Question

1. Complete an epidemiological assessment for your chosen community. Use health department data, vital statistics, etc. to determine the leading causes of morbidity and mortality within your community [e.g., county or city as health department data will be listed by county or city). Be sure to consider and discuss results by age group, gender, and socioeconomic status. Remember that epidemiological data is numerically driven, therefore you should report the numerical data associated with these health issue. Identify the top emerging health concerns in your community.

Note: Of these identified top health concerns, you will be asked to choose one (1) to use as your focus topic for Final Project, a health promotion program proposal. All remaining benchmark assignments will focus on this health issue as you develop a proposed health promotion program for the chosen community.

2. Complete a needs assessment for your chosen community. Using the same data and other measures of insight described in the week’s reading, determine the community’s greatest concerns, needs, and assets. Explain how these concerns, needs, and assets connect to future health promotion efforts.

Answer 1

Texas adopted the new U.S. Standard Certificates of Death and Fetal Death in 2006. This revision includes changes to items such as alcohol use, race/ethnicity, etc.

The leading cause of death, diseases of the heart, accounted for 22.9 percent of those deaths, while the second most common cause of death, malignant neoplasms (cancer), accounted for 22.1 percent. Cerebrovascular diseases, accidents, and chronic lower respiratory diseases ranked third, fourth, and fifth, respectively. Together, these five leading causes of death represented 61.4 percent of all deaths in 2010.

The number of infant deaths decreased to 2,362 deaths in 2010 compared to 2,394 deaths in 2009. The infant mortality rate increased to 6.1 infant deaths per 1,000 live births. Fetal deaths decreased from 2,270 in 2009 to 2,144 in 2010. The fetal death ratio decreased to 5.6 fetal deaths per 1,000 live births in 2010 compared to 5.7 in 2009. Ninety-five women died in 2010 as a result of pregnancy or childbearing for a maternal mortality rate of 24.6 maternal deaths per 100,000 live births.

Leading Causes of Death

The order of the top three leading causes of death has remained the same since 1979; it changed only in 2007 and 2009 when cerebrovascular diseases and accidents exchanged their positions. In 2010, diseases of the heart claimed 38,096 lives (38,008 in 2009) and continued to be the leading cause of death followed by malignant neoplasms (cancer) with 36,652 deaths (35,531 in 2009). Diseases of the heart and malignant neoplasms have been the first and second leading causes of death in Texas and the nation since 1950.

Cerebrovascular diseases ranked third with 9,154 deaths, compared to 9,118 in 2009. The top three leading causes of death, diseases of the heart, malignant neoplasms, and cerebrovascular diseases, accounted for 50.5 percent of all Texas resident deaths in 2010. Accidents with 9,133 deaths (9,310 in 2009) and chronic lower respiratory diseases with 8,910 deaths (8,624 in 2009) rounded out the top five leading causes of death.

The sixth leading cause was Alzheimer's disease with 5,200 deaths in 2010 (5,062 in 2009) and the number of deaths due to diabetes mellitus was 4,738 in 2010 (4,866 in 2009). Nephritis and related diseases were the eighth leading cause with 3,870 deaths in 2010. Septicemia was the ninth leading cause with 3,166 deaths in 2010. Influenza and pneumonia were the tenth leading cause with 3,013 deaths in 2010.

Although suicide is no longer one of the ten leading causes of death among all Texas residents, it is the eighth leading cause in the White/Other race/ethnicity category. The sixth leading cause of death for the Hispanic category in 2010 was chronic liver disease and cirrhosis. Leading causes of death for the Black race/ethnicity category included homicide and HIV disease in the ninth and tenth positions.

The majority of deaths (29.9 percent) in 2010 to residents ages 1 through 44 were due to accidents. Malignant neoplasms were responsible for 12.3 percent of all deaths to this age group and suicides claimed the lives of another 11.1 percent.

Beginning at age 45, accidents play a less significant role in total deaths; only 10.1 percent of all deaths to individuals 45-54 were due to accidents. However, malignant neoplasms and diseases of the heart were responsible for 46.2 percent of the deaths to this age group. Deaths due to chronic conditions (diseases of the heart, malignant neoplasms, chronic lower respiratory diseases, cerebrovascular diseases, and Alzheimer's disease) were the major causes of death in individuals 55 years and older, accounting for 64.0 percent of deaths to this age group.

Although males represented 49.6 percent of the Texas population in 2010, they accounted for 60.2 percent of all deaths to persons 1 through 74 years of age. In 2010, the mortality rate for diseases of the heart was 86.0 per 100,000 males and 44.5 per 100,000 females in the 1-74 age group. External causes (such as accidents, homicide, and suicide) and HIV infection also contributed to the gender difference in mortality. Males were more likely than females to die at younger ages from these causes .

Infant Mortality

There were 2,362 infant deaths to Texas residents in 2010 for an infant mortality rate of 6.1 infant deaths per 1,000 live births (see Table 29). The Black infant mortality rate (11.4) continued to be considerably greater than the rate of Whites (5.5) and Hispanics (5.5).

The top five leading causes of infant death in 2010 were congenital malformations, deformations, and chromosomal abnormalities (21.9 percent of all infant deaths); disorders related to short gestation and low birth weight, not elsewhere classified (13.8 percent of all infant deaths); Sudden Infant Death Syndrome (9.8 percent); maternal complications of pregnancy (7.3 percent); and complications of placenta, cord, and membranes (5.0 percent). For the selected causes of infant death among Texas residents.

The majority (1,507; 63.8 percent) of infant deaths took place during the first 27 days of life (neonatal period), and the rate of neonatal deaths in Texas was 3.9 per 1,000 live births. By rank, the top leading causes of neonatal death were congenital malformations, deformations, and chromosomal abnormalities (23.8 percent) and disorders related to short gestation and low birth weight, not elsewhere classified (21.3 percent). For the selected causes of neonatal death among Texas residents.

Fetal Deaths and Perinatal Mortality

In Texas, fetal death is the death of a product of conception before complete expulsion or extraction from its mother. It is required to be registered with the Vital Statistics Unit as a fetal death for any fetus weighing 350 grams or more, or if the weight is unknown, a fetus aged 20 weeks or more. However, all reported fetal deaths, regardless of weight or length of gestation, are included in this annual report. There were 2,144 fetal deaths to Texas residents in 2010. The fetal death ratio was 5.6 fetal deaths per 1,000 live births in 2010, which is less than in 2009 (5.7).

Perinatal mortality includes fetal and neonatal deaths. The perinatal mortality rate was 9.0 per 1,000 fetal deaths and live births in 2010 (8.9 in 2009).

Maternal Mortality

In 2010, 95 women died as a result of pregnancy or childbearing, for a maternal mortality rate of 24.6 per 100,000 live births. The maternal mortality rate for Black women of 53.9 is lower in 2010 than it was in 2009 (66.0) but continues to be higher than the state value. The maternal mortality rate for White (excluding Other) women decreased to 27.0 in 2010 from 30.8 in 2009. Among Hispanic women, the maternal mortality rate decreased to 17.5 in 2010 from 18.4 in 2009. However, rates based on small numbers may be misleading.

Life Expectancy at Birth

Texans born in 2010 had a life expectancy at birth of 78.1 years. Because males tend to die from more external causes (such as accidents, homicide, and suicide) and at younger ages than females, females had a higher life expectancy at birth than males: 80.5 years vs. 75.7. A Hispanic child born in 2010 had a life expectancy at birth of 79.3 years, while a White newborn had a life expectancy of 78.2 years. Black life expectancy remained below the average, at 74.7 years.

Age-Adjusted Death Rate

The age-adjusted death rate for Texas in 2010 was 777.7 deaths per 100,000 population. The age-adjusted death rate for males was 887.9 in 2010 and the rate for females was 683.6. The age-adjusted death rate for Whites and Others, regardless of gender, was 798.3 deaths per 100,000 population. The Hispanic rate of 641.1 remained the lowest of all racial/ethnic groups in 2010. The age-adjusted death rate for Blacks continued to be well above the rate for the Texas population as a whole at 932.1 per 100,000 population.

Years of Potential Life Lost (YPLL)

The YPLL statistic is a way to demonstrate both gender and race/ethnicity differences in mortality risks and is the sum of years lost by persons who die before the age of 65 (see Technical Appendix). The total YPLL for Texans in 2010 was 898,205 years, down from 924,888 years in 2009. Male mortality accounted for 558,701 or 62.2 percent of these years and the total YPLL for women was 339,504 or 37.8 percent. This difference is mostly due to males dying at younger ages than females from causes that are primarily external or preventable in nature, such as accidents and HIV infection.

Death by accident was the number one cause of premature mortality in 2010 and represented 174,350 YPLL, or 7.7 years per 1,000 person ages 0-64. Malignant neoplasms were responsible for the second largest number of years lost with 135,561 YPLL, for a rate of 6.0. Diseases of the heart had a rate of 4.5 and remained the third leading cause of YPLL in Texas, with 100,779 years of potential life lost. Certain conditions originating in the perinatal period was the fourth leading cause of premature mortality with 71,831 YPLL, with a rate of 3.2. The number of years lost from suicide and homicide was the fifth and sixth leading cause of premature mortality in Texas with YPLLs of 60,381 and 42,722 respectively (or 2.7 and 1.9 years per 1,000 person ages 0-64 respectively).

2. In the statistical data of Texas, we have seen that the leading cause of death is due to cardiovascular disease.

Cardiovascular disease (CVD) is a term that encompasses a number of different diseases. CVD is related to a number of risk factors, some of which can be influenced through public health prevention methods, such as;

Smoking

Obesity

Physical Activity

High blood Cholesterol levels

High Blood pressure

Non-healthy Diet

Prevention

1. Heath checks are a national scheme to reduce the risk of CVD by monitoring and modifying risk in all people over 50.

2.There have higher levels of acceptance to health checks than the national average, but uptake is higher in less deprived areas, where CVD has lower incidence and mortality.

3 Provides comprehensive services for healthy lifestyles and smoking cessation.

4. Steps were taken for successful smoking quit rate

5. High cholesterol can increase the risk of CVD; cholesterol should be lowered with statins in people with high risk.

6. Diabetes is a significant risk factor for CVD. Take the measures to lowers the blood sugar levels of people they are at risk. We have to roughly in line with national standards for reducing the risk of CVD in diabetics.

The specific intervention for reducing the risk for CVD:

• Smoking cessation
• Promotion of regular exercises
• Impaired fasting glucose lifestyle intervention
• Diet intervention
• Weight reduction