Wisconsin Department of Health Services

January 2014 P-00522Q

Healthiest Wisconsin 2020 Baseline and Health Disparities Report

Black Population

BLACK POPULATION

Background• Overview of Healthiest Wisconsin 2020 Baseline and Health Disparities

Report • Key points

Data• Demographic and socioeconomic data• Access to health care• Overall health and mental health• Risk behaviors• Chronic disease outcomes• Reproductive and sexual health

References

Links to additional reports and resources

Contacts

Chapter Outline

Chapter outline

2

BLACK POPULATION

Report Overview

• This chapter is part of a larger report created by the Wisconsin Department of Health Services to track the progress on objectives of Healthiest Wisconsin 2020 (HW2020) and identify health disparities in the state. The full report is available at: http://www.dhs.wisconsin.gov/publications/P0/p00522.pdf

• The report is designed to address the Health Focus Areas in HW2020. Where direct measures exist, data are presented; where direct measures are not available, related information may be included.

• Information about populations experiencing health disparities is provided in the Health Focus Area chapters and is summarized in separate chapters devoted to specific populations.

• Technical notes are available at: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf

Report overview

3

BLACK POPULATION

Report Format

Full Report• Format: PDF • Intended use: reference document

Chapters• Format: Annotated PowerPoint slide set• Intended uses: presentations to

– Decision-makers– Service providers– Community leaders– The public

Sample annotated slide

Report overview

4

BLACK POPULATION

Report Outline

Executive Summary

Section 1: Introduction

Section 2: Demographic overview

Section 3: Health focus areas

Section 4: Infrastructure focus areas

Section 5: Data summaries by population

Section 6: Technical notes

Report overview

5

BLACK POPULATION

Report Outline: Detail

Section 3: Health focus areas

• Alcohol and other drug use• Chronic disease prevention and management• Communicable diseases• Environmental and occupational health• Healthy growth and development• Injury and violence• Mental health• Nutrition and healthy foods• Oral health• Physical activity• Reproductive and sexual health• Tobacco use and exposure

Section 4: Infrastructure focus areas• Access to health services

Report overview

6

BLACK POPULATION

Report Outline: Detail

Section 5: Data summaries by population

Racial/ethnic minority populationso American Indianso Asianso Blackso Hispanics

  People of lower socioeconomic status  People with disabilities  Lesbian, gay, bisexual, and transgender populations  Geography

Report overview

7

BLACK POPULATION

Data notes

• Please refer to the Technical Notes chapter for a more detailed description of limitations and methods: http://www.dhs.wisconsin.gov/publications/P0/p00522y.pdf

• The 95% confidence intervals are denoted by error bars. Where

confidence intervals do not overlap, as shown in the example on

the right, differences are statistically significant. Larger confidence

intervals may indicate less reliable estimates that should be

interpreted with caution.

• Population estimates that are considered unreliable are excluded.

• Misclassification of racial/ethnic groups may affect the accuracy of rates.

• Unless otherwise indicated, the Hispanic population may include people of various races; Whites, Blacks, Asians, and American Indians are non-Hispanic.

Report overview

8

BLACK POPULATION

Factors that influence health

Social determinants

of health

Source: University of Wisconsin Population Health Institute. County Health Rankings 2013, http://www.countyhealthrankings.org/our-approach

Report overview

9

BLACK POPULATION

Historical trauma• Historical trauma is the cumulative exposure to traumatic events

that not only affect the individual exposed, but continue to affect subsequent generations.

• Descendants of those who experienced the traumatic stressor may still exhibit symptoms.

• Populations affected by historical trauma include American Indians, African Americans/Blacks, Hispanics/Latinos, Asians, immigrants and refugees, war veterans, and families experiencing intergenerational poverty.

• Current manifestations may include:• Mistrust of health care, legal, and educational systems; • Higher rates of risk behaviors such as alcohol and drug abuse,

suicide, homicide, and domestic violence; and • Higher rates of chronic diseases.

Report overview

Sources: SAMHSA, Fact Sheet: Historical Trauma http://gainscenter.samhsa.gov/cms-assets/documents/93078-842830.historical-trauma.pdf, Texas Department of Health Services, Trauma Informed Care Training, http://www.dfps.state.tx.us/Training/Trauma_Informed_Care/page35.asp

10

BLACK POPULATION

Key Points: Black population

• Demographics: The Black population in Wisconsin is younger than the general population and is concentrated in the Southeastern part of the state.

• Socioeconomic status: Blacks in Wisconsin are more likely to live in poverty and less likely to have a college degree compared to Whites.

• Access to health care: Blacks have lower rates of health insurance and dental care coverage, similar rates of cancer screening, and higher rates of doctor visits compared to Whites.

Key points

11

BLACK POPULATION

Key Points: Black population

Health risk behaviors and outcomes:

Blacks face significant health disparities compared to Whites, and in some cases compared to other racial/ethnic groups.

• Worse overall health and mental health outcomes.

• Less of a sense of safety at school, neighborhood, and personal levels.

• Higher rates of risk behaviors that bear upon chronic disease, such as obesity, lack of exercise, and smoking, but lower rates of binge drinking.

12

Key points

BLACK POPULATION

Key Points: Black population

Health risk behaviors and outcomes (continued):

• Worse chronic disease outcomes, including for stroke, diabetes, high cholesterol, and asthma.

• Higher rates of cancer incidence and mortality.

• Higher rates of reproductive and sexual risk behaviors and outcomes, including unintended pregnancies, sexually transmitted diseases, and HIV.

• Higher infant mortality rates, despite a significant decrease in recent years.

13

Key points

BLACK POPULATION

Demographic and socioeconomic data

14

BLACK POPULATION

Demographic Characteristics

• Wisconsin's Black population, 2010: 336,056; 6.2% of state total

• Change in the Black population, 2000 to 2010: 20% increase

• Median age, 2010: Black, 27 years (White, 41.5 years)

The median age is the age at which half the population is older and half is younger.

• Percent of Blacks who are living with a disability, 2010: 28% (White, 21%)

• Percent of Blacks who are foreign-born, 2010: 3% (Total population, 4%)

Source: http://www.dhs.wisconsin.gov/health/MinorityHealth/Report.htm and U.S. Census Bureau.

Demographics and socioeconomic data

15

BLACK POPULATION

Socioeconomic data

Wisconsin’s Black population has a higher poverty rate and less education compared to Whites.

• Median household income in Wisconsin, 2008-2010: Blacks, $27,400 (Whites, $53,000)

• Poverty rate, 2010: Blacks, 39% (Whites, 10%) The poverty rate is the percent living below the federal poverty level.

• Bachelor’s degree or more education (age 25 and older), 2007-2010: Blacks, 14% (Whites, 27%)

• Married couple households as a percent of family households, 2008-2010: Blacks: 33% (other racial/ethnic groups range from American Indians, 52% to Whites, 82%)

Source: http://www.dhs.wisconsin.gov/health/MinorityHealth/Report.htm and U.S. Census Bureau, American Community Survey.

Demographics and socioeconomic data

16

BLACK POPULATION

Black population by county, Wisconsin, 2010

Source: U.S. Census, 2010.

Demographics and socioeconomic data

17

Black population

3 - 2,856

2,857 - 10,655

10,656 - 24,717

248,794

Blacks as a percent of total population

0.1% - 1%

1.1% - 2.9%

3% - 10.9%

11% - 26.3%

BLACK POPULATION

Level of urbanization of Wisconsin residents, by race/ethnicity, 2007-2011

Source: American Community Survey, 2007-2011..

White Black American Indian Asian Hispanic0%

10%

20%

30%

40%

50%

60%

70%

80%

11% 67% 12% 24% 37%59% 28% 39% 66% 48%30% 4% 49% 10% 15%

Milwaukee CountySmaller metropolitan countiesNon-metropolitan counties

18

Demographics and socioeconomic data

BLACK POPULATION

Access to health care

19

BLACK POPULATION

Lack of health insurance coverage and Medicaid enrollment among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Access to health care

20

No health insurance coverage, ages 18-64

Receive Medicaid or BadgerCare, all adults

0%

10%

20%

30%

40%

50%

60%

13% 12%19% 39%35% 21%19% 27%

WhiteBlackHispanicAmerican Indian

BLACK POPULATION

Public health insurance coverage and inadequacy of health insurance among children ages 6-17, by race/ethnicity, Wisconsin, 2011-2012

Source: 2011-2012 National Survey of Children's Health. Note: Wisconsin estimates were only available for White, Black, and Hispanic children.

Public insurance Current insurance not adequate0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

27% 26%71% 26%51% 22%

WhiteBlackHispanic

21

Access to health care

BLACK POPULATION

Source: 2011-2012 National Survey of Children's Health.Note: Wisconsin estimates were only available for White, Black, and Hispanic children.

Lack of routine preventive medical and dental care among children, by race/ethnicity, Wisconsin, 2011-2012

Did not receive routine preventive medical and dental care during the past 12 months 0%

10%

20%

30%

40%

50%

60%

70%

30% 42% 41%

WhiteBlackHispanic

22

Access to health care

BLACK POPULATION

Age-adjusted rates of use of and barriers to health care among Wisconsin adults, by race/ethnicity, 2008-2011

Did not have a doctor's visit in past year

Do not have a personal doctor Unable to obtain medical care due to cost

0%

10%

20%

30%

40%

50%

60%

35% 16% 10%21% 16% 18%33% 20% 20%25% 17% 21%33% 16%

White Black

Hispanic Asian

American Indian

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

23

Access to health care

BLACK POPULATION

Emergency room utilization among Wisconsin residents, by race/ethnicity, 2008-2010

Source: Wisconsin Department of Health Services, Family Health Survey, 2008-2010.

Treated in emergency room during past year0%

5%

10%

15%

20%

25%

30%

35%

40%

15% 23% 16% 6% 19%

White Black

Hispanic Asian

American Indian

24

Access to health care

BLACK POPULATION

Physical health and safety and mental health

25

BLACK POPULATION

Age-adjusted indicators of poor health status among Wisconsin adults by race/ethnicity, 2008-2011

Physical health

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group. 26

Fair or poor health Physical health not good on at least one day during past month

Of those with at least one day of poor health, percent whose poor health limited usual activities on

at least one day during past month

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

12% 35% 67%31% 49% 68%23% 42% 75%17% 46% 64%32% 78%

WhiteBlackHispanicAsianAmerican Indian

BLACK POPULATION

Neighborhood environment of children less than 18 years of age, by race/ethnicity, Wisconsin, 2011-2012

Source: 2011-2012 National Survey of Children's Health. *Neighborhoods that include all four of these amenities. Data were not available for other racial/ethnic groups.

Environmental health

Children living in neighborhoods with sidewalks, libraries, recreation centers, and parks*

Children living in neighborhoods their parents feel are usually or always safe

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

55% 94%63% 61%55% 86%

WhiteBlackHispanic

27

BLACK POPULATION

Perceptions of school safety among Wisconsin high school students, by race/ethnicity, 2007-2011

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Skipped school because felt unsafe

Felt threatened at school Rarely feel safe from physical harm while at school

0%

5%

10%

15%

20%

25%

3% 4% 7%8% 12% 21%7% 6% 13%12% 19%

WhiteBlackHispanicAsianAmerican Indian

Injury and violence

28

BLACK POPULATION

Intentional injury deaths by race/ethnicity, age-adjusted rates per 100,000, Wisconsin, 2008-2010

Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates.29

Suicide Homicide0

5

10

15

20

25

13.5 1.57.3 19.25.9 3.810.1 2.716.0 4.8

WhiteBlackHispanicAsianAmerican Indian

Ra

te p

er

10

0,0

00

po

pu

latio

nInjury and violence

BLACK POPULATION

Partner violence among Wisconsin high school students, by race/ethnicity, 2007-2011

Hit by boyfriend or girlfriend in past 12 months

Ever forced into having sex0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

7% 9%15% 12%8% 10%7% 9% 9%

White Black

Hispanic Asian

American Indian

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Injury and violence

30

BLACK POPULATION

Age-adjusted rate of four or more Adverse Childhood Experiences (ACEs) among Wisconsin adults, by race/ethnicity, 2010 and 2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only datasetNote: Question asked in 2010 and 2011. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Mental health

Four or more ACEs0%

5%

10%

15%

20%

25%

30%

35%

40%

15% 23% 21%

White Black

Hispanic

31

BLACK POPULATION

Age-adjusted rate of frequent mental distress among Wisconsin adults, by race/ethnicity, 2009-2011

Frequent mental distress 0%

5%

10%

15%

20%

25%

30%

35%

40%

9% 18% 18% 11%

WhiteBlackHispanicAmerican Indian

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Question asked in 2009-2011. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Mental health

32

BLACK POPULATION

Depression among Wisconsin high school students by race/ethnicity, 2007-2011

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS).

Note: 95% confidence intervals are denoted by the error bars; larger confidence interval s may indicate less reliable estimates that should be interpreted with caution.

Felt sad/hopeless for at least 2 weeks and stopped doing usual activities

-10%

0%

10%

20%

30%

40%

50%

60%

20% 28% 28% 32% 32%

White Black

Hispanic Asian

American Indian

Mental health

33

BLACK POPULATION

Suicide risk during past 12 months among Wisconsin high school students by race/ethnicity, 2007-2011

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS).

Note: 95% confidence intervals are denoted by the error bars; larger confidence interval s may indicate less reliable estimates that should be interpreted with caution. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Mental health

Considered suicide

Planned suicide Attempted suicide Suicide attempt with injury

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

13% 10% 5%17% 15% 12%14% 10%20% 13% 9%25% 22% 16%

White Black

Hispanic Asian

American Indian

34

BLACK POPULATION

Risk behaviors for chronic disease

35

BLACK POPULATION

Physical activity and sedentary behaviors among Wisconsin high school students by race/ethnicity, 2007-2011

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.

Physical activity

36

Exercise 1+ hour, 5 out of 7 days

Attended physical education at least

once in past 7 days

Watch 3+ hours of TV on average

school day

Play 3+ hours of video/computer games on aver-age school day

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

48% 55% 21% 19%35% 43% 49% 26%29% 46% 34% 25%37% 54% 28% 31%49% 54% 20% 24%

White Black

Hispanic Asian

American Indian

BLACK POPULATION

Age-adjusted rate of physical inactivity among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset

Did not participate in any physical activity in past month, other than at job

-10%

0%

10%

20%

30%

40%

50%

60%

22% 37% 33% 28% 26%

WhiteBlackHispanicAsianAmerican Indian

Physical activity

37

BLACK POPULATION

Age-adjusted rates of overweight and obesity among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Overweight or Obese Obese0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

63% 27%78% 44%67% 29%45% 71% 38%

WhiteBlackHispanicAsianAmerican Indian

Nutrition

38

BLACK POPULATION

Age-adjusted smoking rates among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group. .

Tobacco use and exposure

Current smoker0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

20% 29% 27% 34%

White Black

Hispanic American Indian

39

BLACK POPULATION

Rates of secondhand smoke exposure among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: The smoking at work question was only asked in years 2009 and 2010. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Smoking allowed at home Exposed to others' smoke at home

Smoking permitted at work0%

10%

20%

30%

40%

50%

60%

23% 13% 12%39% 24% 15%26% 15%30% 24% 36%

WhiteBlackHispanicAmerican Indian

Tobacco use and exposure

40

BLACK POPULATION

Rates of current drinking, binge drinking, and marijuana use among Wisconsin high school students, by race/ethnicity, 2007-2011

Alcohol and other drug abuse

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

41

Drank alcohol in last 30

days

Binge drank in last 30

days

Used mari-juana in last

30 days

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

30% 8% 33%39% 15% 20%34% 9% 14%

WhiteBlackHispanicAsian

BLACK POPULATION

Age-adjusted rates of binge drinking and heavy drinking among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Binge drinking Heavy drinking0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

25% 9%15% 7%21% 28%

WhiteBlackHispanicAmerican Indian

Alcohol and other drug abuse

42

BLACK POPULATION

Chronic disease outcomes

43

BLACK POPULATION

Age-adjusted rates of asthma among Wisconsin adults, by race/ethnicity, 2008-2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Have ever been told you have asthma Currently have asthma0%

5%

10%

15%

20%

25%

30%

13% 9%23% 16%13% 9%10%

WhiteBlackHispanicAmerican Indian

Environmental health

44

BLACK POPULATION

Asthma hospitalizations by race/ethnicity, age-adjusted rate per 10,000, Wisconsin, 2010

Source: Wisconsin Inpatient Hospitalization Discharge file, 2010.Note: Race groups include both Hispanic and non-Hispanic people; Hispanics may include people of various races.

Environmental health

45

White Black Asian American Indian Hispanic Non-Hispanic0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

6.1 31.4 6.6 12.4 11.3 8.1

BLACK POPULATION

Age-adjusted rates of diabetes and prediabetes among Wisconsin adults, by race/ethnicity, 2008-2011

Chronic diseases

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Diabetes excludes women who were diagnosed during pregnancy, and does not differentiate between type 1 and type 2. diabetes. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Ever been diagnosed with diabetes Ever been told you have prediabetes0%

5%

10%

15%

20%

25%

7% 6%17% 7%10% 8%16%

WhiteBlackHispanicAmerican Indian

46

BLACK POPULATION

Hospitalizations due to long-term complications from diabetes among Wisconsin adults, age-adjusted rate per 10,000, by race/ethnicity, 2010

Source: Wisconsin Inpatient Hospitalization Discharge file, 2010.Note: Hospitalization rates considered unreliable are excluded.

0.0

5.0

10.0

15.0

20.0

25.0

30.0

5.6 2.026.3 7.414.9

White Black

Hispanic

Age

-ad

just

ed

rat

e p

er

10

,00

0 p

op

ula

tio

n,

age

18

an

d o

lde

r

Chronic diseases

47

BLACK POPULATION

Incidence of end-stage renal disease incidence among Wisconsin adults, age-adjusted rate per 100,000, by race/ethnicity, 2009

Incidence of end-stage renal disease with diabetes as primary diagnosis0.0

10.0

20.0

30.0

40.0

50.0

60.0

8.7 45.1 44.3

WhiteBlackHispanic

Age

-adj

uste

d ra

te p

er 1

00,0

00 p

opul

ation

, ag

es 1

8 an

d ol

der

Source: United States Renal Data System (USRDS), Renal Data Extraction and Referencing (RenDER) System.Note: Incidence rates considered unreliable are excluded.

Chronic diseases

48

BLACK POPULATION

Age-adjusted rates of high cholesterol and high blood pressure among Wisconsin adults, by race/ethnicity, 2009 and 2011

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Questions only asked in 2009 and 2011.Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Ever been told you have high cholesterol Ever been diagnosed with high blood pressure0%

10%

20%

30%

40%

50%

60%

31% 25%40% 39%28% 35%23% 38%

White Black

Hispanic American Indian

Chronic diseases

49

BLACK POPULATION

Age-adjusted rate of arthritis among adults, and percent of those with arthritis whose activity is limited due to joint pain, by race/ethnicity, 2009-2011

0%

10%

20%

30%

40%

50%

60%

70%

80%

23% 40%29% 50%23% 39%23%

WhiteBlackHispanicAmerican Indian

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Arthritis question was asked in 2009-2011. Question about limited activity due to joint pain question was asked in 2009 and 2011. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Chronic diseases

50

BLACK POPULATION

Cancer incidence and mortality (all sites) age-adjusted rate per 100,000, by race/ethnicity, Wisconsin, 2010

Sources: Wisconsin Cancer Reporting System, Office of Health Informatics, Division of Public Health, Department of Health Services; and National Center for Health Statistics, Wisconsin mortality file 1995-2102, Vital Statistics Cooperative Program, 2013.Note: Racial groups include both Hispanics and non-Hispanics; Hispanics include all races.

Incidence Mortality0

100

200

300

400

500

600

436.9 171.4532.3 243.9322.8 95.0287.7 106.2503.6 229.7

White Black

Hispanic Asian

American Indian

Age-

adju

sted

rate

per

100

,000

pop

ulati

onChronic diseases

51

BLACK POPULATION

Colorectal cancer mortality age-adjusted rate per 100,000, by race/ethnicity, Wisconsin and United States, 2006-2010

White Black Hispanic Asian American Indian0

5

10

15

20

25

14.8 23.0 9.1 4.8 13.715.9 22.8 12.7 11.2 12.6

WisconsinUnited States

Age

-adj

uste

d ra

te p

er 1

00,0

00 p

opul

ation

Source: National Center for Health Statistics. Wisconsin mortality data file 1995-2010, Vital Statistics Cooperative Program, 2013.Note: In this figure, racial groups include both Hispanics and non-Hispanics; Hispanics include all races.

Chronic diseases

52

BLACK POPULATION

Female breast cancer mortality age-adjusted rate per 100,000, by race/ethnicity, Wisconsin and United States, 2006-2010

White Black Hispanic Asian American Indian

0

5

10

15

20

25

30

35

21.1 29.1 6.7 9.8 23.222.1 30.8 14.8 11.5 12.5

WisconsinUnited States

Age

-adj

uste

d ra

te p

er 1

00,0

00 fe

mal

e po

pula

tion

Sources: Source: National Center for Health Statistics. Wisconsin mortality data file 1995-2010, Vital Statistics Cooperative Program, 2013.Note: In this figure, racial groups include both Hispanics and non-Hispanics; Hispanics include all races.

Chronic diseases

53

BLACK POPULATION

Sexual risk and reproductive behaviors and

health outcomes

54

BLACK POPULATION

Estimated prevalence of sexual risk behaviors among Wisconsin high school students by race/ethnicity, 2007-2011

Source: Wisconsin Department of Public Instruction, Youth Risk Behavior Survey (YRBS); 2007, 2009, 2011 combined dataset.Note: Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Reproductive and sexual health

55

Ever had sex-ual intercourse

Had inter-course before

age 13

Intercourse in last three months

Four or more lifetime part-

ners

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

70% 18% 47% 28%43% 7% 35% 12%32% 20% 9%50% 35% 20%

White Black

Hispanic Asian

American Indian

BLACK POPULATION

Births to teens ages 15-19 as a percent of all births, by race/ethnicity, Wisconsin, 2000-2010

Per

cen

t o

f al

l bir

ths

Source:  Wisconsin Department of Health Services, Division of Public Health, Office of Health Informatics:  Births to Teens in Wisconsin, 2010.  January 2012.

Black American Indian

Hispanic Laotian/Hmong White Other Asian0%

5%

10%

15%

20%

25%

30%

25% 22% 19% 24% 7% 6%20% 16% 13% 12% 5% 3%

20002010

56

Reproductive and sexual health

BLACK POPULATION

Unintended pregnancy as a percent of births, by race/ethnicity, Wisconsin, 2009-2011

Healthy growth and development

Source: Wisconsin Department of Health Services, Division of Public Health, PRAMS, 2009-2011. 57

Percent of births in which pregnancy was unintended0%

10%

20%

30%

40%

50%

60%

70%

32% 65% 43%

White Black

Hispanic

BLACK POPULATION

Percentage of births to mothers who received prenatal care during the first trimester, by race/ethnicity, Wisconsin, 2010

Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident birth certificates.

Prenatal care during first trimester0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

88% 74% 75% 66% 72%

WhiteBlackHispanicLaotian/HmongAmerican Indian

Healthy growth and development

58

BLACK POPULATION

Percentage of low birthweight (<5.5 pounds) births, by maternal race/ethnicity, Wisconsin, 2008-2010

Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident birth certificates.

Healthy growth and development

59

Low birthweight0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

6.0% 13.7% 6.1% 7.1% 6.8%

WhiteBlackHispanicLaotian/HmongAmerican Indian

BLACK POPULATION

Infant mortality by race/ethnicity, rate per 1,000 births, Wisconsin, 2001-2010

Source: Wisconsin Interactive Statistics on Health (WISH), Wisconsin resident death certificates.

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 20100

5

10

15

20

25 BlackAmerican IndianLaotian/HmongHispanicWhite

Ra

te p

er

1,0

00

bir

ths

Healthy growth and development

60

BLACK POPULATION

Reported cases of selected sexually transmitted diseases, rate per 100,000, by race/ethnicity, Wisconsin, 2010

White

Black

Hispanic

Asian

American Indian

Source: Wisconsin Department of Health Services, Sexually Transmitted Diseases Program.

Chlamydia

144

1,859

377222

621

Gonorrhea

17

676

46 22144

Syphilis

1

25

5 3 2

61

Reproductive and sexual health

BLACK POPULATION

Source: Wisconsin Department of Health Services, Behavioral Risk Factor Survey (BRFS); 2008-2011 landline-only dataset.Note: Testing rates are not age-adjusted; rates of exposure to high-risk situations are age-adjusted. Estimates that are unreliable (based on Relative Standard Error or small sample size) are not shown; this means an estimate may not be presented for every population group.

Rates of HIV testing and age-adjusted risk behaviors among Wisconsin adults, by race/ethnicity, 2008-2011

62

Ever been tested for HIV Ever been in any HIV high-risk situations

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

29% 2%66%

7%

41% 37%

WhiteBlackHispanicAmerican Indian

Reproductive and sexual health

BLACK POPULATION

MSM Non-MSM males Females0%

5%

10%

15%

20%

25%

30%

27%

1.2% 0.7%

7%

0.4% 0.2%

3%

0.2% 0.0%

BlackHispanicWhite

Less than 1.5%

Est

ima

ted

HIV

pre

vale

nce

wit

hin

dem

og

rap

hic

gro

up

Demographic Group

Estimated prevalence of HIV in selected demographic groups, ages 15-59, by race/ethnicity, Wisconsin, as of December 31, 2012

Reproductive and sexual health

Source: Wisconsin Department of Health Services, Wisconsin HIV Surveillance System.Note: MSM = Men who have sex with men. The estimated prevalence is adjusted to account for the CDC’s estimate that 18% of HIV-infected persons are unaware of their infection and therefore not reported. The MSM population for each racial/ethnic group uses the CDC’s estimate that 4% of adult males are MSM

63

BLACK POPULATION

References1. 2010 Census Briefs: Blacks/African Americans. http://www.census.gov/prod/cen2010/briefs/c2010br-06.pdf

2. University of Wisconsin Population Health Institute. County Health Rankings, 2013.

http://www.countyhealthrankings.org/our-approach

3. Center for Urban Population Health. Milwaukee Health Report, 2011.

http://www.cuph.org/mhr/2011-milwaukee-health-report.pdf

4. LaVeist TA, Gaskin DA, Richard P (2009). The Economic Burden of Health Inequalities in the United States. Joint

Center for Political and Economic Studies.

http://www.jointcenter.org/sites/default/files/upload/research/files/The%20Economic%20Burden%20of%20Health%20Inequalities%20in%20the%20United%20States.pdf

5. Thomas JC, Sage M, Dillenberg J, Guillory VJ (2002). A Code of Ethics for Public Health. Am Journal of Public

Health. 92(7):1057–1059. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447186/

6. Wisconsin Department of Health Services (DHS). Healthiest Wisconsin 2020.

http://www.dhs.wisconsin.gov/publications/P0/P00187.pdf

7. CDC. Health Care: See Why Being Insured Matters. http://www.cdc.gov/features/vitalsigns/HealthcareAccess/

8. Gindi RM, Cohen RA, Kirzinger WK. Emergency room use among adults aged 18–64: Early release of estimates

from the National Health Interview Survey, January–June 2011. National Center for Health Statistics. May 2012.

Available from: http://www.cdc.gov/nchs/nhis/releases.htm

  64

References

BLACK POPULATION

9. Kaiser Commission on Medicaid and the Uninsured. Next Steps in Covering Uninsured Children.

Findings from the Kaiser Survey of Children’s Health Coverage. http://

kaiserfamilyfoundation.files.wordpress.com/2013/01/7844.pdf

10. CDC. Regular Check-Ups Are Important. http://www.cdc.gov/family/checkup/

11. RAND Corporation. The Evolving Role of Emergency Departments in the United States.

http://www.rand.org/content/dam/rand/pubs/research_reports/RR200/RR280/RAND_RR280.pdf

12. CDC. State Indicator Report on Physical Activity, 2010.

http://www.cdc.gov/physicalactivity/downloads/PA_State_Indicator_Report_2010.pdf

13. CDC. Understanding Teen Dating Violence.

http://www.cdc.gov/ViolencePrevention/pdf/TeenDatingViolence2012-a.pdf

14. CDC. Adverse Childhood Experiences Study. http://www.cdc.gov/ace/

15. O’Connor C, Finkbiner C, & Watson L. (2012). Adverse Childhood Experiences in Wisconsin:

Findings from the 2010 Behavioral Risk Factor Survey. Madison, Wisconsin: Wisconsin Children’s

Trust Fund and Child Abuse Prevention Fund of Children’s Hospital & Health System. http://

wichildrenstrustfund.org/index.php?section=adverse-childhood

16. Centers for Disease Control and Prevention (CDC). Self-Reported Frequent Mental Distress Among

Adults --- United States, 1993—2001. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5341a1.htm

 

65

References

BLACK POPULATION

17. Office of Adolescent Health. Mental Health.

http://www.hhs.gov/ash/oah/adolescent-health-topics/mental-health/home.html

18. Keenan-Miller D, Hammen CL, Brennan PA. Health outcomes related to early adolescent

depression. Journal of Adolescent Health.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2034364/

19. CDC. Mortality Among Teenagers Aged 12-19 Years: United States, 1999-2006.

http://www.cdc.gov/nchs/data/databriefs/db37.htm

20. National Institute of Mental Health. Many Teens Considering Suicide Do Not Receive

Specialized Mental Health Care. 2012.

http://www.nimh.nih.gov/news/science-news/2012/many-teens-considering-suicide-do-not-receive-specialized-mental-health-care.shtml

21. CDC. Adolescent and School Health: Physical Activity.

http://www.cdc.gov/healthyyouth/physicalactivity/facts.htm

22. CDC. Association Between Sedentary Behavior, Physical Activity, and Obesity: Inactivity

Among Active Kids. http://www.cdc.gov/pcd/issues/2009/jan/07_0242.htm

23. CDC: Physical Activity. http://www.cdc.gov/physicalactivity/everyone/guidelines/index.html

24. National Cancer Institute: Menthol and Tobacco. http://

cancercontrol.cancer.gov/tcrb/research_topic-menthol.html

25. CDC. Smoking and Tobacco Use: Secondhand Smoke Facts.

http://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/general_facts/index.htm

 

66

References

BLACK POPULATION

26. DHS. Bringing Everyone Along: A Strategic Plan to Eliminate Tobacco-Related Disparities in Wisconsin http://www.dhs.wisconsin.gov/tobacco/pdffiles/DHSReport2008LowRes.pdf

27. CDC. Underage Drinking. http://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm

28. National Institute on Drug Abuse. Drug Facts: Marijuana. http://www.drugabuse.gov/publications/drugfacts/marijuana

29. DHS. Burden of Asthma in Wisconsin, 2010. http://www.dhs.wisconsin.gov/eh/asthma/pdf/BurdenofAsthma2010Web.pdf

30. Agency for Healthcare Research and Quality (AHRQ). Diabetes mellitus: hospital admission rate for long-term complications. http://www.qualitymeasures.ahrq.gov/content.aspx?id=38559

31. National Institute of Diabetes and Digestive and Kidney Disease. National Diabetes Statistics, 2011. http://diabetes.niddk.nih.gov/dm/pubs/statistics/

32. Ward MM, et al. Access to care and the incidence of end-stage renal disease due to diabetes. http://care.diabetesjournals.org/content/32/6/1032.full.pdf+html

33. Siegel R, et al. Cancer Statistics, 2013. A Cancer Journal for Clinicians. http://onlinelibrary.wiley.com/doi/10.3322/caac.21166/pdf

34. CDC. Vital Signs: Racial Disparities in Breast Cancer Severity — United States, 2005–2009. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6145a5.htm?s_cid=mm6145a5_w

67

References

BLACK POPULATION

35. Journal of the National Cancer Institute. Racial and Ethnic Disparities in the Receipt of Cancer Treatment. http://jnci.oxfordjournals.org/content/94/5/334.long

36. National Cancer Institute. Fact Sheet: Cancer Health Disparities. http://www.cancer.gov/cancertopics/factsheet/disparities/cancer-health-disparities

37. CDC. Basic Information about Colorectal Cancer. http://www.cdc.gov/cancer/colorectal/basic_info/index.htm

38. White A, et al. Racial Disparities in Colorectal Cancer Survival: To What Extent Are Racial Disparities Explained by Differences in Treatment, Tumor or Hospital Characteristics? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946464

39. Loconte NK, et al. Increasing disparity in colorectal cancer incidence and mortality among African Americans and Whites: A state's experience. http://www.ncbi.nlm.nih.gov/pubmed/21712962

40. Perdue DG, et al. Regional differences in colorectal cancer incidence, stage, and subsite among American Indians and Alaska Natives, 1999-2004. http://onlinelibrary.wiley.com/doi/10.1002/cncr.23726/abstract

41. CDC. Sexual and Reproductive Health of Persons Aged 10–24 Years. http://www.cdc.gov/healthyyouth/sexualbehaviors/srh.htm

42. CDC. Birth Rates for the United States: Teenagers Reach Historic Lows for All Age and Ethnic Groups. http://www.cdc.gov/nchs/data/databriefs/db89.pdf

68

References

BLACK POPULATION

43. National Center for Health Statistics. Child Trends analysis of 1990-2009 Natality microdata files from Centers for Disease Control and Prevention. http://datacenter.kidscount.org/data/acrossstates/Rankings.aspx?loct=3&by=v&order=d&ind=4&dtm=252&tf=38

44. CDC. Unintended Pregnancies. http://www.cdc.gov/reproductivehealth/UnintendedPregnancy/

45. CDC. During Pregnancy. http://www.cdc.gov/pregnancy/during.html 46. CDC. Is low birthweight a health problem?

http://www.cdc.gov/pednss/how_to/interpret_data/case_studies/low_birthweight/what.htm

47. CDC. PNSS Health Indicators. http://www.cdc.gov/pednss/what_is/pnss_health_indicators.htm#Smoking/Drinking Indicators

48. National Center for Health Statistics. National Vital Statistics Reports. Deaths: Preliminary Data for 2010. http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_04.pdf

49. U.S. Department of Health and Human Services. Infant Mortality Fact Sheet. http://www.hhs.gov/news/factsheet/infant.html

50. Lieb S, et al. Statewide estimation of populations of MSM in the United States. Public Health Reports 2011;126(1):60–72.

51. CDC. HIV in the United States: At A Glance, 2013. http://www.cdc.gov/hiv/resources/factsheets/PDF/stats_basics_factsheet.pdf

69

References

BLACK POPULATION

Links to additional reports and resources

• Centers for Disease Control and Prevention, Minority Health, Black or African American Populations: http://www.cdc.gov/minorityhealth/populations/REMP/black.html

• U.S. Department of Health and Human Services, Office of Minority Health, African Americans: http://www.minorityhealth.hhs.gov/templates/browse.aspx?lvl=3&lvlid=23

70

Links

BLACK POPULATION

Contacts

Evelyn Cruz, Minority Health OfficerWisconsin Division of Public Health, Office of Policy and Practice AlignmentE-mail: Evelyn2.Cruz@dhs.wisconsin.gov

Karl Pearson, DemographerWisconsin Division of Public Health, Office of Health InformaticsE-mail: KarlT.Pearson@dhs.wisconsin.gov

71

Contacts