Diabetes in Texas

Prevalence

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DATA LIMITATIONS/DISCLOSURE

All data presented in this presentation include both type 1 and type 2 diabetes.

Data from the Behavioral Risk Factor Surveillance System (BRFSS) are for persons who are eighteen years of age and older. They do not include children.

Women who report diabetes only during pregnancy are not included in prevalence.

All reported rates (%) from the Behavioral Risk Factor Surveillance System are weighted for Texas demographics and the probability of selection and thus are not derived from the simple division of numerator and denominator cases.

Population data come from the Texas State Data Center, Office of the State Demographer, Institute for Demographic and Socioeconomic Research, College of Business, University of Texas at San Antonio. Population data use 0.5 migration scenario.

Mortality data are from the Texas Department of State of Health Services, Center for Health Statistics.

Data Limitations

Data Limitations

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Diabetes in Texas, 2008*

Area Prevalence*

Texas 9.7%

US 8.3%

*Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008, for persons who are eighteen years of age and older, and include both Type 1 and Type 2 Diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes. Women who report diabetes only during pregnancy are not included in prevalence. Note: All reported rates (%) are weighted for Texas demographics and the probability of selection and thus are not derived from the simple division of numerator and denominator cases.

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Prevalence of Diabetes, US and Texas, 1995 - 2008*

0

2

4

6

8

10

12

14

16

18

20

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

YEAR

%

Texas

US

*Source: CDC Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008, for persons who are eighteen years of age and older, and include both Type 1 and Type 2 Diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes.

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Estimated* Number of Adult Texans with Diabetes, Diagnosed and Undiagnosed, 2008

2008 Texas Adult Population: 17,735,442 (Age 18 Years and Older, uses migration scenario 0.5.)

*Undiagnosed diabetes estimate based on 2003-20060 NHANES age-adjusted prevalence estimate of 2.5% for persons twenty years of age and older. Diagnosed diabetes estimate based on 2008 Texas BRFSS, and use migration scenario 0.5.

Undiagnosed

Diagnosed

1,720,338

425,157

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Texas Projected Population Increase, 2040*

17,735,44224,383,647

27,879,449

35,761,159

0

20,000,000

40,000,000

60,000,000

80,000,000

100,000,000

18+ All Ages

Estimated Number of People

2008

2040

*Uses migration scenario of 0.5. Includes male and female, all races/ethnicities.

Source: Texas State Data Center - Office of the State Demographer, Institute for Demographic and Socioeconomic Research, College of Business, University of Texas at San Antonio.

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Texas Projected Population Increases by Race/Ethnicity, 2000-2040*

0

5,000,000

10,000,000

15,000,000

20,000,000

25,000,000

30,000,000

35,000,000

40,000,000

2000 2010 2020 2030 2040

YEAR *Uses 0.5 migration scenario. Texas State Data Center - Off ice of

the State Demographer, Institute for Demographic and Socioeconomic Research, College of Business, University of

Texas at San Antonio.

Pop

ulat

ion

Hispanic

Black, non-Hispanic

White, non-Hispanic

TOTAL

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Texas Projected Diabetes Cases 2000 - 2040*

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

2000 2010 2020 2030 2040

YEAR *Uses 2007 diabetes prevalence by race/ethnicity from BRFSS and population data from the Texas State Data Center - Off ice of the State Demographer, Institute for Demographic and Socioeconomic Research. Uses 0.5

migration scenario.

Nu

mb

er

of

Dia

be

tes

Ca

se

s

Hispanic (Prevalence = 12.3%) Black, non-Hispanic (Prevalence = 12.9%)

White, non-Hispanic (Prevalence = 8.5%) TOTAL (Prevalence = 10.3%)

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Diabetes Prevalence by Sex, Texas, 2008*

Gender PrevalenceEstimated

Number of People

Male 9.8% 865,221

Female 9.7% 863,946

2008 Texas Diabetes Prevalence is 9.7%.

*Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008, for persons who are eighteen years of age and older, and include both Type 1 and Type 2 Diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes.

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Diabetes Prevalence by Sex, 20 Years and Older, United States, 2008*

Gender Prevalence

Male 8.6%

Female 7.9%

*Source: CDC Behavioral Risk Factor Surveillance System, 2008, for persons who are eighteen years of age and older, and include both Type 1 and Type 2 Diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes.

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Diabetes Prevalence by Race/Ethnicity, Texas, 2008*

Area: Texas 9.7% 1,205,993

Race/Ethnicity Prevalence Estimated # of People

White, non-Hispanic 8.3% 736,987

Black, non-Hispanic 13.0% 251,543

Hispanic 11.1% 680,351

Other 7.5% 59,389

*Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008. Note: All reported rates (%) are weighted for Texas demographics and the probability of selection and thus are not derived from the simple division of numerator and denominator cases.

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2008 Texas Diabetes Prevalence* by Race/Ethnicity and Age Group

Age GroupWhite, non-

HispanicBlack, non-

Hispanic Hispanic Other

18 - 44 2.9 3.0 4.3 1.4

45 - 64 10.4 23.8 20.9 13.9

65+ 17.0 33.5 34.8 28.7

Overall 8.3 13.0 11.1 8.1

*Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008. Note: All reported rates (%) are weighted for Texas demographics and the probability of selection and thus are not derived from the simple division of numerator and denominator cases.

State Rate = 9.7%

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2004 - 2008 Texas Diabetes Prevalence by Race/Ethnicity*

*Source: 2008 Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, for persons who are eighteen years of age and older. Data include both type 1 and type 2 diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes. Women who report diabetes only during pregnancy are not included in prevalence.

Figure 2: 2004 - 2008 Texas Diabetes Prevalence by Race/Ethnicity1

8.08.5 8.313.0

7.1

11.4

7.97.5

13.1

8.110.3

7.812.6 12.3 11.1

0.0

10.0

20.0

30.0

40.0

50.0

White African-American Hispanic/Latino

Race/Ethnicity

%

2004 2005 2006 2007 2008

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Diabetes Prevalence by Race/Ethnicity, United States, 2008*

Race/Ethnicity Prevalence

White, non-Hispanic 7.4%

Black, non-Hispanic 13.1%

Hispanic 7.5%

Other 8.3%

Multiracial (chooses more than one category) 9.2%

2008 US Diabetes Prevalence is 8.3%.

*Source: CDC Behavioral Risk Factor Surveillance System, BRFSS Survey, 2008, for persons who are eighteen years of age and older, and include both type 1 and type 2 Diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes.

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2008 Texas Diabetes Prevalence by Age Group*

*Source: 2008 Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, for persons who are eighteen years of age and older. Data include both type 1 and type 2 diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes. Women who report diabetes only during pregnancy are not included in prevalence. Population data come from the Texas State Data Center, Office of the State Demographer, Institute for Demographic and Socioeconomic Research, College of Business, University of Texas at San Antonio.

Age Group Prevalence

18-29 Years 1.8%

30-44 Years 4.6%

45-64 Years 14.6%

65+ 22.7%

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Diabetes Prevalence by Educational Level, Texas, 2008*

Educational Level Prevalence

No High School Diploma 14.2%

High School Graduate 9.7%

Some College 9.8%

College + 6.9%

2008 Diabetes Prevalence for Texas is 9.7%.

*Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008, for persons who are eighteen years of age and older, and include both type 1 and type 2 Diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes.

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Diabetes Prevalence by Income Level, Texas, 2008*

Income Level Prevalence

Less Than $25,000 14.2%

$25,000 thru $49,999 10.6%

$50,000 or more 6.0%

2008 Diabetes Prevalence for Texas is 9.7%.

*Source: Texas Behavioral Risk Factor Surveillance System, Statewide BRFSS Survey, 2008, for persons who are eighteen years of age and older, and include both Type 1 and Type 2 Diabetes. Persons with diabetes include those who report that they have been told by a doctor that they have diabetes.

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Texas Death Certificates

• Uses ICD-10 for years 1999 and later.

• Uses E-CODES (External Cause of Injury) to classify leading cause of death.

• Diabetes Mellitus is E10 – E14.

• Required to be filed no later than 10 days after death.

• Can be filled out by a variety of people:– Physicians– Nurses– Funeral home directors– Medical Examiners

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Texas Death Certificate

• How causes of death are reported:

– Immediate cause of death—occurred closest to the time of death.

– Underlying cause of death—initiated events leading to immediate death. There can only be one.

– Contributing cause of death—significant diseases or conditions that may have contributed to death but did not result in the underlying cause of death. There can be multiple contributing causes.

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Diabetes Mellitus – Underlying Cause of Death

2003-2006, Texas

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Diabetes Mellitus – Underlying or Contributing Cause of Death

2003-2006, Texas

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Top Ten Leading Causes of Death, Texas, 2006*

*Source: Texas Department of State Health Services, Center for Health Statistics. Includes male and female, all ages, and all races/ethnicities.

Rank Underlying Cause Number of Deaths

1 Disease of the Heart 38,487

2 Malignant Neoplasms 34,776

3 Cerebrovascular Diseases 9,332

4 Accidents 9,006

5 Chronic Lower Respiratory Disease

7,599

6 Diabetes Mellitus

5,180

7 Alzheimer’s Disease

4,880

8 Influenza and Pneumonia 3,325

9 Nephritis, Nephrotic Syndrome and Nephrosis 2,967

10 Septicemia 2,649

All Other Causes 38,324

All Causes 156,525

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Diabetes as a Cause of Death by Race/Ethnicity, Texas, 2006*

*Source: Texas Department of State Health Services, Center for Health Statistics. Includes male and female, all ages.

Race/Ethnicity RankNumber of Deaths

White, non-Hispanic 7 2,638

Black, non-Hispanic 5 884

Hispanic 5 1,549

Other 5 109

All 6 5,180

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*Source: Texas Department of State Health Services, Center for Health Statistics. Includes male and female, all ages.

Diabetes Mortality Rate (Per 100,000) by Race/Ethnicity, Texas, 2006*

Mortality rates for each race/ethnicity were applied to the 2006 population by race/ethnicity:

20 per 100,000 whites (non-Hispanic).

42 per 100,000 Hispanics.

49 per 100,000 blacks (non-Hispanic).

21 per 100,000 persons who fall in the “Other” category.

The 2006 mortality rates (per 100,000) for blacks (non-Hispanic) and Hispanics were more than double that of whites (non-Hispanic).