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Moving Forward
                           in 2010
Progress Toward Health Equity by Race and Ethnicity in Utah




  UTAH D...
Moving Forward in 2010
Moving Forward in 2010

Contents
Health Status by Race and Ethnicity: 2005 Vs. 2010 ..................
Moving Forward in 2010
Moving Forward in 2010
Health Status by Race and Ethnicity: 2005 Vs. 2010
Background               ...
Moving Forward in 2010
Moving Forward in 2010
Methods
The baselines for determining health         Indicators that were no...
Moving Forward in 2010
Moving Forward in 2010
Moving Forward in 2010
Changes in Utah Minority Health since 2005
  Positive...
Moving Forward in 2010
Moving Forward in 2010
Utah Minority Health Summary
 Access to Health Care                     •   ...
Moving Forward in 2010
Moving Forward in 2010

•   A higher percentage of Asians          •   Although birth outcomes were...
Moving Forward in 2010
Moving Forward in 2010
Depression                               •   When adjusting for age, the His...
Moving Forward in 2010
Moving Forward in 2010
Utah American Indians
Access to Health Care                                 ...
Moving Forward in 2010
Moving Forward in 2010
Utah Asians
Access to Health Care                                        Tub...
Moving Forward in 2010
Moving Forward in 2010
Utah Blacks/African Americans
Access to Health Care                         ...
Moving Forward in 2010
Moving Forward in 2010
Utah Pacific Islanders
                                                     ...
Moving Forward in 2010
Moving Forward in 2010
Utah Hispanics/Latinos
Access to Health Care                                ...
Moving Forward in 2010
Moving Forward in 2010
Moving Forward in 2010
Utah Whites
 Access to Health Care                   ...
Moving Forward in 2010
Moving Forward in 2010
Acknowledgments
Primary Author                              Community Review...
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Progress Toward Health Equity by Race and Ethnicity in Utah

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Moving Forward in 2010 highlights some of the most pressing minority health issues described in more detail and compares the health status of Utah minorities reported in 2010 to the baselines established in the 2005 report.

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Progress Toward Health Equity by Race and Ethnicity in Utah

  1. 1. Moving Forward in 2010 Progress Toward Health Equity by Race and Ethnicity in Utah UTAH DEPARTMENT OF HEALTH Center for Multicultural Health
  2. 2. Moving Forward in 2010 Moving Forward in 2010 Contents Health Status by Race and Ethnicity: 2005 Vs. 2010 ....................................................... 3 Background ................................................................................................................................................. 3 Factors Influencing Change ............................................................................................................ 3 Methods .............................................................................................................................................................. 4 Changes in Utah Minority Health since 2005 ........................................................................ 5 Positive Progress .................................................................................................................................... 5 Setbacks ......................................................................................................................................................... 5 Utah Minority Health Summary ......................................................................................................... 6 Access to Health Care ....................................................................................................................... 6 Life Expectancy ........................................................................................................................................ 6 Risk Factors for Illness ................................................................................................................... 6 Mother and Infant Health .................................................................................................................7 Infectious Diseases ................................................................................................................................. 8 Heart Disease ............................................................................................................................................ 8 Cancer ............................................................................................................................................................ 8 Utah American Indians ............................................................................................................................. 9 Utah Asians .................................................................................................................................................... 10 Utah Blacks/African Americans ...................................................................................................... 11 Utah Pacific Islanders .............................................................................................................................12 Utah Hispanics/Latinos ............................................................................................................................13 Utah Whites ....................................................................................................................................................14 Acknowledgments ......................................................................................................................................15 2
  3. 3. Moving Forward in 2010 Moving Forward in 2010 Health Status by Race and Ethnicity: 2005 Vs. 2010 Background At the same time, the racial and ethnic In 2005 and 2010, the Utah Department minority populations of Utah have grown at of Health (UDOH) published editions of rates exceeding the growth of the statewide Health Status by Race and Ethnicity, population, largely through migration. A high comprehensive reports of public health proportion of newcomers from other states data available about Utah racial and and countries are of racial or ethnic minority ethnic groups at each time period. status. Therefore, the state racial and ethnic Moving Forward in 2010 highlights minority populations measured in 2005 and some of the most pressing minority 2010 may be substantially different from health issues described in more detail each other. and compares the health status of A smaller proportion of Utahns had health Utah minorities reported in 2010 to the insurance coverage at the time period of the baselines established in the 2005 report. 2010 report compared with the 2005 report. Factors Influencing Change Health care costs have risen steadily during Since 2005, many changes have taken this time period and an economic downturn place in Utah that may have influenced began in 2008. health status of racial and ethnic groups. In 2004, the Center for Multicultural Health (CMH) was established to facilitate health programs for Utah racial and ethnic minorities. CMH was funded by the U.S. Office of Minority Health to serve as the state office of minority health in 2005. CMH, other UDOH programs, local, federal and tribal governments, and private and non-profit organizations have conducted health promotion campaigns to encourage healthy lifestyles and environments. Frequently, these efforts have been specifically designed to address disparities highlighted by the 2005 report. 3
  4. 4. Moving Forward in 2010 Moving Forward in 2010 Methods The baselines for determining health Indicators that were not included in both status change were the point estimates reports and data that were collected or for indicator rates reported in the 2005 analyzed differently in the two reports could edition of Health Status by Race and not be analyzed for change over time. The Ethnicity. 2010 rates were originally Asian and Pacific Islander racial groups were reported in Health Status by Race and combined in some of the data sets for one Ethnicity: 2010. but not both reports. These indicators could The rates reported in the 2005 edition not be analyzed for change over time for of Health Status by Race and Ethnicity these two racial categories only. are referred to as “2005” rates and Data were compiled using data from birth rates reported in the 2010 edition are and death certificates, statewide surveys, and referred to as “2010” rates. However, mandated reporting of certain diseases and the actual years of data analysis varied, conditions by health organizations. depending on data availability. The For more information about the health exact years of data analysis are listed in indicators, data collection and analysis the original reports. methodologies, data collection years, and Change was defined as follows: The age-adjusted rates, see the original reports: estimated rate for 2005 Status does not Office of Public Health Assessment (2005). fall within the 95% confidence intervals Health Status by Race and Ethnicity. Salt for 2010 Status. Lake City, UT: Utah Department of Health. When appropriate, age-adjusted rates http://health.utah.gov/opha/publications/ were used to determine if there was raceeth05/Race-Eth_Report.pdf a change over time or a difference Center for Multicultural Health (2010). Health from the statewide rate, but only the Status by Race and Ethnicity: 2010. Salt Lake crude rates are listed in this report for City, UT: Utah Department of Health. purposes of brevity and simplicity. The http://health.utah.gov/cmh/ age-adjusted rates are listed in the data/healthstatus.pdf original reports. 4
  5. 5. Moving Forward in 2010 Moving Forward in 2010 Moving Forward in 2010 Changes in Utah Minority Health since 2005 Positive Progress Setbacks Many Utah racial and ethnic minority In spite of the progress, Utah racial and groups saw improvement in health status ethnic minority groups also saw health since 2005: status decline in other ways since 2005: • Hispanics saw declines in several • The lung cancer rate rose among diseases, including gonorrhea, Blacks/African Americans. tuberculosis, arthritis, and cancer. • The breast cancer rate rose among This ethnic group also had lower American Indians and Blacks/African rates of death from diabetes, Americans. coronary heart disease, and stroke. • As with all Utahns, all minority groups • The Black/African American prostate for whom data were available saw a cancer rate dropped. rise in chlamydia rates. • Blacks/African Americans reported • The proportion of Blacks/African improvements in overall physical and Americans with recommended mental health. physical activity dropped. • A lower percentage of American • As with Utahns statewide, American Indian and Black/African American Indians had a higher overweight/ babies had low birth weights. obesity rate. • The Hispanic and Black/African • More Pacific Islanders and Hispanics American infant mortality rates lacked health insurance. dropped. • The proportion of Asians with no • The American Indian motor vehicle usual place of medical care more than traffic crash death rate improved. doubled. • More Asians were physically active. • Hispanics reported higher rates of prenatal care and colon cancer screening. Pacific Islanders reported higher rates of colon cancer screening and blood cholesterol screening. 5
  6. 6. Moving Forward in 2010 Moving Forward in 2010 Utah Minority Health Summary Access to Health Care • The proportion of Asians with no usual • For American Indians, the • All racial and ethnic minority place of medical care more than doubled overweight/obesity rate rose from groups had higher poverty rates from 2005 to 2010, increasing from 63.4% in 2005 to 72.5% in 2010. than the statewide population. 6.6% to 14.1%. • Large proportions of the American • Hispanics had the lowest rate of Life Expectancy Indian (26.5%), Black/African health insurance coverage in the • Asians had the highest life expectancy American (28.6%) and Hispanic/ state, with 35.7% uninsured. at birth of all Utah racial/ethnic groups. Latino (31.1%) populations were Statewide, 11.1% of Utahns were Asians had the lowest obesity rate of all physically inactive. Statewide, uninsured. Utah racial/ethnic groups, as well as low 18.6% were inactive. • Only 8.8% of Pacific Islanders rates of chronic disease indicators such • The proportion of Blacks/African lacked health insurance in 2005, as heart disease death, cancer incidence Americans with recommended but 23.0% were uninsured in and arthritis. physical activity dropped from 2010. The Hispanic uninsured rate • American Indians had the lowest life 58.0% in 2005 to 45.5% in 2010. also rose from 25.8% in 2005 to expectancy at birth of all Utah racial/ 35.7% in 2010. ethnic groups. They had the highest • In spite of the decline in health rates of unintentional injury death and insurance coverage, Hispanics violent death in the state. However, the and Pacific Islanders reported American Indian motor vehicle traffic improvements in certain kinds of crash death rate improved greatly, with preventive care. Hispanics had 20.5 deaths/100,000 people in 2010 higher rates of early prenatal care compared to 38.5/100,000 in 2005. (from 60.4% to 63.4%) and colon cancer screening (from 27.4% to Risk Factors for Illness 38.0%). Pacific Islanders reported • Smoking rates for American Indians higher rates of colon cancer (19.8%) and Blacks/African Americans screening (from 19.9% to 55.7%) (20.0%) were nearly double the smoking and blood cholesterol screening rate of the statewide (from 44.7% to 54.2%). population (10.8%). • American Indians were least likely • The majority of Utah adults were to have access to needed medical overweight (56.4%), but American care, with 38.2% of American Indian (72.5%), Black/African American Indians reporting that they could (66.3%), Pacific Islander (75.1%) and not obtain such care, compared to Hispanic (62.2%) Utahns had even 15.9% of all Utahns. higher rates of overweight. Only 32.4% of Asians were overweight. 6
  7. 7. Moving Forward in 2010 Moving Forward in 2010 • A higher percentage of Asians • Although birth outcomes were still poor Overall Health reported getting the recommended for Blacks/African Americans, these rates improved since 2005, when the Black/ • Blacks/African Americans reported amount of physical activity in 2010 African American infant mortality rate improvements in overall health. In (51.6%) than in 2005 (45.8%). was 13.8/1,000 births and 14.7% of 2010, only 8.7% of Black/African • Higher percentages of Asians American adults reported seven reported eating the recommended Black/African American infants had low birth weights. or more days per month of poor daily servings of fruits (43.9%) and physical health, compared to 15.0% vegetables (29.0%) than statewide • The Hispanic infant death rate also in 2005 and just 16.5% of Black/ (30.5% and 22.7%). dropped (from 6.4/1,000 births to African American adults reported 5.1/1,000). seven or more days per month of Mother and Infant Health • Pacific Islander infants under one • Fewer American Indian babies had low poor mental health, compared to year had nearly twice the death birth weights in 2010 (7.8%) compared 28.0% in 2005. rate (8.8 deaths/1,000 births) of to 2005 (9.2%). infants statewide (4.5 deaths/1,000 • All racial and ethnic minority groups had births). Pacific Islander women lower rates of receiving early prenatal had the lowest rate of folic acid care than the statewide rate of 79.1%. consumption (31.8% compared Rates for the groups were as follows: to 46.2% statewide) and early American Indians 56.2%; Asians 75.2%; prenatal care (48.1% compared to Blacks/African Americans 61.2%; Pacific 79.1% statewide) and the highest Islanders 48.1%; and Hispanics/Latinas rate of obesity during pregnancy 63.4%. (39.5% compared to 15.9% • Pacific Islanders had the highest rate statewide). of postpartum depression (27.0% • Black/African American infants had compared to 13.0% statewide). the highest rate of low birth weight • Only 70.3% of American Indians (11.4%) and preterm birth (13.0%) initiated breastfeeding, and only 43.9% of all Utah infants. (Statewide low of those who initiated birth weight rate was 6.8% and breastfeeding were preterm birth rate was 9.7%). The still doing so 2-6 months postpartum. Black/African American infant death Statewide, 91.1% of mothers initiated rate was 8.4 deaths/1,000 births. breastfeeding and 67.5% of those continued 2-6 months postpartum. • Black/African American, Pacific Islander, and Hispanic mothers were also less likely to continue breastfeeding 2-6 months postpartum than all Utahns. 7
  8. 8. Moving Forward in 2010 Moving Forward in 2010 Depression • When adjusting for age, the Hispanic • Hispanics had a higher rate of coronary heart disease and stroke death major depression (8.2%) than all rates both declined. Utahns (4.2%). Cancer Infectious Diseases • The Black/African American prostate • As with all Utahns, all of the cancer rate dropped from 72.5 new minority groups for whom data cases/100,000 males to 53.4/100,000. were available have seen a rise in chlamydia rates since 2005. • Lung cancer is on the rise among Utah Blacks/African Americans: in 2005, the • Hispanics have seen fewer rate was 6.1/100,000, while in 2010 it new cases of gonorrhea was 14.1/100,000. This rate was higher (from 34.6/100,000 people to than the statewide rate when controlling 26.4/100,000) and tuberculosis for age. (from 5.9/100,000 to 4.2/100,000). • The breast cancer rate rose among Diabetes American Indians (from 8.3/100,000 • American Indians had the highest females in 2005 to 19.9/100,000) diabetes rate (9.2%) of all Utahns and Blacks/African Americans (from (statewide rate was 5.6%). 17.8/100,000 females in 2005 to • Pacific Islanders had the 32.6/100,000). highest rate of diabetes death • Hispanics saw improvement in the (52.9/100,000 vs. 43.5/100,000 incidence rates of all cancers measured: statewide). colorectal (13.6 new cases/100,000 • The Hispanic diabetes death rate people vs. 14.7/100,000), lung dropped from 24.3/100,000 people (8.8/100,000 vs. 10.5/100,000), breast in 2005 to 20.8/100,000 in 2010. (41.8/100,000 women vs. 46.6/100,000) and prostate (33.9/100,000 men vs. Heart Disease 36.7/100,000). • No minority groups had higher heart disease death rates than the statewide population. American Indians (43.8 deaths/100,000 people), Asians (41.9/100,000) and Hispanics (27.6/100,000) had lower rates of heart disease death than Utahns statewide (110.1/100,000). 8
  9. 9. Moving Forward in 2010 Moving Forward in 2010 Utah American Indians Access to Health Care Obesity Progress Since 2005 Diabetes American Indians were the The majority of Utah adults were Moving in the Right Direction American Indians had the least likely of all Utah racial/ overweight (56.4%), but American Chronic Drinking highest diabetes rate (9.2%) of Motor Vehicle Traffic Crash ethnic groups to have access to Indians had an even higher rate at all Utahns. (Statewide rate was Deaths needed medical care, with 38.2% 72.5%, up from 63.4% in 2005. Low Birth Weight 5.6%.) reporting that they could not Breastfeeding obtain such care, compared to Infectious Disease Moving Backward Only 70.3% of American Indians Breast Cancer Incidence 15.9% of all Utahns. They also Like all Utahns, American Indians initiated breastfeeding, and only Overweight or Obese had a high poverty rate (22.1% have seen a rise in chlamydia Chlamydia 43.9% of those who initiated compared to 10.0% statewide) rates since 2005. breastfeeding continued 2-6 and uninsured rate (17.7% Breast Cancer months postpartum. Therefore, compared to 11.1% statewide). The Utah American Indian only 30.9% of Utah American Early Death breast cancer rate rose from Indian infants benefited from American Indians had the lowest 8.3/100,000 females in 2005 to breastfeeding 2-6 months life expectancy at birth of all Utah 19.9/100,000 in 2010. Screening postpartum. Statewide, 91.1% of racial/ethnic groups. They had for breast cancer did not increase mothers initiated breastfeeding the highest rates of poor physical during this time period. At and 67.5% of those continued 2-6 health, poor mental health, 51.6%, the proportion of Utah months postpartum. unintentional injury death, American Indian women over Alcohol Use and violent death in the state. 40 receiving a mammogram to Chronic drinking declined among However, the Utah American detect breast cancer early and Utah American Indians. Only Indian motor vehicle traffic crash improve survival is lower than 6.5% of Utah American Indians death rate improved greatly, with the state rate (67.6%). The reported this behavior in 2010 20.5 deaths/100,000 people in exact causes of breast cancer are compared to 9.7% in 2005. Binge 2010 compared to 38.5/100,000 unknown, but lifestyle choices drinking remained a problem, with in 2005. that may protect against breast 17.6% reporting it (statistically cancer include maintaining a Smoking unchanged from the 2005 rate). healthy weight, being physically American Indians had nearly active, and breastfeeding. Birth Weight double the smoking rate (19.8%) Fewer Utah American Indian of all Utahns (10.8%). babies had low birth weights in 2010 (7.8%) than in 2005 (9.2%). Better Than Statewide in 2010 Greater Needs Than Statewide in 2010 Heart Disease Deaths No Health Insurance Coverage Binge Drinking Homicide Colorectal Cancer Incidence Unable to Access Health Care Chlamydia Violent Deaths Colorectal Cancer Deaths Early Prenatal Care Obesity in Pregnancy Fair or Poor Health Breast Cancer Incidence Mammogram Gestational Diabetes Physical Health Status Prostate Cancer Incidence Blood Cholesterol Screening Births to Adolescents Mental Health Status Note: Fewer American Indians Overweight or Obese Unintended Pregnancy Arthritis Prevalence reported high cholesterol than all No Physical Activity Ever Breastfeeding Diabetes Prevalence Utahns, but this is likely due to the low rate of cholesterol screening. Cigarette Smoking Breastfeeding 2-6 Months Postpartum Exposure to Secondhand Smoke Orofacial Clefts 9
  10. 10. Moving Forward in 2010 Moving Forward in 2010 Utah Asians Access to Health Care Tuberculosis Obesity Progress Since 2005 Asians had a high poverty rate Asians had a higher rate Asians had the lowest obesity rate Moving in the Right Direction (14.3% compared to 10.0% of tuberculosis (14.1 new of any Utah racial or ethnic group. Recommended Physical Activity statewide). cases/100,000 people) than The majority of Utah adults– Moving Backward Primary Care Provider all Utahns (1.4/100,000). 56.4%–were overweight, but only No Primary Care Provider Most people diagnosed with 32.4% of Asian Utah adults were Pap Test The proportion of Asians with no usual place of medical care tuberculosis in Utah were born overweight. The better nutrition Note: A higher proportion of Asians reported chronic drinking in 2010 than approximately doubled between outside of the United States. practices of Asians contribute 2005, but both rates were very low. 2005 and 2010, increasing from Gestational Diabetes to this difference. Higher 6.6% to 14.1%. This change A higher percentage of Asian percentages of Asians reported may be related to the steady rise infants were born to mothers who eating the recommended daily in health care costs during the had gestational diabetes (6.8% in servings of fruits (43.9%) and same time period. 2010) than statewide (3.1%). vegetables (29.0%) than statewide (30.5% and 22.7%). Pap Test Physical Activity The percentage of Asian women More Asians were physically Life Expectancy receiving a Pap test to screen active than in the past; a higher Asians had the highest life for cervical cancer dropped from percentage of Asians reported the expectancy at birth of all Utah 87.4% in 2005 to 69.1% in 2010. recommended amount of physical racial/ethnic groups. Asians had Cervical cancer is one of the activity in 2010 (51.6%) than in low rates of chronic disease most curable cancers if detected 2005 (45.8%). indicators such as heart disease early through routine screening. deaths, cancer incidence and Persons without a usual place arthritis. A low obesity rate of medical care are less likely to reduces risk for chronic disease. receive health screenings than those who have a primary care provider to manage their care. Better Than Statewide in 2010 Greater Needs Than Statewide in 2010 Overweight or Obese Activity Limitation Early Prenatal Care Daily Fruit Consumption Arthritis Prevalence Knowledge of Stroke Symptoms Daily Vegetable Consumption Asthma Prevalence Low Birth Weight Obesity in Pregnancy Heart Disease Deaths Gestational Diabetes Births to Adolescents Coronary Heart Disease Deaths Tuberculosis Major Structural Birth Defects* Colorectal Cancer Incidence* Homicide Poisoning Deaths Breast Cancer Incidence* Violent Deaths Prostate Cancer Incidence* Mental Health Status * This indicator combined the Utah Asian and Pacific Islander populations. 10
  11. 11. Moving Forward in 2010 Moving Forward in 2010 Utah Blacks/African Americans Access to Health Care Lung Cancer Prostate Cancer Progress Since 2005 Blacks/African Americans had In 2005, the Black/African The Black/African American Moving in the Right Direction a high poverty rate (19.6% American lung cancer rate was prostate cancer rate dropped from Infant Mortality compared to 10.0% statewide) 6.1/100,000 but in 2010, it rose 72.5 new cases/100,000 males to Low Birth Weight Physical Health Status and poor access to health to 14.1/100,000 and was higher 53.4/100,000. Mental Health Status care (21.9% lacked access to than the statewide rate when Obesity Prostate Cancer Incidence needed care compared to 15.9% controlling for age. (The age- The majority of Utah adults were Moving Backward statewide). adjusted Black/African American overweight (56.4%), but Blacks/ Physical Activity Births lung cancer rate was 46.3 vs. African Americans had an even Chlamydia 29.7 statewide.) Black/African Gonorrhea Black/African American infants higher rate at 66.3%. Meanwhile, Lung Cancer Incidence had the highest rates of low birth Americans had nearly double the proportion of Blacks/African Breast Cancer Incidence weight (11.4%) and preterm the adult smoking rate of the Americans who were physically birth (13.0%) of all Utah infants. statewide population (20.0% active dropped from 58.0% in Statewide, the low birth weight compared to 10.8%). 2005 to 45.5% in 2010. rate was 6.8% and the preterm Breast Cancer Infectious Diseases birth rate was 9.7%. The Black/ The Black/African American As with all Utahns, Blacks/African African American infant death breast cancer rate rose from Americans have seen a rise in rate was 8.4 deaths/1,000 births. 17.8/100,000 females in 2005 to chlamydia rates since 2005. The Although birth outcomes are still 32.6/100,000 in 2010. Screening gonorrhea rate for Blacks/African poor, these rates have improved for breast cancer did not increase Americans has also risen. since 2005, when the Black/ during this time period. Lifestyle Mental Health African American infant mortality choices that may protect against Blacks/African Americans had rate was 13.8/1,000 births and breast cancer include maintaining lower rates of major depression 14.7% of Black/African American a healthy weight, being physically (2.6% of adults) and suicide infants had low birth weights. active and breastfeeding. Blacks/ (6.6/100,000 people) than all Physical Health African Americans were less Utahns (4.2% and 13.6/100,000). Only 8.7% of Black/African likely to continue breastfeeding In 2010, only 16.5% of Black/ American adults reported seven 2-6 months postpartum than all African American adults reported or more days per month of Utahns. seven or more days per month of poor physical health in 2010, poor mental health, compared to compared to 15.0% in 2005. 28.0% in 2005. Better Than Statewide in 2010 Greater Needs Than Statewide in 2010 Activity Limitation Unable to Access Health Care Unintended Pregnancy Major Depression Early Prenatal Care Breastfeeding 2-6 Months Suicide Overweight or Obese Postpartum No Physical Activity Tuberculosis Cigarette Smoking Chlamydia Knowledge of Stroke Symptoms Gonorrhea Low Birth Weight Homicide Preterm Birth Lung Cancer Incidence Note: Fewer Blacks/African Americans reported high cholesterol than all Utahns, but this is likely due to the low rate of cholesterol screening. 11
  12. 12. Moving Forward in 2010 Moving Forward in 2010 Utah Pacific Islanders Progress Since 2005 Poverty Pregnancy Diabetes Pacific Islanders had a high Pacific Islander women had Pacific Islanders had the highest Moving in the Right Direction Colon Cancer Screening poverty rate (14.4% compared to the lowest rate of folic acid rate of diabetes death at Blood Cholesterol Screening 10.0% statewide). This problem consumption (31.8% compared to 52.9/100,000. The statewide rate is likely to affect health status. 46.2% statewide) and the lowest was 43.5/100,000. Maintaining a Moving Backward No Health Insurance Coverage Health Insurance Coverage rate of early prenatal care (48.1% healthy weight can help prevent Prostate Cancer Screening Only 8.8% of Pacific Islanders compared to 79.1% statewide). type 2 diabetes and complications Note: A higher proportion of Pacific lacked health insurance in 2005, Women who were obese during from diabetes, including death. Islanders reported chronic drinking in 2010 than 2005, but both rates were but 23.0% were uninsured in pregnancy gave birth to 39.5% of Obesity very low. 2010. This change may be related Pacific Islander infants, compared The majority of Utah adults were to the steady rise of health care to 15.9% statewide. Pacific overweight (56.4%), but Pacific costs during the same time Islanders had the highest rate of Islanders had an even higher rate period. obesity during pregnancy of all at 75.1%. Utah races/ethnicities. Preventive Screening Overall Health Pacific Islander adults had the Infant Deaths The majority of 4.7% of Pacific highest percentage of receiving Pacific Islander infants under Islander Utahns reported that routine medical check-ups one year had nearly twice the overall, their health was not good, of all racial groups (79.5% death rate (8.8 deaths/1,000 compared to 11.8% of all Utahns. compared to 71.3% statewide). births) of infants statewide (4.5 Screenings for blood cholesterol deaths/1,000 births). While only levels (54.2% of Pacific Islander 1.3% of all Utah infants were adults) and colon cancer (55.7% born to Pacific Islander mothers, of Pacific Islander adults age their babies made up 2.5% of all 50+) have increased since infants who died. 2005 (44.7% for cholesterol Postpartum Depression and 19.9% for colon cancer). Pacific Islanders had the highest However, a smaller proportion of rate of postpartum depression men age 40+ received prostate (27.0% compared to 13.0% cancer screenings (35.5% in statewide). 2010 vs. 46.5% in 2005). Better Than Statewide in 2010 Greater Needs Than Statewide in 2010 Unintended Pregnancy Early Prenatal Care Breastfeeding 2-6 Months Routine Medical Check-Up Overweight or Obese Postpartum Major Structural Birth Defects* Infant Mortality Postpartum Depression Fair or Poor Health Obesity in Pregnancy Tuberculosis Activity Limitation Gestational Diabetes Chlamydia Major Depression Folic Acid Consumption Homicide Colorectal Cancer Incidence* Births to Adolescents Diabetes Deaths Breast Cancer Incidence* * This indicator combined the Utah Asian and Pacific Islander populations. 12
  13. 13. Moving Forward in 2010 Moving Forward in 2010 Utah Hispanics/Latinos Access to Health Care Cancer Diabetes Progress Since 2005 Hispanics had a high poverty The rates of all cancers measured The Hispanic diabetes death rate Moving in the Right Direction rate (19.5% compared to 10.0% have declined among Utah dropped from 24.3/100,000 people Colon Cancer Screening Early Prenatal Care statewide) and poor access to Hispanics, including lung (8.8 in 2005 to 20.8/100,000 in 2010. Chronic Drinking health care (21.3% lacked access new cases/100,000 people However, diabetes continued to be Infant Mortality to needed care compared to vs. 10.5/100,000), breast more prevalent among Hispanics Gonorrhea Tuberculosis 15.9% statewide). (41.8/100,000 vs. 46.6/100,000) than all Utahns when adjusting for Arthritis Prevalence Health Insurance Coverage and prostate (33.9/100,000 vs. age. Diabetes Deaths 36.7/100,000). Coronary Heart Disease Deaths Hispanics were the least likely of Heart Disease Stroke Deaths all Utah racial/ethnic groups to Births Hispanics had a lower rate of heart Colorectal Cancer Incidence Lung Cancer Incidence have health insurance coverage. More Hispanic infants were born disease death (27.6/100,000) than Breast Cancer Incidence 35.7% reported being uninsured, to mothers with early prenatal Utahns statewide (110.1/100,000). Prostate Cancer Incidence compared to 11.1% of all Utahns. care (63.4% vs. 60.4% in 2005), When adjusting for age, the Moving Backward This rate has risen since 2005, but still fewer than statewide Hispanic coronary heart disease and No Health Insurance Coverage when it was 25.8%. (79.1%). Hispanic infant deaths stroke death rates both declined. Routine Medical Check-up Depression dropped from 6.4/1,000 births Arthritis Low Birth Weight Chlamydia Hispanics had a higher rate of to 5.1/1,000. However, 7.4% of Fewer Hispanic adults (11.0%) major depression (8.2%) than all Hispanic babies had low birth suffered from arthritis in 2010 than Utahns (4.2%). weights, compared to 6.6% in in 2005 (14.4%). Hispanics had a 2005. lower prevalence of arthritis than all Colon Cancer Screening More Hispanic adults age 50+ Obesity Utahns (22.3%). obtained screenings to detect or The majority of Utah adults Infectious Diseases prevent colon cancer than in the were overweight (56.4%), but Like all Utahns, Hispanics have past (38.0% compared to 27.4% Hispanics had an even higher seen a rise in chlamydia rates since in 2005), but not as many as rate at 62.2%. Many Hispanics 2005. However, this group has statewide (50.8%). The Hispanic were physically inactive (31.1% seen fewer new cases of gonorrhea colorectal cancer rate dropped vs. 18.6% statewide) and (from 34.6/100,000 people to from 14.7 new cases/100,000 few Hispanics consumed the 26.4/100,000) and tuberculosis people to 13.6/100,000. recommended daily servings of (from 5.9/100,000 to 4.2/100,000). vegetables (14.2% vs. 22.7% statewide). Better Than Statewide in 2010 Greater Needs Than Statewide in 2010 Smoking During Arthritis Prevalence No Health Insurance Coverage Binge Drinking Gestational Diabetes Pregnancy Asthma Prevalence Unable to Access Health Care Physical Activity Folic Acid Consumption Major Structural Birth Heart Disease Deaths No Primary Care Provider Daily Vegetable Consumption Births to Adolescents Defects Coronary Heart Disease Early Prenatal Care Knowledge of Stroke Symptoms Unintended Pregnancy Poisoning Deaths Deaths Colon Cancer Screening Knowledge of Heart Attack Breastfeeding 2-6 Months Postpartum Suicide Breast Cancer Incidence Prostate Cancer Screening Symptoms Postpartum Depression Violent Deaths Breast Cancer Deaths Blood Cholesterol Screening Tuberculosis Homicide Activity Limitation Prostate Cancer Incidence Influenza Immunization Chlamydia Fair or Poor Health Pneumonia Immunization Gonorrhea Poor Physical Health Status Note: Fewer Hispanics/Latinos reported high cholesterol than all Utahns, but this is likely due to the low rate of cholesterol Overweight or Obese Low Birth Weight Major Depression screening. Cigarette Smoking Obesity in Pregnancy Diabetes Prevalence 13
  14. 14. Moving Forward in 2010 Moving Forward in 2010 Moving Forward in 2010 Utah Whites Access to Health Care Obesity Progress Since 2005 Whites had the lowest poverty rate Overweight and obesity continued Moving in the Right Direction Moving Backward (9.2%) of all racial groups. A lower Routine Medical Check-up No Primary Care Provider to rise, with 55.9% of Utah Whites Pap Test Influenza Immunization proportion were uninsured (8.0%) overweight in 2010 compared to 53.9% Early Prenatal Care Mammogram compared to the state rate (11.1%). in 2005. Colon Cancer Screening High Cholesterol Fewer Whites lacked a primary care Infant Mortality Overweight or Obese Heart Disease High Blood Pressure Low Birth Weight provider (9.0%) than statewide Tuberculosis The White coronary heart disease Cigarette Smoking (10.9%) and more White infants Driving Under the Influence Gonorrhea death rate (61.2/100,000 people) Chronic Drinking Chlamydia were born to mothers who had early was lower than in 2005, when it was Daily Vegetable Consumption Arthritis Prevalence prenatal care (80.5%) than statewide Prostate Cancer Incidence 68.9/100,000. Stroke deaths also Motor Vehicle Traffic Crash (79.1%). Deaths declined from 38.3/100,000 in 2005 to Diabetes Deaths Correlation with Statewide Rates 28.8/100,000 in 2010. Coronary Heart Disease Deaths Because Whites make up 91.8% of the Stroke Deaths Cancer Colorectal Cancer Incidence Utah population, changes in statewide Although prostate cancer incidence Lung Cancer Incidence rates usually reflected changes in the Breast Cancer Incidence increased slightly among Utah Whites White rates. (from 115.5/100,000 people to Infant Mortality 124.9/100,000), there were small drops Among Whites, the infant death rate in colorectal, lung, and breast cancer dropped to 4.4/1,000 births in 2010 incidence. More Whites aged 50+ from 5.1/1,000 in 2005. This may be obtained screening to prevent or detect related to health care interventions in colon cancer (51.2% in 2010 vs. 37.2% early pregnancy as Whites have the in 2005) and fewer Whites smoked highest rate of early prenatal care (10.3% in 2010 vs. 12.2% in 2005), (80.5%) of all Utah races. reducing cancer risk. Better Than Statewide in 2010 Greater Needs Than Statewide in 2010 Health Insurance Knowledge of Stroke Symptoms Major Structural Birth Defects Coverage Knowledge of Heart Attack Symptoms Violent Deaths Primary Care Provider Fair or Poor Health Activity Limitation Early Prenatal Care Blood Cholesterol Screening Physical Activity 14
  15. 15. Moving Forward in 2010 Moving Forward in 2010 Acknowledgments Primary Author Community Review April Young Bennett, MPA, Masha Boguslavsky, Multicultural Health Utah Department of Health (UDOH) Network, Comunidades Unidas Center for Multicultural Health Terry Haven, Voices for Utah Children Data Analysis Kevin McCulley, Association for Utah Laurie Baksh, MPH, UDOH Maternal and Community Health Infant Health Program Fahina Pasi, National Tongan American Jerry Carlile, MSPH, UDOH Bureau of Society Epidemiology Jesse M. Soriano, MS, MA, Jeffrey Duncan, MS, UDOH Vital Records Utah State Office of Ethnic Affairs and Statistics Ming Wang, Multicultural Health Network Marcia Feldkamp, PhD, PA, MSPH, Utah Indian Health Advisory Board Utah Birth Defect Network Anna Fondario, MPH, UDOH Violence Center for Multicultural Health and Injury Prevention Program Owen Quiñonez Michael Friedrichs, MS, UDOH Bureau of Dulce Diez, MPH, CHES Health Promotion Christine Espinel Wendy Langeberg, MPH, Utah Cancer Registry Joanne McGarry, MSPH, UDOH Maternal and Infant Health Program Brian Paoli, UDOH Office of Public Health Assessment Kimberly Partain McNamara, MS, UDOH Offic of Public Health Assessment Brenda Ralls, PhD, UDOH Diabetes Prevention and Control Program Photographer Sean Carpenter 15

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