The Chronic Disease Experience of Sacramento County ... · The Chronic Disease Experience of Sacramento County Residents ... This report presents the chronic disease morbidity and

REPORT FROM SACRAMENTO COUNTY DHHS

The Chronic Disease Experience of Sacramento County Residents

Prepared for:

The Healthy Sacramento Coalition

April 2013


i

This assessment of the Sacramento County residents’ morbidity and mortality due to chronic disease

was completed on behalf of the Healthy Sacramento Coalition. The Healthy Sacramento Coalition is

supported by a Community Transformation Grant from the Centers for Disease Control and Prevention1.

In addition to CDC, funding support for the assessment was provided by Sierra Health Foundation. The

analyses presented were conducted by Sacramento County Division of Public Health and prepared by:

Helen Zheng, MPH

Jake Pry, MPH

Helena Chung, MPH

Acknowledgements

The Sacramento County Department of Health and Human Services acknowledges the Disease Control

and Epidemiology Unit of the Division of Public Health for their contributions towards the development of

this report.

1 The views expressed in this report do not necessarily reflect the official policies of the CDC or imply endorsement by the U.S.

Government.


ii

Technical Notes

This report presents the chronic disease morbidity and mortality experiences of Sacramento County

residents using public health data that can be directly compared with clearly established benchmarks,

such as national standards, and populations of similar compositions. The report is meant to be a tool for

learning as well as planning for the Healthy Sacramento Coalition.

The report includes data on demographics, life expectancy, chronic disease morbidity and chronic

disease mortality. The broad purpose of the report is to assist the community, policy-makers and

program planners to identify and prioritize important health issues and their associated measures to

improve the health of Sacramento County residents. This may be accomplished by promoting tobacco-

free living, active living and healthy eating, evidence-based clinical preventive and other services, social

and emotional awareness, and healthy and safe physical environments.

Population Data

Population estimates used in this report are from the State of California, Department of Finance,

Race/Ethnic Population with Age and Sex Detail, 2000–2010, Sacramento, CA, May 2009.

Mortality Data

Starting in 1999 the 10th revision of the International Classification of Disease (ICD-10) replaced the

International Classification of Disease version 9 (ICD-9) in coding and classifying mortality data from

death certificates. This change produced new causes of death titles and corresponding codes,

breaks in comparability of cause of death statistics and restructuring of the leading causes. All

mortality statistics in this report start with year 2003 when applicable.

Mortality data presented in this report was obtained from the California Department of Health

Services Center for Health Statistics, and are current through 2010.

Chronic Disease Data

The data addressing chronic diseases in Sacramento County is based on the information obtained

from the 2001, 2003, 2005, 2007 and 2009 California Health Interview Survey (CHIS).


iii

Results in Brief

The purpose of this report is to assist the Healthy Sacramento Coalition in monitoring the prevalence of

chronic disease and chronic disease mortality in Sacramento County. This report focuses on general

chronic disease measures, including, but not limited to, diabetes, hypertension and heart disease.

Statistical methods are employed in order to provide a representation of the chronic disease morbidity

and mortality experiences of Sacramento County residents. The content of this report was developed

from data sources available, such as the California Health Interview Survey of 2001, 2003, 2005, 2007,

2009 and vital statistics from 2003 to 2010.

This report supports the essential public health functions of monitoring the health status of a

community to identify community health problems, and informing, educating and empowering people

to manage health issues in their communities.

Demographics The population in Sacramento County increased 15.4% between 2000 and 2010.

The population is aging. Sacramento County residents aged 65 years and over increased by 16.5%

and those over age 85 years increased by 46.1% between 2000 and 2010.

Compared to all racial and ethnic groups, the Sacramento County Hispanic population increased the

most (53.4%) between 2000 and 2010.

Life Expectancy From 2001 to 2010 life expectancy increased for all racial and ethnic groups.

In 2010, Hispanic residents had the highest life expectancy (86.6 years) and African Americans had

the lowest (74.2 years). On average, Hispanic residents live 12.4 more years than their African

American counterparts, 7.6 more years than Caucasians and 3.8 more years than Asians and Pacific

Islanders.

African Americans however experienced the greatest increase in life expectancy over the time span

(3.9 years).

Chronic Disease Prevalence Asthma: Based on the 2001, 2003, 2007 and 2009 California Health Interview Survey (CHIS) results,

Sacramento County had a higher prevalence of asthma than the State of California average. In 2009,

Multi-race (23.9%) followed by Caucasians (18.0%) and African Americans (12.0%) had the highest

prevalence of asthma, and young adults aged 18-24 years (23.9%) followed by young children aged

5-11 years (15.7%) had the highest prevalence of all age groups.

Diabetes: In 2009, Sacramento County had lower diabetes prevalence than the State of California,

with the prevalence of diabetes in resident’s ages 65 years and over being significantly higher than

in other age groups.

Obesity and overweight: Obesity and overweight are significant health problems in Sacramento

County. In 2007-2009, 12.8% of children aged 2-11 years were overweight and 5.7% of children aged

12-17 years were overweight. In 2009, nearly 1 in 3 adults was overweight and 1 in 4 adults are


iv

obese in Sacramento County. Adult males had higher overweight rates compared to females across

the 5-year time span (2005-2009).

Heart disease: The prevalence of heart disease in Sacramento County was higher than the State of

California average (6.4% versus 5.9%). Residents greater than age 65 years had the highest heart

disease prevalence. The rate declined by 23.8% from 2001 to 2009.

Hypertension: At least 1 out of 4 Sacramento County residents had hypertension in Sacramento

County and the State of California.

Chronic Disease Mortality

Zip Codes with High Chronic Disease-Related Mortality

At least 2 zip codes were consistently among the highest chronic disease related mortality

categories for Chronic Lower Respiratory Disease (CLRD), Heart Disease, Hypertension, Stroke and

All-Causes Mortality (2006-2010). These zip codes were the following:

o 95608 (Carmichael)

o 95823 (Sacramento)

Other zip code areas among the higher categories of chronic disease deaths in Sacramento County

from 2006 to 2010 were the following:

o 95822 (Sacramento)

o 95828 (Florin)

o 95831 (Greenhaven)

o 95624 (Sheldon/Elk Grove)

Mortality

In 2010, cancer surpassed heart disease as the number 1 cause of death in Sacramento County,

followed by chronic lower respiratory disease (CLRD) (3rd) and stroke (4th). Diabetes was the 8th

leading cause of death.

Heart disease mortality was ranked number 1 for Caucasians and number 2 for all other racial and

ethnic groups. Stroke morality was ranked 3rd for African Americans and Asian Pacific Islanders

whereas CLRD was ranked 3rd for Caucasians and American Indian and Alaskan Natives. Diabetes

ranked as the 6th leading cause of death for African Americans and Asian/Pacific Islanders and 8th for

Caucasians and Hispanic residents. Hypertension related deaths ranked 7th for Asian/Pacific

Islanders and 8th for African Americans.

In 2010, unintentional and intentional injuries together accounted for more than 50% of all deaths

in children between the ages of 1 and 18. Of the unintentional fatal injuries, the vast majority were

due to motor vehicle crashes.

Homicide appeared in the top ten causes of death for African Americans (7th).

Alcohol and other drug-related age-adjusted mortality rates increased by 8.7% from 2003 to 2010.


v

Table of Contents

Technical Notes ______________________________________________________________ ii

Results in Brief _______________________________________________________________ iii

Demographics _____________________________________________________________________ iii

Life Expectancy ____________________________________________________________________ iii

Chronic Disease Prevalence __________________________________________________________ iii

Chronic Disease Mortality ___________________________________________________________ iv

The Chronic Disease Experience of Sacramento County Residents ______________________ 1

Demographics _____________________________________________________________________ 1

Sacramento County Population _______________________________________________________________ 1

Sacramento County Population by Gender ______________________________________________________ 2

Sacramento County Population by Race and Ethnicity _____________________________________________ 2

Sacramento County Population Compared to California ___________________________________________ 4

Life Expectancy ____________________________________________________________________ 5

Life Expectancy in Sacramento County _________________________________________________________ 5

Life Expectancy by Zip Code __________________________________________________________________ 7

Chronic Disease __________________________________________________________________ 10

Chronic Lower Respiratory Disease ___________________________________________________________ 10

Asthma _______________________________________________________________________________ 10

CLRD Mortality _________________________________________________________________________ 12

Diabetes ________________________________________________________________________________ 15

Prevalence of Diabetes by Age ____________________________________________________________ 15

Prevalence of Diabetes by Race/Ethnicity ___________________________________________________ 16

Diabetes Mortality ______________________________________________________________________ 17

Overweight ______________________________________________________________________________ 20

Definition of Overweight and At Risk for Overweight __________________________________________ 20

Overweight Children ____________________________________________________________________ 20

Adult Obesity __________________________________________________________________________ 20

Heart Disease and Hypertension _____________________________________________________________ 21

Heart Disease Mortality __________________________________________________________________ 22

Heart Disease by Age ____________________________________________________________________ 25

Hypertension and Stroke _________________________________________________________________ 25

Mortality ________________________________________________________________________ 31

Number of Deaths and Death Rates __________________________________________________________ 31

Top 10 Leading Causes of Death _____________________________________________________________ 34

Leading Causes of Death by Gender ________________________________________________________ 34

Leading Causes of Death by Race/Ethnicity __________________________________________________ 35

Leading Causes of Death for Seniors (Ages 65 Years and Older) __________________________________ 36

Leading Causes of Death for Children (ages 1 to 18) ___________________________________________ 37


vi

Deaths due to Accidents (Unintentional Injuries) ________________________________________________ 37

Deaths due to Intentional Injury _____________________________________________________________ 39

Alcohol and Drug Related Deaths ____________________________________________________________ 40

Definitions__________________________________________________________________ 44


1

The Chronic Disease Experience of Sacramento County Residents

Demographics

Sacramento County Population

Population data recently released by the California Department of Finance (DOF) revealed that as of July

1, 2010, there were 1,420,447 residents living in Sacramento County. This is an increase of 15.4% or

189,946 residents since July 1, 2000. The figure below details the age distribution of the Sacramento

County population and gives a picture of how the population age has changed between 2000 and 2010

(Figure 1).

During the last decade, the population in Sacramento County has increased in the older and younger age

categories. From 2000 to 2010, there was a 16.5% increase in the population over age 65, and a 46.1%


2

increase over age 85 years. Likewise, the number of babies aged less than 1 year, young adults aged 20-

24 years and adolescents and young adults aged 10-19 years, increased significantly.

Sacramento County Population by Gender

Figure 2 compares the age and sex distribution for residents in Sacramento County in 2010. This graph

shows that there were more female residents than male residents in 2010. The illustration indicates

that males are more likely to die at younger ages than females due to heart disease and injury. This

distribution illustrates the higher count of females to males in the senior categories. Figure 2 shows,

12.4% of females were 65 years or older compared to 9.6% of males 65 years or older.

Sacramento County Population by Race and Ethnicity

Figure 3 illustrates the diversity in Sacramento County by race and ethnicity. In 2000, the United States

Census Bureau began recording reports of multi-race, which enables residents to identify themselves


3

with two or more racial groups. In 2010, 3.9% of residents in Sacramento County identified themselves

as multi-race, 47.8% Caucasian, 22.2% Hispanic, 15.6% Asian/Pacific Islander, 10.0% African American

and 0.5% American Indian and Alaskan Native.

Figure 4 shows how the racial and ethnic composition in Sacramento County is expected to change over

the next 10 years. According to population estimates from the California Department of Finance there

will be a marginal decline in Caucasian and American Indian residents, whereas all other racial and

ethnic groups will experience moderate to significant increases.


4

Sacramento County Population Compared to California

Figure 5 compares the population of Sacramento County with that of California by race and ethnicity in

2010. Hispanics continue to be the fastest growing population in California. In Sacramento County,

Hispanics comprise 22.2% of the population. African Americans comprise 10.0% of residents compared

to only 5.8% of the state of California. Almost half the population in Sacramento County is Caucasian

(47.8%) compared to 40.1% in California.


5

Life Expectancy

Life Expectancy in Sacramento County

Life Expectancy is a measure that summarizes health over the entire lifespan. Life expectancy at birth is

the average number of years a newborn can expect to live, assuming he or she experiences the currently

prevailing rates of death throughout his or her lifespan. Over the ten year span, the life expectancy for

Sacramento County increased from 77.5 years to 79.7 years (2.9% change). Life expectancy also

increased for all racial and ethnic groups in Sacramento County, especially for African Americans and

Hispanics. In 2010, Hispanic residents had the highest life expectancy (86.6 years), followed by

Asian/Pacific Islanders (82.8 years), Caucasians (79 years) and African Americans (74.2 years). The

largest increase of 3.9% was experienced by African Americans (Table 1). This increase was nearly four

times the increase compared to Asian/Pacific Islanders. As with national life expectancy by race, African

Americans in Sacramento County lagged behind all other racial and ethnic groups (Figure 6).


6


7

Life Expectancy by Zip Code

Of the 56 zip codes in Sacramento County, two zip codes (95834 and 95835) were associated with the

highest life expectancy during 2011 and 2012 (See Map 1 and Map 2). When comparing 2011 to 2012 no

changes occurred in the Northern section of the County. Zip code areas with significant changes should

be interpreted with caution especially since dramatic changes in life expectancy should not occur within

a 1 year period.


8


9


10

Chronic Disease

Asthma, diabetes, overweight, heart disease, hypertension and health status estimates presented in this

report are based on the 2001-2009 California Health Interview Survey (CHIS) public use files for

Sacramento County and the State of California. CHIS is an ongoing, California-based, random-digit-dialed

telephone survey of the California civilian, non-institutionalized population. CHIS is considered to be the

largest telephone survey in California and the largest health survey of its kind in the country. The

sample frame may consist of over 55,000 households. The CHIS sample is designed to provide

population-based estimates for most California counties, all major ethnic groups, and several ethnic

subgroups. Major content areas for the survey include health-related behaviors, health status and

conditions, health insurance coverage, and access to health care services.

Chronic Lower Respiratory Disease

Chronic Lower Respiratory Diseases (CLRD) are a diverse group of disorders Involving impairment of lung

function. CLRD comprises 3 major diseases: chronic bronchitis, emphysema and asthma. Conditions are

characterized by shortness of breath due to airway obstruction.

Asthma

In 2009, 15.5%, (an estimated 214,000 of Sacramento County residents of all ages) were diagnosed with

asthma at some point in their lives (lifetime asthma prevalence). Compared to California, the lifetime

asthma prevalence for residents in Sacramento County is higher than California across all years. In 2009,

the lifetime asthma prevalence was 13.1% higher in Sacramento County than the state of California.

From 2001 to 2009, the lifetime asthma prevalence for Sacramento County increased 3.3% (Figure 7).


11

The prevalence of asthma was higher in Sacramento County during 2007 than in neighboring counties

(Table 2). In 2005, the prevalence of asthma (17.7) was lower than Contra Costa County (18.6). In 2009,

the prevalence of asthma was lower than all neighboring counties except for El Dorado County.

Figure 8 shows the distribution of lifetime asthma prevalence by age group. In Sacramento County,

young adults aged 18-24 years of age had the highest lifetime asthma prevalence (23.9%), followed by

residents 5-11 years (15.7%).

Lifetime asthma prevalence varied across different racial and ethnic groups in Sacramento County.

Residents identifying as multi-race had the highest lifetime asthma prevalence (23.9%) which may be

unreliable due to small sample size, followed by Caucasians (18.0%).


12

CLRD Mortality

CLRD mortality is high in older age groups, especially greater than age 65 years. Deaths were distributed

primarily in the following zip codes: 95608 (Carmichael), 95823 (Sacramento), and 95621(Citrus

Heights). The zip codes with the highest proportion of CLRD deaths were 95608 (Carmichael), 95823

(Sacramento), 95621 (Citrus Heights), 95828 (Florin) and 95630 (Folsom/Clarksville).


13


14


15

Diabetes

In 2005, it was estimated that 57,000 adults in Sacramento County had been diagnosed with diabetes at

some point in their lives. The prevalence of diabetes in Sacramento County was 5.8%. Compared to the

state of California, the Sacramento County diabetes rate was lower in 2005, but higher in 2001 and

2003. In 2005, it is estimated that there were 25,000 (5.3%) adult males and 31,000 (6.2%) females

diagnosed with diabetes in Sacramento County. Among those diagnosed with diabetes in 2005, 13.9%

were type I diabetes and 86.1% were type II diabetes.

Prevalence of Diabetes by Age

Seniors (residents ages 65 years and older) had the highest prevalence of diabetes (17.0%), followed by

residents ages 50-64 years (8.3%). In 2005, the Sacramento County diabetes rate was lower than the

state of California across all age groups (Figure 11)


16

Prevalence of Diabetes by Race/Ethnicity

Diabetes prevalence varied across different racial and ethnic groups in Sacramento County. American

Indian and Alaskan Natives had the highest lifetime asthma prevalence (27.0%, followed by Latinos

(18.7%) and African Americans (11.1%). The prevalence for diabetes was also higher for American Indian

and Alaskan Natives (24.8%) for the State of California, followed by African Americans (12.6%).


17

Diabetes Mortality

Diabetes is the overall seventh leading cause of death in Sacramento County. The death rate is twice as

high for persons aged 45-60 years. Mortality is related primarily to heart disease. The risk for stroke is

also higher for persons with diabetes as well as end-stage renal disease. Diabetes deaths were primarily

distributed in the following zip Codes: 95608 (Carmichael), 95823 (Sacramento), 95628 (Florin), and

95822 (Sacramento). Of the diabetes deaths the zip codes with the highest proportion was 95608

(Carmichael), 95823 (Sacramento), 95628(Florin), and 95822 (Sacramento).


18


19


20

Overweight

Definition of Overweight and At Risk for Overweight

Body Mass Index (BMI) is an index of weight and height that is defined as body weight in kilograms

divided by height in meters squared (kg/m2). For children, BMI is gender and age specific; therefore

BMI-for-age is the measure used for children ages 2 to 20 years. The California Health Interview Survey

was used to generate BMI-for-age measures for children ages 2-17 years based on the year 2000

Centers for Disease Control and Prevention’s BMI-for-age-growth charts for the United States. In this

report, children with BMI-for-age values at or above the 95th percentile of the gender-specific BMI

growth charts are categorized as overweight and those with BMI values between the 85th and 95th

percentiles are categorized as at risk of being overweight.

Overweight Children

During 2007-2009, 16.7% of teens aged 12 to17 years in Sacramento County were considered at risk of

overweight and 5.7% were considered overweight or obese whereas 12.8% children ages 2-11 years

were considered overweight (Table 3).

Adult Obesity

In 2009, an estimated 273,000 (26.5%) adults aged 18 years and older were obese (Body Mass Index

greater than or equal to 30) and 328,000 (31.9%) adults were considered overweight (Body Mass Index

between 25.0 to 29.9). From 2001 to 2009, the obesity rate for adults increased by 21.6% (Table 4).


21

Figure 13 shows that male residents had higher overweight rates than female residents across all years.

In 2005, adult females had slightly higher obesity rates than adult males in Sacramento County.

Heart Disease and Hypertension

Cardiovascular disease (CVD), which includes heart disease, heart failure and stroke, is the leading cause

of death in Sacramento County and in the State of California. In 2009, an estimated 66,000 adult

residents in Sacramento County reported living with the diagnosis of heart disease. The prevalence rate

for heart disease was 6.4% in Sacramento County, which is 8.5% higher than the State of California

(5.9%).


22

Heart Disease Mortality

During the last 50 years, heart disease mortality has declined steadily in the United States. The Healthy

People 2020 objective is to reduce the CVD death rate by 20% from 126.0 per 100,000 population in

2007 to 100.8 per 100,000 in 2020. In Sacramento County, CVD deaths were primarily distributed in the

following zip Codes: 95608 (Carmichael), 95823 (Sacramento) and 95622 (Sacramento). Of the CVD

deaths the zip codes with the highest proportion of CVD deaths was 95608 (Carmichael), 95823

(Sacramento), and 95822 (Sacramento)


23


24


25

Heart Disease by Age

The prevalence rate for heart disease was higher for older adults. Residents aged 65 years and older had

the highest prevalence rate of heart disease in Sacramento County (Figure14). From 2001 to 2009, the

prevalence rates for seniors aged 65 and older declined. In 2009, heart disease prevalence decreased

23.8% compared to 2001. In 2009, the heart disease prevalence rate for seniors in Sacramento County

was 5.8% higher than the statewide rate (Figure 15).

Hypertension and Stroke

Hypertension is a modifiable risk factor that can contribute to the development of heart disease.

Approximately 30% of adults in the United States have hypertension. The prevalence rate for

hypertension disease increased from 2001 to 2009. In 2007, there was a 28.5 increase in the prevalence

compared to 2001. From 2003 to 2009, the prevalence rate of hypertension for seniors was

approximately 60% (Table 6).

One in 7 deaths in the United States is attributed to hypertension including stroke. Stroke is the fourth

leading cause of death in the United States and the leading cause of long-term severe disability. In

Sacramento County, stroke is the 4th leading cause of death whereas hypertension is the 9th leading


26

cause. The Healthy People 2020 objective is to reduce the stroke death rate from 42.2 per 100,000

population in 2007 to 33.8 per 100,000 in 2020. The Healthy People 2020 objective for hypertension is

to reduce hypertension prevalence from 29.9% of adults aged 18 years and older to 26.9%. This is a 10%

improvement. In Sacramento County, hypertension deaths were primarily distributed in the following

zip Codes: 95823 (Sacramento) and 95622 (Sacramento), 95608 (Carmichael) and 95831 (Greenhaven).

For the proportion of hypertension deaths, the zip codes are the same.

Stroke related deaths were primarily distributed in the following zip codes: 95823 (Sacramento), 95822

(Sacramento), 95608 (Carmichael), 95828 (Florin), 95624 (Sheldon/Elk Grove), 95670 (Rancho

Cordova/Gold River), 95621 (Citrus Heights) and 95610 (Citrus Heights). The proportion of stroke

related deaths were disturbed primarily in 95608 (Carmichael), 95823 (Sacramento) and 95822

(Sacramento).


27


28


29


30


31

Mortality

Number of Deaths and Death Rates

The total number of deaths of Sacramento County residents increased from 9,744 deaths in 2003 to

10,048 deaths (3.1%) in 2010. During this 8-year period the number of male deaths increased by 153

deaths (3.1%) and the number of female deaths increased by 151 (3.1%) deaths. The population in

Sacramento County grew by 119,757 during the same period (9.0%).

Between 2003 and 2010, the crude death rate for Sacramento County residents decreased 5.4% from

731.5 per 100,000 population to 692.1 per 100,000 population. The male crude death rate decreased

5.6% from 747.6 per 100,000 population in 2003 to 705.8 per 100,000 population in 2010. The female

crude death rate dropped only 5.2% from 716.0 per 100,000 population in 2003 to 678.8 per 100,000

population in 2010.

From 2003 to 2010, the age-adjusted death rate for Sacramento County residents fell by 10.7% from

793.6 deaths per 100,000 population to 708.7 deaths per 100,000 population. The male age-adjusted

death rate dropped 12.9% and the female age-adjusted death rate dropped 9.0% (Table 8). In 2010, the

age-adjusted death rate for County residents was 708.7 deaths per 100,000 population.


32


33


34

Top 10 Leading Causes of Death

The 10 leading causes of death in 2010 accounted for 75.2% of all deaths. Over an 8-year span, heart

disease, malignant neoplasm (cancer), cerebrovascular disease (stroke) and CLRD remained the top four

causes of death across all years. In 2010, cancer became the number one cause of all deaths in

Sacramento County and CLRD became the third leading cause. From 2007 to 2010, the number of

deaths from influenza and pneumonia dropped from sixth place in 2003-2006, to seventh place from

2007-2010. Accidents became the fifth leading cause of death from 2003 to 2010. Alzheimer’s disease

deaths increased from 8th cause of all deaths to the 6th cause of all deaths in 2010 (Table 9).

* Chronic Lower Respiratory Disease ** Accidents (Unintentional Injuries) ( ): Cause of Death Numerical Rank for that Year.

Leading Causes of Death by Gender

In 2010, cancer and heart disease were the first and second leading causes of death for both females

and males, and accounted for 45.0% of female deaths and 47.7% of male deaths. Accidents were the

third leading cause of death for males and the sixth leading cause for females. Stroke was the fourth


35

leading cause of death for females and the fifth leading cause of death for males. Lung disease (CLRD)

was the third leading cause for females and fourth cause for males. Diabetes was the eighth leading

cause of death for both males and females. Hypertension was the ninth leading cause of death for

females (Table 10).

* Chronic Lower Respiratory Disease (CLRD) ** Accident (Unintentional Injuries)

Leading Causes of Death by Race/Ethnicity

In 2010, heart disease and cancer were the top two leading causes of death across all racial and ethnic

groups. Stroke was the third leading cause of death for African Americans and Asian/Pacific Islanders.

Chronic lower respiratory disease (CLRD) was the third leading cause of death for Caucasians and

American Indians and Alaskan Natives. The third leading cause of death for Hispanics was accidents.

Stroke became the fourth leading cause of death for Hispanics and Caucasians. Accidents were the

fourth leading cause of death for African Americans. Influenza & Pneumonia disease was the fourth

leading cause of death for American Indians and Alaskan Natives (Table 11).


36

Leading Causes of Death for Seniors (Ages 65 Years and Older)

In 2010, deaths among seniors (65 years and older) comprised 70.5% (7,083 out 10,048) of all deaths in

Sacramento County. Table 12 shows the leading causes of death for seniors from 2003 to 2010. The

majority of death among seniors was due to heart disease followed by cancer, stroke and CLRD.


37

Leading Causes of Death for Children (ages 1 to 18)

From 2003-2010, accidents were the number one leading cause of death for children ages 1 to 18 years.

The majority of deaths in this category was due to motor vehicle crashes, followed by drowning (Table

13). The second leading cause of death was homicide.

Deaths due to Accidents (Unintentional Injuries)

From 2003 to 2010, the number of unintentional injury deaths increased 8.3% from 421 to 456 (Figure

16). After 2006, unintentional injury deaths declined from 536 in 2006 to 456 in 2010, which was a

17.5% decrease. Poisoning and exposure to noxious substances was the first leading cause of

unintentional injury death in 2010, followed by transportation accidents and fall related injuries and

drowning (Figure 17). Of the 456 unintentional injury deaths in 2010, 144 (31.6%) were due to

transportation accidents. Of these deaths, 86.8% were due to motor vehicle accidents.


38


39

Deaths due to Intentional Injury

There was a total of 270 intentional deaths in 2010. Of these deaths, 189 (70.0%) were suicides and 81

(30.0%) were homicides. The leading manner of suicide was use of firearms, which accounted for 32.3%

of all suicides, followed by hanging, strangulation and suffocation, poisoning and exposure to noxious

substances. The first leading manner of homicide was also the use of a firearm, which accounted for

72.8% of all homicides. The second leading manner of homicide was assault with a sharp object,

followed by hanging, strangulation and suffocation (Table 15).


40

From 2003 to 2010, the number of intentional injury deaths caused by suicide increased. In 2010, there

were 34 more suicides than in 2003. Over the same span homicides decreased from 93 in 2003 to 81 in

2010 (Figure 18)

Alcohol and Drug Related Deaths

From 2003-2010, 3,140 deaths were associated with alcohol and drugs in Sacramento County. Alcohol

and drug-related deaths represented 4.0% of the 78,494 deaths recorded during the 8-year period

(Table 16).


41

The number of alcohol and drug-related deaths increased from 322 in 2003 to 382 in 2010. The age-

adjusted mortality rate increased from 24.2 per 100,000 population in 2003 to 26.3 per 100,000

population in 2010 (Figure19).


42

Figure 20 shows the racial and ethnic distribution of alcohol and drug related deaths over the eight-year

period. Caucasians accounted for 71.3% of alcohol and other drug related deaths followed by Hispanics

(12.7%) and African Americans (11.0%).

The age group with the largest number of alcohol and drug related deaths were aged 45-54 year and

accounted for 35.6% of all alcohol and drug related deaths during the eight-year period. The next

highest number of deaths was to residents aged 55-64 years (22.1%).


43

There were 904 alcohol related deaths attributed to alcoholic liver disease (28.8%), of which 512 (56.6%)

were due to alcoholic cirrhosis. Nearly 42% of all alcohol and other drug related deaths were associated

with alcohol or drug poisoning; 13.6% were caused by mental or behavioral disorders and 9.4% were

related to suicide (Table 17).


44

Definitions

Age-Adjusted Death Rate: Age-adjusted death rates are used to compare relative mortality risk across

groups and over time. These rates show expected mortality if the age distribution of population were

the same. Age-adjusted rates are index numbers and cannot be compared to crude or other types

of rates. The rate is calculated by dividing the total number of expected deaths in a standard population

if the people in this population had experienced the same age-specific death rates as the population

being adjusted to the total standard population. The rate is expressed per 100,000 population. In this

report, the 2000 US standard population is used.

Causes of Death: The standard diagnostic categories of the International Statistical Classification of Diseases Code the tenth revision (ICD 10) were used to identify the leading causes of death.

Crude Death Rate: Total number of deaths divided by the estimated total population in the same time

period. The rate is expressed per 100,000 or 1,000 population.

Incidence: The number of new cases of disease or other condition that occurs in a specified population

during a given period.

Life Expectancy: Average number of years a newborn can expect to live at birth.

Prevalence: The proportion of cases of a disease or other condition present in a population without any

distinction between new and old cases. When used without qualification, the term usually refers to the

number of cases as a proportion of the population at risk at a specified point in time (point prevalence).

Rate: An expression of the change in one quantity per unit time. It is a ratio whose essential characteristic is that time is an element of the denominator and in which there is a distinct relationship between numerator and denominator.

Documents

The Chronic Disease Experience of Sacramento County ... · The Chronic Disease Experience of Sacramento County Residents ... This report presents the chronic disease morbidity and