The Burden of Diabetes in South Carolina Chapter 1. Demographics and Access to Health Care.
Download ReportTranscript The Burden of Diabetes in South Carolina Chapter 1. Demographics and Access to Health Care.
The Burden of Diabetes in South Carolina 2009 Chapter 1. Demographics and Access to Health Care Figure 1.1. South Carolina Estimated Population Distribution as of July 1, 2007 Racial/Ethnic Distribution Black 28% White 67% American Indian 0% Other* 1% Asian 1% Data Source: ORS, Generated by DHEC Chronic Disease Epidemiology & Evaluation Hispanic 4% February 2009 Figure 1.2. Trends in Race/Ethnic Populations 1980-2007 (other than white and African American) 200 Hispanic Asian All Other Races Native American 1,000 Pop 150 100 50 0 1980 1990 Data Source: ORS, Generated by DHEC Chronic Disease Epidemiology & Evaluation 2000 2007 February 2009 Figure 1.3. Age Distribution of Estimated Population as of July 1, 2008 40% 35% 30% 25% 20% 15% 10% 5% 0% <18 18-44 45-64 Data Source: ORS, Generated by DHEC Chronic Disease Epidemiology & Evaluation 65+ February 2009 Figure 1.4. Urban, Rural and Very Rural Counties Based on Size of Largest Town Cherokee Greenville Spartanburg Pickens Oconee York Union Chester Anderson Lancaster Chesterfield Marlboro Laurens Fairfield Kershaw Newberry Darlington Abbeville Lee Dillon Marion Greenwood Saluda Lexington Richland Florence Sumter McCormick Horry Edgefield Calhoun Williamsburg Clarendon Aiken Orangeburg Urban Barnwell Georgetown Bamberg Dorchester Rural Berkeley Allendale Colleton Very Rural Hampton Charleston Jasper Beaufort Data Source: ORS, Generated by DHEC Chronic Disease Epidemiology & Evaluation February 2009 Figure 1.5. South Carolina Primary Care Health Professional Shortage Assessment by Type, as of June 2007 Generated by DHEC Chronic Disease Epidemiology & Evaluation Data Source: http://www.scdhec.gov/health/opc/docs/HPSA_primarycare.pdf February 2009 Fig 1.6. Physicians Employed in South Carolina, 2005 Cherokee Greenville Spartanburg Pickens York Oconee Union Chester Lancaster Chesterfield Marlboro Laurens Anderson Fairfield Kershaw Darlington Dillon Newberry Abbeville Lee Greenwood McCormic k Marion Saluda Richland Lexington Florence Sumter Horry Edgefield Calhoun Clarendon Aiken Orangeburg County Total Barnwell 100-600 Georgetown Bamberg 1-39 40-99 Williamsburg Berkeley Dorchester Allendale Colleton Hampton Charleston 1200+ Jasper Beaufort Data Source: ORS, Generated by DHEC Chronic Disease Epidemiology & Evaluation February 2009 Fig. 1.7. Number of Certified Diabetes Educators by County, 2008 Cherokee Pickens 4 Oconee 14 Greenville Spartanburg York 3 8 23 7 Union 5 Laurens Anderson 1 2 Newberry 1 Greenwood 5 Chesterfield 3 Kershaw 2 Saluda Lexington Marion 16 Florence Sumter 30 Horry 4 Calhoun Clarendon Aiken Diabetes Prevalence 2 Orangeburg 8 Barnwell Bamberg 8.9-10.3% 9 Williamsburg 1 13 2 4 Richland 13 Dillon Darlington Lee McCormick Edgefield < 8.9% Marlboro Fairfield 2 Abbeville 2 Lancaster 3 Chester 6 Georgetown 4 Berkeley Dorchester Allendale > 10.3% State Rate: 9.6% 1 Colleton 2 Hampton 2 Jasper 6 Charleston 60 Beaufort 2 14 Data Source: AADE , Generated by Chronic Disease Epidemiology and Evaluation February 2009 Fig 1.8. Pharmacists Employed in South Carolina, 2005 Cherokee Greenville York Spartanburg Pickens Oconee Union Chester Lancaster Chesterfield Marlboro Anderson Laurens Fairfield Kershaw Dillon Darlington Newberry Abbeville Lee Marion Greenwood McCormic k Saluda Lexington Richland Sumter Florence Horry Edgefield Clarendon Calhoun Williamsburg Aiken Orangeburg County Total Barnwell Georgetown Bamberg Dorchester 1-39 Berkeley Allendale 40-99 Hampton Colleton 100-600 Charleston 1200+ Jasper Beaufort Data Source: ORS, Generated by DHEC’s Chronic Disease Epidemiology & Evaluation February 2009 Figure 1.9. South Carolina DPCP* Diabetes Coalitions ● Cherokee Greenville ● ● ● York Spartanburg Pickens Oconee Union ● ● Chester ● ● Lancaster Marlboro Chesterfield Anderson Laurens ● Fairfield Abbeville Newberry ● Kershaw Dillon Darlington ● Greenwood ● ● Lee ● Richland ● Saluda McCormick Lexington Marion Florence ● ● ● Sumter ● Horry ● Edgefield Calhoun Aiken Clarendon ● ● ● Orangeburg Barnwell Bamberg Dorchester • Active • Non-Active Data Source: Diabetes Prevention and Control Program Georgetown ● Berkeley Allendale ● ● Colleton Hampton ● Charleston ● Jasper * Coalitions are considered “Non-Active” if no activity has been reported in one year. Williamsburg ● Beaufort ● February 2009 Chapter 2. Risk Factors Chapter 2.a Risk Factors in the General Population Figure 2.1. Prevalence of Overweight or Obese among Adults by Race-Sex, SC, 1986-2007 90 80 70 Percent 60 50 40 30 20 10 White Men White Women Black Men Data Source: SC BRFSS, Generated by DHEC’s Chronic Disease Epidemiology & Evaluation Black Women 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 0 TOTAL February 2009 Figure 2.2. Prevalence of Overweight or Obese among Adults, 2007 Cherokee Greenville Spartanburg Pickens Oconee York Union Chester Lancaster Chesterfield Marlboro Laurens Anderson Fairfield Kershaw Darlington Dillon Newberry Abbeville Lee Marion Greenwood Saluda McCormick Lexington Richland Sumter Florence Horry Edgefield Calhoun Clarendon Aiken Williamsburg Orangeburg Georgetown Percent of Adults 45.0-59.9 60.0-69.9 70.0-79.9 80.0 Barnwell Bamberg Dorchester Berkeley Allendale Colleton Hampton Charleston Jasper Beaufort Data Source: 2007 BRFSS; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 2.3. Prevalence of Physical Inactivity among Adults by Race-Sex, SC, 2000-2006 80 70 60 Percent 50 40 30 20 10 0 2000 2001 White Men 2002 White Women 2003 2004 Black Men Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation 2005 Black Women February 2009 2006 Figure 2.4. Prevalence of Physical Inactivity among Adults, SC BRFSS, 2007 Cherokee Greenville York Spartanburg Pickens Oconee Union Chester Lancaster Chesterfield Marlboro Laurens Anderson Fairfield Kershaw Newberry Abbeville Dillon Darlington Lee Marion Greenwood McCormic k Florence Richland Saluda Lexington Horry Sumter Edgefield Calhoun Clarendon Aiken Williamsburg Orangeburg % Physical Inactivity Georgetown Barnwell Berkeley Bamberg Dorchester 10-19 20-24 25-30 31-36 Allendale Colleton Hampton Charleston Jasper Beaufort Data Source: SCDHEC SCAN; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 2.5. Prevalence of Consuming Fruits and Vegetables Less Than 5-A-Day among Adults by Race-Sex, SC, 1990-2007 % 100 90 80 70 60 50 40 30 20 10 0 1990 1991 1992 White Men 1993 1994 1995 White Women 1996 1997 1998 Black Men Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation 2000 2002 2003 Black Women 2005 2007 TOTAL February 2009 Figure 2.6. Prevalence of Consuming Fruits and Vegetables Less than 5-A-Day among Adults, SC BRFSS, 2007 Cherokee Greenville York Spartanburg Pickens Oconee Union Chester Chesterfield Lancaster Marlboro Laurens Anderson Fairfield Darlington Newberry Dillon Kershaw Abbeville Lee Marion Greenwood McCormic k Florence Richland Saluda Lexington Sumter Horry Edgefield Calhoun Clarendon Aiken Williamsburg Percent Orangeburg Georgetown 15.0-15.9 16.0-17.9 Barnwell Berkeley Bamberg Dorchester Allendale Colleton 18.0-19.9 Hampton 20.0-25.0 Jasper Charleston Beaufort Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 2.7. Prevalence of Current Cigarette Smoking among Adults with Diabetes by Race-Sex, SC, 2007 % 35 30 25 20 15 10 5 0 White Men White Women Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation Black Men Black Women February 2009 Figure 2.8. Prevalence of Smoking among Adults, SC BRFSS, 2007 Cherokee Greenville York Spartanburg Pickens Oconee Union Chester Chesterfield Lancaster Marlboro Laurens Anderson Fairfield Darlington Newberry Dillon Kershaw Abbeville Lee Marion Greenwood McCormic k Florence Richland Saluda Lexington Sumter Horry Edgefield Calhoun Clarendon Aiken Williamsburg Percent of Smokers Orangeburg Georgetown Barnwell 16.0-19.9 20.0-21.9 22.0-24.9 25.0-30.0 Berkeley Bamberg Dorchester Allendale Colleton Hampton Charleston Jasper Beaufort Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 2.9. Age-Specific Prevalence of Major Behavioral Risk Factors among Adults, SC BRFSS, 2007 90 80 70 Percent 60 50 40 30 20 10 0 <30 30-39 Overweight 40-49 50-59 Physical inactivity Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation 60-69 Smoking 70-79 < 5-A-Day February 2009 80+ Chapter 2.b Diabetes Management and Control Figure 2.10. Prevalence of Taking Insulin or Diabetes Pills Among People with Diabetes by Race and Sex, SC, 2007 80 70 60 Percent 50 40 30 20 10 0 White Men White Women Insulin Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation Black Men Black Women Pills February 2009 Figure 2.11. Prevalence of Taking Insulin and Diabetes Pills by Age among People with Diabetes, SC, 2007 80 70 60 Percent 50 40 30 20 10 0 18-44 45-54 Insulin 55-64 65+ Pills Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 2.12. Prevalence of Having Blood Glucose Checked among People with Diabetes by Race, Sex, SC, 2007 80 70 60 Percent 50 40 30 20 10 0 White Men White Women Daily Black Men Less than daily Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation Black Women Never February 2009 Figure 2.13. Prevalence of Having HbA1c Checked among People with Diabetes, SC, 2007 80 70 60 Percent 50 40 30 20 10 0 White Men White Women 2+ Black Men 1 only Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation Black Women Never February 2009 Figure 2.14. Prevalence of Having Eyes Examined among People with Diabetes by Race-Sex, SC BRFSS, 2007 100% 90% 80% 70% Percent 60% 50% 40% 30% 20% 10% 0% White Men White Women < 1 Year Black Men > 1 Year Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation Black Women Never February 2009 Figure 2.15. Prevalence of Eyes Being Affected by Diabetes among People with Diabetes, SC, 2007 30 25 Percent 20 15 10 5 0 White Men White Women Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation Black Men Black Women February 2009 Figure 2.16. Prevalence of Having Taken a Course for Managing Diabetes among People with Diabetes, SC, 2007 80 70 60 Percent 50 40 30 20 10 0 White Men White Women Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation Black Men Black Women February 2009 Figure 2.17. Prevalence of Receiving Flu Shot in Past 12 Months and Ever Received Pneumonia Vaccine among People with Diabetes, SC, 2007. 80 70 60 Percent 50 40 30 20 10 0 Flu Diabetes Pneumonia No Diabetes Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 2.18. Prevalence of Having Feet Checked by a Health Professional in the Last Year among People with Diabetes, SC, 2007 80 78 76 74 Percent 72 70 68 66 64 62 60 White Men White Women Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation Black Men Black Women February 2009 Figure 2.19. Prevalence of Self-Checking Feet for Sores or Irritations among People with Diabetes, By Race, Sex, SC, 2007 80 70 60 Percent 50 40 30 20 10 0 White Men White Women Daily Black Men <Daily Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation Black Women Never February 2009 Figure 2.20. Prevalence of Seeing a Health Professional for Diabetes in Past Year, SC, 2007 90 80 70 Percent 60 50 40 30 20 10 0 White Men White Women < Monthly Black Men Monthly Black Women None Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Chapter 3. Diabetes Morbidity Figure 3.1. Prevalence of Self-reported Diabetes by Race-Sex, SC 1988-2007 18 16 14 Percent 12 10 8 6 4 2 White Men White Women Black Men Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation Black Women 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 0 Total February 2009 Figure 3.2. Prevalence of Self-Reported Diabetes among Adults by Age, SC 2002-2007 25 20 Percent 15 10 5 0 2002 2003 18-44 2004 45-54 2005 55-64 Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation 2006 >= 65 2007 TOTAL February 2009 Figure 3.3. Age of Diagnosis of Diabetes among People with Diabetes, 2007 <18 2% 65+ 17% 18-44 35% 45-64 46% Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 3.4. Prevalence of Diabetes among Adults, 2007 Cherokee Pickens Greenville Spartanburg Oconee York Union Chester Laurens Anderson Lancaster Chesterfield Marlboro Fairfield Kershaw Dillon Darlington Newberry Abbeville Greenwood Lee Saluda Marion Richland Lexington McCormick Edgefield Florence Sumter Calhoun Horry Clarendon Williamsburg Aiken Orangeburg < 8.9% Georgetown Barnwell Bamberg Dorchester Berkeley Allendale 8.9-10.3% Colleton Hampton Charleston >10.3% Jasper State Rate: 9.6% Beaufort Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 3.5. Proportion of Hospitalizations with Diabetes of All Hospitalizations by Race-Age 2006 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% <20 20-29 30-39 40-49 Age 50-59 60-69 Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation 70-79 80+ February 2009 Figure 3.6. Total Number of Hospitalizations for Diabetes as the Primary Diagnosis, SC, 1987-2006 10,000 Hospital Discharges 9,000 8,000 7,000 6,000 5,000 4,000 3,000 2,000 1,000 Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 0 February 2009 Figure 3.7. Number of Hospital Discharges with Diabetes as the Primary Diagnosis by Age, SC, 1997, 2001 and 2006 Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 3.8. Rate of Hospitalizations with Diabetes as Primary or Secondary Diagnosis, 2006 5000 4500 4000 3500 3000 2500 2000 1500 1000 500 0 White Male White Female Primary Black Male Black Female Secondary Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 3.9. Age-Standardized Rate of Hospitalizations for Diabetes, (Primary Diagnosis), SC, 2006 Cherokee Greenville Spartanburg Pickens Oconee York Union Chester Lancaster Chesterfield Marlboro Laurens Anderson Fairfield Kershaw Newberry Darlington Abbeville Dillon Lee Marion Greenwood Saluda Lexington Richland Sumter Florence Horry McCormick Edgefield Calhoun Clarendon Williamsburg Aiken More than 250 Orangeburg Barnwell Georgetown Bamberg 176-250 Dorchester Berkeley Allendale 175 or less Colleton Hampton Charleston Jasper State Rate: 197.8 per 100,000 Beaufort Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 3.10. Total Hospital Charges (Million Current & Constant $) for Diabetes as the Primary Diagnosis, SC, 1987-2006 250 Dollars (Million) 225 200 175 In Current $ 150 In Constant $ 125 100 75 50 25 Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 0 February 2009 Figure 3.8. Rate of Hospitalizations with Diabetes as Primary or Secondary Diagnosis, 2006 (Rate per 100,000) 5000 4500 Primary Secondary (Rate per 100,000) 4000 3500 3000 2500 2000 1500 1000 500 0 White Male White Female Black Male Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation Black Female February 2009 Figure 3.11. Total Charges for Hospitalization among Patients with Diabetes by Race-Sex, 1987, 1997, 2001, and 2006 2000 1800 Primary Diagnosis 1600 Secondary Diagnosis 1200 1000 800 $1,000,000 1400 600 400 200 0 1987 1997 2001 2006 1987 1997 2001 2006 1987 1997 2001 2006 1987 1997 2001 2006 Male Female White Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation Black February 2009 Figure 3.12. Average Hospital Charge for Diabetes as Primary Diagnosis by Age, SC, 1991-2006 35000 30000 Dollars 25000 20000 15000 10000 5000 0 0- 10- 201991 301997 40- 50- 60- 2001 Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation 70- 80 + 2006 February 2009 Figure 3.13. Sources of Payment for Hospitalization among Patients with Diabetes as the Primary Diagnosis, SC, 2006 Pvt Ins 23% Self/Indigent 11% Other 1% Medicare 51% Medicaid 14% Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 3.14. Total Length of Hospital Stay for Patients with Diabetes as the Primary Diagnosis, 1996-2006 60,000 50,000 Days 40,000 30,000 20,000 10,000 Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation February 2009 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 0 Figure 3.15. Prevalence of CVD and Stroke by Diabetes Status, SC, BRFSS 2006 16 14 12 Percent 10 8 6 4 2 0 Myocardial Infarction Diabetes Coronary Heart Disease Stroke No Diabetes Data Source: SC BRFSS; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 3.16. Number of Hospitalizations for Major Diseases & Procedures by Diabetes Status, SC, 2006 150,000 140,000 With Diabetes 137,591 Without Diabetes 130,000 120,000 110,000 100,000 90,000 80,000 69,545 70,000 60,120 60,000 50,000 40,212 40,000 30,000 26,612 21,517 20,056 20,000 10,000 2,806 7,022 10,146 9,502 4,380 0 CVD MI CHD Stroke ESRD Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation HTN February 2009 Figure 3.17. Distribution of Complications among Inpatients with Diabetes as Primary Diagnosis, SC, 2006 Peripheral circulatory disorders 10% Hyperosmolar or other coma 6% Neurologic and eye 17% Renal 5% Unspecified complication 2% Ketoacidosis 31% Hypoglycemia 29% Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 3.18. Age-Adjusted Hospitalization of Diabetic Ketoacidosis by Race-Sex, SC, 2006 150 126.9 125 114 per 100,000 population 103.9 100 89.8 75 60.7 50 47 25 0 White Male White Female Black Male Black Female Other Male Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation Other Female February 2009 Figure 3.19. Age-specific Hospitalization Rates of Diabetic Ketoacidosis by Race-Sex, SC, 2006 180 per 100,000 population 160 140 120 100 80 60 40 20 0 <30 30-39 White Male 40-49 White Female 50-59 Black Male 60-69 Black Female Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation 70+ Total February 2009 Figure 3.20. Age-Adjusted Hospitalization Rate of Diabetic Renal Failure by Race-Sex, SC, 2006 1200 1100 988.4 1025.3 1000 per 100,000 population 900 800 700 638.2 600 520.4 500 400 359.8 253.6 300 200 100 0 White Male White Female Black Male Black Female Other Male Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation Other Female February 2009 Figure 3.21. Age-Specific Hospitalization Rate of Diabetic Renal Failure by Race-Sex, SC, 2006 6000 per 100,000 population 5000 4000 3000 2000 1000 0 <30 30-39 White Male 40-49 White Female 50-59 60-69 Black Male Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation 70+ Black Female February 2009 Figure 3.22. Dialysis Prevalence with Diabetes as Major Diagnosis, SC, 1997-2006. 3000 2750 2500 Number of Patients 2250 2000 1750 1500 1250 1000 750 500 250 0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 Year Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 3.23. Age-Adjusted Hospitalization Rate of Diabetic Dialysis by Race-Sex, SC, 2006 400 350 350 289 per 100,000 population 300 250 200 150 100 50 48 34 0 White Male White Female Black Male Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation Black Female February 2009 Figure 3.24. Age-Adjusted Hospitalization Rate of Diabetic Lower Extremity Amputation by Race-Sex, SC, 1997-2006 120 100.4 98.7 82.4 88.7 per 100,000 population 99.8 94.7 100 80 85.0 86.9 74.2 68.5 60 40.8 41.2 40.6 37.2 35.3 40 35.0 34.8 35.7 34.3 33.1 20 15.4 17.0 14.3 17.1 13.3 0 2002 Total 2003 Black Female 2004 Black Male 2005 White Female Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation 2006 White Male February 2009 Figure 3.25. Age-Specific Hospitalization Rates for Diabetic Foot Amputation by Race-Sex, SC, 2006 400 per 100,000 population 350 300 250 200 150 100 50 0 <30 30-39 White Male 40-49 White Female 50-59 Black Male 60-69 Black Female Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation 70+ Total February 2009 Figure 3.26. Percent of Live Births by Mother's Diabetes Status, SC, 2004 -2006 10 9 8 7 Percent 6 5 4 3 2 1 0 2004 2005 Gestational 2006 Prepregnancy Data Source: SCDHEC SCAN; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 3.27. Age-Adjusted Hospitalization Rate of Gestational Diabetes, SC, 2006 150 125 Percent 100 75 50 25 0 White Black 10 -- 19 20 -- 29 30 -- 39 Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation 40 -- 49 February 2009 Figure 3.28. Age-Adjusted Rate of ER Visits for Diabetes as the Primary Diagnosis by Race-Sex, SC, 1997-2006 Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 3.29. Rates of ER Visits with Diabetes as the Primary Diagnosis by Age, SC, 1997, 1999, 2001 and 2006 900 800 Per 100,000 population 700 600 500 400 300 200 100 0 0- 10- 20- 30- 40- 50- 60- 70+ Age 1997 1999 2001 2006 Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 3.30. Age-Standardized Rate of ER Visits for Diabetes, (Primary Diagnosis), SC, 2006 Cherokee Greenville Spartanburg Pickens Oconee York Union Chester Lancaster Chesterfield Marlboro Laurens Anderson Fairfield Kershaw Newberry Darlington Abbeville Dillon Lee Marion Greenwood Saluda Lexington Richland Sumter Florence Horry McCormick Edgefield Calhoun Clarendon Williamsburg Aiken More than 340 Orangeburg Barnwell Georgetown Bamberg 221-340 Dorchester Berkeley Allendale 220 or less Colleton Hampton Charleston Jasper State Rate: 263.9 per 100,000 Beaufort Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 3.31. Number of ER Visits with Selected Diabetic Complications by Race-Sex, SC, 2006 3000 2500 Frequency 2000 1500 1000 500 0 White Male White Female Black Male Complications Black Female Other Male Other Female No Complications Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 3.32. Total Charges for ER Visits with Diabetes as the Primary Diagnosis by Age, SC, 1997-2006 5,000 Thousand Dollars 4,500 4,000 3,500 3,000 2,500 2,000 1,500 1,000 500 0 0- 10- 20- 30- 40- 50- 60- 70+ Age 1997 1999 2001 2003 2006 Data Source: SC Office of Research and Statistics; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Chapter 4. Diabetes Mortality Figure 4.1. Age Adjusted Mortality Rate for Diabetes as the Underlying Cause of Death, SC, 1996-2006 70 Rate per 100,000 population 60 50 40 30 20 10 0 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 Year Total White Men White Women Data Source: SCDHEC SCAN; Generated by Chronic Disease Epidemiology and Evaluation Black Men Black Women February 2009 Year White Black Male Data Source: SCDHEC SCAN; Generated by Chronic Disease Epidemiology and Evaluation Female Total May 2009 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 65 60 55 50 45 40 35 30 25 20 15 10 5 0 1990 Rate per 100,000 Figure 4.2. Age Adjusted Mortality Rates for Diabetes as the Underlying Causes of Death by Race, Sex, SC, 1990-2006 Figure 4.3. Age-Specific Crude Mortality Rate for Diabetes as the Underlying Cause of Death, SC, 2006 600 500 400 300 200 100 0 15 to 19 20 to 24 25 to 34 Total 35 to 44 45 to 54 White 55 to 64 Black Data Source: SCDHEC SCAN; Generated by Chronic Disease Epidemiology and Evaluation 65 to 74 75 to 84 85 plus Other May 2009 Figure 4.4. Age-Adjusted Mortality of Diabetes (Underlying Cause of Death), SC, 2003-2006 Cherokee Greenville York Spartanburg Picken s Ocone e Union Chester Chesterfield Lancaster Marlboro Laurens Anderson Fairfield Darlington Newberry Dillon Kershaw Abbeville Lee Marion Greenwood McCormic k Florence Richland Saluda Lexington Sumter Horry Edgefield Calhoun Clarendon Aiken Williamsburg County 3 Year Mortality Rate per 100,0000 Orangeburg Georgetown Barnwell 8.0-19.9 20.0-29.9 Berkeley Bamberg Dorchester Allendale 30.0-39.9 Colleton Hampton Charleston 40.0-64.0 Jasper Beaufort Data Source: SCDHEC SCAN; Generated by Chronic Disease Epidemiology and Evaluation February 2009 Figure 4.5. Racial Rate Ratio of Diabetes as the Diabetes Death Racial Rate Ratios SC, (2004-2006 Averaged) Underlying Cause of Death, 2004-2006 Cherokee Greenville York Spartanburg Pickens Oconee Union Chester Chesterfield Lancaster Marlboro Laurens Anderson Fairfield Darlington Newberry Dillon Kershaw Abbeville Lee Marion Greenwood Florence Richland Saluda McCormick Lexington Sumter Horry Edgefield Calhoun Clarendon Aiken Williamsburg Orangeburg Black to White Rate Ratios Georgetown 0.00-0.99 1.00-1.99 2.00-2.99 Barnwell Berkeley Bamberg Dorchester Allendale Colleton 3.00-3.99 4.00-5.99 15.40 Hampton Charleston Jasper Beaufort Data Source: SCDHEC SCAN; Generated by Chronic Disease Epidemiology and Evaluation January 2009 Figure 4.6 . Total Number of Years of Potential Life Lost for Diabetes as Underlying Cause of Death by Race-Sex, SC, 1997-2006 Before the age of 75 600 550 500 TOTAL YEARS OF LIFE LOST 450 400 350 300 250 200 150 100 50 0 1997 1998 1999 White Male 2000 2001 White Female 2002 2003 Black Male Data Source: SCDHEC SCAN; Generated by Chronic Disease Epidemiology and Evaluation 2004 2005 2006 Black Female May 2009