1. Massachusetts Deaths 2007 Bruce Cohen, PhD
Massachusetts Department of Public Health
Bureau of Health Information, Statistics,
Research, and Evaluation
Division of Research and Epidemiology
Registry of Vital Records and Statistics
April 2009

2. Causes of Death Massachusetts: 1842-2007

3. Outline Highlights Selected Causes of Death
Cancer
Heart Disease
Diabetes
HIV/AIDS
Injury
Race, Education and Mortality
Applications of Mortality Data
Summary

4. HIGHLIGHTS

5. On An Average Day in Massachusetts
144 DEATHS
36 Cancer
6 CLRD
8 Injury
35 Heart Disease
1 Infant
death
5 Alzheimer’s
7 Stroke
3 Diabetes
52,690
Total deaths in 2007

6. Life Expectancy at Birth Massachusetts vs. U.S.1: 1900-2007
United States
U.S. data was not available at the time of this release, 2006 U.S. data used.

7. Overall Mortality Rates Massachusetts and U.S.1 : 1994-2007
United States
- 1.9%* APC
Massachusetts
- 2.4%* APC
* Statistically significant (p<0.05)
APC= Annual Percent Change
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population.
Data U.S. Data was not available at the time of this release

8. Percentage Difference in Mortality Rates Massachusetts vs. U.S.1: 2007
Nephritis*
Homicide*
Diabetes*
Heart
Disease*
Infant
Mortality*
Cancer*
Suicide*
Overall*
% difference
Higher than US
Lower than US
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population *Statistically Significant (p ≤ .05)
Data U.S. Data was not available at the time of this release

9. Leading Causes of Death Massachusetts: 2007
Other 23.4%
Cancer 24.6%
Septicemia 1.7%
Diabetes 2.3%
Nephritis 2.6%
Heart Disease 24.2%
Alzheimer’s 3.2%
Pneumonia & Influenza 2.9%
In 2007:
12,961 cancer deaths
12,735 heart disease deaths
Chronic Lower Respiratory Disease
4.4%
Stroke 5.1%
Injury 5.6%

10. Ranking of Leading Causes of Death by Race and Ethnicity Massachusetts: 2007
White1
(N=48,.518)
Black1
(N=2,211)
Asian1
(N=610)
Hispanic
(N=1,264)
Cancer 1
Heart Disease 2
Stroke 3 6 5
CLRD2 4 9 16
Unintentional Injuries
Alzheimer’s Disease 14 15
Influenza & Pneumonia 7 17
Nephritis 8
Diabetes
HIV/AIDS 29 --
Homicide 30 21
Note: The lower the number the higher the rank
1 Non-Hispanic, 2 Chronic Lower Respiratory Disease

11. Leading Causes of Death by Age Massachusetts: 2007
% of Total in Total Age Leading Cause Age Group Deaths
Injuries 32% 128
Injuries 72% 505
Injuries 44% ,023
Cancer 37% ,560
Cancer 40% ,494
Cancer 27% ,781
85+ Heart Disease 30% ,816

12. Changes in Mortality Rates Massachusetts: 2000 and 2007
Cause
Rate
% Change
2000
2007
Cancer
206.1
179.0 *
13%
Heart Disease
216.7
166.0
23%
Stroke
50.9
35.0
31%
Chronic Lower Respiratory Disease
41.8
31.5
25%
All Injuries
35.9
42.5
18%
Alzheimer’s Disease
19.5
20.9
 7%
Nephritis
17.6
17.9
 2%
Diabetes
19.6
16.5
16%
All Diabetes-related
61.5
52.9
14%
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population.
* Statistically different than 2000 rate (p<0.05)

13. SELECTED CAUSES OF DEATH

14. Cancer Mortality Rates Massachusetts and U.S. : 1994-20071
United States
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population
Data U.S. Data was not available at the time of this release

15. Female Breast Cancer Mortality Rates Massachusetts: 1994-2007
- 4%* APC
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population
* Statistically significant (p<0.05)
APC= Annual Percent Change

16. Heart Disease Mortality Rates Massachusetts and U.S.: 1994-20071
United States
Massachusetts
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population
* Statistically significant (p<0.05)
APC= Annual Percent Change
Data U.S. Data was not available at the time of this release

17. Number of Heart Disease Deaths by Age and Gender Massachusetts: 2007

18. Diabetes-Related Deaths Massachusetts: 2007
All Diabetes-related
N=3,899
Underlying Cause (Disease or injury which initiated the train of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury)1
N=1,216
Contributing Cause (Looking at all other 15 conditions mentioned on death certificates)
N=2,683
1 World Health Organization. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision.
2d ed. Geneva: World Health Organization

19. Diabetes Mortality Rates by Race and Ethnicity Massachusetts: 2007* * *
N=1,041
N=96
N=15
N=62
N=1,216
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population
* Statistically different than state rate (p<0.05)

20. Number of HIV/AIDS Deaths Massachusetts: 1987-2007
Highly Active
Antiretroviral Therapy
HAART

21. Percent of HIV/AIDS Deaths by Age Group Massachusetts: 1994-2007
Less than 45 years
45+ years

22. Injury Deaths

23. Causes of Injury Deaths Massachusetts: 2007
Total Injuries = 2,967
Other
18%
66% Opioids
18% Alcohol
16% Other (gases,
vapor, NSAIDS, etc)
Poisonings 33%
Firearm 8%
Suffocation, Hanging or Strangulation %
Falls
16%
Motor Vehicle-related 15%

24. Number of Poisoning Deaths Where Opioids Are Mentioned Massachusetts: 2000-2007

25. Unintentional Fall Mortality Rates Persons Ages 65+ Massachusetts and U.S.: 1994-2007
United States1
Massachusetts
Rates are per 100,000 population ages 65+.
1 Available from URL:

26. Intentional Injury Deaths by Cause Massachusetts: 2007
Other
(n=55)
Other (n=37)
Suicide (n=504)
Homicide (n=183)
Firearm
(n=112)
Firearm (n=113)
Hanging
(n=220)
Cut/Pierce (n=33)
Poisoning (n=117)
N= 687 deaths
(183 homicides)
(504 suicides)

27. Suicides by Gender and by Age Massachusetts: 2007

28. Suicide Rates by Gender Massachusetts: 1994-2007
Males
- 3%* APC
Massachusetts
Females
* Statistically significant (p<0.05)
APC= Annual Percent Change
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population.

29. Child Homicides (Ages 1-14) Massachusetts: 1997-2007

30. Race, Education, and Mortality

31. Mortality Rates by Education and Race/Ethnicity, Adults 25-64 Years1 Massachusetts: 2007* * *
* Statistically higher than those with 13+ yrs of education (p<0..05)
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population Uses 2000 Population Estimates

32. Mortality Rates by Race/Ethnicity Adults 25-64 Years1 with 13+Years of Education Massachusetts: 2007*
* Statistically higher than the rate for whites (p<0..05)
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population Uses 2000 Population Estimates

33. Applications of Mortality Data

34. Premature Mortality Rate (PMR)1
Definition
deaths before age 75, age-adjusted to the 2000 US standard population under 75 years of age
Focus
two-thirds of deaths to persons ages 75+
majority of deaths to persons age 75+ are due to chronic conditions associated with aging
deaths to persons less than 75 years may be preventable
Value
excellent measure to reflect the health status of a population
used as a health status indicator that can be used to focus prevention initiatives and target programs
1 Age-adjusted to the 2000 US standard population under 75 years of age.

35. Premature Mortality Rates by Race and Hispanic Ethnicity Massachusetts: 2007* *
(*) Statistically different from State (p ≤.05)
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population persons ages 0-74

36. Premature Mortality Rates (PMR) by Community Health Network Area (CHNA) Massachusetts: 2007

37. Mortality Amenable to Health Care
Definition: Deaths for persons ages 0-74 from certain causes that should not occur in the presence of timely and effective health care1,2
Value: A useful tool to assess
Performance of health care systems and
Track changes over time1
1 Nolte E and McKee CM. Measuring The Health of Nations: Updating An Earlier Analysis. Health Affairs 2008; Vol 27, Number 1: 58-71; Jan/Feb 2008.
2 Nolte E and McKee CM . Does Health Care Save Lives? Avoidable Mortality Revisited. The Nullfield Trust London, England

38. Mortality Causes Amenable to Health Care
Causes considered as amenable to health care:
Amenable to secondary prevention
where screening and treatment are effective;
for example colorectal, breast, cervical, and skin cancer
Amenable to improved treatment and medical care:
that require direct medical and/or surgical intervention
for example appendicitis and hypertension
that rely on efficient medical care delivery
accurate and timely diagnosis, transport, and treatment
that respond to antibiotic treatments and immunizations
infectious diseases

39. Percent Deaths Amenable to Health Care Massachusetts: 2007
All Deaths
Deaths to Persons Ages 0-74
Amenable Deaths
Amenable Deaths

40. Mortality Rates for Causes Amenable to Health Care by Race/Ethnicity Massachusetts: 2000 and 2007** **
** Statistically lower than 2000 rate (p<0.05)
Rates are per 100,000 population. Age-adjusted to the 2000 US standard population persons ages 0-74

41. SUMMARY

42. Summary The Massachusetts death rate was the lowest on record
Life expectancy reached an all-time high
Massachusetts continues to compare favorably with the U.S.
Cancer remained the leading cause of death followed by heart disease. As in previous years, cancer and heart disease accounted for almost half of all deaths
Death rates for chronic lower respiratory disease, overall cancer, and female breast cancer declined from 2006

43. Summary (continued)
Lowest annual number of HIV/AIDS deaths in Massachusetts
Almost ¾ of HIV/AIDS deaths occurred among persons 45+ years
Poisoning deaths, the leading cause of injury deaths, were stable from 2006 to 2007
Two out of 3 poisoning deaths were associated with opioids
Suicide rates had leveled off since 2002 but increased for men from 2006 to 2007
Continued increasing trend in unintentional fall-related deaths

44. Summary (continued) Disparities Persist:
The cancer death rate for men was 46% higher than the rate for women
Blacks had the highest premature mortality rate, times the rate of whites
The death rate for those with less education was almost 3 times higher than the rate for those with more education
Springfield, Lowell, Fall River, Taunton, Worcester, and New Bedford had the highest premature mortality rates

45. How to Access the Death Report and Data
To access the 2007 Report:
Hard Copies: (617)
TDD/TTY: (617)
DPH Website:
mass.gov/dph/bhsre/resep/resep.htm#birth
To access Death data via MassCHIP (DPH’s Internet based public health information service):
Website:
Telephone: MASCHIP (Mass only)
(617)