A Closer Look at Leading Causes of Death in Guilford County

2015 GCDHHS Division of Public Health Data Brief A Closer Look at Leading Causes of Death in Guilford County Highlights Heart disease mortality rates declined 43% from 244.8 deaths per 100,000 in 1995 to 142.5 in 2013. After decades in which heart disease was the leading killer, cancer became the leading cause of death in 2008. About two-thirds of all deaths in the county are due to chronic diseases, including cancer, heart disease, stroke, Alzheimer s disease, chronic lower respiratory disease and diabetes. In 2013, the leading causes of death among children and young adults were motor vehicle accidents and other unintentional injuries. African-Americans had higher age-adjusted mortality rates than Whites for heart disease, cancer, stroke, diabetes, septicemia, kidney disease, homicide and HIV infection. Whites had higher age-adjusted mortality rates than African-Americans for chronic lower respiratory disease, unintentional injuries and suicide. Men had higher mortality rates than women for many conditions, including heart disease, cancer, diabetes, motor vehicle and other unintentional injuries and HIV infection. Women had higher mortality rates than men for Alzheimer s disease. Inside this Data Brief Leading Causes of Death, All Residents 2 Leading Causes of Death by Race 2-3 Leading Causes of Death by Sex 4 Leading Causes of Death Trends 5 Leading Causes of Death by Age 5-7 Leading Cancer Mortality Types 8 Trends in leading Cancer Types 8 Cancer Mortality Types by Sex 9 Guilford County Race/Ethnicity- Specific and Sex-Specific Age-Adjusted Death Rates 10 1 GCDHHS Division of Public Health Leading Causes of Death Data Brief 2015

Leading Causes of Death, All Residents Cancer 862 170.2 Diseases of the Heart 722 142.5 Cerebrovascular Disease (Stroke) 223 44.0 Chronic Lower Respiratory Disease 221 43.6 Unintentional Injuries 211 41.6 Motor Vehicle Injuries 47 9.3 All Other Injuries 164 32.4 Alzheimer s Disease 179 35.3 Diabetes Mellitus 104 20.5 Nephritis, other Kidney Diseases 97 19.1 Pneumonia and Influenza 77 15.2 Septicemia 64 12.6 Suicide 52 10.3 Chronic Liver Disease and Cirrhosis 46 9.1 Homicide 33 6.5 HIV Infection 24 4.7 Source: NC Mortality File, NC Center for Health Statistics Total Number of Deaths in Guilford County 3,976 Guilford County Population in 2013 506,610 Overall Mortality Rate (Not Age Adjusted) 987.3 per 100,000 Leading Causes of Death, Guilford County, 2013 4.7 6.5 9.1 9.3 10.3 12.7 15.2 19.1 20.5 32.4 35.3 43.6 44 142.5 170.2 HIV Infection Homicide Respiratory Disease Motor Vehicle Injuries Suicide Septicemia Flu & Pneumonia Kidney Disease Diabetes Unintentional Injuries Alzheimer's Disease Chronic Lower Respiratory Disease Stroke Heart Disease Cancer 0 50 100 150 200 Rate per 100,000 Source: NC State Center for Health Statistics Chart prepared by the GCDHHS, Division of Public Health. 2 GCDHHS Division of Public Health Leading Causes of Death Data Brief 2015

Leading Causes of Death, Black/African-American Race Cancer 247 145.1 Diseases of the Heart 194 113.9 Cerebrovascular Disease 58 34.1 Unintentional Injuries 52 30.5 Motor Vehicle Injuries 20 11.7 Other Injuries 32 18.8 Diabetes Mellitus 46 27.0 Nephritis, other Chronic Kidney Disease 40 23.5 Alzheimer s Disease 35 20.6 Chronic Lower Respiratory Disease 34 20.0 Septicemia 20 11.7 Homicide 19 11.2 HIV Infection 17 10.0 Pneumonia and Influenza 14 8.2 Suicide 13 7.6 Chronic Liver Disease and Cirrhosis 12 7.0 Total Number of Deaths among Blacks 1,080 Black Guilford County Population in 2013 170,260 Black Mortality Rate (Not Age Adjusted) 763.5 per 100,000 Leading Causes of Death, White Race Cancer 596 199.4 Diseases of the Heart 523 175.0 Chronic Lower Respiratory Disease 186 62.2 Cerebrovascular Disease 164 54.9 Unintentional Injuries 155 51.8 Motor Vehicle Injuries 26 8.7 Other Injuries 129 43.2 Alzheimer s Disease 141 47.2 Pneumonia and Influenza 61 20.4 Diabetes Mellitus 57 19.1 Nephritis, other Chronic Kidney Diseases 57 19.1 Septicemia 43 14.4 Suicide 38 12.7 31 10.4 Homicide 12 4.0 Source: NC Mortality File, NC Center for Health Statistics. Total Number of Deaths among Whites 2,839 White Guilford County Population in 2013 298,914 White Mortality Rate (Not Age Adjusted) 1,216.1 per 100,000 3 GCDHHS Division of Public Health Leading Causes of Death Data Brief 2015

Leading Causes of Death for Men Cancer 449 187.0 Diseases of the Heart 370 154.1 Unintentional Injuries 126 52.7 Motor Vehicle Injuries 38 15.8 All Other Injuries 88 36.6 Chronic Lower Respiratory Disease 105 43.7 Cerebrovascular Disease (Stroke) 81 33.7 Diabetes Mellitus 56 23.3 Alzheimer s Disease 52 21.7 Nephritis, other Kidney Diseases 44 18.3 Pneumonia and Influenza 41 17.1 Chronic Liver Disease and Cirrhosis 35 14.6 Suicide 34 14.2 Septicemia 29 12.1 Homicide 25 10.4 HIV Infection 20 8.3 Source: NC Mortality File, Center for Health Statistics Total Number of Deaths for Men 1,929 Male Guilford County Population in 2013 240,126 Male Mortality Rate (Not age-adjusted) 803.3 per 100,000 Leading Causes of Death for Women Cancer 413 154.5 Diseases of the Heart 352 131.7 Cerebrovascular Disease (Stroke) 142 53.1 Alzheimer s Disease 127 47.5 Chronic Lower Respiratory Disease 116 43.4 Unintentional Injuries 85 31.8 Motor Vehicle Injuries 9 3.4 All Other Injuries 76 28.4 Nephritis, other Kidney Diseases 53 19.8 Diabetes Mellitus 48 18.0 Pneumonia and Influenza 36 13.5 Septicemia 35 13.1 Homicide 18 6.7 Chronic Liver Disease and Cirrhosis 11 4.1 Suicide 8 3.0 HIV Infection 4 1.5 Total Number of Deaths for Women 2,047 Female Guilford County Population in 2013 267,293 Female Mortality Rate (Not age-adjusted) 765.8 per 100,000 4 GCDHHS Division of Public Health Leading Causes of Death Data Brief 2015

Leading Causes of Death: Chronic Diseases Guilford County, 1995-2013 300 250 Rate per 100,000 200 150 100 50 0 170.2 142.5 44 43.6 20.5 Heart Disease Cancer Stroke Diabetes COPD Note: COPD is Chronic Obstructive Pulmonary Disease, also known as Chronic Lower Respiratory Disease Source: Data provided by the NC State Center for Health Statistics Chart prepared by the Guilford County Department of Public Health Leading Causes of Death, Ages 1-19 Unintentional Injuries/Accidents 12 9.5 Motor Vehicle Injuries 6 4.7 All Other Injuries 6 4.7 Suicide 4 3.2 Diseases of the Heart 3 2.4 Homicide 3 2.4 Cancer 1 0.8 Chronic Lower Respiratory Disease 1 0.8 Pneumonia and Influenza 1 0.8 Total Number of Deaths ages 1-19 30 Age 1-19 Guilford County Population in 2013 126,622 Age 1-19 Mortality Rate (Not age-adjusted) 23.7 per 100,000 5 GCDHHS Division of Public Health Leading Causes of Death Data Brief 2015

Leading Causes of Death, Ages 20-44 Unintentional Injuries/Accidents 52 29.4 Motor Vehicle Injuries 22 12.4 All Other Injuries 30 17.0 Diseases of the Heart 28 15.8 Cancer 25 14.1 Suicide 24 13.6 Homicide 19 10.7 Diabetes Mellitus 7 4.0 Septicemia 7 4.0 Cerebrovascular Disease (Stroke) 5 2.8 Chronic Liver Disease and Cirrhosis 5 2.8 Chronic Lower Respiratory Disease 4 2.3 HIV Disease 4 2.3 Pneumonia and Influenza 4 2.3 Nephritis, other Kidney Diseases 2 1.1 Total Number of Deaths ages 20-44 225 Age 20-44 Guilford County Population in 2013 176,853 Age 20-44 Mortality Rate (Not Age Adjusted) 127.2 per 100,000 Leading Causes of Death, Ages 45-64 Cancer 222 171.0 Diseases of the Heart 118 90.9 Unintentional Injuries/Accidents 44 33.9 Motor Vehicle Injuries 14 10.8 All Other Injuries 30 23.1 Diabetes Mellitus 33 25.4 Chronic Lower Respiratory Disease 32 24.7 Chronic Liver Disease and Cirrhosis 27 20.8 Cerebrovascular Disease (Stroke) 25 19.3 Suicide 18 13.9 HIV Disease 17 13.1 Nephritis, other Kidney Diseases 17 13.1 Septicemia 15 11.6 Homicide 10 7.7 Pneumonia and Influenza 4 3.1 Total Number of Deaths ages 45-64 745 Age 45-64 Guilford County Population in 2013 129,810 Age 45-64 Mortality Rate (Not Age Adjusted) 573.9 per 100,000 6 GCDHHS Division of Public Health Leading Causes of Death Data Brief 2015

Leading Causes of Death, Ages 65-84 Cancer 461 784.6 Diseases of the Heart 310 527.2 Chronic Lower Respiratory Disease 125 212.6 Cerebrovascular Disease (Stroke) 90 153.1 Alzheimer s Disease 48 81.6 Unintentional Injuries/Accidents 46 78.2 Motor Vehicle Injuries 4 6.8 All Other Injuries 42 71.4 Diabetes Mellitus 43 73.1 Nephritis, other Kidney Diseases 39 66.3 Pneumonia and Influenza 28 47.6 Septicemia 27 45.9 Chronic Liver Disease and Cirrhosis 13 22.1 Suicide 6 10.2 Total Number of Deaths ages 65-84 1,623 Age 65-84 Guilford County Population in 2013 58,796 Age 65-84 Mortality Rate (Not Age Adjusted) 2,760.4 per 100,000 Leading Causes of Death, Ages 85 and Older Diseases of the Heart 263 2,862.7 Cancer 153 1,665.4 Alzheimer s Disease 130 1,415.0 Cerebrovascular Disease (Stroke) 102 1,110.3 Chronic Lower Respiratory Disease 59 642.2 Unintentional Injuries/Accidents 54 587.8 Motor Vehicle Injuries 1 10.9 All Other Injuries 53 576.9 Nephritis, other Kidney Diseases 39 424.5 Pneumonia and Influenza 39 424.5 Diabetes Mellitus 21 228.6 Septicemia 14 152.4 Total Number of Deaths ages 85+ 1,300 Age 85+ Guilford County Population in 2013 9,187 Age 85+ Mortality Rate (Not Age Adjusted) 14,150.4 per 100,000 7 GCDHHS Division of Public Health Leading Causes of Death Data Brief 2015

Leading Causes of Death from Cancer by Type All Residents Cancer Types Lung 236 46.6 Pancreatic 68 13.4 Breast 67 25.1 Colorectal 55 10.9 Leukemia 37 7.3 Prostate 36 15.0 Liver 29 5.7 Brain 28 5.5 Ovarian 19 7.1 Source: NC Mortality File, Center for Health Statistics; NC Demographers Office *Mortality Rates for breast and ovarian cancers are calculated using the female and population size, respectively. Total Number of Cancer Deaths in Guilford County 665 Guilford County Population in 2013 506,610 Overall Cause Specific Mortality Rate (Not Age Adjusted) 131.3 per 100,000 Leading Types of Cancer Mortality, 1995-2013 70 Rate per 100,000 60 50 55.7 46.6 40 33.3 30 29.5 20 16.5 12.6 10 12.5 0 25.1 15 13.4 10.9 7.3 Lung Breast Prostate Pancreatic Colon Leukemia Source: NC State Center for Health Statistics Chart prepared by the GCDHHS, Division of Public Health. 8 GCDHHS Division of Public Health Leading Causes of Death Data Brief 2015

Leading Causes of Death from Cancer by Type White Race Cancer Types Lung 174 58.2 Pancreatic 41 13.7 Breast 40 25.8 Colorectal 35 11.7 Leukemia 27 9.03 Liver 23 7.7 Brain 20 6.7 Prostate 17 11.8 Ovarian 16 10.3 Source: NC Mortality File, Center for Health Statistics; NC Demographers Office. *Mortality Rates for breast and ovarian cancers are calculated using the female and male population size respectively. Total Number of Cancer Deaths among Whites 366 White Guilford County Population in 2013 298,914 White Cause Specific Mortality Rate (Not Age Adjusted) 122.4 per 100,000 Leading Causes of Death from Cancer by Type Black/African-American Race Cancer Types Lung 57 33.5 Breast 26 28.1 Pancreatic 23 11.0 Colorectal 19 11.2 Prostate 19 24.5 Leukemia 10 5.9 Brain 7 4.1 Liver 6 3.5 Ovarian 3 3.2 Source: NC Mortality File, Center for Health Statistics; NC Demographers Office *Mortality Rates for breast and ovarian cancers are calculated using the female and male population size respectively. Total Number of Cancer Deaths among Blacks 160 Black Guilford County Population in 2013 170,260 Black Cause Specific Mortality Rate (Not Age Adjusted) 94.0 per 100,000 This report was prepared by Health Surveillance & Analysis Unit of the Division of Public Health: Mark H. Smith, Ph.D., Epidemiologist Laura Mrosla, MPH, MSW, Community Health Educator Terrance J. Earle, MS Healthcare Informatics Candidate, University of Central Florida For more information about Guilford County health statistics, visit www.myguilford.com/humanservices/health/health-statistics 9 GCDHHS Division of Public Health Leading Causes of Death Data Brief 2015

2009-2013 Guilford County Race/Ethnicity-Specific and Sex-Specific Age-Adjusted* Death Rates** *Standard = Year 2000 U.S. Population; **Rates Per 100,000 Population White, non- Hispanic African American, non-hispanic American Indian, non-hispanic Other Races, non-hispanic Hispanic Male Female Overall Cause of Death: Deaths Rate Deaths Rate Deaths Rate Deaths Rate Deaths Rate Deaths Rate Deaths Rate Deaths Rate All Causes 13,636 730.7 4,980 879.8 55 636.9 181 418.5 181 310.8 9,018 886.8 10,016 660.0 19,034 757.3 Diseases of Heart 2,828 147.0 1,018 180.4 15 N/A 27 74.7 27 54.1 1,980 197.5 1,928 124.1 3,908 154.1 Acute Myocardial Infarction 663 34.2 193 36.0 5 N/A 3 N/A 3 N/A 425 43.3 444 28.2 869 34.3 Other Ischemic Heart Disease 1,054 55.4 344 61.5 7 N/A 12 N/A 12 N/A 840 82.4 588 38.2 1,428 56.2 Cerebrovascular Disease 757 39.0 287 53.1 2 N/A 18 N/A 18 N/A 411 42.3 657 42.2 1,068 42.6 Cancer 2,994 161.8 1,129 194.5 15 N/A 61 119.3 61 47.9 2,152 203.3 2,069 141.5 4,221 166.6 Colon, Rectum, and Anus 219 11.9 108 19.2 1 N/A 4 N/A 4 N/A 162 15.4 173 11.7 335 13.4 Pancreas 212 11.4 55 9.0 0 N/A 2 N/A 2 N/A 138 12.8 132 9.1 270 10.7 Trachea, Bronchus, and Lung 929 50.2 310 52.3 11 N/A 16 N/A 16 N/A 709 65.4 563 38.7 1,272 50.1 Breast 222 21.8 102 28.0 0 N/A 5 N/A 5 N/A 0 N/A 330 22.8 330 22.8 Prostate 142 19.2 74 44.7 2 N/A 1 N/A 1 N/A 219 23.2 0 N/A 219 23.2 Diabetes Mellitus 220 11.8 170 30.6 0 N/A 1 N/A 1 N/A 184 17.3 210 14.3 394 15.6 Pneumonia and Influenza 333 17.0 80 14.9 1 N/A 1 N/A 1 N/A 186 19.7 229 14.5 415 16.4 Chronic Lower Respiratory Diseases 804 42.5 125 23.8 5 N/A 2 N/A 2 N/A 420 43.2 523 35.3 943 38.1 Chronic Liver Disease and Cirrhosis 146 8.5 51 7.8 0 N/A 6 N/A 6 N/A 136 11.5 71 5.1 207 8.0 Septicemia 215 11.4 99 18.2 1 N/A 1 N/A 1 N/A 133 13.1 185 12.1 318 12.7 Nephritis, Nephrotic Syndrome, and Nephrosis 272 14.1 167 33.2 0 N/A 3 N/A 3 N/A 209 21.8 234 15.4 443 17.8 Unintentional Motor Vehicle Injuries 151 10.4 87 10.6 1 N/A 7 N/A 7 N/A 203 17.7 63 4.6 266 10.7 All Other Unintentional Injuries 576 34.0 133 21.1 1 N/A 9 N/A 9 N/A 391 38.2 339 22.8 730 29.3 Suicide 216 14.6 27 3.4 2 N/A 4 N/A 4 N/A 173 14.8 78 5.8 251 9.9 Homicide 50 4.0 97 10.9 1 N/A 2 N/A 2 N/A 123 10.4 33 2.6 156 6.3 Alzheimer's disease 700 34.5 141 32.9 0 N/A 1 N/A 1 N/A 229 26.6 616 37.3 845 33.8 Acquired Immune Deficiency Syndrome 18 N/A 72 9.6 1 N/A 0 N/A 0 N/A 70 5.8 24 2.0 94 3.8 Source: NC State Center for Health Statistics, County Health Databook. Technical Note: Rates based on fewer than 20 cases (indicated by N/A ) are unreliable and have been suppressed. Rates for Breast and Prostate Cancers have sex-specific denominators (female and male, respectively). 10 GCDHHS Division of Public Health Leading Causes of Death Data Brief 2015