug use, health insurance, dental care):
Border Binational RFSS - 2005