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Alarmed Officials Misconstrue AIDS Death Statistics


GLENDALE — When Glendale Mayor Larry Zarian saw the list, the statistics jumped out at him.

The list released by the U.S. Centers for Disease Control and Prevention ranked 11 large California cities in which AIDS was the leading cause of death for young men in 1990.

Pasadena ranked No. 2 and Zarian's city ranked No. 7.

Calls poured into the mayor's KIEV-AM radio talk show. What's happening, callers demanded. Why Glendale? Why Pasadena?

"I jumped like everybody else," Zarian said. "I said, 'Oh, my God, it cannot happen in our city.' "

Alan La Sha, director of the Pasadena AIDS Resource Center, also was shocked when he saw the list in his morning paper.

He thought Pasadena's ranking meant the city had a higher rate of AIDS deaths than anywhere but San Francisco, which was No. 1 on the list.

"I was very surprised," La Sha said. "It was an unanswered question for me--how could that possibly be? I was, 'Whoa. Wait a minute. Back up.' "

In fact, the numbers can be misleading. Even the study's authors acknowledge that the numbers, reported by The Times and other media, have been misconstrued.

The study's aim was to show that AIDS and related infections are the leading cause of death among men ages 25 to 44 in California and four other states, as well as 64 U.S. cities.

But the way the figures work, they tend to weight toward suburban cities that are largely white and middle-class--not because there are bigger AIDS problems but because there are fewer deaths from homicide and accidents.

"If you look at the percentage of AIDS deaths, it looks like it's worse in Pasadena (than Los Angeles, which ranked sixth), but it's not," said Susan Y. Chu, the study's co-author. "People are just not dying of other things. . . . In Los Angeles, there's a lot of people dying of homicide or drug abuse."

In Los Angeles, for instance, 17% of the deaths in 1990 among young men were homicides; in Pasadena, 8.5%, and in Glendale, 7.5%.

It's just a matter of how one looks at the numbers. The study, which was released June 15, looked at percentages of AIDS deaths among all deaths, rather than the AIDS death rate, which measures how many AIDS deaths there were among the population involved.

"If you want to know which city has the bigger problem with HIV, it's better expressed in terms of the AIDS rate rather than percentages of death," said Dr. Richard M. Selik, the study's co-author.

"The value of looking at percentages of deaths is it allows you to compare HIV with other causes in a way that can help the people living in a particular area to set their priorities."

The authors did not rank cities, but the media did: In California, Los Angeles was ranked No. 6, and Long Beach, No. 4. But the rate of AIDS deaths was actually higher in Long Beach than in Los Angeles.

Also, the study looked only at cities with more than 100,000 population; several smaller cities have much higher AIDS rates.

For instance, consider the AIDS death rate for young men in 1990, per 100,000 population: 38 in Glendale, and 111 in Pasadena. By comparison, the rate was 65 in Palm Springs and 588 in Laguna Beach; neither of the smaller cities was included in the study.

Nonetheless, the study's main point is indisputable: AIDS is the leading cause of death among young males in Pasadena, Glendale and nine other California cities. The number of deaths from AIDS is rising steadily, while the number of deaths from diseases such as heart disease, cancer and strokes stays about the same.

The proportion of deaths among young adults from AIDS is high. But deaths among young adults accounted for only 7% of all deaths in 1990, a small percentage. Still, people 25 to 44 make up about half of the country's work force, so their loss is "disproportionately disruptive," the researchers said.

AIDS workers in Pasadena have another explanation for the figures: Cities that offer services to AIDS patients tend to attract such patients, leading to higher numbers of deaths.

All Saints AIDS Service Center in Pasadena serves more than 2,000 people each month; in addition, the city runs the Andrew Escajeda AIDS clinic, and St. Luke Medical Center offers a special unit for AIDS and cancer patients.

That's not to say that the figures aren't alarming, said Dina Rosen, director of client services for All Saints.

"The other thing is that Pasadena isn't the lily-white picture that people think it is," she said. "Pasadena, wake up. We have a problem. The bottom line is that it's a pandemic. It's not 'them' anymore. It's in our own back yard."

Last year, Pasadena spent $243,222 on AIDS services. AIDS funds came out of a special health budget, apart from the city's $114.7-million general fund budget for services such as libraries and police. Pasadena also has an AIDS Community Coordinating Committee that develops AIDS services in the city.

AIDS Deaths

AIDS is the leading cause of death among men 25 to 44 in California and four other states, according to a recent report by the U.S. Centers for Disease Control and Prevention.

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