The 130th Annual Meeting of APHA

Abstract #45802

Christopher J. Mansfield, PhD and Denise Kirk, MS. Center for Health Services Research and Development, East Carolina University, Building "N", Physicians Quadrangle, Greenville, NC 27858, 252-816-2785, mansfieldc@mail.ecu.edu

Background. The second goal in Healthy People 2010, eliminating health disparities, is a daunting challenge not only in regard to achievement but measurement as well. Premature mortality is a simple measure of health disparity, which addresses this goal as well as the first, increasing length of life. We use premature mortality rates to compare disparity by race (non-whites to whites) in the United States over the last 30 years, project forward to the year 2010, and examine association of the rates with major changes in national health policy. Method. Calculate age-adjusted premature mortality, measured as years of life lost before age 75 (yll-75) by race, plot and project linear trends, and examine association with federal policy changes and health expenditures. Results. Premature mortality decreased substantially for whites and non-whites between 1968 and 1998 but more so for non-whites; the disparity is diminishing markedly. Years of life lost for non-whites declined by 51%; for whites, by 43%. For non-whites the rate in 1968 was 2,389 yll-75, 93% greater than the rate for whites. By 1998, the disparity declined to 59% greater and is projected to be less than 35% greater by 2010. The association of this progress with major federal health programs and policies is discussed. Conclusions. Measurement of disparity by premature mortality shows that substantial progress is being made. Elimination of the racial disparity in premature mortality by 2020 is suggested but likely to depend on policy decisions that determine access to care and initiatives influencing individual health behaviors.

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