YEARS OF POTENTIAL LIFE LOST: VALUABLE

INFORMATION, OR JUST MORE NUMBERS?

Kirk Bol, MSPH, Vital Statistics Unit, Health Statistics & Evaluation BranchColorado Department of Public Health and Environment

June 8, 2014NAPHSIS Annual

Meeting

Measuring mortality in Colorado Available methods…

Leading causes of death (based on counts) Age-adjusted and age-specific mortality

rates Life and healthy life expectancy Years of potential life lost (YPLL)

Leading causes of death

0

5,000

10,000

15,000

20,000

25,000

0.0

20.0

40.0

60.0

80.0

100.0

120.0

140.0

160.0

Deaths and age-adjusted rates for leading causes: Colorado residents, 2010-2012

N Adj. rateLeading causes of death

Num

ber

of

death

s

Age-a

dju

ste

d d

eath

rate

Age-adjusted death rates are per 100,000 populationSource: Vital Statistics, Health Statistics Unit, Colorado Department of Public Health and Environment

Leading causes of deathLeading causes of death by age group: Colorado residents, 2010-2012

Age group

Leading causes of deathFirst Second Third Fourth Fifth

Perinatal period conditions Birth defects Unintentional injuries Homicide/legal

interventionCertain other

intestinal infections

1-4 Unintentional injuries Birth defects Homicide/legal intervention Cancer

Other and unspecified infectious and

parasitic diseases

5-9 Unintentional injuries Cancer Influenza and pneumonia

Homicide/legal intervention

Chronic lower respiratory diseases

10-14 Unintentional injuries Suicide Cancer Birth defects Homicide/legal intervention

15-24 Unintentional injuries Suicide Homicide/legal intervention Cancer Heart disease

25-34 Unintentional injuries Suicide Cancer Homicide/legal intervention Heart disease

35-44 Unintentional injuries Suicide Cancer Heart disease Chronic liver disease and cirrhosis

45-54 Cancer Heart disease Unintentional injuries Suicide Chronic liver disease and cirrhosis

55-64 Cancer Heart disease Unintentional injuries Chronic lower respiratory diseases

Chronic liver disease and cirrhosis

65+ Heart disease Cancer Chronic lower respiratory diseases

Cerebrovascular diseases Alzheimers disease

Leading causes of deathLeading causes of death by age group: Colorado residents, 2010-2012

Age group

Leading causes of deathFirst Second Third Fourth Fifth

Perinatal period conditions Birth defects Unintentional injuries Homicide/legal

interventionCertain other intestinal

infections

1-4 Unintentional injuries Birth defects Homicide/legal intervention Cancer

Other and unspecified infectious and parasitic

diseases

5-9 Unintentional injuries Cancer Influenza and pneumonia

Homicide/legal intervention

Chronic lower respiratory diseases

10-14 Unintentional injuries Suicide Cancer Birth defects Homicide/legal intervention

15-24 Unintentional injuries Suicide Homicide/legal intervention Cancer Heart disease

25-34 Unintentional injuries Suicide Cancer Homicide/legal intervention Heart disease

35-44 Unintentional injuries Suicide Cancer Heart disease Chronic liver disease and cirrhosis

45-54 Cancer Heart disease Unintentional injuries Suicide Chronic liver disease and cirrhosis

55-64 Cancer Heart disease Unintentional injuries Chronic lower respiratory diseases

Chronic liver disease and cirrhosis

65+ Heart disease Cancer Chronic lower respiratory diseases

Cerebrovascular diseases Alzheimers disease

Life and healthy life expectancy

Tota

l

Fem

ale

Male

Tota

l

Fem

ale

Male

Tota

l

Fem

ale

Male

Tota

l

Fem

ale

Male

Infancy 25-29 years 45-49 years 65-69 years

0

10

20

30

40

50

60

70

80

90

Life expectancy and healthy life expectancy at se-lected ages by sex: Colorado residents, 2008-2010

Healthy life expectancy

Ye

ars

Error bars represent 95% confidence interval for life expectancy estimateSource: Vital Statistics, Health Statistics Section, Colorado Department of Public Health and Environment

Gaps

Mortality

Counts and

Rates

Life Expecta

ncy

Population Mortality

Defined as the years of potential life lost due to premature death.

Years of potential life lost

Years of potential life lost

12 46 58 67 67 70 80 82 87 890

1

Deaths: Colorado residents, 2010-2012

DeathsAge (years)

De

ath

Source: Vital Statistics, Health Statistics Unit, Colorado Department of Public Health and Environment

Yes

Years of potential life lost

1 2 3 4 5 6 7 8 9 100

65

12

4658

67 67 7080 82 87 89

Deaths: Colorado residents, 2010-2012

Deaths

Decedents

Ag

e (

ye

ars

)

Source: Vital Statistics, Health Statistics Unit, Colorado Department of Public Health and Environment

Years of potential life lost

1 2 3 4 5 6 7 8 9 100

65

12

4658

67 67 7080 82 87 89

Deaths and Years of Potential Life Lost before Age 65: Colorado residents, 2010-2012

Deaths

Decedents

Ag

e (

ye

ars

)

Source: Vital Statistics, Health Statistics Unit, Colorado Department of Public Health and Environment

Years of potential life lost

1 2 3 4 5 6 7 8 9 100

65

12

4658

67 67 7080 82 87 89

53

197

Deaths and Years of Potential Life Lost before Age 65: Colorado residents, 2010-2012

Deaths

Decedents

Ag

e (

ye

ars

)

Source: Vital Statistics, Health Statistics Unit, Colorado Department of Public Health and Environment

Years of potential life lost

0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60 63 66 69 72 75 78 81 84 87 90 93 96 990

65

Deaths and Years of Potential Life Lost before Age 65: Colorado residents, 2010-2012

Deaths

Decedents

Ag

e (

ye

ars

)

Source: Vital Statistics, Health Statistics Unit, Colorado Department of Public Health and Environment

Years of potential life lost

9 409 809 12091609200924092809320936094009440948095209560960096409680972097609800984098809920996090

65

Deaths and Years of Potential Life Lost before Age 65: Colorado residents, 2010-2012

DeathsDecedents

Ag

e (

ye

ars

)

Source: Vital Statistics, Health Statistics Unit, Colorado Department of Public Health and Environment

Years of potential life lost

9 409 809 12091609200924092809320936094009440948095209560960096409680972097609800984098809920996090

65

Deaths and Years of Potential Life Lost before Age 65: Colorado residents, 2010-2012

DeathsDecedents

Ag

e (

ye

ars

)

Source: Vital Statistics, Health Statistics Unit, Colorado Department of Public Health and Environment

Years of potential life lost

9 409 809 12091609200924092809320936094009440948095209560960096409680972097609800984098809920996090

75

Deaths and Years of Potential Life Lost before Age 75: Colorado residents, 2010-2012

Deaths

Decedents

Ag

e (

ye

ars

)

Source: Vital Statistics, Health Statistics Unit, Colorado Department of Public Health and Environment

Years of potential life lost

9 429 849 1269168921092529294933693789420946295049546958896309672971497569798984098829924996690

81

Deaths and Years of Potential Life Lost before Life Expectancy:

Colorado residents, 2010-2012

Deaths

Decedents

Ag

e (

ye

ars

)

Source: Vital Statistics, Health Statistics Unit, Colorado Department of Public Health and Environment

Years of potential life lost

9 429 849 1269168921092529294933693789420946295049546958896309672971497569798984098829924996690

55

Deaths and Years of Potential Life Lost before Age 55:

Colorado residents, 2010-2012

Deaths

Decedents

Ag

e (

ye

ars

)

Source: Vital Statistics, Health Statistics Unit, Colorado Department of Public Health and Environment

Years of potential life lost

0

20,000

40,000

60,000

80,000

100,000

120,000

0.0

100.0

200.0

300.0

400.0

500.0

600.0

700.0

800.0

900.0

Years of potential life lost before age 65 (YPLL-65) and age-adjusted rates for leading causes: Colorado

residents, 2010-2012

Leading causes of YPLL-65

YP

LL-6

5

Age-a

dju

ste

d Y

PL-6

5 r

ate

Age-adjusted YPLL-65 rates are per 100,000 populationSource: Vital Statistics, Health Statistics Unit, Colorado Department of Public Health and Environment

Years of potential life lost

Leading causes of YPLL-65 by race/ethnicity: Colorado residents, 2010-2012

Race/ethnicityLeading causes of years of potential life lost before age 65 (YPLL-65)

First Second Third Fourth Fifth

All races/ethnicities

Unintentional injuries Cancer Suicide Heart disease Perinatal period

conditions

White, Non-Hispanic

Unintentional injuries Cancer Suicide Heart disease Perinatal period

conditions

White, Hispanic Unintentional injuries

Perinatal period conditions Cancer Suicide Heart disease

Black/African American

Unintentional injuries

Perinatal period conditions

Homicide/legal intervention Cancer Heart disease

Asian/Pacific Islander Cancer Suicide Unintentional

injuries Birth defects Heart disease

American Indian/Native

AlaskanUnintentional

injuries SuicideChronic liver disease and

cirrhosisCancer Heart disease

Years of potential life lost

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

0.0

1,000.0

2,000.0

3,000.0

4,000.0

5,000.0

6,000.0

Years of potential life lost before age 65 (YPLL-65) and age-adjusted rates by race/ethnicity: Colorado

residents, 2010-2012

Age-adjusted rate YPLL-65

Race/ethnicity

YP

LL-6

5

Age-a

dju

ste

d Y

PL-6

5 r

ate

Age-adjusted YPLL-65 rates are per 100,000 populationSource: Vital Statistics, Health Statistics Unit, Colorado Department of Public Health and Environment

Years of potential life lost

Leading causes of YPLL-65 by geographic area poverty: Colorado residents, 2010-2012

Area-based poverty status

Leading causes of years of potential life lost before age 65 (YPLL-65)

First Second Third Fourth Fifth

<10% Unintentional injuries Cancer Suicide Heart disease Perinatal period

conditions

10-19.9% Unintentional injuries Cancer Suicide Heart disease Perinatal period

conditions

20-29.9% Unintentional injuries Cancer Heart disease Suicide Perinatal period

conditions

30%+ Unintentional injuries

Perinatal period conditions Suicide Heart disease Homicide/legal

intervention

Years of potential life lost

<10% 10-19.9% 20-29.9% 30%+0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

0.0

1,000.0

2,000.0

3,000.0

4,000.0

5,000.0

6,000.0

Years of potential life lost before age 65 (YPLL-65) and age-adjusted rates by area-based poverty status:

Colorado residents, 2010-2012

Age-adjusted rate YPLL-65

Area-based poverty status

YP

LL-6

5

Age-a

dju

ste

d Y

PL-6

5 r

ate

Age-adjusted YPLL-65 rates are per 100,000 populationArea based poverty represents the % of population in poverty in the decedent's census tract of residence.Source: Vital Statistics, Health Statistics Unit, Colorado Department of Public Health and Environment

Years of potential life lost

Leading causes of death by Health Statistics Region: Colorado residents, 2010-2012Region of residence Leading causes of years of potential life lost before age 65 (YPLL-65)

First Second Third Fourth FifthColorado Unintentional injuries Cancer Suicide Heart disease Perinatal period conditions

HSR 1 Unintentional injuries Cancer Suicide Heart disease Perinatal period conditionsHSR 2 Unintentional injuries Cancer Suicide Heart disease Perinatal period conditionsHSR 3 Cancer Unintentional injuries Suicide Perinatal period conditions Heart diseaseHSR 4 Unintentional injuries Suicide Cancer Heart disease Perinatal period conditionsHSR 5 Unintentional injuries Cancer Suicide Heart disease Homicide/legal interventionHSR 6 Unintentional injuries Cancer Perinatal period conditions Suicide Heart disease

HSR 7 Unintentional injuries Heart disease Cancer Suicide Chronic liver disease and cirrhosis

HSR 8 Unintentional injuries Suicide Cancer Heart disease Chronic liver disease and cirrhosis

HSR 9 Unintentional injuries Suicide Cancer Heart disease Chronic liver disease and cirrhosis

HSR 10 Unintentional injuries Cancer Suicide Heart disease Perinatal period conditionsHSR 11 Unintentional injuries Cancer Suicide Perinatal period conditions Heart diseaseHSR 12 Unintentional injuries Suicide Cancer Perinatal period conditions Heart disease

HSR 13 Unintentional injuries Cancer Heart disease Suicide Chronic lower respiratory diseases

HSR 14 Unintentional injuries Cancer Suicide Heart disease Perinatal period conditionsHSR 15 Unintentional injuries Cancer Suicide Perinatal period conditions Heart diseaseHSR 16 Suicide Unintentional injuries Cancer Heart disease Perinatal period conditionsHSR 17 Unintentional injuries Cancer Suicide Heart disease Perinatal period conditionsHSR 18 Unintentional injuries Cancer Suicide Perinatal period conditions Heart diseaseHSR 19 Unintentional injuries Suicide Cancer Heart disease Homicide/legal interventionHSR 20 Unintentional injuries Cancer Suicide Heart disease Perinatal period conditions

HSR 21 Unintentional injuries Cancer Suicide Heart disease Chronic liver disease and cirrhosis

Years of potential life lost

HSR 1HSR 2

HSR 3HSR 4

HSR 5HSR 6

HSR 7HSR 8

HSR 9

HSR 10

HSR 11

HSR 12

HSR 13

HSR 14

HSR 15

HSR 16

HSR 17

HSR 18

HSR 19

HSR 20

HSR 210

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

0.0

1,000.0

2,000.0

3,000.0

4,000.0

5,000.0

6,000.0

Years of potential life lost before age 65 (YPLL-65) and age-adjusted rates by Health Statistics: Colorado

residents, 2010-2012

Age-adjusted rate YPLL-65Health Statsitics Region of residence

YP

LL-6

5

Age-a

dju

ste

d Y

PL-6

5 r

ate

Age-adjusted YPLL-65 rates are per 100,000 populationSource: Vital Statistics, Health Statistics Unit, Colorado Department of Public Health and Environment

Years of potential life lost

63.8% of YPLL-65 during 2010-2012 attributed to 5 leading causes Between 60%-69% across all

race/ethnicities (2010-2012) Between 57%-67% across all area-based

poverty levels (2007-2011) Between 58%-82% across Colorado’s

Health Statistics Regions (2010-2012)

Filling the gaps…

Mortality

Counts and

Rates

Life Expecta

ncy

Years of Potentia

l Life Lost

Population Mortality

FOR INQUIRIES OR MORE INFORMATION, PLEASE CONTACT THE VITAL STATISTICS UNIT, HEALTH STATISTICS & EVALUATION

BRANCH,COLORADO DEPARTMENT OF PUBLIC HEALTH AND

ENVIRONMENT4300 CHERRY CREEK DRIVE SOUTHDENVER, COLORADO 80246-1530

P: (303) 692-2160 | (800) 886-7689 | F: (303) 691-7821CDPHE.HEALTHSTATISTICS@STATE.CO.US |

WWW.CHD.DPHE.STATE.CO.US

Kirk Bol, MSPH, Vital Statistics Unit, Health Statistics & Evaluation BranchColorado Department of Public Health and Environment

June 8, 2014NAPHSIS Annual

Meeting

Colorado Health Statistics Regions