Monitoring racial/ethnic mortality disparities in Wisconsin: 1991-2000

Background: Wisconsin has a goal to eliminate health disparities by 2010, but there is no consistent standard used to evaluate progress. Methodological debates persist regarding using individual group change or relative comparisons to monitor disparities. Objectives: To examine mortality disparities among racial/ethnic populations in Wisconsin using statistically significant changes in individual population mortality rates and rate ratios as measures of disparity. These measures are proposed to monitor and evaluate progress in eliminating racial/ethnic health disparities. Methods: The Wisconsin Interactive Statistics on Health database was queried to obtain Wisconsin all-cause mortality data by race and age for the 1991-1995 and 1996-2000 periods. Age-specific and age-adjusted rates were compared across 5 major racial/ethnic populations in Wisconsin. Results: Age-adjusted mortality generally declined for all racial/ethnic populations in Wisconsin from 1991-1995 to 1996-2000. However, disparities increased significantly for African American infants, African Americans 45-64 years old, and Hispanics/Latinos 25-44 years old. Using non-Hispanic whites as a referent resulted in a paradoxical increase in disparities for Hispanics/Latinos despite a significant reduction in mortality in this group. Conclusion: A statistically significant percent change in mortality rates and rate ratios is a useful standard to monitor health disparities and foster communication and targeted action around Wisconsin's goal to eliminate racial/ethnic health disparities.