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Racial Disparities in Smoking-Attributable Mortality and Years of Potential Life Lost—Missouri, 2003–2007

November 26, 2010 / Vol. 59 / No. 46


MMWR Highlights

Smoking-Attributable Mortality (SAM)

  • During 2003–2007, smoking caused an estimated average of 9,377 deaths annually among adults in Missouri.
    • 8,400 among whites
    • 853 among blacks
  • An estimated 18.1% of deaths among persons aged ≥35 years in Missouri was the result of cigarette smoking (total number of deaths for this age group was 51,856).
  • During 2003–2007 in Missouri, smoking caused
    • 32.1% of all deaths from cancer
    • 15.3% of all circulatory deaths
    • 46.5% of all respiratory deaths

SAM Disparities

  • The SAM rate in Missouri for blacks was 18% higher than for whites, and this disparity was larger for black men (28%) than for black women (11%).
  • The SAM rates in Missouri for blacks were higher than for whites for malignant neoplasm and circulatory diseases but lower for respiratory diseases.
    • SAM rates for blacks were 26% higher than for whites for malignant neoplasm (e.g., cancers of the trachea, lung, or bronchus).
    • SAM rates for blacks were 53% higher than for whites for circulatory diseases (e.g., heart disease).
    • SAM rates for blacks were 32% lower than for whites for respiratory diseases (e.g., chronic airway obstruction).

Years of Potential Life Lost (YPLL) Disparities

  • The smoking-attributable YPLL rate for blacks was 18% higher than for whites.
  • Black men had a YPLL rate 25% higher than white men.
  • Black women had a YPLL rate 15% higher than white women.
  • The YPLL rates for blacks were higher than for whites for malignant neoplasm and circulatory diseases but lower for respiratory diseases.
    • The YPLL rate resulting from smoking-related cancer deaths for blacks was 19% higher than for whites, and blacks had a 14% higher YPLL rate specifically for lung cancer.
    • For circulatory deaths, the YPLL rate for blacks was 54% higher than for whites, and blacks had a 35% higher YPPL rate specifically for ischemic heart disease.
    • For respiratory diseases, the YPLL rate for blacks was 33% lower than for whites, and blacks had a 38% lower rate specifically for chronic airway obstruction.


 

Factors Associated with Disparities

  • The primary driver of SAM disparities is differences in the prevalence of smoking.
    • Although the smoking prevalence among blacks and whites in Missouri fluctuated during the past two decades, blacks tended to have a higher smoking prevalence than whites.
    • In 2009, the smoking prevalence was 27.1% among black adults and was 22.1% among white adults.
  • Racial disparities in smoking-related morbidity and mortality may be associated with the following:
    • socioeconomic status
    • cigarette smoking patterns (e.g., amount and duration of smoking)
    • differences in biologic and genetic factors (e.g., nicotine metabolism)
    • differences in population demographics
    • geographic variations in tobacco control programs and policies
    • tobacco industry marketing strategies


 

Background

  • The adult module of CDC's Smoking-Attributable Mortality, Morbidity, and Economic Costs (SAMMEC) system was used to calculate the SAM and YPLL rates for this report.
 
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