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CHRONIC DISEASE HEALTH PROFILE REGIONS AND COUNTIES: TENNESSEE

METROPOLITAN COUNTIES

TENNESSEE DEPARTMENT OF HEALTH OFFICE OF POLICY, PLANNING & ASSESSMENT SURVEILLANCE, EPIDEMIOLOGY AND EVALUATION
DECEMBER 2011

TABLE OF CONTENTS

SECTION 1: STATE PROFILE TENNESSEE 1

SECTION 2: RANKINGS REGIONAL RANKINGS OF SELECTED INDICATORS COUNTY RANKINGS OF SELECTED INDICATORS COUNTY RANKINGS OF SELECTED INDICATORS BY RURAL REGION 15 16 20

SECTION 3: METROPOLITAN COUNTY PROFILES DAVIDSON HAMILTON KNOX MADISON SHELBY SULLIVAN 24 38 52 66 80 94

SECTION 4: TECHNICAL NOTES TECHNICAL NOTES 108

Tennessee
Demographics
Quick Facts
Median Age1:
1

37.3

Median Income : $42,943 Home Ownership1: 72.0% Unemployment1: 7.9% Crime Rate2 (per 1,000):
3

91.9

Teen Pregnancy Rate (per 1,000)

Population by Age, Gender and Race, 2005-2009


Age Gender Female Male NonHispanic White 1,025,898 1,699,802 1,315,508 698,898 4,740,106

Overall: 63.4

Race NonHispanic Black 298,159 410,678 226,209 81,004 1,016,050

Total Hispanic

White: 52.4 Black: 103.3 Infant Mortality4 (per 1,000) Overall: 8.1

<18 18-44 45-64 65+ Total

720,623 1,143,968 827,771 464,909 3,157,271

754,407 1,140,065 775,142 332,068 3,001,682

90,277 106,533 25,576 6,057 228,443

1,475,030 2,284,033 1,602,913 796,977 6,158,953

White: 5.6 Black: 15.2 Automobile Accident Deaths4 (per 100,000): 18.7

Demographics of Tennessee, 2005-20091


Male Female NH White NH Black Hispanic HS Graduate Families in Poverty Individuals in Poverty 0
12.2 16.1 48.7 51.3 77.0 16.5 3.7 82.0

20

40 Percent

60

80

100

Data Source: U.S. Census Bureau, American Community Survey, 2005-2009.

Data Source: Tennessee Bureau of Investigation. "Tennessee Incident Based Reporting System (TIBRS)" accessed July 26, 2011. http://www.tennesseecrimeonline.com/tibrspublic2005, 2007-2009. Data Source: Birth Statistical System, Fetal Death Statistical System, and Induced Abortion Statistical System. Tennessee Department of Health, Division of Health Statistics, 2007-2009.
4 3

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics, 2007-2009.

Tennessee
General Health
"Fair/Poor" Health1
40 40

Lacking Health Insurance1

Percent

Percent

20

20.5 20.5 21.3 19.9 20.7 18.1 19.4 19.5 18.8 18.3

20
11.9 10.7

13.0

12.7

11.8

14.0

13.2

14.7

16.6

15.7

0 2000

2002

2004

2006

2008

0 2000

2002

2004

2006

2008

Pneumonia and Influenza Vaccination Status1


100 80 Percent 60 40 20 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
52.3 76.7 55.4 61.3 60.8 63.5 63.8 66.5 65.3 64.3 63.9

50.8

55.0

53.1

53.0 41.6

53.0

57.0

54.1

55.7

Ever received pneumonia vaccination (age 65+)

Received flu shot in past 12 months (age 50+)


1

Prevalence for General Health Indicators Among Tennessee Adults 18+, 2009
Indicator Fair/Poor Health Status (%) Lacking Health Insurance (%) Ever Received Pneumonia Vaccination (%) Received Flu Shot in Past 12 Months (%) Mean # of Days of Poor Physical Health per Month (%) Mean # of Days of Poor Mental Health per Month (%)
3 2

Total 21.3 15.7 63.9 55.7 12.4 13.9

NH White 22.1 14.2 66.1 57.2 12.9 14.2

NH Black 20.6 20.0 44.5 43.7 10.9 13.5

Female 22.4 12.9 65.3 56.6 12.5 12.9

Male 20.1 18.9 62.0 54.7 12.4 15.3

1 2 3

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. Age 65+. Age 50+.

Tennessee
Behavioral Risk Factors
60 40 20
11.8 12.8 12.9 15.7 15.0 18.4 17.4 17.7 19.2 20.5 34.8 34.3 32.2 33.1 34.8 35.2 32.7

Overweight and Obesity1


35.0 35.2 36.1 36.5 35.4 36.8 35.4 37.0 34.9 36.5 36.7 36.8 36.1

Percent

22.9

23.4

24.5

25.0

27.2

27.4

28.8

30.7

31.2

32.9

0 1990

1992

1994

1996 1998 Overweight

2000

2002

2004 Obese

2006

2008

Nutrition and Physical Activity1


100
77.8 76.7

40

Cholesterol Screening and High Cholesterol1


33.1 30.6 30.2 30.7 30.6 34.6 32.9 34.2 33

80
62.9

73.4

73.7

Percent

63.1

62.4

63.8

61.2

64.1

Percent

60 40 20 0 2001

29.0

26.6

20

24.6 25.2 23.9 20.5 18.7

2003

2005

2007

2009

0 2000

2002

2004

2006

2008

Eating < 5 Fruit & Vegetables/Day Not Meeting Physical Activity Recommendations

Cholesterol Not Checked in 5 Years Ever Told Had High Cholesterol

Prevalence for Behavioral Risk Factors Among Tennessee Adults 18+, 20091
Risk factor Eating <5 Fruits & Vegetables per Day (%) Not Meeting Physical Activity Recommendations (%) Overweight or Obese (%) Have Not Checked Cholesterol Within the Past 5 Years (%) Ever Told Had High Cholesterol (%) Ever Told Had High Blood Pressure (%) Total 76.7 64.1 69.1 18.7 33.0 32.7 NH White 75.3 63.6 66.9 18.3 34.1 32.5 NH Black 82.9 67.7 78.8 20.3 28.5 41.6 Female 73.9 66.8 64.4 16.7 32.0 33.5 Male 79.7 61.2 73.8 20.9 34.1 31.8

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

Tennessee
Cigarette & Alcohol Use
5 4 Cost in Dollars 3 2 1 0 1990 1993 1996 1999 Since 1990: 338.7% Increase in Cost per Pack 63.2% Decrease in Sales 2002 2005 Pack Sales Per Capita 2008

Cigarette Cost and Sales in Tennessee1

140 120 100 80 60 40 20 0

Average Cost Per Pack

Current Cigarette Smokers2


40 35 30 25.7 25 20 15 10 5 0 2000 20 15 Percent
10.5 27.8 24.4 25.7 26.1 26.8 22.6

24.3

23.2

22.1

Percent

2002

2004

2006

2008

Alcohol Use2

10 5

8.3 6.5 3.3 2.2

8.2

8.6

8.5

9 6.8 3.5 2.6 1.9

3.6

3.4

3.4

0 2002

2004

2006 Heavy Drinking

2008 Binge Drinking

Prevalence for Alcohol and Tobacco Use Among Tennessee Adults 18+, 20092
Indicator
Heavy Drinking (%) Binge Drinking (%) Current Smokers (%)
1 2

Total
1.9 6.8 22.1

NH White
2.3 6.5 22.3

NH Black
1.0 6.8 20.9

Female
1.9 4.6 19.7

Male
2.0 9.0 24.7

Data Source: Centers for Disease Control and Prevention (CDC) State Tobacco Activities Tracking and Evaluation (STATE) System. Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

Pack Sales Per Capita

Tennessee
Leading Causes of Death
Leading Causes of Death, Tennessee, 2007-20091 Rank
1 2 3 4 5 6 7 8 9 10
2 3

Cause
Heart Disease Cancer Chronic Lower Respiratory Diseases Stroke Accidents Alzheimer's Disease Diabetes Mellitus Influenza and Pneumonia Suicide Kidney Disease 1 2

# Deaths
42,982 39,629 10,157 9,857 9,574 6,880 5,174 4,204 2,737 2,670 3 4 5

Age Adjusted Mortality Rate and Demographic Ranking


Total 220.7 200.8 52.7 51.3 50.8 36.2 26.5 21.9 14.4 13.9 White 214.7 196.4 55.2 48.3 53.0 36.8 23.3 22.1 16.0 12.1 Black 272.4 242.4 33.6 73.0 40.7 32.0 52.7 19.6 6.3 28.6 Female 174.7 159.8 45.6 49.1 33.9 38.7 23.7 19.4 6.3 12.1 Male 284.2 264.3 65.5 53.7 70.5 30.8 30.2 26.7 23.5 17.1

Ranking Key:

All Cause Mortality by Race, Tennessee, 2007-20091


Total White Black Female Male 0 200 400 600 800 Deaths per 100,000 1000
741.3 1,107.4 895.0 871.9 1,073.1

1200

1 2 3

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjusted to the 2000 standard US population. Ranking order is based on counts for the total population. Demographic ranking is based on counts for each subgroup. Annual Mortality Rate per 100,000 population, age adjusted to the 2000 standard US population.

Tennessee
Heart Disease
Age Adjusted Mortality1 and Hospitalization2, Heart Disease
2000 Rate Per 100,000
1,525 1,528 1,545 1,545 1,549 1,505 1,456 1,436

1500 1000 500


297 293 279 284 273 253 245 233

1,357

1,323

1,242

223

226

213

0 1999

2001

2003

2005 Mortality

2007 2009 Hospitalization

Heart Disease Mortality1, Hospitialization2, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000) 220.7 1,306.8 White 214.7 1,144.7 Black 272.4 1,615.2 Female 174.7 1,069.4 Male 284.2 1,601.0

Heart Disease Prevalence3, 2009


Total Prevalence of MI4 (%) P Prevalence l of f CHD (%)
5

NH White 5.2 5.1 51

NH Black 3.6 2.5 25

Female 4.4 4.2 42

Male 5.1 4.8 48

4.7 4.5 45

Age Specific Mortality by Race, Heart Disease, 2007-20091


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 1000 2000 3000 Deaths per 100,000
58.4 37.7 163.0 119.6 416.5 244.6 854.6 533.9 1,826.1 1,451.3 3,996.9 4,433.6

Black White

4000

5000

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3 4 5

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. MI= Myocardial Infarction. CHD=Coronary Heart Disease.

Tennessee
Stroke
Age Adjusted Mortality1 and Hospitalization2, Stroke
500 Rate per 100,000
402 398 400 394

400 300 200 100


76 78 73 71

382

363

356

356

329

322

303

68

63

61

55

55

51

48

0 1999

2001

2003

2005 Mortality

2007

2009 Hospitalization

Stroke Mortality1, Hospitialization2, and Prevalence3, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000) Prevalence (%)
4

White 48.3 273.4 31 3.1

Black 73.0 431.1 34 3.4

Female 49.1 299.8 37 3.7

Male 53.7 342.0 22 2.2

51.3 318.0 30 3.0

Age Specific Mortality by Race, Stroke, 2007-20091


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 200 400 600 Deaths per 100,000 800 1000
18.2 5.6 44.3 14.7 96.6 35.1 217.9 106.2 517.8 387.1 1121.5 1138

Black White

1200

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3 4

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. 2009 data, NH white and NH black race groups.

Tennessee
CLRD1
600 Rate per 100,000 500 400 300 200 100
50 52 52 52 53 50 52 48 50 55 53 456 435

Age Adjusted Mortality2 and Hospitalization3, CLRD


441 454 459 429 457 417 461 400 451

0 1999

2001

2003

2005

2007 Mortality

2009 Hospitalization

Chronic Lower Respiratory Disease Mortality2 and Hospitialization3, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000) 52.7 437.5 White 55.2 402.8 Black 33.6 457.6 Female 45.6 481.1 Male 65.5 397.4

Asthma Prevalence, 20094


Total Ever Had Asthma (%) Currently Have Asthma (%) 11.9 8.3
4

NH White 12.8 8.9

NH Black 9.1 6.4

Female 11.9 9.5

Male 11.9 7.0


2

Prevalence of Self-Reported Current Asthma


12

Age Specific Mortality by Race, CLRD, 2007-2009


35-44
18.2 5.6 44.3 14.7 96.6 35.1 217.9 106.2 517.8 387.1

10
8.2 8.0

9.0 7.3 6.8 7.7

8.5

8.6

8.9 8.1

45-54

Age Group

Percent

55-64 65-74 75-84

Black White

6 4 2

85+ 0

1121.5 1138

2001
1 2

2003

2005

2007

2009

200

400 600 800 Deaths per 100,000

1000

1200

CLRD= Chronic Lower Respiratory Disease. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
4

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

Tennessee
Diabetes
Age Adjusted Mortality1 and Hospitalization2, Diabetes
Rate per 100,000 200 100
26 28 31 30 163 165 179 188 193 199 197 191 189 188 174

32

31

30

27

27

27

26

0 1999

2001

2003

2005

2007 Mortality

2009 Hospitalization

Diabetes Mortality1 and Hospitialization2, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000)
3

White 23.3 134.2


3

Black 52.7 409.8

Female 23.7 176.7

Male 30.2 192.7

26.5 183.7

Diabetes Prevalence and Diabetes Management Indicators , 2009


Total Prevalence (%) Self-Blood Glucose Monitoring at Least Once Daily (%) Foot Examined by a Doctor in Past 12 Months (%) Received a Dilated Eye Exam in past 12 Months (%) 10.3 73.8 72.7 68.2 NH White 10.4 75.5 73.5 68.1 NH Black 10.3 66.5 68.0 67.2 Female 10.6 76.3 67.4 63.4 Male 9.9 71.1 78.9 73.6

Age Specific Mortality by Race, Diabetes, 2007-20091


35-44 Age Group 45-54 55-64 65-74 75-84 85+ 0
1

13.3 6.2 30.6 16.7 75.2 36.9 192.2 71.3 393.2 159.7 551.4 300.1

Black White

100

200

300 Deaths per 100,000

400

500

600

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

Tennessee
Cancer
Age Adjusted Incidence1, Mortality1 and Hospitalization2, All Cancers
600 500 Rate per 100,000 400
407.6 399.8 208.7 390.8 202.7 473.2 444.2 470.8 475.8 473.3

300
206.7

371.0 199.2

367.4 194.5

200 100 0 2004

2005

2006 Incidence

2007 Mortality

2008 Hospitalization

Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 467.8 202.2 White 466.6 196.9 Black 468.1 249.8 Female 405.3 163.3 Male 559.1 260.5

Age Specific Mortality by Race, All Cancer, 2007-20093


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 500 1000 Deaths Per 100,000 1500
46.9 35.9 182.1 138.2 495.3 369.2 958.8 802.9 1,608.3 1355.5 1,834.9 1528.5

Black White

2000

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

10

Tennessee
Lung Cancer
120 100 Rate per 100,000
83.2 83.4 82.2 78.6 78.0

Age Adjusted Incidence1 and Mortality1, Lung Cancer

80 60 40 20 0 2004
67.7 69.5 67.4 65.3

63.0

2005

2006

2007 Incidence

2008 Mortality

Lung Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortalit (per 100,000) Mortality 100 000) 81.0 66 5 66.5 White 81.7 66 5 66.5 Black 77.8 66 5 66.5 Female 60.8 66 5 66.5 Male 108.8 66 5 66.5

Age Specific Mortality by Race, Lung Cancer, 2007-20092


35-44
5.9 7.3 48.2 41.9 148.9 134.2 316.2 329.2 430.1 453.8 327.1 317.4

45-54 Age Group

55-64

Black White

65-74

75-84

85+ 0
1

100

200 300 Deaths Per 100,000

400

500

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

11

Tennessee
Breast Cancer
140 120
121.1

Age Adjusted Incidence1 and Mortality1, Female Breast Cancer

Rate per 100,000

100 80 60 40 20

110.4

117.3

117.9

119.7

25.4

26.2

24.3

23.3

22.2

0 2004

2005

2006

2007 Incidence

2008 Mortality

Female Breast Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 117.3 24.3 White 116.9 22.4 Black 116.7 36.6

Age Specific Mortality by Race, Female Breast Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 50 100
13.8 8.0 46.8 23.9 88.2 50.3 98.1 75.4 158 114.6 275.7 142.1

Black White

150 Deaths Per 100,000

200

250

300

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

12

Tennessee
Colorectal Cancer
Age Adjusted Incidence1 and Mortality1, Colorectal Cancer
100 80 60 40
19.3 18.8 17.5 18.6 18.2 48.9 52.0 48.9 47.7 47.0

Rate per 100,000

20 0 2004

2005

2006

2007 Incidence

2008 Mortality

Colorectal Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 48.8 18.5 White 47.3 17.3 Black 58.6 28.4 Female 42.2 15.5 Male 57.5 22.6

Age Specific Mortality by Race, Colorectal Cancer, 2007-20092


35-44
6.7 3.9 21.9 13.7 52.3 31.9 107.1 60.1 179.5 121.7 252.3 179.4

45-54

Black White

Age Group

55-64

65-74

75-84

85+ 0 50 100 150 Deaths Per 100,000

200

250

300

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

13

Tennessee
Prostate Cancer
200

Age Adjusted Incidence1 and Mortality1, Prostate Cancer


156.7 153.2

Rate per 100,000

150
120.7

137.2

142.4

100

50

27.7

27.5

26.8

26.2

23.4

0 2004

2005

2006

2007
Incidence

2008
Mortality

Prostate Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 142.5 26.2 White 134.3 22.6 Black 205.7 63.1

Age Specific Mortality by Race, Prostate Cancer, 2007-20092


45-54
1.1 1.0 21.4 7.0 71.2 26.7 194.5 77.2 271.0 140.1

55-64 Age Group

65-74

Black White

75-84

85+ 0 50 100

150 Deaths Per 100,000

200

250

300

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

14

Regional Rankings of Selected Indicators, Tennessee*


South Central UpperCumberland 14 1 10 13 10 11 9 1 8 6 6 10 1 4 8 11 5 10 10 5 4 11 5 8 4 2 12 14 12 11 2 4 4 9 6 7 MidCumberland Northwest Southwest 12 2 1 7 5 8 3 6 11 12 2 3 6 14 6 5 8 14 4 2 2 4 4 2 3 7 7 6 1 7 3 14 13 6 2 4 Northeast Southeast Hamilton Davidson Madison Sullivan 7 10 11 4 11 3 8 7 1 1 9 7 8 7 3 4 10 10 6 10 13 3 2 14 13 13 4 4 8 1 10 2 3 3 12 9 Shelby 4 2 2 1 1 1 11 12 14 7 7 11 2 12 12 1 14 4 5 6 6 9 13 3 9 14 6 7 5 9 4 9 14 2 1 1 Knox 2 12 14 6 14 13 13 13 4 2 10 14 12 3 5 9 13 10 9 12 14 13 9 12 5 7 12 10 14 8 12 1 5 1 13 2

Indicator High School Education or Higher Individuals in Poverty Unemployment Crime Teen Pregnancy Infant Mortality Fair/Poor Health Status Lacking Health Insurance Ever Received Pneumonia Vaccination1 2 Received Flu Shot in Past 12 Months 3 Eating <5 F&V 4 Not Meeting PA Recommendations Overweight or Obese Cholesterol Not Checked Within the Past 5 Years Ever Told High Cholesterol Ever Told High Blood Pressure Current Cigarette Smoker Heavy Drinking Binge Drinking All Cause Mortality Heart Disease Mortality Myocardial Infarction Prevalence CHD5 Prevalence Stroke Mortality Stroke Prevalence CLRD6 Mortality Asthma Prevalence (Ever) Asthma Prevalence (Current) Diabetes Mortality Diabetes Prevalence Cancer Mortality Cancer Incidence Lung Cancer Incidence Breast Cancer Incidence Colorectal Cancer Incidence Prostate Cancer Incidence
* 1 2 3 4 5 6

4 11 12 2 2 10 14 9 6 10 14 13 13 2 9 14 7 7 1 9 10 14 11 10 12 12 10 12 4 14 9 6 8 4 8 6

11 8 9 8 8 12 1 3 5 5 1 1 5 8 1 3 2 7 7 8 12 5 10 11 7 4 2 1 8 4 6 3 2 5 10 5

East

3 13 8 5 6 4 11 14 13 13 11 9 14 11 10 10 11 2 3 13 8 8 14 9 14 6 14 11 7 6 13 5 10 6 11 3

6 6 6 3 3 2 6 8 12 8 4 5 3 10 14 13 12 9 2 14 11 12 7 1 11 11 11 12 6 2 14 13 12 14 4 11

1 14 13 14 13 14 10 11 2 9 12 8 9 6 13 12 9 1 11 11 9 7 11 5 5 9 5 8 13 13 11 8 9 6 7 8

8 4 6 12 12 8 5 10 3 3 13 4 11 13 4 7 5 13 14 7 3 1 1 13 2 3 8 3 10 10 8 11 7 12 14 14

9 4 4 10 7 5 7 4 6 4 3 6 7 5 6 2 1 3 12 1 1 2 3 4 1 5 3 5 3 3 1 12 1 13 5 13

9 8 5 8 4 6 4 5 10 11 8 12 4 9 2 8 3 6 13 4 5 6 8 7 8 9 9 9 11 12 4 7 6 11 3 12

13 7 3 11 9 7 2 2 9 14 5 2 10 1 11 6 4 4 8 3 7 10 6 6 10 1 1 2 2 5 7 10 11 10 9 10

Regional rankings are in descending order, where a rank of 1 indicates the highest value for that indicator among all regions.

For population age 65+. For population age 50+. Fruit and vegetable. Physical Activity. Coronary heart disease. Chronic lower respiratory disease.

Data Sources: U.S. Census Bureau, American Community Survey, 2005-2009: High School Education or Higher, Individuals in Poverty, Unemployment. Tennessee Bureau of Investigation, "Tennessee Incident Based Reporting System (TIBRS)" 2007-2009: Crime. Tennessee Birth Statistical System, Fetal Death Statistical System, and Induced Abortion Statistical System, 2007-2009: Teen Pregnancy. Tennessee Death Statistical System, 2007-2009: Infant Mortality, All Cause Mortality, Heart Disease Mortality, Stroke Mortality, CLRD Mortality, Diabetes Mortality. Tennessee Behavioral Risk Factor Surveillance System, 2009: Fair/Poor Health Status, Lacking Health Insurance, Ever Received Pneumonia Vaccination, Received Flu Shot in Past 12 Months, Eating <5 FV, Not Meeting PA Recommendations, Overweight or Obese, Cholesterol Not Checked Within the Past 5 Years, Ever Told High Cholesterol, Ever Told High Blood Pressure, Current Cigarette Smoker, Heavy Drinking, Binge Drinking, Myocardial Infarction Prevalence, CHD Prevalence, Stroke Prevalence, Asthma Prevalence Ever/Current, Diabetes Prevalence. Tennessee Cancer Registry, 2004-2008: Cancer Mortality, Cancer Incidence, Lung Cancer Incidence, Breast Cancer Incidence, Colorectal Cancer Incidence, Prostate Cancer Incidence.

15

County Rankings of Selected Indicators, Tennessee*


All Cause Mortality Diabetes Mortality CLRD1 Mortality Stroke Mortality Teen Pregnancy Infant Mortality Colorectal Cancer Incidence 57 67 75 37 22 71 31 80 44 29 61 43 79 56 84 57 4 74 12 50 35 64 5 2 46 61 37 Cancer Incidence Cancer Mortality High School Education and Higher Unemployment Heart Disease Mortality Individuals in Poverty Prostate Cancer Incidence 15 9 6 44 4 28 11 41 20 45 53 18 48 24 1 24 22 28 74 13 37 54 65 47 78 51 40 Breast Cancer Incidence 31 37 14 52 23 27 41 25 45 28 75 34 76 20 35 77 2 62 71 37 90 48 17 29 3 51 48 Lung Cancer Incidence 60 70 38 76 86 34 50 66 2 5 47 14 31 26 53 32 1 49 15 43 57 28 16 45 24 46 68

County

Metropolitan Counties Davidson 9 Hamilton 7 Knox 5 Madison 14 Shelby 9 Sullivan 18 East Region Anderson 17 Blount 7 Campbell 89 Claiborne 84 Cocke 77 Grainger 93 Hamblen 43 Jefferson 48 Loudon 13 Monroe 74 Morgan 67 Roane 22 Scott 59 Sevier 27 Union 91 Mid-Cumberland Region Cheatham 16 Dickson 24 Houston 26 Humphreys 20 Montgomery 2 Robertson 32

70 77 74 48 34 65 63 88 11 31 15 55 65 49 86 56 20 77 9 83 32 92 82 21 86 81 91

76 57 92 51 30 69 67 64 22 51 26 55 48 48 76 13 69 64 15 87 93 78 69 14 74 82 69

Crime 3 9 26 2 1 11 19 61 7 34 23 71 17 49 47 42 90 35 14 12 81 48 22 33 77 15 53

5 41 77 10 3 59 78 70 56 79 22 61 6 44 40 24 82 66 34 15 47 79 48 4 76 21 11

44 29 68 17 6 28 83 61 58 24 35 85 61 24 88 63 76 16 86 36 80 91 33 87 57 48 58

76 87 86 88 55 80 81 89 31 16 25 24 49 30 91 61 47 60 22 84 66 72 52 54 46 71 33

70 67 89 71 55 79 84 94 43 11 8 41 64 66 86 65 92 80 45 50 77 56 53 83 30 82 14

63 55 71 20 26 83 92 66 95 49 77 62 40 34 72 38 82 53 94 87 52 43 30 2 13 12 8

74 56 57 72 89 78 66 52 15 36 86 27 22 47 87 53 18 60 4 95 12 64 71 14 31 26 81

35 50 82 43 38 54 81 69 66 69 52 45 7 9 52 41 63 33 18 88 31 85 89 85 3 37 32

74 84 79 73 41 66 52 87 13 4 44 6 31 34 82 42 9 39 19 86 62 76 22 53 29 60 26

34 31 21 54 43 23 28 39 17 18 51 8 45 7 15 48 1 55 37 20 80 53 9 49 11 58 47

16

All Cause Mortality

Diabetes Mortality

CLRD1 Mortality

Stroke Mortality

Teen Pregnancy

Infant Mortality

Colorectal Cancer Incidence 80 6 48 34 63 55 89 71 . 82 83 89 64 76 16 53 44 32 51 59 8 47 54 26 18 41 40 21

Cancer Incidence

Cancer Mortality

High School Education and Higher

Unemployment

Heart Disease Mortality

Individuals in Poverty

County

Rutherford Stewart Sumner Trousdale Williamson Wilson Northeast Region Carter Greene Hancock Hawkins Johnson Unicoi Washington Northwest Region Benton Carroll Crockett Dyer Gibson Henry Lake Obion Weakley South Central Region Bedford Coffee Giles Hickman Lawrence Lewis

4 31 6 74 1 3 50 52 95 43 86 63 11 41 57 41 46 35 21 92 25 36 72 28 28 69 55 48

90 45 93 88 95 94 21 37 1 42 8 52 69 46 26 29 25 37 57 5 72 37 37 58 58 50 58 18

78 39 62 31 95 94 46 57 23 11 18 62 78 21 9 41 69 31 27 3 78 57 25 51 16 68 48 1

Crime

28 74 43 49 92 37 72 51 85 44 82 79 27 59 73 76 5 32 38 83 29 45 67 18 41 65 13 57

63 84 65 57 95 90 73 48 71 62 48 79 86 30 19 33 8 43 36 1 24 93 9 26 67 20 46 58

65 74 68 92 90 73 13 76 37 65 83 43 20 92 45 8 4 38 38 27 26 71 15 51 68 7 76 30

90 28 83 37 94 79 68 38 6 57 82 13 77 2 7 27 42 17 23 1 39 63 29 56 44 62 64 8

72 4 74 47 90 60 46 19 22 62 91 17 54 2 3 1 35 38 9 25 33 63 10 68 24 93 68 5

63 84 63 6 49 23 70 68 32 93 59 57 78 27 39 56 41 13 11 81 60 80 36 19 21 89 88 29

61 72 67 1 90 80 50 33 8 41 40 23 77 28 79 92 48 75 61 3 29 35 64 58 45 53 46 76

76 28 78 75 89 68 45 56 11 74 17 59 71 42 34 48 84 15 67 4 14 10 83 80 29 72 29 1

83 36 67 50 92 71 55 15 64 71 63 21 78 25 14 77 51 15 59 1 35 27 20 28 69 32 46 9

52 22 36 86 39 71 89 42 82 58 88 65 46 30 10 60 83 37 61 72 41 78 63 19 74 33 14 73

74 48 54 72 90 79 72 17 84 39 80 67 61 9 7 22 57 25 36 10 40 63 64 40 68 8 13 71

47 60 44 78 10 56 86 30 53 59 84 22 21 58 26 7 78 40 56 46 66 67 36 63 72 15 16 91

Prostate Cancer Incidence 19 46 16 70 12 69 94 76 23 55 95 93 62 34 61 89 90 49 17 68 52 37 58 10 62 67 26 72

Breast Cancer Incidence

Lung Cancer Incidence

17

All Cause Mortality

Diabetes Mortality

CLRD1 Mortality

Stroke Mortality

Teen Pregnancy

Infant Mortality

Colorectal Cancer Incidence 19 7 51 94 1 25 88 73 11 26 76 69 42 59 15 86 92 39 91 48 85 20 9 13 3 24 36 87

Cancer Incidence

Cancer Mortality

High School Education and Higher

Unemployment

Heart Disease Mortality

Individuals in Poverty

County

Lincoln 33 Marshall 33 Maury 14 Moore 19 Perry 62 Wayne 65 Southeast Region Bledsoe 88 Bradley 30 Franklin 36 Grundy 94 Marion 61 McMinn 39 Meigs 60 Polk 76 Rhea 66 Sequatchie 52 Southwest Region Chester 54 Decatur 87 Fayette 23 Hardeman 90 Hardin 68 Haywood 63 Henderson 39 Lauderdale 82 McNairy 45 Tipton 12 Upper-Cumberland Region Cannon 51 Clay 83

76 46 85 83 13 63 14 72 80 2 68 50 11 54 30 23 71 44 77 34 24 4 62 7 27 53 75 43

82 38 61 90 66 7 11 43 46 45 43 51 23 28 5 55 34 74 18 16 28 2 20 4 8 31 84 9

Crime

38 64 8 86 68 84 94 21 54 69 58 6 36 46 56 70 62 74 66 40 10 4 20 16 63 25 89 87

32 16 28 94 87 92 18 52 88 83 53 54 42 17 7 27 91 14 51 22 38 13 45 2 38 54 85 68

31 4 33 92 19 79 17 71 40 9 20 47 48 11 14 11 31 3 74 80 67 1 58 9 41 48 89 53

51 40 59 95 69 53 48 78 70 3 20 43 14 65 18 36 85 9 67 73 41 26 35 34 11 32 75 45

20 28 81 95 57 21 29 61 78 27 49 88 51 58 39 76 36 23 37 52 26 6 13 15 12 32 84 40

37 46 35 54 51 43 5 73 17 48 28 23 16 86 25 47 57 15 66 69 4 22 1 75 10 74 43 60

94 63 59 84 49 43 30 68 38 5 13 42 18 38 20 16 90 69 51 83 88 93 85 44 16 24 32 24

87 91 48 23 57 61 93 35 39 45 20 12 44 8 16 73 6 24 2 5 61 19 27 25 64 64 58 94

56 37 68 95 11 32 94 80 80 47 3 56 93 18 43 24 90 49 70 65 38 23 60 7 48 12 89 58

70 13 27 95 15 75 91 81 57 29 44 77 4 35 2 66 92 79 94 64 84 85 67 62 32 50 68 90

78 42 37 94 20 34 80 92 77 30 27 87 11 18 4 85 93 19 95 75 44 88 62 65 56 57 89 91

42 11 12 . 64 54 70 50 68 9 24 73 8 68 1 81 18 83 93 61 80 87 13 88 5 55 89 94

Prostate Cancer Incidence 83 35 27 64 21 85 73 87 36 50 57 71 28 86 42 59 88 91 75 33 92 14 60 32 80 8 56 77

Breast Cancer Incidence

Lung Cancer Incidence

18

All Cause Mortality

Diabetes Mortality

CLRD1 Mortality

Stroke Mortality

Teen Pregnancy

Infant Mortality

Colorectal Cancer Incidence 78 23 10 66 13 69 68 32 30 93 17 26

Cancer Incidence

Cancer Mortality

High School Education and Higher

Unemployment

Heart Disease Mortality

Individuals in Poverty

County Cumberland Dekalb Fentress Jackson Macon Overton Pickett Putnam Smith Van Buren Warren White
1

38 69 79 79 77 79 56 57 46 84 73 71

58 6 3 10 15 32 17 19 65 28 41 34

34 5 39 34 34 85 89 87 86 90 60 41

Crime

29 31 52 88 80 78 95 24 91 93 59 55

29 35 69 74 12 71 89 75 63 60 37 31

55 22 23 92 54 80 2 51 46 64 55 41

92 12 10 5 4 21 58 74 15 93 50 19

75 44 16 7 18 31 48 59 73 87 34 41

90 7 85 9 33 18 91 79 3 75 42 31

82 21 11 9 7 10 2 55 6 34 70 37

92 55 21 50 77 25 95 60 13 40 79 21

91 45 8 75 2 17 88 54 5 85 30 40

26 55 6 87 24 76 12 3 69 93 25 5

82 28 3 55 22 33 6 21 52 83 51 12

32 33 65 82 6 92 85 4 74 43 39 18

*County rankings are in descending order, where a rank of 1 indicates the highest value for that indicator among all counties. Chronic lower respiratory disease. Data Sources: U.S. Census Bureau, American Community Survey, 2005-2009: High School Education or Higher, Individuals in Poverty, Unemployment. Tennessee Bureau of Investigation, "Tennessee Incident Based Reporting System (TIBRS)" 2007-2009: Crime. Tennessee Birth Statistical System, Fetal Death Statistical System, and Induced Abortion Statistical System, 2007-2009: Teen Pregnancy. Tennessee Death Statistical System, 2007-2009: Infant Mortality, All Cause Mortality, Heart Disease Mortality, Stroke Mortality, CLRD Mortality, Diabetes Mortality. Tennessee Cancer Registry, 2004-2008: Cancer Mortality, Cancer Incidence, Lung Cancer Incidence, Breast Cancer Incidence, Colorectal Cancer Incidence, Prostate Cancer Incidence.

Prostate Cancer Incidence 7 79 5 81 43 81 31 3 66 84 39 2

Breast Cancer Incidence

Lung Cancer Incidence

19

County Rankings of Selected Indicators by Rural Region, Tennessee*


Stroke Mortality Infant Mortality Teen Pregnancy Prostate Cancer Incidence 2 11 5 12 14 4 13 7 1 7 6 9 15 3 10 8 9 6 12 7 4 3 5 2 11 1 10 6 High School Education and Higher Unemployment Breast Cancer Incidence 8 3 9 4 12 5 13 2 6 14 1 10 11 7 15 7 3 4 1 9 7 6 11 5 12 2 10 7 Heart Disease Mortality Individuals in Poverty Lung Cancer Incidence Colorectal Cancer Incidence 4 14 7 3 11 6 13 9 15 10 1 12 2 8 5 11 2 1 6 9 5 12 3 7 4 10 8 5 All Cause Mortality CLRD Mortality Cancer Incidence 8 10 5 6 13 3 11 2 4 12 1 14 9 7 15 9 1 7 2 10 6 8 3 4 12 5 11 7 Diabetes Mortality 14 12 11 12 8 7 1 2 8 6 10 5 3 15 4 9 11 9 1 4 3 7 2 8 6 11 5 3 Cancer Mortality 11 15 4 1 10 2 6 7 13 9 3 8 5 14 12 10 1 6 3 7 2 11 4 8 5 12 9 3
1

County

East Region Anderson 3 Blount 1 Campbell 13 Claiborne 12 Cocke 11 Grainger 15 Hamblen 6 Jefferson 7 Loudon 2 Monroe 10 Morgan 9 Roane 4 Scott 8 Sevier 5 Union 14 Mid-Cumberland Region Cheatham 6 Dickson 8 Houston 9 Humphreys 7 Montgomery 2 Robertson 11 Rutherford 4 Stewart 10 Sumner 5 Trousdale 12 Williamson 1 Wilson 3 Northeast Region Carter 3

10 15 2 5 3 8 11 7 14 9 4 12 1 13 6 9 4 1 5 3 8 7 2 10 6 12 11 3

11 9 3 7 4 8 5 5 13 1 12 9 2 14 15 8 5 1 7 10 5 8 3 4 2 12 11 4

Crime 5 12 1 7 6 13 4 11 10 9 15 8 3 2 14 7 2 4 11 1 9 3 10 6 8 12 5 4

13 12 9 14 3 10 1 7 6 4 15 11 5 2 8 9 4 1 8 3 2 6 10 7 5 12 11 5

12 7 6 2 4 13 7 2 15 9 10 1 14 5 11 11 1 9 3 2 4 5 8 6 12 10 7 1

12 14 6 1 4 3 8 5 15 10 7 9 2 13 11 8 5 6 4 7 2 11 1 10 3 12 9 5

12 15 4 2 1 3 7 9 13 8 14 11 5 6 10 6 5 11 3 10 2 8 1 9 4 12 7 4

13 8 15 4 10 7 3 1 9 2 11 6 14 12 5 8 7 1 5 4 3 10 12 10 2 9 6 5

12 9 3 7 13 6 5 8 14 10 4 11 1 15 2 6 8 2 4 3 11 5 9 7 1 12 10 6

12 15 2 3 10 4 7 6 13 8 1 11 5 9 14 3 1 4 2 5 8 10 6 7 9 12 11 5

20

Stroke Mortality

Infant Mortality

Teen Pregnancy

County

Greene Hancock Hawkins Johnson Unicoi Washington Northwest Region Benton Carroll Crockett Dyer Gibson Henry Lake Obion Weakley South Central Region Bedford Coffee Giles Hickman Lawrence Lewis Lincoln Marshall Maury Moore Perry Wayne Southeast Region Bledsoe Bradley

4 7 2 6 5 1 5 8 5 7 3 1 9 2 4 12 3 3 11 8 7 5 5 1 2 9 10 9 1

4 1 5 2 6 7 7 3 4 2 5 8 1 9 5 3 6 6 5 6 2 10 4 12 11 1 9 3 9

5 3 1 2 6 7 3 2 6 8 5 4 1 9 7 4 7 3 10 6 1 11 5 8 12 9 2 2 5

3 7 2 6 5 1 6 7 8 1 3 4 9 2 5 9 3 5 8 2 6 4 7 1 12 10 11 10 2

1 4 3 1 6 7 5 3 6 2 8 7 1 4 9 1 4 9 3 7 8 6 2 5 12 10 11 3 6

6 3 5 7 4 2 9 7 2 1 5 5 4 3 8 3 8 9 2 10 5 6 1 7 12 4 11 5 10

3 1 4 7 2 6 2 3 6 8 4 5 1 7 9 2 7 4 9 10 1 5 3 8 12 11 6 7 10

2 3 6 7 1 5 2 3 1 7 8 4 5 6 9 2 8 5 11 8 1 3 6 10 12 7 4 2 7

4 1 7 3 2 6 3 4 6 5 2 1 9 7 8 5 1 2 12 11 3 6 8 4 10 9 7 1 9

3 1 5 4 2 7 2 8 9 5 7 6 1 3 4 9 6 2 5 3 10 12 8 7 11 4 1 6 10

4 1 7 2 5 6 6 5 7 9 4 8 1 3 2 10 9 3 8 3 1 11 12 5 2 6 7 10 5

1 5 6 4 2 7 4 2 9 7 3 8 1 6 5 3 4 11 5 8 1 9 7 10 12 2 5 10 7

1 5 3 6 4 2 2 1 5 9 3 6 7 4 8 7 4 10 6 2 9 8 1 5 12 3 11 10 9

1 7 2 6 4 3 2 1 4 8 5 6 3 7 9 8 6 9 1 2 10 11 7 5 12 3 4 7 10

3 4 5 6 2 1 6 2 1 9 3 5 4 7 8 5 8 10 3 4 11 6 1 2 . 9 7 8 5

2 . 3 4 5 1 9 2 7 4 3 6 8 1 5 11 7 3 9 8 5 4 2 10 12 1 6 10 7

Prostate Cancer Incidence 4 1 2 7 5 3 2 6 8 9 4 1 7 5 3 6 1 7 9 3 10 11 5 4 8 2 12 8 10

High School Education and Higher

Unemployment

Breast Cancer Incidence

Heart Disease Mortality

Individuals in Poverty

Lung Cancer Incidence

Colorectal Cancer Incidence

All Cause Mortality

CLRD Mortality

Cancer Incidence

Diabetes Mortality

Cancer Mortality

Crime

21

Stroke Mortality

Infant Mortality

Teen Pregnancy

County

Franklin 2 Grundy 10 Marion 6 McMinn 3 Meigs 5 Polk 8 Rhea 7 Sequatchie 4 Southwest Region Chester 5 Decatur 9 Fayette 2 Hardeman 10 Hardin 7 Haywood 6 Henderson 3 Lauderdale 8 McNairy 4 Tipton 1 Upper-Cumberland Region Cannon 3 Clay 13 Cumberland 1 Dekalb 6 Fentress 10 Jackson 10 Macon 9 Overton 10 Pickett 4 Putnam 5 Smith 2 Van Buren 14

10 1 8 6 2 7 5 4 9 6 10 5 3 1 8 2 4 7 14 11 12 2 1 3 4 8 5 6 13 7

8 7 5 9 3 4 1 10 9 10 5 4 7 1 6 2 3 8 9 2 3 1 6 3 3 10 13 12 11 14

5 8 7 1 3 4 6 9 7 10 9 6 2 1 4 3 8 5 11 9 2 3 4 10 8 7 14 1 12 13

10 9 7 8 5 2 1 4 10 3 8 4 5 2 7 1 5 9 13 8 2 4 9 11 1 10 14 12 7 6

7 1 6 8 9 2 4 2 4 2 9 10 8 1 7 3 5 6 13 7 9 2 3 14 8 12 1 6 5 11

9 1 4 6 2 8 3 5 10 1 8 9 7 3 6 5 2 4 12 8 13 4 3 2 1 7 10 11 5 14

9 1 4 10 5 6 3 8 8 5 9 10 6 1 3 4 2 7 13 6 12 8 2 1 3 4 9 10 11 14

3 8 6 4 2 10 5 7 6 4 7 8 2 5 1 10 3 9 8 9 13 2 12 3 6 4 14 11 1 10

7 1 2 9 4 7 5 3 9 5 4 6 8 10 7 3 1 2 9 8 14 7 6 4 3 5 1 12 2 10

6 8 4 2 7 1 3 9 3 5 1 2 8 4 7 6 9 9 8 13 12 7 2 6 10 4 14 9 1 5

7 5 1 6 9 2 4 3 10 6 9 8 4 3 7 1 5 2 13 9 14 7 3 10 1 4 12 8 2 11

6 3 5 8 2 4 1 7 9 6 10 4 7 8 5 3 1 2 9 13 7 8 3 12 5 11 4 1 10 14

6 5 4 9 2 3 1 8 9 1 10 7 2 8 5 6 3 4 13 14 11 6 1 10 5 7 2 4 9 12

6 3 4 9 2 6 1 10 3 7 10 5 6 8 2 9 1 4 12 14 4 5 8 10 2 13 11 1 9 7

1 3 8 6 4 5 2 9 10 6 9 7 8 4 2 3 1 5 8 13 12 4 1 9 2 11 10 7 6 14

Prostate Cancer Incidence 2 4 5 7 1 9 3 6 8 9 6 4 10 2 5 3 7 1 8 10 4 11 3 12 7 12 5 2 9 14

High School Education and Higher

Unemployment

Breast Cancer Incidence

Heart Disease Mortality

Individuals in Poverty

Lung Cancer Incidence

Colorectal Cancer Incidence

All Cause Mortality

CLRD Mortality

Cancer Incidence

Diabetes Mortality

Cancer Mortality

Crime

22

Stroke Mortality

Infant Mortality

Teen Pregnancy

County Warren White


1

8 7

10 9

8 7

6 5

5 3

9 4

9 6

5 7

7 5

13 11

11 2

5 6

6 2

8 3

6 3

3 5

*County rankings are in descending order, where a rank of 1 indicates the highest value for that indicator among all counties. Chronic lower respiratory disease. Data Sources: U.S. Census Bureau, American Community Survey, 2005-2009: High School Education or Higher, Individuals in Poverty, Unemployment. Tennessee Bureau of Investigation, "Tennessee Incident Based Reporting System (TIBRS)" 2007-2009: Crime. Tennessee Birth Statistical System, Fetal Death Statistical System, and Induced Abortion Statistical System, 2007-2009: Teen Pregnancy. Tennessee Death Statistical System, 2007-2009: Infant Mortality, All Cause Mortality, Heart Disease Mortality, Stroke Mortality, CLRD Mortality, Diabetes Mortality. Tennessee Cancer Registry, 2004-2008: Cancer Mortality, Cancer Incidence, Lung Cancer Incidence, Breast Cancer Incidence, Colorectal Cancer Incidence, Prostate Cancer Incidence.

Prostate Cancer Incidence 6 1

High School Education and Higher

Unemployment

Breast Cancer Incidence

Heart Disease Mortality

Individuals in Poverty

Lung Cancer Incidence

Colorectal Cancer Incidence

All Cause Mortality

CLRD Mortality

Cancer Incidence

Diabetes Mortality

Cancer Mortality

Crime

23

Davidson
Demographics
Quick Facts
Median Age1: Median Income1: Home Ownership : Unemployment : Crime Rate (per 1,000) :
3 2 1 1

34.3 $ 45,828 61.5% 6.8% 135.7

Teen Pregnancy Rate (per 1,000)

Population by Age, Gender, and Race Distribution (2005-2009)


Age Gender Female Male NonHispanic White 65,570 158,497 100,626 52,401 377,094 Race NonHispanic Black 46,045 74,010 35,721 12,183 167,959

Overall:

81.6 66.9 101.1

Total Hispanic

White: Black:
4

Infant Mortality (per 1,000) Overall: 7.5 5.4 12.1 12.7

<18 18-44 45-64 65+ Total

67,983 134,860 76,385 40,844 320,072

70,256 134,733 70,242 26,162 301,393

18,550 24,215 5,252 1,021 49,038

138,239 269,593 146,627 67,006 621,465

White: Black: Automobile Accident Deaths4 (per 100,000):

Demographics, 2005-20091
Male Female NH White NH Black Hispanic HS Graduate Families in Poverty Individuals in Poverty 0
11.9 15.6 48.5 51.5 60.7 27.0 7.9 79.5

20

40 Percent

60

80

100

Data Source: U.S. Census Bureau, American Community Survey, 2005-2009.

Data Source: Tennessee Bureau of Investigation. "Tennessee Incident Based Reporting System (TIBRS)" accessed July 26, 2011. http://www.tennesseecrimeonline.com/tibrspublic2005, 2007-2009.

Data Source: Birth Statistical System, Fetal Death Statistical System, and Induced Abortion Statistical System. Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics, 2007-2009.

24

Davidson
General Health
60

"Fair/Poor" Health1

60

Lacking Health Insurance1

Percent

40 Percent
15.9

40
15.8 11.4 16.2 16.3

20

15.5

13.5

15.5

14.2

20

13.5

0 2005

2006

2007

2008

2009

0 2005

2006

2007

2008

2009

Pneumonia and Influenza Vaccination Status1


100 80 Percent 60 40
42.2 50.1 55.5 55.4 53.2 65.6 63.6 64.9 60.3 65.7

20 0 2005 2006 Ever received pneumonia vaccination (age 65+) 2007 2008 2009

Received flu shot in past 12 months (age 50+)


1

Prevalence for General Health Indicators Among Adults 18+, 2009


Indicator Fair/Poor Health Status (%) Lacking Health Insurance (%) Ever Received Pneumonia Vaccination2 (%) Received Flu Shot in Past 12 Months (%) Mean # of Days of Poor Physical Health per Month Mean # of Days of Poor Mental Health per Month
3

Total

NH White

NH Black

Female

Male

14.2 13.5 65.7 53.2 11.0 11.7

15.5 13.7 70.9 56.2 9.7 11.9

13.6 9.0 51.5 40.5 12.3 10.9

16.5 7.1 70.3 54.4 11.7 12.6

11.8 20.3 58.1 52.1 10.3 10.1

1 2 3

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. Age 65+. Age 50+.

25

Davidson
Behavioral Risk Factors
60

Overweight and Obesity1

40 Percent

35.8

35.5

33.3

33.0

34.7

20

27.0

31.8

28.0

29.5

29.2

0 2005

2006 Overweight

2007

2008 Obese

2009

100 80 60 Percent Perce 40 20 0 2005

Nutrition and Physical Activity1


70.0 68.5 69.7

60

Cholesterol Screening and High Cholesterol1


31.0 28.7 30.8

40
57.6

Percent Percen

63.8

61.2

20

22.6

25.4 21.6

2007
Eating <5 Fruit Vegetables/Day

2009

0 2005

2007
Cholesterol Not Checked in 5 Years Ever Told Had High Cholesterol

2009

Not Meeting Physical Activity Recommendations

Prevalence for Behavioral Risk Factors, 20091


Risk factor Eating <5 Fruits & Vegetables per Day (%) Not Meeting Physical Activity Recommendations (%) Overweight or Obese (%) Have Not Checked Cholesterol Within the Past 5 Years (%) Ever Told High Cholesterol (%) Ever Told High Blood Pressure (%)

Total
69.7 57.6 63.9 21.6 30.8 25.4

NH White
62.1 53.9 57.8 21.7 29.5 22.3

NH Black
83.2 67.7 78.8 17.9 32.5 36.6

Female
70.9 64.5 56.6 22.0 35.2 24.7

Male
68.5 50.1 71.3 21.1 26.6 26.2

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

26

Davidson
Cigarette & Alcohol Use

Current Cigarette Smokers1


40 35 30 25 22.6 20 15 10 5 0 2005

Percent

20.5

21.6 17.6 18.6

2006

2007

2008

2009

20 15 Percent Per 10 5
3.7 12.0 7.7

Alcohol Use1
11.8 9.0 13.1

3.1

3.2

3.2 1.8

0 2005

2006

2007 Heavy Drinking

2008 Binge Drinking

2009

Prevalence for Alcohol and Tobacco Use, 2009


Indicator Heavy Drinking (%) Binge Drinking (%) Current Smokers (%) Total 1.8 13.1 21.6 2.4 14.7 21.1

NH White

NH Black 0.6 6.0 20.8

Female 2.2 8.0 17.6

Male 1.3 18.5 25.8

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

27

Davidson
Leading Causes of Death
Leading Causes of Death, 2007-20091
Rank2 Cause # Deaths Age Adjusted Mortality Rate3 and Demographic Ranking Total White Black Female Male 211.0 195.5 48.2 49.1 48.1 31.4 29.3 17.3 12.9 12.4 198.6 185.6 52.1 53.1 43.6 32.0 21.9 17.2 6.6 14.6 266.5 245.9 38.7 34.2 67.1 30.2 60.5 18.2 26.9 7.2 167.6 157.5 34.6 43.8 46.3 31.9 26.2 16.2 3.8 6.1 273.3 262.5 63.8 59.7 50.3 29.4 33.8 20.2 21.8 19.5

1 2 3 4 5 6 7 8 9 9

Heart disease Cancer Accidents Chronic lower respiratory diseases Stroke Alzheimers disease Diabetes mellitus Influenza and pneumonia Homicide Suicide

3,637 3,329 855 822 821 532 503 298 222 222

Ranking Key:

All Cause Mortality by Race, 2007-20091,3


Total White Black Female Male 0 200 400 600 800 Deaths per 100,000 1000
718.1 1,089.7 869.2 820.3 1,087.7

1200

1 2 3

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjusted to the 2000 standard US population. Ranking order is based on counts for the total population. Demographic ranking is based on counts for each subgroup. Annual mortality rate per 100,000 population. Age adjusted to the 2000 standard US population.

28

Davidson
Heart Disease
2000 Rate Per 100,000
1,462

Age Adjusted Mortality1 and Hospitalization2, Heart Disease


1,449 1,437 1,393 1,409 1,373 1,354 1,323 1,270 1,289

1500 1000 500


298

1,229

1,174

1,063

286

286

276

265

268

255

237

238

221

218

221

194

0 1997

1999

2001

2003

2005 Mortality

2007 Hospitalization

2009

Heart Disease Mortality1 and Hospitialization2, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000)
3 Heart Disease Prevalence , 2009

White 198.6 1,041.4

Black 266.5 1,481.2

Female 167.6 925.1

Male 273.3 1,445.7

211.0 1,154.6

Total Prevalence of MI (%) Pre alence of CHD (%) Prevalence


5 4

NH White 3.6 46 4.6

NH Black 2.1 33 3.3

Female 1.9 42 4.2

Male 4.0 37 3.7

2.9 39 3.9

Age Specific Mortality by Race, Heart Disease, 2007-20091


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 1000 2000 3000 Deaths per 100,000 4000
52.6 32.5 154.9 97.5 384.1 227.2 847.4 438.3 1,768.8 1,324.0 4,145.7 4,562.1

Black White

5000

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to 2000 US standard population.
3 4 5

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. MI= Myocardial Infarction. CHD=Coronary Heart Disease.

29

Davidson
Stroke
Age Adjusted Mortality1 and Hospitalization2, Stroke
500 Rate per 100,000 400 300 200 100
76 65 73 80 70 69 69 55 52 53 50 49 46 380 367 370 384 361 343 347 329 328 321 280 274 258

0 1997

1999

2001

2003

2005 Mortality

2007

2009

Hospitalization

Stroke Mortality1, Hospitialization2, and Prevalence3, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000) Prevalence (%)
4

White 43.6 238.8 15 1.5

Black 67.1 363.0 36 3.6

Female 46.3 255.2 28 2.8

Male 50.3 294.3 11 1.1

48.1 270.6 20 2.0

Age Specific Mortality by Race, Stroke, 2007-20091


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 200 400 600 Deaths per 100,000 800
19.1 5.7 32.5 14.0 119.1 39.8 173.6 119.2 497.2 317.8 987.1 958.3

Black White

1000

1200

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3 4

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. 2009 data, NH white and NH black race groups.

30

Davidson
CLRD1
600 500 Rate per 100,000 400 300 200 100
45 43 47 43 48 49 53 48 46 48 47 54 47 434 392 429

Age Adjusted Mortality2 and Hospitalization3, CLRD


391 384 363 373 341 354 373 321 318 312

0 1997

1999

2001

2003

2005 Mortality

2007

2009 Hospitalization

Chronic Lower Respiratory Disease Mortality2 and Hospitialization3, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000) 49.1 334.4 White 53.1 304.6 Black 34.2 406.2 Female 43.8 384.8 Male 59.7 283.5

Asthma Prevalence, 20094


Total Ever Had Asthma (%) Currently Have Asthma (%) 9.2 5.7 NH White 11.5 7.3 NH Black 6.3 3.2 Female 10.6 7.0 Male 7.8 4.3

Prevalence of Self-Reported Current Asthma4


12
9.6

Age Specific Mortality by Race, CLRD, 2007-20092


35-44
4.8 3.4 8.9 24.2 41.3 64.6 117.4 206.1 286.8 416.4 482.6 720.8

10

9.1 7.6

45-54

Percent

Age Group

8 6 4
5.4 5.7

Black White

55-64 65-74 75-84

2 85+ 0

2005

2006

2007

2008

2009

200

400 600 Deaths per 100,000

800

1 2

CLRD= Chronic Lower Respiratory Disease. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
4

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

31

Davidson
Diabetes
Age Adjusted Mortality1, and Hospitalization2, Diabetes
Rate per 100,000 200 100
32 28 30 31 186 196 195 187 189 201 201 229 219 202 201 193 155

32

30

27

32

28

32

32

27

29

0 1997

1999

2001

2003

2005 Mortality

2007

2009 Hospitalization

Diabetes Mortality1 and Hospitialization2, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000)
3

White 21.9 116.0

Black 60.5 386.9


3

Female 26.2 183.1

Male 33.8 184.7

29.3 182.9

Diabetes Prevalence and Diabetes Management Indicators , 2009


Total Prevalence (%) Self-Blood Glucose Monitoring at Least Once Daily (%) Foot Examined by a Doctor in Past 12 Months (%) Received a Dilated Eye Exam in past 12 Months (%) 6.0 62.1 85.4 79.7 NH White 5.2 61.8 80.8 75.0 NH Black 5.6 66.4 96.8 92.3 Female 5.9 51.6 91.5 71.9 Male 6.1 72.8 80.0 87.3

35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0

23.9 4.6 47.2 16.2 85.1 36.9

Age Specific Mortality by Race, Diabetes, 2007-20091

194.0 69.5 439.8 144.3

Black White

614.2 283.3

100

200

300 400 Deaths per 100,000

500

600

700

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

32

Davidson
Cancer
Age Adjusted Incidence1 and Mortality1, All Cancers
600 500 Rate per 100,000 400 300
195.6 193.3 200.3 193.8 190.5 469.4 438.6 479.5 488.2 483.1

200 100 0 2004

2005

2006

2007 Incidence

2008 Mortality

Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 472.4 194.7 White 475.4 187.8 Black 479.4 233.5 Female 417.8 159.3 Male 561.8 252.4

Age Specific Mortality by Race, All Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 500 1000 1500 Deaths Per 100,000
49.4 27.4 183.0 132.5 459.4 323.0 985.2 707.8 1673.2 1376.9 1908.3 1583.2

Black White

2000

2500

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

33

Davidson
Lung Cancer
200

Age Adjusted Incidence1, and Mortality1, Lung Cancer

Rate per 100,000

150
89.1 74.5 75.8

100

79.8

85.2

50

65.2

63.6

69.2

61.9

59.6

0 2004

2005

2006

2007 Incidence

2008 Mortality

Lung Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortalit (per 100,000) Mortality 100 000) 80.9 63 9 63.9 White 82.4 64 3 64.3 Black 80.7 66 9 66.9 Female 64.7 48 3 48.3 Male 105.5 87 3 87.3

Age Specific Mortality by Race, Lung Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 100 200
263.2 362.5 1.6 5.7 62.0 36.6 133.7 108.6 311.4 285.6 564.1 454.7

Black White

300 Deaths Per 100,000

400

500

600

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

34

Davidson
Breast Cancer
200

Age Adjusted Incidence1 and Mortality1, Female Breast Cancer

Rate per 100,000

150
117.2 119.4 118.6

127.9

118.8

100

50
21.6

25.2

24.6

24.8

24.4

0 2004

2005

2006

2007 Incidence

2008 Mortality

Female Breast Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 120.4 24.2 White 121.9 22.2 Black 119.1 29.9

Age Specific Mortality by Race, Female Breast Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 50 100
23.9 3.7 43.5 27.0 83.5 56.1 62.0 86.2 87.7 101.5 366.2 153.4

Black White

150 200 250 Deaths Per 100,000

300

350

400

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

35

Davidson
Colorectal Cancer
Age Adjusted Incidence1 and Mortality1, Colorectal Cancer
100 80 60
45.2 44.8 47.2 47.3 49.6

Rate per 100,000

40 20
17.8 16.5 16.6 18.5 19.2

0 2004

2005

2006

2007 Incidence

2008 Mortality

Colorectal Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 46.9 17.7 White 44.7 15.9 Black 55.6 26.1 Female 40.6 14.5 Male 55.7 22.5

Age Specific Mortality by Race, Colorectal Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 50 100
11.2 4.0 1.4 10.2 58.3 30.5 102.1 47.2 143.4 107.7 307.1 183.3

Black White

150 200 Deaths Per 100,000

250

300

350

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

36

Davidson
Prostate Cancer
200

Age Adjusted Incidence1 and Mortality1, Prostate Cancer


168.5 152.4 164.0 143.2

Rate per 100,000

150
116.8

100

50

25.9

24.3

27.1

24.7

32.0

0 2004

2005

2006

2007
Incidence

2008
Mortality

Prostate Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 149.5 26.9 White 136.5 21.1 Black 206.7 60.1

Age Specific Mortality by Race, Prostate Cancer, 2007-20092


45-54 55-64 Age Group 65-74 75-84 85+ 0 200 400
6.5 2.1 49.0 17.7 241.1 59.5 441.9 192.3 1,387.5 546.8

Black White

600 800 1000 Deaths Per 100,000

1200

1400

1600

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

37

Hamilton
Demographics
Quick Facts
Median Age1: Median Income1: Home Ownership : Unemployment : Crime Rate (per 1,000) :
3 2 1 1

39.0 $ 45,557 69.9% 8.1% 94.4

Teen Pregnancy Rate (per 1,000)

Population by Age, Gender, and Race Distribution (2005-2009)


Age Gender Female Male NonHispanic White 47,734 86,441 70,826 39,819 244,820 Race NonHispanic Black 18,584 24,874 16,170 6,896 66,524

Overall:

61.7 49.2 95.7

Total Hispanic

White: Black:
4

Infant Mortality (per 1,000) Overall: 9.1 1.1 16.4 12.3

<18 18-44 45-64 65+ Total

35,782 60,618 47,419 28,403 172,222

37,697 58,401 43,309 19,312 158,719

4,112 4,094 1,401 343 9,950

73,479 119,019 90,728 47,715 330,941

White: Black: Automobile Accident Deaths4 (per 100,000):

Demographics, 2005-20091
Male Female NH White NH Black Hispanic HS Graduate Families in Poverty Individuals in Poverty 0
10.0 14.0 48.0 52.0 74.0 20.1 3.0 79.8

20

40 Percent

60

80

100

Data Source: U.S. Census Bureau, American Community Survey, 2005-2009.

Data Source: Tennessee Bureau of Investigation. "Tennessee Incident Based Reporting System (TIBRS)" accessed July 26, 2011. http://www.tennesseecrimeonline.com/tibrspublic2005, 2007-2009.

Data Source: Birth Statistical System, Fetal Death Statistical System, and Induced Abortion Statistical System. Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics, 2007-2009.

38

Hamilton
General Health
60

"Fair/Poor" Health1

60

Lacking Health Insurance1

Percent

40
21.4 18.5 16.5

40 Percent

20

18.3

14.8

20

12.2

9.3

11.5

13.5

10.4

0 2005

2006

2007

2008

2009

0 2005

2006

2007

2008

2009

Pneumonia and Influenza Vaccination Status1


100
76.7

80 Percent 60 40

67.1

67.1

62.7 53.7

53.8 43.8

55.8

56.8 48.4

20 0 2005 2006 Ever received pneumonia vaccination (age 65+) 2007 2008 2009

Received flu shot in past 12 months (age 50+)


1

Prevalence for General Health Indicators Among Adults 18+, 2009


Indicator Fair/Poor Health Status (%) Lacking Health Insurance (%) Ever Received Pneumonia Vaccination (%) Received Flu Shot in Past 12 Months (%) Mean # of Days of Poor Physical Health per Month Mean # of Days of Poor Mental Health per Month
3 2

Total

NH White

NH Black

Female

Male

16.5 10.3 53.7 48.4 8.9 11.7

14.6 7.0 54.3 49.0 8.8 11.9

25.5 23.0 35.8 29.7 8.4 9.4

18.3 12.6 60.8 49.9 10.4 10.3

14.4 7.8 41.0 46.2 6.9 14.1

1 2 3

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. Age 65+. Age 50+.

39

Hamilton
Behavioral Risk Factors
60

Overweight and Obesity1

40.6

40 Percent

32.4

33.6

35.7 31.0 32.4

20

27.3

25.7

27.8

25.8

0 2005

2006 Overweight

2007

2008 Obese

2009

100 80 60 Percent Perce 40 20 0 2005

Nutrition and Physical Activity1


73.8 71.7 73.8

60

Cholesterol Screening and High Cholesterol1


29.9 30.4

40 Percent Percen
63.2 64.7 63.6 27.7

20

25.0 17.3 16 8 16.8

2007
Eating <5 Fruit Vegetables/Day

2009

0 2005

2007
Cholesterol Not Checked in 5 Years Ever Told Had High Cholesterol

2009

Not Meeting Physical Activity Recommendations

Prevalence for Behavioral Risk Factors, 20091


Risk factor Eating <5 Fruits & Vegetables per Day (%) Not Meeting Physical Activity Recommendations (%) Overweight or Obese (%) Have Not Checked Cholesterol Within the Past 5 Years (%) Ever Told High Cholesterol (%) Ever Told High Blood Pressure (%)

Total
73.8 63.6 56.8 16.8 30.4 31.1

NH White
70.1 62.1 53.5 17.3 32.4 26.9

NH Black
86.2 80.3 76.3 17.2 32.2 47.7

Female
76.4 67.0 54.2 17.5 30.8 31.5

Male
70.7 59.5 59.5 16.1 30.0 30.7

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

40

Hamilton
Cigarette & Alcohol Use

Current Cigarette Smokers1


40 35 30 25 22.7 20 15 10 5 0 2005

22.6 17.6

23.5 17.6

Percent

2006

2007

2008

2009

20 15 Percent Per
10.0

Alcohol Use1
12.4 10.2 8.6 6.1 6.1 4.1 4.7 2.3 2.7

10 5 0 2005

2006

2007 Heavy Drinking

2008 Binge Drinking

2009

Prevalence for Alcohol and Tobacco Use, 2009


Indicator Heavy Drinking (%) Binge Drinking (%) Current Smokers (%) Total 2.7 10.2 17.6 3.0 9.1 18.5

NH White

NH Black 1.0 14.5 10.1

Female 3.5 10.7 17.8

Male 1.8 9.5 17.5

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

41

Hamilton
Leading Causes of Death
Leading Causes of Death, 2007-20091
Rank2 Cause # Deaths Age Adjusted Mortality Rate3 and Demographic Ranking Total White Black Female Male 213.6 183.9 54.6 49.7 41.2 40.8 27.4 13.7 13.4 11.1 200.8 177.1 54.9 48.4 42.7 42.7 22.7 13.6 15.1 8.6 288.7 226.8 54.7 55.0 34.3 34.7 54.0 13.7 7.2 26.7 169.7 145.7 46.4 49.1 44.2 26.8 24.7 12.9 6.7 9.1 275.5 245.9 69.0 49.7 34.5 58.0 31.7 14.7 20.6 15.2

1 2 3 4 5 6 7 8 9 10

Heart disease Cancer Chronic lower respiratory diseases Stroke Alzheimers disease Accidents Diabetes mellitus Influenza and pneumonia Suicide y disease Kidney

2,450 2,051 615 565 486 409 307 154 129 125

Ranking Key:

All Cause Mortality by Race, 2007-20091,3


Total White Black Female Male 0 200 400 600 800 Deaths per 100,000 1000
704.4 1,045.3 845.2 809.5 1,040.2

1200

1 2 3

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjusted to the 2000 standard US population. Ranking order is based on counts for the total population. Demographic ranking is based on counts for each subgroup. Annual mortality rate per 100,000 population. Age adjusted to the 2000 standard US population.

42

Hamilton
Heart Disease
2000 Rate Per 100,000 1500 1000 500
319 293 285 278 262 245 234 234 223 219 201 221 219 1,361 1,395

Age Adjusted Mortality1 and Hospitalization2, Heart Disease


1,348 1,357 1,412 1,422 1,442 1,367 1,275

1,230

1,168

1,118

1,053

0 1997

1999

2001

2003

2005 Mortality

2007 Hospitalization

2009

Heart Disease Mortality1 and Hospitialization2, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000)
3 Heart Disease Prevalence , 2009

White 200.8 1,050.1

Black 288.7 1,375.0

Female 169.7 857.6

Male 275.5 1,454.3

213.6 1,112.7

Total Prevalence of MI (%) Pre alence of CHD (%) Prevalence


5 4

NH White 4.7 16 1.6

NH Black 3.3 35 3.5

Female 4.8 25 2.5

Male 3.4 14 1.4

4.1 19 1.9

Age Specific Mortality by Race, Heart Disease, 2007-20091


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 1000 2000 3000 Deaths per 100,000
65.9 34.9 184.6 98.9 449.3 231.9 937.2 490.6 2,047.0 1,301.9 3,648.6 4,437.1

Black White

4000

5000

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to 2000 US standard population.
3 4 5

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. MI= Myocardial Infarction. CHD=Coronary Heart Disease.

43

Hamilton
Stroke
Age Adjusted Mortality1 and Hospitalization2, Stroke
500 Rate per 100,000 400 300 200 100
69 74 58 73 63 71 66 71 52 52 57 50 43 364 382 477 422 440 436 445 474 424 393 374 361 307

0 1997

1999

2001

2003

2005 Mortality

2007

2009

Hospitalization

Stroke Mortality1, Hospitialization2, and Prevalence3, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000) Prevalence (%)
4

White 48.4 320.9 15 1.5

Black 55.0 467.3 10 1.0

Female 49.1 315.8 16 1.6

Male 49.6 389.3 10 1.0

49.7 346.8 13 1.3

Age Specific Mortality by Race, Stroke, 2007-20091


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 200 400
8.2 5.1 46.2 12.3 84.9 25.3 166.0 104.1 419.5 403.7 602.2 1174.5

Black White

600 800 Deaths per 100,000

1000

1200

1400

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3 4

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. 2009 data, NH white and NH black race groups.

44

Hamilton
CLRD1
600 500 Rate per 100,000 400 300 200 100
39 45 49 54 63 62 59 65 63 50 48 61 54 358 321 357 315 308 316 326 305 313 265 245 281

Age Adjusted Mortality2 and Hospitalization3, CLRD

254

0 1997

1999

2001

2003

2005 Mortality

2007

2009 Hospitalization

Chronic Lower Respiratory Disease Mortality2 and Hospitialization3, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000) 54.6 260.0 White 54.9 238.1 Black 54.7 355.5 Female 46.4 289.2 Male 69.0 235.0

Asthma Prevalence, 20094


Total Ever Had Asthma (%) Currently Have Asthma (%) 7.2 5.8 NH White 5.5 4.1 NH Black 9.3 8.3 Female 9.5 8.3 Male 4.6 3.0

Prevalence of Self-Reported Current Asthma4


12

Age Specific Mortality by Race, CLRD, 2007-20092


35-44
4.1 2.1 21.3 23.6 89.9 63.8 244.1 211.4 402.7 469.3 495.9 694.0

10

9.6

45-54

Percent

6.5 5.5 3.9 5.8

Age Group

8 6 4

Black White

55-64 65-74 75-84

2 85+ 0

2005

2006

2007

2008

2009

200

400 600 Deaths per 100,000

800

1 2

CLRD= Chronic Lower Respiratory Disease. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
4

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

45

Hamilton
Diabetes
Age Adjusted Mortality1, and Hospitalization2, Diabetes
Rate per 100,000
211 227 203 229 232 239 222 225 218

200 100

157

156

167

183

21

27

24

23

33

31

27

30

25

23

25

29

28

0 1997

1999

2001

2003

2005 Mortality

2007

2009 Hospitalization

Diabetes Mortality1 and Hospitialization2, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000)
3

White 22.7 171.8

Black 54.0 452.2


3

Female 24.7 229.2

Male 31.7 218.3

27.4 221.9

Diabetes Prevalence and Diabetes Management Indicators , 2009


Total Prevalence (%) Self-Blood Glucose Monitoring at Least Once Daily (%) Foot Examined by a Doctor in Past 12 Months (%) Received a Dilated Eye Exam in past 12 Months (%) 11.7 68.0 71.6 69.7 NH White 11.1 74.2 73.1 70.6 NH Black 17.0 42.2 62.9 76.4 Female 11.0 61.9 57.7 52.1 Male 12.6 74.2 84.5 86.8

35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0

20.6 6.2 42.6 18.4 59.9 39.5 61.1

Age Specific Mortality by Race, Diabetes, 2007-20091

146.4 402.7 166.5

Black White

637.6 266.9

100

200

300 400 Deaths per 100,000

500

600

700

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

46

Hamilton
Cancer
Age Adjusted Incidence1 and Mortality1, All Cancers
600 500 Rate per 100,000 400 300
199.2 198.4 187.0 452.5 464.5 484.1 501.8 488.6

200 100 0 2004

170.6

177.1

2005

2006

2007 Incidence

2008 Mortality

Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 478.6 186.1 White 485.6 182.1 Black 456.8 212.8 Female 409.0 147.6 Male 581.7 246.6

Age Specific Mortality by Race, All Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 500 1000 Deaths Per 100,000 1500
45.3 51.3 174.0 98.9 469.2 259.2 800.5 721.8 1610.7 1312.0 1735.7 1566.0

Black White

2000

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

47

Hamilton
Lung Cancer
200

Age Adjusted Incidence1, and Mortality1, Lung Cancer

Rate per 100,000

150
93.5 76.7 78.3 75.2 69.1

100

50

66.5

64.9

61.9

56.8

49.1

0 2004

2005

2006

2007 Incidence

2008 Mortality

Lung Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortalit (per 100,000) Mortality 100 000) 78.3 59 7 59.7 White 79.0 58 6 58.6 Black 76.1 65 6 65.6 Female 60.2 43 8 43.8 Male 104.0 82 7 82.7

Age Specific Mortality by Race, Lung Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 50 100 150 200 250 Deaths Per 100,000 300
8.2 7.2 60.4 32.4 109.8 86.1 322.2 239.5 302.0 418.8 389.7 302.5

Black White

350

400

450

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

48

Hamilton
Breast Cancer
200

Age Adjusted Incidence1 and Mortality1, Female Breast Cancer

Rate per 100,000

150
120.2 109.1

132.9 111.9 114.2

100

50
20.7

30.1

25.1

16.6

18.8

0 2004

2005

2006

2007 Incidence

2008 Mortality

Female Breast Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 117.6 22.2 White 115.4 19.7 Black 128.6 34.3

Age Specific Mortality by Race, Female Breast Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 50 100
22.3 6.3 51.3 12.0 63.1 23.7 66.7 66.4 51.1 110.8 372.8 154.3

Black White

150 200 250 Deaths Per 100,000

300

350

400

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

49

Hamilton
Colorectal Cancer
Age Adjusted Incidence1 and Mortality1, Colorectal Cancer
100 80 60 40 20
13.6 14.4 17.3 12.0 11.7 48.7 42.4 49.2 42.1

Rate per 100,000

44.2

0 2004

2005

2006

2007 Incidence

2008 Mortality

Colorectal Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 45.3 13.8 White 44.5 13.0 Black 48.8 18.3 Female 40.9 10.9 Male 51.2 18.4

Age Specific Mortality by Race, Colorectal Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 50
4.1 3.1 0.0 9.6 49.9 13.2 78.1 49.6

Black White
218.1 103.4 141.7 172.0

100 150 Deaths Per 100,000

200

250

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

50

Hamilton
Prostate Cancer
Age Adjusted Incidence1 and Mortality1, Prostate Cancer
200
162.9 145.8 185.2 193.8

Rate per 100,000

150

129.5

100

50

33.2

33.6

33.0

27.6

31.8

0 2004

2005

2006

2007
Incidence

2008
Mortality

Prostate Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 164.3 31.7 White 155.5 27.0 Black 224.1 64.8

Age Specific Mortality by Race, Prostate Cancer, 2007-20092


45-54 55-64 Age Group 65-74 75-84 85+ 0 100 200 300 400 500 Deaths Per 100,000 600
7.9 3.6 44.8 10.4 188.5 87.5 537.1 261.9 738.6 615.7

Black White

700

800

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

51

Knox
Demographics
Quick Facts
Median Age1: Median Income1: Home Ownership : Unemployment : Crime Rate (per 1,000) :
3 2 1 1

37.0 $ 46,233 71.4% 5.6% 85.2

Teen Pregnancy Rate (per 1,000)

Population by Age, Gender, and Race Distribution (2005-2009)


Age Gender Female Male NonHispanic White 74,142 141,800 96,847 49,732 362,521 Race NonHispanic Black 10,130 15,616 8,493 3,347 37,586

Overall:

48 41.6 100.4

Total Hispanic

White: Black:
4

Infant Mortality (per 1,000) Overall: 5.6 1 12.6 15.2

<18 18-44 45-64 65+ Total

45,014 84,726 56,361 32,005 218,106

47,760 82,378 53,229 22,182 205,549

3,804 4,260 1,448 387 9,899

92,774 167,104 109,590 54,187 423,655

White: Black: Automobile Accident Deaths4 (per 100,000):

Demographics, 2005-20091
Male Female NH White NH Black Hispanic HS Graduate Families in Poverty Individuals in Poverty 0
10.0 14.7 48.5 51.5 85.6 8.9 2.3 80.1

20

40 Percent

60

80

100

Data Source: U.S. Census Bureau, American Community Survey, 2005-2009.

Data Source: Tennessee Bureau of Investigation. "Tennessee Incident Based Reporting System (TIBRS)" accessed July 26, 2011. http://www.tennesseecrimeonline.com/tibrspublic2005, 2007-2009.

Data Source: Birth Statistical System, Fetal Death Statistical System, and Induced Abortion Statistical System. Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics, 2007-2009.

52

Knox
General Health
60

"Fair/Poor" Health1

60

Lacking Health Insurance1

Percent

40
16.4 19.8 15.7

40 Percent

20

15.4 12.5

20
10.5 6.4

12.8

9.3

11.6

0 2005

2006

2007

2008

2009

0 2005

2006

2007

2008

2009

Pneumonia and Influenza Vaccination Status1


100
79.3 76.5 77.9

80 Percent 60 40 20
40.6 57.7 63.1

74.3

69.1

67.3

61.5

0 2005

2006 Ever received pneumonia vaccination (age 65+)

2007

2008

2009

Received flu shot in past 12 months (age 50+)


1

Prevalence for General Health Indicators Among Adults 18+, 2009


Indicator Fair/Poor Health Status (%) Lacking Health Insurance (%) Ever Received Pneumonia Vaccination2 (%) Received Flu Shot in Past 12 Months (%) Mean # of Days of Poor Physical Health per Month Mean # of Days of Poor Mental Health per Month
3

Total

NH White

NH Black

Female

Male

15.6 11.4 69.1 61.5 11.0 10.6

16.4 9.3 67.8 62.3 11.1 11.0

11.4 35.0 78.3 67.7 13.8 7.7

14.4 6.6 63.2 64.7 10.9 10.7

16.9 16.8 78.1 57.4 11.1 10.5

1 2 3

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. Age 65+. Age 50+.

53

Knox
Behavioral Risk Factors
60

Overweight and Obesity1

40 Percent

36.4

35.2

35.9 31.0

33.6

31.2

20

21.8

25.0

26.0

25.2

0 2005

2006 Overweight

2007

2008 Obese

2009

100 80 60 Percent Perce 40 20 0 2005

Nutrition and Physical Activity1


70.4 71.5 75.4

60

Cholesterol Screening and High Cholesterol1


34.6 29.9 34.9

40
58.7 56.9

Percent Percen

62.2

20
17.9 21.0 14 5 14.5

2007
Eating <5 Fruit Vegetables/Day

2009

0 2005

2007
Cholesterol Not Checked in 5 Years Ever Told Had High Cholesterol

2009

Not Meeting Physical Activity Recommendations

Prevalence for Behavioral Risk Factors, 20091


Risk factor Eating <5 Fruits & Vegetables per Day (%) Not Meeting Physical Activity Recommendations (%) Overweight or Obese (%) Have Not Checked Cholesterol Within the Past 5 Years (%) Ever Told High Cholesterol (%) Ever Told High Blood Pressure (%)

Total
75.4 56.9 64.7 21.0 34.9 31.5

NH White
74.7 54.1 65.2 19.8 34.2 29.9

NH Black
73.2 81.6 79.3 34.9 49.3 53.2

Female
69.3 58.6 58.2 15.9 48.1 31.2

Male
82.5 54.8 71.3 26.5 24.3 31.8

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

54

Knox
Cigarette & Alcohol Use

Current Cigarette Smokers1


40 35 30 25 21.8 20 15 10 5 0 2005

Percent

20.6 18.8

21.1 15.7

2006

2007

2008

2009

20 15 Percent Per 10 5
2.1

Alcohol Use1
13.4 11.3 11.2 7.0 2.7 1.2 6.0

6.7

1.6

0 2005

2006

2007 Heavy Drinking

2008 Binge Drinking

2009

Prevalence for Alcohol and Tobacco Use, 2009


Indicator Heavy Drinking (%) Binge Drinking (%) Current Smokers (%) Total 1.2 6.0 15.7 1.4 6.8 16.9

NH White

NH Black 0.0 0.0 9.0

Female 2.3 7.0 13.9

Male 0.0 4.8 17.6

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

55

Knox
Leading Causes of Death
Leading Causes of Death, 2007-20091
Rank2 Cause # Deaths Age Adjusted Mortality Rate3 and Demographic Ranking Total White Black Female Male 189.3 178.1 53.8 49.3 45.5 35.9 23.2 19.1 15.3 15.4 187.8 175.2 55.0 50.3 44.7 36.0 23.1 18.0 13.4 16.4 213.8 233.1 35.4 43.3 53.1 33.7 25.5 40.1 44.9 4.8 153.1 137.9 49.2 34.0 43.7 36.6 20.5 16.4 13.6 7.3 250.0 238.3 60.7 68.1 47.9 35.0 29.9 23.5 18.5 24.4

1 2 3 4 5 6 7 8 9 10

Cancer Heart disease Chronic lower respiratory diseases Accidents Stroke Alzheimers disease Influenza and pneumonia Diabetes mellitus Kidney disease Suicide

2,572 2,424 720 646 609 485 311 257 205 201

Ranking Key:

All Cause Mortality by Race, 2007-20091,3


Total White Black Female Male 0 200 400 600 800 Deaths per 100,000 1000
700.9 1,063.8 845.8 831.8 1,080.9

1200

1 2 3

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjusted to the 2000 standard US population. Ranking order is based on counts for the total population. Demographic ranking is based on counts for each subgroup. Annual mortality rate per 100,000 population. Age adjusted to the 2000 standard US population.

56

Knox
Heart Disease
2000 Rate Per 100,000 1500 1000 500
267 271 258 246 232 231 208 191 181 181 175 178 1,383 1,310

Age Adjusted Mortality1 and Hospitalization2, Heart Disease


1,268 1,241 1,290 1,242 1,275

1,186

1,168

1,088

1,051

963

968

266

0 1997

1999

2001

2003

2005 Mortality

2007 Hospitalization

2009

Heart Disease Mortality1 and Hospitialization2, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000)
3 Heart Disease Prevalence , 2009

White 175.2 723.1

Black 233.1 1,225.4

Female 137.9 771.2

Male 238.3 1,279.4

178.1 993.3

Total Prevalence of MI (%) Pre alence of CHD (%) Prevalence


5 4

NH White 3.2 48 4.8

NH Black 2.0 09 0.9

Female 2.1 66 6.6

Male 4.3 26 2.6

3.2 45 4.5

Age Specific Mortality by Race, Heart Disease, 2007-20091


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 500 1000 1500 2000 2500 Deaths per 100,000 3000
77.7 24.1 170.8 117.9 381.6 217.9 678.6 417.2 1,486.7 1,201.4 3,122.4 3,422.3

Black White

3500

4000

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to 2000 US standard population.
3 4 5

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. MI= Myocardial Infarction. CHD=Coronary Heart Disease.

57

Knox
Stroke
Age Adjusted Mortality1 and Hospitalization2, Stroke
500 Rate per 100,000 400 300 200 100
64 54 53 59 60 59 56 60 54 45 48 45 44 367 362 327 320 332

316

297

298

272

292

300 268 270

0 1997

1999

2001

2003

2005 Mortality

2007

2009

Hospitalization

Stroke Mortality1, Hospitialization2, and Prevalence3, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000) Prevalence (%)
4

White 44.7 203.1 32 3.2

Black 53.1 348.0 23 2.3

Female 43.7 265.4 23 2.3

Male 47.9 300.1 41 4.1

45.5 278.9 31 3.1

Age Specific Mortality by Race, Stroke, 2007-20091


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 200 400 600 Deaths per 100,000 800
7.1 7.2 44.3 15.9 78.3 30.9 135.7 84.9 389.4 374.6 821.7 1025.7

Black White

1000

1200

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3 4

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. 2009 data, NH white and NH black race groups.

58

Knox
CLRD1
600 500 Rate per 100,000 400 300 200 100
48 47 58 52 57 57 49 49 55 47 46 60 55 370 360 381 331

Age Adjusted Mortality2 and Hospitalization3, CLRD


412 405 338 336 337 296 294 287 279

0 1997

1999

2001

2003

2005 Mortality

2007

2009 Hospitalization

Chronic Lower Respiratory Disease Mortality2 and Hospitialization3, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000) 53.8 286.9 White 55.0 218.6 Black 35.4 404.7 Female 49.2 312.9 Male 60.7 258.0

Asthma Prevalence, 20094


Total Ever Had Asthma (%) Currently Have Asthma (%) 7.9 6.3 NH White 7.3 5.6 NH Black 14.9 14.9 Female 7.3 6.7 Male 8.7 5.8

Prevalence of Self-Reported Current Asthma4


16 14 12
11.9 14.2

Age Specific Mortality by Race, CLRD, 2007-20092


35-44 45-54
0.0 2.6 25.3 12.4 48.9 66.3 135.7 237.3 212.4 473.6 493.0 661.5

Percent

10 8 6 4 2 0
6.5

Age Group

9.3

Black White

55-64 65-74 75-84 85+

6.3

2005

2006

2007

2008

2009

200

400 600 Deaths per 100,000

800

1 2

CLRD= Chronic Lower Respiratory Disease. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
4

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

59

Knox
Diabetes
Age Adjusted Mortality1, and Hospitalization2, Diabetes
Rate per 100,000 200
134 125 134 123 128 139 140

134

128

125

136

124

123

100
24 23 28 26 28 21 31 21 20 22 19 19 19

0 1997

1999

2001

2003

2005 Mortality

2007

2009 Hospitalization

Diabetes Mortality1 and Hospitialization2, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000)
3

White 18.0 83.3

Black 40.1 315.4


3

Female 16.4 104.4

Male 23.5 156.9

19.1 129.0

Diabetes Prevalence and Diabetes Management Indicators , 2009


Total Prevalence (%) Self-Blood Glucose Monitoring at Least Once Daily (%) Foot Examined by a Doctor in Past 12 Months (%) Received a Dilated Eye Exam in past 12 Months (%) 11.0 73.1 78.5 89.8 NH White 12.3 73.1 78.7 90.4 NH Black 3.3 70.2 70.2 70.2 Female 8.7 75.6 74.9 83.2 Male 13.6 71.3 81.5 94.6

35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0

7.1 3.9 12.7 11.8 58.7 21.4

Age Specific Mortality by Race, Diabetes, 2007-20091

116.3 64.9 318.6 132.0

Black White

657.4 225.3

100

200

300 400 Deaths per 100,000

500

600

700

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

60

Knox
Cancer
Age Adjusted Incidence1 and Mortality1, All Cancers
600 500 Rate per 100,000 400 300
201.2 190.0 184.2 192.8 479.3 496.8 498.5 499.3 490.6

200 100 0 2004

179.9

2005

2006

2007 Incidence

2008 Mortality

Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 493.0 189.4 White 497.1 188.1 Black 441.2 227.4 Female 417.5 158.2 Male 602.2 237.8

Age Specific Mortality by Race, All Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 500 1000 1500 Deaths Per 100,000
35.3 36.5 139.2 130.8 479.4 346.0 853.0 719.4 1132.7 1337.3 2218.6 1586.5

Black White

2000

2500

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

61

Knox
Lung Cancer
200

Age Adjusted Incidence1, and Mortality1, Lung Cancer

Rate per 100,000

150
90.4

100

85.3

87.8

83.4

82.8

50

65.6

66.6

60.6

61.8

57.7

0 2004

2005

2006

2007 Incidence

2008 Mortality

Lung Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortalit (per 100,000) Mortality 100 000) 85.9 62 3 62.3 White 86.1 61 8 61.8 Black 86.9 77 9 77.9 Female 65.8 48 1 48.1 Male 113.1 82 4 82.4

Age Specific Mortality by Race, Lung Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 100 200
0.0 5.9 31.6 36.0 176.1 119.3 329.6 287.3 389.4 428.9 739.5 311.6

Black White

300 400 500 Deaths Per 100,000

600

700

800

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

62

Knox
Breast Cancer
200

Age Adjusted Incidence1 and Mortality1, Female Breast Cancer

Rate per 100,000

150
117.5

135.7

128.3

127.6

137.3

100

50

24.0

23.1

17.7

17.9

18.4

0 2004

2005

2006

2007 Incidence

2008 Mortality

Female Breast Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 129.1 20.2 White 130.2 20.1 Black 116.7 21.7

Age Specific Mortality by Race, Female Breast Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 50
32.3 63.5 53.6 100.1 212.1 142.7 26.1 6.5 48.4 25.5 54.0 43.9

Black White

100 150 Deaths Per 100,000

200

250

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

63

Knox
Colorectal Cancer
Age Adjusted Incidence1 and Mortality1, Colorectal Cancer
100 80 60
42.5 47.5 47.7

Rate per 100,000

43.4

38.4

40
19.2

20 0 2004

16.1

14.1

13.4

15.3

2005

2006

2007 Incidence

2008 Mortality

Colorectal Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 43.8 15.6 White 43.5 14.8 Black 44.2 29.5 Female 36.7 12.7 Male 53.6 19.4

Age Specific Mortality by Race, Colorectal Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 20 40 60 80 100 Deaths Per 100,000 120 140 160
0.0 7.2 0.0 11.2 48.9 25.8 96.9 50.0 106.2 81.5 164.3 167.8

Black White

180

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

64

Knox
Prostate Cancer
200
162.8

Age Adjusted Incidence1 and Mortality1, Prostate Cancer


176.9 156.4 165.3

191.6

Rate per 100,000

150

100

50
22.5 15.2 18.2

23.7

23.8

0 2004

2005

2006

2007
Incidence

2008
Mortality

Prostate Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 171.1 20.8 White 168.1 18.6 Black 215.9 61.7

Age Specific Mortality by Race, Prostate Cancer, 2007-20092


45-54 55-64 Age Group 65-74 75-84 85+ 0 200 400
13.3 2.4 64.3 12.3 96.9 55.6 417.5 189.1 1,459.9 532.4

Black White

600 800 1000 Deaths Per 100,000

1200

1400

1600

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

65

Madison
Demographics
Quick Facts
Median Age1: Median Income1: Home Ownership : Unemployment : Crime Rate (per 1,000) :
3 2 1 1

35.7 $ 39,743 69.1% 8.3% 133.7

Teen Pregnancy Rate (per 1,000)

Population by Age, Gender, and Race Distribution (2005-2009)


Age Gender Female Male NonHispanic White 12,517 21,030 16,507 9,183 59,237 Race NonHispanic Black 9,566 12,662 7,160 2,578 31,966

Overall:

73.2 45.3 112.5

Total Hispanic

White: Black:
4

Infant Mortality (per 1,000) Overall: 10.2 0.2 14.7 15.0

<18 18-44 45-64 65+ Total

11,700 18,329 12,795 7,108 49,932

12,505 17,549 11,541 4,819 46,414

1,104 1,455 310 30 2,899

24,205 35,878 24,336 11,927 96,346

White: Black: Automobile Accident Deaths4 (per 100,000):

Demographics, 2005-20091
Male Female NH White NH Black Hispanic HS Graduate Families in Poverty Individuals in Poverty 0
14.9 18.0 48.2 51.8 61.5 33.2 3.0 78.0

20

40 Percent

60

80

100

Data Source: U.S. Census Bureau, American Community Survey, 2005-2009.

Data Source: Tennessee Bureau of Investigation. "Tennessee Incident Based Reporting System (TIBRS)" accessed July 26, 2011. http://www.tennesseecrimeonline.com/tibrspublic2005, 2007-2009.

Data Source: Birth Statistical System, Fetal Death Statistical System, and Induced Abortion Statistical System. Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics, 2007-2009.

66

Madison
General Health
60

"Fair/Poor" Health1

60

Lacking Health Insurance1

Percent

40
25.1 17.2 15.9 19.6

40 Percent
15.5 12.9 16.8

20

19.3

20

13.9

15.4

0 2005

2006

2007

2008

2009

0 2005

2006

2007

2008

2009

Pneumonia and Influenza Vaccination Status1


100 80
60.4 63.7 54.5 51.1 38.7 58.6 57.3 57.4 50.0 49.1

Percent

60 40 20

0 2005

2006 Ever received pneumonia vaccination (age 65+)

2007

2008

2009

Received flu shot in past 12 months (age 50+)


1

Prevalence for General Health Indicators Among Adults 18+, 2009


Indicator Fair/Poor Health Status (%) Lacking Health Insurance (%) Ever Received Pneumonia Vaccination2 (%) Received Flu Shot in Past 12 Months (%) Mean # of Days of Poor Physical Health per Month Mean # of Days of Poor Mental Health per Month
3

Total

NH White

NH Black

Female

Male

25.0 15.4 57.3 57.4 12.4 11.3

21.6 11.8 59.2 60.3 12.8 11.1

33.9 22.2 47.0 49.3 11.0 10.1

27.5 17.3 63.7 53.3 11.4 10.1

22.3 13.0 48.2 62.1 13.8 14.2

1 2 3

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. Age 65+. Age 50+.

67

Madison
Behavioral Risk Factors
60

Overweight and Obesity1


41.0

38.2

38.8 34.7

38.3

40 Percent
30.7

30.2

20

28.4

32.1

31.2

0 2005

2006 Overweight

2007

2008 Obese

2009

100 80 60 Percent Perce 40 20 0 2005

Nutrition and Physical Activity1


79.7 74.3 79.3

60

Cholesterol Screening and High Cholesterol1

40 33.7
67.3

Percent Percen

64.5

67.9

24.8

25.6

20

23.8

22.6 17.1

2007
Eating <5 Fruit Vegetables/Day

2009

0 2005

2007
Cholesterol Not Checked in 5 Years Ever Told Had High Cholesterol

2009

Not Meeting Physical Activity Recommendations

Prevalence for Behavioral Risk Factors, 20091


Risk factor Eating <5 Fruits & Vegetables per Day (%) Not Meeting Physical Activity Recommendations (%) Overweight or Obese (%) Have Not Checked Cholesterol Within the Past 5 Years (%) Ever Told High Cholesterol (%) Ever Told High Blood Pressure (%)

Total
79.3 67.9 72.2 17.1 25.6 25.9

NH White
80.5 67.9 70.5 17.6 29.3 26.7

NH Black
81.8 65.8 78.9 18.1 18.8 26.1

Female
80.2 66.2 68.9 19.7 22.2 29.8

Male
78.2 70.0 75.7 14.2 28.7 21.7

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

68

Madison
Cigarette & Alcohol Use

Current Cigarette Smokers1


40 35 30 26.9 25 20 15 10 5 0 2005

21.5 17.0 18.1 17.0

Percent

2006

2007

2008

2009

20 15

Alcohol Use1
10.8

Percent Per

10 5

7.6 3.6

6.4

7.1

7.5

1.5

2.4 07 0.7

1.4

0 2005

2006

2007 Heavy Drinking

2008 Binge Drinking

2009

Prevalence for Alcohol and Tobacco Use, 2009


Indicator Heavy Drinking (%) Binge Drinking (%) Current Smokers (%) Total 1.4 10.8 17.0 2.2 10.8 16.9

NH White

NH Black 0.0 12.7 18.5

Female 0.7 6.6 14.3

Male 2.3 15.6 20.0

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

69

Madison
Leading Causes of Death
Leading Causes of Death, 2007-20091
Rank2 Cause # Deaths Age Adjusted Mortality Rate3 and Demographic Ranking Total White Black Female Male 209.0 181.1 61.5 49.6 36.9 33.3 28.0 16.0 14.9 14.3 197.3 170.0 51.6 53.6 38.9 35.0 17.8 15.9 18.2 13.8 246.3 213.4 90.8 33.0 34.1 28.7 64.1 16.0 7.0 17.1 171.0 145.0 56.7 43.8 22.4 30.8 23.0 12.2 5.0 17.4 264.0 238.6 66.8 63.0 54.8 37.0 34.8 21.0 26.4 9.6

1 2 3 4 5 6 7 8 9 10

Heart disease Cancer Stroke Chronic lower respiratory diseases Accidents Alzheimers disease Diabetes mellitus Influenza and pneumonia Suicide p Septicemia

651 547 190 145 111 105 86 50 45 44

Ranking Key:

All Cause Mortality by Race, 2007-20091,3


Total White Black Female Male 0 200 400 600 800 Deaths per 100,000 1000
694.9 1,056.8 844.9 785.5 1,019.0

1200

1 2 3

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjusted to the 2000 standard US population. Ranking order is based on counts for the total population. Demographic ranking is based on counts for each subgroup. Annual mortality rate per 100,000 population. Age adjusted to the 2000 standard US population.

70

Madison
Heart Disease
2000
1,584

Age Adjusted Mortality1 and Hospitalization2, Heart Disease


1,497 1,454 1,407 1,378 1,339 1,470 1,585 1,571 1,665 1,475 1,317 1,356

Rate Per 100,000

1500 1000 500

233

293

265

262

220

265

256

213

243

225

202

212

213

0 1997

1999

2001

2003

2005 Mortality

2007 Hospitalization

2009

Heart Disease Mortality1 and Hospitialization2, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000)
3 Heart Disease Prevalence , 2009

White 197.3 1,172.2

Black 246.3 1,951.0

Female 171.0 1,070.8

Male 264.0 1,780.5

209.0 1,381.7

Total Prevalence of MI (%) Pre alence of CHD (%) Prevalence


5 4

NH White 4.1 69 6.9

NH Black 2.0 05 0.5

Female 3.2 43 4.3

Male 3.5 52 5.2

3.3 47 4.7

Age Specific Mortality by Race, Heart Disease, 2007-20091


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 1000 2000 3000 Deaths per 100,000 4000
55.8 27.3 139.1 111.5 448.1 241.4 578.8 433.5 1,554.2 1,325.3 4,412.9 4,259.9

Black White

5000

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to 2000 US standard population.
3 4 5

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. MI= Myocardial Infarction. CHD=Coronary Heart Disease.

71

Madison
Stroke
Age Adjusted Mortality1 and Hospitalization2, Stroke
500 Rate per 100,000 400 300 200 100
81 85 93 85 85 68 96 59 67 67 57 70 58 370 330 374 341 373 382 379 360 367 355 337 280 293

0 1997

1999

2001

2003

2005 Mortality

2007

2009

Hospitalization

Stroke Mortality1, Hospitialization2, and Prevalence3, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000) Prevalence (%)
4

White 51.6 254.2 33 3.3

Black 90.8 438.1 04 0.4

Female 56.7 267.4 24 2.4

Male 66.8 346.4 21 2.1

61.5 302.9 23 2.3

Age Specific Mortality by Race, Stroke, 2007-20091


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 200 400 600 800 1000 Deaths per 100,000 1200
8.0 7.8 73.2 3.5 160.9 16.9 251.6 117.0 532.9 413.5 1497.2 1395.9

Black White

1400

1600

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3 4

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. 2009 data, NH white and NH black race groups.

72

Madison
CLRD1
700 600 Rate per 100,000 500 400 300 200 100
46 45 35 48 39 54 45 47 48 40 44 62 42 502 483 530

Age Adjusted Mortality2 and Hospitalization3, CLRD


514 461 410 414 354 441 388 420 461 407

0 1997

1999

2001

2003

2005 Mortality

2007

2009 Hospitalization

Chronic Lower Respiratory Disease Mortality2 and Hospitialization3, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000) 49.6 429.3 White 53.6 373.9 Black 33.0 508.1 Female 43.8 427.9 Male 63.0 446.8

Asthma Prevalence, 20094


Total Ever Had Asthma (%) Currently Have Asthma (%) 9.0 5.7 NH White 8.9 4.4 NH Black 8.9 8.0 Female 13.8 7.7 Male 3.6 3.6

Prevalence of Self-Reported Current Asthma4


10 9 8 7 6 5 4 3 2 1 0
2.2 6.4 8.0 9.5

Age Specific Mortality by Race, CLRD, 2007-20092


35-44 45-54
23.9 0.0 14.6 13.9 46.0 55.0 125.8 178.9 222.0 583.1 315.2 577.6

Percent

Age Group

5.7

Black White

55-64 65-74 75-84 85+

2005

2006

2007

2008

2009

200

400 600 Deaths per 100,000

800

1 2

CLRD= Chronic Lower Respiratory Disease. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
4

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

73

Madison
Diabetes
Age Adjusted Mortality1, and Hospitalization2, Diabetes
Rate per 100,000 300
194 259 226 174 164 192 145 34 38 37 41 234 221 229 238 248 208

200 100
39

35

27

28

28

32

31

25

28

0 1997

1999

2001

2003

2005 Mortality

2007

2009 Hospitalization

Diabetes Mortality1 and Hospitialization2, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000)
3

White 17.8 98.1

Black 64.1 537.8


3

Female 23.0 250.0

Male 34.8 217.1

28.0 231.3

Diabetes Prevalence and Diabetes Management Indicators , 2009


Total Prevalence (%) Self-Blood Glucose Monitoring at Least Once Daily (%) Foot Examined by a Doctor in Past 12 Months (%) Received a Dilated Eye Exam in past 12 Months (%) 13.0 75.9 55.4 67.3 NH White 13.3 71.7 51.9 60.1 NH Black 12.1 82.1 62.4 100.0 Female 13.5 71.1 50.6 55.7 Male 12.4 82.0 61.4 90.3

35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0

8.0 0.0 22.0 17.4 91.9 38.1

Age Specific Mortality by Race, Diabetes, 2007-20091

302.0 55.1 444.1 106.0

Black White

709.2 240.7

100

200

300 400 500 Deaths per 100,000

600

700

800

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

74

Madison
Cancer
Age Adjusted Incidence1 and Mortality1, All Cancers
600
510.8

500 Rate per 100,000 400 300 200 100

464.4 420.7

429.4

424.9

220.1

225.7 176.1 176.1 181.8

0 2004

2005

2006

2007 Incidence

2008 Mortality

Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 449.3 195.9 White 440.9 180.2 Black 467.8 241.1 Female 374.4 160.7 Male 556.6 248.4

Age Specific Mortality by Race, All Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 200 400 600 800 1000 Deaths Per 100,000 1200 1400
47.8 19.5 175.7 87.1 459.6 283.7 830.4 750.1 1332.2 1198.1 1497.2 1612.5

Black White

1600

1800

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

75

Madison
Lung Cancer
200

Age Adjusted Incidence1, and Mortality1, Lung Cancer

Rate per 100,000

150

100

87.3

80.2

76.0

79.8 61.4

50

68.0

71.1 47.9 52.4 56.2

0 2004

2005

2006

2007 Incidence

2008 Mortality

Lung Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortalit (per 100,000) Mortality 100 000) 76.7 59 0 59.0 White 74.1 53 3 53.3 Black 82.9 76 1 76.1 Female 51.6 38 1 38.1 Male 112.6 89 0 89.0

Age Specific Mortality by Race, Lung Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 50 100
236.4 288.8 8.0 3.9 43.9 27.9 114.9 72.0

Black White
327.1 295.9 355.2 360.5

150 200 250 Deaths Per 100,000

300

350

400

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

76

Madison
Breast Cancer
200

Age Adjusted Incidence1 and Mortality1, Female Breast Cancer

Rate per 100,000

150
113.4 121.5 96.4 105.0 103.6

100

50

25.2

23.5 ^

24.1

31.9

0 2004

2005

2006

2007 Incidence

2008 Mortality

Female Breast Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 108.1 23.3 White 105.8 22.4 Black 108.9 22.6

Age Specific Mortality by Race, Female Breast Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 50 100 150 Deaths Per 100,000 200
0.0 89.3 265.8 104.9 213.2 265.9 0.0 8.0 92.0 27.3 84.4 16.5

Black White

250

300

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

^ Indicates data has been suppressed due to small numbers.

77

Madison
Colorectal Cancer
Age Adjusted Incidence1 and Mortality1, Colorectal Cancer
100 80 60
43.0 66.3 56.8 53.4 42.3 22.3

Rate per 100,000

40 20
15.1 17.1 18.2 18.2

0 2004

2005

2006

2007 Incidence

2008 Mortality

Colorectal Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 52.2 18.3 White 50.6 15.6 Black 55.7 25.9 Female 42.4 13.1 Male 66.4 24.4

Age Specific Mortality by Race, Colorectal Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 50 100 150 Deaths Per 100,000
15.9 0.0 7.4 0.0 34.5 42.3 100.7 55.1 177.6 180.2 236.4 168.5

Black White

200

250

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

78

Madison
Prostate Cancer
200

Age Adjusted Incidence1, Prostate Cancer*

181.2

Rate per 100,000

150
122.3 111.7 121.1

123.5

100

50

0 2004

2005

2006

2007
Incidence

2008

Prostate Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 132.8 24.2 White 114.4 20.8 Black 196.9 38.6

Age Specific Mortality by Race, Prostate Cancer, 2007-20092


45-54 55-64 Age Group 65-74 75-84 85+ 0 100 200 300 400 Deaths Per 100,000 500
0.0 0.0 75.7 8.7 59.6 44.8 401.6 215.6 604.2 523.6

Black White

600

700

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

*All mortality trend data suppressed due to small numbers.

79

Shelby
Demographics
Quick Facts
Median Age1: Median Income1: Home Ownership : Unemployment : Crime Rate (per 1,000) :
3 2 1 1

34.1 $ 44,146 63.6% 9.6% 141.1

Teen Pregnancy Rate (per 1,000)

Population by Age, Gender, and Race Distribution (2005-2009)


Age Gender Female Male NonHispanic White 79,064 131,982 113,410 54,833 379,289 Race NonHispanic Black 145,623 184,412 101,383 33,398 464,816

Overall:

90.8 43.8 118.2

Total Hispanic

White: Black:
4

Infant Mortality (per 1,000) Overall: 12.6 0.6 18 14.8

<18 18-44 45-64 65+ Total

125,139 179,290 120,010 55,592 480,031

128,155 168,584 105,697 35,719 438,155

17,198 18,251 4,978 1,317 41,744

253,294 347,874 225,707 91,311 918,186

White: Black: Automobile Accident Deaths4 (per 100,000):

Demographics, 2005-20091
Male Female NH White NH Black Hispanic HS Graduate Families in Poverty Individuals in Poverty 0
15.2 19.3 41.3 50.6 4.5 79.5 47.7 52.3

20

40 Percent

60

80

100

Data Source: U.S. Census Bureau, American Community Survey, 2005-2009.

Data Source: Tennessee Bureau of Investigation. "Tennessee Incident Based Reporting System (TIBRS)" accessed July 26, 2011. http://www.tennesseecrimeonline.com/tibrspublic2005, 2007-2009.

Data Source: Birth Statistical System, Fetal Death Statistical System, and Induced Abortion Statistical System. Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics, 2007-2009.

80

Shelby
General Health
60

"Fair/Poor" Health1

60

Lacking Health Insurance1

Percent

40
18.9

40 Percent
16.6 18.8 11.2 13.4 12.6

20

14.9

12.6

15.7

20

18.2

0 2005

2006

2007

2008

2009

0 2005

2006

2007

2008

2009

Pneumonia and Influenza Vaccination Status1


100 80
59.2 59.4 66.8 54.2 50.5 57.8

Percent

60 40 20 0 2005 2006 Ever received pneumonia vaccination (age 65+)


47.4 47.6

49.6

49.0

2007

2008

2009

Received flu shot in past 12 months (age 50+)


1

Prevalence for General Health Indicators Among Adults 18+, 2009


Indicator Fair/Poor Health Status (%) Lacking Health Insurance (%) Ever Received Pneumonia Vaccination2 (%) Received Flu Shot in Past 12 Months (%) Mean # of Days of Poor Physical Health per Month Mean # of Days of Poor Mental Health per Month
3

Total

NH White

NH Black

Female

Male

16.5 12.5 49.0 57.8 9.0 13.8

11.6 6.7 54.2 63.7 9.3 11.4

23.3 17.4 43.5 47.4 9.5 16.1

21.7 12.2 47.9 56.2 9.5 11.1

10.6 12.9 50.7 60.1 8.3 18.0

1 2 3

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. Age 65+. Age 50+.

81

Shelby
Behavioral Risk Factors
60

Overweight and Obesity1


42.9

40 Percent

37.5 31.7 32.7 33.4

40.0

33.6 28.2

20

28.6

26.9

0 2005

2006 Overweight

2007

2008 Obese

2009

100 80 60 Percent Perce 40 20 0 2005

Nutrition and Physical Activity1


72.2 71.7 77.1

60

Cholesterol Screening and High Cholesterol1


32.0 25.8 29.1

40
58.4

Percent Percen

63.3

61.4

20

23.4 13.5 15.9 15 9

2007
Eating <5 Fruit Vegetables/Day

2009

0 2005

2007
Cholesterol Not Checked in 5 Years Ever Told Had High Cholesterol

2009

Not Meeting Physical Activity Recommendations

Prevalence for Behavioral Risk Factors, 20091


Risk factor Eating <5 Fruits & Vegetables per Day (%) Not Meeting Physical Activity Recommendations (%) Overweight or Obese (%) Have Not Checked Cholesterol Within the Past 5 Years (%) Ever Told High Cholesterol (%) Ever Told High Blood Pressure (%)

Total
77.1 61.4 73.6 15.9 29.1 41.8

NH White
72.6 58.7 70.0 10.4 34.7 38.3

NH Black
82.2 67.1 77.5 20.6 23.7 47.3

Female
69.0 65.6 69.1 16.6 30.0 45.6

Male
86.2 56.6 78.6 15.1 28.3 37.3

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

82

Shelby
Cigarette & Alcohol Use

Current Cigarette Smokers1


40 35 30 25.8 25 20 15 10 5 0 2005

22.8 18.2 18.8 14.8

Percent

2006

2007

2008

2009

20
14.5

Alcohol Use1
12.3 10.2 13.1 7.9 4.0 5.0 2.3

15 Percent Per 10
5.5 7.5

5 0 2005

2006

2007 Heavy Drinking

2008 Binge Drinking

2009

Prevalence for Alcohol and Tobacco Use, 2009


Indicator Heavy Drinking (%) Binge Drinking (%) Current Smokers (%) Total 2.3 7.9 14.8 4.3 11.1 12.0

NH White

NH Black 0.7 4.1 17.9

Female 1.6 6.5 16.3

Male 3.1 9.4 13.1

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

83

Shelby
Leading Causes of Death
Leading Causes of Death, 2007-20091
Rank2 Cause # Deaths Age Adjusted Mortality Rate3 and Demographic Ranking Total White Black Female Male 231.0 206.7 57.6 43.9 41.7 38.9 28.9 18.0 19.5 16.4 198.8 175.8 41.8 42.8 48.3 40.4 16.9 5.8 19.0 10.5 276.6 252.4 80.8 43.1 30.1 36.4 47.9 29.3 18.8 26.2 187.2 170.3 53.3 27.4 37.1 39.8 26.5 5.7 16.9 13.8 298.6 271.4 64.2 64.6 50.8 36.2 32.6 31.2 24.7 21.0

1 2 3 4 5 6 7 8 9 10

Heart disease Cancer Stroke Accidents Chronic lower respiratory diseases Alzheimers disease Diabetes mellitus Homicide Influenza and pneumonia y disease Kidney

5,577 5,100 1,382 1,172 968 880 715 494 463 391

Ranking Key:

All Cause Mortality by Race, 2007-20091,3


Total White Black Female Male 0 200 400 600 800 Deaths per 100,000 1000
761.3 1,147.0 777.9 1,090.3 914.8

1200

1400

1 2 3

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjusted to the 2000 standard US population. Ranking order is based on counts for the total population. Demographic ranking is based on counts for each subgroup. Annual mortality rate per 100,000 population. Age adjusted to the 2000 standard US population.

84

Shelby
Heart Disease
2000 Rate Per 100,000
1,519 1,557

Age Adjusted Mortality1 and Hospitalization2, Heart Disease


1,548 1,579 1,554 1,628 1,660 1,561 1,490 1,453 1,412 1,339 1,290

1500 1000 500


348 340 346 344 305 318 308 287 277 243

239

229

225

0 1997

1999

2001

2003

2005 Mortality

2007 Hospitalization

2009

Heart Disease Mortality1 and Hospitialization2, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000)
3 Heart Disease Prevalence , 2009

White 198.8 1,034.0

Black 276.6 1,726.6

Female 187.2 1,139.8

Male 298.6 1,629.7

231.0 1,346.7

Total Prevalence of MI (%) Pre alence of CHD (%) Prevalence


5 4

NH White 3.9 42 4.2

NH Black 4.5 31 3.1

Female 3.7 26 2.6

Male 4.1 41 4.1

3.9 34 3.4

Age Specific Mortality by Race, Heart Disease, 2007-20091


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 1000 2000 3000 Deaths per 100,000 4000
63.0 27.6 162.7 73.4 408.4 178.1 864.7 477.3 1,859.5 1,420.9 4,142.2 4,645.1

Black White

5000

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to 2000 US standard population.
3 4 5

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. MI= Myocardial Infarction. CHD=Coronary Heart Disease.

85

Shelby
Stroke
Age Adjusted Mortality1 and Hospitalization2, Stroke
500 Rate per 100,000 400 300 200
89 87 83 87 470 495 483 483 488 479 477 436 464 441 382 378 350

100 0 1997

79

84

73

73

73

63

65

57

51

1999

2001

2003

2005 Mortality

2007

2009

Hospitalization

Stroke Mortality1, Hospitialization2, and Prevalence3, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000) Prevalence (%)
4

White 41.8 275.7 36 3.6

Black 80.8 483.0 25 2.5

Female 53.3 361.6 42 4.2

Male 64.2 379.8 13 1.3

57.6 369.8 28 2.8

Age Specific Mortality by Race, Stroke, 2007-20091


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 200 400 600 800 Deaths per 100,000 1000
20.6 2.9 46.1 14.0 102.9 29.4 267.4 73.6 570.7 331.6 1174.0 1068.2

Black White

1200

1400

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3 4

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. 2009 data, NH white and NH black race groups.

86

Shelby
CLRD1
600 500 Rate per 100,000 400 300 200 100
42 46 43 45 41 38 43 40 44 36 46 40 38 375 355 372 365 360 377 378 362

Age Adjusted Mortality2 and Hospitalization3, CLRD


393 369 354 354

334

0 1997

1999

2001

2003

2005 Mortality

2007

2009 Hospitalization

Chronic Lower Respiratory Disease Mortality2 and Hospitialization3, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000) 41.7 347.6 White 48.3 247.7 Black 30.1 439.9 Female 37.1 368.4 Male 50.8 323.9

Asthma Prevalence, 20094


Total Ever Had Asthma (%) Currently Have Asthma (%) 11.2 7.5 NH White 11.2 9.3 NH Black 9.6 6.1 Female 11.2 8.3 Male 11.2 6.4

Prevalence of Self-Reported Current Asthma4


9
7.8 7.5 6.7 5.9

Age Specific Mortality by Race, CLRD, 2007-20092


35-44 45-54
2.6 1.2 16.2 6.3 39.4 36.7 98.4 173.4 246.9 448.3 388.6 793.1

8 7

Percent

Age Group

6 5 4 3 2 1 0

5.3

Black White

55-64 65-74 75-84 85+

2005

2006

2007

2008

2009

200

400 600 Deaths per 100,000

800

1000

1 2

CLRD= Chronic Lower Respiratory Disease. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
4

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

87

Shelby
Diabetes
Age Adjusted Mortality1, and Hospitalization2, Diabetes
Rate per 100,000 400 300 200 100
172 193 190 200 212 222 251 251 258 243 248 249 256

25

27

31

36

34

31

34

29

36

28

28

30

28

0 1997

1999

2001

2003

2005 Mortality

2007

2009 Hospitalization

Diabetes Mortality1 and Hospitialization2, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000)
3

White 16.9 113.0

Black 47.9 413.0


3

Female 26.5 230.2

Male 32.6 273.1

28.9 250.7

Diabetes Prevalence and Diabetes Management Indicators , 2009


Total Prevalence (%) Self-Blood Glucose Monitoring at Least Once Daily (%) Foot Examined by a Doctor in Past 12 Months (%) Received a Dilated Eye Exam in past 12 Months (%) 10.8 77.9 76.3 55.2 NH White 12.0 72.7 82.0 64.7 NH Black 11.1 85.1 46.4 46.6 Female 13.8 79.1 72.6 47.6 Male 7.4 75.4 84.0 71.6

35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0

13.2 5.9 26.9 11.1 71.9 34.3

Age Specific Mortality by Race, Diabetes, 2007-20091

173.9 58.2 352.7 103.2 487.8 194.2

Black White

100

200

300 Deaths per 100,000

400

500

600

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

88

Shelby
Cancer
Age Adjusted Incidence1 and Mortality1, All Cancers
600
503.2 484.6 471.5 460.2

500 Rate per 100,000


405.6

400 300
210.7 223.6 218.8

209.7

205.0

200 100 0 2004

2005

2006

2007 Incidence

2008 Mortality

Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 465.2 213.5 White 446.7 177.2 Black 484.4 271.8 Female 402.6 182.0 Male 563.7 267.1

Age Specific Mortality by Race, All Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 500 1000 Deaths Per 100,000 1500
48.7 22.3 175.4 88.9 512.8 274.8 1025.5 686.3 1686.3 1370.2 1885.1 1739.9

Black White

2000

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

89

Shelby
Lung Cancer
200

Age Adjusted Incidence1, and Mortality1, Lung Cancer

Rate per 100,000

150

100
67.0

74.8

67.5

62.1

63.3

50

57.7

63.3

62.1

56.4

58.6

0 2004

2005

2006

2007 Incidence

2008 Mortality

Lung Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortalit (per 100,000) Mortality 100 000) 67.0 59 6 59.6 White 61.4 52 8 52.8 Black 74.5 70 2 70.2 Female 53.2 44 4 44.4 Male 87.5 83 1 83.1

Age Specific Mortality by Race, Lung Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 100
264.6 424.9 7.4 5.3 40.7 18.4 147.7 79.5 301.9 233.9 432.8 421.2

Black White

200 300 Deaths Per 100,000

400

500

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

90

Shelby
Breast Cancer
200

Age Adjusted Incidence1 and Mortality1, Female Breast Cancer

Rate per 100,000

150
110.0

126.9

127.0

128.7

123.3

100

50

33.9

33.5

33.7

28.6

30.8

0 2004

2005

2006

2007 Incidence

2008 Mortality

Female Breast Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 123.3 32.1 White 124.4 24.0 Black 118.7 43.1

Age Specific Mortality by Race, Female Breast Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 50
11.5 2.4 45.0 16.3 97.7 53.7 141.1 76.3 220.8 121.7 338.0 93.8

Black White

100

150 200 250 Deaths Per 100,000

300

350

400

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

91

Shelby
Colorectal Cancer
Age Adjusted Incidence1 and Mortality1, Colorectal Cancer
100 80
62.6 62.3 50.5 51.8

Rate per 100,000

60 40

52.0

22.4

21.3

22.5

23.3

22.8

20 0 2004

2005

2006

2007 Incidence

2008 Mortality

Colorectal Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 55.8 22.4 White 47.5 16.2 Black 66.0 32.8 Female 49.6 19.8 Male 64.9 26.4

Age Specific Mortality by Race, Colorectal Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 50 100 150 Deaths Per 100,000 200
5.8 2.9 2.6 8.7 51.0 23.3 123.1 64.1 185.9 131.9 248.0 230.6

Black White

250

300

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

92

Shelby
Prostate Cancer
250 200 Rate per 100,000 150
115.7

Age Adjusted Incidence1 and Mortality1, Prostate Cancer


183.5 193.9 196.9 176.5

100 50
39.2 45.9 37.0 44.7 30.8

0 2004

2005

2006

2007
Incidence

2008
Mortality

Prostate Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 173.7 39.4 White 155.4 25.2 Black 203.5 71.2

Age Specific Mortality by Race, Prostate Cancer, 2007-20092


45-54 55-64 Age Group 65-74 75-84 85+ 0 200 400
0.0 4.9 45.9 11.3 177.3 51.3 647.2 244.0 1,265.4 562.0

Black White

600 800 Deaths Per 100,000

1000

1200

1400

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

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Demographics
Quick Facts
Median Age1: Median Income1: Home Ownership : Unemployment : Crime Rate (per 1,000) :
3 2 1 1

42.2 $ 39,106 76.8% 7.0% 97.5

Teen Pregnancy Rate (per 1,000)

Population by Age, Gender, and Race Distribution (2005-2009)


Age Gender Female Male NonHispanic White 30,051 47,421 42,411 26,041 145,924 Race NonHispanic Black 717 1,116 913 332 3,078

Overall:

55.4 55.3 64.3

Total Hispanic

White: Black:
4

Infant Mortality (per 1,000) Overall: 9.2 0.2 9.3 12.3

<18 18-44 45-64 65+ Total

15,856 25,092 22,712 15,578 79,238

16,660 24,811 21,390 11,215 74,076

654 638 157 175 1,624

32,516 49,903 44,102 26,793 153,314

White: Black: Automobile Accident Deaths4 (per 100,000):

Demographics, 2005-20091
Male Female NH White NH Black Hispanic HS Graduate Families in Poverty Individuals in Poverty 0
12.4 16.1 48.3 51.7 95.2 2.0 1.1 77.7

20

40 Percent

60

80

100

Data Source: U.S. Census Bureau, American Community Survey, 2005-2009.

Data Source: Tennessee Bureau of Investigation. "Tennessee Incident Based Reporting System (TIBRS)" accessed July 26, 2011. http://www.tennesseecrimeonline.com/tibrspublic2005, 2007-2009.

Data Source: Birth Statistical System, Fetal Death Statistical System, and Induced Abortion Statistical System. Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics, 2007-2009.

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General Health
60

"Fair/Poor" Health1

60

Lacking Health Insurance1

Percent

40
21.9 21.0 24.4 22.5 22.9

40 Percent
17.7

20

20

14.4

13.8

15.3

15.8

0 2005

2006

2007

2008

2009

0 2005

2006

2007

2008

2009

Pneumonia and Influenza Vaccination Status1


100 80 Percent 60
62.3 71.0 75.4 69.9 72.1 59.0 80.6 74.1

68.8

40 20

47.0

0 2005

2006 Ever received pneumonia vaccination (age 65+)

2007

2008

2009

Received flu shot in past 12 months (age 50+)


1

Prevalence for General Health Indicators Among Adults 18+, 2009


Indicator Fair/Poor Health Status (%) Lacking Health Insurance (%) Ever Received Pneumonia Vaccination2 (%) Received Flu Shot in Past 12 Months (%) Mean # of Days of Poor Physical Health per Month Mean # of Days of Poor Mental Health per Month
3

Total

NH White

NH Black

Female

Male

22.9 15.8 74.1 68.8 12.9 15.0

22.0 15.0 73.5 68.5 13.0 14.7

28.9 78.9 100.0 71.3 19.7 24.0

25.6 13.5 69.0 69.8 13.4 13.9

19.9 18.3 81.1 67.7 12.2 16.8

1 2 3

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. Age 65+. Age 50+.

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Sullivan
Behavioral Risk Factors
60
41.1

Overweight and Obesity1

39.9 33.1

40 Percent

33.6

36.6

20

26.1

26.8

27.7

29.1

31.9

0 2005

2006 Overweight

2007

2008 Obese

2009

100 80 60 Percent Perce 40 20 0 2005

Nutrition and Physical Activity1


68.7 66.2 59.0 74.4 76.1

60

Cholesterol Screening and High Cholesterol1


38.0 30.6 29.8

40 Percent Percen
65.2

20
22.1 21.6 18.2

2007
Eating <5 Fruit Vegetables/Day

2009

0 2005

2007
Cholesterol Not Checked in 5 Years Ever Told Had High Cholesterol

2009

Not Meeting Physical Activity Recommendations

Prevalence for Behavioral Risk Factors, 20091


Risk factor Eating <5 Fruits & Vegetables per Day (%) Not Meeting Physical Activity Recommendations (%) Overweight or Obese (%) Have Not Checked Cholesterol Within the Past 5 Years (%) Ever Told High Cholesterol (%) Ever Told High Blood Pressure (%)

Total
76.1 65.2 68.6 18.2 38.0 38.0

NH White
75.9 65.1 68.3 17.6 38.0 38.1

NH Black
81.7 60.2 72.2 59.5 35.8 56.3

Female
67.7 67.3 64.7 13.9 37.8 39.6

Male
85.4 62.9 72.4 22.7 38.2 36.1

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

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Sullivan
Cigarette & Alcohol Use

Current Cigarette Smokers1


40 35 30 25.5 25 20 15 10 5 0 2005
30.5 22.5 17.5

Percent

18.7

2006

2007

2008

2009

20 15 Percent Per 10 5
7.1

Alcohol Use1

8.5 7.1 6.5 6.8

2.4

1.4

2.1

1.6

1.2

0 2005

2006

2007 Heavy Drinking

2008 Binge Drinking

2009

Prevalence for Alcohol and Tobacco Use, 2009


Indicator Heavy Drinking (%) Binge Drinking (%) Current Smokers (%) Total 1.2 6.8 18.7 0.9 6.6 18.5

NH White

NH Black 21.3 21.3 45.8

Female 0.9 3.6 21.8

Male 1.5 10.2 15.2

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

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Leading Causes of Death
Leading Causes of Death, 2007-20091
Rank2 Cause # Deaths Age Adjusted Mortality Rate3 and Demographic Ranking Total White Black Female Male 199.4 194.1 47.9 41.1 45.8 33.4 26.7 19.9 14.4 11.9 197.7 194.5 48.6 40.2 46.1 33.6 25.9 19.8 14.3 11.6 325.1 188.0 13.6 103.7 19.1 24.6 89.2 39.7 18.0 36.6 151.5 161.4 42.2 41.8 27.5 34.2 23.7 17.0 14.5 11.7 262.3 242.7 59.2 38.7 65.7 30.0 31.0 24.9 14.7 12.1

1 2 3 4 5 6 7 8 9 10

Heart disease Cancer Chronic lower respiratory diseases Stroke Accidents Alzheimers disease Diabetes mellitus Influenza and pneumonia Kidney disease Essential hypertension and hypertensive renal disease 1 2 3

1,249 1,208 305 262 225 214 165 125 91 76

Ranking Key:

All Cause Mortality by Race, 2007-20091,3


Total White Black Female Male 0 200 400 600 800 Deaths per 100,000 1000
712.0 1,056.2 860.4 858.2 1,115.1

1200

1 2 3

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjusted to the 2000 standard US population. Ranking order is based on counts for the total population. Demographic ranking is based on counts for each subgroup. Annual mortality rate per 100,000 population. Age adjusted to the 2000 standard US population.

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Heart Disease
2000 Rate Per 100,000 1500 1000 500
287 269 244 240 245 250 250 224 218 224 199 196 204 1,431 1,271 1,156 1,168

Age Adjusted Mortality1 and Hospitalization2, Heart Disease


1,310 1,353 1,293 1,301 1,314 1,250 1,263 1,257

1,223

0 1997

1999

2001

2003

2005 Mortality

2007 Hospitalization

2009

Heart Disease Mortality1 and Hospitialization2, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000)
3 Heart Disease Prevalence , 2009

White 197.7 261.5

Black 325.1 205.3

Female 151.5 1,041.1

Male 262.3 1,504.7

199.4 1,256.4

Total Prevalence of MI (%) Pre alence of CHD (%) Prevalence


5 4

NH White 6.7 71 7.1

NH Black 9.5 95 9.5

Female 4.8 97 9.7

Male 8.8 51 5.1

6.7 73 7.3

Age Specific Mortality by Race, Heart Disease, 2007-20091


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 500 1000 1500 2000 2500 Deaths per 100,000 3000
0.0 57.1 138.4 132.6 795.2 282.4 378.1 543.2 3,039.5 1,172.8 3,521.1 3,562.3

Black White

3500

4000

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to 2000 US standard population.
3 4 5

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. MI= Myocardial Infarction. CHD=Coronary Heart Disease.

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Stroke
Age Adjusted Mortality1 and Hospitalization2, Stroke
500 Rate per 100,000 400 300 200 100
69 72 72 87 71 61 60 58 61 57 48 37 39 378 389 354 334 369 342 319 339 336 358 316 311 292

0 1997

1999

2001

2003

2005 Mortality

2007

2009

Hospitalization

Stroke Mortality1, Hospitialization2, and Prevalence3, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000) Prevalence (%)
4

White 40.2 64.4 17 1.7

Black 103.7 0.0 00 0.0

Female 41.8 288.4 26 2.6

Male 38.7 330.1 06 0.6

41.1 306.4 17 1.7

Age Specific Mortality by Race, Stroke, 2007-20091


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 500
0.0 0.0 138.4 5.8 0.0 35.7 378.1 77.3 607.9 330.8 2112.7 1001.0

Black White

1000 1500 Deaths per 100,000

2000

2500

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3 4

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise. 2009 data, NH white and NH black race groups.

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CLRD1
600 500 Rate per 100,000 400 300 200 100
59 53 46 61 57 57 65 54 51 51 49 52 42 273 275 269 271 275 317 272 299 312 324 292 323 345

Age Adjusted Mortality2 and Hospitalization3, CLRD

0 1997

1999

2001

2003

2005 Mortality

2007

2009 Hospitalization

Chronic Lower Respiratory Disease Mortality2 and Hospitialization3, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000) 47.9 319.8 White 48.6 81.8 Black 13.6 81.8 Female 42.2 346.9 Male 59.2 290.5

Asthma Prevalence, 20094


Total Ever Had Asthma (%) Currently Have Asthma (%) 13.4 9.4 NH White 13.6 9.5 NH Black 11.6 11.6 Female 13.9 10.9 Male 12.8 7.8

Prevalence of Self-Reported Current Asthma4


16 14 12
9.5 10.4 14.7

Age Specific Mortality by Race, CLRD, 2007-20092


35-44 45-54
0.0 1.6 0.0 16.0 0.0 74.7 0.0 194.3 304.0 432.3 0.0 461.2

Percent

10 8 6 4 2 0

Age Group

9.5

9.4

Black White

55-64 65-74 75-84 85+

2005

2006

2007

2008

2009

100

200 300 Deaths per 100,000

400

500

1 2

CLRD= Chronic Lower Respiratory Disease. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
4

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

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Diabetes
Age Adjusted Mortality1, and Hospitalization2, Diabetes
Rate per 100,000
214 209 174 157 182 183 197 188

200
136

152

149

163 139

100
22 20 23 27

33

30

40

36

34

36

33

24

23

0 1997

1999

2001

2003

2005 Mortality

2007

2009 Hospitalization

Diabetes Mortality1 and Hospitialization2, 2007-2009


Total Mortality (per 100,000) Hospitalization (per 100,000)
3

White 25.9 45.6

Black 89.2 35.6


3

Female 23.7 189.0

Male 31.0 191.8

26.7 189.2

Diabetes Prevalence and Diabetes Management Indicators , 2009


Total Prevalence (%) Self-Blood Glucose Monitoring at Least Once Daily (%) Foot Examined by a Doctor in Past 12 Months (%) Received a Dilated Eye Exam in past 12 Months (%) 14.2 83.2 71.3 82.1 NH White 13.9 83.5 73.0 84.4 NH Black 31.0 0.0 0.0 100.0 Female 13.8 88.6 71.4 80.3 Male 14.7 77.9 71.3 84.0

35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0

0.0 14.7 0.0 11.7 198.8 55.2 0.0 77.3

Age Specific Mortality by Race, Diabetes, 2007-20091

Black White
607.9

172.9 2112.7 255.2

500

1000 1500 Deaths per 100,000

2000

2500

Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics. Age adjustment based on the 2000 standard US population.

Data Source: Hospital Discharge Data System, Tennessee Department of Health, Division of Health Statistics, 2007-2009. Data are for discharges, not necessarily for unique patients and are calculated for all ages. Age adjusted to the 2000 standard US population.
3

Data Source: Tennessee Behavioral Risk Factor Surveillance System (BRFSS). Statistics are for 18+ unless indicated otherwise.

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Cancer
Age Adjusted Incidence1 and Mortality1, All Cancers
600
517.4 496.7 471.7 483.2 487.0

500 Rate per 100,000 400 300


199.3

197.8

204.6

197.1

193.1

200 100 0 2004

2005

2006

2007 Incidence

2008 Mortality

Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 491.3 198.1 White 494.2 198.8 Black 389.8 204.6 Female 428.3 158.7 Male 581.2 254.7

Age Specific Mortality by Race, All Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0 200 400 600 800 1000 Deaths Per 100,000 1200
0.0 1338.3 1408.5 1432.8 0.0 48.9 138.4 154.5 695.8 332.7 1134.2 779.7

Black White

1400

1600

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

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Sullivan
Lung Cancer
200

Age Adjusted Incidence1, and Mortality1, Lung Cancer

Rate per 100,000

150
95.9 91.1 89.3 77.9 74.5

100

83.8

50

71.4

68.8

67.6

64.4

0 2004

2005

2006

2007 Incidence

2008 Mortality

Lung Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortalit (per 100,000) Mortality 100 000) 87.4 69 3 69.3 White 88.2 69 7 69.7 Black ^ 60 6 60.6 Female 66.7 49 1 49.1 Male 115.8 96 8 96.8

Age Specific Mortality by Race, Lung Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0
0.0 443.6 0.0 333.7 0.0 6.5 0.0 53.9 298.2 120.1 189.0 330.1

Black White

100

200 300 Deaths Per 100,000

400

500

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

^ Indicates data has been suppressed due to small numbers.

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Sullivan
Breast Cancer
200

Age Adjusted Incidence1 and Mortality1, Female Breast Cancer

Rate per 100,000

150

136.9 124.5 108.4 116.3 122.6

100

50
16.7

22.1

19.9

29.6 19.7

0 2004

2005

2006

2007 Incidence

2008 Mortality

Female Breast Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 121.7 21.6 White 122.8 20.9 Black ^ ^

Age Specific Mortality by Race, Female Breast Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0
0.0 77.8 0.0 104.3 0.0 178.7 0.0 9.7 143.9 22.9 192.3 62.2

Black White

50

100 150 Deaths Per 100,000

200

250

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

^ Indicates data has been suppressed due to small numbers.

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Sullivan
Colorectal Cancer
Age Adjusted Incidence1 and Mortality1, Colorectal Cancer
100 80 60 40 20
16.1 17.0 15.0 18.5 16.7 52.3 46.4 40.3 38.2

Rate per 100,000

45.8

0 2004

2005

2006

2007 Incidence

2008 Mortality

Colorectal Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 44.6 16.6 White 44.5 16.7 Black ^ ^ Female 39.8 12.9 Male 50.4 21.2

Age Specific Mortality by Race, Colorectal Cancer, 2007-20092


35-44 45-54 Age Group 55-64 65-74 75-84 85+ 0
0.0 39.8 0.0 146.6 0.0 186.5 0.0 1.6 0.0 18.9 99.4 32.5

Black White

50

100 Deaths Per 100,000

150

200

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

^ Indicates data has been suppressed due to small numbers.

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Sullivan
Prostate Cancer
200
163.3

Age Adjusted Incidence1 and Mortality1, Prostate Cancer


154.1 129.2 130.7 120.5

Rate per 100,000

150

100

50
20.6 0.0

27.6 13.4

20.0

0 2004

2005

2006

2007
Incidence

2008
Mortality

Prostate Cancer Incidence and Mortality , 2004-2008


Total Incidence (per 100,000) Mortality (per 100,000) 139.4 18.8 White 138.8 18.5 Black 203 ^

Age Specific Mortality by Race, Prostate Cancer, 2007-20092


45-54 55-64 Age Group 65-74 75-84 85+ 0
0.0 0.0 0.0 17.0 0.0 51.1 0.0 106.7 0.0 445.8

Black White

100

200 300 Deaths Per 100,000

400

500

Data Source: Cancer Registry, Tennessee Department of Health, Office of Cancer Surveillance, all ages. Age adjusted to the 2000 standard US population. Data Source: Death Statistical System, Tennessee Department of Health, Division of Health Statistics.

^ Indicates data has been suppressed due to small numbers.

107

Technical Notes
Data Sources
American Community Survey (ACS) The American Community Survey is an ongoing survey administered by the U.S. Census Bureau that captures information related to demographic, socioeconomic status, employment status, and housing status. Demographic indicator definitions are as follows: Percent high school graduates: adults aged 18 and over that have completed high school, including those that have completed an education beyond high school. Poverty: families and individuals who are identified as having income at or below the 100% federal poverty level. http://www.census.gov/acs. State Tobacco Activities Tracking and Evaluation (STATE) System The STATE System is an electronic data warehouse maintained by the Centers of Disease Control and Prevention (CDC) in the Office on Smoking and Health (OSH), National Center for Chronic Disease Prevention and Health Promotion. It contains up-to-date and historical state-level data on tobacco use prevention and control. http://www.cdc.gov/tobacco/statesystem. Tennessee Incident Based Reporting System (TIBRS) TIBRS is an incident based reporting system that collects data on crimes that occur in the State of Tennessee. All law enforcement agencies, including colleges and universities, report monthly crime statistics to TIBRS. Population estimates used for calculating crime rates were taken from the 2010 U.S. Census. Crime statistics in this report include any crimes against persons, properties, or society. http://www.tennesseecrimeonline.com/tibrspublic2005. Tennessee Population Estimates The population estimates used to calculate rates for incidence, mortality, hospitalization and teen pregnancy were the 2003 Population Estimates and Projections, 2008 Revision, from the Tennessee Department of Healths Division of Health Statistics. Tennessee Death Statistical System (DSS) The DSS is an annual, state-based compilation of mortality data. Analyses were limited to Tennessee residents. The DSS was used to calculate infant mortality, automobile accident mortality, leading causes of death, age-specific mortality for selected chronic diseases and mortality time trends for non-cancer chronic diseases. An infant death is defined as one that occurs before one year of age and infant mortality rates were calculated by dividing the number of infant deaths in a calendar year(s) by the number of live births registered for the same period of time. DSS data were provided by the Tennessee Department of Healths Division of Health Statistics. Tennessee Birth Statistical System (BSS) The BSS is an annual, state-based compilation of birth data. All data included in this report are for births to Tennessee residents that occurred both in and out of state. Data were collected on the 2003 revision of the Tennessee version of the U.S. Standard Certificate of Live Birth. The BSS was used to calculate teen pregnancy rate and to determine the denominator for infant mortality rates based on the DSS. BSS data were provided by the Tennessee Department of Healths Division of Health Statistics. Hospital Discharge Data System (HDDS) The HDDS is an annual, state-based compilation of data on patients discharged from all acute care hospitals licensed by the Tennessee Department of Health. The HDDS does not include federal facilities (i.e., VA hospitals, etc.) or facilities licensed by the Tennessee Department of Mental Health and Developmental Disabilities. Analyses were limited to the records of Tennessee residents. HDDS data were provided by the Tennessee Department of Healths Division of Health Statistics. Tennessee Cancer Registry (TCR) Cancer incidence data contain records of cases of primary cancer that were first diagnosed among Tennessee residents between January 1, 2004 and December 31, 2008, and that were reported to the TCR as of December 2010. Cases with unknown race (732 cases) were included in the All Races category. Seven cases with gender reported

108

as hermaphrodite or transsexual and twelve cases with unknown age were excluded from all analyses. TCR data were provided by the Tennessee Department of Healths Office of Cancer Surveillance. Behavioral Risk Factor Surveillance System (BRFSS) The BRFSS is an annual, state-based, random-digit-dialed telephone survey of the U.S. non-institutionalized population, 18 years of age and older, which gathers self-reported data on certain health conditions and behavioral risk factors. BRFSS data were used to calculate time trends and prevalence for many of the behavioral risk factors presented in this report. Risk factor definitions are as follows: Overweight: body mass index (BMI) greater than or equal to 25 and less than 30. Obese: BMI greater than or equal to 30. Meeting physical activity recommendations: participating in either moderate physical activity for 30 or more minutes per day on five or more days per week, or vigorous activity for 20 or more minutes per day on three or more days per week. Current cigarette smokers: individuals who have smoked at least 100 cigarettes in their lifetime and who now smoke everyday or some days. Heavy drinking: men having more than two drinks per day or women having more than one drink per day. Binge drinking: men having five or more drinks on one occasion or women having four or more drinks on one occasion. Ever had asthma: having ever been told by a doctor, nurse, or other health care professional you have asthma. Currently having asthma: having been told by a doctor, nurse, or other health care professional you have asthma and still having asthma at the time of the survey.

Definition of Terms
Disease classifications For mortality data through 1998 and hospital discharge data for all years the International Classification of Diseases, 9th Revision (ICD-9) was used; for mortality data after 1999 the ICD-10 was used; for cancer incidence data International Classification of Diseases Oncology, 3rd Revision (ICD-O3) was used. List of the International Classification of Diseases codes for select diseases: Disease Category
All cancers Colorectal cancer Lung cancer Breast cancer (Female) Prostate cancer Diabetes mellitus Diseases of heart Stroke Chronic lower respiratory diseases (CLRD)

ICD-10
C00-C97 C18-C21 C33-C34 C50 C61 E10-E14 I00-I09, I11, I13, I20-I51 I60-I69 J40-J47 V02-V04, V09.0, V09.2, V12-V14, V19.0, V19.2, V19.4-V19.6, V20-V79, V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2

ICD-9
140-208 153-154 162 174 185 250 390-398,402,404,410-429 430-434,435,436-438 490-494,496

ICD-O3
C00.0-C80.9 C18.0-C18.9, C19.9, C20.9,C26.0 C34.0-C34.9 C50.0-C50.9 C61.9 N/A N/A N/A N/A

Motor vehicle accidents

E810-E825

N/A

Race and ethnicity For BSS, DSS and HDDS data the terms white and black refer to persons of any ethnicity. For BRFSS and U.S. Census data, the terms NH white and NH black refer to persons of non-Hispanic origin only, and the term Hispanic refers to persons of Hispanic ethnicity regardless of race.

109

Leading causes of death ranking Leading causes of death for the total population are listed in tables. A color code key was used to highlight the top five leading causes of death for each demographic group: total, white, black, female, and male. Ranks were based on number of deaths; however only diseases that appear in the top 10 leading causes of death for the total population are shown and/or highlighted for demographic subgroups. In most cases, the top five leading causes of death among demographic subgroups fall within the leading causes of death for the total population. Site-specific cancers Due to small numbers of site-specific (i.e. lung, female breast, colorectal, prostate) cancer deaths in most counties, county-level mortality time trends are not presented. Cancer incidence data were suppressed when there were only 1-9 cases. Cancer incidence time trends were presented for counties where at least three years of data were not suppressed. Teen pregnancy Teen pregnancy was defined as pregnancies among females aged 15-19 and was reported as rate per 1,000. The number of pregnancies was the sum of live births, reportable fetal deaths, and reported induced abortions. Teen pregnancy data were provided by Tennessee Department of Health, Division of Health Statistics. Ranking Regional and county rankings for select indicators are in descending order, where a rank of 1 indicates the highest value for that indicator among all regions or counties. Age-adjusted rate Cancer incidence and mortality rates were age-adjusted to the 2000 U.S. standard population with 5-year age intervals (19 age groups) except for age-specific rates. Counting of cases and calculation of rates were performed in SEER*STAT 7.0.4. Mortality rates for other diseases and hospitalization rates for all diseases were age-adjusted to the 2000 U.S. standard population with 10-year age intervals (11 age groups) unless indicated otherwise. Counting of cases and calculation of rates were performed using the SAS 9.2 software. Suppression of data Rates were suppressed for all conditions in which the population at risk was less than 100 persons. For cancer incidence data, rates were suppressed if the count was between 1 and 9 cases. Suppression of data is represented by a ^ symbol. A rate of 0 indicates that there were no events.

110