Transcript Slide 1

Genesee County Health Department and
Genesee County Community Mental Health
Mortality Analyses
Fannie Rackover, Fatema Mamou, Tisha Deeghan
University of Michigan School of Public Health,
Genesee County Health Department, Genesee County Community Mental Health
Introduction
• People with serious mental illness die 25-30 years
sooner than the general population
• ≈ 30% of deaths in Genesee County Community
Mental Health (GCCMH) consumers are due to
cardiovascular disease
• Compared the health statuses of GCCMH and
Genesee County residents, using mortality data
provided by the Michigan Department of
Community Health
Aim
Results
Table 1. Results: Standardized Mortality Ratios (SMRs)
GCCMH
Genesee County
Age-adjusted all-cause
1.88
1.17
(95% CI, 1.81, 1.93) (95% CI, 1.16, 1.18)
Sex-stratified
Male
2.01
(95% CI, 1.69, 2.33)
1.78
(95% CI, 1.46, 2.1)
Female
Race-stratified
White
2.05
(95% CI, 1.96, 2.13)
0.98
(95% CI, 0.77, 1.20)
African-American
•To determine the magnitude of poor health
outcomes in a population with serious mental illness
as compared with the general population of Genesee
County
1.18
(95% CI, 1.18, 1.18)
1.23
(95% CI, 1.20, 1.26)
1.12
(95% CI, 1.10, 1.15)
1.12
(95% CI, 1.09, 1.14)
Standardized Mortality Ratio (all causes)
• Among GCCMH consumers who die of
cardiovascular disease, 50% die before age 55
whereas 15% of Genesee County residents die
before the same age.
by Gender
5 year average: 2005-2009
2.5
2
• Among GCCMH consumers who die of opiate use,
the mean age at death is 33.9 (95% CI, 32.4, 35.4)
whereas the mean age at death for Genesee County
residents is 41.3 (95% CI, 40.2, 42.4)
1.78
1.5
1.18
2
1.07
1
County
State
0.5
0
Female
Ratio to United States deaths, 2007
Standardized Mortality Ratio (all causes)
by Race
5 year average: 2005-2009
2.5
2.05
2
1.88
1.5
1.12
Among Genesee
County residents who
die of cardiovascular
disease, 15% die
before age 55
CMH
1.23
1.05
Male
• Among GCCMH consumers who die by suicide,
the mean age at death is 37 (95% CI, 35.8, 38.2),
whereas the mean age at death for Genesee County
residents is 46.4 (95% CI, 43.6, 49.2)
Standardized Mortality Ratio (all causes)
5 year average: 2005-2009
Among CMH
consumers who die of
cardiovascular disease,
50% die before age 55
2.01
1.03
1
1.5
0.98
1.12
CMH
1.05
County
State
1.17
0.5
1.06
1
0
White
0.5
Black
Ratio to United States deaths, 2007
0
CMH
Cumulative Distribution: Age at Death due to Cardiovascular Disease
5 year average (2005-2009)
Methods
• Genesee County residents matched to GCCMH
consumers within state mortality data
• GCCMH N = 328, Genesee County N = 19,798
• 5 year averages (2005-2009)
Conclusion
State
55
Mean Ages at Death due to Opiate Use (2005-2009)
Mean Ages at Death due to Suicide (2005-2009)
42
50
County
mean
38
CMH 3 year
average
(2007-2009)
36
Age
40
Age
• Statistical comparisons:
o Average age-adjusted, sex- and race-stratified allcause standardized mortality ratios (SMRs)
o Cumulative distribution for age at death due to
cardiovascular disease
o Mean ages at death due to opiate use and suicide
44
County
Ratio to United States deaths, 2007
County
mean
45
CMH 3 year
average
(2007-2009)
40
34
32
30
2004
35
2004
2005
2006
2007
Years
2008
2009
2005
2006
Years
2007
2008
The findings suggest poorer health outcomes at
younger ages for people with serious mental illness
as compared to the general population of Genesee
County. Both GCCMH and Genesee County have
more deaths than expected as compared to the
average United States death rate in 2007 (803.6
deaths per 100,000 population).
Further analysis is needed in order to determine the
extent of a possible protective factor for African
Americans served by a community mental health
organization.
2009
Acknowledgements
Thank you to: Dr. Sung Kyun Park, Dan Russell,
Jon Nigrine, Tracey Malin, Kristie Schmiege, Lisa
Coleman, Lauren Tompkins, Pat McLuckie, Lisa
Hutchins, & Office of Public Health Practice