Health Outcomes of Western NC Compared to Eastern NC Relating to Race & Ethnicity

Casey Mullen Kirsten Dickson Amanda Marshall

Who? What? Where?

A comparative display of statistics on health outcomes by race and/or ethnicity for Eastern NC as compared with Western NC

Location We started off comparing the Eastern Counties of

PittHalifaxCarteret

And the Western Counties ofHendersonAsheBurke

However, we found our sample was better represented when just comparing Eastern NC to Western NC

Comparison Groups

X variable= the independent variableIn our case the independent variable was due to

race & ethnicity○ White○ Black○ Hispanic

Measures

Y variable= dependent variableHad to do with the annual mortality rate from

the health outcomes of 2010 due to…○ Heart disease○ All types of cancers○ COPD○ Stroke

What Does This Mean?

TheoryThe specific population of mortality from

each disease (D.V.) depends on the race and ethnicity (I.V.) of those diagnosed with these diseases and upon which region they live in (East vs. West) in North Carolina

Understanding the Slope Correlation

Two random variables are positively correlated if high values of one are likely to be associated with high values of the other (upward slope to the right corner of the graph)

They are negatively correlated if high values of one are likely to be associated with low values of the other (downward slope to the right)

If there is no correlation then the two variables simply do not affect one another and share no relation (straight line on the graph)

So, how well can we predict one from the other?

What Does This Mean?

Therefore, if one race has a positive correlation with a particular mortality rate, then that race is more strongly associated with dying from that disease or vice versa

Western Region Independent variable (x)-

Percent white

Dependent variable (y)- One year Mortality rate of heart disease (2010 count)

Correlation- Negative/ weak

Thus, the higher the value of the sum of people dying from heart disease annually in the Western Region of North Carolina, then the lower the percentage of white people will be of dying from this disease (versus their black and Hispanic counterparts)

Western Region Independent variable (x)-

percent black

Dependent variable (y)- One year Mortality rate of heart disease (2010 count)

Correlation- Positive/ strong

Thus, the larger the sum of people dying of heart disease (in the west), then the more likely those dying were to be black

Western Region Independent variable (x)-

Percent Hispanic

Dependent variable (y)- One year Mortality rate of heart disease (2010 count)

Correlation- Positive

Similar to blacks in the western region of NC, more Hispanics are positively associated with mortality from this disease than whites

Summary

Blacks and Hispanics are more strongly associated with death due to heart disease than whites in the Western Region of North Carolina

Eastern Region Independent variable (x)- Percent

white

Dependent variable (y)- One year Mortality rate of heart disease

Correlation- Negative (almost flat as if no correlation were present)

Eastern Region Independent variable (x)-

Percent black

Dependent variable (y)- One year Mortality rate of heart disease

Correlation- Negative

Eastern Region Independent variable (x)- Percent Hispanic

Dependent variable (y)- One year Mortality rate of heart disease

Correlation- Positive

In Sum

Whites and blacks are less associated with death due to heart disease than Hispanics are in the Eastern portion of North Carolina

Western Region I.V.- White

D.V.- One year mortality, all cancers

Correlation- Negative

Western Region I.V.- Black

D.V.- One year mortality, all cancers

Correlation- Positive

Western Region I.V.- Hispanic

D.V.- One year mortality, all cancers

Correlation- Positive

Eastern Region I.V.- White

D.V.- One year mortality, all cancers

Correlation- Negative

Eastern Region I.V.- Black

D.V.- One year mortality, all cancers

Correlation- Positive

Eastern Region I.V.- Hispanic

D.V.- One year mortality, all cancers

Correlation- Positive

Summary

Whites are more weakly assoc. with death due to cancers in the West and the East than blacks and Hispanics

Western Region I.V.- White

D.V.- One year mortality, COPD

Correlation- Negative

Western Region I.V.- Black

D.V.- One year mortality COPD

Correlation- Positive

Western Region I.V.- Hispanic

D.V.- One year mortality COPD

Correlation- Positive

Summary

Whites are less associated with death due to COPD in the Western Region of NC than blacks and Hispanics

Eastern Region I.V.- White

D.V.- One year mortality, COPD

Correlation- Negative

Eastern Region I.V.- Black

D.V.- One year mortality, COPD

Correlation- Negative

Eastern Region I.V.- Hispanic

D.V.- One year mortality, COPD

Correlation- Positive

Summary

Hispanics are more strongly associated with death due to COPD than whites and blacks in the East part of NC

Western Region I.V.- White

D.V.- One year mortality rate, Stroke

Correlation- Negative

Western Region I.V.- Black

D.V.- One year mortality rate, Stroke

Correlation- Positive

Western Region I.V.- Hispanic

D.V.- One year mortality rate, Stroke

Correlation- Positive

Summary

Hispanics and blacks from the Western portion of NC are more highly associated with mortality from stroke than whites are

Eastern Region I.V.- White

D.V.- One year mortality rate, Stroke

Correlation- None

Eastern Region I.V.- Black

D.V.- One year mortality rate, Stroke

Correlation- Negative

Eastern Region I.V.- Hispanic

D.V.- One year mortality rate, Stroke

Correlation- Positive

In Sum

Whites show no correlation is evident between their race and its effects on the mortality rate of stroke in the East

Blacks show a weak correlation

While Hispanics show a strong correlation

Overview of SES Both African Americans and Hispanics, as a whole,

have lower income, lower educational level, and higher unemployment rates than Whites

Both minority groups also have higher percentages of people who don’t have current health insurance, couldn’t see a doctor due to cost, or who had no personal doctor when compared to their white counterparts

These things contribute to higher rates of health problems

Blacks & Hispanics

Less likely than whites to get the recommended level of physical activity or to engage in any leisure time activity

Less likely to consume recommended amount of fruits and vegetables each day

Hispanics

Top 3 causes of deathCancerMotor vehicle injuriesHeart disease

Hispanics Continued

Higher percentages reported of fair or poor health when compared to whites or blacks

Less likely to report diabetes, high blood pressure, or asthma than whites or blacks

In reality, Hispanics are worse off than whites, but better off than blacks

Blacks

Top 4 diseases among African AmericansHeart DiseaseCancerStrokeDiabetes

Higher rates of obesity when compared to whites

Blacks Continued

Heart DiseaseAfrican Americans are 30% more likely to die

from heart disease than whites

CancerSubstantially higher rates of prostate cancer

compared to whites

Higher rates of colon/rectum and cervical cancer

Steps should be considered in developing policies to eliminate racial and ethnic disparities:[

Consistent racial and ethnic data collection by health care providers

Effective evaluation of disparities-reduction programs

Minimum standards for culturally and linguistically competent health services

Greater minority representation within the health care workforce

Establishment or enhancement of government offices of minority health

Expanded access to services for all ethnic and racial groups

Involvement of all health system representatives in minority health improvement efforts

How can we generate these changes? Interpreter services

Recruitment

Specialized Training

Use of Community Health Workers

Culturally competent health promotion

Including family and/or community members

Immersion into another culture

Administrative and Organizational accommodations