What does this indicator measure?
This indicator measures the racial/ethnic disparity among the leading causes of death in Dallas County, as reported by the Texas Department of State Health Services (DSHS). Age-adjusted rates of death are calculated for each racial/ethnic group separately, per 100,000 individuals of each race/ethnicity. The rates are adjusted for differences in the population’s age structure according to the U.S. 2000 Standard Million. Texas DSHS classifies the causes of death according to the ICD-10 coding system. Texas DSHS uses self-reported race/ethnicity designations, in which all Hispanic individuals are grouped together for comparison with non-Hispanic white and non-Hispanic black individuals.
Why is this indicator important?
Extreme disparities in health outcomes fall along racial/ethnic lines across the United States. Certain diseases and conditions are affected by genetic predispositions that are disproportionately concentrated among one racial/ethnic group or another—yet this only a relatively minor factor in health disparities. Enduring social and economic inequalities that also fall largely along racial/ethnic lines are a far greater problem. Racial/ethnic patterns in socioeconomic status, education, and access to health care combine to produce differential health outcomes. Studies have shown that racial minorities are more likely than whites to be uninsured and identify hospitals as their primary healthcare provider. Numerous studies have also indicated that racial minorities “receive less ambulatory, hospital, and disease-specific care than whites and experience greater barriers in their interaction with the medical care system” (Shi, 1075). Insofar as good health is a basic component of quality of life, eliminating health disparities is of paramount importance to a community.
How are we doing?
Overall, blacks suffer higher age-adjusted death rates in 7 of the 12 leading causes of death, with large disparities in many instances, particularly in the case of homicide, HIV, heart disease, cancer, diabetes, and stroke/cerebrovascular diseases. Hispanics generally have the lowest death rates, especially among the two biggest killers (heart disease and cancer), but are more susceptible than whites in some chronic diseases, such as diabetes. The lack of primary care experienced by Hispanics, who experience greater barriers in accessing the health care system, is of particular concern with respect to diabetes. Whites suffered the highest death rates from suicide and Alzheimer’s disease.
Leading Causes of Death by Race/Ethnicity, Age-Adjusted Rate per 100,000 Population,
Dallas County, 2004 |
Cause of Death | All Races | White | Black | Hispanic |
Diseases of the Heart | 229.8 | 223.4 | 331.6 | 157.9 |
Cancer | 187.7 | 187.8 | 271.8 | 118.6 |
Stroke and Cerebrovascular Diseases | 63.2 | 56.6 | 96.3 | 53.7 |
Chronic Lower Respiratory Diseases | 38.9 | 46.8 | 27.6 | * |
Accidents | 36.1 | 39.3 | 35.3 | 29.7 |
Alzheimer's Disease | 30.9 | 33.8 | 33.3 | * |
Diabetes Mellitus | 22.9 | 17.4 | 50.4 | 28.2 |
Influenza and Pneumonia | 16.9 | 16.2 | 25.6 | 13.7 |
Kidney Disease | 16.3 | 12.9 | 29.6 | 19.1 |
Assault (Homicide) | 11.3 | 4.4 | 26.7 | 9.2 |
Intentional Self-Harm (Suicide) | 9.5 | 13.7 | 4.6 | 4.3 |
Chronic Liver Disease and Cirrhosis | 8.8 | 8.6 | 8.1 | 13.8 |
Human Immunodeficiency Virus (HIV) Disease | 8.6 | 8.2 | 17 | 6.1 |
Source:
Texas Department of State Health Services (DSHS).
An * indicates data is not available or unreliable due to the very small number of cases.
References
Shi, L. (1999). Experience of Primary Care by Racial and Ethnic Groups in the United States. Medical Care. 37(10), 1068-1077.
Collins, F. (2004). What we do and don’t know about ‘race’, ‘ethnicity’, genetics and health at the dawn of the genome era. Nature Genetics Supplement. 36(11). 513-515.
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