Premature mortality in North Carolina: progress, regress, and disparities by county and race, 2000-2010.

BACKGROUND This study examined trends in premature mortality--defined as years of potential life lost before age 75 years--in North Carolina during the period 2000-2010. METHODS Premature mortality at the county level was calculated and compared for two 5-year periods (1996-2000 and 2006-2010) for the entire population, among whites, and among nonwhites. This study also examined and compared leading causes of death that contributed to premature mortality among whites and nonwhites in each county and in the state as a whole. RESULTS Premature mortality in North Carolina was reduced 13.3% for the population as a whole, 26.6% for nonwhites, and 7.2% for whites. However, premature mortality actually increased for the population as a whole in 20 counties, among whites in 35 counties, and among nonwhites in 8 counties. Among whites, chronic obstructive pulmonary disease, suicide, injuries, and motor vehicle crashes each contributed an above-average share of premature mortality. Among nonwhites, stroke, diabetes, homicide, and heart disease each contributed an above-average share of premature mortality. LIMITATIONS We were unable to calculate reliable rates of premature mortality for Hispanics, Asians, American Indians, and other nonwhite ethnic groups because the numbers at the county level were too small. CONCLUSIONS Public health professionals should focus attention on counties in which premature mortality is increasing or remaining constant and should address the specific underlying causes of such deaths. In counties in which premature mortality among whites is increasing, community health efforts should focus on prevention of smoking, suicide, and injury. In counties with large nonwhite populations, programs should focus on prevention of stroke, heart disease, diabetes, homicide, and kidney disease.