Chapter 6: Community Health Indicators. 56 Chartbook 2000 Population The population of the United...
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Transcript of Chapter 6: Community Health Indicators. 56 Chartbook 2000 Population The population of the United...
Chapter 6:Community Health
Indicators
Community Health Indicators
2Chartbook 2000
Population
The population of the United States is expected to grow at a relatively constant rate into the early part of this century. The composition of the population by age, however, is expected to change substantially. By 2050, people 65 and older are projected to grow to 20 percent of the population from 11 percent in 1980. People 85 and older are projected to grow to five percent of the population from one percent in 1980. This demographic shift results as people live longer and have fewer children. The birth rate has declined by 13 percent since 1990, although it increased slightly between 1997 and 1998 (Charts 6.1 - 6.2).
Mortality
Since 1980, mortality rates have been declining for many diseases contributing to the longer life span and aging population noted above. Mortality rates for heart and cerebrovascular diseases have declined sharply as surgical and pharmaceutical technologies for treating these diseases have advanced. Meanwhile, mortality for malignant neoplasms has seen only moderate improvement with mortality for some cancers, like those of the respiratory system, actually rising. Mortality due to chronic obstructive pulmonary diseases and diabetes-related conditions has also increased (Chart 6.3).
The overall mortality rate for injuries and adverse events is down by 24 percent. Contributing to this decline, the death rate for motor vehicle accidents is down nearly 30 percent. The death rate for suicides, however, is up by over 50 percent (Chart 6.3).
Over the last 10 years, the infant mortality rate has decreased by 28 percent (Chart 6.4).
Chapter 6:Community Health
Indicators
Community Health Indicators
3Chartbook 2000
Disease
Although the overall mortality rate for cancer has declined, the incidence has gone up. The incidence of prostate cancer has risen by over 80 percent between 1980 and 1996 and the incidence of breast cancer went up by over 27 percent. The greater incidence may in part reflect increased awareness, better diagnostic techniques, and increased screening levels (Chart 6.5). After peaking in 1993, Acquired Immunodeficiency Syndrome (AIDS) cases have been trending down. The prevalence of hypertension and diabetes have shown recent declines, while the prevalence of asthma continues to rise(Charts 6.6 - 6.9).
Risk Factors
Lifestyles and behavior play an important role in mortality and disease.
From 1988 to 1994, more people were overweight than at a healthy weight, a substantial change from just a decade earlier. The percent of people considered obese has increased from 14.5 percent to 22.6 percent, an increase of 56 percent. Being overweight is a risk factor for cardiac disease and diabetes, and may be linked to various other diseases (Chart 6.10).
Smoking and substance abuse remain important public health issues, especially among the nation’s youth. One out of five youth between the ages of 12 and 17 smoke. While gains have been made in reducing heavy alcohol use among this population, rates of marijuana and cocaine use are trending up (Charts 6.11 - 6.14).
Smoking rates among adults have changed little since 1990. Substance abuse rates and trends vary by age group (Charts 6.11 - 6.14).
Community Health Indicators
4Chartbook 2000
Chart 6.1:US Population Trends and Projections
1980 - 2050
0
50,000
100,000
150,000
200,000
250,000
300,000
350,000
400,000
450,000
1980 1990 2000 2010 2020 2030 2040 2050Source: US Bureau of the Census
Th
ou
san
ds
20-64
65 -84
0-19
85 and over
Chart 6.2:Live Births per 1,000 Persons
1980 - 1998
13.0
13.5
14.0
14.5
15.0
15.5
16.0
16.5
17.0
80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98
Source: Centers for Disease Control and Prevention; excludes births to nonresidents of the US
Community Health Indicators
5Chartbook 2000
Chart 6.3:Age-adjusted Death Rates per 100,000 Persons
for Selected Causes of Death1980 and 1997
Source: National Center for Health Statistics, Health United States, 1999
5.8
13.5
7.4
12.9
21.1
17.4
16.0
49.9
19.4
13.9
12.0
38.7
125.6
25.9
82.9
130.5
10.1
12.2
12.9
15.9
11.3
22.8
65.8
22.7
14.4
15.5
36.4
132.8
40.8
149.8
202.0Diseases of the Heart
Ischemic Heart Disease
Cerebrovascular Diseases
Malignant Neoplasms
Malignant Neoplasms ofthe Respiratory System
Colorectoal MalignantNeoplasms
Malignant Neoplasmsof the Prostate
Malignant Neoplasmsof the Breast
Chronic ObstructivePulmonary Diseases
Pneumonia and Influenza
Chronic Liver Diseaseand Cirrhosis
Diabetes Mellitus
Human ImmunodeficiencyVirus Infection
1980 1997
Injury andAdverse Events
Motor Vehicle Accidents
Suicide
Community Health Indicators
6Chartbook 2000
Chart 6.4:Infant Mortality Rate
1988 - 1997
0
2
4
6
8
10
12
88 89 90 91 92 93 94 95 96 97
Death
s per
1,0
00
Liv
e B
irth
s
Source: National Center for Health Statistics
Community Health Indicators
7Chartbook 2000
Chart 6.5:Age-adjusted Incidence Rates per 100,000
Personsfor Selected Types of Cancer
1980 and 1996
0 10 20 30 40 50 60 70 80 90
Source: National Cancer Institute; excludes non-invasive cancers1980 1996
78.5
87.6Digestive System
65.5
36.3Prostate Cancer
64.6
62.7Respiratory System
63.1
49.5Breast Cancer
28.5
26.4Urinary System
19.5
14.1Lymphoma
10.3
11.5Leukemia
8.0
7.6Ovarian Cancer
4.3
5.8Cervical Cancer
373.4
419.3All
Community Health Indicators
8Chartbook 2000
Chart 6.6:Acquired Immunodeficiency Syndrome
(AIDS) Cases1985 - 1997
0
20,000
40,000
60,000
80,000
100,000
120,000
85 92 93 94 95 96 97
Source: National Center for Health Statistics, Health United States, 1999
Chart 6.7:Hypertension Among Persons 20 to 74 Years of Age
Percent of Population1960 - 1994
36.9%38.3% 39.0%
23.1%
0%
5%
10%
15%
20%
25%
30%
35%
40%
1960-1962 1971-1974 1976-1980 1988-1994
Source: National Center for Health Statistics, Health United States, 1999, age-adjusted
8,161
41,540
102,082
77,09270,839
66,39853,254
Community Health Indicators
9Chartbook 2000
Chart 6.8:Diabetes Prevalence Rates per 1,000
Persons1979 - 1996
Chart 6.9:Asthma Prevalence Rates per 1,000 Persons
1979 - 1996
0
10
20
30
40
50
60
1979 - 1981 1994 - 19961990 - 19921986 - 19881983 - 1985
Source: National Health Interview Survey, Vital and Health Statistics Series 10, No. 194
31.0
37.140.8
46.2
56.0
Source: National Center for Health Statistics, The National Health Interview Survey
1979 - 1981 1984 1988 1992 19960
5
10
15
20
25
35
20
24.926.1 25.8
29.5 24.9
Community Health Indicators
10Chartbook 2000
0%
5%
10%
15%
20%
25%
30%
90 91 92 93 94 95 96 97
Chart 6.11:Percent of Persons Who Currently Smoke
by Age Group1990 - 1997
Source: Health United States 1999
18 Years and Older
12 - 17 Years
Chart 6.10:Healthy Weight, Overweight and Obesity Among
Persons20 Years of Age and Older
1976 - 1994
0%
10%
20%
30%
40%
50%
60%
ObeseOverweightHealthy Weight
1976-1980 1988-1994Source: Health United States, 1999
49.1%
41.7%
22.6%
14.5%
46.0%
54.6%
Community Health Indicators
11Chartbook 2000
0%
2%
4%
6%
8%
10%
12%
14%
90 91 92 93 94 95 96 97
Chart 6.12:Percent of Persons Reporting Heavy Alcohol Use(1)
in the Past Month by Age Group1990 - 1997
Source: Health United States, 1999(1) Five or more drinks on the same occasion at least once in the past month
18 - 25 Years
26 - 34 Years
12 - 17 Years
35 Years and Older
Chart 6.13:Percent of Persons Reporting Use of
Marijuanain the Past Month by Age Group
1990 - 1997
18 - 25 Years
26 - 34 Years
12 - 17 Years
35 Years and Older
Source: Health United States 1999
0%
5%
10%
15%
20%
25%
30%
35%
40%
90 91 92 93 94 95 96 97
Community Health Indicators
12Chartbook 2000
0.0%
0.5%
1.0%
1.5%
2.0%
2.5%
90 91 92 93 94 95 96 97
Chart 6.14:Percent of Persons Reporting Use of Cocaine
in the Past Month by Age Group1990 - 1997
Source: Health United States, 1999
18 - 25 Years
26 - 34 Years
12 - 17 Years
35 Years and Older