The Arizona factbook on men's health

              Arizona Fact Book on Men’s Health
Table of Contents
Table of Tables
1
Acknowledgements
7
Introduction
8
1. Mortality
9
Table 1.1: Age-Adjusted Mortality Rates for All Causes by Gender and Year, Arizona, 1990-2000.
9
Table 1.2: Leading Cause of Death for Males by Race/Ethnicity, U.S., 1999.
9
Table 1.3: Age-Adjusted Mortality Rates by Gender and Year for Selected Leading Causes of Death, Arizona, 1990-2000.
11
Table 1.4: Mortality Rates for the Five Leading Causes of Death among Young Adults (20-44 Years) by Gender, Arizona, 1990-2000.
13
Table 1.5: Mortality Rates or the Five Leading Causes of Death among Middle-Aged Adults (45-64 years) by Gender, Arizona, 1990-2000.
14
Table 1.6: Mortality Rates or the Five Leading Causes of Death among Elderly (65 Years and Older) by Gender, Arizona, 1990-2000.
15
Table 1.7: Age-Adjusted Mortality Rates for Selected Causes of Death by Urban/Rural Area and Gender, Arizona, 2000.
16
Table 1.8: Mortality Rates by Gender and Year among Selected Age Groups, Arizona, 1990-2000.
17
Table 1.9: Age-Adjusted Mortality Rates for Chronic Lower Respiratory Diseases by Gender and Year, Arizona, 1990-2000.
17
Table 1.10: Age-Adjusted Mortality Rates for Influenza and Pneumonia by Gender and Year, Arizona, 1994-2000.
17
Table 1.11: Age-Adjusted Mortality Rates for Alzheimer’s Disease by Gender and Year, Arizona, 1994-2000.
18
Table 1.12: Average Age at Death from All Causes by Gender and Ethnicity, Arizona, 1990-2000.
18
Table 1.13: Percent of Deaths before Expected Years of Life Reached by Gender and Ethnicity, Arizona, 1990-2000.
19
2. Chronic Diseases
21
Table 2.1: Cardiovascular Disease Mortality Trends for Males and Females, U.S., 1990-1999.
21
Table 2.2: Cardiovascular Disease Mortality Trends, Arizona, 1990-2000.
22
Table 2.3: Prevalence of Cardiovascular Diseases by Age and Sex, U.S., 1988-94.
22
Table 2.4: Age-Adjusted Mortality Rates for Diseases of Heart by Gender and Year, Arizona, 1990-2000
22
Table 2.5: Prevalence of Coronary Heart Disease by Age and Sex, U.S., 1988-94.
22
1
Table 2.6: Prevalence of Congestive Heart Failure by Age and Sex, U.S., 1988-94.
23
Table 2.7: Annual Number of Diagnosed Heart Attack by Age and Sex, U.S., 1987-1994.
23
Table 2.8: Number of Deaths from Diseases of the Heart by Category, Gender and Year, Arizona, 1990-2000.
24
Table 2.9: Prevalence of High Blood Pressure in Americans Age 20 and Older by Age and Sex, U.S. 1988-94.
25
Table 2.10: Age-Adjusted Prevalence Trends for High Blood Pressure, Ages 20-74 by Race/Ethnicity, Sex and Survey Year, U.S., 1976-80 and 1988-94.
25
Table 2.11: Prevalence of High Blood Pressure by Age, Sex, and Race, U.S., 1988-94.
25
Table 2.12: Prevalence of Stroke by Age and Sex, U.S., 1988-94.
26
Table 2.13: Age-Adjusted Mortality Rates for Cerebrovascular Disease by Gender and Year, Arizona, 1990-2000.
26
Table 2.14: Age-Adjusted Mortality Rates for Diabetes by Gender and Year, Arizona, 1990-2000.
26
Table 2.15: Age-Adjusted Mortality Rates for Diabetes by Race/Ethnicity, Arizona, 1980, 1990, 2000.
27
Table 2.16: Prevalence of Diagnosed Diabetes, per 1000 Population by Sex and Age, U.S., 1990-1996.
27
Table 2.17: Incidence of Diabetes per 1000 Population by Sex and Age, U.S. 1990-1996.
28
Table 2.18: Number and Percentage of Adults Who Reported Arthritis by Sex, Arizona, 2000.
28
3. Cancer
29
Table 3.1: Age-Adjusted Mortality Rates for Malignant Neoplasms (Cancer) by Gender and Year, Arizona, 1990-2000
29
Table 3.2: Age-Adjusted Mortality Rates for Cancer by Race/Ethnicity, Arizona, 1980, 1990, 2000.
29
Table 3.3: Age-Specific Malignant Neoplasm Mortality Rates, All Causes by Age Group and Sex, Arizona, 1997.
30
Table 3.4: Age-Specific Incidence Rates, All Sites by Age Group and Sex, Arizona, 1997.
30
Table 3.5: Age-Adjusted Incidence Malignant Neoplasm Mortality Rates, All Causes by County of Residence and Sex, Arizona, 1997.
31
Table 3.6: Age-Adjusted Incidence Rates for Invasive Cancer, All Sites, by County of Residence and Sex, Arizona, 1997.
31
Table 3.7: Death Rates for the Five Leading Causes of Cancer Related Deaths, Arizona, 2000.
32
Table 3.8: Age-Adjusted Mortality Rates for Selected Cancer Related Causes of Death by Race/Ethnicity, Arizona, 2000.
32
Table 3.9: Incidence and Mortality Rates by Site, Race, and Ethnicity, U.S., 1990-1997.
33
Table 3.10: Cancer Death Rates by Site, Arizona, U.S., 1993-1997.
34
2
Table 3.11: Cancer Incidence Rates by Site, Arizona, U.S., 1993-1997.
34
Table 3.12: Age-Adjusted Mortality Rates for the Top Five Cancers for Men, Arizona, 1990-1997.
35
Table 3.13: Age-Adjusted Incidence Rates for the Top Five Cancers for Men, Arizona, 1990-1997.
35
Table 3.14: Ten Most Common Invasive Cancer Types (Males).
35
Table 3.15: Ten Most Common Invasive Cancer Types (Females).
36
Table 3.16: Frequency of Invasive Cancer Cases by Site and Sex, Arizona, 1997.
37
Table 3.17: Probability of Developing Invasive Cancers over Selected Age Intervals, by Sex, U.S., 1995-1997.
38
Table 3.18: Annualized Incidence Rates of Prostate Cancer by County, 1995-1997.
39
Table 3.19: Annualized Mortality Rates of Prostate Cancer by County, 1995-1997.
39
4. Injury
40
Table 4.1: Age-Adjusted Mortality Rates for Accidents (unintentional injuries) by Gender and Year, Arizona, 1990-2000.
40
Table 4.2: Age-Adjusted Mortality Rates for Total Injury Deaths by Gender and Year, Arizona, 1990-2000.
40
Table 4.3: Age-Adjusted Mortality Rates for Intentional Self-Harm (Suicide) by Gender and Year, Arizona, 1990-2000.
41
Table 4.4: Age-Adjusted Mortality Rates for Suicide by Race/Ethnicity Group and Gender, Arizona, 1990 and 2000.
41
Table 4.5: Suicide Mortality Rates by Age Group and Gender, Arizona, 2000.
41
Table 4.6: Rates of Firearm-Related Fatalities by Gender and Year, Arizona, 1990-2000.
42
Table 4.7: Firearm-Related Death Rates by Gender and Race/Ethnicity, Arizona, 2000.
42
Table 4.8: Firearm-Related Death Rates by Age Group and Gender, Arizona, 2000.
42
Table 4.9: Age-Adjusted Mortality Rates for Assault (Homicide) by Gender and Year, Arizona, 1990-2000.
43
Table 4.10: Number of Homicide Deaths by Gender, Age Group and Year, Arizona, 1990-2000.
43
5. Mental Health and Substance Abuse
44
Table 5.1: Estimated Number and Percent Distribution of Prevalence of 12-Month Mental Health and Substance Abuse Problem by Gender.
44
Table 5.2: Percentages of Persons Aged 18 or Older Who Reported Receiving Mental Health Services in the Past Year, U.S., 2000.
45
Table 5.3: Percentages Reporting Past Month Use of Any Illicit Drug and Alcohol Among Persons Aged 18 or Older, by Receipt of and Perceived Need for Mental Health Treatment/Counseling, U.S., 2000.
45
Table 5.4: Rate per 100,000 U.S. Civilian Population of Admissions, by Race/Ethnicity, Gender, and Type of Less than 24-Hour Care Program, U.S., 1997.
46
Table 5.5: Rate per 100,000 U.S. Civilian Population of Persons under Care, by
47
3
Race/Ethnicity, Gender, and Type of Less than 24-Hour Care Program, U.S., 1997.
Table 5.6: Rate per 100,000 U.S. Civilian Population of Admissions by Race/Ethnicity, Gender, and Type of Residential Care Program, U.S., 1997.
48
Table 5.7: Rate per 100,000 U.S. Civilian Population of Persons under Care by Race/Ethnicity, Gender, and Type of Residential Care Program, U.S. 1997.
49
Table 5.8: Rate per 100,000 U.S. Civilian Population of Admissions, by Race/Ethnicity, Gender, and Type of Inpatient Psychiatric Care Program, U.S., 1997.
50
Table 5.9: Rate per 100,000 U.S. Civilian Population of Admissions, by Race/Ethnicity, Gender, and Type of Inpatient Psychiatric Care Program, U.S., 1997.
51
Table 5.10: Percentage Current Smokers, U.S. and Arizona, 1990-2000.
52
Table 5.11: Percentages Reporting Lifetime, Past Year, and Past Month Use of Cigarettes Among Persons Aged 18 or Older, U.S., 1999 and 2000.
53
Table 5.12: Percentages Reporting Lifetime, Past Year, and Past Month Use of Any Tobacco Product Among Persons Aged 18 or Older, U.S., 1999 and 2000.
53
Table 5.13: Percentages Reporting Lifetime, Past Year, and Past Month Use of Various Drugs Among Persons Aged 18 and Older, U.S. 1999 and 2000.
54
Table 5.14: Percentages Reporting Lifetime, Past Month Alcohol Use, Past Month “Binge” Alcohol Use, and Past Month Heavy Alcohol Use Among Persons Aged 18 or Older, U.S., 1999 and 2000.
54
Table 5.15: Percentage Reporting Chronic Drinking, U.S. and Arizona, 1990-2000.
55
Table 5.16 Percentages Reporting Driving Under the Influence of Any Illicit Drug or Alcohol in the Past Year Among Persons Aged 18 or Older, U.S., 1999 and 2000.
55
Table 5.17: Drug-Related Death Rates by Mortality Category and Gender, Arizona, 2000.
56
Table 5.18: Drug-Related Death Rates by Type of Drug and Gender, Arizona, 2000.
56
Table 5.19: Drug-Related Mortality by Gender and Year, Arizona, 1990-2000.
57
6. Sexually Transmitted Diseases
58
Table 6.1: Reported Rates of Chlamydia, Gonorrhea, and Syphilis, Arizona and U.S., 1996-2000.
58
Table 6.2: Rates of Reported Cases of Gonorrhea, Chlamydia, Early Syphilis and Genital Herpes by Age and Gender, Arizona, 2000.
59
Table 6.3: Reported Cases of AIDS by Year of Diagnosis and Gender, Arizona, 1990-2000.
60
Table 6.4: AIDS Cases by Age Group, Exposure Category, and Sex, Reported through June 2001, U.S.
61
Table 6.5: HIV Infection Cases by Age Group, Exposure Category, and Sex, Reported through June 2001, from the 36 Areas with Confidential HIV Infection Reporting, U.S.
62
4
Table 6.6: Male Adult/Adolescent AIDS Cases by Exposure Category and Race/Ethnicity, Reported through June 2001, U.S.
63
Table 6.7: Male Adult/Adolescent HIV Infection Cases by Exposure Category and Race/Ethnicity, Reported through June 2001, from the 34 Areas with Confidential HIV Infection Reporting, U.S.
65
Table 6.8: Estimated Number of Males Living with AIDS, by Exposure Category and Year, 1993 through 2000, U.S.
67
Table 6.9: Estimated Number of Deaths among Males with AIDS, by Exposure Category and Year of Death, 1993 through 2000, U.S.
67
7. Sexual Dysfunction
68
Table 7.1: Prevalence of Erectile Dysfunction in the United States.
69
Table 7.2: Estimated Number of New Cases of Erectile Dysfunction Annually in the U.S.; Massachusetts Male Aging Study Rates and 1990 U.S. Census Data (Men, Aged 40-69).
69
Table 7.3: Percentage of Men Over 45 Years Old Who Have Sought Treatment for Sexual Problems.
69
8. Other Factors Affecting Health
70
Table 8.1: Body Mass Index Classification.
70
Table 8.2: Trends in Obesity, Adults Aged 20-74, U.S., 1971-1974 to 1988-1994.
70
Table 8.3: Percent Obese, U.S. and Arizona, 1990-2000.
71
Table 8.4: Prevalence of Male Obesity by Demographic and Behavioral Characteristics, U.S., 1994 and 1998.
72
Table 8.5: Percent Overweight, U.S. and Arizona, 1990-2000.
73
Table 8.6: Overweight Prevalence by Gender, Adults, U.S., 1998.
73
Table 8.7: Percentage of Adults Aged 18+ years reporting no Participation in Leisure-Time Physical Activity, by Various Demographic Characteristics, U.S.
74
Table 8.8: Percentage of Adults Aged 18+ years Reporting Participation in Regular, Sustained Physical Activity by Various Demographic Characteristics, U.S.
75
Table 8.9: Percentage of Adults Aged 18+ years Participating in Regular, Vigorous Physical Activity by Various Demographic Characteristics, U.S.
76
Table 8.10: Percent Reporting No Leisure Time Physical Activity, U.S. and Arizona, 1990-2000.
77
Table 8.11: Prevalence of Moderate or Vigorous Physical Activity in Americans Age 20 and Older by Sex, Race/Ethnicity and BMI, U.S., 1988-1994.
77
Table 8.12: Percentage of Adults Aged 18+ Years Reporting Participation in Selected Common Physical Activities in the Prior 2 Weeks, by Sex and Age, U.S., 1991.
78
Table 8.13: Percentage of Adults Aged 18+ Years Reporting Participation in Any Strengthening Activities or Stretching Exercises in the Prior 2 Weeks, by Various Demographic Characteristics, U.S., 1991.
79
5
Table 8.14: Trends in the Percentage of Adults Aged 18+ Years Reporting Participation in No Activity; Regular, Sustained Activity; and Regular, Vigorous Activity, by Sex, U.S., 1985-1994.
80
Table 8.15: Percentage Reporting Not Eating Enough Fruits and Vegetables, U.S. and Arizona, 1990-2000.
81
References
82
6
Acknowledgements
This volume, The Arizona Fact Book on Men’s Health, is one of several Fact Books published by Arizona State University West’s Partnership for Community Development to inform public policy and assist public and community-based organizations as they develop programs and services to address issues relevant to residents of Arizona. The Fact Book’s intent is not to advocate for particular programs or political agendas, but to present data and other information that may be used as a basis for decision-making. While not an exhaustive treatment of men’s health issues (in some instances statistics that would prove useful have not been compiled), this book attempts to provide a current examination of the set of issues facing this population in Arizona today.
I am appreciative of the contributions of Mr. Rudy Navarro, who researched, compiled, and developed this volume. In addition, Ms. Nicole Kruse of the College of Human Services contributed to the development of this book. Mr. Geoffrey Boyarsky provided design, production, and layout preparation.
In addition to the individuals who worked to develop and produce The Arizona Fact Book on Men’s Health, it is important to recognize the support of its sponsor. St. Luke’s Health Initiative provided generous funding and support that made the development of this volume possible and I am grateful for the value to the State of Arizona they saw in producing a volume of this nature.
John Hultsman, Re.D.
Director, Partnership for
Community Development
College of Human Services
Arizona State University West
September, 2002
7
Introduction
This fact book is about the health and wellness of men in Arizona and the United States. Health is a difficult and complicated condition to describe and measure and no one statistic can adequately represent a population’s overall wellbeing. This volume conceptualizes men’s health as a combination of multiple domains related to physical, behavioral, and psychological functioning. Using this approach, information is presented on a variety of indicators or markers of health such as mortality, disease, and behaviors or conditions that have been found to contribute to illness.
Chapters are organized around health topics such as mortality, cancer, or mental health. Data on various aspects of the chapter topics are displayed in tables. All information has come directly from existing sources and has been modified only to accommodate the layout of the fact book. In some cases, percentages have been computed to better illustrate change over time or differences between statistics and certain information may be highlighted. The significance of a chapter topic may also be discussed. These computations and statements are meant to provide a context for the reader; attempts to interpret data to argue a point or position have been avoided.
In general, data is presented in the form of percentages or rates so that comparisons can be made between time periods or population groups. When possible, statistics for both Arizona and the Unites States are provided. While this book is about the status of men’s health, data on female health is often displayed as well. Again, this is provided for comparison purposes so that the significance of the data becomes more apparent.
It is important that the data in this fact book be perceived as credible and accurate. Most of the information was taken from government agencies that collect this data on a regular basis or articles published in scientific, peer-reviewed journals. Brief citations for the source of the data are provided at the bottom of each table and are interspersed throughout the narrative. When available, Internet addresses that correspond to these citations will be found in the References section at the end of the fact book. The reader is encouraged to investigate the Internet resources for additional information. Data in some tables come from a variety of sources that were combined by another organization into a single table. The source cited in the fact book is the publication from which the table was taken. Readers may access the cited publication on-line to see what other sources may have been used to obtain the data presented in the table.
Two terms are frequently used in the fact book and should be defined. Prevalence refers to the occurrence of a condition in a population at a given point in time. Incidence refers to the number of new cases of a condition in a population in a period of time, usually one year.
8
1. Mortality
The causes of death and the age at which people die are important measures of a community’s health. These data are also some of the most regularly collected and accurate information available about the overall health of a population.
This section reports mortality rates for various populations, leading causes of death among people in Arizona and the U.S., and mortality rate trends for selected diseases. Mortality information specific to cardiovascular disease and cancer will be found in subsequent sections.
According to Table 1.1, over the past two years, mortality rates for both men and women have increased with men experiencing a smaller increase (9.1 percent) than women (9.7 percent). Still, the mortality rate for men in 2000 was 941.1 per 100,000 persons compared to 654.6 per 100,000 persons for women. This represents a mortality rate for men that is 43.7 percent higher than the mortality rate for women.
Table 1.1: Age-Adjusted Mortality Rates (Number of Deaths per 100,000 Persons Adjusted to the 2000 Standard U.S. Population) for All Causes by Gender and Year, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Male
1056.7
1028.9
1054.7
1075.2
1049.8
966.0
958.8
916.7
860.3
896.9
941.1
Female
666.4
661.0
656.3
691.4
681.7
659.1
652.8
641.2
596.2
624.8
654.6
Both
839.9
825.5
834.3
865.0
850.1
804.8
796.4
771.8
720.9
752.8
785.6
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
The leading causes of death in the U.S. for men by racial and ethnic origin are presented in Table 1.2. In 1999, diseases of the heart and stroke and cancer were the leading causes of death for all groups. Chronic lower respiratory diseases such as emphysema and chronic bronchitis were the third leading cause of death for White and Asian/Pacific Islander males. It is interesting to note that homicides were a leading cause of death for Black and Hispanic men while HIV/AIDS was a leading cause of death for Black males.
Table 1.2: Leading Cause of Death for Males by Race/Ethnicity, U.S., 1999.
White
Black
Hispanic
Asian/Pacific Islander
American Indian/Alaska Native
Diseases of the heart and stroke
36.1
31.2
28.2
36.2
25.2
Cancer
24.6
22.5
18.4
25.3
15.6
Chronic Lower Respiratory Disease
5.7
3.9
Accidents
5.3
6.0
11.3
5.3
14.6
Diabetes Mellitus
2.5
4.0
2.9
5.3
Assault (homicide)
4.3
4.1
HIV (AIDS)
3.8
Chronic liver disease and cirrhosis
4.9
Source: American Heart Association, 2001. 2002 Heart and Stroke Statistical Update.
9
Table 1.3 presents mortality rate trends for leading causes of death in Arizona. Note that cardiovascular disease includes diseases of the heart as well as diseases that affect the veins and other vessels that transport fluids in the body. Diseases of the heart refer to conditions that affect the heart itself. Similar to national statistics, heart disease, stroke (cerebrovascular disease), and cancer (malignant neoplasms) are the leading causes of death for Arizonans accounting for 54.8 percent of total deaths in 2000 (Arizona Department of Health Services, 2001). In 2000, the risk of death from heart disease for males was 59.5 percent greater than the risk of death from heart disease for females. A man’s risk of dying from cancer in 2000 was 40 percent greater than a Men’s risk. A man’s risk of dying from stroke was 2.3 percent less than the risk of dying from stroke for females in 2000.
Male death rates for accidents, suicide, and homicide have decreased over the four to five years since 1994 and are lower than 1990 levels. In 2000, males were 2.3 times as likely to die from accidents as females, 4.7 times more likely than females to kill themselves, and 2.9 times more likely to die as a result of a homicide.
Mortality rates for leading causes of death for different age groups are presented in Tables 1.4 through 1.6. While the causes of death were similar among middle age men (45-64) and older men (65+), causes of death were noticeably different for younger men (22-44). Younger men were more likely to die from accidents, suicides, homicides, and HIV disease.
According to Table 1.4, mortality rates for all the leading causes of death for young men decreased from 1990 to 2000. Still, men were much more likely than women to die from accidents, suicides, heart disease, and homicide. HIV disease, a leading cause of death for men, was not one of the five leading causes of death for women. HIV disease also dropped from the 5th leading cause of death in 1996 to the 6th leading cause in 1997 and 7th leading cause in 1998, 1999, and 2000 (Arizona Department of Health Services, 2001). Men were 3.3 times as likely to die from a violent cause of death (accidents, suicides, and homicides) than women.
For middle aged men, three of the leading causes of death in 2000 were lower than 1990 as shown in Table 1.5. Deaths from heart disease decreased by 30.1 percent, deaths from chronic lower respiratory disease decreased by 26.1 percent, and cancer deaths decreased by 24.4 percent. Middle aged men experienced an overall decrease in mortality of 5.3 percent compared to 11.6 percent experienced by women.
As shown in Table 1.6, rates of death due to heart disease and cancer decreased for older men from 1990 to 2000 although not as much as the decrease seen in middle aged men during this same period of time. Cerebrovascular disease and influenza and pneumonia become leading causes of death in this older population. Older men continue to have higher mortality rates than women among all leading causes of death with the exception of stroke. In the decade between 1990 and 2000, older men saw a decrease of 11.9 percent in cerebrovascular disease while older women experienced an increase of 10.6 percent.
According to Table 1.7, several differences exist in mortality for urban and rural men. The rural accident rate for men is 74.6 per 100,000 males compared to 54.9 per 100,000 males for urban
10
men. Motor vehicle death rates are also higher for men in rural areas (37.6 per 100,000 males) than urban areas (21.7 per 100,000 males). Men in rural areas are more likely to commit suicide (34.1 per 100,000 males) than their urban counterparts (22.5 per 100,000 males). The rural mortality rate for alcohol induced deaths is 24.4 per 100,000 males which is higher than the mortality rate of 11.2 per 100,000 males for urban men.
Table 1.3: Age-Adjusted Mortality Rates by Gender and Year for Selected Leading Causes of Death, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Total, all causes
Total
839.9
825.5
834.3
865.0
850.1
804.8
796.4
771.8
720.9
752.8
785.6
Male
1056.7
1028.9
1054.7
1075.2
1049.8
966.0
958.8
916.7
860.3
896.9
941.1
Female
666.4
661.0
656.3
691.4
681.7
659.1
652.8
641.2
596.2
624.8
654.6
Cardiovascular disease
Total
338.6
324.5
327.0
338.3
323.3
299.5
289.6
277.5
255.7
262.7
276.1
Male
410.6
389.8
396.9
404.0
384.1
347.9
342.6
320.3
302.4
311.0
333.1
Female
280.7
269.1
269.5
282.4
270.2
255.3
242.6
238.2
214.1
219.8
230.0
Diseases of heart
Total
263.8
251.2
255.5
263.9
247.7
229.3
218.0
207.6
189.4
194.6
206.1
Male
330.7
313.9
319.7
329.4
305.4
278.1
269.9
251.0
235.1
241.0
259.3
Female
210.3
199.3
202.8
209.6
198.6
185.9
173.3
169.0
149.3
154.2
163.6
Malignant neoplasms
Total
190.4
193.3
190.5
191.9
190.7
177.5
178.0
172.9
158.2
166.4
170.4
Male
238.8
240.4
239.5
238.7
236.6
211.6
216.5
206.3
187.2
196.4
204.0
Female
156.2
160.1
155.3
158.7
157.8
151.2
148.2
146.9
135.5
142.9
145.8
Cerebrovascular disease
Total
54.6
52.8
51.5
54.6
54.6
50.3
51.3
50.7
44.7
43.5
51.7
Male
54.6
52.5
54.1
50.9
54.9
47.3
50.6
47.0
42.9
43.6
50.8
Female
54.1
51.8
49.5
56.0
53.3
51.8
50.7
52.6
45.6
42.9
51.8
Chronic lower respiratory diseases
Total
44.4
45.1
43.1
47.7
44.3
44.6
44.9
47.3
43.3
45.7
47.4
Male
58.2
61.5
56.4
62.2
57.7
52.5
51.8
56.5
51.2
52.8
56.2
Female
35.0
34.2
34.1
37.4
35.6
38.4
39.8
40.4
37.4
40.6
41.3
Accidents (unintentional injuries)
Total
42.6
38.3
40.9
43.3
46.5
45.7
46.5
45.0
44.7
44.1
41.1
Male
61.4
53.3
59.9
62.9
66.9
65.2
66.6
64.1
62.6
61.9
58.0
Female
24.5
24.1
23.3
24.8
27.0
26.4
27.1
26.3
26.9
26.6
24.9
Motor vehicle accidents
Total
23.6
20.4
20.5
20.4
22.0
23.7
23.3
20.9
20.8
19.9
17.5
Male
33.1
27.8
29.3
28.4
31.3
32.7
32.7
28.7
18.0
17.9
24.4
Female
14.3
13.2
12.3
12.7
13.0
14.7
14.2
13.0
13.6
11.9
10.6
Influenza and pneumonia
Total
39.3
36.6
31.5
35.4
21.7
19.1
19.8
18.7
19.1
23.0
24.4
Male
49.2
45.4
39.3
45.2
26.3
22.6
23.8
20.8
21.9
27.8
29.2
Female
32.6
30.9
25.9
28.9
18.5
16.4
16.6
16.9
17.0
19.2
21.1
11
12
Table 1.3 (cont.): Age-Adjusted Mortality Rates by Gender and Year for Selected Leading Causes of Death, Arizona, 1990-2000.
Alzheimer’s disease
Total
6.2
6.8 7.
9 9.
2 14
.4
13.7
16.0
14.3
14.1
16.0
21.8
Male
6.5 5.
9 7.
9 7.
4 14
.3
13.0
12.4
11.5
11.0
13.5
17.5
Female
6.0
7.3
7.8
10.3
14.4
13.8 18
.0 16
.2 15
.8 17
.9
24.2
Diabetes
Total
15.6 16
.2 17
.4 16
.6 18
.7 18
.3
19.5
19.7
18.8
20.0
19.0
Male
16.9 18
.5 18
.8 16
.8 19
.4 18
.6
20.5
20.6
21.3
23.3
21.0
Female
14.2 14
.5 16
.2 16
.5 17
.8 18
.0
18.9
18.8
16.5
17.3
17.2
Intentional self harm (suicide)
Total
19.0
17.9
17.4 19
.1 20
.2 19
.8
17.2
17.7
17.7
15.8
14.6
Male
32.6 30
.5 29
.1 32
.4 33
.5 31
.5
28.7
29.5
28.6
25.7
24.7
Female
6.5 6.
4 6.
6 7.
0 7.
6 8.
8
6.4
6.4
7.1
6.5
5.2
Chronic liver disease and cirrhosis
Total
12.4
13.4
12.0 13
.6 14
.2 13
.6
12.5
13.7
12.0
12.0
12.8
Male
17.3 18
.0 16
.2 18
.7 19
.6 18
.3
16.5
19.0
17.2
16.9
17.7
Female
8.3 9.
3 8.
5 9.
0 9.
3 9.
3
8.7
8.9
7.4
7.5
8.3
Nephritis, nephrotic syndrome and nephrosis
Total
8.7
8.8
10.5
9.4
10.3
8.3 8.
6 8.
5 8.
5 9.
7
11.7
Male
11.0 11
.4 14
.7 11
.9 12
.6 8.
9
9.4
10.0
10.0
12.2
13.9
Female
6.9 7.
1 7.
6 7.
7 8.
9 7.
8
8.1
7.4
7.4
8.0
10.4
Septicemia
Total
6.1 6.
7 7.
0 7.
1 6.
7 6.
7
7.2
7.9
6.6
7.5
6.7
Male
7.6 8.
1 8.
3 8.
4 7.
3 8.
1
7.9
8.8
7.5
8.8
7.3
Female
4.9 5.
8 6.
3 6.
3 6.
2 5.
4
6.6
6.9
5.9
6.2
6.1
Assault (homicide)
Total
8.1
8.6 8.
9 9.
5 11
.5
12.1
10.2
9.6
9.5
8.7
7.6
Male
12.2 13
.0 14
.2 14
.2 18
.5 19
.6
16.9
15.8
15.4
13.6
11.1
Female
4.0
4.5
4.3
5.0
4.7
5.2
4.1
4.2
4.3
4.7
3.8
Adjusted to the 2000 standard U.S. population. The cause-of-death titles are according to the Tenth Revision of the International Classification of Diseases (ICD-10). The causes of death for 1994 through 2000 are classified by ICD-10. The causes of death for 1990-1993 are classified by the Ninth Revision (ICD-9). Rates for Influenza and Pneumonia; Alzheimer’s Disease; Nephritis, Nephrotic Syndrome, and Nephrosis; and Septicemia from 1990 through 1993 should not be compared to rates from 1994 through 2000 because of the different classification systems. The rates are per 100,000 persons in specified gender group.
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000. Table 1.4: Mortality Rates1 for the Five Leading Causes2 of Death among Young Adults (20-44 Years) by Gender, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
% change from 1990
M
Accidents (unintentional injuries)
70.8
59.9
67.5
68.8
80.0
87.6
81.9
78.7
78.9
70.5
57.3
-19.1
Intentional self-harm (suicide)
40.3
32.6
34.0
40.0
46.6
45.4
36.9
39.1
38.6
30.4
28.3
-29.8
HIV disease
23.8
28.3
33.9
39.0
43.3
45.2
29.7
14.8
*9.7
*9.2
*7.3
-69.3
Assault (homicide)
20.2
21.8
22.5
24.4
31.1
34.0
28.8
28.6
28.4
24.7
20.0
-1.0
Diseases of heart
16.8
20.9
21.5
23.0
21.0
22.5
24.3
20.1
21.6
19.1
16.2
-3.6
ALL CAUSES
229.1
233.9
250.8
273.2
303.6
318.6
284.4
258.8
253.5
221.9
213.0
-7.0
Fe
Malignant neoplasm
21.7
20.7
19.1
258.9
22.4
23.1
22.9
22.8
24.4
23.4
16.7
-17.3
Accidents (unintentional injuries)
20.2
18.5
17.8
20.3
22.9
23.0
24.7
22.4
24.4
23.4
16.7
-17.3
Intentional self-harm (suicide)
7.2
7.4
7.5
8.6
9.0
11.8
9.6
8.7
9.7
7.8
7.2
0.0
Diseases of heart
5.8
8.0
6.0
7.4
9.0
9.2
8.7
8.4
8.2
7.5
6.2
6.9
Assault (homicide)
6.0
6.2
5.7
7.4
6.8
8.0
5.6
6.6
7.1
7.3
4.5
-25.0
ALL CAUSES
87.0
88.6
88.7
108.7
110.6
121.4
113.2
107.6
113.6
99.5
96.3
10.7
T
Accidents (unintentional injuries)
45.9
39.5
43.0
45.0
51.9
55.9
53.7
51.0
52.1
47.5
37.7
-17.9
Intentional self-harm (suicide)
24.0
20.2
20.9
24.5
28.1
28.9
23.4
24.1
24.4
19.4
18.1
-24.6
Diseases of heart
11.2
14.6
13.9
15.3
15.1
16.0
16.6
14.4
15.0
13.4
11.4
1.8
Malignant neoplasm
20.0
20.1
17.6
22.8
19.9
20.5
22.0
20.7
22.9
19.8
18.3
-8.5
Assault (homicide)
13.2
14.1
14.2
16.0
19.1
21.3
17.3
17.8
18.0
16.2
12.5
-5.3
ALL CAUSES
159.1
162.3
170.9
192.3
208.7
221.7
199.9
184.4
184.8
162.0
156.5
-1.6
* The fifth leading cause based on the combined number of deaths during 1990-2000, but not among the five leading causes of death in 1998, 1999, and 2000.
1 Rates are presented per 100,000 persons 20-44 years old.
2 The five causes with the greatest number of deaths over the 1990-2000 period.
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
13
Table 1.5: Mortality Rates1 or the Five Leading Causes2 of Death among Middle-Aged Adults (45-64 years) by Gender, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
% change from 1990
M
Diseases of heart
288.8
289.1
287.4
303.9
281.3
266.0
253.0
239.0
240.9
225.3
202.0
-30.1
Malignant neoplasm
281.7
278.8
285.9
279.5
282.4
252.7
250.0
225.0
236.7
229.0
212.9
-24.4
Accidents (unintentional injuries)
58.7
50.3
50.6
60.6
68.8
60.0
64.4
65.4
66.3
74.0
65.8
12.1
Chronic lower respiratory diseases
37.9
37.2
34.1
36.4
32.8
34.2
32.5
37.2
33.3
41.7
28.0
-26.1
Chronic liver disease and cirrhosis
37.2
38.8
38.1
42.8
46.6
42.0
38.1
40.0
43.0
42.3
41.9
12.6
ALL CAUSES
953.7
942.9
964.4
1000.3
983.5
912.5
894.5
856.7
863.9
866.1
808.6
-5.3
Fe
Malignant neoplasm
216.4
247.7
222.4
223.0
223.7
211.5
192.1
195.8
190.7
192.5
181.5
-16.1
Diseases of heart
104.6
95.5
103.6
107.7
100.7
102.6
87.6
89.1
85.2
81.7
79.5
-24.0
Chronic lower respiratory diseases
30.5
31.2
29.0
28.4
24.9
25.7
23.7
27.8
22.3
23.5
20.6
-32.5
Cerebrovascular disease
22.5
19.3
22.2
23.2
20.4
21.3
18.7
20.0
19.4
19.5
21.7
-3.6
Accidents (unintentional injuries)
24.0
18.8
20.6
15.8
21.7
21.6
19.2
21.5
23.4
22.7
21.0
-12.5
ALL CAUSES
531.7
548.4
531.8
546.2
544.1
527.1
492.4
490.4
489.0
500.9
470.0
-11.6
T
Malignant neoplasm
247.8
262.6
262.6
250.3
252.1
231.3
220.1
209.9
212.9
210.1
196.7
-20.6
Diseases of heart
193.1
188.5
188.5
202.7
188.3
181.3
167.5
161.5
160.4
151.0
138.8
-28.1
Accidents (unintentional injuries)
40.7
33.9
33.9
37.5
44.5
40.1
41.0
42.7
44.1
47.4
42.7
4.9
Chronic lower respiratory diseases
34.5
34.1
34.1
32.3
28.7
29.8
28.0
32.4
27.6
27.2
24.2
-29.9
Chronic liver disease and cirrhosis
29.0
28.6
27.5
29.9
31.4
29.3
27.5
27.9
28.7
28.7
29.1
0.3
ALL CAUSES
734.3
737.8
737.8
766.1
757.2
712.8
686.8
667.3
669.9
677.1
633.9
-13.7
1 Rates are presented per 100,000 persons 45-64 years old.
2 The five causes with the greatest number of deaths over the 1990-2000 period.
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
14
Table 1.6: Mortality Rates1 or the Five Leading Causes2 of Death among Elderly (65 Years and Older) by Gender, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
% change from 1990
M
Diseases of heart
1759.5
1675.0
1755.2
1861.0
1810.0
1640.9
1515.7
1430.8
1449.3
1406.8
1475.7
-16.1
Malignant neoplasm
1277.2
1323.0
1348.5
1357.0
1401.5
1242.9
1204.3
988.8
1114.2
1118.4
1171.9
-8.2
Chronic lower respiratory diseases
308.8
385.5
364.4
422.0
390.2
357.51
340.6
368.2
364.4
354.1
369.3
19.6
Cerebrovascular disease
351.8
297.9
312.1
306.4
339.9
300.4
304.6
295.5
285.9
297.3
309.9
-11.9
Influenza and pneumonia
253.2
(NA)
228.3
(NA)
208.8
(NA)
244.3
(NA)
208.0
(145.2)
194.1
(135.5)
199.2
(139.1)
172.3
(120.3)
210.5
(147.0)
238.8
(166.7)
161.7
*-3.0
ALL CAUSES
4981.7
4944.5
5167.8
5360.8
5352.4
4846.0
4671.4
4593.8
4603.3
4618.9
4761.6
-4.4
Fe
Diseases of heart
1319.9
1275.8
1333.0
1396.7
1366.0
1270.1
1199.8
1191.1
1154.1
1117.9
1165.3
-11.7
Malignant neoplasm
811.5
794.7
823.9
836.3
854.7
794.7
803.2
788.3
765.5
771.2
814.6
0.4
Cerebrovascular disease
339.9
337.9
320.4
376.7
370.3
360.3
362.8
378.9
353.2
312.5
376.0
10.6
Chronic lower respiratory diseases
223.3
216.9
224.0
254.7
247.8
260.3
272.9
278.8
282.7
293.7
300.6
34.6
Influenza and pneumonia
197.2
(NA)
189.2
(NA)
169.5
(NA)
192.7
(NA)
178.2
(124.4)
157.3
(109.8)
163.5
(114.2)
164.9
(115.1)
181.0
(126.4)
193.5
(135.1)
147.5
*9.2
ALL CAUSES
3673.9
3661.6
3768.8
4006.8
4036.7
3831.8
3883.2
3889.0
3862.6
3870.0
4095.0
11.5
T
Diseases of heart
1509.9
1448.4
1515.5
1594.7
1554.8
1427.5
1339.8
1297.4
1285.1
1246.5
1303.0
-13.7
Malignant neoplasm
1012.8
1023.0
1050.7
1058.7
1087.1
989.0
981.0
877.2
920.2
925.7
973.1
-3.9
Cerebrovascular disease
326.5
320.6
316.8
346.7
357.4
334.3
337.1
341.9
323.3
297.3
346.6
6.2
Chronic lower respiratory diseases
278.8
289.3
284.7
326.0
308.3
302.4
302.9
318.4
319.0
320.5
331.1
18.8
Influenza and pneumonia
221.4
(NA)
206.1
(NA)
186.5
(NA)
217.7
(NA)
190.9
(133.3)
173.2
(120.9)
179.3
(152.2)
168.1
(117.4)
194.1
(135.5)
213.6
(149.1)
153.8
*3.2
ALL CAUSES
4239.2
4216.1
4373.5
4584.2
4596.1
4271.5
4232.5
4201.6
4191.1
4203.4
4390.7
3.6
1 Rates are presented per 100,000 persons 65 years and older.
2 The five causes with the greatest number of deaths over the 1990-2000 period.
*Percent change from 1999.
Note: the cause-of-death titles are according to the Tenth Revision of the International Classification of Diseases (ICD-10). The causes of death for 2000 are classified by ICD-10, replacing the Ninth Revision (ICD-9) used during 1979-1999. The numbers in parentheses present comparability modified data: the annual number of deaths for 1994-1999 that would have been classified as influenza and pneumonia, had the ICD-10 classification system and coding rules been in place.
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
15
16
Table 1.7: Age-Adjusted* Mortality Rates for Selected Causes of Death by Urban/Rural Area and Gender, Arizona, 2000.
Arizona
Urban
Rural
Total
Male
Female
Total
Male
Female
Total
Male
Female
Total, all causes
785.6
941.1
654.6
778.3
933.0
649.9
818.2
978.1
675.6
Cardiovascular disease
276.1
333.1
230.0
275.5
332.2
230.5
276.4
334.7
226.4
Disease of heart
206.1
259.3
163.6
205.8
259.7
163.5
205.7
255.5
162.6
Malignant neoplasm
170.4
204.0
145.8
170.5
204.6
145.8
170.3
201.8
145.6
Colorectal cancer
17.0
20.5
14.1
17.1
20.2
14.6
16.4
21.7
11.8
Lung cancer
46.1
59.2
35.8
46.3
59.8
35.9
45.4
56.4
35.7
Prostate cancer
NA
28.4
NA
NA
28.5
NA
NA
27.9
NA
Female breast cancer
NA
NA
25.4
NA
NA
25.7
NA
NA
24.2
Cerebrovascular disease
51.7
50.8
51.8
51.5
50.3
51.7
52.1
52.8
51.7
Chronic lower respiratory disease
47.4
56.2
41.3
48.2
56.6
42.6
43.8
54.6
35.5
Accidents (unintentional injuries)
41.1
58.0
24.9
38.3
54.9
22.6
55.2
74.6
36.2
Motor vehicle accidents
17.5
24.4
10.6
15.3
21.7
8.8
28.5
37.6
19.5
Falls
7.6
9.8
5.9
7.5
10.1
5.6
7.8
8.9
6.7
Accidental drowning
1.7
2.5
.9
1.7
2.5
1.0
1.8
2.9
.6
Accidental poisoning
5.0
8.0
2.1
5.2
8.1
2.3
4.1
7.4
.8
Influenza and pneumonia
24.4
29.2
21.1
23.9
29.2
20.4
27.0
29.1
25.0
Alzheimer’s disease
21.8
17.5
24.2
22.6
17.4
25.4
18.0
17.7
18.3
Diabetes
19.0
21.0
17.2
18.5
21.2
16.3
21.0
20.3
21.1
Intentional self-harm (suicide)
14.6
24.7
5.2
13.1
22.5
4.4
21.2
34.1
9.0
Chronic liver disease and cirrhosis
12.8
17.7
8.3
12.1
16.6
8.0
16.3
23.4
9.6
Nephritis
11.7
13.9
10.4
11.1
13.2
9.9
14.4
16.9
12.4
Septicemia
6.7
7.3
6.1
6.2
6.9
5.6
8.7
9.0
8.2
Assault (homicide)
7.6
11.1
3.8
7.9
11.7
3.8
5.9
8.0
3.7
Parkinson’s disease
6.8
10.1
4.7
7.1
10.8
4.9
5.2
7.3
3.7
Essential (primary) hypertension
5.6
6.2
5.1
5.8
6.2
5.5
4.6
6.3
3.3
Aortic aneurysm
5.0
8.0
2.7
4.7
7.4
2.7
6.4
10.6
2.8
Congenital malformations
3.6
3.6
3.6
3.5
3.5
3.6
3.9
4.3
3.6
HIV disease
3.2
5.5
1.0
3.3
5.7
.9
2.9
4.4
1.5
Injury by firearms
15.3
26.9
4.3
14.4
25.8
3.5
19.1
30.8
8.1
Drug-induced deaths
6.8
9.4
4.1
7.2
9.9
4.4
4.8
7.2
2.3
Alcohol-induced deaths
8.7
13.5
4.3
7.4
11.2
3.8
15.2
24.4
6.5
*Adjusted to the 2000 standard U.S. population. The causes of death for 2000 are classified by the Tenth Revision of the International Classification of Diseases (ICD-10). The rate for breast cancer is per 100,000 females. The rate for prostate cancer is per 100,000 males.
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000. Table 1.8 presents mortality trends by gender and age group. Between 1990 and 2000, young men (20-44 years old) improved their survival chances with death rates in 2000 7 percent lower than those in 1990. The female mortality rate during the same time period was 10.7 percent higher. Older adults (ages 45-64) experienced larger improvements with mortality rates improving for men by 15.2 percent from 1990 to 2000 and 11.6 percent for women in the same time period.
Table 1.8: Mortality Rates by Gender and Year among Selected Age Groups, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
20-44 years old
Male
229.1
233.9
250.8
273.2
303.6
318.6
284.4
258.8
253.5
221.9
213.0
Female
87.0
88.6
88.7
108.7
110.6
121.4
113.2
107.6
113.6
99.5
96.3
45-64 years old
Male
953.7
94.9
964.4
1000.3
983.5
912.5
894.5
856.7
863.9
866.1
808.6
Female
531.7
548.4
531.8
546.2
544.1
527.1
492.4
490.4
489.0
500.9
470.0
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
Tables 1.9 through 1.11 address mortality rates for chronic lower respiratory diseases, influenza and pneumonia, and Alzheimer’s disease. Chronic lower respiratory disease was the 4th leading cause of death for men in 2000 (Table 1.3). As shown in Table 1.9, rates of death from chronic lower respiratory diseases decreased 3.8 percent for men from 1990 to 2000 and rose 16.4 percent for women. Men were still 35.6 percent more likely to die from chronic lower respiratory diseases than women (Arizona Department of Health Services, 2001).
Table 1.9: Age-Adjusted Mortality Rates for Chronic Lower Respiratory Diseases by Gender and Year, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Male
58.2
61.5
56.4
62.2
57.7
52.5
51.8
56.5
51.2
52.8
56.2
Female
35.0
34.2
34.1
37.4
35.6
38.4
39.8
40.4
37.4
40.6
41.3
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
Influenza and pneumonia were the 6th leading cause of death for all men in 2000 (Table 1.3) and the 5th leading cause of death for elderly men ages 65 and older (Table 1.6). According to the data in Table 1.10, mortality rates for influenza and pneumonia increased for both men and women between 1994 and 2000. Men experienced an 11 percent increase and women experienced a 14.1 percent increase.
Table 1.10: Age-Adjusted Mortality Rates for Influenza and Pneumonia by Gender and Year, Arizona, 1994-2000.
1994
1995
1996
1997
1998
1999
2000
Male
26.3
22.6
23.8
20.8
21.9
27.8
29.2
Female
18.5
16.4
16.6
16.9
17.0
19.2
21.1
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
17
In 2000, Alzheimer’s disease was the 9th leading cause of death for men (Table 1.3). Mortality rates increased 22.4 percent for men and 68.1 percent for women between 1994 and 2000 (Table 1.11).
Table 1.11: Age-Adjusted Mortality Rates for Alzheimer’s Disease by Gender and Year, Arizona, 1994-2000.
1994
1995
1996
1997
1998
1999
2000
Male
14.3
13.0
12.4
11.5
11.0
13.5
17.5
Female
14.4
13.8
18.0
16.2
15.8
17.9
24.2
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
Table 1.12 presents information about the average age of death for racial and ethnic groups over time. All groups experienced an increase in age at death from 1990 to 2000. American Indian males experienced the largest percent increase (6 percent) followed by White, non-Hispanic males (4 percent), Black males (2.3 percent), Hispanic males (2.2 percent), and Asian males (1.7 percent). Still, in 2000, White non-Hispanic males’ average age of death exceeded the average age of death for Asian males by 9.3 years, Black males by 14.1 years, Hispanic males by 15.1 years, and American Indian males by 19.3 years.
Table 1.12: Average Age at Death from All Causes by Gender and Ethnicity, Arizona, 1990-2000.
All ethnic groups*
White, non-Hispanic
Hispanic
Black
American Indian
Asian
1990
Total
68.4
70.6
58.5
58/.1
51.4
NA
Male
65.4
67.9
54.6
55.5
48.7
NA
Female
72.2
73.9
64.1
61.6
56.1
NA
1991
Total
68.5
70.8
57.6
58.8
52.3
NA
Male
65.6
68.1
54.7
54.4
50.4
NA
Female
71.9
73.7
61.5
64.4
54.8
NA
1992
Total
68.7
71.1
58.3
57.8
52.8
NA
Male
65.8
68.5
54.8
54.7
49.0
NA
Female
72.4
74.2
63.7
62.3
58.7
NA
1993
Total
68.6
71.1
57.9
56.2
51.9
NA
Male
65.6
68.3
54.7
54.1
49.3
NA
Female
72.2
74.3
62.7
59.2
55.8
NA
1994
Total
68.4
71.0
56.6
56.8
52.0
NA
Male
65.2
68.2
52.5
54.5
48.7
NA
Female
72.2
74.2
62.3
60.6
57.2
NA
1995
Total
68.5
71.0
57.4
57.4
52.2
NA
Male
65.2
68.2
53.1
53.7
48.2
NA
Female
72.4
74.2
63.6
62.9
57.8
NA
18
Table 1.12 (cont.): Average Age at Death from All Causes by Gender and Ethnicity, Arizona, 1990-2000.
1996
Total
69.6
72.4
56.5
57.8
52.9
62.1
Male
66.1
69.2
52.6
54.9
49.9
60.6
Female
73.6
75.9
62.4
61.3
57.2
63.9
1997
Total
71.0
73.1
61.3
61.9
55.4
64.2
Male
67.5
70.1
57.2
57.6
51.2
61.4
Female
74.9
76.3
67.4
67.7
61.4
68.0
1998
Total
71.2
73.4
61.8
62.5
56.5
62.7
Male
67.9
70.5
57.4
59.4
53.2
60.8
Female
74.9
76.5
68.0
66.3
61.2
62.7
1999
Total
71.7
74.1
59.2
60.5
55.7
63.9
Male
68.8
71.5
56.2
57.8
51.8
62.3
Female
74.9
77.0
63.3
63.9
60.6
65.5
2000
Total
71.6
73.9
59.2
60.8
55.4
62.3
Male
68.7
70.9
55.8
56.8
51.6
61.6
Female
74.9
77.0
63.7
65.8
60.4
63.0
* May include records with other/unknown ethnic groups.
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
In contrast to increases in average age of years lived for all groups, the proportion of males within ethnic groups, other than White, non-Hispanic males, living beyond life expectancy decreased (Table 1.13). In other words, ethnic groups were living longer but were more likely to die before average life expectancy was reached. In 2000, 70 percent or more of deaths among Hispanic, Black, American Indian, and Asian males were premature.
Table 1.13: Percent of Deaths before Expected Years of Life Reached1 by Gender and Ethnicity, Arizona, 1990-2000.
All ethnic groups2
White, non-Hispanic
Hispanic
Black
American Indian
Asian
1990
Total
53.1
50.1
66.1
68.8
75.4
NA
Male
60.0
57.0
73.8
74.3
78.4
NA
Female
44.5
42.0
54.7
61.1
70.4
NA
1991
Total
55.6
52.6
70.4
70.5
76.0
NA
Male
63.0
60.1
75.6
78.4
78.7
NA
Female
46.7
43.7
62.7
59.7
72.1
NA
1992
Total
54.6
51.3
69.5
71.5
75.9
NA
Male
61.9
58.6
75.3
77.5
80.2
NA
Female
45.6
42.6
60.5
62.8
69.2
NA
19
Table 1.13 (cont.): Percent of Deaths before Expected Years of Life Reached1 by Gender and Ethnicity, Arizona, 1990-2000.
1993
Total
54.2
50.7
68.9
74.7
77.8
NA
Male
61.5
58.2
73.6
79.7
81.3
NA
Female
45.6
42.0
62.2
67.8
72.7
NA
1994
Total
54.5
50.6
72.0
72.2
79.3
NA
Male
62.5
58.6
78.9
78.3
84.7
NA
Female
44.8
41.3
62.2
62.8
70.8
NA
1995
Total
54.0
50.2
70.5
72.0
78.6
NA
Male
61.7
57.8
77.3
77.6
84.9
NA
Female
44.9
41.6
90.7
63.9
69.6
NA
1996
Total
52.0
47.7
70.9
72.9
78.0
65.1
Male
59.8
55.6
77.3
78.5
81.1
67.5
Female
42.9
39.0
61.5
64.7
73.8
62.3
1997
Total
53.6
49.9
69.6
71.2
79.9
68.5
Male
61.6
57.8
75.6
79.3
84.5
74.3
Female
44.7
41.5
60.6
60.6
73.3
60.5
1998
Total
52.5
48.7
69.8
68.9
77.2
67.3
Male
60.2
56.7
78.0
76.3
81.4
68.2
Female
43.8
40.7
62.4
63.6
73.5
68.1
1999
Total
51.8
47.4
71.7
70.7
76.9
67.0
Male
59.3
54.8
78.0
76.6
83.4
63.9
Female
43.3
39.3
62.6
63.1
69.0
70.1
2000
Total
51.6
47.3
70.5
69.3
78.7
69.6
Male
59.6
55.4
76.7
75.7
83.1
70.6
Female
42.9
38.7
62.2
61.2
72.9
68.6
1 Based on expected years of life at birth for all U.S. residents
2 May include records with other/unknown ethnic groups.
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000. 20
2. Chronic Diseases
According to the Centers for Disease Control and Prevention, chronic diseases are those “illnesses that are prolonged, do not resolve spontaneously, and are rarely cured completely” (1999). The impact of these diseases on the health and well-being of both men and women is significant. Chronic diseases are a leading cause of death with five chronic diseases, heart disease, cancer, stroke, chronic obstructive pulmonary disease, and diabetes, responsible for over 65 percent of all deaths in the United States (Centers for Disease Control and Prevention, 2002c). Two chronic diseases, heart disease and cancer, account for over half of all deaths. In 1999, the five leading chronic disease killers accounted for 65 percent of all deaths in Arizona. In addition, over 75 percent of the nation’s health care costs can be attributed to chronic disease care.
Chronic diseases that will be discussed in this chapter are cardiovascular disease, diabetes, cerebrovascular disease, and arthritis. Cancer is also considered a chronic disease but will be discussed in its own chapter.
The label, cardiovascular disease, includes a wide variety of illnesses and conditions of the heart, veins, and lymphatic vessels. Cardiovascular diseases include high blood pressure, stroke, and heart disease. Heart disease or diseases of the heart is a subset of cardiovascular disease related specifically to the heart and includes conditions such as coronary heart disease and congestive heart failure.
Table 2.1 shows national trends in deaths caused by cardiovascular diseases. The numbers represent deaths in thousands. Approximately the same number of men were killed by cardiovascular disease between 1990 and 1999. Women however saw an increase in deaths.
Table 2.1: Cardiovascular Disease Mortality Trends for Males and Females, U.S., 1990-1999.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
Male
440
440
440
450
450
450
450
450
440
440
Female
470
470
470
500
490
500
500
500
500
510
Source: American Heart Association, 2002. Biostatistical Fact Sheet.
Cardiovascular mortality rates for men and women in Arizona are presented in Table 2.2. Men and women experienced similar decreases in cardiovascular disease death rates between 1990 and 2000. Men saw a decrease of 19 percent and women experienced a decrease of 18 percent. Still, male mortality from cardiovascular disease was 45 percent greater than female mortality from cardiovascular disease.
21
Table 2.2: Cardiovascular Disease Mortality Trends, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Total
338.6
324.5
327.0
338.3
323.3
299.5
289.6
277.5
255.7
262.7
276.1
Male
410.6
389.8
396.9
404.0
384.1
347.9
342.6
320.3
302.4
311.0
333.1
Female
280.7
269.1
269.5
282.4
270.2
255.3
242.6
238.2
214.1
219.8
230.0
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
In addition to death caused by cardiovascular disease, the prevalence, or the proportion of the population that experiences the illness, is useful for measuring the disease’s impact. Table 2.3 displays the percentage of the population by age group that suffer from cardiovascular disease. Risk of cardiovascular disease for men doubles between the ages of 35-44 and 45-54 and again between the ages 45-54 and 65-74.
Table 2.3: Prevalence of Cardiovascular Diseases by Age and Sex, U.S., 1988-94.
20-24
25-34
35-44
45-54
55-64
65-74
75+
Male
5.5
10.4
17.4
34.2
51.0
65.2
70.7
Female
4.6
4.2
13.6
28.9
48.1
65.2
79.0
Source: American Heart Association, 2001. 2002 Heart and Stroke Statistical Update.
In 2000, heart disease was the most common cause of death for Arizona citizens. As shown in Table 2.4, heart disease mortality for men decreased by 22 percent between 1990 and 2000. A man’s risk for dying from heart disease in 2000 was 59.5 percent greater than a woman’s risk.
Table 2.4: Age-Adjusted Mortality Rates for Diseases of Heart by Gender and Year, Arizona, 1990-2000
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Male
330.7
313.9
319.7
329.4
305.4
278.1
269.9
251.0
235.1
241.0
259.3
Female
210.3
199.3
202.8
209.6
198.6
185.9
173.3
169.0
149.3
154.2
163.6
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
Ischemic or coronary heart disease, the restriction of blood through the vessels in the heart, accounted for the largest proportion of deaths attributable to heart disease (Table 2.8). Coronary heart disease increases with age (Table 2.5). A man’s risk of coronary heart disease triples between the ages of 25-44 and 45-54 and doubles between the ages 45-54 and 55-64.
Table 2.5: Prevalence of Coronary Heart Disease by Age and Sex, U.S., 1988-94.
25-44
45-54
55-64
65-74
75+
Male
2.0
6.7
13.1
17.7
18.6
Female
2.8
5.5
8.4
11.1
16.1
Source: American Heart Association, 2001. 2002 Heart and Stroke Statistical Update.
22
23
Congestive heart failure or the inability of the heart to pump enough blood to other parts of the body also increases with age as shown in Table 2.6.
Table 2.6: Prevalence of Congestive Heart Failure by Age and Sex, U.S., 1988-94.
20-24
25-34
35-44
45-54
55-64
65-74
75+
Male
0.1 0.
1
0.7 1.
8
6.2 6.
8
9.8
Female
0.1
0.1
0.5
1.3
3.4
6.6
9.7
Source: American Heart Association, 2001. 2002 Heart and Stroke Statistical Update
As seen in Table 2.7, men are much more likely than women to experience heart attack, the death of heart tissue due to a restriction in the tissue’s blood supply. Between the ages of 29 and 44, men are three and a half times more likely to experience heart attack than women and three times more likely than women to have a heart attack between the ages of 45 and 64. Like other forms of cardiovascular disease, the risk of heart attack increases with age.
Table 2.7: Annual Number of Diagnosed Heart Attack by Age and Sex, U.S., 1987-1994.
29-44
45-64
65+
Male 32
,000
218,000
418,000
Female
9,000
74,000
356,000
Source: American Heart Association, 2001. 2002 Heart and Stroke Statistical Update.
Table 2.8 presents the number of deaths from various forms of heart disease from 1990 through 2000.24
Table 2.8: Number of Deaths from Diseases of the Heart by Category, Gender and Year, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Total
8,666
8,619
9,185
9,955
9,851
10,104
9,995
10,002
10,276
10,355
10,430
Male
4,676
4,658
4,948
5,343
5,248
5,389
5,400
5,276
5,542
5,580
5,594
All forms of heart disease
Female
3,990
3,961
4,237
4,612
4,603
4,715
4,595
4,726
4,734
4,775
4,836
Total
94
63
68
61
81
64
55
65
52
51
32
Male
19
25
21
18
26
18
20
25
14
19
13
Acute rheumatic fever and chronic rheumatic heart disease
Female
75
38
47
43
55
46
35
40
38
32
19
Total
7
11
8
8
10
10
3
7
4
3
*30
Male
3
2
4
3
6
6
3
2
2
1
13
Hypertensive heart and renal disease
Female
4
9
4
5
4
4
0
5
2
2
17
Total
6,220
6,054
6,217
6,455
6,404
6,671
6,373
6,303
6,367
6,383
7,949
Male
3,490
3,419
3,473
3,622
3,509
3,689
3,543
3,427
3,562
3,537
4,386
Ischemic heart disease
Female
2,730
2,635
2,744
2,833
8,895
2,982
2,830
2,876
2,805
2,846
3,563
Total
115
142
167
156
139
142
185
265
233
229
261
Male
43
53
69
46
46
43
71
116
99
99
136
Hypertensive heart disease
Female
72
89
98
110
93
99
114
149
134
130
125
Total
2,230
2,349
2,725
3,275
3,217
3,217
3,379
3,362
3,620
3,689
2,158
Male
1,121
1,159
1,381
1,654
1,661
1,633
1,763
1,706
1,865
1,924
1,046
All other forms of heart disease
Female
1,109
1,190
1,349
1,621
1,556
1,584
1,616
1,656
1,755
1,765
1,112
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.High blood pressure or hypertension accounted for 42,997 deaths in the U.S. in 1999. (American Heart Association, 2001). One in four American adults have high blood pressure (American Heart Association, 2001). According to Table 2.9, until the age of 54, men have a higher prevalence of high blood pressure than women.
Table 2.9: Prevalence (Percent of Population) of High Blood Pressure in Americans Age 20 and Older by Age and Sex, U.S., 1988-94.
20-34
35-44
45-54
55-64
65-74
75+
Male
8.6
20.9
34.1
42.9
57.3
64.2
Female
3.4
12.7
25.1
44.2
60.8
77.3
Source: American Heart Association, 2002. Biostatistical Fact Sheet.
Prevalence rates for high blood pressure decreased for all racial and ethnic categories between 1976-80 and 1988-94 as shown in Table 2.10. High blood pressure in Non-Hispanic White males decreased the most (26 percent), followed by Hispanic males (21 percent), and non-Hispanic Black males (18 percent).
Table 2.10: Age-Adjusted Prevalence (Percent of Population) Trends for High Blood Pressure, Ages 20-74 by Race/Ethnicity, Sex and Survey Year, U.S., 1976-80 and 1988-94.
Non-Hispanic White men
Non-Hispanic White women
Non-Hispanic Black men
Non-Hispanic Black women
Hispanic men
Hispanic women
1976-80
34.2
25.9
44.8
46.7
31.0
31.4
1988-94
25.2
20.5
36.7
36.6
24.2
22.4
Source: American Heart Association, 2002. Biostatistical Fact Sheet.
Table 2.11 compares high blood pressure prevalence rates for White males and females with rates for Black males and females. In all age groups, Black males are more likely than White males to have high blood pressure.
Table 2.11: Prevalence (Percent of Population) of High Blood Pressure by Age, Sex, and Race, U.S., 1988-94.
25-34
35-44
45-54
55-64
65-74
75+
White Male
8.1
14.3
29.1
43.0
54.9
59.0
Black Male
10.6
29.5
44.3
58.0
65.2
71.3
White Female
1.6
8.5
22.6
41.1
61.7
76.1
Black Female
6.2
22.9
48.8
63.0
75.6
77.9
Source: American Heart Association, 2001. 2002 Heart and Stroke Statistical Update.
25
Stroke is the disruption of blood to the brain leading to injury or death of brain tissue. In the U.S. and Arizona, stroke or cerebrovascular disease is the third leading cause of death. In 2000, stroke was the fifth leading cause of death for men in Arizona. In addition to being a leading cause of death, it is also a leading cause of serious, long-term disability with more than 1,100,000 Americans reporting difficulties with activities of daily living in 1999 as a result of stroke (American Heart Association, 2001). As reported in Table 2.12, up to the age 74, more men than women experience stroke but women are more likely than men to die from stroke (Table 2.13)
Table 2.12: Prevalence (Percent of Population) of Stroke by Age and Sex, U.S., 1988-94.
20-24
25-34
35-44
45-54
55-64
65-74
75+
Male
0.1
0.5
0.5
2.2
4.0
5.9
12.5
Female
0.3
0.0
0.4
1.0
2.7
5.8
10.7
Source: American Heart Association, 2001. 2002 Heart and Stroke Statistical Update.
Table 2.13 shows mortality rates for cerebrovascular disease in the ten-year period between 1990 and 2000. Rates of death decreased for both men and women during this time.
Table 2.13: Age-Adjusted Mortality Rates for Cerebrovascular Disease by Gender and Year, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Male
54.6
52.5
54.1
50.9
54.9
47.3
50.6
47.0
42.9
43.6
50.8
Female
54.1
51.8
49.5
56.0
53.3
51.8
50.7
52.6
45.6
42.9
51.8
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
Diabetes, the inability of the body to properly regulate sugar, is a serious disease that causes complications such as heart disease, kidney failure, amputations, and blindness. These complications can in turn lead to death and disability. In 1999, diabetes was the sixth leading cause of death in the United States (Centers for Disease Control and Prevention, 2002c). In 2000, diabetes was the eighth leading cause of death for men in Arizona.
Between 1990 and 2000, diabetes mortality rates for men have increased by 24 percent (Table 2.14). This is slightly higher than the 21 percent increase in death rates experienced by women over the same time period.
Table 2.14: Age-Adjusted Mortality Rates for Diabetes by Gender and Year, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Male
16.9
18.5
18.8
16.8
19.4
18.6
20.5
20.6
21.3
23.3
21.0
Female
14.2
14.5
16.2
16.5
17.8
18.0
18.9
18.8
16.5
17.3
17.2
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
A more significant variation is seen when comparing diabetes death rates among men by racial and ethnic groups (Table 2.15). Black men experienced a 549 percent increase in deaths attributable to diabetes in the 20 year period between 1980 and 2000, followed by
26
Hispanic men with an increase of 157 percent, White, non-Hispanic men with a 34 percent increase and American Indian men with a 27 percent increase. Asian men had a 35 percent decrease in mortality from diabetes. American Indian men had the highest mortality rate, two and a half times greater than the rate for all groups.
Table 2.15: Age-Adjusted Mortality Rates for Diabetes by Race/Ethnicity, Arizona, 1980, 1990, 2000.
All men
White, non-Hispanic men
Hispanic men
Black men
American Indian men
Asian men
1980
14.4
13.0
16.3
6.3
58.4
16.7
1990
16.9
13.2
32.2
20.2
86.1
7.2
2000
21.0
17.4
41.9
40.9
74.1
10.9
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
Tables 2.16 and 2.17 show trends for diabetes prevalence and incidence in the U.S. Prevalence and incidence rates have increased since 1990 for both men and women. Prevalence and incidence rates are also related to age with older adults more likely to be diagnosed with diabetes.
Table 2.16: Prevalence of Diagnosed Diabetes, per 1000 Population by Sex and Age, U.S., 1990-1996.
Age Group
0-44
45-64
65-74
75+
Total
Age-adjusted
1990
Male
6.2
56.4
91.3
85.1
23.9
25.4
Female
8.7
53.6
104.0
86.2
29.9
27.5
1991
Male
6.4
52.4
105.7
92.7
24.6
26.0
Female
8.7
55.9
106.5
92.5
31.0
28.4
1992
Male
7.4
57.9
104.1
98.0
26.8
28.0
Female
9.1
58.2
107.1
103.2
32.7
29.5
1993
Male
7.3
59.8
106.4
104.9
27.7
28.7
Female
8.7
60.2
104.7
102.5
32.7
29.5
1994
Male
7.4
63.0
110.9
109.2
29.0
29.9
Female
9.0
62.4
111.4
107.5
34.4
30.8
1995
Male
6.5
60.3
118.6
117.2
29.0
29.6
Female
9.2
62.5
105.4
99.4
33.7
30.2
1996
Male
6.1
59.2
126.0
117.6
29.2
29.7
Female
9.3
62.4
109.4
104.0
34.6
30.8
Source: Centers for Disease Control and Prevention, 2002a. 1999 Diabetes Surveillance Report.
27
Table 2.17: Incidence of Diabetes per 1000 Population by Sex and Age, U.S. 1990-1996.
Age Group
0-44
45-64
65+-
Total
Age-adjusted
1990
Male
0.53
6.84
4.04
2.04
2.16
Female
1.96
4.72
5.44
2.99
2.89
1991
Male
0.53
5.07
6.13
1.94
2.05
Female
1.59
3.74
7.63
2.88
2.70
1992
Male
0.91
6.34
8.00
2.67
2.78
Female
1.62
4.03
8.16
3.04
2.83
1993
Male
0.99
6.44
8.80
2.85
2.94
Female
1.78
5.40
9.17
3.58
3.33
1994
Male
0.92
6.93
9.77
3.02
3.10
Female
1.79
6.06
10.34
3.90
3.60
1995
Male
0.68
7.10
7.05
2.62
2.66
Female
1.82
5.89
9.37
3.76
3.47
1996
Male
0.50
7.29
7.30
2.59
2.60
Female
1.53
4.86
8.52
3.24
2.97
Source: Centers for Disease Control and Prevention, 2002a. 1999 Diabetes Surveillance Report.
Arthritis and other rheumatic conditions that affect the joints, tissues around the joints, and other connective tissue, are experienced by one of every six people in the U.S. (Centers for Disease Control and Prevention, 1999). Arthritis is the leading cause of disability for Americans. In 2000, 22.7 percent of men in Arizona reported arthritis (Table 2.18)
Table 2.18: Number and Percentage of Adults Who Reported Arthritis by Sex, Arizona, 2000.
Women
Men
Number
Percent
Number
Percent
586,000
32.1
394,000
22.7
Source: Centers for Disease Control and Prevention, 2002c. The Burden of Chronic Diseases and Their Risk Factors: National and State Perspectives 2002.
28
3. Cancer
Cancer is the label for a variety of diseases characterized by uncontrolled growth and spread of abnormal cells (American Cancer Society, 2001). If unchecked, the spread and growth of these cells can result in illness and death. Cancer is the second leading cause of death for Americans and Arizonans. It is estimated that 22,100 new cases of cancer will be diagnosed in Arizona in 2002 and 9,600 Arizonans will die from cancer in 2002 (Centers for Disease Control and Prevention, 2002c). In the U.S., one of every four deaths is a result of cancer (American Cancer Society, 2001). Note that in the following tables, cancer is often referred to as malignant neoplasms.
As shown in Table 3.1, cancer mortality rates for men have decreased by 15 percent from 1990 to 2000. In 2000, men in Arizona had a 40 percent greater risk than women of dying from cancer.
Table 3.1: Age-Adjusted Mortality Rates for Malignant Neoplasms (Cancer) by Gender and Year, Arizona, 1990-2000
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Male
238.8
240.4
239.5
238.7
236.6
211.6
216.5
206.3
187.2
196.4
204.0
Female
156.2
160.1
155.3
158.7
157.8
151.2
148.2
146.9
135.5
142.9
145.8
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
According to Table 3.2, cancer death rates increased for men in all ethnic and racial groups except White males. Asian men experienced the largest increase, 54 percent, in cancer death rates, followed by an increase of 17 percent for American Indian men, 15 percent for Hispanic men, and less than one percent for Black men. In all three time periods, Black males had the highest cancer mortality rates followed by White, non-Hispanic males.
Table 3.2: Age-Adjusted Mortality Rates for Cancer by Race/Ethnicity, Arizona, 1980, 1990, 2000.
All men
White, non-Hispanic men
Hispanic men
Black men
American Indian men
Asian men
1980
242.3
253.8
175.0
272.3
122.0
67.4
1990
238.8
245.9
185.3
360.7
123.1
132.4
2000
204.0
208.1
201.5
274.7
142.7
103.6
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000
The risk of dying from cancer increases with age. As shown in Table 3.3, the risk triples every ten years beginning at age 29 and ending at age 59. The risk continues to increase after age 59 though not as dramatically.
29
Table 3.3: Age-Specific Malignant Neoplasm Mortality Rates (per 100,000 persons), All Causes by Age Group and Sex, Arizona, 1997.
Age group
Male
Female
Total
0-19 years
6.1
7.2
6.6
20-29 years
8.7
5.4
7.1
30-39 years
17.1
22.0
20.0
40-49 years
60.4
69.4
64.9
50-59 years
234.2
191.8
212.3
60-69 years
612.5
456.2
529.6
70-79 years
1183.0
727.8
939.2
80+ years
1764.4
1149.1
1393.7
Total
196.6
170.2
183.4
Source: Arizona Department of Health Services, 1999. Cancer in Arizona: Cancer Incidence and Mortality in 1997.
Similarly, incidence rates also increase with age as shown in Table 3.4. The term, “all sites” refers to the location in the body where the cancer occurs.
Table 3.4: Age-Specific Incidence Rates (per 100,000 persons), All Sites by Age Group and Sex, Arizona, 1997.
Age group
Male
Female
Total
0-9 years
14.43
13.41
13.94
10-19 years
10.47
12.72
11.53
20-29 years
34.27
44.64
39.23
30-39 years
75.53
128.05
101.68
40-49 years
171.75
313.66
244.03
50-59 years
619.85
652.97
636.99
60-69 years
1760.09
1106.90
1413.85
70-79 years
2413.77
1564.30
1948.28
80+ years
2350.32
1700.90
1959.06
Total
434.74
408.24
421.51
Source: Arizona Department of Health Services, 1999. Cancer in Arizona: Cancer Incidence and Mortality in 1997.
The next two tables present information on cancer mortality and incidence by county. In 1997, men in several counties including Cochise, Gila, Mohave, Navajo, Pima, Pinal, and Santa Cruz had cancer mortality rates higher than the state rate of 134.7 per 100,000 persons (Table 3.5). Men in several counties including Cochise, Coconino, Gila, La Paz, Maricopa, Mohave, Navajo, Pima, and Santa Cruz experienced a cancer incidence rate higher than the state rate (Table 3.6)
30
Table 3.5: Age-Adjusted Incidence Malignant Neoplasm Mortality Rates (per 100,000 persons), All Causes by County of Residence and Sex, Arizona, 1997.
County
Male
Female
Total
Apache
86.4
62.4
73.2
Cochise
137.0
112.6
123.9
Coconino
86.6
96.3
91.6
Gila
151.0
81.5
114.2
Graham
125.3
76.1
99.3
Greenlee
-
-
113.0
La Paz
102.1
161.2
128.9
Maricopa
132.0
103.0
115.7
Mohave
169.6
120.6
144.3
Navajo
160.0
95.9
125.8
Pima
138.1
95.2
113.8
Pinal
142.5
99.9
120.8
Santa Cruz
179.3
90.4
129.9
Yavapai
130.2
112.5
120.3
Yuma
116.5
92.1
103.9
Arizona
134.7
101.6
116.5
- Insufficient cases for an adjusted rate calculation.
Source: Arizona Department of Health Services, 1999. Cancer in Arizona: Cancer Incidence and Mortality in 1997.
Table 3.6: Age-Adjusted Incidence Rates for Invasive Cancer, All Sites, by County of Residence and Sex, Arizona, 1997.
County
Male
Female
Total
Apache
289.48
184.73
232.17
Cochise
409.48
331.0
366.13
Coconino
416.71
363.30
385.65
Gila
414.27
298.48
353.75
Graham
295.94
302.51
293.45
Greenlee
244.01
371.25
288.26
La Paz
414.65
386.91
395.07
Maricopa
392.21
314.60
347.92
Mohave
444.41
374.18
408.10
Navajo
471.15
287.34
370.98
Pima
397.29
320.92
352.88
Pinal
354.40
318.72
334.01
Santa Cruz
411.42
275.34
337.47
Yavapai
356.79
348.60
351.16
Yuma
320.23
288.20
303.97
Arizona
389.56
317.56
348.96
Source: Arizona Department of Health Services, 1999. Cancer in Arizona: Cancer Incidence and Mortality in 1997.
The rest of the tables in this chapter address different types of cancer. According to Table 3.7, cancers associated with the lungs, trachea, and bronchus were the leading causes of cancer related deaths for Arizonan men in 2000. Lung cancer itself accounts for 28 percent of all cancer deaths in the United States (Centers for Disease Control and Prevention, 2002c). The next leading cause of cancer-related death for men in Arizona is prostate cancer followed by colon and rectum cancers.
31
Table 3.7: Death Rates for the Five Leading Causes of Cancer Related Deaths, Arizona, 2000.
Total
Male
Female
Malignant neoplasm
175.3
185.7
164.9
Malignant neoplasm of trachea, bronchus and lung
48.5
55.8
41.3
Malignant neoplasm of prostate
11.7
23.4
0.0
Malignant neoplasm of colon, rectum, and anus
17.3
18.3
16.3
Malignant neoplasm of lymphoid, hematopoietic and related tissue
16.9
18.1
15.7
Malignant neoplasm of pancreas
9.2
9.4
9.0
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
Table 3.8 presents cancer related mortality rates for various cancers by race and ethnicity. Black men have the highest mortality rates for all forms of cancer reported in the table and have a prostate cancer mortality rate that is two and a half times higher than the next highest group, Hispanic men. Asian men have the lowest death rates for colorectal and prostate cancers. American Indian men have the lowest death rates from lung cancer.
Table 3.8: Age-Adjusted Mortality Rates for Selected Cancer Related Causes of Death by Race/Ethnicity, Arizona, 2000.
All men
White, non-Hispanic men
Hispanic men
Black men
American Indian men
Asian men
Malignant neoplasm
204.0
208.1
201.5
274.7
142.7
103.6
Lung cancer
59.2
61.9
49.6
79.8
13.1
29.0
Colorectal cancer
20.5
20.7
20.5
26.3
15.1
12.9
Prostate cancer
28.4
28.0
30.0
74.8
27.1
8.9
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000.
Table 3.9 shows national incidence and mortality rates for various types of cancer by race, ethnicity, and gender. Like Arizona, Black men in the U.S. have the highest mortality resulting from cancer of all racial and ethnic groups and are more likely to develop cancer. Black men die at a rate 50 percent greater than White males which have the second highest cancer rate. Like Arizona, prostate cancer death rates for Black males are 2.3 times higher than death rates for White males.
Cancer incidence and mortality rates for Arizona and the United States are compared in Tables 3.10 and 3.11. With the exception of urinary bladder cancer incidence rates, Arizona is lower than the national death and incidence rates for all forms of cancer reported. The cancer death rate for all forms of cancer for males in Arizona is 11 percent lower than the national mortality rate.
32
33
Table 3.9: Incidence and Mortality Rates1 by Site, Race, and Ethnicity, U.S., 1990-1997.
Incidence White
Black
Asian/Pacific Islander
American Indian
Hispanic2
All sites
Males
476.3 59
7.9 32
3.3
175.9
323.2
Females
352.4 33
7.4 24
6.9
137.3
240.9
Total
402.1 44
4.6 27
9.3
152.8
272.9
Colon & Rectum
Males
52.7 58
.3 47
.2
20.4
35.7
Females
36.6 45
.2 30
.9
13.1
23.6
Total
43.6 50
.7 38
.1
16.3
28.8
Lung & bronchus
Males 71
.9
111.1
51.9
25.1
38.0
Females
43.3 45
.8 22
.5
13.3
19.4
Total
55.4 73
.3 35
.5
18.4
27.1
Prostate
145.8 22
5.0 80
.4
45.8
101.6
Mortality White
Black
Asian/Pacific Islander
American Indian
Hispanic2
All sites
Males
207.0 30
5.5 12
7.2
124.6
130.6
Females
139.1 16
7.7 83
.0
90.0
85.6
Total
166.5 22
1.9 10
2.3
104.5
104.0
Colon & rectum
Males
21.3 27
.7 13
.1
11.6
13.1
Females
14.3 19
.9 8.
9
8.9
8.3
Total
17.2 23
.0 10
.8
10.1
10.3
Lung & bronchus
Males
69.5 99
.5 34
.2
40.9
31.6
Females
34.0 33
.0 14
.9
19.8
11.0
Total
49.1 60
.1 23
.4
29.0
19.8
Prostate
23.3
54.1
10.4
14.2
16.2
1 Per 100,000 age-adjusted to the 1970 U.S. standard population.
2 Hispanic is not mutually exclusive from white, black, Asian/Pacific Islanders, and American Indian.
Source: American Cancer Society, 2001. Cancer Facts & Figures 2001. 34
Table 3.10: Cancer Death Rates by Site, Arizona, U.S., 1993-1997*.
All sites
Colon & Rectum
Lung & Bronchus
Non-Hodgkin’s Lymphoma
Pancreas
Prostate
Male
Female
Male
Female
Male
Female
Male
Female
Male
Female
Male
Arizona
186.0
127.3
17.6
12.2
59.2
31.7
8.0
5.4
9.1
6.6
22.3
U.S.
209.7
139.8
21.0
14.4
69.4
34.0
8.5
5.6
9.7
7.2
27.7
* Per 100,000, age adjusted to the 1970 U.S. standard population.
Source: American Cancer Society, 2001. Cancer Facts & Figures 2001.
Table 3.11: Cancer Incidence Rates by Site, Arizona, U.S., 1993-1997*.
All sites
Colon & Rectum
Lung & Bronchus
Non-Hodgkin’s Lymphoma
Prostate
Urinary Bladder
Male
Female
Male
Female
Male
Female
Male
Female
Male
Male
Female
Arizona
397.4
305.1
43.9
31.2
66.1
39.8
15.4
11.1
115.9
29.0
7.8
U.S.
475.5
347.8
52.4
37.2
73.7
43.0
19.8
12.7
147.0
28.7
7.6
* Per 100,000, age adjusted to the 1970 U.S. standard population.
Source: American Cancer Society, 2001. Cancer Facts & Figures 2001. Trends in mortality and incidence rates for the top five cancers for men are shown in Tables 3.12 and 3.13. From 1990 to 1997, lung cancer was the leading cause of cancer related death for men followed by prostate cancer and then colorectal cancer. With the exception of lymphoma, mortality rates for all forms of cancer reported in the tables decreased slightly. It is interesting to note that while death rates declined in this seven-year period, the number of new cases reported annually increased.
Table 3.12: Age-Adjusted Mortality Rates for the Top Five Cancers for Men, Arizona, 1990-1997.
1990
1991
1992
1993
1994
1995
1996
1997
Lung
47.41
49.57
49.24
49.69
47.11
44.77
45.78
42.92
Prostate
16.75
17.23
16.37
16.92
16.47
17.20
15.66
14.96
Colorectal
12.69
13.40
14.67
14.17
13.60
12.41
14.02
12.63
Pancreas
8.34
6.70
7.52
6.96
7.23
6.92
7.07
7.31
Lymphoma
6.68
6.09
6.39
6.91
6.38
6.29
7.27
6.84
Source: Arizona Department of Health Services, 2000. Prostate Cancer Incidence and Mortality in Arizona, 1990-1997.
Table 3.13: Age-Adjusted Incidence Rates for the Top Five Cancers for Men, Arizona, 1990-1997.
1990
1991
1992
1993
1994
1995
1996
1997
Prostate
85.33
114.60
164.49
116.06
95.53
119.09
123.82
122.67
Lung
52.41
61.74
71.56
61.68
57.81
75.48
72.23
63.19
Colorectal
36.79
39.16
48.03
41.20
39.88
47.02
46.00
44.78
Bladder
22.57
25.34
28.26
25.92
28.85
28.93
31.03
29.87
Lymphoma
14.16
15.52
18.48
16.17
16.45
16.67
19.20
18.31
Source: Arizona Department of Health Services, 2000. Prostate Cancer Incidence and Mortality in Arizona, 1990-1997.
The most common types of cancer for men and women are shown in Tables 3.14 and 3.15. While more deaths are attributed to lung and bronchus cancer types, the most common form of cancer is prostate cancer for men and breast cancer for women.
Table 3.14: Ten Most Common Invasive Cancer Types (Crude Rate per 100,000 Males)
Prostate
133.9
Lung &bronchus
69.94
Colorectal
49.63
Bladder
34.18
Lymphoma
20.41
Skin melanoma
19.43
Oral cavity & pharynx
12.39
Leukemias
9.83
Pancreas
9.34
Stomach
8.94
Source: Arizona Department of Health Services, 1999. Cancer in Arizona: Cancer Incidence and Mortality in 1997.
35
36
Table 3.15: Ten Most Common Invasive Cancer Types (Crude Rate per 100,000 Females)
Breast 13
2.62
Lung &bronchus
55.99
Colorectal 46.24
Corpus Uteri
20.42
Lymphoma 17
.24
Ovary 16
.67
Skin melanoma
12.23
Bladder 10
.84
Endocrine system
9.66
Pancreas
9.66
Source: Arizona Department of Health Services, 1999. Cancer in Arizona: Cancer Incidence and Mortality in 1997.
Information about the occurrence of specific forms of cancer in Arizonans in 1997 is presented in Table 3.16.
Statistics on the likelihood of developing cancer are presented in Table 3.17. The risk for cancer increases with age with men having about a 1 in 2 lifetime chance of developing cancer and women having a 1 in 3 chance. According to the American Cancer Society (2001), 80 percent of cancers will be diagnosed after the age of 55.
As mentioned previously, prostate cancer is the most common cancer for men and the second deadliest. Prostate cancer more than any other cancer increases in incidence with age. Incidence and mortality rates for prostate cancer in Arizona’s counties are presented in Tables 3.18 and 3.19. Four counties, Navajo, Pima, Maricopa, and Coconino have higher incidence rates than the state in general. Men are more likely to die from prostate cancer in Graham, Cochise, Santa Cruz, and Coconino counties. Table 3.16: Frequency of Invasive Cancer Cases by Site and Sex, Arizona, 1997.
Male
Female
Total
Male
Female
Total
All sites
9985
9387
19384
Respiratory system
1760
1328
3088
Oral cavity & pharynx
280
126
406
Nose, nasal cavity, & middle ear
7
8
15
Lip
22
7
29
Larynx
147
23
170
Tongue
76
33
109
Lung & bronchus
1573
1286
2859
Salivary gland
32
13
45
Pleura
27
8
35
Floor of mouth
19
10
29
Trachea & other respiratory organs
6
3
9
Gum & other oral cavity
33
25
58
Bone & joints
21
14
35
Nasopharynx
17
3
20
Soft tissue (including heart)
75
62
137
Tonsil
25
9
34
Skin (excluding basal & squamous)
491
304
795
Oropharynx
20
8
28
Melanomas of the skin
439
281
720
Hypopharynx
23
10
33
Other non-epithelial skin
52
23
75
Other oral cavity & pharynx
13
8
21
Male genital system
3187
NA
3187
Digestive system
1920
1652
3572
Prostate
3024
NA
3024
Esophagus
152
39
191
Testis
139
NA
139
Stomach
202
120
322
Penis
23
NA
23
Small intestine
30
20
50
Other male genital system
1
NA
1
Colon
779
779
1558
Urinary system
1109
441
1550
Rectum
342
283
625
Urinary bladder
772
249
1021
Anus, anal canal & anorectum
19
33
52
Ureter
22
10
32
Liver
93
43
136
Other urinary system
3
2
5
Intrahepatic bile duct
18
8
26
Eye and orbit
19
20
39
Gallbladder
20
37
57
Brain & nervous system
134
128
262
Other biliary
39
35
74
Brain
119
118
237
Pancreas
211
222
433
Cranial nerves & other nervous system
15
10
25
Retroperitoneum & peritoneum
8
25
33
Lymphomas
461
396
857
Other digestive system
7
8
15
Hodgkin’s disease
60
49
109
Leukemias
223
175
398
Non-Hodgkin’s lymphomas
401
347
748
Lymphocytic
95
67
162
Multiple myeloma
117
84
201
Myeloid
91
79
170
Ill-defined & unspecified
330
304
634
Monocytic
1
1
2
Endocrine system
78
222
300
Other
36
28
64
Thyroid
70
216
286
Other endocrine system
8
6
14
Source: Arizona Department of Health Services, 1999. Cancer in Arizona: Cancer Incidence and Mortality in 1997
37
38
Table 3.17: Probability of Developing Invasive Cancers over Selected Age Intervals, by Sex, U.S., 1995-1997*.
Birth to 39 (%)
40 to 59 (%)
60 to 79 (%)
Birth to death (%)
All sites
Male
1.56 ( 1 in 64)
8.25 (1 in 12)
33.13 (1 in 3)
43.48 (1 in 2)
Female
1.97 (1 in 51)
9.37 (1 in 11)
22.39 (1 in 4)
38.34 (1 in 3)
Bladder
Male
0.03 (1 in 3,437)
0.44 (1 in 226)
2.39 (1 in 42)
3.40 (1 in 29)
Female
Less that 1 in 10,000
0.14 (1 in 699)
0.68 (1 in 146)
1.18 (1 in 85)
Colon & Rectum
Male
0.07 (1 in 1,531)
0.87 ( 1 in 115)
4.00 (1 in 25)
5.78 (1 in 17)
Female
0.05 (1 in 1,855)
0.69 (1 in 146)
3.04 (1 in 33)
5.55 (1 in 18)
Leukemia
Male
0.15 (1 in 654)
0.21 (1 in 467)
0.84 (1 in 119)
1.42 (1 in 70)
Female
0.11 (1 in 900)
0.15 (1 in 671)
0.50 (1 in 199)
1.05 (1 in 95)
Lung & Bronchus
Male
0.04 (1 in 2,499)
1.24 (1 in 80)
6.29 (1 in 16)
8.09 (1 in 12)
Female
0.03 (1 in 2,977)
0.92 (1 in 108)
4.04 (1 in 25)
5.78 (1 in 17)
Melanoma of the skin
Male
0.13 (1 in 744)
0.53 (1 in 190)
0.94 (1 in 106)
1.68 (1 in 60)
Female
0.22 (1 in 453)
0.40 (1 in 249)
0.48 (1 in 207)
1.25 (1 in 80)
Non-Hodgkin’s Lymphoma
Male
0.19 (1 in 513)
0.50 (1 in 198)
1.21 (1 in 83)
2.11 (1 in 47)
Female
0.08 (1 in 1,296)
0.32 (1 in 312)
0.97 (1 in 103)
1.74 (1 in 57)
Prostate
Male
15.89 (1 in 6)
13.42 (1 in 7)
2.06 (1 in 49)
Less than 1 in 10,000
* For those free of cancer at beginning of age interval.
Source: American Cancer Society, 2001. Cancer Facts & Figures 2001.Table 3.18: Annualized Incidence Rates* of Prostate Cancer by County, 1995-1997.
Navajo
136
Pima
134
Maricopa
128
Coconino
125
Pinal
122
AZ
122
Cochise
117
Graham
117
Santa Cruz
112
Mohave
110
Yavapai
101
Greenlee
99
La Paz
93
Gila
80
Yuma
72
Apache
60
* Age-adjusted to the 1970 U.S. census population with rates per 100,000.
Source: Arizona Department of Health Services, 2000. Prostate Cancer Incidence and Mortality in Arizona, 1990-1997.
Table 3.19: Annualized Mortality Rates1 of Prostate Cancer by County, 1995-1997.
Graham
26
Cochise
23
Santa Cruz
22
Coconino
19
Pima
16
Maricopa
16
AZ
16
Navajo
16
Yavapai
15
Mohave
14
Pinal
14
Yuma
13
Gila
12
La Paz
10
Apache
9
Greenlee2
-
1 Age-adjusted to 1940 U.S. census population with rates per 100,000.
2 The number of prostate cancer deaths were less than 5 cases in the three year period.
Source: Arizona Department of Health Services, 2000. Prostate Cancer Incidence and Mortality in Arizona, 1990-1997.
39
4. Injury
In 2000, accidents, often referred to as unintentional injuries, were the fifth leading cause of death for Arizonans but the third leading cause of death for men. Accidents include motor vehicle accidents, falls, accidental poisoning, and accidental drowning. As shown in Table 4.1 death rates from 1990 to 2000 associated with accidents decreased for men but slightly increased for women. In 2000 men were 2.3 times more likely to die from accidents than women.
Table 4.1: Age-Adjusted Mortality Rates* for Accidents (unintentional injuries) by Gender and Year, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Male
61.4
53.3
59.9
62.9
66.9
65.2
66.6
64.1
62.6
61.9
58.0
Female
24.5
24.1
23.3
24.8
27.0
26.4
27.1
26.3
26.9
26.6
24.9
* Number of deaths per 100,000 population age-adjusted to the 2000 U.S. standard.
Source: Arizona Department of Health Service, 2001. Arizona Health Status and Vital Statistics, 2000.
The statistics reported in Table 4.2 reflect deaths from accidental injuries, suicides, and injury inflicted by another person as in the case of homicide. Mortality rates for men increased to a high of 122.8 deaths per 100,000 persons in the age-adjusted population in 1994 but have decreased by 11.8 percent in the period from 1990 to 2000. Men were 2.7 times more likely to die from injury than females in 2000.
Table 4.2: Age-Adjusted* Mortality Rates for Total Injury Deaths by Gender and Year, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Male
108.8
99.8
99.0
106.7
122.8
115.9
114.6
112.8
109.5
103.4
96.0
Female
36.1
36.2
40.3
43.8
40.6
45.3
38.5
38.3
39.9
39.1
35.1
Both
71.4
67.0
69.2
74.5
81.0
79.8
76.0
75.2
74.5
71.0
64.9
*Number of deaths per 100,000 population age-adjusted to the 2000 U.S. standard.
Source: Arizona Department of Health Services, 2002. Injury Mortality Among Arizona Residents, 1990-2000.
Mortality trends for suicide or what is sometimes referred to as intentional self-harm are shown in Table 4.3. Suicide was the eighth leading cause of death for men in 2000 (Table 1.3). In the ten-year period from 1990 to 2000, men have consistently had a higher suicide rate than women. In 2000, men were 4.8 times more likely to die from suicide than women were. The suicide death rate for men declined 24.2 percent between 1990 and 2000.
40
Table 4.3: Age-Adjusted* Mortality Rates for Intentional Self-Harm (Suicide) by Gender and Year, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Male
32.6
30.5
29.1
32.4
33.5
31.5
28.7
29.5
28.6
25.7
24.7
Female
6.5
6.4
6.6
7.0
7.6
8.8
6.4
6.4
7.1
6.5
5.2
Both
19.0
17.9
17.4
19.1
20.2
19.8
17.2
17.7
17.7
15.8
14.6
*Number of deaths per 100,000 population age-adjusted to the 2000 U.S. standard.
Source: Arizona Department of Health Services, 2002. Injury Mortality Among Arizona Residents, 1990-2000.
Suicide death rates have decreased for men in all racial and ethnic groups with the exception of Asian men who saw an increase in 2000 of 21 percent over 1990 levels (Table 4.4). The largest decrease in suicide mortality was among Black men who experienced a decline of 29.1 percent since 1990. In 2000, American Indian males had the highest suicide mortality rate.
Table 4.4: Age-Adjusted Mortality Rates* for Suicide by Race/Ethnicity Group and Gender, Arizona, 1990 and 2000.
All Arizonans
White non-Hispanic
American Indian
Black
Hispanic
Asian
Male
1990
32.6
36.1
39.1
17.2
16.6
10.2
2000
24.7
27.6
29.7
12.2
12.7
12.3
Female
1990
6.5
7.2
2.6
7.7
2.8
4.6
2000
5.2
6.8
3.7
0.0
1.4
0.0
* Number of deaths per 100,000 population in specified group age-adjusted to the 2000 U.S. standard.
Source: Arizona Department of Health Services, 2002. Injury Mortality Among Arizona Residents, 1990-2000.
Suicide rates vary with age groups. According to Table 4.5, older Arizona men (65 and older) have the highest suicide mortality rates with 45.6 men dying per 100,000 men in this age group. Young adults between the ages of 20 and 24 have the next highest rate of 39.8.
Table 4.5: Suicide Mortality Rates (per 100,000 Population in the Specified Group) by Age Group and Gender, Arizona, 2000.
<15
15-19
20-24
25-34
35-4
45-54
55-64
65+
Male
2.6
18.9
39.8
22.5
28.6
32.8
25.2
45.6
Female
0.5
2.8
4.1
6.7
8.9
10.0
3.4
5.9
Source: Arizona Department of Health Services, 2002. Injury Mortality Among Arizona Residents, 1990-2000.
In 2000, firearm related deaths were the seventh leading cause of death for men in Arizona. Like suicide and accidents, firearms are much more likely to cause death among men than they are among women. Trends in firearm mortality are presented in Table 4.6. In 2000, men were 6.1 times more likely to die as a result of a firearm 41
42
inflicted wound than women. In 2000, firearm mortality for men had decreased 36.1 percent from a mortality rate high in 1995 of 41.3.
Table 4.6: Rates of Firearm-Related Fatalities by Gender and Year, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998 1
999 2
000
Male
32.7 31
.5
32.6
35.7
39.9
41.3 33
.7 33
.7
33.5 28
.4 26
.4
Female
5.3
5.3
6.1
6.7
7.0
7.4
6.0
5.5
6.0
6.2
4.3
Source: Arizona Department of Health Services, 2002. Injury Mortality Among Arizona Residents, 1990-2000.
Black men are much more likely to die from firearms than any other racial or ethnic group (Table 4.7). Firearm death rates for Black men are 58 percent higher than the firearm death rate for Hispanic men and 75 percent higher than the rate for White, non-Hispanic men.
Table 4.7: Firearm-Related Death Rates by Gender and Race/Ethnicity, Arizona, 2000.
White non-Hispanic
Hispanic
Black
American Indian
Asian
Male
25.2 27
.9 44
.2 21
.6 15
.0
Female
4.5
3.2
8.0
3.1
7.7
Source: Arizona Department of Health Services, 2002. Injury Mortality Among Arizona Residents, 1990-2000.
As show in Table 4.8, men who are 65 years old and older are the most likely to die from firearms followed by men in the 20-44 year age group.
Table 4.8: Firearm-Related Death Rates by Age Group and Gender, Arizona, 2000.
<15
15-19
20-44
45-64
65+
Male
1.2
33.6 35
.2 26
.6 41
.9
Female
0.2
4.5
5.6
5.6
5.1
Source: Arizona Department of Health Services, 2002. Injury Mortality Among Arizona Residents, 1990-2000.
Death rates as a result of assault, also know as homicide, increased to 18.5 deaths per 100,000 persons in 1994 and declined over the subsequent years to 11.1 in 2000 (Table 4.9). This represents a decline of 41 percent. Homicide rates for men have been consistently higher than the rate for women with men almost three times as likely to die from assault than women in 2000.
Trend information on numbers of homicides from 1990 to 2000 are presented in Table 4.10. The largest number of deaths occurs in the 20-44 year old age group. 43
Table 4.9: Age-Adjusted* Mortality Rates for Assault (Homicide) by Gender and Year, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Male
12.2
13.0
14.2
14.2
18.5
16.9
16.9
15.8
15.4
13.6
11.1
Female
4.0
4.5
4.3
5.0
4.7
5.2
4.1
4.2
4.3
4.7
3.8
Both
8.1
8.6
8.9
9.5
11.5
12.1
10.2
9.6
9.5
8.7
7.6
*Number of deaths per 100,000 population age-adjusted to the 2000 U.S. standard.
Source: Arizona Department of Health Services, 2002. Injury Mortality Among Arizona Residents, 1990-2000.
Table 4.10: Number of Homicide Deaths by Gender, Age Group and Year, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Total, all groups
302
334
351
387
477
530
459
443
447
430
394
<1
7
6
11
4
7
8
4
6
4
6
6
1-14
16
9
25
23
22
26
26
13
24
11
9`
15-19
28
50
50
61
72
89
72
56
55
51
53
20-44
181
204
200
238
292
324
279
290
299
273
234
45-64
45
43
50
36
53
58
59
56
48
66
65
65+
21
22
12
23
27
19
17
21
13
21
26
Unknown
4
0
3
2
4
6
2
1
4
2
1
Male
Total
226
248
268
286
378
417
368
352
348
315
295
<1
2
2
5
1
4
4
3
4
4
3
4
1-14
11
2
19
14
11
18
13
8
14
5
6
15-19
24
41
44
49
62
77
65
46
42
42
43
20-44
140
159
159
183
240
262
233
236
238
208
193
45-64
34
28
33
23
41
43
45
46
38
41
39
65+
12
16
6
14
17
9
7
11
9
14
9
Unknown
3
0
2
2
3
4
2
1
3
2
1
Female
Total
76
86
83
101
99
113
91
91
99
115
99
<1
5
4
6
3
3
4
1
2
0
3
2
1-14
5
7
6
9
11
8
13
5
10
6
3
15-19
4
9
6
12
10
12
7
10
13
9
10
20-44
41
45
41
55
52
62
46
54
61
65
41
45-64
11
15
17
13
12
15
14
10
10
25
26
65+
9
6
6
9
10
10
10
10
4
7
17
Unknown
1
0
1
0
1
2
0
0
1
0
0
Source: Arizona Department of Health Services, 2002. Injury Mortality Among Arizona Residents, 1990-2000. 5. Mental Health and Substance Abuse
Approximately one in five Americans have a diagnosable mental illness in any given year (National Institute of Mental Health, 2001). Such mental disorders are accompanied by a variety of limitations and disabilities that may equal or exceed those resulting from chronic physical conditions (Center for Mental Health Services, 1998). For example, symptoms of depression are reported to produce greater limitations in physical and social functioning than such illnesses as diabetes, arthritis, and back problems (Center for Mental Health Services, 1998). In fact, major depression, bipolar disorder, schizophrenia, and obsessive-compulsive disorder are four of the ten leading causes of disability in the U.S. and other industrialized countries (National Institute of Mental Health, 2001).
Information presented in this fact book on the prevalence of mental disorders, including substance abuse, in the U.S. comes from three sources. The first is the National Health Interview Survey that is conducted annually by the National Center for Health Statistics. Data in Table 5.1 comes from the 1994 survey that included a supplement that looked at the occurrence of mental health disorders in the general population. The second source is the National Household Survey on Drug Abuse that is conducted annually for the Substance Abuse and Mental Health Services Administration and collects data on a variety of issues related to the use of drugs including tobacco and alcohol. Tables 5.2 and 5.3 report on data collected by this survey. The third source is the 1997 Client/Patient Sample Survey conducted by the Center for Mental Health Services. This survey collected information on the characteristics of people in mental health treatment. Data in Tables 5.4 through 5.10 come from this study.
In Table 5.1, a mental or emotional disorder was determined to be present if the person being interviewed stated they had a specific mental/emotional disorder at some point in the prior 12 months that persisted for at least two weeks, reported specific mental health symptoms, or stated they has used a prescription medication for an ongoing mental/emotional disorder at some time during the prior 12 months. A smaller percentage of men (38.2 percent) reported mental/emotional problems than women (61.8 percent) but a larger percentage of men (70.0 percent) stated they had a substance abuse problem compared with women (29.1 percent).
Table 5.1: Estimated Number and Percent Distribution of Prevalence of 12-Month Mental Health and Substance Abuse Problem by Gender (U.S. Civilian Noninstitutionalized Population Aged 18 to 69 Years).
Household population
Selected M/E problem
Substance abuse disorder
(000)
%
(000)
%
(000)
%
Male
82,090
48.8
3,144
38.2
873
70.9
Female
86,150
51.2
5,095
61.8
358
29.1
Source: Center for Mental Health Services, 1998. Mental Health, United States, 1998.
Another measure of the prevalence of mental disorders is the number of people who report having utilized mental health services. Table 5.2 reports that men were less likely
44
45
than women to receive inpatient and outpatient mental health treatment or counseling and use prescription medications for mental health disorders.
Table 5.2: Percentages of Persons Aged 18 or Older Who Reported Receiving Mental Health Services in the Past Year, U.S., 2000.
Type of mental health service
Received mental health treatment or counseling1
Inpatient treatment/ counseling
Outpatient treatment/ counseling
Prescription medication
Total
9.9 0.
7 5.
6
7.8
Male
7.0 0.
6 3.
9
5.1
Female
12.6
0.8
7.1
10.3
1Mental health treatment/counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems.
Source: Substance Abuse and Mental Health Services Administration, 2001. Summary of Findings from the National Household Survey on Drug Abuse, 2000.
Table 5.3 compares the percentage of people who have used illicit drugs or alcohol with the percentage of people who have used treatment services or perceive a need for these services.
Table 5.3: Percentages Reporting Past Month Use of Any Illicit Drug and Alcohol Among Persons Aged 18 or Older, by Receipt of and Perceived Need for Mental Health Treatment/Counseling, U.S., 2000.
Mental health treatment/counseling in the past year2
Received
Not received
Total1
Unmet need
No unmet need
Unmet need
No unmet need
Illicit Drugs
Total
5.9 20
.8
8.3 18
.9
5.0
Male
7.4
24.9 11
.4 27
.2 6.
6
Female
4.5 19
.0
6.7 14
.5
3.4
Alcohol
Total
50.2 58
.8 49
.6 60
.0 49
.8
Male
58.3 63
.7 54
.5 66
.2 58
.4
Female
42.7
56.5
47.0
56.8
41.4
1 Estimates in the total column represent past month use for all persons aged 18 or older, including those with unknown mental health treatment/counseling information.
2 Mental health treatment/counseling is defined as having received inpatient care, outpatient care, or using prescription medication for mental or emotional problems. Unmet treatment/counseling need is defined as a perceived need for treatment that was not received.
Source: Substance Abuse and Mental Health Services Administration, 2001. Summary of Findings from the National Household Survey on Drug Abuse, 2000.
Tables 5.4 through 5.9 report on new admissions and persons currently under care in less than 24-hour care programs, residential care programs, and inpatient psychiatric care programs for 1997. For all types of care, men had higher rates than women for admissions and current care. African American males had the highest admission and under care rates of all other ethnic and racial groups for residential and in-patient care programs. American Indian and Alaskan Native males had the highest admission and under care rates for less than 24-hour care programs. Asian or Pacific Islander males had the lowest rates for admissions and care. Table 5.4: Rate per 100,000 U.S. Civilian Population1 of Admissions, by Race/Ethnicity, Gender, and Type of Less than 24-Hour Care Program, U.S., 1997.
Total, all less than 24-hour care programs
State/County mental hospitals
Private psychiatric hospitals
Non-federal general hospital
VA medical centers
Multi-service mental health organizations
Total
1,252.9
12.9
78.6
224.5
51.1
513.4
Male
1,270.8
14.6
72.5
203.4
96.4
513.1
Female
1,235.9
11.2
84.3
244.5
8.2
513.6
American Indian or Alaska Native
4,425.1
-
*
427.7
*
2,402.9
Male
2,031.1
-
*
*
*
717.5
Female
2,394.0
-
-
*
-
1,685.4
Asian or Pacific Islander
1,115.0
*
39.6
105.7
40.1
500.2
Male
490.0
*
*
73.7
*
185.3
Female
625.1
*
*
32.0
*
314.9
Black or African American
3,539.6
45.8
150.7
538.2
152.9
1,587.7
Male
1,941.2
26.9
95.1
283.3
136.8
829.2
Female
1,598.4
18.9
55.5
255.0
16.1
758.5
White
2,412.9
22.1
178.1
426.7
105.0
970.9
Male
1,209
13.2
76.5
191.4
98.2
486.6
Female
1,203.6
8.9
101.6
235.3
6.8
484.4
Hispanic or Latino
2,326.9
28.9
66.1
608.8
62.6
859.6
Male
1,167.8
11.5
34.2
238.3
53.3
446.3
Female
1,159.1
17.4
31.9
370.5
9.3
413.4
1 U.S. Bureau of the Census population estimates for May 1997 are used as denominators for rate computations.
* Estimate is based on five or fewer sample cases or estimate has a relative standard error 50% or higher.
Source: Center for Mental Health Services, 2000. Mental Health, United States, 2000.
46
47
Table 5.5: Rate per 100,000 U.S. Civilian Population1 of Persons under Care, by Race/Ethnicity, Gender, and Type of Less than 24-Hour Care Program, U.S., 1997.
Total, all less than 24-hour care programs
State/County mental hospitals
Private psychiatric hospitals
Non-federal general hospital
VA medical centers
Multi-service mental health organizations
Total
808.4
15.7
20.4
113.0
56.2
332.5
Male
842.5
16.1
20.2
100.5
107.8
322.5
Female
776.0
15.4
20.6
124.9
7.3
342.0
American Indian or Alaska Native
2,784.3
*
*
*
307.7
1,195.9
Male
1,701.3
-
-
*
307.7
792.9
Female
1,083.1
*
*
*
-
403.0
Asian or Pacific Islander
472.5
*
*
43.4
*
106.1
Male
348.5
*
*
*
*
65.8
Female
124.0
*
*
*
-
*
Black or African American
2,630.9
73.2
46.6
290.2
230.0
1,127.8
Male
1,465.5
*
22.1
108.2
215.2
567.8
Female
1,165.4
30.5
24.5
182.0
14.8
560.0
White
1,494.6
18.6
42.2
201.6
104.6
631.0
Male
748.3
8.6
20.5
83.8
97.2
299.7
Female
746.3
10.0
21.8
117.7
7.4
331.2
Hispanic or Latino
1,628.4
*
38.1
380.0
72.3
522.4
Male
904.9
*
*
228.5
71.1
264.6
Female
723.5
*
257.8
151.5
*
14.6
1 U.S. Bureau of the Census population estimates for May 1997 are used as denominators for rate computations.
* Estimate is based on five or fewer sample cases or estimate has a relative standard error 50% or higher.
Source: Center for Mental Health Services, 2000. Mental Health, United States, 2000.Table 5.6: Rate per 100,000 U.S. Civilian Population1 of Admissions by Race/Ethnicity, Gender, and Type of Residential Care Program, U.S., 1997.
Total, all residential care programs
RTCs for emotionally disturbed children
All other organizations2
Total
64.4
16.3
48.1
Male
83.9
21.5
62.5
Female
45.9
11.4
34.5
American Indian or Alaska Native
*
*
*
Male
86.2
*
*
Female
*
*
-
Asian or Pacific Islander
43.0
*
30.7
Male
15.6
*
*
Female
*
*
*
Black or African American
214.3
78.5
135.8
Male
138.3
47.8
90.5
Female
76.0
30.7
45.3
White
122.3
24.7
97.6
Male
80.0
16.9
63.1
Female
42.4
7.8
34.6
Hispanic or Latino
113.1
37.1
76.0
Male
74.4
25.8
48.6
Female
38.8
11.4
27.4
1 U.S. Bureau of the Census population estimates for May 1997 are used as denominators for rate computations.
2 Includes the residential care programs of State and County mental hospitals, private psychiatric hospitals, non-Federal general hospitals, VA medical centers, and multiservice mental health organizations.
* Estimate is based on five or fewer sample cases or estimate has a relative standard error 50% or higher. The estimate is not shown because it does not meet standards of reliability.
Source: Center for Mental Health Services, 2000. Mental Health, United States, 2000.
48
49
Table 5.7: Rate per 100,000 U.S. Civilian Population1 of Persons under Care by Race/Ethnicity, Gender, and Type of Residential Care Program, U.S. 1997.
Total, all residential care programs
RTCs for emotionally disturbed children
All other organizations2
Total
31.2 10
.4 20
.8
Male
40.9 15
.2 25
.7
Female 22
.0
5.9
16.1
American Indian or Alaska Native
116.7 85
.5
*
Male
82.8 54
.9 *
Female
* * *
Asian or Pacific Islander
15.5
*
12.9
Male
* * *
Female
* * *
Black or African American
137.3 54
.9
82.4
Male
91.8 39
.0 52
.8
Female
45.5 15
.9 29
.6
White
53.8 15
.9 37
.9
Male
35.5 11
.6 23
.8
Female 18
.4
4.3
14.1
Hispanic or Latino
53.9
20.1
33.8
Male
30.8 14
.9 15
.9
Female
23.2
5.2
17.9
1 U.S. Bureau of the Census population estimates for May 1997 are used as denominators for rate computations.
2 Includes the residential care programs of State and County mental hospitals, private psychiatric hospitals, non-Federal general hospitals, VA medical centers, and multiservice mental health organizations.
* Estimate is based on five or fewer sample cases or estimate has a relative standard error 50% or higher. The estimate is not shown because it does not meet standards of reliability.
Source: Center for Mental Health Services, 2000. Mental Health, United States, 2000. Table 5.8: Rate per 100,000 U.S. Civilian Population1 of Admissions, by Race/Ethnicity, Gender, and Type of Inpatient Psychiatric Care Program, U.S., 1997.
Total, all inpatient programs2
State/County mental hospitals
Private psychiatric hospitals
Non-federal general hospital
VA medical centers
Total
764.9
71.5
187.1
389.1
38.2
Male
847.5
89.0
201.0
398.8
73.3
Female
686.7
54.9
173.8
379.9
5.0
American Indian or Alaska Native
2,399.8
184.0
*
*
*
Male
1,326.0
*
*
*
*
Female
1,073.8
*
*
*
-
Asian or Pacific Islander
477.4
26.3
*
263.7
*
Male
161.9
*
*
*
*
Female
315.5
*
*
195.1
-
Black or African American
2,400.4
293.8
503.7
1,151.6
223.0
Male
1,497.7
188.8
253.4
692.8
204.8
Female
902.7
104.9
250.2
458.8
18.2
White
1,478.7
131.1
347.1
781.0
64.9
Male
798.2
80.3
191.3
389.1
61.3
Female
680.5
50.8
155.7
391.9
3.6
Hispanic or Latino
1,249.4
100.7
525.9
454.4
40.8
Male
674.8
68.6
260.8
213.8
39.6
Female
574.6
32.1
265.1
240.6
*
1 U.S. Bureau of the Census population estimates for May 1997 are used as denominators for rate computations.
2 Multiservice mental health organizations are include in the total column but are not detailed separately.
* Estimate is based on five or fewer sample cases or estimate has a relative standard error 50% or higher.
Source: Center for Mental Health Services, 2000. Mental Health, United States, 2000.
50
51
Table 5.9: Rate per 100,000 U.S. Civilian Population1 of Admissions, by Race/Ethnicity, Gender, and Type of Inpatient Psychiatric Care Program, U.S., 1997.
Total, all inpatient programs2
State/County mental hospitals
Private psychiatric hospitals
Non-federal general hospital
VA medical centers
Total
43.7
20.3
6.6
10.9
2.5
Male
55.5
29.2
6.6
10.5
4.9
Female
32.4
11.9
6.5
11.2
0.3
American Indian or Alaska Native
99.0
61.1
10.5
*
*
Male
78.3
*
*
*
-
Female
20.7
*
*
*
-
Asian or Pacific Islander
23.1
14.2
*
*
-
Male
13.3
*
*
*
-
Female
9.8
*
*
*
-
Black or African American
171.1
90.1
20.1
39.3
14.4
Male
123.2
66.5
12.1
23.4
14.3
Female
47.9
23.6
8.0
15.9
*
White
80.7
34.7
12.9
21.1
4.2
Male
48.0
24.0
6.1
9.3
3.9
Female
32.6
10.6
6.8
11.8
0.3
Hispanic or Latino
67.3
38.0
10.7
12.9
2.9
Male
46.0
28.3
6.1
8.2
2.6
Female
21.4
9.7
4.6
4.7
*
1 U.S. Bureau of the Census population estimates for May 1997 are used as denominators for rate computations.
2 Multiservice mental health organizations are include in the total column but are not detailed separately.
* Estimate is based on five or fewer sample cases or estimate has a relative standard error 50% or higher.
Source: Center for Mental Health Services, 2000. Mental Health, United States, 2000. Substance abuse results in more deaths, illnesses, and disabilities than any other preventable condition (Robert Wood Johnson Foundation, 2001). Approximately one in four deaths are attributable to substance abuse with alcohol related deaths accounting for 100,000 deaths and illicit drugs accounting for 16,000 deaths each year.
Tobacco use is the most preventable cause of death and illness in the U.S. (Centers for Disease Control and Prevention, 2002c). It is responsible for 87 percent of lung cancers and is associated with other cancers of the mouth, pharynx, larynx, esophagus, pancreas, uterine cervix, kidney, and bladder (American Cancer Society, 2001). People who use tobacco are also at increased risk for cardiovascular and respiratory illnesses. The Centers for Disease Control and Prevention estimate that approximately 440,000 people die as a result of cigarette smoking each year (Centers for Disease Control and Prevention, 2002c).
Between 1990 and 2000, the percentage of current male smokers remained relatively stable in the U.S. (Table 5.10). The percentage of men in Arizona that currently smoked during the same time period fluctuated between 18.3 and 27.1 percent. Men are more likely than women to smoke.
Table 5.10: Percentage Current Smokers*, U.S. and Arizona, 1990-2000.
Males
Females
U.S.
Arizona
U.S.
Arizona
1990
24.9
22.7
21.3
18.6
1991
25.1
26.3
21.3
21.4
1992
24.2
21.7
21.0
17.0
1993
24.0
22.0
21.1
19.9
1994
23.9
21.2
21.6
24.7
1995
24.8
26.8
20.9
19.2
1996
25.5
27.1
21.9
20.5
1997
25.4
22.0
21.1
20.2
1998
25.3
24.6
20.9
19.2
1999
24.2
23.6
20.8
16.7
2000
24.4
18.3
21.2
19.0
* All respondents 18 and older who have ever smoked 100 cigarettes in their lifetime and reported smoking every day or some days.
Source: Centers for Disease Control and Prevention, 2002b. Behavioral Risk Factor Surveillance System.
Results of cigarette and tobacco use questions from the National Household Survey on Drug Abuse (NHSDA) are presented in Table 5.11. Over three-quarters of the male population in the U.S. has smoked cigarettes at some point in their lifetime. Based on estimates provided in Tables 5.10 and 5.11, between 24.4 and 28.7 percent of men in the U.S. were current smokers in 2000.
52
Table 5.11: Percentages Reporting Lifetime, Past Year, and Past Month Use of Cigarettes Among Persons Aged 18 or Older, U.S., 1999 and 2000.
Time period
Lifetime
Past year
Past month
1999
2000
1999
2000
1999
2000
Total
71.8
70.2
30.9
30.1
27.0
26.3
Male
78.2
76.6
34.3
33.0
30.0
28.7
Female
66.0
64.3
27.8
27.4
24.3
24.0
Source: Substance Abuse and Mental Health Services Administration, 2001. Summary of Findings from the National Household Survey on Drug Abuse, 2000.
Data from 1999 and 2000 reporting the use of any form of tobacco product is shown in Table 5.12. Again, men are more likely than women to have used a tobacco product during their lifetime, in the past year, or in the past month.
Table 5.12: Percentages Reporting Lifetime, Past Year, and Past Month Use of Any Tobacco Product Among Persons Aged 18 or Older, U.S., 1999 and 2000.
Time period
Lifetime
Past year
Past month
1999
2000
1999
2000
1999
2000
Total
75.6
74.4
37.1
36.3
31.7
30.9
Male
84.5
83.6
45.6
44.3
38.8
37.5
Female
67.5
65.9
29.4
29.0
25.2
24.9
Source: Substance Abuse and Mental Health Services Administration, 2001. Summary of Findings from the National Household Survey on Drug Abuse, 2000.
The prevalence of illicit drug use and alcohol is presented in the following tables. Men are more likely than women to have used illicit drugs in their lifetime, in the past year, or in the past month (Table 5.13). This includes marijuana, cocaine, hallucinogens, and nonmedical use of prescription drugs.
As with illicit drugs, a larger percentage of men than women report using alcohol (Table 5.14). In 2000, men were more than twice as likely as women to binge drink (having five or more drinks on the same occasion on at least 1 day in the past 30 days) and more than three times as likely to drink heavily (drinking five or more drinks on the same occasion on each of five or more days in the past 30 days).
53
Table 5.13: Percentages Reporting Lifetime, Past Year, and Past Month Use of Various Drugs Among Persons Aged 18 and Older, U.S. 1999 and 2000.
Lifetime
Past year
Past month
1999
2000
1999
2000
1999
2000
Any illicit drug
Total
41.1
40.3
10.5
10.1
5.8
5.9
Male
45.6
45.6
13.1
12.2
7.8
7.4
Female
37.0
35.6
8.2
8.1
4.0
4.5
Marijuana
Total
36.4
36.0
8.0
7.7
4.4
4.5
Male
41.1
41.3
10.6
10.0
6.4
6.0
Female
32.1
31.3
5.6
5.7
2.7
3.2
Cocaine
Total
12.6
12.2
1.7
1.5
0.7
0.5
Male
15.5
15.1
2.2
1.9
1.0
0.7
Female
9.9
9.5
1.2
1.0
0.5
0.4
Hallucinogens
Total
12.0
12.4
1.2
1.3
0.3
0.4
Male
14.9
15.5
1.6
1.7
0.5
0.5
Female
9.3
9.6
0.8
0.9
0.2
0.3
Nonmedical use of prescription type psychotherapeutic
Total
15.9
15.0
3.8
3.6
1.7
1.6
Male
17.6
16.5
4.0
3.6
1.8
1.7
Female
14.5
13.5
3.6
3.5
1.5
1.5
Source: Substance Abuse and Mental Health Services Administration, 2001. Summary of Findings from the National Household Survey on Drug Abuse, 2000.
Table 5.14: Percentages Reporting Lifetime, Past Month Alcohol Use, Past Month “Binge” Alcohol Use, and Past Month Heavy Alcohol Use Among Persons Aged 18 or Older, U.S., 1999 and 2000.
Type of alcohol use
Any alcohol use
“Binge” alcohol use
Heavy alcohol use
1999
2000
1999
2000
1999
2000
Total
50.0
50.2
21.4
21.8
6.1
6.0
Male
57.8
58.3
30.2
30.5
10.0
9.4
Female
42.8
42.7
13.4
13.9
2.5
2.8
Note: “Binge” alcohol use is defined as drinking five or more drinks on the same occasion on at least 1 day in the past 30 days. By “occasion” is meant at the same time or within a couple hours of each other. Heavy alcohol use is defined as drinking five or more drinks on the same occasion on each of 5 or more days in the past 30 days; all heavy alcohol users are also binge alcohol users.
Source: Substance Abuse and Mental Health Services Administration, 2001. Summary of Findings from the National Household Survey on Drug Abuse, 2000.
54
Table 5.15 presents data from 1990 through 1999 on the percentage of people in the U.S. and Arizona who would be considered chronic drinkers (2 or more drinks per day). In 1999, men were 22 times more likely than women to be considered chronic drinkers.
Table 5.15: Percentage Reporting Chronic Drinking*, U.S. and Arizona, 1990-2000.
Males
Females
U.S.
Arizona
U.S.
Arizona
1990
5.8
6.4
0.8
0.9
1991
6.2
6.5
0.9
0.7
1992
5.2
3.0
0.8
0.8
1993
5.5
4.0
0.9
0.9
1994
No data
5.1
No data
0.9
1995
5.0
4.4
0.8
0.6
1996
No data
8.2
No data
2.0
1997
5.3
4.1
0.8
1.1
1998
No data
No data
No data
No data
1999
6.4
8.8
0.9
0.4
2000
No data
No data
No data
No data
* All respondents 18 and older who report an average of two or more drinks per day i.e., 60 or more alcoholic drinks a month.
Source: Centers for Disease Control and Prevention, 2002b. Behavioral Risk Factor Surveillance System.
As might be expected since men report higher rates of using drugs and alcohol than women, men are also more likely to drive under the influence of drugs and alcohol (Table 5.16).
Table 5.16 Percentages Reporting Driving Under the Influence of Any Illicit Drug or Alcohol in the Past Year Among Persons Aged 18 or Older, U.S., 1999 and 2000.
Drove under the influence in past year
Any illicit drug
Alcohol
Any illicit drug or alcohol
1999
2000
1999
2000
1999
2000
Total
3.5
3.1
11.8
10.8
12.5
11.5
Male
5.1
4.4
17.0
15.3
17.9
16.1
Female
2.0
1.9
7.0
6.7
7.5
7.2
Source: Substance Abuse and Mental Health Services Administration, 2001. Summary Findings from the National Household Survey on Drug Abuse, 2000.
Tables 5.17 and 5.18 display mortality rates for drug related deaths in Arizona. Men have a death rate from drugs (8.9 deaths per 100,000 persons) that is more than twice as high as that for women (4.0 deaths per 100,000 persons). Female death rates for suicide by drugs (1.4 deaths per 100,000 persons) are higher than the suicide by drugs rate for men (0.8 deaths per 100,000 persons). Narcotics and hallucinogens are the most common drugs that cause death for men (Table 5.18).
55
56
Table 5.17: Drug-Related Death Rates (per 100,000 Persons in Specified Group) by Mortality Category and Gender, Arizona, 2000.
Abuse of psychoactive substances
Suicide by drugs
Accidents in the use of drugs
All drug-related deaths
Male
0.4 0.
8 7.
2
8.9
Female
0.3
1.4
1.8
4.0
Source: Arizona Department of Health Services, 2002. Injury Mortality among Arizona Residents, 1990-2000.
Table 5.18: Drug-Related Death Rates (per 100,000 Persons in Specified Group) by Type of Drug and Gender, Arizona, 2000.
Nonopiod analgesics, antipyretics, antirheumatics
Antiepileptic, sedative-hypnotic, psychotropic
Narcotics, psychodysleptics (hallucinogens)
Other and unspecified
Male
0.1 0.
4 5.
3
3.1
Female
0.3
0.3
1.3
2.1
Source: Arizona Department of Health Services, 2002. Injury Mortality among Arizona Residents, 1990-2000.
Table 5.19 shows the cause of drug-related death from 1990 through 2000. The number of people dying as a result of drugs increased from 1990 to 1999. Drug-related deaths decreased in 2000. For both men and women, accidental poisoning is the most common cause for drug-related deaths followed by self-poisoning.57
Table 5.19: Drug-Related Mortality by Gender and Year, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Total
174
185
283
310
357
397
404
408
508
543
331
Abuse of psychoactive substances
16
25
57
42
25
42
49
10
16
14
19
Accidental poisoning by drugs
81
77
125
153
224
221
268
289
362
383
230
Intentional self-poisoning by drugs
66
61
78
85
81
108
56
73
87
101
58
Assault by drugs
0
1
0
1
0
0
1
2
1
1
0
Undetermined intent of poisoning by drugs
9
20
17
20
18
18
21
27
37
41
21
Drugs causing adverse effects in therapeutic use
2
1
6
9
9
8
9
7
5
3
3
M
Total
125
119
205
218
247
277
300
301
359
396
229
Abuse of psychoactive substances
14
21
50
32
22
36
36
8
13
13
11
Accidental poisoning by drugs
64
60
97
122
171
181
220
237
287
304
184
Intentional self-poisoning by drugs
39
26
44
42
43
46
26
35
41
56
21
Assault by drugs
0
0
0
0
0
0
1
0
0
0
0
Undetermined intent of poisoning by drugs
6
11
10
16
8
10
12
17
17
21
12
Drugs causing adverse effects in therapeutic use
2
1
4
6
3
4
5
4
1
2
1
Fem
Total
49
66
78
92
110
120
104
107
149
147
102
Abuse of psychoactive substances
2
4
7
10
3
6
13
2
3
1
8
Accidental poisoning by drugs
17
17
28
31
53
40
48
52
75
79
46
Intentional self-poisoning by drugs
27
35
34
43
38
62
30
38
46
45
37
Assault by drugs
0
1
0
1
0
0
0
2
1
1
0
Undetermined intent of poisoning by drugs
3
9
7
4
10
8
9
10
20
20
9
Drugs causing adverse effects in therapeutic use
0
0
2
3
6
4
4
3
4
1
2
Source: Arizona Department of Health Services, 2002. Injury Mortality among Arizona Residents, 1990-2000.58
6. Sexually Transmitted Diseases
According to the Centers for Disease Control and Prevention (2000), there are more than 25 diseases that are spread through sexual contact resulting in 15 million new sexually transmitted disease cases each year. With the exception of HIV disease, most people are not aware of the extent of the problem caused by sexually transmitted diseases even though these diseases have significant consequences on the physical, public, and financial health of the country. The most common sexually transmitted diseases are gonorrhea, chlamydia, syphilis, genital herpes, human papillomavirus, hepatitis B, trichomoniasis, and bacterial vaginosis.
Arizona and U.S. rates for three of the most common sexually transmitted diseases are compared in Table 6.1. Chlamydia and gonorrhea rates for men in Arizona and the U.S. have increased in the five-year period between 1996 and 2000. Rates for syphilis infection have decreased for men in Arizona but have increased for men in the U.S. Men in Arizona have higher rates of gonorrhea and syphilis than women. Women are 3.8 times more likely to contract chlamydia than men are.
Table 6.1: Reported Rates (per 100,000) of Chlamydia, Gonorrhea, and Syphilis, Arizona and U.S., 1996-2000.
1996 1
997 1
998 1
999 2
000
Chlamydia
Men
AZ
93.6 96
.8 10
7.1
110.6
109.2
US
59.8 70
.5 82
.4 93
.8 10
2.8
Women
AZ
385.9 37
4.3 38
2.0 39
3.4 41
4.6
US
319.5 33
7.1 37
7.6 40
0.8 40
4.0
Gonorrhea
Men
AZ
91.9 96
.4 10
7.5
107.1
100.5
US
127.4 12
4.9 13
2.7 13
4.7 13
4.6
Women
AZ
75.5 70
.8 73
.3 72
.9 72
.7
US
119.0 11
9.0 13
0.0 12
8.7 12
8.3
Primary and Secondary Syphilis
Men
AZ
2.7 4.
2 5.
1 6.
2 4.
6
US
4.6 3.
6 3.
0 2.
9 2.
7
Women
AZ
1.9 1.
6 2.
8 2.
7 3.
3
US
4.0
2.9
2.2
2.0
1.8
Source: Centers for Disease Control and Prevention, 2001b. Sexually Transmitted Disease Surveillance 2000.
Year 2000 rates among different age groups for four of the most common sexually transmitted diseases are presented in Table 6.2. The highest gonorrhea, chlamydia, and genital herpes infection rates for men occur between the ages of 20-24. Men between the ages of 30-34 are more likely to contract syphilis than other age groups. 59
Table 6.2: Rates (per 100,000) of Reported Cases of Gonorrhea, Chlamydia, Early Syphilis and Genital Herpes by Age and Gender, Arizona, 2000.
Gonorrhea
Chlamydia
Early syphilis
Genital herpes
Males
Females
Total
Males
Females
Total
Males
Females
Total
Males
Females
Total
0-4
3.6
0.5
2.1
7.1
6.4
6.8
0
0
0
1.0
0.5
0.8
5-9
0
1.6
0.8
0
1.6
0.8
0
0
0
0.5
0
.03
10-14
4.6
17.4
10.9
8.8
112.5
59.3
0
1.0
0.5
0.5
3.3
1.9
15-19
197.3
319.2
256.0
301.1
2104.5
1168.8
5.2
12.4
8.7
10.5
66.7
37.5
20-24
319.9
288.4
305.0
482.7
2042.4
1221.8
17.8
22.7
20.1
44.0
126.7
81.0
25-29
229.2
150.3
191.4
257.4
805.6
519.7
20.0
20.7
20.3
38.0
73.7
55.1
30-34
178.1
97.7
139.6
133.3
337.3
231.2
21.4
21.5
21.4
31.3
61.0
45.5
35-39
111.5
53.9
83.2
77.5
134.7
105.6
12.0
17.6
14.8
22.0
32.1
27.0
40-44
83.1
33.2
58.3
34.4
54.6
44.4
12.2
13.9
13.0
19.6
26.7
23.1
45-54
47.6
8.1
27.4
16.3
20.3
18.6
11.7
4.4
8.0
6.2
15.6
11.0
55-64
13.8
3.5
8.3
5.7
5.2
5.4
5.7
0.9
3.2
3.8
6.0
5.0
65-over
5.4
0.3
2.6
1.0
0.8
0.9
1.4
0
0.6
1.4
3.8
2.3
Total
92.3
67.7
80.0
100.5
386.8
243.9
8.7
8.3
8.5
13.8
29.7
21.8
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000. 60
As of the year 2000, men continue to make up the majority of new HIV infections with 70 percent of new infections occurring among men (Centers for Disease Control and Prevention, undated). In Arizona, 86 percent of the AIDS cases reported in 2000 were among men (Table 6.3). Tables 6.4 and 6.5 provide data about AIDS cases and HIV infection cases in the U.S. by gender. Men comprise seventy five percent of AIDS cases in the U.S. reported between July 2000 and June 2001 (Table 6.4).
Information about AIDS and HIV infection cases in the U.S. by race and gender are presented in Tables 6.6 and 6.7. HIV and AIDS disproportionately affect racial and ethnic minorities with Black, non Hispanic men accounting for 42.3 percent of AIDS cases reported from July 2000 to June 2001. White, non Hispanic men accounted for 36 percent and Hispanic men accounted for 20 percent in this same time period. A similar picture presents itself for HIV infections reported from July 2000 to June 2001 in the U.S. Black, non-Hispanic men comprise 44 percent of infections, White, non-Hispanic men make up 39 percent of infections, and Hispanic men account for 14 percent of infections.
Men are living longer with AIDS as shown in Tables 6.8 and 6.9. The number of men living with AIDS increased by 84.3 percent from 1993 to 2000. Death from AIDS decreased in the same time period by 70 percent.
Table 6.3: Reported Cases of AIDS by Year of Diagnosis and Gender, Arizona, 1990-2000.
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999 2
000
Males
505 52
8
660
623
587
609 48
5 44
9
430 33
9 28
5
Females
35
36
55
64
51
71
63
59
62
48
47
Source: Arizona Department of Health Services, 2001. Arizona Health Status and Vital Statistics, 2000. Table 6.4: AIDS Cases by Age Group, Exposure Category, and Sex, Reported through June 2001, U.S.
Males
Females
Total
July 2000-June 2001
Cumulative total
July 2000-June 2001
Cumulative total
July 2000-June 2001
Cumulative total
No.
%
No.
%
No.
%
No.
%
No.
%
No.
%
Men who have sex with men
13,293
43
361,867
56
-
-
-
-
13,293
33
361,867
46
Injecting drug use
5,369
18
142,888
22
2,306
23
54,203
40
7,675
19
197,091
25
Men who have sex with men and inject drugs
1,477
5
50,066
8
-
-
-
-
1,477
4
50,066
6
Hemophilia/coagulation disorder
95
0
4,949
1
8
0
285
0
103
0
5,234
1
Heterosexual contact
2,560
8
30,956
5
3,912
39
54,782
41
6,472
16
85,738
11
Sex with injecting drug user
506
9,496
928
21,111
1,434
30,607
Sex with bisexual male
-
-
171
3,672
171
3,672
Sex with person with hemophilia
4
67
11
422
15
489
Sex with transfusion recipient
22
436
25
614
47
1,050
Sex with HIV-infected person, risk not specified
2,028
20,957
2,777
28,963
4,805
49,920
Receipt of blood transfusion, blood components, or tissue
125
0
5,031
1
124
1
3,863
3
249
1
8,894
1
Other/risk not reported or identified
7,664
25
53,429
8
3,767
37
21,712
16
11,431
28
75,142
10
Adult/adolescent subtotal
30,583
100
649,186
100
10,117
100
134,845
100
40,700
100
784,032
100
Source: Centers for Disease Control and Prevention, 2001a. HIV/AIDS Surveillance Report.
61
Table 6.5: HIV Infection Cases* by Age Group, Exposure Category, and Sex, Reported through June 2001, from the 36 Areas with Confidential HIV Infection Reporting, U.S.
Males
Females
Total
July 2000-June 2001
Cumulative total
July 2000-June 2001
Cumulative total
July 2000-June 2001
Cumulative total
No.
%
No.
%
No.
%
No.
%
No.
%
No.
%
Men who have sex with men
6,671
44
47,305
46
-
-
-
-
6,671
31
47,305
33
Injecting drug use
1,275
8
13,536
13
835
12
7,717
19
2,110
10
21,254
15
Men who have sex with men and inject drugs
594
4
6,244
6
-
-
-
-
594
3
6,244
4
Hemophilia/coagulation disorder
17
0
436
0
7
0
31
0
24
0
467
0
Heterosexual contact
1,216
8
7,670
7
2,462
36
16,964
42
3,678
17
24,634
17
Sex with injecting drug user
218
1,612
426
4,232
644
5,844
Sex with bisexual male
-
-
-
-
156
1,253
156
1,253
Sex with person with hemophilia
2
15
13
134
15
149
Sex with transfusion recipient
5
83
10
113
15
196
Sex with HIV-infected person, risk not specified
991
5,960
1,857
11,232
2,848
17,192
Receipt of blood transfusion, blood components, or tissue
53
0
416
0
39
1
440
1
92
0
856
1
Other/risk not reported or identified
5,183
35
27,346
27
3,443
51
15,433
38
8,626
40
42,787
30
Adult/adolescent subtotal
15,009
100
102,953
100
6,786
100
40,585
100
21,795
100
143,547
100
* Includes only persons reported with HIV infection who have not developed AIDS.
Source: Centers for Disease Control and Prevention, 2001a. HIV/AIDS Surveillance Report.
62
Table 6.6: Male Adult/Adolescent AIDS Cases by Exposure Category and Race/Ethnicity, Reported through June 2001, U.S.
White, not Hispanic
Black, not Hispanic
Hispanic
July 2000-June 2001
Cumulative total
July 2000-June 2001
Cumulative total
July 2000-June 2001
Cumulative total
No.
%
No.
%
No.
%
No.
%
No.
%
No.
%
Men who have sex with men
6,882
62
226,768
74
3,872
30
80,622
37
2,295
38
49,448
42
Injecting drug use
1,115
10
28,560
9
2,781
21
73,034
33
1,436
23
40,637
35
Men who have sex with men and inject drugs
696
6
25,435
8
521
4
16,250
7
229
4
7,847
7
Hemophilia/coagulation disorder
74
1
3,831
1
14
0
574
0
7
0
439
0
Heterosexual contact
380
3
5,798
2
1,583
12
17,966
8
558
9
6,898
6
Sex with injecting drug user
96
2,006
301
5,552
10