1. Diabetes in Texas Prevalence

2. 2 DATA LIMITATIONS/DISCLOSURE All data presented in this presentation include both type 1 and type 2 diabetes. Data from the Behavioral Risk Factor Surveillance System (BRFSS) are for persons who are eighteen years of age and older. They do not include children. Women who report diabetes only during pregnancy are not included in prevalence. All reported rates (%) from the Behavioral Risk Factor Surveillance System are weighted for Texas demographics and the probability of selection and thus are not derived from the simple division of numerator and denominator cases. Population data come from the Texas State Data Center, Office of the State Demographer, Institute for Demographic and Socioeconomic Research, College of Business, University of Texas at San Antonio. Population data use 0.5 migration scenario. Mortality data are from the Texas Department of State of Health Services, Center for Health Statistics. Data Limitations

3. 3 Diabetes in Texas, 2008* AreaPrevalence* Texas 9.7% US 8.3% *Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008, for persons who are eighteen years of age and older, and include both Type 1 and Type 2 Diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes. Women who report diabetes only during pregnancy are not included in prevalence. Note: All reported rates (%) are weighted for Texas demographics and the probability of selection and thus are not derived from the simple division of numerator and denominator cases.

4. 4 Prevalence of Diabetes, US and Texas, 1995 - 2008* *Source: CDC Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008, for persons who are eighteen years of age and older, and include both Type 1 and Type 2 Diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes.

5. 5 Estimated* Number of Adult Texans with Diabetes, Diagnosed and Undiagnosed, 2008 2008 Texas Adult Population: 17,735,442 (Age 18 Years and Older, uses migration scenario 0.5.) *Undiagnosed diabetes estimate based on 2003-20060 NHANES age-adjusted prevalence estimate of 2.5% for persons twenty years of age and older. Diagnosed diabetes estimate based on 2008 Texas BRFSS, and use migration scenario 0.5. 1,720,338 425,157

6. 6 Texas Projected Population Increase, 2040* *Uses migration scenario of 0.5. Includes male and female, all races/ethnicities. Source: Texas State Data Center - Office of the State Demographer, Institute for Demographic and Socioeconomic Research, College of Business, University of Texas at San Antonio.

7. 7 Texas Projected Population Increases by Race/Ethnicity, 2000-2040*

8. 8 Texas Projected Diabetes Cases 2000 - 2040*

9. 9 Diabetes Prevalence by Sex, Texas, 2008* GenderPrevalence Estimated Number of People Male9.8%865,221 Female9.7%863,946 2008 Texas Diabetes Prevalence is 9.7%. *Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008, for persons who are eighteen years of age and older, and include both Type 1 and Type 2 Diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes.

10. 10 Diabetes Prevalence by Sex, 20 Years and Older, United States, 2008* Gender Prevalence Male8.6% Female7.9% *Source: CDC Behavioral Risk Factor Surveillance System, 2008, for persons who are eighteen years of age and older, and include both Type 1 and Type 2 Diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes.

11. 11 Diabetes Prevalence by Race/Ethnicity, Texas, 2008* Area: Texas9.7%1,205,993 Race/EthnicityPrevalenceEstimated # of People White, non-Hispanic 8.3%736,987 Black, non-Hispanic13.0%251,543 Hispanic 11.1%680,351 Other 7.5%59,389 *Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008. Note: All reported rates (%) are weighted for Texas demographics and the probability of selection and thus are not derived from the simple division of numerator and denominator cases.

12. 12 2008 Texas Diabetes Prevalence* by Race/Ethnicity and Age Group Age Group White, non- Hispanic Black, non- HispanicHispanicOther 18 - 442.93.04.31.4 45 - 6410.423.820.913.9 65+17.033.534.828.7 Overall8.313.011.18.1 *Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008. Note: All reported rates (%) are weighted for Texas demographics and the probability of selection and thus are not derived from the simple division of numerator and denominator cases. State Rate = 9.7%

13. 13 2004 - 2008 Texas Diabetes Prevalence by Race/Ethnicity* *Source: 2008 Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, for persons who are eighteen years of age and older. Data include both type 1 and type 2 diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes. Women who report diabetes only during pregnancy are not included in prevalence.

14. 14 Diabetes Prevalence by Race/Ethnicity, United States, 2008* Race/EthnicityPrevalence White, non-Hispanic 7.4% Black, non-Hispanic13.1% Hispanic 7.5% Other 8.3% Multiracial (chooses more than one category) 9.2% 2008 US Diabetes Prevalence is 8.3%. *Source: CDC Behavioral Risk Factor Surveillance System, BRFSS Survey, 2008, for persons who are eighteen years of age and older, and include both type 1 and type 2 Diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes.

15. 15 2008 Texas Diabetes Prevalence by Age Group* *Source: 2008 Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, for persons who are eighteen years of age and older. Data include both type 1 and type 2 diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes. Women who report diabetes only during pregnancy are not included in prevalence. Population data come from the Texas State Data Center, Office of the State Demographer, Institute for Demographic and Socioeconomic Research, College of Business, University of Texas at San Antonio. Age GroupPrevalence 18-29 Years 1.8% 30-44 Years 4.6% 45-64 Years14.6% 65+22.7%

16. 16 Diabetes Prevalence by Educational Level, Texas, 2008* Educational LevelPrevalence No High School Diploma14.2% High School Graduate 9.7% Some College 9.8% College + 6.9% 2008 Diabetes Prevalence for Texas is 9.7%. *Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008, for persons who are eighteen years of age and older, and include both type 1 and type 2 Diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes.

17. 17 Diabetes Prevalence by Income Level, Texas, 2008* Income LevelPrevalence Less Than $25,00014.2% $25,000 thru $49,99910.6% $50,000 or more 6.0% 2008 Diabetes Prevalence for Texas is 9.7%. *Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008, for persons who are eighteen years of age and older, and include both Type 1 and Type 2 Diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes.

18. 18 Texas Death Certificates Uses ICD-10 for years 1999 and later. Uses E-CODES (External Cause of Injury) to classify leading cause of death. Diabetes Mellitus is E10 – E14. Required to be filed no later than 10 days after death. Can be filled out by a variety of people: –Physicians –Nurses –Funeral home directors –Medical Examiners

19. 19 Texas Death Certificate How causes of death are reported: –Immediate cause of deathoccurred closest to the time of death. –Underlying cause of deathinitiated events leading to immediate death. There can only be one. –Contributing cause of deathsignificant diseases or conditions that may have contributed to death but did not result in the underlying cause of death. There can be multiple contributing causes.

20. 20 Diabetes Mellitus – Underlying Cause of Death 2003-2006, Texas

21. 21 Diabetes Mellitus – Underlying or Contributing Cause of Death 2003-2006, Texas

22. 22 Top Ten Leading Causes of Death, Texas, 2006* *Source: Texas Department of State Health Services, Center for Health Statistics. Includes male and female, all ages, and all races/ethnicities. RankUnderlying CauseNumber of Deaths 1Disease of the Heart38,487 2Malignant Neoplasms34,776 3Cerebrovascular Diseases9,332 4Accidents9,006 5Chronic Lower Respiratory Disease7,599 6Diabetes Mellitus5,180 7Alzheimers Disease4,880 8Influenza and Pneumonia3,325 9Nephritis, Nephrotic Syndrome and Nephrosis2,967 10Septicemia2,649 All Other Causes38,324 All Causes156,525

23. 23 Diabetes as a Cause of Death by Race/Ethnicity, Texas, 2006* * Source: Texas Department of State Health Services, Center for Health Statistics. Includes male and female, all ages. Race/EthnicityRankNumber of Deaths White, non-Hispanic72,638 Black, non-Hispanic5884 Hispanic51,549 Other5109 All65,180

24. 24 *Source: Texas Department of State Health Services, Center for Health Statistics. Includes male and female, all ages. Diabetes Mortality Rate (Per 100,000) by Race/Ethnicity, Texas, 2006* Mortality rates for each race/ethnicity were applied to the 2006 population by race/ethnicity: 20 per 100,000 whites (non-Hispanic). 42 per 100,000 Hispanics. 49 per 100,000 blacks (non-Hispanic). 21 per 100,000 persons who fall in the Other category. The 2006 mortality rates (per 100,000) for blacks (non-Hispanic) and Hispanics were more than double that of whites (non-Hispanic).