-- Health - Status and comparisons
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-- Health status
In February 2020, New Jersey, along with other states and foreign nations, was forced to confront the coronavirus designated by the World Health Organization as COVID-19 which had originated in the city of Wuhan in China. Through March 2020, New Jersey would rank second behind only New York State in the number of confirmed cases and deaths among the 50 states.
The overall health status of New Jersey residents as compared to those of other states has been a special concern since 1973, when the National Cancer Institute published a cancer atlas showing extremely high levels of cancer in New Jersey-- with 19 of the state’s 21 counties ranking in the top 10% of all counties in the US in cancer death rates and particularly high rates along the New Jersey Turnpike corridor. The report led to the state being branded by one prominent academic researcher and the media as the site for "Cancer Alley," provoking understandable controversy over the basis for the findings. At the time, both the Institute and high-level state environmental officials attributed the cancer incidence to the number of petrochemical facilities in the area, but later analysts disputed the methodology of the report to the point where it was largely discredited.
Whatever the scientific merits of the NCI report, it provoked a political response which sparked a series of legislative and regulatory measures. Among other actions, the state initiated a comprehensive program to monitor the sites of toxic chemical production and storage; disclose the nature and risks of chemicals to workers at each site; track shipping of such substances through the state; establish a fund for cleanup of toxic spills and existing landfills; and create a statewide registry of cancer cases. New Jersey's aggressive program became the model for similar actions in other states, as well as for the federal Superfund program to identify and clean up toxic sites around the country.
The most recent cancer statistics report (based on 2013 data) of the Center for Disease Control and Prevention ranked New Jersey just behind Kentucky, Delaware and New York with the highest rates of cancer, among all types and genders. New Jersey cancer rates exceeded the national average, with breast cancer leading among women and prostate cancer among men. Although incidence rates were high compared to other states, data also showed that death rates from cancer in New Jersey are lower than in many other parts of the country--a fact which some analysts attributed to patients having access to high quality care in the state and at nearby out-of-state cancer treatment centers.
On most other current measures of health status and behavior, New Jersey appears to rank either better or equal with its sister states. In a survey released in December 2017, New Jersey ranked as the 12th-healthiest state in the nation (falling from 9th in the prior year), according to the annual state health rankings published by the United Health Foundation, an affiliate of the health insurer UnitedHealth Group. The top-ranked states were 1) Massachusetts 2) Hawaii, 3) Vermont, 4) Utah and 5) Connecticut. First released in 1990, the rankings are compiled based on death rates, disease incidence, health status and other factors. In its most recent report released April 2017, the nonprofit Leapfrog Group ranked New Jersey hospitals overall among the 50 states as 15th best in safety (infection rates, re-admissions, complaints etc.) based on the number of hospitals that earned the highest grade of 'A', an improvement from its 22nd rating in the prior year survey.
Over the past 25 years, the state ranked among the top six states in improving its health status, rising from a low of 25th. The most progress, according to the report, was found in areas such as "smoking cessation, reducing the infant mortality rate and lowering the number of cardiovascular deaths.” Continuing concerns were identified as increasing rates of obesity (26.3% of adults in 2014 compared to 9.9% in 1990) and diabetes (9.2% in 2014, over twice the rate in 1996); relatively low rates of physical activity; high prevalence of low birth weight babies; high rates of preventable hospitalizations; and large disparities in health status by race and educational attainment.
Within the state, wealth and socioeconomic status are the strongest indicators of health in a particular area. Hunterdon County--the wealthiest county in New Jersey--was the healthiest in the state for the eighth straight year, according to the annual analysis released in March 2017 co-sponsored by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. Cumberland County--the poorest county with a poverty rate of 18%--also ranked as the least healthy in the state.
* America's Health Rankings 2017, United Health Foundation
* 2017 New Jersey County Health Rankings, Robert Wood Johnson Foundation/University of Wisconsin Population Health Institute
* New Jersey State Cancer Registry, New Jersey Department of Health
* Cancer Incidence and Mortality in New Jersey, 2008-2012, New Jersey Department of Health
* New Jersey State Nutrition, Physical Activity and Obesity Profile 2015, Centers for Disease Control and Prevention
* The Dartmouth Atlas of Health Care
* New Jersey Hospital Ratings, Leapfrog Group
* Protecting New Jersey's Environment: From Cancer Alley to the New Garden State, Thomas Belton (2010)
* New Jersey Health Profiles 1900 and 2000, New Jersey Department of Health
* How Disease Rates Vary by State--And What States Can Do About It, 12/12/2016, Stateline.org
-- Life expectancy
In 2018, New Jersey's estimated population was 8,908,520 persons, according to the US Census Bureau. Life expectancy for those born in New Jersey during 2014 was 80.9 years, above the national average of 78.8 years. Among the 50 states, it tied for seventh with New Hampshire in the longest life expectancy, which was led by Hawaii at 81.3 years. Female life expectancy was 82.5 years compared to 77.8 years for males.
Since the early 1990s, the birth rate among New Jersey residents has followed the same trend as that of the nation as a whole while always remaining below the US birth rate. Over half the births among New Jersey mothers are to those aged 25 through 34 years old. Since 1987, there have been more births to women aged 35 and over than to those under age 20. The median age of all mothers peaked in 2003-2004 at 30.5 years but the median age among first time mothers reached a high point of 28 years in 2011. For all births, the median age among African American and Hispanic mothers is about four years younger than among white and Asian/Pacific Islander mothers. For first births, the median age among African American and Hispanic mothers is about seven years younger than among white and Asian/Pacific Islander mothers.
In 2013, there were a total of 71,063 deaths in the state based on state health data. Over the three-year period through the end of 2013, New Jersey's age-adjusted death rate was 681.5 deaths per 100,000 persons in its population, compared to the national average of 751.3, making it the 42nd lowest rate of all states, according to the Centers for Disease Control and Prevention. The age-adjusted death rate among African Americans, however, is 25% higher than the rate among whites, nearly double the rate among Hispanics, and nearly triple the rate among Asians.
The number and rate of drug-related deaths, which had decreased to levels seen in the early part of the decade in 2007 and 2008, began to increase again in late 2009 and at higher growth rates in 2010 and 2011, the most recent year for which data is available as of December 2015. In 2011, 1,025 deaths were attributed to drug-related causes compared to 793 in 2000; the rate per 100,000 population was 11.4 compared to 13.9 for the nation. The state Department of Health partly attributed the growth to an increased supply of and demand for heroin, unintentional deaths due to heroin tainted with adulterants (including fentanyl), and an expanded prescription opioid diversion network and substance abuse base, especially among younger populations. In 2011, 1,025 deaths were attributed to drug-related causes compared to 793 in 2000; the rate per 100,000 population was 11.4 compared to 13.9 for the nation.
From 1990 through 2014, infant mortality decreased by 50% in the state, from 9.6 to 4.8 deaths per 1,000 live births. The rate among African Americans, however, is over three times the rate among whites and more than twice the rate among Hispanics. The difference in New Jersey between white and African American infant mortality is the largest of all states, primarily due to a relatively low rate among white births. The rate is highest among the oldest and the youngest mothers and, regardless of age, unmarried mothers have rates two to three times that of married mothers. Infants whose mothers receive no prenatal care are nine times more likely to die than those whose mothers receive prenatal care, and a key objective of state health policy is to further expand care to all prospective mothers.
-- Causes of death
As in the nation as a whole, heart disease and cancer are the first and second leading causes of death in New Jersey, accounting together for about half of all deaths each year. In the counties of Gloucester, Hunterdon, Monmouth, Somerset, and Sussex, however, due to relatively low heart disease death rates, cancer is the leading cause of death ahead of heart disease. It is the second leading cause of death in all other counties, as well as in the nation. Cape May County has had, on average, the highest rate of cancer incidence of all state counties for the last 10 years, which has been linked to the older average age of its residents who grew up during a time when smoking tobacco was more prevalent and cancer prevention was limited.
For 2018, the American Cancer Society estimated that there would be 16,040 deaths from cancer during the year in New Jersey. Over the 2008-2012 period, the average annual deaths resulting from cancer was 16,684, and both New Jersey men and women had higher incidence rates compared to the US for the most common cancers with some exceptions, such as for lung and colorectal cancer. The leading deaths by cancer types in 2018 were projected to be lung and bronchus (3,670); colon and rectum (1,400); female breast (1,250); prostate (750); and pancreas (700).
Behind heart disease and cancer, stroke, chronic lower respiratory diseases, unintentional injury, diabetes, Alzheimer's disease, septicemia, kidney disease, and influenza/pneumonia constitute the remainder of the ten leading causes of death for New Jersey. Suicide is the tenth leading cause of death in the US, but ranks 13th in New Jersey.
* National Center for Health Statistics, Centers for Disease Control and Prevention
* Life Expectancy at Birth by State, Kaiser Family Foundation
* Cancer Facts & Figures 2018, American Cancer Society
* New Jersey State Cancer Registry, New Jersey Department of Health
-- Communicable Disease
Sexually transmitted diseases ("STDs") were the most common form of communicable disease with 52,000 cases reported in the state in 2017, according to data released annually by the state Department of Health. (The state statistics only cover diseases required to be reported to the Department, excluding such frequent illnesses as the common cold and other diseases). Influenza ranked second with over 13,000 cases of various strains. Hepatitis C, a blood-borne illness affecting the liver, had some 7,500 cases reported in 2017.
For primarily childhood diseases, there were a reported 480 cases of chicken pox; 41 of mumps; and 3 of measles. No cases of polio were reported.
Of the diseases which historically were causes of major epidemics and thousands of deaths in New Jersey, in 2017 there were no reported cases of smallpox, yellow fever or diphtheria and only four cases of cholera.
* 2017 New Jersey Reportable Communicable Disease Report, NJ Department of Health