3026.0: Monday, October 22, 2001 - 12:30 PM

Abstract #21143

Public health priorities in North Carolina: The message changes with the measure

Christopher J. Mansfield, PhD, Matthew D. Curry, MA, Denise Kirk, MS, and Kevin H. Gross, PhD. Center for Health Services Research and Development, East Carolina University, Building "N", Physicians Quadrangle, Greenville, NC 27858, 252-816-2785, mansfieldc@mail.ecu.edu

Background. Although mortality rates are often used to determine priorities for public health intervention, Healthy People 2010 has focused attention on increasing span of life. We were interested to know how a focus on premature mortality might change public health priorities in North Carolina (NC). Method. Determine leading causes of mortality and premature mortality in NC between 1979 and 1998. Calculate crude mortality and premature mortality rates (measured as years of life lost before age 75) for the five leading causes over 20 years. Results. Heart disease, cancer, stroke, chronic obstructive pulmonary disease (COPD), and unintentional injury have been the leading causes of mortality since 1979. Mortality rates for heart disease, stroke, and injury have declined, while rates for COPD and cancer have increased. The mortality rate for COPD has exceeded the rate for unintentional injury since the mid-1990’s. The leading causes of premature mortality have changed considerably since 1979. Premature mortality rates for heart disease, unintentional injury, and perinatal causes have declined. The premature morality rate for cancer has increased and has exceeded the rate for heart disease since 1987. Rates of premature mortality for homicide and AIDS increased during the 1990’s. Currently, leading causes of premature mortality are cancer, heart disease, unintentional injury, perinatal causes, and homicide. Conclusions. Both mortality and premature mortality rates justify resource allocation for heart disease, cancer, and unintentional injury. However, a focus on premature mortality might lead to greater resource allocation for perinatal conditions, homicide, and AIDS, but less for COPD and stroke. See www.chsrd.med.ecu.edu

Learning Objectives: At the conclusion of the session, the learner will : 1. Understand how premature mortality is calculated. 2. How this metric can be used to guide resource allocation. 3. How priorities might change if this metric is used for targeting disease specific interventions.

Keywords: Public Health Policy, Healthy People 2000/2010

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
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.

Handout (.ppt format, 1650.0 kb)

The 129th Annual Meeting of APHA