Limits...
Calculating expected years of life lost for assessing local ethnic disparities in causes of premature death.

Aragón TJ, Lichtensztajn DY, Katcher BS, Reiter R, Katz MH - BMC Public Health (2008)

Bottom Line: The results were stratified by sex, ethnicity, and underlying cause of death.The ASYR for men was 65% higher compared to the ASYR for women (8971.1 vs. 5438.6 per 100,000 persons per year).Except for homicide among Latino men, Latinos and Asians have comparable or lower YLL rates among the leading causes of death compared to whites.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Epidemiology, School of Public Health, University of California, Berkeley, California, USA. aragon@berkeley.edu

ABSTRACT

Background: A core function of local health departments is to conduct health assessments. The analysis of death certificates provides information on diseases, conditions, and injuries that are likely to cause death - an important outcome indicator of population health. The expected years of life lost (YLL) measure is a valid, stand-alone measure for identifying and ranking the underlying causes of premature death. The purpose of this study was to rank the leading causes of premature death among San Francisco residents, and to share detailed methods so that these analyses can be used in other local health jurisdictions.

Methods: Using death registry data and population estimates for San Francisco deaths in 2003-2004, we calculated the number of deaths, YLL, and age-standardized YLL rates (ASYRs). The results were stratified by sex, ethnicity, and underlying cause of death. The YLL values were used to rank the leading causes of premature death for men and women, and by ethnicity.

Results: In the years 2003-2004, 6312 men died (73,627 years of life lost), and 5726 women died (51,194 years of life lost). The ASYR for men was 65% higher compared to the ASYR for women (8971.1 vs. 5438.6 per 100,000 persons per year). The leading causes of premature deaths are those with the largest average YLLs and are largely preventable. Among men, these were HIV/AIDS, suicide, drug overdose, homicide, and alcohol use disorder; and among women, these were lung cancer, breast cancer, hypertensive heart disease, colon cancer, and diabetes mellitus. A large health disparity exists between African Americans and other ethnic groups: African American age-adjusted overall and cause-specific YLL rates were higher, especially for homicide among men. Except for homicide among Latino men, Latinos and Asians have comparable or lower YLL rates among the leading causes of death compared to whites.

Conclusion: Local death registry data can be used to measure, rank, and monitor the leading causes of premature death, and to measure and monitor ethnic health disparities.

Show MeSH

Related in: MedlinePlus

Leading causes of premature death among men (ranked by YLLs), comparing age-standardized YLL rates (ASYR) by cause of death and ethnicity, San Francisco, 2003–2004. Symbols: African American (○), Latino/Hispanic (△), Asian/Pacific Islander (×), White (+).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2386472&req=5

Figure 2: Leading causes of premature death among men (ranked by YLLs), comparing age-standardized YLL rates (ASYR) by cause of death and ethnicity, San Francisco, 2003–2004. Symbols: African American (○), Latino/Hispanic (△), Asian/Pacific Islander (×), White (+).

Mentions: Age-standardized YLL rates (ASYRs) allow comparisons of the burden of premature mortality by ethnic group and specific cause of death (Figures 1, 2, 3). For example, for almost every leading cause of premature death in men and women, African Americans had the highest ASYRs compared to other ethnic groups. Among African American men, the disparity in ASYRs was most notable for violent assault (homicide), followed by HIV/AIDS, vascular diseases (ischemic and hypertensive heart, and cerebrovascular disease), accidental drug overdose, and lung cancer. Among African American women, the disparity in ASYRs was most notable for vascular diseases (ischemic and hypertensive heart, and cerebrovascular diseases), breast cancer, HIV/AIDS, and accidental drug overdose.


Calculating expected years of life lost for assessing local ethnic disparities in causes of premature death.

Aragón TJ, Lichtensztajn DY, Katcher BS, Reiter R, Katz MH - BMC Public Health (2008)

Leading causes of premature death among men (ranked by YLLs), comparing age-standardized YLL rates (ASYR) by cause of death and ethnicity, San Francisco, 2003–2004. Symbols: African American (○), Latino/Hispanic (△), Asian/Pacific Islander (×), White (+).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2386472&req=5

Figure 2: Leading causes of premature death among men (ranked by YLLs), comparing age-standardized YLL rates (ASYR) by cause of death and ethnicity, San Francisco, 2003–2004. Symbols: African American (○), Latino/Hispanic (△), Asian/Pacific Islander (×), White (+).
Mentions: Age-standardized YLL rates (ASYRs) allow comparisons of the burden of premature mortality by ethnic group and specific cause of death (Figures 1, 2, 3). For example, for almost every leading cause of premature death in men and women, African Americans had the highest ASYRs compared to other ethnic groups. Among African American men, the disparity in ASYRs was most notable for violent assault (homicide), followed by HIV/AIDS, vascular diseases (ischemic and hypertensive heart, and cerebrovascular disease), accidental drug overdose, and lung cancer. Among African American women, the disparity in ASYRs was most notable for vascular diseases (ischemic and hypertensive heart, and cerebrovascular diseases), breast cancer, HIV/AIDS, and accidental drug overdose.

Bottom Line: The results were stratified by sex, ethnicity, and underlying cause of death.The ASYR for men was 65% higher compared to the ASYR for women (8971.1 vs. 5438.6 per 100,000 persons per year).Except for homicide among Latino men, Latinos and Asians have comparable or lower YLL rates among the leading causes of death compared to whites.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Epidemiology, School of Public Health, University of California, Berkeley, California, USA. aragon@berkeley.edu

ABSTRACT

Background: A core function of local health departments is to conduct health assessments. The analysis of death certificates provides information on diseases, conditions, and injuries that are likely to cause death - an important outcome indicator of population health. The expected years of life lost (YLL) measure is a valid, stand-alone measure for identifying and ranking the underlying causes of premature death. The purpose of this study was to rank the leading causes of premature death among San Francisco residents, and to share detailed methods so that these analyses can be used in other local health jurisdictions.

Methods: Using death registry data and population estimates for San Francisco deaths in 2003-2004, we calculated the number of deaths, YLL, and age-standardized YLL rates (ASYRs). The results were stratified by sex, ethnicity, and underlying cause of death. The YLL values were used to rank the leading causes of premature death for men and women, and by ethnicity.

Results: In the years 2003-2004, 6312 men died (73,627 years of life lost), and 5726 women died (51,194 years of life lost). The ASYR for men was 65% higher compared to the ASYR for women (8971.1 vs. 5438.6 per 100,000 persons per year). The leading causes of premature deaths are those with the largest average YLLs and are largely preventable. Among men, these were HIV/AIDS, suicide, drug overdose, homicide, and alcohol use disorder; and among women, these were lung cancer, breast cancer, hypertensive heart disease, colon cancer, and diabetes mellitus. A large health disparity exists between African Americans and other ethnic groups: African American age-adjusted overall and cause-specific YLL rates were higher, especially for homicide among men. Except for homicide among Latino men, Latinos and Asians have comparable or lower YLL rates among the leading causes of death compared to whites.

Conclusion: Local death registry data can be used to measure, rank, and monitor the leading causes of premature death, and to measure and monitor ethnic health disparities.

Show MeSH
Related in: MedlinePlus