1. Congressional Black Caucus Joint Meeting of the Environmental Justice and Health Braintrusts June 7-8, 2002 Prepared by: National Center for Health Statistics Centers for Disease Control and Prevention A Demographic and Health Snapshot of Region IV

2. Public Health Service Region IV D.C. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee

3. Demographic characteristics

4. 510152005101520 85 and over 75-84 65-74 60-64 55-59 45-54 35-44 25-34 20-24 15-19 10-14 5-9 Under 5 Age in years 510152005101520 Percent distribution of the population by age and race: United States and Region IV, 2000 Percent of population Black/African American Source: Census 2000 Summary File 1, US Bureau of the Census. United States United States Total Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Region IV Region IV

5. Region IVUnited States Black/African American, not-Hispanic American Indian/ Alaska Native* Hispanic** White, not-HispanicAsian/Pacific Islander* Percent distribution of the population by specified race/ethnicity: United States and Region IV, 2000 *Includes persons of Hispanic and non-Hispanic origin. **Persons of Hispanic origin may be any race. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Source: Census 2000 Summary File 1, US Bureau of the Census. Percent

6. United States Percent Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia Percent of population that is black/African American: United States and Region IV States, 2000 Source: Census 2000 Summary File 1, US Bureau of the Census.

8. Percent Percent of households that are headed by females*: United States and Region IV States, by race, 2000 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia Source: Census 2000 Summary File 1, US Bureau of the Census. *No spouse present.

9. Percent Percent of population that lives in a rural area: United States and Region IV States, 1990 United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia Source: 1990 Census of Population and Housing, US Bureau of the Census.

10. Black/African AmericanTotal population In thousands (dollars) Median household income in the past 12 months: United States and Region IV States, by race, 2000 United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia Source: Census 2000 Supplementary Survey, US Bureau of the Census. I = 90% confidence interval.

11. Percent of population below the federal poverty level : United States and Region IV States, by race, 2000 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia Percent Source: Census 2000 Supplementary Survey, US Bureau of the Census. Percents are based on income in the past 12 months. I = 90% confidence interval.

12. Source: Census 2000 Supplementary Survey, US Bureau of the Census. Percent Percent of civilian labor force 16 and older who are unemployed: United States and Region IV States, 2000 United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia

13. Mortality

14. *Rank based on number of deaths. **Cause-of-death definitions may differ for those used in Healthy People 2010 and the Leading Health Indicators. ***Age-adjusted rates per 100,000 standard population based on year 2000 standard. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. 15 Leading causes of death, 1999

15. *Coronary heart disease (ICD-10 codes: I11, I20-I25) is a subcategory of Diseases of heart (ICD-10 codes: I00-I09, I11, I13, I51). **Includes persons of Hispanic and non-Hispanic origin. ***Persons of Hispanic origin may be any race. Rates are age-adjusted to the year 2000 standard population. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population Region IVUnited States Coronary heart disease* death rates: United States and Region IV, by specified race, 1999 Black/African American, not-Hispanic American Indian/ Alaska Native** Hispanic*** White, not-HispanicAsian/Pacific Islander** 2010 target (US)

16. Coronary heart disease* death rates: United States and Region IV States, by race, 1999 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia *Coronary heart disease(ICD-10 codes: I11, I20-I25) is a subcategory of Diseases of heart (ICD-10 codes: I00-I09, I11, I13, I51). Rates are age-adjusted to the year 2000 standard population. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population 2010 target (US)

17. *HIV deaths are classified by ICD-10 codes: I11, I20-I25. Rates are age-adjusted to the year 2000 standard population. American Indian/Alaska Native and Asian/Pacific Islander death rates from HIV are unreliable in Region IV. Information on these populations have been suppressed. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population Region IVUnited States Human immunodeficiency virus (HIV)* death rates: United States and Region IV, by specified race, 1999 Black/African American, not-Hispanic Hispanic*** White, not-Hispanic 2010 target (US)

18. Human immunodeficiency virus (HIV)* death rates: United States and Region IV States, by race, 1999 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia *HIV deaths are classified by ICD-10 codes: I11, I20-I25. Rates are age-adjusted to the year 2000 standard population. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population 2010 target (US)

19. *Cancer deaths are classified by ICD-10 codes: C00-C97. **Includes persons of Hispanic and non-Hispanic origin. ***Persons of Hispanic origin may be any race. Rates are age-adjusted to the year 2000 standard population. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Region IV United States Malignant neoplasms (cancer)* death rates: United States and Region IV, by specified race, 1999 Black/African American, not-Hispanic American Indian/ Alaska Native** Hispanic*** White, not-HispanicAsian/Pacific Islander** Age-adjusted rate per 100,000 standard population 2010 target (US)

20. Malignant neoplasms (cancer)* death rates: United States and Region IV States, by race, 1999 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia *Cancer deaths are classified by ICD-10 codes: C00-C97. Rates are age-adjusted to the year 2000 standard population. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population 2010 target (US)

21. Region IVUnited States Infant*mortality: United States and Region IV, by specified race, 1999 Black/African American, not-Hispanic American Indian/ Alaska Native** Hispanic*** White, not-HispanicAsian/Pacific Islander** Rate per 1,000 live births *Under 1 year. **Includes persons of Hispanic and non-Hispanic origin. ***Persons of Hispanic origin may be any race. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Source: National Vital Statistics System (NVSS) Linked Birth and Infant Death File, Centers for Disease Control and Prevention, NCHS. 2010 target (US)

22. Infant* mortality: United States and Region IV States, by race, 1999 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia Rate per 1,000 live births *Under 1 year. Source: National Vital Statistics System (NVSS) Linked Birth and Infant Death File, Centers for Disease Control and Prevention, NCHS. 2010 target (US)

23. *Unintentional injury deaths are classified by ICD-10 codes: V01-X59, Y85-Y86. **Includes persons of Hispanic and non-Hispanic origin. ***Persons of Hispanic origin may be any race. Rates are age-adjusted to the year 2000 standard population. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Region IVUnited States Unintentional injury* death rates: United States and Region IV, by specified race, 1999 Black/African American, not-Hispanic American Indian/ Alaska Native** Hispanic*** White, not-HispanicAsian/Pacific Islander** Age-adjusted rate per 100,000 standard population 2010 target (US)

24. Unintentional injury* death rates: United States and Region IV States, by race, 1999 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia *Unintentional injury deaths are classified by ICD-10 codes: V01-X59, Y85-Y86. Rates are age-adjusted to the year 2000 standard population. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population 2010 target (US)

25. *Stroke deaths are classified by ICD-10 codes: I60-I69. **Includes persons of Hispanic and non-Hispanic origin. ***Persons of Hispanic origin may be any race. Rates are age-adjusted to the year 2000 standard population. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Region IVUnited States Cerebrovascular disease (stroke)* death rates: United States and Region IV, by specified race, 1999 Black/African American, not-Hispanic American Indian/ Alaska Native** Hispanic*** White, not-HispanicAsian/Pacific Islander** Age-adjusted rate per 100,000 standard population 2010 target (US)

26. Cerebrovascular disease (stroke)* death rates: United States and Region IV States, by race, 1999 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia *Stroke deaths are classified by ICD-10 codes: I60-I69. Rates are age-adjusted to the year 2000 standard population. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population 2010 target (US)

27. *Diabetes deaths are classified by ICD-10 codes: E10-E14 and may be the underlying or contributing cause of death. **Includes persons of Hispanic and non-Hispanic origin. ***Persons of Hispanic origin may be any race. Rates are age-adjusted to the year 2000 standard population. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Region IV United States Diabetes death* rates: United States and Region IV, by specified race, 1999 Black/African American, not-Hispanic American Indian/ Alaska Native** Hispanic*** White, not-HispanicAsian/Pacific Islander** Age-adjusted rate per 100,000 standard population 2010 target (US)

28. Diabetes death* rates: United States and Region IV States, by race, 1999 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia *Diabetes deaths are classified by ICD-10 codes: E10-E14 and may be the underlying or contributing cause of death. Rates are age-adjusted to the year 2000 standard population. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population 2010 target (US)

29. *Chronic lower respiratory disease deaths are classified by ICD-10 codes: J40-J47. **Includes persons of Hispanic and non-Hispanic origin. ***Persons of Hispanic origin may be any race. Rates are age-adjusted to the year 2000 standard population. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Region IVUnited States Chronic lower respiratory disease* death rates for people 45 years and older: United States and Region IV, by specified race, 1999 Chronic lower respiratory disease* death rates for people 45 years and older: United States and Region IV, by specified race, 1999 Black/African American, not-Hispanic American Indian/ Alaska Native** Hispanic*** White, not-HispanicAsian/Pacific Islander** Age-adjusted rate per 100,000 standard population 2010 target (US)

30. Chronic lower respiratory disease* death rates for people 45 years and older: United States and Region IV States, by race, 1999 Black/African American Total population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia *Chronic lower respiratory disease deaths are classified by ICD-10 codes: J40-J47. Rates are age-adjusted to the year 2000 standard population. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population 2010 target (US)

31. *Influenza and pneumonia deaths are classified by ICD-10 codes: J10-J18. **Includes persons of Hispanic and non-Hispanic origin. ***Persons of Hispanic origin may be any race.Rates are age-adjusted to the year 2000 standard population. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population Region IVUnited States Influenza and pneumonia* death rates: United States and Region IV, by specified race, 1999 Black/African American, not-Hispanic American Indian/ Alaska Native** Hispanic*** White, not-HispanicAsian/Pacific Islander**

32. Influenza and pneumonia* death rates: United States and Region IV States, by race, 1999 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia *Influenza and pneumonia deaths are classified by ICD-10 codes: J10-J18. Rates are age-adjusted to the year 2000 standard population. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population

33. *Breast cancer deaths are classified by ICD-10 code: C50. **Persons of Hispanic origin may be any race.Rates are age-adjusted to the year 2000 standard population. American Indian/Alaska Native and Asian/Pacific Islander female breast cancer death rates are unreliable for Region IV. Information for these populations have been suppressed. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population Region IVUnited States Breast cancer* death rates among females: United States and Region IV, by specified race, 1999 Black/African American, not-Hispanic Hispanic**White, not-Hispanic 2010 target (US)

34. Breast cancer* death rates among females: United States and Region IV States, by race, 1999 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia *Breast cancer deaths are classified by ICD-10 code: C50. Rates are age-adjusted to the year 2000 standard population. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population 2010 target (US)

35. *Prostate cancer deaths are classified by ICD-10 code: C61. **Persons of Hispanic origin may be any race.Rates are age-adjusted to the year 2000 standard population. American Indian/Alaska Native and Asian/Pacific Islander prostate cancer death rates are unreliable for Region IV. Information for these populations have been suppressed. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population Region IVUnited States Prostate cancer* death rates among males : United States and Region IV, by specified race, 1999 Black/African American, not-Hispanic Hispanic**White, not-Hispanic 2010 target (US)

36. Prostate cancer* death rates among males: United States and Region IV States, by race, 1999 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia *Prostate cancer deaths are classified by ICD-10 code: C61. Rates are age-adjusted to the year 2000 standard population. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population 2010 target (US)

38. Healthy People 2010 and the Leading Health Indicators

39. Healthy People 2010 2 broad goals  Increase quality and years of healthy life  Eliminate health disparities 28 Focus Areas 467 specific objectives U.S. targets to be reached by the year 2010 Tracking Healthy People 2010 – Statistical compendium

40. Leading Health Indicators Areas of broad public health importance Specific Healthy People 2010 objectives Measurable at the State and local level Ability to educate and motivate action

41. Mental health Injury and violence Environmental quality Immunization Access to health care Leading Health Indicators: Ten major public health issues Physical activity Overweight and obesity Tobacco use Substance abuse Responsible sexual behavior

42. Leading Health Indicators

43. I = 95% confidence interval. *Exercising or participating for at least 20 minutes in physical activity that makes them sweat and breathe hard 3 or more days per week. **Persons of Hispanic origin may be any race. American Indian/Alaska Native and Asian/Pacific Islander activity rates are unreliable. Information on these populations have been suppressed. Source: Youth Risk Behavior Surveillance System (YRBSS), Centers for Disease Control and Prevention, NCCDPHP. Percent of students in grades 9 - 12 who engage in vigorous physical activity*: United States, by specified race, 1999 Percent of students in grades 9 - 12 who engage in vigorous physical activity*: United States, by specified race, 1999 Black/African American, not-Hispanic Hispanic** White, not-Hispanic Percent 2010 target (US)

44. Percent Black/African American, Not-Hispanic Total population Percent of students in grades 9 - 12 who engage in vigorous physical activity*: United States and Region IV States, by race, 1999 I = 95% confidence interval. *Exercising or participating for at least 20 minutes in physical activity that makes them sweat and breathe hard 3 or more days per week. Region IV States include Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee. Student activity rates are unreliable for Florida and Kentucky. Information on these States have been suppressed. Student activity rates are unavailable from Georgia and North Carolina. Source: Youth Risk Behavior Surveillance System (YRBSS), Centers for Disease Control and Prevention, NCCDPHP. United States Mississippi South Carolina Tennessee Alabama 2010 target (US)

45. Age-adjusted percent Percent of adults 18 and older who engage in moderate and/or vigorous physical activity*: United States and Region IV, by specified race, 2000 Region IV Total population 2010 target (US) I = 95% confidence interval. *Vigorous: Exercising or participating in physical activity that causes sweating and hard breathing for at least 20 minutes 3 or more times per week. Moderate: Exercising or participating in physical activity that causes light sweating and slight to moderate increase in breathing or heart rate for at least 30 minutes 5 or more times per week. **Includes persons of Hispanic and non-Hispanic origin. ***Persons of Hispanic origin may be any race. Percents are age-adjusted to the year 2000 standard population. American Indian/Alaska Native activity rates are unreliable. Information for this population has been suppressed. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee. Source: National Health Interview Survey (NHIS), Centers for Disease Control and Prevention, NCHS. Black/African American, not-Hispanic Hispanic*** White, not-Hispanic Asian/Pacific Islander**

46. I = 95% confidence interval. *Vigorous: Exercising or participating in physical activity that causes sweating and hard breathing for at least 20 minutes 3 or more times per week. Moderate: Exercising or participating in physical activity that causes light sweating and slight to moderate increase in breathing or heart rate for at least 30 minutes 5 or more times per week. Percents are age-adjusted to the year 2000 standard population. Source: National/Regional - National Health Interview Survey (NHIS), Centers for Disease Control and Prevention, NCHS; State – Behavioral Risk Factor Surveillance System (BRFSS), Centers for Disease Control and Prevention, NCCDPHP. Percent of adults 18 and older who engage in moderate and/or vigorous physical activity*: United States and Region IV States, by race, 2000 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia Age-adjusted percent 2010 target (US)

47. Percent of adults 20 and older who are obese*: United States and Region IV States, by race, 2000 Black/African American Total population Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia Age adjusted percent I = 95% confidence interval. *Body mass index > 30 kg/m 2 (based on self-reported height and weight). **The 2010 target for the United States is based on measured height and weight data. Percents are age-adjusted to the year 2000 standard population. Source: Behavioral Risk Factor Surveillance System (BRFSS), Centers for Disease Control and Prevention, NCCDPHP. 2010 target (US)**

48. Percent Black/African American, Not-Hispanic Total population Percent of students in grades 9 - 12 who smoked cigarettes in the past month: United States and Region IV States, by race, 1999 I = 95% confidence interval. *Region IV States include Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee. Student smoking rates are unreliable for Florida and Kentucky. Information on these States have been suppressed. Student smoking rates are unavailable from Georgia and North Carolina. Source: Youth Risk Behavior Surveillance System (YRBSS), Centers for Disease Control and Prevention, NCCDPHP. United States Mississippi South Carolina Tennessee Alabama 2010 target (US)

49. Age-adjusted percent Percent of adults 18 and older who are current smokers*: United States and Region IV, by specified race, 2000 Region IV Total population I = 95% confidence interval. *Current smokers have smoked more than 100 cigarettes in their life and now smoke cigarettes every day or some days. **Includes persons of Hispanic and non-Hispanic origin. ***Persons of Hispanic origin may be any race. Percents are age-adjusted to the year 2000 standard population. American Indian/Alaska Native smoking rates for Region IV are unreliable. Information for this population has been suppressed. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee. Source: National Health Interview Survey (NHIS), Centers for Disease Control and Prevention, NCHS. Black/African American, not-Hispanic Hispanic*** White, not-Hispanic Asian/Pacific Islander** 2010 target (US)

50. Percent of adults 18 and older who are current smokers*: United States and Region IV States, by race, 2000 Black/African American Total population Age adjusted percent I = 95% confidence interval. *Current smokers have smoked more than 100 cigarettes in their life and now smoke cigarettes every day or some days. Percents are age-adjusted to the year 2000 standard population. Source: National/Regional - National Health Interview Survey (NHIS), Centers for Disease Control and Prevention, NCHS; State – Behavioral Risk Factor Surveillance System (BRFSS), Centers for Disease Control and Prevention, NCCDPHP. 2010 target (US) United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia

51. Percent Percent of adults 18 and older who engaged in binge alcohol use* in the past month: United States, by specified race, 2000 I = 95% confidence interval. *Binge alcohol use is drinking 5 or more drinks on the same occasion on at least 1 day in the past 30 days. ***Persons of Hispanic origin may be any race. Source: National Household Survey on Drug Abuse (NHSDA), Substance Abuse and Mental Health Service Administration, OAS. Black/African American, not-Hispanic Hispanic*** White, not-Hispanic Asian, not-Hispanic 2010 target (US) American Indian/Alaska Native not-Hispanic

52. Percent of adults 18 and older who engaged in binge alcohol use* in the past month: United States and Region IV States, by race, 1999 Black/African American Total population I = 95% confidence interval. *Binge alcohol use is drinking 5 or more drinks on the same occasion on at least 1 day in the past 30 days. **Black/African American data is for Black/African American, not-Hispanic Source: National- National Household Survey on Drug Abuse (NHSDA), Substance Abuse and Mental Health Service Administration, OAS. State – Behavioral Risk Factor Surveillance System (BRFSS), Centers for Disease Control and Prevention, NCCDPHP. 2010 target (US) United States** Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia Percent

53. Black/African American, not-Hispanic Total population Percent of students in grades 9 - 12 who exhibit responsible sexual behavior*: United States and Region IV States, by race, 1999 I = 95% confidence interval. *responsible sexual behavior is never having sexual intercourse, not having sexual intercourse in the past 3 months, or used a condom at last sexual encounter within the past 3 months. Region IV States include Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee. Student behavior rates are unreliable for Florida and Kentucky. Information on these States have been suppressed. Student behavior rates are unavailable from Alabama, Georgia and North Carolina. Source: Youth Risk Behavior Surveillance System (YRBSS), Centers for Disease Control and Prevention, NCCDPHP. United StatesMississippiSouth CarolinaTennessee 2010 target (US)

54. *Suicides are classified by ICD-10 codes: X60-X84, Y87.0. **Includes persons of Hispanic and non-Hispanic origin. ***Persons of Hispanic origin may be any race. Rates are age-adjusted to the year 2000 standard population. American Indian/Alaska Native death rates from suicide are unreliable in Region IV. Information on this population has been suppressed. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Region IVUnited States Suicide* among people 20 and older: United States and Region IV, by specified race, 1999 Suicide* among people 20 and older: United States and Region IV, by specified race, 1999 Black/African American, not-Hispanic Hispanic*** White, not-Hispanic Asian/Pacific Islander** Age-adjusted rate per 100,000 standard population 2010 target (US)

55. Suicide* among people 20 and older: United States and Region IV States, by race, 1999 Black/African American Total population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia *Suicides are classified by ICD-10 codes: X60-X84, Y87.0. Rates are age-adjusted to the year 2000 standard population. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population 2010 target (US)

56. *Traffic-related motor vehicle crash deaths are classified by ICD-10 codes: V30-V39(.4-.9), V40-V49(.4-.9), V50-V59(.4-.9), V60-V69(.4-.9), V70-V79(.4-.9), V81.1, V82.1, V83-V86(.0-.3), V20-V28(.3-.9), V29(.4-.9), V12-V14(.3-.9), V19(.4-.6), V02-V04(.1,.9), V09.2, V80(.3-.5), V87(.0-.8), V89.2. **Includes persons of Hispanic and non-Hispanic origin. ***Persons of Hispanic origin may be any race. Rates are age-adjusted to the year 2000 standard population. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Region IVUnited States Traffic-related motor vehicle crash* death rates: United States and Region IV, by specified race, 1999 Black/African American, not-Hispanic American Indian/ Alaska Native** Hispanic*** White, not-HispanicAsian/Pacific Islander** Age-adjusted rate per 100,000 standard population 2010 target (US)

57. Traffic-related motor vehicle crash* death rates: United States and Region IV States, by race, 1999 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia *Traffic-related motor vehicle crash deaths are classified by ICD-10 codes: V30-V39(.4-.9), V40-V49(.4-.9), V50-V59(.4-.9), V60-V69(.4-.9), V70-V79(.4-.9), V81.1, V82.1, V83-V86(.0-.3), V20-V28(.3-.9), V29(.4-.9), V12-V14(.3-.9), V19(.4-.6), V02-V04(.1,.9), V09.2,V80(.3-.5), V87(.0-.8), V89.2. Rates are age-adjusted to the year 2000 standard population. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population 2010 target (US)

58. *Homicides are classified by ICD-10 codes: X85-Y09, Y87.1. **Includes persons of Hispanic and non-Hispanic origin. ***Persons of Hispanic origin may be any race.. Rates are age-adjusted to the year 2000 standard population. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Region IVUnited States Homicide*: United States and Region IV, by specified race, 1999 Homicide*: United States and Region IV, by specified race, 1999 Black/African American, not-Hispanic American Indian/ Alaska Native** Hispanic*** White, not-HispanicAsian/Pacific Islander** Age-adjusted rate per 100,000 standard population 2010 target (US)

59. Homicide*: United States and Region IV States, by race, 1999 Black/African American Total population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia *Homicides are classified by ICD-10 codes: X85-Y09, Y87.1. Rates are age-adjusted to the year 2000 standard population. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Age-adjusted rate per 100,000 standard population 2010 target (US)

60. Nonattainment designations for ozone as of January 2002: Region IV States, by county As of January 2002, there were 18 counties comprising the nonattainment areas in Region IV. These nonattainment designations are based on the ozone 1-hour air quality standard. Source: Aerometric Information Retrieval System (AIRS), US Environmental Protection Agency, OAR. Nonattainment Attainment 50 40 30 20 10 0 Population (millions) Nonattainment status

61. Percent Percent of children 6 and under who are regularly exposed to tobacco smoke*: United States and Region IV, by race, 1998 I = 95% confidence interval. *lived in a household where someone smoked inside the house at least 4 days per week. **Persons of Hispanic origin may be any race. American Indian/Alaska Native and Asian/Pacific Islander exposure rates for Region IV are unreliable. Information for these populations have been suppressed. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee. Source: National Health Interview Survey (NHIS), Centers for Disease Control and Prevention, NCHS. Region IVUnited States Black/African American, not-Hispanic Hispanic** White, not-Hispanic 2010 target (US)

62. Percent Black/African American, Not-Hispanic Total population Percent of children 6 and under who are regularly exposed to tobacco smoke*: United States and Region IV States, by race, 2000 I = 95% confidence interval. *lived in a household where someone smoked inside the house at least 4 days per week. Region IV States include Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee. Exposure rates are unavailable from Alabama, Florida, Georgia, Kentucky and Tennessee. Source: Behavioral Risk Factor Surveillance System (BRFSS), Centers for Disease Control and Prevention, NCCDPHP. United StatesMississippiSouth Carolina 2010 target (US) North Carolina

63. Percent of children 19 to 35 months who are fully immunized*: United States and Region IV, by specified race, 2000 Black/African American, not-Hispanic Hispanic**White, not-HispanicAsian, not-Hispanic Percent I = 95% confidence interval. *Four or more doses of DTP, three or more doses of poliovirus, one or more doses of MCV, three or more doses of Hib, and three or more doses of HepB. **Persons of Hispanic origin may be any race. American Indian/Alaska Native immunization rates are unreliable for Region IV. Information on this population has been suppressed. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee. Source: National Immunization Survey (NIS), Centers for Disease Control and Prevention, NIP and NCHS. 2010 target (US)

64. Percent of children 19 to 35 months who are fully immunized*: United States and Region IV States, by race, 2000 Black/African American, not-Hispanic Total population United States Mississippi North Carolina South Carolina Tennessee Alabama Georgia Percent I = 95% confidence interval. *Four or more doses of DTP, three or more doses of poliovirus, one or more doses of MCV, three or more doses of Hib, and three or more doses of HepB. Black/African American immunization rates are unreliable for Florida and Kentucky. Information on these States have been suppressed. Source: National Immunization Survey (NIS), Centers for Disease Control and Prevention, NIP and NCHS. 2010 target (US) Region IV

65. I = 95% confidence interval. *Persons of Hispanic origin may be any race. Percents are age-adjusted to the year 2000 standard population. American Indian/Alaska Native and Asian/Pacific Islander vaccination rates are unreliable for Region IV. Information for these populations have been suppressed. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee. Source: National Health Interview Survey (NHIS), Centers for Disease Control and Prevention, NCHS. Percent of non-institutionalized adults 65 and over who received an influenza vaccination in the past 12 months: United States and Region IV, by specified race, 2000 Age-adjusted percent Black/African American, not-Hispanic Hispanic*White, not-Hispanic Region IVUnited States 2010 target (US)

66. I = 95% confidence interval. *Persons of Hispanic origin may be any race. Percents are age-adjusted to the year 2000 standard population. American Indian/Alaska Native and Asian/Pacific Islander vaccination rates are unreliable for Region IV. Information for these populations have been suppressed. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee. Source: National Health Interview Survey (NHIS), Centers for Disease Control and Prevention, NCHS. Percent of non-institutionalized adults 65 and over who received a pneumonia vaccination in their lifetime: United States and Region IV, by specified race, 2000 Age-adjusted percent Black/African American, not-Hispanic Hispanic*White, not-Hispanic Region IVUnited States 2010 target (US)

67. Region IVUnited States Percent of people under 65 years with health insurance coverage: United States and Region IV, by specified race, 2000 Black/African American, not-Hispanic American Indian/ Alaska Native* Hispanic** White, not-HispanicAsian/Pacific Islander* I = 95% confidence interval. *Includes persons of Hispanic and non-Hispanic origin. **Persons of Hispanic origin may be any race. Percents are age-adjusted to the year 2000 standard population. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Source: National Health Interview Survey (NHIS), Centers for Disease Control and Prevention, NCHS. Age-adjusted percent 2010 target (US)

68. Percent of people under 65 years with health insurance coverage: United States and Region IV States, by race, 2000 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia Age-adjusted percent I = 95% confidence interval. Percents are age-adjusted to the year 2000 standard population. Source: National/Regional - National Health Interview Survey (NHIS), Centers for Disease Control and Prevention, NCHS; State – Behavioral Risk Factor Surveillance System (BRFSS), Centers for Disease Control and Prevention, NCCDPHP. 2010 target (US)

69. I = 95% confidence interval. *Includes persons of Hispanic and non-Hispanic origin. **Persons of Hispanic origin may be any race. Percents are age-adjusted to the year 2000 standard population. American Indian/Alaska Native care rates are unreliable in Region IV. Information for this population has been suppressed. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Source: National Health Interview Survey (NHIS), Centers for Disease Control and Prevention, NCHS. Percent of population with a specific source of ongoing care: United States and Region IV, by specified race 2000 Age-adjusted percent Region IVUnited States Black/African American, not-Hispanic Hispanic**White, not-HispanicAsian/Pacific Islander* 2010 target (US)

70. *Includes persons of Hispanic and non-Hispanic origin. **Persons of Hispanic origin may be any race. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee. Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Region IVUnited States Percent of mothers who began prenatal care in the first trimester of pregnancy: United States and Region IV, by specified race, 2000 Black/African American, not-Hispanic American Indian/ Alaska Native* Hispanic** White, not-HispanicAsian/Pacific Islander* Percent 2010 target (US)

71. Percent of mothers who began prenatal care in the first trimester of pregnancy: United States and Region IV States, by race, 2000 Black/African American Total population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia Source: National Vital Statistics System (NVSS), Centers for Disease Control and Prevention, NCHS. Percent 2010 target (US)

72. Oral health and Preventive services

73. Percent of adults 65 to 74 who have lost all of their natural permanent teeth: United States, by specified race, 2000 2010 target (US) Black/African American, not-Hispanic American Indian/ Alaska Native* Hispanic**White, not-Hispanic Percent I = 95% confidence interval. *1999 data for IHS service areas. Includes persons of Hispanic and non-Hispanic origin. **Persons of Hispanic origin may be any race. Asian/Pacific Islander edentulous rates are unreliable. Information for this population has been suppressed. Source: National Health Interview Survey (NHIS), Centers for Disease Control and Prevention, NCHS; American Indian/Alaska Native – Oral Health Survey of Native Americans, HIS.

74. Black/African American, not-Hispanic Total population United States Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia Percent I = 95% confidence interval. *The 2010 target for the United States is for people ages 65 to 74 years. Source: Behavioral Risk Factor Surveillance System (BRFSS), Centers for Disease Control and Prevention, NCCDPHP. 2010 target (US)* Percent of adults 65 and over who have lost all of their natural permanent teeth: United States and Region IV States, by race, 2000

75. Black/African American, not-Hispanic Total population United States Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia Percent I = 95% confidence interval. *The 2010 target for the United States is for people ages 2 years and older. Source: Behavioral Risk Factor Surveillance System (BRFSS), Centers for Disease Control and Prevention, NCCDPHP. 2010 target (US)* Percent of people 18 and older who visited a dentist or dental clinic within the past year: United States and Region IV States, by race, 1999

76. I = 95% confidence interval. *Persons of Hispanic origin may be any race. Percents are age-adjusted to the year 2000 standard population. American Indian/Alaska Native and Asian/Pacific Islander mammogram rates are unreliable for Region IV. Information for these populations have been suppressed. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Source: National Health Interview Survey (NHIS), Centers for Disease Control and Prevention, NCHS. Age-adjusted percent Region IV United States Black/African American, not-Hispanic Hispanic*White, not-Hispanic Percent of women 40 and older who have received a mammogram within the past 2 years: United States and Region IV, by specified race, 2000 2010 target (US)

77. Percent of women 40 and older who have received a mammogram within the past 2 years: United States and Region IV States, by race, 2000 Black/African AmericanTotal population United States Region IV Kentucky Mississippi North Carolina South Carolina Tennessee Alabama Florida Georgia Age-adjusted percent I = 95% confidence interval. Percents are age-adjusted to the year 2000 standard population. Source: National/Regional - National Health Interview Survey (NHIS), Centers for Disease Control and Prevention, NCHS; State – Behavioral Risk Factor Surveillance System (BRFSS), Centers for Disease Control and Prevention, NCCDPHP. 2010 target (US)

78. Percent of adults 18 and older with diabetes who had an annual dilated eye examination: United States and Region IV States, by race, 2000 Black/African AmericanTotal population United States Mississippi North Carolina South Carolina Alabama Florida Georgia Age-adjusted percent I = 95% confidence interval. Percents are age-adjusted to the year 2000 standard population. Region IV: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee. Examination rates for the black/African American population in Kentucky and Tennessee are unreliable. Information for these States have been suppressed. Source: Behavioral Risk Factor Surveillance System (BRFSS), Centers for Disease Control and Prevention, NCCDPHP. 2010 target (US)