Natality
Tables 1a - 1h provide selected natality information for the period of time from 1997 - 2001. The natality data include the number of women of child-bearing age, fertility rate, number of births according to county of residence and occurrence, birth rate, teen pregnancy rate, low birth weight rate, and infant mortality rates. For selected community natality data for 2001, go to the Arizona Department of Health Services (ADHS) website: http://www.azdhs.gov/plan/report/cvs/cvs01/index.htm.

In 2001, there were 1,121,957 females of childbearing age (15-44 years) in Arizona (Table 1a). Seventy-nine percent (79.2%) resided in the two urban counties (Maricopa and Pima). Of the 20.8 percent in the rural counties, 5.4 percent resided in the two rural-urban counties and 15.4 percent resided in the remaining 11 rural-rural counties.

Arizona’s fertility rate (number of live births per 1,000 women of childbearing age) in 2001 was 76.0 (Table 1b). Seven counties had higher fertility rates than the 2001 state fertility rate. Yuma (94.4) and Santa Cruz (89.8) had the highest rates in the state, while Greenlee (57.2) and Yavapai (60.2) had the lowest in the state. Of the urban counties, Maricopa had a consistent significantly higher fertility rate than Pima during the five years. Greenlee County (95.2 to 57.2) had a steady fertility rate decline over the five-year period.

Tables 1c and 1d summarize the number of births according to residence and occurrence for Arizona and its 15 counties during the five-year period. In 2001, there were 85,749 births in Arizona in which 85,213 were state residents (99.4%). The two urban counties comprised 81.2 percent of the total births. Maricopa and Pima (97.3%) had a higher percentage of in-county residence births than the two rural-urban counties (90.0%). The 11 rural-rural counties comprised 12.5 percent of the state’s births. Approximately 18 percent (1,880 out-of-county / 10,696 residents = 17.6%) of the births occurred outside of the 11 rural-rural counties. Neither Greenlee nor La Paz Counties have hospitals and comprise 14.9 percent (280) of the out-of-county births. Two rural-rural counties showed a steady decline in the number of births during the five-year period: Greenlee County declined from 491 to 443 and Graham County declined from 166 to 95.

In 2001, Arizona’s birth rate was 16.1 (Table 1e). Three counties had higher birth rates than the state rate: Santa Cruz (19.2), Yuma (18.2) and Maricopa (17.4). Of the two urban counties, Maricopa’s birth rate (17.4) was higher than Pima’s (14.1). During the five-year period, three rural counties showed a steady decline in birth rates: Yuma (22.3 to 18.2), Greenlee (19.0 to 11.4), and Mohave (13.3 to 11.2).

Arizona’s teen pregnancy rate was 72.0 in 2001 (Table 1f). Five counties had teen pregnancy rates that were higher than the state rate: Pinal (91.5), Gila (91.2), Yuma (76.1), Maricopa (74.9), and La Paz (74.1). During the five-year period, both Pinal and Yuma had the highest teen pregnancy rates in the state. Pinal County had the highest rate for 1998 – 2001. Greenlee (37.5) and Apache (47.6) had the lowest teen pregnancy rates in 2001.

Tables 1g and 1h summarize birth outcomes for 1997 - 2001: low birth weight rate (< 2,500 grams per 1,000 live births) and infant mortality rate (number of infant deaths per 1,000 live births). In 2001, Arizona’s low birth weight rate was 69.7. There were 10 counties that had higher low birth weight rates than the state rate (Table 1g). The three counties with the highest low birth weight rates were: Greenlee (84.2), Coconino (82.8), and Navajo (80.7), and the three counties with the lowest low birth weight rates were: Gila (57.0), Yuma (58.0), and Mohave (58.8).

In 2001, Arizona’s infant mortality rate was 6.9. Nine counties had higher infant mortality rates than the state rate; the two highest rates were La Paz (10.8) and Greenlee (10.5) counties. Both of these counties do not have a hospital. The two counties with the lowest infant mortality rates were Santa Cruz (2.6) and Coconino (3.2).         

Morbidity
Publicly available county level data on morbidity rates is quite limited. The only morbidity rates reported are those related to communicable diseases. These morbidity rates were compared to available Healthy People 2000, Healthy People 2010, or Healthy Arizona 2000 objectives (targets). Tables 2a – 2f summarize the selected vaccine preventable communicable diseases for Arizona and its 15 counties for 1997 through 2001. The vaccine preventable communicable diseases include: Measles, Mumps, Pertussis, Rubella, Congenital Rubella Syndrome, and Haemophilus Influenzae (invasive). All six of these met the Healthy Arizona 2000 objectives for the state. Arizona and its 15 counties met five of the six Healthy People 2010 vaccine preventable communicable diseases of either reduce or eliminate rate in 2001 (Measles, Mumps, Rubella, Congenital Rubella Syndrome, and Haemophilus Influenzae). For Pertussis, the state also met the Healthy People 2010 objective, but only six counties met the Healthy People 2010 objective. Pima (22.6) and Mohave (13.6) counties had the highest Pertussis rates. 

Other selected non-vaccine preventable communicable diseases are presented in Tables 3a – 3m. These rates were compared to available Healthy People 2000, Healthy People 2010, or Healthy Arizona 2000 objectives (targets). Only a few communicable diseases had Healthy People 2000, Healthy People 2010, or Healthy Arizona 2000 objectives. These include: Meningitis, Hepatitis A and B, Total Tuberculosis, Gonorrhea, and Syphilis (Primary and Secondary). Only these will be reported in this section.

The Healthy People 2010 Meningitis goal is 1.0, and the state rate was 4.3 in 2001 (Table 3a). Only two counties had rates higher than the state: Maricopa (6.5) and La Paz (5.1). Eight counties met the Healthy People 2010 Meningitis objective:  Apache (0.0), Coconino (0.0), Gila (0.0), Graham (0.0), Greenlee (0.0), Yuma (0.0), Pima (0.8), and Navajo (1.0).

The Hepatitis A state rate was 7.7 in 2001, and the Healthy People 2010 goal is 4.5 (Table 3c). Seven counties met the Healthy People 2010 goal: Apache (0.0), Graham (0.0), Greenlee (0.0), Gila (1.9), Coconino (3.4), Yavapai (3.4), and Mohave (4.3). Santa Cruz (85.9) and Yuma (36.4) counties had the highest Hepatitis A rates in the state. During the five-year period, the Hepatitis A state rate declined steadily (from 50.7 to 7.7), with Pima County showing a similar trend (declining from 53.2 to 8.5).

In 2001, the state Hepatitis B rate (3.1) was lower than the Hepatitis A rate. The Healthy People 2010 goal is to reduce the Hepatitis B rate. Twelve of the 15 counties reduced their Hepatitis B rates between 2000 and 2001 (Table 3d). Only three counties showed increases in Hepatitis B rates between 2000 and 2001: Gila (1.9 to 3.9), Pima (2.7 to 3.8), and Yavapai (1.2 to 2.3). The state met the Healthy Arizona 2000 objectives.

The Total Tuberculosis (TB) state rate was 5.4 in 2001, and the Healthy People 2010 goal is 1.0 (Table 3g). Only three counties met the Healthy People 2010 goal: Greenlee (0.0), La Paz (0.0), and Yavapai (0.0) in 2001. Apache (21.9), Yuma (13.3), and Santa Cruz (10.1) counties had the highest Total TB rates in the state. The state met the Healthy Arizona 2000 Total TB objectives.

Arizona met the Healthy Arizona 2000 Gonorrhea objectives. The Healthy People 2010 goal was 19.1. In 2001, Arizona’s Gonorrhea rate was 73.9. From 1998 to 2001, the state rate declined steadily (88.3 to 73.9). Maricopa County showed a similar trend (125.1 to 92.0), while the rate in Pima County rose (48.4 to 89.1). Eleven county rates were below the state rate (Table 3i). Of these 11, seven counties met the Healthy People 2010 goal: Greenlee (0.0), Yavapai (8.9), Mohave (9.0), La Paz (10.0), Graham (12.1), Cochise (12.7), and Yuma (14.4). In 2001, Apache (92.0), Maricopa (92.0), Pima (89.1), and Navajo (87.6) had the highest county rates.

The Healthy People 2010 Syphilis (primary and secondary) goal is 0.2. Ten counties met this goal (all at 0.0) in 2001 (Table 3k). In 2001, Arizona’s rate was 3.5. Four counties exceeded the state’s rate:  Graham (9.1), Maricopa (4.8), Apache (4.4), and Navajo (4.1). From 1999 to 2001, Arizona’s Syphilis rate declined steadily (4.3 to 3.5). Coconino (1.6 to 0.0), Maricopa (6.7 to 4.8), and Pinal (2.4 to 0.0) showed similar declining trends during the same time period, while Apache’s rates rose steadily (1.5 to 4.4). The state met the Healthy Arizona 2000 Syphilis objectives.   

Tables 4a – 4i provide selected 2004 age-specific chronic disease estimates in Arizona and its 15 counties. These include: Coronary Heart Disease, Angina Pectoris, Heart Attack, Stroke, Cancer, Diabetes, Asthma, Emphysema, and Chronic Bronchitis. The estimates provided by the Arizona Department of Health Services, Public Health Preventive Services, were based on the 2001 National Health Interview Survey. These estimates are useful in determining the number of persons who may use disease specific county programs. There are two limitations to the estimates: (1) there may be underestimation of the specific disease numbers for minority populations who have high prevalence rates of these diseases, such as diabetes in the American Indian and Hispanic populations, and (2) there may be underestimation of the disease numbers that are affected by environmental factors, such as high air pollution, that may have resulted in higher incidences of pulmonary diseases.

The ADHS Community Health Profile website provides selected community infectious diseases and new cases of cancer data for 2001: http://www.azdhs.gov/hsd/chpweb/2001/index.htm.

Mortality
The five-year age-adjusted mortality rates for selected chronic health conditions for Arizona and its 15 counties are summarized in Tables 5a – 5i. The top eight causes of death (age-adjusted) for 2001 are presented: (1) Cardiovascular Disease, (2) Cancer [total], (3) Cerebrovascular Disease, (4) Chronic Lower Respiratory Disease, (5) Accidents [unintentional accidents], (6) Pneumonia and Influenza, (7) Alzhelmer’s Disease, and (8) Diabetes. Of the top eight causes of death, five of the state’s mortality rates decreased between 2000 and 2001: Cardiovascular Disease (282.4 to 267.3), Cancer (176.3 to 169.2), Cerebrovascular Disease (52.9 to 47.7), Chronic Lower Respiratory Disease (49.0 to 46.9), and Pneumonia and Influenza (24.8 to 21.9). When available, these mortality rates were compared to Healthy People 2000, Healthy People 2010, or Healthy Arizona 2000 objectives (targets). For selected community mortality data for 2001, go to the ADHS website: http://www.azdhs.gov/plan/report/cvs/cvs01/index.htm.

Two recent changes have had profound effects on the comparability of age-adjusted mortality data (tabulation of leading causes of death) and continuity in statistical trends (computation of mortality rates and analyses of mortality data over time)1. Beginning with the year 2000, two major changes have occurred. First, a new revision of the International Classification of Diseases (ICD), used to classify causes of death, was implemented (using ICD-10 instead of ICD-9). Second, a new population standard for the age adjustment of mortality rates (2000 U.S. projected population) has replaced the standard based on the 1940 population, and which was used since 1943. The age-adjusted mortality data presented will indicate the changes; caution should be exercised in interpreting any trends.

The Healthy People 2010 Cardiovascular Disease mortality goal is 166.0, and Arizona’s age-adjusted mortality rate was 267.3 in 2001 (Table 5b). Both urban counties had higher Cardiovascular Disease mortality rates (Maricopa – 271.2 and Pima – 279.0) than the state rate, while the two rural-urban counties had lower rates (Coconino - 264.5 and Yuma – 199.9) than the state rate. In 2001, there were no counties that met the Healthy People 2010 Cardiovascular Disease goal; however, Greenlee County (169.5) was the closest in meeting the goal. Gila (316.1) and Cochise (305.4) Counties had the highest Cardiovascular Disease mortality rates in the state.      

The Healthy People 2010 Cancer mortality goal is 159.9, and the state’s age-adjusted rate was 169.2 in 2001 (Table 5c). In 2001, Five counties met the Healthy People 2010 goal: Apache (123.9), Yuma (128.0), La Paz (132.8), Navajo (140.8), and Coconino (159.5). The counties with the highest age-adjusted Cancer mortality rates in the state were Gila (217.7) and Santa Cruz (206.1).

In 2001, the state’s age-adjusted Cerebrovascular Disease mortality rate (47.7) was lower than the Healthy People 2010 goal (48.0). Both urban counties had higher age-adjusted Cerebrovascular Disease mortality rates (Maricopa – 48.3 and Pima – 49.7) than the state rate. In 2001, six counties met the Healthy People 2010 goal: La Paz (15.7), Greenlee (17.1), Yuma (30.1), Apache (37.5), Mohave (38.0), and Pinal (38.3) (Table 5d). The counties with the highest age-adjusted Cerebrovascular Disease mortality rates were Coconino (65.7) and Graham (64.3).

The state’s age-adjusted Chronic Lower Respiratory Disease mortality rate (46.9) in 2001 was significantly lower than the Healthy People 2010 goal (60.0). All 15 counties met the Healthy People 2010 goal (Table 5e). Only four counties exceeded the state mortality rate: Gila (58.5), Pinal (54.0), Pima (51.7), and Maricopa (47.6).

The Healthy People 2010 Accidents (Unintentional Injury) mortality goal is 17.5, and Arizona’s age-adjusted mortality rate was 46.6 in 2001 (Table 5f). Nine counties exceeded the state’s mortality rate. As expected, the top three mortality rates occurred in rural-rural counties:  Navajo (106.3), Apache (105.9), and La Paz (102.4). 

In 2001, Arizona’s age-adjusted Pneumonia and Influenza mortality rate was 21.9 (Table 5g). There was no Healthy People 2010 goal established for Pneumonia and Influenza. Eight counties exceeded the state mortality rate: Navajo (33.9) and Graham (30.1) had the highest county mortality rates. Santa Cruz County had the lowest rate (7.1).

There was no Healthy People 2010 goal established for Alzheimer’s mortality rate. The state’s age-adjusted Alzheimer’s mortality rate was 22.5 in 2001. There were three counties that exceeded the state mortality rates: Navajo (33.5), Maricopa (25.7), and Yavapai (23.2).

Arizona’s age-adjusted Diabetes mortality rate (19.9) in 2001 was significantly lower than the Healthy People 2010 goal (45.0). Ten counties exceeded the state’s mortality rate. Fourteen counties met the Healthy People 2010 goal, and only Santa Cruz County (52.6) did not meet the goal (Table 5i).

Reference

1. Arizona Department of Health Services, Arizona Health Status and Vital Statistics, 2001.