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Trends in Disparity by Sex and Race/Ethnicity for the Leading Causes of Death in the United States—1999-2010

Chang, Man-Huei MPH; Moonesinghe, Ramal PhD; Athar, Heba M. MD, MPH; Truman, Benedict I. MD, MPH

Journal of Public Health Management and Practice: January/February 2016 - Volume 22 - Issue - p S13–S24
doi: 10.1097/PHH.0000000000000267
Original Articles

Context: Temporal trends in disparities in the leading causes of death within and between US demographic subgroups indicate the need for and success of interventions to prevent premature death in vulnerable populations. Studies that report recent trends are limited and outdated.

Objective: To describe temporal trends in disparities in death rates by sex and race/ethnicity for the 10 leading causes of death in the United States during 1999-2010.

Design: We used underlying cause of death data and population estimates from the National Vital Statistics System to calculate age-adjusted death rates for the 10 leading causes of death during 1999-2010. We measured absolute and relative disparities by sex and race/ethnicity for each cause and year of death; we used weighted linear regression to test for significance of trends over time.

Results: Of the 10 leading causes of death, age-adjusted death rates by sex and race/ethnicity declined during 1999-2010 for 6 causes and increased for 4 causes. But sex and racial/ethnic disparities between groups persisted for each year and cause of death. In the US population, the decreasing trend during 1999-2010 was greatest for cerebrovascular disease (−36.5%) and the increasing trend was greatest for Alzheimer disease (52.4%). For each sex and year, the disparity in death rates between Asian/Pacific Islanders (API) and other groups varied significantly by cause of death. In 2010, the API–non-Hispanic black disparity was largest for heart disease, malignant neoplasms, cerebrovascular diseases, and nephritis; the API-American Indian/Alaska Native disparity was largest for unintentional injury, diabetes mellitus, influenza and pneumonia, and suicide; and the API–non-Hispanic white disparity was largest for chronic lower respiratory diseases and Alzheimer disease.

Conclusions: Public health practitioners can use these findings to improve policies and practices and to evaluate progress in eliminating disparities and their social determinants in vulnerable populations.

Supplemental Digital Content is Available in the Text.This article describes temporal trends in disparities in death rates by sex and race/ethnicity for the 10 leading causes of death in the United States during 1999-2010.

National Center for HIV/AIDS, Viral Hepatitis, STD, & TB Prevention (NCHHSTP) (Ms Chang and Dr Truman), Office of Minority Health and Health Equity (Dr Moonesinghe), and Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Athar).

Correspondence: Man-Huei Chang, MPH, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mail Stop E-07, Atlanta, GA 30333 (mdc9@cdc.gov).

The authors thank Paula Yoon, ScD, Center for Surveillance, Epidemiology, and Laboratory Services; Sigrid A. Economou, CDC WONDER; Elizabeth Connor, individual contractor for their support and assistance with this project.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (http://www.JPHMP.com).

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.