Georgia Annual Health Status Measures 2018

Georgia Annual Health Status Measures 2018 with comparisons to the U.S. and Healthy People 2000, 2010 & 2020 objectives Prepared by the Office of Health Indicators for Planning (OHIP), Georgia Department of Public Health. V17.0

Leading Causes and Overview Top Causes of Death and Population Characteristics

Leading* Causes of Death, Georgia Number of Deaths 2012-2016 Diseases of Heart Cancers 83,948 82,230 Chronic Lower Respiratory Diseases Unintentional Injury Stroke Alzheimer's Disease Diabetes Kidney Disease Septicemia Influenza and Pneumonia 21,637 19,676 19,602 14,356 10,849 8,638 7,462 7,196 0 10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000 90,000 Number of Deaths * Cause categories are the National Centers for Health Statistics (NCHS), rankable causes of deaths applied to Georgia. Source: Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP), OASIS Dashboard http://oasis.state.ga.us

Leading* Causes of Premature Deaths (before age 75), Georgia Years of Potential Life Lost 2012-2016 Cancers 682,701 Diseases of Heart Unintentional Injury (incl. MVA) 497,270 561,946 Perinatal Period Conditions Suicide Homicide Stroke Chronic Lower Respiratory Disease Diabetes Birth Defects 188,224 179,993 141,231 103,428 101,111 94,495 83,812 * Cause categories are the National Centers for Health Statistics (NCHS), rankable causes of deaths applied to Georgia. Source: Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP), OASIS Dashboard. http://oasis.state.ga.us/ 0 100,000 200,000 300,000 400,000 500,000 600,000 700,000 800,000 Years of Potential Life Lost

Total YPLL Rate 10,000.0 Rate of Premature Death (Years of Potential Life Lost (YPLL)) from Any Cause, Georgia, 1994-2016 9,500.0 9,000.0 8,500.0 8,000.0 7,500.0 7,000.0 6,500.0 6,000.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia YPLL Rate YPLL 75 represents the number of years of potential life lost due to death before age 75, as a measure of premature death. The YPLL 75 Rate is the years of potential life lost before age 75 that occur per 100,000 population less than 75 years of age. Source: Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Leading Actual Causes of Death*, Georgia Tobacco 12,141 Poor diet & physical inactivity 10,196 Alcohol Microbial agents Toxic agents Motor vehicle Firearms Sexual behavior Illicit drug use 2,348 2,079 1,543 1,207 805 537 470 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 Number of deaths Source: Georgia Department of Public Health, Vital Records Death File, 2006 Based on methodology by Foege and McGinnis.

Number Population by Race, and Hispanic or Latino Ethnicity*, Georgia, 1994-2016 6,500,000 6,000,000 5,500,000 5,000,000 4,500,000 4,000,000 3,500,000 3,000,000 2,500,000 2,000,000 1,500,000 1,000,000 500,000 0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 White Black or African-American Asian** American Indian or Alaska Native Multi-racial Hispanic or Latino Ethnicity *Hispanic can be of any race. ** Asian includes Native Hawaiian or Other Pacific Islander to be comparable across all years. Source: U.S. Census data as found in Online Analytical Statistical Information System (OASIS) Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Percentage Poverty Rates, Georgia and U.S., 2000-2016 30.0 20.0 12.3 12.7 13.0 13.4 13.7 14.5 14.8 14.3 14.7 16.6 18.0 19.2 19.2 19.0 18.4 17.2 16.1 10.0 0.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia U.S. Source: U.S. Census Small Area Income and Poverty Estimates (SAIPE). http://www.census.gov/did/www/saipe/data/interactive/

Percentage Poverty Rates of Children <5 years old, Georgia and U.S., 2000-2016 40.0 30.0 29.4 30.3 31.2 30.6 29.6 26.4 26.9 26.6 23.1 23.0 23.2 23.8 20.0 19.2 20.1 19.5 20.6 21.5 10.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia U.S. Source: U.S. Census Small Area Income and Poverty Estimates (SAIPE). http://www.census.gov/did/www/saipe/data/interactive/

Percentage Annual Average Unemployment Rates, Georgia and U.S., 1994-2016 15.0 10.0 5.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia US Source: Bureau of Labor Statistics; http://www.bls.gov/lau/tables.htm

Maternal and Child Health

Infant Deaths per 1,000 Live Births Infant Mortality Rate by Race, Georgia, and U.S., 1994-2016 20.0 10.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. Healthy People 2010 Objective = 4.5 Healthy People 2020 Objective = 6.0 Note: 2010 is underreported. Sources: Centers for Disease Control, Vital Statistics System, Mortality Data. September 14, 2009 http://www.cdc.gov/nchs/deaths.htm Online Analytical Statistical Information System (OASIS) Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Feto-Infant Deaths per 1,000 Live Births and Fetal Deaths Feto-Infant Mortality Rate, Perinatal Periods of Risk, Georgia, 1994-2015 Birth Cohorts 8.0 6.0 4.0 2.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Maternal Care Women's Health Linear (Women's Health) Axis Title Newborn Care Infant Care Source: Online Analytical Statistical Information System (OASIS) Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Premature Births per 100 Live Births Percentage of Live Births born Premature (<37 weeks), Georgia, and U.S. by Race, 1994-2016* 20.0 Change in definition* 10.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. Healthy People 2010 Objective = 7.6 * Georgia gestation calculated by OE method starting with 2008 data. U.S. figures from NCHS started using OE in 2007. Source: Online Analytical Statistical Information System (OASIS), Georgia Department Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Percentage Percentage of Live Births Weighing Less than 2,500 Grams (Low Birthweight), Georgia and U.S., by Race, 1994-2016 15.0 10.0 5.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. 1 Formula = [Total Number of Live Births under 2,500 grams / Total Number of Live Births] * 100. Healthy People 2000 Objective = 5.0% Healthy People 2010 Objective = 5.0% Healthy People 2020 Objective = 7.8% Sources: Centers for Disease Control & Prevention, CDC WONDER-DATA2010, http://wonder.cdc.gov/data2010/ Online Analytical Statistical Information System (OASIS), Georgia Department Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Age-Specific Rate per 1,000 Pregnancies 125.0 Age-Specific Pregnancy 1 Rate 2, Females 15-17 Years of Age, Georgia and U.S., by Race, 1994-2016 100.0 75.0 50.0 25.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. Healthy People 2000 Objective = 50.0 per 1,000 Healthy People 2010 Objective = 43.0 per 1,000 Healthy People 2020 Objective = 36.2 per 1,000 1 Pregnancies include conceptions that result in one or more Live Births, all Fetal Deaths and Induced Terminations. 2 The total number of pregnancies occurring to females in specified age group per 1,000 females in the specified age group. Formula = [Total number of pregnancies in age group / Total females in age group] * 1,000. Sources: Stephanie J. Ventura, M.A., Sally C. Curtin, M.A., Joyce C. Abma, Ph.D., Division of Vital Statistics; and Stanley K. Henshaw, Ph.D., The Guttmacher Institute. Estimated Pregnancy Rates and Rates of Pregnancy Outcomes for the United States, 1990 2008. National Vital Statistics Reports; vol 60 no 7. Hyattsville, MD: National Center for Health Statistics. June 20, 2012. Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Repeat Pregnancies per 100 Pregnancies 10-17 Percent Repeat Pregnancies, 10-17 Years of Age, Total and by Race, Georgia, 1994-2016 30.0 25.0 20.0 15.0 10.0 5.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Source: OASIS. Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us

Maternal Deaths per 100,000 Live Births Maternal Mortality Ratio, Total and by Race, Georgia, and U.S. Total, 1994-2016 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. Healthy People 2020 Objective = 11.4 * Defined by ICD10 ICD 10 codes A34, O00 O95, and O98 O99 (ICD9 630-676). Source: Online Analytical Statistical Information System (OASIS), Georgia Department Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Percentage Percent of Infants Being Breastfed at the Time of Discharge, Total and by Race, Georgia, 2007-2016 90.0 80.0 70.0 60.0 50.0 40.0 30.0 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia Healthy People 2020 Objective: 81.9% Source: Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP), Birth Files (accessed February 2, 2018)

Percentage 40.0 Of Repeat Births, Percent with Less Than Two-Year Birth Interval, Total and by Race, Georgia, 1994-2016 35.0 30.0 25.0 20.0 15.0 10.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia Source: OASIS. Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us

Obesity and Related Conditions

Percent of Adults Percentage of Adults 18 Years of Age and Older, who are Obese (BMI 30), Georgia and U.S., 1990-2016 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia U.S. Data after 2010 are not comparable with prior years Healthy People 2010 Objective: 15.0% Healthy People 2020 Objective: 30.5% Obesity is self-reported. Body Mass Index (BMI) is measured as weight in kilograms/height in meters Source: Centers for Disease Control & Prevention, National Center for Chronic Disease Prevention and Health Promotion, Behavioral Risk Factor Surveillance System (BRFSS), http://www.cdc.gov/brfss/ http://apps.nccd.cdc.gov/brfss/

Geographic Trends in Obesity 1993-1996 1997-1999 2000-2003 2004-2006 2007-2009 Percent of Obese Adults: < 10% 10-14% 15%-19% 20-24% 25-29% 30%+ Source: Georgia BRFSS

Rate per 100,000 population 100.0 Age-specific Rate of Obesity/Overweight-related Hospitalizations, 2-19 Years of Age, Georgia, by Race, 1999-2016 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10/1/15 change from ICD9-CM to ICD10-CM 10.0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia Definition: Obesity/Overweight-related hospitalization is defined as the hospital discharge where any one of the codes listed below was present in either the primary or other contributing cause. ICD-9 Codes: 278.0, 278.0[0-2], 278.1, 278.8, V85.2[1-5], V85.3[0-9], V85.4[1-5], V85.5[3-4] (before 10/1/15). ICD-10 Codes: E66.[0-3,9], E65, E67.8, Z68.2[5-9], Z68.3[0-9], Z68.4[1-5], Z68.5[3-4] (10/1/15 and after). Source: Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP).

Percent of Adults Percentage of Adults 18 Years of Age and Older who have Diabetes, Georgia and U.S., 1990-2016 20.0 15.0 10.0 5.0 0.0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia U.S. Healthy People 2000 Objective: 2.5% Healthy People 2010 Objective: 2.5% Source: Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011-2013 (accessed January 28, 2015). http://apps.nccd.cdc.gov/brfss/

Age-Adjusted Rate Age-Adjusted Diabetes Mortality Rates, Georgia and U.S., by Race, 1994-2016 50.0 45.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia U.S. GA. White GA. Black or African-American 1 Age-Adjusted to the 2000 Standard Million. Sources: Centers for Disease Control & Prevention, CDC WONDER, http://wonder.cdc.gov/ Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Age-Adjusted Rate 50.0 Age-Adjusted Alzheimer s Mortality Rates, Georgia and U.S., by Race, 1994-2016 45.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 1999 change from ICD-9 to ICD-10 coding of mortality data 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia GA. Black or African-American GA. White U.S. 1 Age-Adjusted to the 2000 Standard Million. Source: Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Cardiovascular Disease

Age-Adjusted Rate Age-Adjusted Stroke Mortality Rates, Georgia and U.S., by Race, 1994-2016 100.0 80.0 60.0 40.0 20.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. Healthy People 2020 Objective: 34.8 1 Age-Adjusted to the 2000 Standard Million. Stroke = ICD I60-I69 (ICD9 430-434, 436-438) Sources: Centers for Disease Control & Prevention, CDC WONDER, http://wonder.cdc.gov/ Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Age-Adjusted Rate 550.0 Age-Adjusted Cardiovascular Mortality Rates, Georgia and U.S, by Race, 1994-2016 450.0 350.0 250.0 150.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. 1 Age-Adjusted to the 2000 Standard Million. Cardiovascular = ICD10 I00-I78 (ICD9 390-434, 436-448) Sources: Centers for Disease Control & Prevention, CDC WONDER, http://wonder.cdc.gov/ Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Cancers

Age-Adjusted Rate 70.0 Age-Adjusted Cancer Mortality Rates, Georgia, 1994-2016 60.0 50.0 40.0 30.0 20.0 10.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Cervical Breast Lung Colon Prostate 1 Age-Adjusted to the 2000 Standard Million. Sex-specific causes have sex-specific denominators. Sources: Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Age-Adjusted Rate Age-Adjusted Lung Cancer Mortality Rates, Georgia and U.S., by Race, 1994-2016 70.0 65.0 60.0 55.0 50.0 45.0 40.0 35.0 30.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. Healthy People 2000 Objective: 42.0 Healthy People 2010 Objective: 44.9 Healthy People 2020 Objective: 45.5 1 Age-Adjusted to the 2000 Standard Million. Sources: Centers for Disease Control & Prevention, CDC WONDER, http://wonder.cdc.gov/ Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Percentage Percentage of Adults, 18 Years of Age and Older Who Smoke, Georgia and U.S., 1990-2016 30.0 25.0 20.0 15.0 10.0 5.0 0.0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia U.S. Data after 2010 are not comparable with prior years Healthy People 2000 Objective: 12.0% Healthy People 2010 Objective: 15.0% Healthy People 2020 Objective: 12.0% Source: Centers for Disease Control & Prevention, National Center for Chronic Disease Prevention and Health Promotion, Behavioral Risk Factor Surveillance System (BRFSS), http://www.cdc.gov/brfss/

Percentage 40.0 Percentage of Middle and High School Students Who Smoke, Georgia and U.S., 2001-2015 30.0 20.0 10.0 0.0 2001 2003 2005 2007 2009 2011 2013 2015 GA. Middle School (6th - 8th grades) GA. High School (9th - 12th grades) United States (9th - 12th grades) Healthy People 2010 Objective: 16.0% Healthy People 2020 Objective: 16.0% 1 Sources: Georgia Youth Risk Behavior Survey (YRBS), OASIS https://oasis.state.ga.us/oasis/yrbs/ Centers for Disease Control & Prevention, Youth Risk Behavior Survey, Trends in the Prevalence of Tobacco Use, National YRBS 1993-2011

Age-Adjusted Rate Age-Adjusted 1 Prostate Cancer Mortality Rates, Georgia and U.S., Males by Race, 1994-2016 100.0 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. Healthy People 2020 Objective: 21.8 1 Age-Adjusted to the 2000 Standard Million. Men only in denominator. Sources: Centers for Disease Control & Prevention, CDC WONDER, http://wonder.cdc.gov/ Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Age-Adjusted Rate 45.0 Age-Adjusted Breast Cancer Mortality Rates, Georgia and U.S. Women by Race, 1994-2016 40.0 35.0 30.0 25.0 20.0 15.0 10.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. 1 Age-Adjusted to the 2000 Standard Million. Women only in denominator. Healthy People 2020 Objective: 20.7 Sources: Centers for Disease Control & Prevention, CDC WONDER, http://wonder.cdc.gov/ Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Title 100.0 Percentage of Women 40 Years of Age and Older, Who Have Received a Mammogram Within the Last Two Years, Georgia and U.S., 1993-2016 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia U.S. Healthy People 2010 Objective: 70% Source: Georgia Department of Public Health, Georgia Behavioral Risk Factor Surveillance System (BRFSS)

Age-Adjusted Rate Age-Adjusted 1 Colon Cancer Mortality Rates, Georgia and U.S., by Race, 1994-2016 40.0 30.0 20.0 10.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. Healthy People 2020 Objective: 14.5 1 Age-Adjusted to the 2000 Standard Million. Sources: Centers for Disease Control & Prevention, CDC WONDER, http://wonder.cdc.gov/ Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Title Age-Adjusted Cervical Cancer Mortality Rates, Georgia and U.S. Women, by Race, 1994-2016 10.0 8.0 6.0 4.0 2.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. 1 Age-Adjusted to the 2000 Standard Million. Women only in denominator. Healthy People 2020 Objective: 2.2 Sources: Centers for Disease Control & Prevention, CDC WONDER, http://wonder.cdc.gov/ Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Percentage 100.0 Percentage of Women 18 Years of Age and Older, who had a Pap Smear within the Last Three Years, Georgia and U.S., 1992-2014 95.0 90.0 85.0 80.0 75.0 70.0 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Georgia U.S. Data after 2010 are not comparable with prior years Healthy People 2000 Objective: 90.0% Healthy People 2010 Objective: 85.0% Healthy People 2020 Objective: 93.0% Source: Georgia Department of Public Health, Georgia Behavioral Risk Factor Surveillance System (BRFSS)

Infectious Disease

Age-Adjusted Rate 45.0 Age-Adjusted 1 Pneumonia Mortality Rates, Georgia and U.S., by Race, 1994-2016 40.0 35.0 30.0 25.0 20.0 15.0 1999 change from ICD-9 to ICD-10 Coding of mortality data. 10.0 5.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. 1 Age-Adjusted to the 2000 Standard Million. Sources: Centers for Disease Control & Prevention, CDC WONDER, http://wonder.cdc.gov/ Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Percentage Percentage of Adults 65 Years of Age and Older, Ever Vaccinated for Pneumococcal Disease, Georgia, 1995-2016 100.0 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia U.S. Data after 2010 are not comparable with prior years Healthy People 2000 Objective: 60.0% Healthy People 2010 Objective: 90.0% Healthy People 2020 Objective: 90.0% Source: Centers for Disease Control & Prevention, National Center for Chronic Disease Prevention and Health Promotion, Behavioral Risk Factor Surveillance System (BRFSS), http://www.cdc.gov/brfss/

Rate per 100,000 population Age-Specific Influenza Hospital Discharge Rate, Adults 65+ Years of Age, Georgia, by Race, 1999-2016 100.0 80.0 60.0 40.0 20.0 0.0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Rate per 100,000 Age-Specific Influenza Mortality Rate, Adults 65+ Years of Age, U.S. and Georgia, 1994-2016 10.0 9.0 8.0 7.0 6.0 5.0 4.0 3.0 2.0 1.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia U.S. GA rates not displayed when < 5 events Sources: Centers for Disease Control & Prevention, CDC WONDER, http://wonder.cdc.gov/ Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Percentage 100.0 Percentage of Adults 65+ Years of Age, Who Have Received a Flu Vaccination within the Past 12 Months, Georgia and U.S., 1995-2016 80.0 60.0 40.0 20.0 0.0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia U.S. Data after 2010 are not comparable with prior years Healthy People 2000 Objective: 60% Healthy People 2010 Objective: 90% Healthy People 2020 Objective: 90% Source: Centers for Disease Control & Prevention, National Center for Chronic Disease Prevention and Health Promotion, Behavioral Risk Factor Surveillance System (BRFSS), http://www.cdc.gov/brfss/

Asthma

Rate per 100,000 5.0 Age-Adjusted Asthma Mortality Rates, Georgia and U.S., by Race, 1994-2016 4.0 3.0 2.0 1.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. Source: Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Rate per 100,000 Age-Adjusted Asthma Emergency Room Visit Rates, Georgia, by Race, 2002-2016 1,200.0 1,000.0 800.0 600.0 400.0 200.0 0.0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia * Please note: the last quarter of 2015 reflect a switch from icd9 to icd10 codes. Trends may be affected. Source: Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

12,000 Number of Asthma Emergency Room Visits, Georgia, by Age Group, Georgia, 2002-2016 11,000 10,000 9,000 8,000 7,000 6,000 5,000 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 0-4 years 5-9 years 10-17 years Source: Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

External Causes Drug Abuse / Suicide / Homicide

Number of Deaths Deaths From Drug Overdoses, Georgia, 1999-2016 1,600 1,400 1,200 1,000 800 600 400 200 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 All Drug Overdoses Heroin Only Unknown Heroin or Opioid Pain Reliever Opioid Pain Relievers (OPR) Only Both Heroin and Opioid Pain Reliever All Drug Overdoses can be from any kind of drug. The Opioid subsets can be broken down into 4 categories: OPR only / Heroin only / Cases where both OPR and Heroin are mentioned / Cases where an opioid is mentioned, but it is not stated what kind. Source: Georgia Department of Public Health, Office of Health Indicators for Planning, OASIS Deaths accessed November 11/08/2016.

Rate per 100,000 Population Age-Adjusted Emergency Room Visit Rate, Mental and Behavioral Conditions*, Total and by Race, Georgia, 2002-2016 1400.0 1200.0 1000.0 800.0 600.0 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia *Includes drug withdrawal syndrome, alcohol withdrawal, drug-induced delirium, etc. Source: OASIS. Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us

Number of Deaths Deaths from Drug Overdoses and Motor Vehicle Crashes, Georgia Residents, 1999-2016 1,800 1,600 1,400 1,200 1,000 800 Drug Overdose Motor Vehicle Crash 600 400 200 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Year Drug Overdose uses underlying cause ICD-10 Codes X40-X44, X60-X64, Y10-Y14, X85, F11-F16, F18 and F19; Motor Vehicle Crashes uses V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6, V20-V79, V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2 (E810-E825). Source: Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP), OASIS https://oasis.state.ga.us

Age-Adjusted Rate Age-Adjusted Suicide Mortality Rates 1, Georgia and U.S., by Race, 1994-2016 20.0 15.0 10.0 5.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. 1 Age-Adjusted to the 2000 Standard Million. Suicide = ICD10 X60-X84, Y87.0 (ICD9 E950-E959) Healthy People 2010 Objective: 4.8 Healthy People 2020 Objective: 10.2 Sources: Centers for Disease Control & Prevention, CDC WISQARS, http://www.cdc.gov/injury/wisqars/ Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Age-Adjusted Rate Age-Adjusted Homicide Mortality Rates 1, Georgia and U.S., by Race, 1994-2016 30.0 25.0 20.0 15.0 10.0 5.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. 1 Age-Adjusted to the 2000 Standard Million. Homicide = ICD10 X85-Y09, Y87.1 (ICD9 E960-E969) Healthy People 2010 Objective: 2.8 Healthy People 2020 Objective: 5.5 Sources: Centers for Disease Control & Prevention, CDC WISQARS, http://www.cdc.gov/injury/wisqars/ Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

External Causes Injury

Age-Adjusted Rate Age-Adjusted Motor Vehicle Crash Mortality Rates 1 Georgia and U.S., by Race, 1994-2016 30.0 25.0 20.0 15.0 10.0 1999 change from ICD-9 to ICD-10 Coding of mortality data 5.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. 1 Age-Adjusted to the 2000 Standard Million. Sources: Centers for Disease Control & Prevention, CDC WISQARS, http://www.cdc.gov/injury/wisqars/ Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Age-Adjusted Rate Per 100,000 Age-Adjusted All Other* Unintentional Injury Mortality Rates, Total and by Race, Georgia, 1994-2016 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia * Falls, Accidental Shooting, Drowning, Fire and Smoke Exposure, Poisoning (incl. some drug overdoses), Suffocation, All Other Unintentional Injuries. Source: OASIS. Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us

Sexually Transmitted Infection and Related Disease

Rate per 100,000 Live Births 150.0 Rate of Newly Diagnosed Cases of Congenital Syphilis, Georgia and U.S., 1992-2016 125.0 100.0 75.0 50.0 25.0 0.0 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia U.S. Healthy People 2010 Objective: 1.0 Healthy People 2020 Objective 9.6 Source: Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Rate per 100,000 Population Rate of Primary and Secondary Syphilis Cases, Georgia and U.S., 1998-2016 16.0 14.0 12.0 10.0 8.0 6.0 4.0 2.0 0.0 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia U.S. Online Analytical Statistical Information System (OASIS), Sexually Transmitted Disease, Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). (accessed 11/102016) http://oasis.state.ga.us/

Rate per 100,000 Population 1,000.0 Crude Rate of Newly Diagnosed Cases of Gonorrhea Georgia and U.S., 1990-2016 800.0 600.0 400.0 200.0 * 0.0 199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016 Georgia U.S. * Note: Data for 1994 are not available, rates presented are estimates. Grady Memorial Hospital started submitting gonorrhea data in 2016 Source: Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Rate per 100,000 Population Rates of Chlamydia Cases in Georgia and U.S., 1998-2016 700.0 600.0 * 500.0 400.0 300.0 2007 - USPHTF screening recommendation 200.0 100.0 0.0 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 U.S. Georgia * Grady Memorial Hospital started submitting gonorrhea and chlamydia data in 2016 Online Analytical Statistical Information System (OASIS), Sexually Transmitted Disease, Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). (accessed 11/102016) http://oasis.state.ga.us/

1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Rate per 100,000 Population Rate of Newly Diagnosed AIDS Cases, Georgia, 1981-2013 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 Georgia NOTE: Mandated reporting began in 1985 Source: Georgia Department of Public Health, AIDS Surveillance Program

Age-Adjusted Rate Age-Adjusted 1 Mortality Rate HIV/AIDS, Georgia and U.S., by Race, 1994-2016 60.0 50.0 40.0 30.0 20.0 10.0 0.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia U.S. 1 Age-Adjusted to the 2000 Standard Million. HIV/AIDS = ICD10 B20.0-B24 (ICD9 042-044) Sources: Centers for Disease Control & Prevention, CDC WONDER, http://wonder.cdc.gov/ Online Analytical Statistical Information System (OASIS). Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us/

Immunization

Percent of Children Up-To-Date 100.0 Immunization Coverage Combined 6 Vaccine Series (4:3:1:3:3:1), Among Children 19-35 Months of Age, Georgia and U.S., 2000-2016 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Georgia U.S. Vaccine DTaP Polio MMR HIB Hep. B Varicella Recommended Doses 4 3 1 3 3 1 Source: Centers for Disease Control & Prevention, National Immunization Survey, https://www.cdc.gov/vaccines/imzmanagers/coverage/childvaxview/index.html

Health Services Access

Percent of Discharges Percent of Hospital Discharges that were Self-Pay, Total and by Race, Georgia, 1999-2016 10.0 8.0 6.0 4.0 2.0 0.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia Definition: The total number of dischargers where Primary Payor was self-pay per 100 total discharges. Source: Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP).

Percentage Percent of Hospitalizations that were Avoidable*, Total and by Race, Georgia, 1999-2016 25.0 20.0 10/1/15 change from ICD9-CM to ICD10-CM 15.0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GA. Black or African-American GA. White Georgia *Ambulatory Care Sensitive Conditions (ACSC): Conditions that respond to timely and effective care in the outpatient (ambulatory) setting. ACSC's are used as Prevention Quality Indicators, and can assist in evaluating quality or use of primary health care. Source: OASIS. Georgia Department of Public Health, Office of Health Indicators for Planning (OHIP). http://oasis.state.ga.us

Prepared by the Office of Health Indicators for Planning (OHIP), Georgia Department of Public Health. Many health indicators used in this report reside in the Department s Health Information Repository, and can be accessed online via the Online Analytical Statistical Information System (OASIS): http://oasis.state.ga.us Please direct questions to (404) 657-2867 or ohip@dph.ga.gov Healthy People information can be found online at http://www.healthypeople.gov Updated 1.30.13 with Intercensal Population Estimates. Updated with race imputation in Birth data 1.11.17 v17.0