IPSPR: Electronic Publications

Definition: This indicator represents the length of time that a person can, on the average, expect to live.

Significance: Life expectancy is an important measure of healthcare and can be a proxy measure for many other issues related to wealth, opportunities, and education. Further, according to the Federal Interagency Forum on Aging, “in the U.S., improvements in healthcare have resulted in increased life expectancy and contributed to the growth of the older population. For example, in 1900, life expectancy at birth was about 49 years. By 1960, life expectancy had increased to 70 years, and in 1997, life expectancy at birth was 79 years for women and 74 years for men.”[i]

Data reflect South Carolina (SC) average, United States (US) average, and Southeast (SE) average. The southeast region consists of Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee.

Selected State Rankings, 1989-1991 (“1” represents state with highest life expectancy)

Definition: This indicator represents the infant mortality rate, which is the probability (expressed as a rate per 1,000 live births) of a child born in a specified year, and dying before reaching the age of one.

Significance: Infant mortality rates, in essence, measure “child survival.” They also suggest the socio-economic and environmental conditions in which children live, including their healthcare. Because data on the incidence and prevalence of diseases (morbidity data) frequently are unavailable, mortality rates are frequently used to identify vulnerable populations.”[ii]

Note: Infant mortality rates are the most commonly used index for measuring the risk of dying during the first year of life. The rates presented in this report are calculated by dividing the number of infant deaths in a calendar year by the number of live births registered for the same period and are presented as rates per 1,000 live births.

Selected State Rankings, 2004 (“1” represents state with highest infant mortality rate)

Definition: The indicators below represent the annual number of resident deaths, rate per 100,000 people, as caused by designated diseases or accident (as based on International Classification of Diseases[iii] or ICD codes). This includes deaths caused by cardiovascular disease, cancer, stroke, and accident.

Significance: Mortality statistics are often used to obtain an overall picture of the most serious diseases. Mortality levels and causes vary with age, gender, marital status, and socio-economic status. Comparisons over time and place may be affected by differences in the methods of reporting, selecting and classifying causes of death. The proportion of all deaths attributable to a single cause has been decreasing. There is an increasing trend toward developing a multiple-cause classification of deaths.”[iv]

A. Heart (Cardiovascular) Disease. This indicator—as defined generally by standards set by the U.S. Department of Health and Human Services—represents the “resident deaths for which the underlying cause of death was given on the death certificate as heart disease. In addition to ‘Ischemic[v] Heart Disease,’ some of the causes included are: rheumatic heart disease, hypertensive heart disease, pulmonary embolism, various valve disorders, cardiomyopathy,[vi] atrial fibrillation, and congestive heart failure.” [vii]

Historical/Trend Analysis, Age-Adjusted Heart Disease Mortality Rates per 100,000 Population

Selected State Rankings, 2004, Deaths from heart disease, rates per 100,000 population, age adjusted (“1” represents state with highest heart disease mortality rate)

B. Cancer (Malignant Neoplasms[viii]) This indicator represents the “resident deaths for which the underlying cause of death was given on the death certificate as cancer. This includes leukemia and cancers of various organs, but excludes benign neoplasms, carcinoma, and neoplasms of uncertain behavior.”

Historical/Trend Analysis, Age-Adjusted Cancer Mortality Rates per 100,000,

Selected State Rankings, 2004, Deaths from cancer, rates per 100,000 population, age adjusted (“1” represents state with highest cancer mortality rate)

C. Stroke (Cerebrovascular Disease). This indicator represents “resident deaths for which the underlying cause of death was given on the death certificate as cerebrovascular disease (stroke), whether due to bleeding or to blockage of arteries in the brain. Also includes deaths due to late effects of strokes.”

Historical/Trend Analysis, Age-Adjusted Cerebrovascular Disease Mortality Rates

Selected State Rankings, 2004, Deaths from cerebrovascular disease (stroke), rates per 100,000 population, age adjusted (“1” represents state with highest stroke mortality rate)

D. Accidental Death. This indicator represents the “resident deaths for which the cause was officially designated as accidental (unintentional) in nature, excluding motor vehicle, suicide, homicide, and injury by firearm.”[ix]

Historical/Trend Analysis, Age-Adjusted Accidental Mortality Rates per 100,000

Selected State Rankings, 2004, Deaths from accidents, rates per 100,000 population, age adjusted (“1” represents state with highest accident mortality rate)

Trends in the Leading Causes of Death in the United States, 1970-2002

A study appearing in the September 2005 issue of the Journal of the American Medical Association provides an analysis of trends in both numbers of deaths and age-standardized death rates between 1970 and 2002. This allows for comparison of populations with different age distributions. The research focused on the six leading causes of mortality and found that the decrease in overall death rates may mask changes in death rates for specific conditions. For example, while death rates from stroke decreased by 63 percent, heart disease by 52 percent, and accidents by 41 percent; rates for chronic obstructive pulmonary disease doubled and diabetes increased by 45 percent during the same time interval. The absolute number of deaths from all leading causes of death continues to increase, although the deaths occur at older ages. To read the full report, see http://jama.ama-assn.org/cgi/reprint/294/10/1255.

Definition: This indicator represents the percent of people with the condition of being obese; increased body weight caused by excessive accumulation of fat. Obesity is defined by Body Mass Index (BMI), which is a ratio of height to weight. For example, a person 5' 8" and weighing 171 pounds has a BMI of 26. The BMI for obesity is 30+ BMI.

Significance: As stated by medical experts: “Obesity is not just an aesthetic consideration; it is a dire health problem directly related to one's health. In the U.S., roughly 300,000 deaths per year are directly related to obesity. Obesity also increases the risk of developing a number of chronic diseases including: diabetes, stroke, heart attack, arthritis, and cancer.”[x]

Selected State Rankings, 2006 (“1” represents state with highest percentage of obesity. Data are ranked using a standard competition ranking method that accounts for ties occurring when two or more states have the same percentage obese.)

Definition: This indicator represents the number of live births per 1,000 women aged 15-19.

Significance: Over time, the birth rate for teens has declined. However, experts agree that the rate continues to be a matter of concern. The indicator suggests the degree to which efforts to curb teen pregnancies have been effective. In addition to the costs assumed by the mother, each baby born to a South Carolina teen costs taxpayers approximately $22,000 per year.

Historical/Trend Analysis, Birth Rates among Teenagers per 1,000 Estimated Population Aged 15-19

Selected State Rankings, 2005 ("1" represents state with highest birth rate among females age 15-19. States are ranked from highest to lowest using a standard competition ranking method that accounts for ties occurring when two or more states have the same teen birth rate. Rates per 1,000 females age 15-19)

[i] “Life expectancies at ages 65 and 85 have also increased. Under current mortality conditions, people who survive to age 65 can expect to live an average of nearly 18 more years, more than five years longer than persons age 65 in 1900. The life expectancy of persons who survive to age 85 today is about 7 years for women and 6 years for men. Also, educational attainment is associated with higher life expectancy. The life expectancy of high school graduates at age 65 is approximately one year longer than the life expectancy at that age for persons who did not graduate from high school. Additionally, life expectancy varies by race, but the difference decreases with age. In 1997, life expectancy at birth was 6 years higher for white persons than for black persons. At age 65, white persons can expect to live an average of 2 years longer than black persons. Among those who survive to age 85, however, the life expectancy among black persons is slightly higher than among white persons. The declining race differences in life expectancy at older ages are a subject of debate. Some research shows that age misreporting may have artificially increased life expectancy for black persons, particularly when birth certificates were not available. Other research, however, suggests that black persons who survive to the oldest ages may be healthier than white persons and have lower mortality rates.” Retrieved July 26, 2005 from http://www.agingstats.gov/chartbook2000/healthstatus.html.

[ii] Retrieved July 26, 2005 from http://www.spc.int/mdgs/MDGIs/indicator_14_definition.htm.

[iii] As defined by the National center for Health Statistics, the International Classification of Diseases (ICD) is the classification used to code and classify mortality data from death certificates.

[iv] Retrieved July 26, 2005 from http://www.healthunit.org/chsr/data_def/hea_sta%20.htm.

[v] Ischemia (is-KE'me-ah) is a condition in which the blood flow (and thus oxygen) is restricted to a part of the body. Cardiac ischemia is the name for lack of blood flow and oxygen to the heart muscle. Retrieved July 27, 2005 from http://www.americanheart.org/presenter.jhtml?identifier=4720.

[vi] Cardiomyopathy is a serious disease in which the heart muscle becomes inflamed and doesn't work as well as it should. There may be multiple causes including viral infections.

[vii] Definitions for cardiovascular disease, cancer, and accidental death retrieved July 26, 2005 from http://www.dhss.state.mo.us/GLRequest/DeathDefinitionofIndicators.html.

[viii] An abnormal growth or tissue, as a tumor.

[ix] Retrieved July 26, 2005 from http://wordnet.princeton.edu/perl/webwn?s=asthma.

[x] Retrieved July 27, 2005 from http://www.answers.com/obesity&r=67. Also see http://www.medicinenet.com/script/main/hp.asp.