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

Mortality or Death

Specific Causes of Death

Cancer 

Coronary Heart Disease

Cerebrovascular Disease (Stroke)

HIV/AIDS

Unintentional Injury

Intentional Injury


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.


City of Berkeley Public Health Division
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Berkeley, CA 94704
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