Presentation And Understanding Of Mortality Through Geospatial And Administrative Boundaries: An Examination Of Rates And Correlates Of Mortality In Texas Census Tracts

This capstone project analyses Texas vital statistics data through visual and tabular presentation of county-level age-adjusted mortality rates for all-cause and cause-specific mortality (including heart, cancer, and stroke) and through multilevel regression analyses of deaths at the census tract level, adjusting for individual and tract and demographic and socioeconomic factors. County-level, mortality rates were developed for three racial/ethnic groups in Texas, non-Hispanic Whites, non-Hispanic Blacks, and Hispanics. The rates were age-standardized based on the age structure of the total population of Texas. Rates are presented in tabular and visual formats using Texas Department of State Health Services Public Health Regions to allow for finer discussion of geographic areas within the state. For the tract data, deaths are analyzed using hierarchical Poisson regression model. This model used demographic factors including age, racial/ethnic category, and gender to identify correlates of deaths on the individual level. For the tract-level demographic factors (i.e. percent Hispanic (quartiles)), socioeconomic factors (percent in poverty (quartile)), and geographic identifiers (e.g. tracts in border counties and urban/rural tracts) were used to identify are-level effects that influence the number of deaths in a tract. These models used population size within each tract as a variable exposure to account for larger population areas having more deaths. The visual and tabular analyses of counties showed that non-Hispanic Blacks, overall, had the worst mortality rates of all groups across the state. Hispanics showed lower rates than non-Hispanic Blacks, overall, and non-Hispanic Whites usually had the better rates of all groups. For all groups, within regions, and across the state, there was considerable variability though non-Hispanic Blacks, again, showed the worst patterns of mortality. Hispanics varied greatly across the state, doing very poorly along the eastern border of Texas but much better in the South, along the border. From the tract analyses, Hispanics, overall, did better than non-Hispanic Whites and non-Hispanic Blacks. This was especially true in areas of higher poverty and higher Hispanic populations.