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CLIMATE CHANGE
The True Vector of Yellow Fever
Aedes africanus & others(sylvatic cycle)
Aedes aegypti (urban cycle)
Distribution of aedes aegypti in the Americasat the end of the eradication program in 1970, and in 1997
Laboratory confirmed Dengue hemorrhagic fever reporting in the Americas
At risk
Reported outbreak
Countries at Risk for Yellow Fever and Having Reported at Least One
Outbreak, 1985-1999
Countries at Risk for Yellow Fever and Having Reported at Least One
Outbreak, 1985-1999
Laredo, Texas
1999 on: the inexorable march of West Nile Virus
Appropriate vectors are abundant throughout the continent
Perhaps the most important emerging diseaseof the early 21st century
Obesity “Obesity is not a simple condition of eating too much. It is now recognized that obesity is a serious, chronic disease. No human condition—not race, religion, gender, ethnicity or disease states—compares to obesity in prevalence and prejudice, mortality and morbidity, sickness and stigma.”American Obesity Association, 2002
Obesity* Trends Among U.S. AdultsBRFSS, 1985
(*BMI 30, or ~ 30 lbs overweight for 5’4” person)
No Data <10% 10%-14% 15-19% 20%
Source: BRFSS, CDC.
Obesity* Trends Among U.S. AdultsBRFSS, 1991
(*BMI 30, or ~ 30 lbs overweight for 5’4” person)
Obesity* Trends Among U.S. AdultsBRFSS, 1995
(*BMI 30, or ~ 30 lbs overweight for 5’4” person)
Obesity* Trends Among U.S. AdultsBRFSS, 1999
(*BMI 30, or ~ 30 lbs overweight for 5’4” person)
No Data <10% 10%-14% 15-19% 20%
Source: BRFSS, CDC.
Obesity* Trends Among U.S. AdultsBRFSS, 2000
(*BMI 30, or ~ 30 lbs overweight for 5’4” person)
Source: Mokdad A H, et al. JAMA 2001;286:10
No Data <10% 10%-14% 15-19% 20%
Texas 1 2 3 4 5 6 7 8 9 10 11
Public Health Region
0
10
20
30
Percent
Texas BRFSS Regional Statistics1988-1993
Percent of population overweight (BMI)
PHR 11 rates significantly higher than regions 1,3,6,7 and 9.
PHR11 also had the highest rates for sedentary lifestyle
PHR 11 rates significantly higher than regions 1,3,6,7 and 9.
PHR11 also had the highest rates for sedentary lifestyle
Source TDH
Age-Standardized Prevalence of Diagnosed Diabetes per 100Adult Population by State, United States, 1994
Age-Standardized Prevalence of Diagnosed Diabetes per 100Adult Population by State, United States, 1998
Age-Standardized Prevalence of Diagnosed Diabetes per 100Adult Population by State, United States, 2000
Number (million) of Persons with Diagnosed Diabetes, United States, 1980-1999
Age-Specific Prevalence of Diagnosed Diabetes, by Race/Ethnicity and Sex, United States, 1999
Texas deaths: diabetesRates per 100,000
1990-1998
LRGV
Figure 1: Liver cancer in white males (includes Hispanics)1990-1994 (age adjusted), all ages.
DEATHS FROM LIVER CANCER BY STATE
Data are from the National Cancer Institute
Texas Hispanics13.5/100,000
Texas, all whites
1980 1983 1986 1989 1992 1995 1998
0
10
20
30
40
Rates/100,000
Deaths from chronic liver diseaseAge adjusted rates: Texas 1980-1998
Male Hispanics PHR 11Male Hispanics TexasMale White Texas
Data from Texas Department of Health
0-4 15-19 30-34 45-49 60-64
Age in years
0
5
Percent of total deaths
Age of death of whites and Hispanics: cirrhosis and liver cancer, Texas 1980-1998
10
15 White (median age 59.6 yrs)( n=25,780)
Hispanic (median age 56.3 yrs)(n=11745)
Data:TDH
LRGV
Item US LRGV
Per Capita Income $25,598 $12,426
Diabetes Cost $98.2 billion $473,000,000
Cost/case/yr $9,514 $9,514
Cost/capita/yr $366 $523
% cost/capita 1.4% 4.2%
Estimated Cost of diabetes in the LRGV
Data sources: NIH, CDC, ADA, TDH
BrownsvilleLaredoMcAllenSan AngelaVictoriaLubbockAbileneTexarkanaEl PasoKilleenWichita FallsWacoBryan-College StationAmarilloShermanCorpus ChristiLongviewSan AntonioGalvestonTylerMidland-OdessaBeaumontFort WorthBrazoriaAustinHouston Dallas
Adjusted for Occupational rate Unadjusted
.0 1 1.1 1.2 1.3 1.4
Occupational Wage Index for Texas Cities
Sources: Occupational EmploymentStatistics Survey, Bureau of Labor
Statistics; author’s calculation {From Dallas Federal Reserve ReportOn the Border Economy, June 2001 (www.dallasfed.com)}
Border Region Surpasses Texas andU.S. in Population Growth in Past Decade(Percent change, 1990 to 2000)
Percent
SOURCE: U.S. Census Bureau and Dallas Federal Reserve ReportOn the Border Economy, June 2001 (www.dallasfed.com)
McAllen Laredo Brownsville Texas El Paso United States
60
50
40
30
20
10
0