1. Massachusetts Deaths 2004 Massachusetts Department of Public Health Center for Health Information, Statistics, Research, and Evaluation Division of Research and Epidemiology July 2006

2. Massachusetts Deaths 2004 Cancer Injuries Heart Disease Infectious Disease Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation

3. Outline  Changes since the 2003 Deaths Report  Added diabetes deaths using multiple causes of death  Increased data on drug overdose deaths  Used most recent population estimates  Highlights  Selected Causes  Summary

4. New Population Estimates Massachusetts: 2000-2004 Estimates are from the U.S. Census Bureau’s Population Estimation Program and the National Center for Health Statistics (NCHS) All death rates for 2000-2003 have been re- calculated using new population estimates 2000-2003 death rate data in previous reports can not be compared to data in this publication These changes affect death rates only

5. Impact : Age-Adjusted Death Rates Massachusetts: 2000-2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Reflects New Estimates for 2000-2004 Using Revised Population Data Reflects Prior Reports Using Year 2000 Census 6%

6. Impact : Age-Adjusted Death Rates by Race and Ethnicity Massachusetts 2000-2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation

7. Impact : A Comparison of White and Black Age-Adjusted Death Rates Massachusetts: 2000-2004 Using NEW 2000-2004 Population Estimates Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation 16%

8. Highlights Trends U.S. Comparisons Gender/Age Race/Ethnicity Education

9. Daily Number of Deaths for Selected Causes On an average day in Massachusetts, there were 149 deaths: Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation 149 deaths (54,419 total in 2004) 1 Infant Death 38 Heart Disease Deaths 36 Cancer Deaths 16 Respiratory Deaths 9 Stroke Deaths7 Injury Deaths 1 HIV/AIDS Death 5 Alzheimer’s Deaths 4 Diabetes Deaths 1 Motor Vehicle Death 1 Suicide Death 5 Other Intentional & Unintentional Injury Deaths

10. Life Expectancy at Birth Massachusetts vs. U.S.: 1900-2004 Massachusetts United States 2004 MA: 79.6 years US: 77.9 years Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation

11. Life Expectancy by Gender and Age Massachusetts: 2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation

12. Trend Analysis: “Joinpoint Regression” Joinpoint Regression is a trend analysis method developed by the National Cancer Institute Every point where the trend changes is called a “joinpoint” Every joinpoint marks a statistically significant change in trend Shows whether trends are significant

13. Mortality Rates Massachusetts and U.S.: 1994-2004 Rates are per 100,000 population. Age-adjusted to the 2000 US standard population Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Massachusetts United States 739.3 801.1 * Statistically Significant (p=.05)  1.4%* per year

14. Percentage Difference in Death Rates Massachusetts vs. U.S. ŧ : 2004 Cancer Overall* Heart Disease* Diabetes* Homicide* Influenza/ Pneumonia* % difference Infant Mortality* ŧ Preliminary data Rates are per 100,000 population. Age-adjusted to the 2000 US standard population Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Suicide* * Statistically Significant (p=.05) MA rates that are lower than the U.S. MA rates that are higher than the U.S.

15. Leading Causes of Death Massachusetts: 2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Heart Disease 25.3% Cancer 24.5% Other 28.7% Stroke 6.0% Injury 4.8% Chronic Lower Respiratory Disease 4.7% Pneumonia & Influenza 3.6% Diabetes 2.4%

16. Leading Causes of Death Massachusetts: 2000 and 2004 Rate % CAUSE 2000 2004 Change Heart Disease 216.7 182.8  19%* Cancer 206.1 188.4  9%* Stroke 50.9 42.5  20%* Injuries 35.9 38.6  7% Chronic Lower Respiratory Disease 41.8 35.2  19%* Alzheimer’s Disease 19.5 20.8  6% Rates are per 100,000 population. Age-adjusted to the 2000 US standard population. Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation * Statistically Significant (p=.05)

17. % of Total in Total Age Leading Cause Age Group Deaths 1-14 Injuries40%137 15-24 Injuries 72%516 25-44 Injuries36% 2,247 45-64 Cancer37% 8,346 65-74 Cancer39% 8,126 75-84 Cancer26% 16,342 85+ Heart Disease31% 18,327 Leading Causes of Death by Age Massachusetts: 2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation

18. Rankings of Selected Causes of Death by Race and Ethnicity Massachusetts: 2004 ŧ Non-Hispanic, † Chronic Lower Respiratory Disease CAUSE White ŧ Black ŧ Asian ŧ Hispanic Heart Disease 1 2 2 2 Cancer 2 1 1 1 Stroke 3 3 3 3 CLRD † 4 10 6 11 Homicide 30 6 - 9 Alzheimer’s Disease 6 15 11 18 Diabetes 8 5 4 6 HIV/AIDS 27 8 - 4 Perinatal Conditions 23 9 15 7 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Note: The lower the number the higher the rank

19. Mortality Rates by Race and Ethnicity Massachusetts: 2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Rates are per 100,000 population. Age-adjusted to the 2000 US standard population

20. Mortality Rates by Education Adults 25-64 Years ŧ - Massachusetts: 2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Rates are per 100,000 population. Age-adjusted to the 2000 US standard population ŧ Uses 2000 Population Estimates

21. Mortality Rates by Education and by Race/Ethnicity, Adults 25-64 Years ŧ Massachusetts: 2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Rates are per 100,000 population. Age-adjusted to the 2000 US standard population ŧ Uses 2000 Population Estimates

22. Selected Causes Heart Disease Cancer Diabetes Injury HIV/AIDS

23. Heart Disease Mortality Rates Massachusetts and U.S.: 1994-2004 Rates are per 100,000 population. Age-adjusted to the 2000 US standard population Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Massachusetts United States 261.5 182.8 300.2 217.5  3.6%* per year * Statistically Significant (p=.05)

24. Number of Heart Disease Deaths by Age and Gender - Massachusetts: 2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation

25. Cancer Mortality Rates Massachusetts and U.S. : 1994-2004 226.3 184.6 Rates are per 100,000 population. Age-adjusted to the 2000 US standard population Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation 212.4 188.4 Massachusetts United States  1.8%* per year * Statistically Significant (p=.05)

26. % of Total in Total Age Most Frequent Age Group Cancer Deaths 1-14 Brain & Nervous System 22% 23 15-24 Leukemia 28%29 25-44 LungCancer 18% 413 45-64 Lung Cancer 30% 3,171 65-74 Lung Cancer 35% 3,256 75-84 Lung Cancer 27% 4,370 85+ Lung Cancer 17% 2,259 Type of Cancer Deaths by Age Massachusetts: 2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation

27. Cancer Mortality Rates by Gender Massachusetts: 2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Rates are per 100,000 population. Age-adjusted to the 2000 US standard population

28. Diabetes Deaths Massachusetts: 1999-2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation

29. Diabetes Deaths by Age Group Massachusetts: 1999-2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation

30. Causes of Injury Deaths Massachusetts: 2004 Poisonings 28% Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation ( Total = 2,615 ) 62% Narcotics & Hallucinogens 38% Other Firearm 8% Other 21% Falls 11% Suffocation, Hanging, or Strangulation 11% Motor Vehicle-related 20% 21% Occupant/Driver 17% Pedestrian 13% Motorcyclist 49% Other/Unspecified

31. 52% 23% ( Total= 2,615 ) Undetermined Intent SUICIDE 71% HOMICIDE 29% Intentional Unintentional “Accidental” Injury Deaths by Intent Massachusetts: 2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation

32. Leading Causes of Injury Deaths Massachusetts: 2000 and 2004 Rates are per 100,000 population. Age-adjusted to the 2000 US standard population. Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Rate % CAUSE 2000 2004 Change Poisonings 9.0 11.2  24% * Narcotics & hallucinogens 5.7 7.0  22% * Motor vehicle-related 7.6 8.0  5% Motorcycle 0.5 1.1  120% * Hanging/Suffocation 4.0 4.4  10% Falls 3.2 4.0  25% Firearm Deaths 2.7 3.2  19% * Statistically Significant (p=.05)

33. Homicide Mortality Rates Massachusetts and US: 1994-2004 Rates are per 100,000 population. Age-adjusted to the 2000 US standard population Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation  16.7%* per year  5.8% per year 1998 * Statistically Significant (p=.05)

34. Homicide Mortality Rates by Race and Ethnicity Massachusetts: 1994-2004 Rates are per 100,000 population. Age-adjusted to the 2000 US standard population Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation

35. Motorcycle Deaths by Age Massachusetts: 1999-2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation 45+ Years 25-44 Years Under 25

36. Number of HIV/AIDS Deaths Massachusetts: 1987-2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation 19951998  41.1%* per year  19.1%* per year0.24% per year * Statistically Significant (p=.05)

37. HIV/AIDS Deaths by Age Group Massachusetts: 1994-2004 Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation

38. Summary: Massachusetts Deaths 2004  The Massachusetts death rate fell to a record low  Life expectancy reached a record high  Death rates from many leading causes continued to decline  Massachusetts compared favorably to the U.S.

39. Summary (cont.)  Disparities persist  by gender  by race  by education  The number of homicides continues to increase  Dramatic rise in motorcycle deaths  The proportion of HIV/AIDS deaths to persons ages 45+ continues to increase

40. How Can YOU Access This Information? Hard Copies: (617) 740-2670 TDD/TTY: (617) 624-6001 MDPH Website: http://www.mass.gov/dph/resep

41. Massachusetts Deaths 2004 Data on MassCHIP MassCHIP: (The Massachusetts Department of Public Health’s Internet-based public health information service) Website: http://masschip.state.ma.us Telephone: 1-888-MASCHIP (Mass only) (617) 624-5629 Fall Release: (New Version) - Massachusetts Deaths 2004 - Updated Data Sets

42. Thank You