Why do African Americans live to be 64.8 years in Cambria County?

Last week I posted on how African Americans in Cambria County lag behind other ethnic groups in the County and behind African Americans in the state and the US in life expectancy.  The numbers are summarized in the table below.

	Cambria County[1]	Pennsylvania	US
Overall	75.6	78.3	78.6
Caucasian	76.1	78.9	78.5
African-American	64.8	73.4	74.8
Hispanic	87.7	85.3	81.8

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[1] Source National Center for Health Statistics - Mortality Files

Looking more closely at the County Health Rankings provides some clues for this result can be seen.  A clue to the reasons for the low life expectancy among African Americans in the county is provided by the rate of child mortality in the county.  The overall county rate was 57 deaths per 100,000 residents.  For African-Americans, the rate was 253/100,000.  For Caucasians in the county, it was 43/100,000, almost six times lower.  The state rate was 49/100,000.  The infant mortality rate was 1% lower than the state rate of 6%.  There were no infant mortality rates by race for the county.  

Other clues can be seen in other health measures that they provide by race.  

• 15% of African American babies are low birth weight while 10% of Hispanic babies are and 8% of Caucasian babies are.  The state rate is 8%.
• The teen birth rate was 59 per 1,000 teens age 15-19.  For Hispanics it was 29/1,000 and for Caucasians it was 21/1,000.  The state rate was 20/1,000.
• 32% of African American medicare enrollees women received Mammography screening.  It was 46% for Hispanics and 37% for Caucasians.  It was 44% for the state.
• 31% of African Americans received a flu vaccination while 38% of Hispanics and Caucasians did.  50% in the state did.
• 73% of African American children were in poverty while 69% of Hispanics and 20% of Caucasians were.17% of children in the state were.
• The median household income for African Americans in the county was $17,230, $36,079 for Hispanics, and $45,940 Caucasians.  It was $59,165 for the state.

There are encouraging signs of people organizing to fix these discrepancies as can be seen in the video below.

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Cambria County African American Life Expectancy lags behind State and US

	Cambria County	Pennsylvania	US
Overall	75.6	78.3	78.6
Caucasian	76.1	78.9	78.5
African-American	64.8	73.4	74.8
Hispanic	87.7	85.3	81.8

The new county health rankings are out for every county in the US for 2019.  My County Cambria County was ranked 65th out of 67 counties in Pennsylvania in health outcomes as reported in the press.  The ranking was determined by composite of length of life and quality of life measures.

I have been working on a book about Johnstown, PA by the numbers and thought I would give my readers a preview.  Only looking at rankings masks the subtle nuances in the data.  Two individuals can have the same IQ score but have very different abilities.  

The life expectancy in the county was 75.6 years for 2016 which was 2.7 years less than the state of Pennsylvania and three years less than the US.  For African Americans in the county (3.4% of the county population) it was 64.8 years which was 8.6 years lower than African Americans in the state and ten years less than the same cohort in the US.  Hispanics fared better than either group in the county, state and US.  They were 1.6% of the county population.

The rate of years of potential life lost in the county for African Americans was 24,443 years/100,000 in the population which was more than double that of Caucasians at 9,671 years per 100,000.  For example if some one dies prematurely at age 35, then they have 40 years of potential life lost before age 75.  These numbers are adjusted for population to make them comparable to other entities.  

I will look at the data more in depth in my book with more updates to come.

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This month it has been reported that life expectancy in 2015 in the US has decreased for the first time since 1993.  The decrease was from 78.9 years in 2014 to 78.8 in 2015.  The reasons for this decrease are unclear though the overall death rate increased by 1.2% last year.  The top causes of death had increased rates except for cancer.  Alzheimer's disease showed the largest increase in mortality.  The study's authors caution that this decrease in life expectancy of 0.1 years (which corresponds to a decrease of 37 days) may be a statistical aberration.

Views of the ACA (CBS News Poll)	Dec 2016	Feb 2015
Working well, keep as is	10%	6%
Good things, but changes needed	63%	60%
Needs to be repealed entirely	25%	32%

One statistic that has changed little in the last 6 years is the level of support for the Affordable Care Act (ACA or Obamacare).  The above table shows how views of the ACA have changed over the last year according to a CBS poll conducted this month.  Overall the poll showed that 45% of the public approve of the ACA while 50% do not.  The same respondents were asked what changes to the law were needed.  Only 10% wanted it kept as is (up from 6% last Feb).  The number who wanted changes made to the law increased to 63% from 60% while the number who want it repealed entirely decreased from 32% in 2015 to 25 this month.  The poll did break the numbers down by political party and found that 47% of Republicans wanted changes compared to 78% of Democrats and 61% of independents.  The poll did not specify which changes were needed to the law.

Opinion of ACA (Pew Research)	Nov 30-Dec 5, 2016	Oct 20-25, 2016	Mar 7-11, 2012	Sep 22-Oct 4, 2011	Jan 5-9, 2011	Nov 4-7, 2010
Expand it	39%	40%	33%	31%	35%	30%
Leave it as is	15%	13%	20%	22%	20%	22%
Repeal it	39%	44%	38%	38%	37%	40%
Don’t Know/Refused	7%	4%	9%	9%	8%	8%
Expand + As is	54%	53%	53%	53%	55%	52%

 
Another poll was published this month showing essentially a 48% to 47% approval/disapproval ratio (essentially a tie) for the ACA published by Pew research.  The poll did ask respondents (n=752) what changes they wanted to see to the ACA.  39% said expand it which is virtually unchanged from October but increased from 2012 and 2011 levels by 5 to 9%.  The number who wanted it left as is increased by 2% from October but decreased from 2011 by 5 to 7%.  The number who want it repealed decreased by 5% from October but stayed within the values from 2012 to 2010.  If one adds the % who want it expanded to those who want it left as is we find a consistent majority across the six year period ranging from 54% this month to 52% in Nov 2010.

It is a matter of interpretation exactly what "expand it" means but other polls have found similar results using wording of the question "Is the ACA not Liberal Enough" or "Approve" as is, found similar majorities when the two categories are added.  The conclusion is that a majority of the US public wants universal health care with a growing percentage wanting a better bill.  Such actions are unlikely in the short term in the Federal Government with Trump in the White House (though he once supported single payer) and the GOP controlling Congress.

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Santorum: No One Has Ever Died Because They Didn’t Have Health Care |The New Civil Rights Movement