Bernard Hedge was screwed. I knew it the moment I laid eyes on him. The former bodybuilder was stuffed into a wheelchair in a two-room apartment with barely enough room for him to maneuver. His kidneys were failing. His blood pressure and diabetes were uncontrollable even with the dozens of pills he took each day. "Life is not guaranteed for any of us," Hedge told me. "I could live another year, five years, 10 years.
Nobody knows." Within a few months of the publication of my stories on the gap in death rates between whites and blacks, he would lose a leg to the diabetes. Then, a few months later, like too many black men, he'd lose his life early. He was 55. Death rate data I had decided to examine the gap in death rates for preventable and treatable diseases after a nurse friend introduced me to Hedge and after hearing Dr.
Patrick Remington, an epidemiologist at the University of Wisconsin School of Medicine, speak at an IRE medical reporting conference. Hedge was screwed, but he wasn't pathetic. His struggle to finish his life with dignity impressed me. Our stories found that black men were dying from these diseases in astonishing numbers.. rate nearly three times greater than white men. Remington introduced me to an invaluable resource for mortality data - the Centers for Disease Control and Prevention online "Wonder" system (http://wonder.edc.gov).
With it, I was able to calculate death rates by race, gender, and disease for every county and state in the nation. With it, I learned just how screwed Bernard was. After experimenting with Wonder, I decided to look at death rates for people under 65 years old suffering from seven treatable or preventable diseases. The idea was that these diseases - female breast cancer, cancer of the cervix and uterus, pneumonia, prostate cancer, colorectal cancer, high blood pressure and diabetes - might be a crude measure of people's access to health care, or lack of access to it in this case.
Our stories, published by The Plain Dealer in May 1998, found that black men were dying from these diseases in astonishing numbers, with more than 140 deaths for every 100,000 black men, a rate nearly three times greater than white men. The death rate for black women was double that of white women. For some of the illnesses, the death rate for blacks was now where it was for whites two decades ago.
And the gap between the races was widening. Pursuing prejudice A short time after my stories came out, I was blown away by a five-day series by Ford Fessenden - then of Newsday and now of The New York Times - that examined many of the same issues, but in much greater detail. Ford had attended the same IRE medical reporting conference I had. His eight-part series, "The Health Divide," published in Newsday in November and December of 1998, is available from IRE and is a must-read for anyone interested in health care reporting.
For my stories, I also used death certificate data that I purchased for $100 a year from the Ohio Health Department. I found these records (one for every person who died in the state that year) useful for finding relatives of people who died of specific illnesses. In the past, I've also used them to analyze C-section rates at hospitals across the state, find premature babies who died in hospitals not properly equipped to care for them, and uncover deaths at dangerous heart cath labs, among other things.
According to the National Center for Health statistics, 19 states make death records publicly available. They are California, New Jersey, Connecticut, Florida, Georgia, Iowa, Kentucky, Maine, Massachusetts, Michigan, Minnesota, North Carolina, Ohio, South Carolina, South Dakota, Vermont, Washington and Wisconsin. Most of them also make birth certificate records available, too. For all but eight states, some restrictions apply or state officials will make you jump through some hoops to get the data, such as producing a research proposal on how you'll use the records.
But I think you'l find the records worth the trouble. Vital Resources for Vital Statistics: National Center for Health Statistics: (301-436-8500). A great resource for reporters working with vital statistics data. National Association of Health Data Organization: (703-532-3282). Keeps tabs on which states make available vital statistics and hospital discharge data and how the public can get it. Centers for Disease Control and Prevention's online "Wonder" data system: (http://wonder.cdc.gov).
Allows you to run queries on mortality data for counties, states, or the nation. You can e-mail the results to yourself and then import the data into a spreadsheet for sorting and making nifty graphics. Dave Davis can be reached by e-mail at ddavis@plaind.com