Public Health Division
Public Health Division

City of Berkeley
Health Status Report, 2001
Mortality and Hospitalization

Executive Summary

Made Available by the City of Berkeley, Department of Health Services, Public Health Division


2001 Health Status Report (PDF) (full report)

This Health Status Report focuses on mortality and related hospitalizations. Mortality and hospitalization data are important measurements of a community’s health.  They demonstrate causes of death, frequency and impact of early death, and how death rates vary between different sectors of the Berkeley community.  Ultimately, with a better understanding of why people die earlier than expected, we can focus on the prevention of disease and work toward a healthier community in which all residents enjoy longer, more productive lives.

Mortality data are one of the most reliable data sets and represent the ultimate unequivocal endpoint for measuring health.  These statistics provide a comprehensive picture of community health.  By comprehensive, we mean that in time, everyone will be a part of the picture, albeit retrospectively.  We use many different measures to talk about mortality.  All are valid measures of the health of a community, but provide different views of that health from differing perspectives.  The measures used in this report are:

Life ExpectancyA summary measurement of population health status based entirely on the mortality experience of a hypothetical cohort that is subjected throughout its lifetime to a set of age-specific death rates. Translated into plain English, this means taking a defined group and counting deaths from all causes at every age of life.  Once that is done, it can be estimated how many of this group will survive each successive year and a life table can then be constructed for that group.  Life expectancy can be calculated for any age, but is most often expressed as life expectancy at birth, which is most heavily influenced by deaths among infants and the very young.  Life expectancy should not be confused with life span which is the maximum age biologically possible for the human species. Life expectancy is used to estimate the number of years left in the life of a person at age x; this number changes as one progresses through life.

Crude Mortality RateA summary measure calculated by dividing the total number of deaths from any cause in a given population by the number of individuals in that population, then multiplying the result by 100,000. Rates express the number of events that occurred over a specified time period (e.g. 1996-1998) per unit of population (per 1,000 or per 100,000 people). Rates are better than a count of the absolute number of cases because they are standardized for every 100,000 people.  So the number of deaths occurring in a small population can be compared to the number of deaths in a large population without being distorted because of the difference in sizes of the two populations.  However, crude rates can be misleading if there are substantial differences between the populations being compared such as different age structures.

Age Adjusted Mortality RateSince age affects most diseases, mortality rates vary with the age composition of a population.  An older population will have more deaths than a younger one. Age adjustment eliminates age as a variable in the calculation of the death rate.  It statistically removes the difference in age structure of a population so that different populations can be compared with “all things being equal,” at least in terms of age.

Average Age at the Moment of DeathAll ages at the moment of death in a population are added up and divided by the number of deaths that occurred.  This statistic gives a picture of the average age at death of a person in a given population. This can be done for all causes or be cause specific.

Years of Potential Life Lost—This measures the impact of premature death in a population.  There are more years of potential life lost in the deaths of young people than deaths to elderly persons.  Many of the deaths to younger persons are preventable and amenable to public health interventions.

The data included in the Year 2002 Health Status Report comes from a variety of sources.  Most of the data on mortality is generated from death certificates collected by the Berkeley Public Health Division, Office of Epidemiology and Health Statistics.  This data is necessarily over two years old as that is the length of time required to verify and complete this data set at the state. Other data sources include the California Department of Finance, US Census Bureau, California Office of Statewide Health Planning and Development.  With some exceptions, the data included in this report cover the years 1996 to 1998.  It is necessary to analyze Berkeley data in 3-year groupings so that year to year variation is eliminated.  It is important to note that the mortality data included in this report cannot be compared with data from 1999 and beyond.  Beginning in 1999, deaths are coded using the International Classification of Diseases, Tenth Revision (ICD-10).  This change in coding is a worldwide standard created by the World Health Organization.  Prior to 1999, all deaths were coded using the ICD, 9th revision.  Mortality rates before 1999 are not comparable to those beginning in 1999. Thus 1999 is the base year for comparisons between future years and trend analysis between pre-1999 and post-1999 will not be statistically reliable for mortality data.  Whenever possible, we have included national, state or county data for comparison of mortality data.


Highlights of Major Findings 

Demographics of Berkeley's Population

  • According to the 2000 Census, there are 102,743 residents living in Berkeley.  This is essentially no change from the 1990 Census population report of 102,724 residents.

  • Since the 1990 Census, the population over the age of 85 has increased by 17% and the population under the age of 5 has decreased by 12%.

  • Ten percent (10%) of the Berkeley population is over the age of 65 years.

  • Twenty-nine percent (29%) of the Berkeley population is between the ages of 30-49 years.

  • The median age for Berkeley residents is 32.5 years.

  • Berkeley’s population continues to be ethnically and racially diverse: 55.2% of residents are White, 16.4% Asian/Pacific Islander, 13.3% African American, 9.7% Hispanic/Latino, and 0.3% American Indian.

  • For the first time a multi-racial category in the census data provided residents the opportunity to identify themselves with 2 or more racial or ethnic groups.  4.5% of Berkeley residents self-identified as multi-racial.

  • Compared to 1998 population estimates presented in the 1999 Health Status Report, there has been a slight increase in the Asian/Pacific Islander population in Berkeley (1.8%) and a more noteworthy decrease in the African American population (5.8%).  The population of Hispanic/Latino and White residents in Berkeley is relatively unchanged.

Mortality or Death

  • The overall age adjusted death rate for all causes of death in Berkeley is 3 times greater for African Americans than for the White population. By comparison, the overall age adjusted death rate for African Americans in the United States as a whole is 1.5 times greater than the age adjusted death rate for Whites in the U.S. 

  • In 1999, the life expectancy at birth in the City of Berkeley was 79.9 years.  However, for African Americans, 50% of deaths occur before the age of 75, whereas for Whites 36% of deaths occur before the age of 75.

  • Heart disease, cancer and stroke are the top three causes of death in Berkeley and account for 59% of all deaths.  Cancer is the leading cause of death for Whites and heart disease is the leading cause of death for African Americans in Berkeley.

Specific Causes of Death

Cancer 

  • African Americans in Berkeley are twice as likely to die from any form of cancer than are Whites.  African Americans are also hospitalized for cancer at a greater rate than any other racial or ethnic group.

  • Lung cancer is the leading cause of cancer-related deaths in Berkeley.  Most lung cancer deaths and disease are related to tobacco use and could be prevented by not smoking or quitting smoking.

  • The age-adjusted mortality rate for lung cancer is 3 times higher for African Americans than for Whites.

  • Breast cancer is the most common cancer related death and the third leading cause of all deaths among women in Berkeley.  The rate of death from breast cancer is higher in Berkeley than in Alameda County or the State of California.

  • The age-adjusted mortality rate for African American women dying of breast cancer is 1.3 times higher than that of White women, yet White females are diagnosed with breast cancer at a rate 1.5 times higher than that of African American females.

Coronary Heart Disease

  • Heart disease is the leading cause of death for Berkeley residents in 1998.  Many of these deaths could be prevented through lifestyle changes in diet, exercise and smoking.

  • The age-adjusted mortality rate for coronary heart disease for African Americans is more than 3 times that of Whites in Berkeley.

  • African Americans are 12 times more likely to be hospitalized for hypertensive heart disease than Whites in Berkeley.  Hypertension (or high blood pressure) is a common precursor to heart disease and stroke.

  • The rate of hospitalization for diabetes is 10 times greater for African Americans than that of Whites and Asian/Pacific Islanders.  The risk of hospitalization for diabetes for Hispanics is 3 times greater than for Whites or Asian/Pacific Islanders.

Cerebrovascular Disease (Stroke)

  • Stroke is one of the top 3 leading causes of death for Berkeley residents.  Many stroke deaths can also be prevented by changes in diet, exercise and smoking.

  • The risk of dying from stroke is almost 5 times higher for African Americans than it is for Whites in Berkeley.

HIV/AIDS

  • The age-adjusted mortality rate for African Americans is 4 times higher than for Whites.

  • AIDS is the second leading cause of premature death among African Americans and the 5th leading cause of premature death for Whites in Berkeley.

Unintentional Injury

  • Unintentional injuries include all injuries caused by an unanticipated event, such as falls, poisonings, motor vehicle injuries, bicycle injuries, burns, drowning and unintentional shootings.   Unintentional injuries are generally preventable but are one of the ten leading causes of death in Berkeley for 1998.

  • The risk of dying from unintentional injuries is 2 times higher for African Americans than for Whites.

  • In 1999, the three major reasons for hospitalizations due to unintentional injuries in Berkeley were: falls affecting primarily persons over the age of 65 years (40%); the use of therapeutic drugs that caused an adverse effect (34%); and motor vehicle injuries (10%).

Intentional Injury

  • Intentional injuries are those injuries purposely inflicted including both homicide and suicide.

  • The risk of dying due to injuries purposely inflicted by another person is 13.5 times higher for African Americans than it is for Whites.

  • Forty-seven percent (47%) of hospitalizations for intentional injuries are among young people ages 14-29 years.  71% of these injuries occurred to males.

  • Sixty-seven percent (67%) of suicide deaths in Berkeley are committed by Whites.  Suicide is the leading cause of premature death for Whites in Berkeley and the 8th leading cause of death overall.


Conclusions 

For the most part, the African American and White population suffer from the same ten leading causes of death, but African Americans in Berkeley still die at a younger age overall than Whites in Berkeley.  The results of this report support and are consistent with those originally presented in the 1999 Health Status Report.

When we look at specific causes of death and examine how these causes effect length of life, African Americans in Berkeley have a far greater risk of premature death than do Whites in Berkeley.  Premature death is defined by the Centers for Disease Control and Prevention (CDC) as dying before the age of 75 for United States residents.  Additionally, when we compare age-adjusted mortality rates for leading causes of death in Berkeley to the 2000 National Health Objectives (national standards set by the CDC), the White population in Berkeley usually meets these standards, whereas the African American population in Berkeley does not. When compared to national data, in general, Whites in Berkeley are healthier and live longer, whereas African Americans in Berkeley suffer more disease and die earlier than African Americans in the United States.

The evidence of health disparities among racial/ethnic groups in Berkeley has not significantly changed since the last report, but change in health status for an entire population does not change that quickly.  It takes diligent and focused efforts at all levels and over many years to close gaps in health status -- from changes in the infrastructure of health services to community action and individual response at the grass roots level.

It should be noted that many of these health disparities exist in other communities.  The knowledge of the existence of health disparities is not new.  What is new to Berkeley is specific comparative data, that is, data specific to a community, that can help neighborhood and community groups focus efforts aimed at the elimination of these disparities.

It has long been recognized that the root causes of poor health and early death are enmeshed in issues of class and race in this country and around the world.   In the larger arena, the social determinants of health need to be addressed. In the Public Health arena, prevention of disease and disability and access to quality health care need to be addressed.  The Health Status Reports are valuable tools for both of these arenas. The mortality and hospitalization section examines in detail the differences in disease, hospitalization and cause of death between racial/ethnic groups in Berkeley.  This report should be used to help identify gaps in services and unmet health needs and, in turn, guide the development of programs, the provision of health services, and health education strategies.  All of these are strong indicators of social equality. Everyone at all levels has the responsibility to respond and take action to eliminate health disparities in Berkeley – city government, community-based agencies, the private sector and residents.  Only by working collectively will Berkeley be a healthier community.


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