Background. Though elimination of health disparities is one of the two overarching goals set for the nation in Healthy People 2010, there is scant empirical description or understanding of disparities at the county and sub-state regional levels. We measure, map, and analyze racial and geographic disparity in mortality for leading causes of death in North Carolina. Method. We calculate race and gender specific, age-adjusted mortality rates (using U.S. 2000 Standard Million) for leading causes of death, compute disparity ratios over 20 years, and use Geographic Information System (GIS) software to map disparities by county, by health service region, and by rural-urban region of the state. Disparity is mapped in three dimensions, depicting both percentage difference in mortality by race and slope of the disparity trend line. Total burden, i.e., numbers of deaths by race, is also described cartographically. Results. Mortality rates are declining but racial disparities are substantial and growing. Though Eastern North Carolina has a higher proportion of non-Whites, racial disparities are greater in the rest of the state for most leading causes of death. Variation in the non-White versus White disparity among the counties is great, ranging from 100 percent less to over 1000 percent greater. Geographic patterns are evident. Conclusions. The cartographic display of these data greatly aids understanding of the scale and nature of disparity and provides compelling argument for interventions targeted to geographic areas. The geographic description of disparity can quickly and easily inform health policymakers.
Learning Objectives: At the conclusion of the session, the participant (learner) will be able to: 1. Describe innovative ways of measuring, depicting, and analyzing disparities in health. 2. Recognize the degree and variation of disparity likely to be found at the county, regional and health service area level. 3. Evaluate and discuss methodological issues and directions of further research
Keywords: Healthy People 2000/2010, Geographic Information Systems
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: DHHS. Public Health Service. Office of Disease Prevention and Health Promotion
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.