BACKGROUND: Mortality rates in Wisconsin, like the rest of the United States, have been trending downward over the last decade and a half. However, this improvement has not been shared equally amongst all residents of the State. The purpose of this study was to examine differences in mortality rates and causes of death by population subgroup in Wisconsin from 1999-2014 in order to identify health disparities and inform opportunities to improve health for all.
METHODS: Data for the current study were downloaded from the CDC WONDER Detailed Mortality File. We calculated the percent change in mortality rates for Wisconsin Population subgroups based on the 2013 NCHS Urban-Rural Classification Scheme for counties, gender, race/ethnicity, and age. Changes in the leading causes of death were explored for subgroups with significant increases in mortality rates over the study period.
RESULTS: Mortality rates for the State of Wisconsin improved by 16.5% between 1999 and 2014. However, tremendous disparities existed by level of urbanization and race/ethnicity. Those in Milwaukee county (Wisconsin’s sole urban area) had much higher deaths rates than those in suburban, smaller metropolitan, and rural counties. By race, mortality rates were also much higher in Blacks and American Indians than Whites, Asians, and Hispanics. In addition, the mortality gaps by level of urbanization and race seem to be increasing. The population subgroups that experienced statitsically significant increases in mortality rates were 20-34 year old White men and women, 35-49 year old American Indian men and women, and 50-64 year old Black women. Worsening mortality was related to increased deaths from poisonings, suffocation and firearms in the 20-34 year old Whites; poisonings, circulatory diseases, and liver disease in the 35-49 year old American Indians; and poisonings and cancer in the 50-64 year old Blacks.
CONCLUSIONS: Overall, less Wisconsinites are dying than 15 years ago . However, the meaningful disparities in mortality rates still persist, and have grown in some cases. The underlying causes of these disparities are actionable and warrant a statewide collaborative approach to better understand and address these gaps.