The 130th Annual Meeting of APHA

Abstract #43377

Peter Kunstadter, PhD, Institute for Health Policy Studies, University of California, San Francisco, 3333 California, Suite 265, Box 0936, San Francisco, CA 94143, 415 476 4921, arttown@itsa.ucsf.edu

Despite an interest in reducing differentials in morbidity and mortality between ethnic groups, data bases for comparing mortality among small ethnic groups do not exist in the US. Distinctive last names allowed identification of 1018 death certificates of Hmong refugees in Fresno County. Cause, age and sex were established for 899. From 1980-1990 to 1996-2001 male-female ratio declined from 1.34 in 1980-1990 to 1.08. Proportion of deaths occurring under age 1 year declined from 30.3% to 4.3% of all deaths, while deaths at age >41 increased from 45.2 to 77.3% of all deaths. Deaths due to congenital, perinatal and birth-associated causes fell from 22.1% to 3.7% of all deaths and deaths due to infectious causes declined from 13.0% to 9.9% but deaths due to cancers and cardiovascular diseases increased from 16.5% to 22.0% and 19.5% to 32.9% respectively. External injuries and violence became the leading cause of deaths at ages 1-10 years, 11-20 years and 21-40 years.

Calculation of death rates is impossible given a rapidly changing and poorly enumerated population base, but changes in proportional rates are consistent with a rapid mortality transition from causes and ages of death characteristic of the SE Asian place of origin to the US place of destination and the associated changes in environment and behavior.

Learning Objectives:

• • List and identify changes in proportions of deaths by age and sex associated with different causes among Hmong refugees since 1980
  • Understand the implications of these changes for public health intervention programs directed at refugee and immigrant populations
  • Understand the method used to derive these data and the application of this method to subpopulations that are n

Keywords: Mortality, Refugees

Presenting author's disclosure statement:
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.