3176.0: Monday, October 22, 2001 - Board 2

Abstract #24775

Assessing health disparities at the county level: A comparison of mortality and premature mortality rates

Christopher J. Mansfield, PhD, Kevin H. Gross, PhD, Matthew D. Curry, MA, and Denise Kirk, MS. 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. Many states and counties are responding to Healthy People 2010 with community-based efforts to increase lifespan and eliminate health disparities. Although mortality rates are often used to measure progress towards these goals, premature mortality rates would focus attention on lifespan. We use both measures to assess and compare health problems and disparities in a typical metropolitan and a typical rural county in North Carolina. Method. Determine the three leading causes of mortality and premature mortality for each county between 1995 and 1998. Calculate five-year average, age-adjusted mortality and premature mortality rates for these causes by county and race. Assess disparities within and between counties using rate ratios. Results. Both counties have the same leading causes of mortality (heart disease, cancer, and stroke) and premature mortality (cancer, heart disease, unintentional injuries). The less populous rural county has a greater number of deaths, as well as much higher rates of mortality and premature mortality. Within each county, non-whites have higher mortality and premature mortality rates than whites for each cause, but racial disparities in mortality and premature mortality are greater in the metropolitan county for each cause, except stroke. For non-whites, mortality and premature mortality rates are similar in both counties, but rural whites have greater rates than metropolitan whites. This finding explains the greater racial disparities in the metropolitan county and the overall disparities between the counties. Conclusions. Either mortality or premature mortality can be used to assess disparities, but premature mortality, a measure incorporating lifespan, is a better metric.

See www.chsrd.ecu.edu

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1) List measures that can be used in community health assessment 2) Describe the differences between mortality and premature mortality rates 3) Compare and contrast the health needs of an urban and a rural county.

Keywords: Community Health Assessment, Healthy People 2000/2010

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.

The 129th Annual Meeting of APHA