Changing Mortality Rates by County

Tim Brown looks into the change in mortality rates due to cardiovascular diseases and diabetes across Texas counties.

By Tim Brown, County Information Senior Analyst

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Recently I saw the premiere episode of “WKRP in Cincinnati” for the first time in decades. If you don’t know the TV show, it was a half-hour comedy about a dysfunctional radio station located in Cincinnati, Ohio. When the rerun began, I was a bit taken aback by how old it all appeared. As the show ended, I watched the credits and saw it had first aired in 1978. I had thought the show was more recent, which got me thinking about how much has changed over the years.

Then on April 2, I saw an article on Nate Silverman’s website about mortality rates by county since 1980. By coincidence, 1978 and 1980 weren’t all the different. Jimmy Carter was president in both years, the first millennials wouldn’t be born until 1981, and the state’s bank crisis didn’t hit until 1982. 

Unlike the “FiveThirtyEight” article, which focused on national changes in mortality rates from 1980 to 2014, with maps of all 50 states, this article focuses on how certain, select mortality rates have changed in Texas.

The data in “FiveThirtyEight” and this article comes from the Institute for Health Metrics and Evaluation (IHME), which used data from the National Vital Statistics System to “estimate annual county-level mortality rates for 21 mutually exclusive causes of death” per 100,000 people from 1980 to 2014.

The first map shows the change in mortality rates due to cardiovascular diseases from 1980 to 2014. While the legend runs from red to blue, note that the mortality rate fell in every county in the state. Twenty-two counties experienced a decline of more than 50 percent in deaths from cardiovascular diseases over this period; a total of 245 counties experienced decreases of at least 25 percent.

Of course, these decreases are based on estimates with margins of error that can be significant in some counties. For example, based on IHME estimates, Ector County’s mortality rate fell 7.69 percent, with a confidence interval from -13.96 percent to -1.40 percent. Meanwhile, the mortality rate for Williamson County dropped 64.51 percent, with a much smaller confidence interval of -66.67 percent to -62.24 percent. 

Unfortunately, the news is not all good. Most counties experienced an uptick in diabetes, urogenital, blood and endocrine diseases — all of which appear as a single group as shown in the second map. IHME estimated that deaths from these diseases decreased in a few counties, shown in bright green. The mortality rate in counties shown in blue increased by at least 20 percent from 1980 to 2014. In some cases, mostly in the Panhandle, the rate increased by more than 80 percent, and it more than doubled in eight counties.

Again, the margin of error can be large. Potter County’s mortality rate from diabetes, urogenital, blood and endocrine diseases increased by 139.20 percent, with a confidence interval ranging all the way from 122.26 percent to 158.92 percent.

Luckily, the decrease in cardiovascular diseases more than offsets the increase in diabetes, urogenital, blood and endocrine diseases. Statewide, the cardiovascular disease mortality rate per 100,000 people fell from 490.07 in 1980 to 261.10 in 2014, while the statewide mortality rate from diabetes, urogenital, blood, and endocrine diseases rose from 50.69 to 60.81.

However, as mentioned above, IHME estimated the mortality rates for 21 categories. The table on mortality causes lists the change in statewide mortality rates from 1980 to 2014,  as estimated by IHME. The confidence interval for each change runs from the minimum to the maximum values shown in the table.

Just as music has changed since Dr. Johnny Fever and Venus Flytrap were spinning discs at WKRP, so too have mortality rates. As Benjamin Franklin opined, “In this world, nothing can be said to be certain, except death and taxes.”

For more details on these mortality rates, check out the article1 or download the data from the IHME2