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Health of Massachusetts Health of Massachusetts Deval L. Patrick Governor Commonwealth of Massachusetts Timothy P. Murray Lt. Governor Commonwealth of Massachusetts JudyAnn Bigby, MD Secretary Executive Office of Health and Human Services John Auerbach Commissioner Massachusetts Department of Public Health Health of Massachusetts April 2010 Photos in this report are used under a licensing agreement. All other material contained in this report is in the public domain and may be used and reprinted without special permission; citation as to source, however, is appreciated. Suggested Citation Massachusetts Department of Public Health. Health of Massachusetts. Boston, MA; April 2010. Online To view this report in its entirety or to download specific sections ofHealth of Massachusetts, visit our website at: www.mass.gov/dph/healthofmassachusetts Massachusetts Department of Public Health 250 Washington Street Boston, MA 02108 617.624.6000 www.mass.gov/dph Commonwealth of Massachusetts Deval L. Patrick Governor Commonwealth of Massachusetts Timothy P. Murray Lt. Governor Executive Office of Health and Human Services JudyAnn Bigby, MD Secretary Massachusetts Department of Public Health John Auerbach, MBA Commissioner Table of Contents Preface 6 Homes Special Projects in Hospital Care Emergency Medical Care Policy Perspective: Paula Griswold About Us 12 Chapter 5: Natality and Early Childhood 74 Chapter 1: Demographics and Socio-Economics 16 Births Teen Births Preterm and Low Birthweight Births Population Gender Marital Status Age Race and Multiple Births and Fertility Treatments Infant and Fetal Ethnicity Foreign Born Language Disability EOHHS Mortality Prenatal Care Gestational Diabetes Mellitus Regions Income Poverty Unemployment Industry Method of Delivery Breastfeeding Women Infants and and Occupation Education Policy Perspective: Barry Children Nutrition Program Newborn Hearing and Blood Bluestone and Mary Huff Stevenson Screening Birth Defects Early Intervention Autism Spectrum Disorders Policy Perspective: Milton Kotelchuck Chapter 2: Community Assets 32 What does community mean? Building a Supportive Chapter 6: Infectious Disease 94 Environment Health Care Infrastructure: Distribution of Vaccine-Preventable Infections Foodborne Illness Insect Resources Community Infrastructures: Supporting Healthy and Tickborne Illnesses Sexually Transmitted Infections Eating and Active Living Policy Perspectives: Mary Bassett HIV/AIDS Hepatitis C Tuberculosis Policy Perspective: and Peter Lee Donna Bright Chapter 3: Health Care Access 50 Chapter 7: Wellness and Chronic Disease 112 Health Insurance Status Preventive Screenings Residents Social Spheres of Influence Obesity Asthma Diabetes Who Have a Doctor Visits to a Dentist Effects of Health Heart Disease and Stroke Cancer Oral Health Care Reform Policy Perspective: Robert Restuccia and Health-Related Quality of Life Mental Health Special Christine Barber Note on American Indian Health Our Aging Population Policy Perspective: Stuart Chipkin Chapter 4: Health Care Quality 62 Monitoring Adverse Events and Infections in Hospitals Chapter 8: Environmental Health 156 Licensure and Inspections Falls Utilization of Nursing Lead Poisoning Asthma and Allergies Drinking Water 2 | Health of Massachusetts Swimming Indoor Air Skating Rinks Ambient Air Food Racial / Ethnic Differences Suicide and Mental Illness Safety Policy Perspective: Joseph Brain Young People and Suicide Geographic Differences Suicide Prevention Strategies Policy Perspective: Ellen Connorton Chapter 9: Occupational Health 168 Fatal Injuries at Work Nonfatal Injuries and Illnesses Chapter 13: Violence 236 Sharps Injuries Among Hospital Workers Work-Related Lung Bullying, Harassment, and Violence in School Settings Diseases Work-Related Injuries to Teens Occupational Community Violence Rape and Sexual Violence Intimate Health Disparities Promoting and Protecting Employee Partner Violence: Dating and Domestic Violence Child Health Policy Perspective: David Wegman and Marcy Maltreatment and Witnessing Family Violence Goldstein-Gelb Chapter 14: Mortality 248 Chapter 10: Alcohol, Tobacco, and Other Drug Use 190 Overall Mortality Racial and Ethnic Differences Leading Dependence and Abuse Substance Use Among Youth Causes of Death Life Expectancy Educational Attainment Substance Use Among Young Adults (18-25) Substance Use Premature Mortality Rate (PMR) Amenable Mortality Among Adults Treatment Need Opioid Related Morbidity and Mortality Tobacco Use Exposure to Secondhand Appendix 260 Tobacco Smoke Policy Perspective: Constance Horgan Data Sources MDPH Contact Information Chapter 11: Unintentional Injury 210 Unintentional Injury Traumatic Brain Injuries Falls Among Older Adults (65+ Years) Motor Vehicle Occupant Injuries Pedestrian Injuries Fire Injuries Drowning/Near Drowning Poisoning Strategies for Injury Prevention Policy Perspective: Cindy Rodgers Chapter 12: Suicide and Self-Inflicted Injury 224 Scope of the Problem in Massachusetts Gender and Age | 3 Letter from the Commissioner Dear Friends: Welcome to the Massachusetts Department of Public Health: Health of Massachusetts. This new report represents a major leap forward in our ability to provide useful data on the health of Massachusetts residents, in an easy-to-understand and accessible format. For the first time, we have coupled statistical information with policy perspectives from some of the leading experts in the field of public health, allowing for greater context in understanding the broad issues we face. This report reflects the dedication and commitment of state and local public health departments across Massachusetts, and the community partnerships that sustain those efforts. The data in these pages form the basis of all these activities, and helps us identify our priorities and target our efforts. In so many ways, Massachusetts is a public health leader. Our programs and initiatives are wide-ranging and forward-thinking. 4 | Health of Massachusetts The health of our residents is better than national averages in many areas. And we lead the country in providing health care coverage to our residents because of our landmark health care reform legislation. Still, many challenges remain: reducing the burden of obesity and its related conditions, addressing racial and ethnic health disparities, ensuring the success of health care reform, manag- ing chronic disease and supporting local public health across the state. With the publication of Health of Massachusetts, we take stock of where we stand in facing these and other chal- lenges – and more important, where we need to go next. Sincerely, John Auerbach Commissioner Letter from the Commissioner | 5 6 | Health of Massachusetts Preface ne of the primary activities and goals of the Massachusetts Depart- The Department of Public Health annually publishes dozens of data reports, fact ment of Public Health is the analysis and wide distribution of health sheets and bulletins. If you are looking data.O This takes the form of dozens of publications published annually for more detailed data, go to www.mass. throughout the Department. Health of Massachusetts is the first report to gov/dph/publications for a current list of bring all those sources of data “under one roof ”. This compilation of more our reports. than fifty data sources gives the reader the “big picture” view of health in the Commonwealth of Massachusetts. About This Report MDPH has been collecting and using data to inform policy makers and the public since 1842, the year the first statewide registration of vital records began. Since then, DPH has implemented many interventions which brought about huge reductions in death from infectious disease, tracked the emergence of heart disease and cancer as the most prevalent Preface | 7 Figure A: Cause of Death in Massachusetts, 1842-2007 Public health offers a practical, goal-oriented, and community- 60% based approach to promoting and Infectious Disease 50% maintaining health. To identify Heart Disease problems and develop solutions 40% for entire population groups, the otal Deaths T 30% public health approach1: Cancer » Defines the problem, using 20% cent of surveillance processes r 10% Pe Injuries designed to gather data that 0% establish the nature of the problem and the trends in its 1842 1850 1858 1866 1874 1882 1890 1898 1906 1914 1922 1930 1938 1946 1954 1962 1974 1982 1990 1998 2003 2007 incidence and prevalence; Source: MDPH, Division of Research and Epidemiology. » Identifies potential causes through epidemiological analyses that identify risk and protective factors associated causes of death today, and studied the causes and treatment of newly with the problem; emerging diseases, such as HIV/AIDS, Lyme disease, H1N1, and others. » Designs, develops, and evalu- ates the effectiveness and We begin this report by describing the Massachusetts population (Chapter 1) generalizability of interven- and the community assets that improve the quality of our lives (Chapter 2). tions; and » Disseminates successful Chapter 3 provides our most recent analysis of the impact of Health Care models as part of a coordi- nated effort to educate and Reform legislation, and focuses on access to health care. reach out to the public. Chapter 4 shows the ways in which we guarantee the quality and safety of that care. Chapters 5 through 7 focuses on life span health issues, from perinatal and childhood issues in Chapter 5 to infectious diseases in Chapter
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