In 2000, the Florida population was 15.9
million and had been estimated to increase
by 6.5 percent to 17 million in 2003.[6]
With rates of 76.3 and 75.2 births
per 1,000 women of childbearing ages,
respectively, Blacks/African-Americans
and Hispanics/Latinos(as), were the fastest
growing major race/ethnic groups in Florida
in 2002. American Indians/Alaskan Natives
had a birth rate of 65.8 per 1,000, and
Asians/Pacific Islanders had a rate of
65.2 per 1,000. In Florida, the lowest
birth rate was for Non-Hispanic Whites
with 53.7 births per 1,000 women of childbearing
ages.
Population
Dynamics
Geographic Distribution
Thirty-four of Florida's 67 counties
were metropolitan. [7]
There were four metropolitan counties
in Florida in 2002 which were home to
over one million residents each: Hillsborough
(1.1 million), where Tampa is located,
Palm Beach (1.2 million), Broward (1.7
million), which contains the city of Ft.
Lauderdale, and Miami-Dade (2.3 million).
Race/Ethnicity
Table 2 shows that in 2003 an estimated
2.8 million Florida residents were Hispanic/Latino(a)
(17 percent); this was a much lower proportion
than in the U.S.-Mexico Border States
(32 percent Hispanic/Latino(a)). Of the
6.9 million people who lived in Border
Counties in the 4 Border States, 49 percent
were Hispanic/Latino(a).[8]
Education
Levels of education completed in Florida
in 2000 were fairly consistent with the
rates across the U.S. Florida residents
were somewhat more likely to have completed
high school or higher education than residents
of the U.S.-Mexico Border States (80 percent
vs. 77 percent) (Table 6).
Income[9]
In Florida, the median family income
in 2000 was $45,625. This was consistent
with median family incomes for the U.S.-Mexico
Border States of Arizona ($46,723), Texas
($45,861), and New Mexico ($39,425), but
was below the median family incomes of
California ($53,035) and the U.S. ($50,035).
In 2000, the median family income for
Hispanics/Latinos(as) in Florida was $36,794.
Poverty
Table 4 shows that 22 percent of Florida
families lived below 150 percent of the
Federal poverty guidelines in 2000; this
was similar to the U.S. rate of 21 percent
but lower than the 25 percent rate in
the U.S.-Mexico Border States. The U.S.
Federal Poverty Thresholds[10]
were established as a baseline to develop
guidelines for determining eligibility
for Federal and State programs such as
Medicaid. In 2000, $17,761 for a family
of four was established as the poverty
threshold.
Health Access
In Florida, 18.0 percent of respondents
to the Behavioral Risk Factor Surveillance
System (BRFSS) indicated that at the current
time they were not covered by health insurance.[11],
[12] In the
U.S.-Mexico Border States, 19.4 percent
of families indicated they had no health
care coverage. The Florida rate was higher
than the U.S. rate of 15.2 percent (Table
5).
Health Professions Shortage Areas (HPSAs)
were the method that HRSA used to identify
areas of a State that did not have a sufficient
supply of health professionals to meet
the health needs of the population. Statewide,
66 percent of the population lived in
a primary care, 41 percent lived in a
dental, and 16.6 percent lived in a mental
HPSA (Tables 64, 65, and 66, respectively),
either single or partial county.
Health
Status
Health status indicators for this Report
were based on the Healthy Border 2010
Goals and Objectives established by the
U.S.-Mexico Border Health Commission in
2003. The Commission is a binational organization
dedicated to addressing the pervasive
health needs of the U.S.-Mexico Border.
The overarching goals of the Healthy
Border Program are:
- Improve the quality and increase the
years of healthy life, and
- Eliminate health disparities
The twenty Healthy Border (HB) 2010 objectives
fall into eleven principal areas with
their specific objectives as follows:
- Improve access to primary health
care
- Reduce cancer mortality in women
through improved screening for breast
and cervical cancers
- Reduce morbidity and mortality from
diabetes mellitus
- Improve water quality through improved
sanitation and reduce amount of acute
pesticide poisoning
- Reduce transmission of HIV
- Improve rates of immunization and
reduce rates of infectious diseases
- Reduce mortality from unintentional
injuries
- Reduce infant mortality and increase
the number of women receiving prenatal
care
- Reduce the suicide mortality rate
by improving mental health
- Increase the usage of dental and oral
health services
- Reduce morbidity from asthma
The tables in this report provide detailed
information about health status in Florida.
Healthy Border objectives are reported
along with rates for the State of Florida.
Breast
and Cervical Cancer
Healthy Border 2010 Objectives
for breast and cervical cancer:
- To reduce the female breast
cancer death rate to 33.7 deaths
per 100,000 women ages 25 or more
- To reduce the cervical cancer
death rate to 4.0 deaths per 100,000
women ages 25 or more
|
- Screening for breast cancer is an
important aspect of women's health.
Evidence from the BRFSS in 2002 showed
that 85 percent of women living in Florida
had a mammogram within the past 2
years; this was consistent with
the proportion of women living in the
Border States (83 percent) who have
had a mammogram within the past 2 years.
[13]
- The breast cancer incidence rate
in Florida was 97 per 100,000 population
(Table 7).
- The 2002 age-adjusted [14]
breast cancer mortality rate in
Florida was 24 per 100,000 females;
this was the same as the Border States.
The loss due to premature breast cancer
death cost 176 years of life per 100,000
females. This was higher than the years
of life lost to breast cancer mortality
in the Border States (145 years per
100,000 females).
- Regular screening with pap smears
helps with early detection of cervical
cancer. Eighty-four percent of women
living in Florida had received a pap
smear within the past 2 years; this
rate was similar to women living in
the Border States (82 percent) in general.
[15]
- In Florida, the 2002 cervical cancer
incidence rate was 11.5 per 100,000
females; this was higher than the Border
States incidence rate of 4.5 per 100,000
females (Table 7).
- In Florida, the 2002 age-adjusted
cervical cancer mortality rate at
2.9 per 100,000 females was similar
to the rate of 2.6 per 100,000 females
in the Border States and the U.S. (2.7
per 100,000 females).
Diabetes
Mellitus
Healthy Border 2010 Objectives
for diabetes mellitus:
- Reduce the hospital discharge
rate to 11.2 per 10,000 population
for diabetes mellitus
- Reduce the diabetes death
rate to 24.2 deaths per 100,000
population
|
In 2002, diabetes was the sixth leading
cause of death in the United States[16]
and Florida.[17]
Recent studies show that Type 2 diabetes
is preventable.[18]
Overweight and obesity contribute to diabetes
prevalence.[19] Findings from the BRFSS indicate that Hispanics/Latinos(as)
have a higher prevalence of diabetes than
Non-Hispanic Whites at comparable Body
Mass Index (BMI) ranking.[20]
Table 8 provides information about diabetes
in Florida.
Sources: Agency for Health Care Administration,
State Center for Health Statistics, Florida
Department of Health (2002), and Office
of Vital Statistics, Florida Department
of Health (2002).
- Fifty-seven percent of Florida residents
are overweight based on Body Mass Index:
38 percent are overweight but not obese,
and 19 percent are obese (Table 9).
- The reported prevalence of diabetes
in Florida was 7.7 percent of adults
responding to the BRFSS; this is slightly
higher than the Border States rate of
7.3 percent.
- Residents of Florida are somewhat
more likely to be hospitalized for
diabetes related issues (17.2 hospitalizations
per 100,000 population) than those living
in the Border States (14.5 per 100,000),
but have a somewhat lower rate than
the general U.S. population at 20 hospitalizations
per 100,000 population (Table 8).
- The diabetes age-adjusted mortality
rate in 2002 was 21 per 100,000
population in Florida; this is lower
than the Border States and U.S. rates
at 26 and 25 deaths per 100,000 population,
respectively.
- Premature death due to diabetes
results in 91 years of potential life
lost per 100,000 population in Florida;
this is 18 more years of life lost per
100,000 population than in the Border
States. This suggests that many of the
people in Florida who die as a result
of diabetes or diabetes complications
die at a younger age than those in the
Border States who die of diabetes. Years
of potential life lost rates in Florida
are also much higher than the U.S. rates
(79 years lost per 100,000 population).
Diabetes hospital discharge rates are
much higher than the HB 2010 goals. Age-adjusted
mortality rates for diabetes in Florida
exceeded HB 2010 goals.
HIV/AIDS
Healthy Border 2010 Objectives
for HIV:
- Reduce the incidence rate
to 4.2 per 100,000 population
for HIV
|
HIV/AIDS, despite recent advances in
treatment, is an increasing concern in
Mexico and a major cause of illness and
death in the United States.[21]
While the latest therapies have reduced
death rates from AIDS in the Border region,
their costs are prohibitive for some segments
of the population.[21]
Estimates in the United States of the
lifetime costs associated with health
care for HIV/AIDS have increased from
$55,000 to $155,000 or more, contributing
to the burden of illness, disability,
and death.[17]
In this context, HIV prevention becomes
even more cost-effective.
- The incidence rate for HIV in Florida
was 40 cases per 100,000 population
in 2002 and was much higher than the
Border States rate of 15.5 cases per
100,000 population (Table 10). The AIDS
incidence rate was 29 cases per 100,000
which was 2.5 times the Border States
rate of 11.5 cases per 100,000.
- The HIV incidence rate in Florida
(at 40 cases per 100,000) was 9.5 times
the established Healthy Border 2010
objective.
Hepatitis
and Tuberculosis
Healthy Border 2010 Objectives
for hepatitis and tuberculosis:
- Reduce the incidence rate
to 5.5 per 100,000 population
for hepatitis A
- Reduce the incidence rate
to 3.2 per 100,000 population
for hepatitis B
- Reduce the incidence rate
to 5.0 per 100,000 population
for tuberculosis (TB)
|
The TB incidence rate of 6.2 cases per
100,000 population in Florida was slightly
lower than the Border States rate of 7.8
cases per 100,000 population (Table 11).
Rates for hepatitis A and B in Florida
are 2.1 and 3.7 per 100,000 population,
respectively. Both rates for hepatitis
are lower than the Border States rates
of 4.3 for hepatitis A and 3.3 for hepatitis
B.
Florida exceeded the HB 2010 objectives
for hepatitis B and tuberculosis. The
hepatitis A incidence rate was less than
one-half the HB goal.
Sources: Bureau of Epidemiology, Florida
Department of Health (2003), and Bureau
of Tuberculosis and Refugee Health, Division
of Disease Control, Florida Department
of Health (2002).
Immunization
Coverage
Healthy Border 2010 Objectives
for immunizations are to achieve
and maintain an immunization coverage
rate of 90 percent for children
19 to 35 months of age for the following
vaccination series:
- 4+ doses of diphtheria, tetanus,
and pertussis or diphtheria and
tetanus (DTP)
- 3+ doses of haemophilus influenzae
(Hib)
- 3+ doses of hepatitis B vaccine
(HepB)
- 3+ does of polio vaccine
- 1 dose of varicella vaccine
- 1 dose of measles, mumps,
German measles vaccine (MCV)
|
If children are properly immunized, most
childhood diseases could be prevented.
This could result in a significant reduction
in the cost of health care. The only reliable
data available about childhood immunization
status come from the National Immunization
Survey (NIS). These data were available
only for the Nation and individual States.
- The NIS results estimated that 74
percent (plus or minus 5.5 percent)[22]
of Florida children 19 to 35 months
of age had coverage for the prescribed
vaccination series. Nationally, the
NIS estimated that 73 percent of children
in this age group (plus or minus 1.0
percent) had received this coverage.
- Non-Hispanic White children were somewhat
more likely to have received immunizations
(82 percent, plus or minus 5.9 percent)
than Hispanics/Latinos(a) (77 percent,
plus or minus 7.6 percent). Data for
other race/ethnic groups was not available
(Table 12).
Injury-Related
Deaths
Healthy Border 2010 Objectives
for selected injury-related deaths:
- Reduce the mortality rate
to 10.0 per 100,000 population
for deaths due to motor vehicle
crashes
- Reduce the mortality rate
to 10.3 per 100,000 population
for deaths due to unintentional
injuries for children ages 0 to
4
|
Injury is identified as the leading health
threat in the first 4 decades of life.[23]
Unintentional injury was the fifth leading
cause of death among all persons in Florida[24],
the Border States, and the United States[25]
in 2002. Most injuries are preventable.
Intentional injury is also among the leading
causes of death with suicide being eleventh,
and homicide being the fourteenth in the
United States.25 Injuries sustained
by violent-intentional or accidental-unintentional
means are responsible for more than 146,000
deaths each year nationwide.[26]
Source: Office of Vital Statistics, Florida
Department of Health (2002).
- The motor vehicle crash age-adjusted
mortality rate in Florida was 18.8
deaths per 100,000 population; this
was higher than the Border States rate
of 14.6 (Table 13).
- In 2002, lives claimed by premature
deaths due to motor vehicle crashes
resulted in the loss of 549 years of
life per 100,000 Florida Residents;
this was significantly higher than the
years of potential life lost rate for
the Border States (436 years lost per
100,000 population).
- In 2002, there were a total of 200
deaths among children ages 0 to 4 due
to unintentional injuries[27]
in Florida. Non-Hispanic White children
accounted for 52 percent of these deaths
(103 of 200) and Hispanic/Latino(a)
children accounted for 14.5 percent
of these deaths (29 of 200) statewide.
The Florida mortality motor vehicle crash
rate was 1.9 times the HB 2010 goal.
Prenatal
Care
Healthy Border 2010 Objective
for prenatal care:
- Increase the percent of women
starting prenatal care in the
first trimester to 85 percent
|
Early prenatal care is important to a
healthy pregnancy and is critical in identifying
potential problems that may put the pregnancy
at risk. Risk factors and maternal health
conditions including pregnancy-related
hypertension, gestational diabetes, and
cigarette smoking, among others, which
can contribute to poor infant outcomes
can be identified by screenings as a part
of prenatal care.[28]
Source: Office of Vital Statistics, Florida
Department of Health (2002).
- In Florida, 84 percent of women received
prenatal care in the first trimester
(Table 15).
- In 2002, 89 percent of Florida's Non-Hispanic
White mothers began prenatal care in
the first trimester. Eighty-three percent
of Hispanic/Latina mothers began prenatal
care in the first trimester.
- Blacks/African-Americans (76 percent)
and American Indians/Alaskan Natives
(70 percent) in Florida fell below the
desired goal set out in the Healthy
Border 2010 Objective (85 percent) for
the proportion of women who should start
prenatal care in their first trimester
of pregnancy.
Prenatal Care - Florida State Teenage
Mothers
Table 17 shows that in Florida, 64 percent
of mothers ages 15 to 17 received prenatal
care in the first trimester. This was
consistent with the proportion in the
Border States (67 percent).
Prenatal Care of Border Teenage Mothers
- Comparison of Race/Ethnicity to State
The proportions of teenage mothers of
all race/ethnicities in Florida who began
prenatal care in the first trimester of
pregnancy were far below the HB 2010 goals.
Source: Office of Vital Statistics, Florida
Department of Health (2002).
Teenage
Pregnancy
Healthy Border 2010 Objective
for teenage pregnancy, ages 15 to
17:
- Reduce teenage pregnancies
to 28.0 per 1,000 women ages 15
to 17
- The birth rate for teenage
women in Florida was 23 births
per 1,000 females ages 15 to 17.
This was consistent with the Border
States teenage birth rate of 29
births for each 1,000 females
ages 15 to 17 in 2002 (Table 16).
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Source: Office of Vital Statistics, Florida
Department of Health (2002).
- In 2002, the Black/African-American
teenage birth rate was 59 per 1,000
females ages 15 to 17 in Florida. There
was considerable variation in the teenage
birth rate by race/ethnicity. The rate
among Hispanics/Latinas was 35 births
per 1,000 teenage women and 12.8 per
1,000 among Non-Hispanic White teenage
women. The higher teenage birth rate
was reflected in all race-ethnic categories
except Non-Hispanic Whites and Asians/Pacific
Islanders.
- Overall, the teenage birth rate in
Florida was lower than the rate for
the U.S. (18 per 1,000 females ages
15 to 17). The Florida teenage birth
rate was below the HB 2010 goal of 28
births per 1,000 women between 15 and
17.
Infant
Mortality
Healthy Border 2010 Objective
for infant deaths:
- Reduce the infant mortality
rate to 4.6 deaths per 1,000 live
births
|
Table 14 shows that, in Florida, the
infant mortality rate in 2002 was
7.5 deaths per 1,000 live births.
Source: Office of Vital Statistics, Florida
Department of Health (2002).
- For Non-Hispanic Whites and Hispanics/Latinos(as),
the infant mortality rate was 6.6 and
4.5, respectively.
- The Black/African-American infant
mortality rate was 13.7 deaths for each
1,000 live births. This reflects an
infant mortality rate that was over
two times greater than occurred in the
Non-Hispanic White and Hispanic/Latino(a)
populations.
Mental
Health
Healthy Border 2010 Objective
for mental health:
- Reduce the mortality rate
for suicides to 9.4 deaths per
100,000 population
|
Meeting mental health needs has been
identified as a national priority in the
United States. The National Action Agenda,
established by the Surgeon General, notes
specific action steps aimed to decrease
the burden of mental illness include promoting
public awareness, supporting mental health-related
research, improving early assessment,
recognition and access to care, and training
appropriate personnel to recognize and
manage mental disorders.[29]
Hospitalizations for psychiatric-related
conditions occurred at the rate of
50 per 10,000 population in Florida in
2002; this was higher than the rate of
38 per 10,000 population for the Border
States (Table 18).
Suicide takes a disproportionate toll
in the community as well as on the family
and friends of the deceased. It also results
in a significant loss of years of potential
life of a productive community member.
Suicide was the ninth leading cause of
death in Florida[30]
and the eleventh in the U.S.[31]
- Table 18 shows that in 2002, the Florida
age-adjusted suicide mortality rate
was 13.4 deaths per 100,000 population.
This was somewhat higher than rates
for the Border States and U.S. (10.9
per 100,000 each).
- In Florida, suicide resulted in the
loss 292 years of life per 100,000 population.
Oral
Health
Healthy Border 2010 Objective
for oral health:
- Increase the use of oral
care system to 75 percent
|
"You are not healthy without good oral
health," noted Dr. C. Everett Koop, former
U.S. Surgeon General.[32]
The importance of meeting oral health
care needs in communities Florida, the
Border States and nationwide is increasing
as research continues to link oral health
with general well-being. Oral infection
has been associated with the onset and
severity of systemic diseases such as
cardiovascular disease and diabetes, and
negative birthing outcomes.[33]
Despite increased use of dental sealants
and water fluoridation, preventable oral
diseases still afflict many children and
adults during their lifetimes, impacting
their self-image and quality of life as
well as compromising their health and
well-being.33 Disparities in
access to preventative and therapeutic
oral care are demonstrated by the unmet
needs of those with lower income and education
levels, underserved populations, and a
notable proportion of untreated tooth
decay (over 40 percent in persons between
2 and 19 years, and approximately 90 percent
of adults) observed in individuals regardless
of sociodemographic characteristics.[34]
While it is now possible to maintain healthy
teeth throughout a lifetime, currently
available preventive measures, knowledge,
and technologies must be utilized universally
by professionals and consumers alike.[35]
The HB 2010 Objective for oral
health includes these essential services:
- Treatment of dental cavities
- Preventive services such as dental
sealants
- Dental restorative treatments such
as replacement of permanent teeth
- Screening and diagnosis of oral
and pharyngeal cancers
- Identification and referral for
treatment of oral birth defects, such
as cleft lip and cleft palate
Information collected in the Behavioral
Risk Factor Surveillance System (BRFSS)
results from answers to the question,
"Have you visited the dentist or dental
clinic within the past year for any reason?"
- In 2002, Florida residents fell below
the HB 2010 goal of 75 percent visiting
a dentist each year. Sixty-nine percent
of adults had visited a dentist or
dental clinic within the past year.
This was similar to the Border States
(66 percent) and the U.S. (70 percent).
Source: Behavioral Risk Factor Surveillance
System (2002).
Asthma
Healthy Border 2010 Objectives
for asthma:
- Reduce the hospital discharge
rate to 5.2 per 10,000 population
|
Of Florida respondents to the BRFSS,
10.5 percent reported that they have been
diagnosed as ever having asthma
by a health professional.
- In 2002, the Florida asthma hospitalization
rate of 15.1 per 10,000 was nearly three
times the HB 2010 goal. The hospitalization
rate reflects only cases that were severe
enough to be admitted to the hospital,
not cases that presented themselves
in the emergency department, treated
and released.
- Death due to asthma was a relatively
rare cause of death; the age-adjusted
mortality rate was 1.2 deaths per 100,000
population. This was similar to the
Border States and the U.S. rates (1.5
and 1.4 deaths per 100,000 respectively).
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