Deaths: preliminary data for 2000.

OBJECTIVES: This report presents preliminary data on deaths for the year 2000 in the United States. U.S. data on deaths are shown by age, sex, race, and Hispanic origin. Data on life expectancy, leading causes of death, and infant mortality are also presented. METHODS: Data in this report are based on a large number of deaths comprising more than 94 percent of the demographic file and 85 percent of the medical file for all deaths in the United States in 2000. The records are weighted to independent control counts of infant deaths, and deaths 1 year and over received in State vital statistics offices for 2000. Unless otherwise indicated, comparisons are made with final data for 1999. For certain causes of death, preliminary data differ from final data because of the truncated nature of the preliminary file. These are, in particular, accidents, homicides, suicides, and respiratory diseases. RESULTS: The age-adjusted death rate in 2000 for the United States decreased slightly from 1999 to a record low in 2000. For causes of death, declines in age-adjusted rates occurred for heart disease, stroke, Chronic liver disease and cirrhosis, diabetes, and cancer. Age-adjusted rates for drug-induced deaths, alcohol-induced deaths, and firearm injuries also decreased during 2000. Declines also occurred for homicides, suicides, unintentional injuries, and Chronic lower respiratory diseases although the extent of the declines cannot be precisely assessed based on the preliminary data. Age-adjusted death rates increased between 1999 and 2000 for the following causes: Pneumonitis from solids and liquids, Alzheimer's disease, kidney disease, hypertension, Influenza and pneumonia, and Septicemia. The infant mortality rate for the black population was 4 percent lower, while the rate for the white population decreased (nonsignificantly) by 2 percent. Life expectancy at birth rose by 0.2 years to a record high of 76.9 years.     

Deaths: preliminary data for 2002.

OBJECTIVES: This report presents preliminary data on deaths for the year 2002 in the United States. U.S. data on deaths are shown by age, sex, race, and Hispanic origin. Death rates for 2002 are based on population estimates consistent with the April 1, 2000, census. Data on life expectancy, leading causes of death, and infant mortality are also presented. METHODS: Data in this report are based on a large number of deaths comprising approximately 97 percent of the demographic file and 93 percent of the medical file for all deaths in the United States in 2002. The records are weighted to independent control counts of infant deaths and deaths 1 year of age and over received in State vital statistics offices for 2002. Unless otherwise indicated, comparisons are made with final data for 2001. For certain causes of death, preliminary data differ from final data because of the truncated nature of the preliminary file. These are, in particular, unintentional injuries, homicides, suicides, and respiratory diseases. Populations were produced for the Centers for Disease Control and Prevention's National Center for Health Statistics under a collaborative arrangement with the U.S. Census Bureau. The populations reflect the results of the 2000 census. This census allowed people to report more than one race for themselves and their household members and also separated the category for Asian or Pacific Islander persons into two groups (Asian and Native Hawaiian or Other Pacific Islander). These changes reflected the Office of Management and Budget's (OMB) 1997 revisions to the standards for the classification of Federal data on race and ethnicity. Because only one race is currently reported in death certificate data, the 2000 census populations were "bridged" to the single race categories specified in OMB's 1977 guidelines for race and ethnic statistics in Federal reporting, which are still in use in the collection of vital statistics data. RESULTS: The age-adjusted death rate in 2002 for the United States decreased from 854.5 deaths per 100,000 population in 2001 to 846.8 in 2002. Declines in age-adjusted death rates occurred for Diseases of heart, Malignant neoplasms, Cerebrovascular diseases, Accidents (unintentional injuries), Chronic liver disease and cirrhosis, and Assault (homicide). The decrease in homicide reflects the effect of the terrorist attacks of September 11, 2001, on the rates for that year. Age-adjusted death rates also decreased for alcohol-induced deaths between 2001 and 2002. Age-adjusted death rates increased between 2001 and 2002 for the following causes: Alzheimer's disease, Influenza and pneumonia, Essential (primary) hypertension and hypertensive renal disease, Septicemia, and Nephritis, nephrotic syndrome and nephrosis. Life expectancy at birth rose by 0.2 years to a record high of 77.4 years. The infant mortality rate increased between 2001 and 2002, the first numerical increase in the infant mortality rate since 1957-58. However, supplemental analyses of fetal death records indicate that the perinatal mortality rate remained stable between 2001 and 2002.     

Deaths: preliminary data for 2001.

OBJECTIVES: This report presents preliminary data on deaths for the year 2001 in the United States. U.S. data on deaths are shown by age, sex, race, and Hispanic origin. Death rates for 2001 are based on population estimates consistent with the April 1, 2000, census. Data on life expectancy, leading causes of death, infant mortality, and deaths resulting from September 11, 2001, terrorist attacks are also presented. For comparison, this report also presents revised final death rates for 2000, based on populations consistent with the April 1, 2000, census. METHODS: Data in this report are based on a large number of deaths comprising approximately 98 percent of the demographic file and 92 percent of the medical file for all deaths in the United States in 2001. The records are weighted to independent control counts of infant deaths and deaths 1 year and over received in State vital statistics offices for 2001. Unless otherwise indicated, comparisons are made with final data for 2000. For certain causes of death, preliminary data differ from final data because of the truncated nature of the preliminary file. These are, in particular, accidents, homicides, suicides, and respiratory diseases. Populations were produced for the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS) under a collaborative arrangement with the U.S. Census Bureau. The populations reflect the results of the 2000 census. This census allowed people to report more than one race for themselves and their household members and also separated the category for Asian or Pacific Islander persons into two groups (Asian and Native Hawaiian or Other Pacific Islander). These changes reflect the Office of Management and Budget's (OMB) 1997 revisions to the standards for the classification of Federal data on race and ethnicity. Because only one race is currently reported in death certificate data, the 2000 census populations were "bridged" to the single race categories specified in OMB's 1977 guidelines for race and ethnic statistics in Federal reporting, which are still in use in the collection of vital statistics data. RESULTS: The age-adjusted death rate in 2001 for the United States decreased slightly from 869.0 deaths per 100,000 population in 2000 to 855.0 in 2001. For causes of death, declines in age-adjusted death rates occurred for Diseases of heart, Malignant neoplasms, Cerebrovascular diseases, Accidents (unintentional injuries), and Influenza and pneumonia. Age-adjusted death rates also declined for drug-induced deaths between 2000 and 2001. Age-adjusted death rates increased between 2000 and 2001 for the following causes: Alzheimer's disease, Nephritis, nephrotic syndrome and nephrosis, Essential (primary) hypertension and hypertensive renal disease, and Assault (homicide). The increase in homicide was a direct result of the terrorist attacks of September 11, 2001. The infant mortality rate did not change between 2000 and 2001. Life expectancy at birth rose by 0.2 years to a record high of 77.2 years.     

Deaths: preliminary data for 2004.

OBJECTIVES: This report presents preliminary U.S. data on deaths, death rates, life expectancy, leading causes of death, and infant mortality for the year 2004 by selected characteristics such as age, sex, race, and Hispanic origin. METHODS: Data in this report are based on a large number of deaths comprising approximately 91 percent of the demographic file and 90 percent of the medical file for all deaths in the United States in 2004. The records are weighted to independent control counts for 2004. For certain causes of death such as unintentional injuries, homicides, suicides, and respiratory diseases, preliminary and final data differ because of the truncated nature of the preliminary file. Comparisons are made with 2003 final data. RESULTS: The age-adjusted death rate for the United States decreased from 832.7 deaths per 100,000 population in 2003 to 801.0 deaths per 100,000 population in 2004. Age-adjusted death rates decreased between 2003 and 2004 for the following major causes of death: Diseases of heart, Malignant neoplasms, Cerebrovascular diseases, Chronic lower respiratory diseases, Accidents (unintentional injuries), Diabetes mellitus, Influenza and pneumonia, Septicemia, Chronic liver disease and cirrhosis, and Pneumonitis due to solids and liquids. Rates increased between 2003 and 2004 for the following: Alzheimer's disease and Essential (primary) hypertension and hypertensive renal disease. Life expectancy at birth rose by 0.4 year to a record high of 77.9 years.     

Deaths: preliminary data for 2003.

OBJECTIVES: This report presents preliminary U.S. data on deaths, death rates, life expectancy, leading causes of death, and infant mortality for the year 2003 by selected characteristics such as age, sex, race, and Hispanic origin. METHODS: Data in this report are based on a large number of deaths comprising approximately 93 percent of the demographic file and 91 percent of the medical file for all deaths in the United States in 2003. The records are weighted to independent control counts for 2003. For certain causes of death such as unintentional injuries, homicides, suicides, and respiratory diseases, preliminary, and final data differ because of the truncated nature of the preliminary file. Comparisons are made with 2002 final data. RESULTS: The age-adjusted death rate for the United States decreased from 845.3 deaths per 100,000 population in 2002 to 831.2 deaths per 100,000 population in 2003. Age-adjusted death rates decreased between 2002 and 2003 for the following causes: Diseases of heart, Malignant neoplasms, Cerebrovascular diseases, Accidents (unintentional injuries), Influenza and pneumonia, Intentional self-harm (suicide), Chronic liver disease and cirrhosis, and Pneumonitis due to solids and liquids. They increased between 2002 and 2003 for the following: Alzheimer's disease, Nephritis, nephrotic syndrome and nephrosis, Essential (primary) hypertension and hypertensive renal disease, and Parkinson's disease. Life expectancy at birth rose by 0.3 years to a record high of 77.6 years.     

Black-white inequalities in mortality and life expectancy, 1933-1999: implications for healthy people 2010

OBJECTIVES: Optimistic predictions for the Healthy People 2010 goals of eliminating racial/ethnic disparities in health have been made based on absolute improvements in life expectancy and mortality. This study sought to determine whether there is evidence of relative improvement (a more valid measure of inequality) in life expectancy and mortality, and whether such improvement, if demonstrated, predicts future success in eliminating disparities. METHODS: Historical data from the National Center for Health Statistics and the Census Bureau were used to predict future trends in relative mortality and life expectancy, employing an Autoregressive Integrated Moving Average (ARIMA) model. Excess mortality and time lags in mortality and life expectancy for blacks relative to whites were also estimated. RESULTS: Based on data for 1945 to 1999, forecasts for relative black:white age-adjusted, all-cause mortality and white:black life expectancy at birth showed trends toward increasing disparities. From 1979, when the Healthy People initiative began, to 1998, the black:white ratio of age-adjusted, gender-specific mortality increased for all but one of nine causes of death that accounted for 83.4% of all US mortality in 1998. From 1980 to 1998, average numbers of excess deaths per day among American blacks relative to whites increased by 20%. American blacks experienced 4.3 to 4.5 million premature deaths relative to whites in 1940-1999. CONCLUSIONS: The rationale that underlies the optimistic Healthy People 2010 forecasts, that future success can be built on a foundation of past success, is not supported when relative measures of inequality are used. There has been no sustained decrease in black-white inequalities in age-adjusted mortality or life expectancy at birth at the national level since 1945. Without fundamental changes, most probably related to the ways medical and public health practitioners are trained, evaluated, and compensated for prevention-related activities, as well as further research on translating the findings of prevention studies into clinical practice, it is likely that simply reducing disparities in access to care and/or medical treatment will be insufficient. Millions of premature deaths will continue to occur among African Americans.     

新疆生产建设兵团1997～1999年居民期望寿命调查分析

目的：分析新疆生产建设兵团20世纪末的居民期望寿命和与寿命有关的指标。方法：采用分层胡机抽样方法，获得期望寿命，死亡率，死因顺位，去死因寿命，潜在减寿年数（YPLL）及人口长寿水平等指标，并对各项指标进行简要分析。结果：新疆生产兵团（兵团）1997－1999年期望寿命为75．61岁，男为72．73岁，女性为80．02岁；农牧团场的期望寿命为73．97岁，相对较低；经济水平高的地区期望寿命较高较高；北疆地区期望寿命高于南疆和东疆，年平均粗死亡率为5．17‰（标化死亡率为4．53‰）。主要死因顺位为：恶性肿瘤、脑血管病，呼吸系统疾病，心脏病，损伤与中毒，传染病与寄生虫病以及围产期情况。7种死因中，去除呼吸系统疾病和围产期情况寿命增幅较明显。主要死因的潜在减行率和标准化潜在减寿（SYPLL）率顺位的第1位均为意外死亡。经济水平较高地区长寿水平也较高，结论：兵团人均期望寿命水平较高，但不同地区相差较大，为全面提高居民健康水平，既要加强自然环境的治理和扶贫力度。也要重视呼吸系统（尤其是婴儿）、老年慢性病的防治和提高围期产期保健质量，进一步改善社会保障环境，降低损伤中毒的发生率。     

Cancer mortality among American Indians and Alaska Natives--United States, 1994-1998

In the United States, public health interventions to control infectious diseases, lower infant and maternal mortality, and improve basic sanitation have led to a substantial increase in life expectancy for American Indians and Alaska Natives (AI/ANs). During 1940-1995, average life expectancy among AI/ANs increased 39%, from 51 years in 1940 to 71 years in 1995; however, AI/ANs experienced a parallel increase in mortality rates for chronic diseases, including cancer, which is the second leading cause of death for AI/ANs nationally and the leading cause of death among Alaska Natives. A previous study examining cancer mortality rates during 1989-1993 documented lower cancer mortality rates for AI/ANs than for the overall U.S. population, with regional variation. To understand cancer mortality among AI/ANs subsequent to that period, the Indian Health Service (IHS) and CDC analyzed death certificate data provided by CDC's National Center for Health Statistics for deaths among AI/ANs in five U.S. geographic regions during 1994-1998. This report summarizes the results of that analysis, which indicate that cancer mortality rates among AI/ANs nationally were lower than cancer mortality rates for all U.S. racial/ethnic populations combined. Rates for AI/ANs varied by region, with the highest rates found in the Alaska and the Northern Plains regions. Plans or modifications for cancer prevention and treatment programs should account for regional variation, and programs to discourage smoking initiation, encourage tobacco cessation, and promote colorectal cancer screening among AI/ANs in the Alaska and the Northern Plains regions should be expanded.     

Age-adjusted death rates: trend data based on the year 2000 standard population.

Age-adjusted death rates are routine mortality risk measures used to compare rates over time or between groups such as those living in different geographic areas. This type of measure eliminates differences that would be caused because one population is older than another. Beginning with mortality data for 1999, the standard population used by the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS) to calculate age-adjusted death rates based on the Year 2000 estimated population distribution replacing that of 1940 used previously. Comparisons of 1999 mortality data with that of 1998 and earlier years cannot be made unless age-adjusted death rates are based on the same standard population. Changing the standard population generally changes the magnitude of an age-adjusted death rate and may change the magnitude of the differential between two groups. Typically, the change in standard makes relatively little difference in the mortality trend but it can when age-specific rates have divergent patterns. This publication provides age-adjusted death rates by race and sex based on the year 2000 population standard and directs readers to the NCHS Web site for age-adjusted death rates by selected causes.     

Alaska native mortality, 1979-1998

OBJECTIVES: This study compares mortality patterns for the Alaska Native population and the U.S. white population for 1989-1998 and examines trends for the 20-year period 1979-1998. METHODS: The authors used death certificate data and Indian Health Service population estimates to calculate mortality rates for the Alaska Native population, age-adjusted to the U.S. 1940 standard million. Data on population and mortality for U.S. whites, aggregated by 10-year age groups and by gender, were obtained from the National Center for Health Statistics, and U.S. white mortality rates were age-adjusted to the U.S. 1940 standard million. RESULTS: Overall, 1989-1998 Alaska Native mortality rates were 60% higher than those for the U.S. white population for the same period. There were significant disparities for eight of 10 leading causes of death, particularly unintentional injury, suicide, and homicide/legal intervention. Although declines in injury rates can be documented for the period 1979-1998, large disparities still exist. Alaska Native death rates for cancer, cerebrovascular disease, chronic obstructive pulmonary disease, and diabetes increased from 1979 to 1998. Given decreases in some cause-specific mortality rates in the U.S. white population, increased rates among Alaska Natives have resulted in new disparities. CONCLUSIONS: These data indicate that improvements in injury mortality rates are offset by marked increases in chronic disease deaths.     

Peer Reviewed: All-Cause Mortality in Tianjin,China, 1999-2004

Introduction

We analyzed trends of major causes of death in Tianjin, China, from 1999 through 2004 to better inform disease prevention and control programs and policies.

Methods

To report all-cause deaths among Tianjin residents from 1999 through 2004, we standardized mortality rates to the world population in 2000. We analyzed age, sex, and geographic distribution of deaths from different causes and the leading causes of death in Tianjin.

Results

The 5 leading causes of death in Tianjin were cardiovascular disease, cerebrovascular disease, malignant neoplasm, chronic lower respiratory disease, and injuries and poisoning. Mortality in Tianjin declined from 0.60% in 1999 to 0.48% in 2004. Noncommunicable diseases accounted for more than 80% of all deaths. Infant and maternal mortality in Tianjin were low. Life expectancy of Tianjin residents increased every year but was consistently longer in women. When deaths from the main chronic diseases are not considered, life expectancy lengthens substantially.

Conclusion

Chronic diseases are the leading cause of death in Tianjin, China. China should commit additional resources to supporting chronic disease prevention and control programs, including proven special health promotion projects.     

2004-2009年福建省0～14岁儿童死亡特征及其流行趋势分析

目的了解福建省0~14岁儿童的死亡原因和流行病学特征,为制定儿童疾病预防控制措施提供依据。方法使用福建省2004-2009年死因监测资料,对0~14岁儿童总死亡率、年龄别死亡率、死因别死亡率和死亡率的时间趋势等进行分析。结果 2004-2009年福建省0~14岁儿童年均死亡率为57.21/10万,呈下降趋势,年平均下降速度为6.8%。男童死亡率高于女童,农村的新生儿和婴儿死亡率高于城市。婴儿死亡占0~14岁儿童死亡的60.4%,新生儿死亡占婴儿死亡的65.5%。围生期疾病、先天异常和损伤中毒为0~14岁儿童的前3位死因。婴儿的粗死亡率为770.77/10万,主要死因为围生期疾病和先天异常,1~14岁儿童的主要死因为损伤和中毒,其中淹死是首位原因。结论福建省0~14岁儿童死亡率明显下降,现阶段仍应积极做好围生期疾病、先天异常和损伤中毒的干预工作。     

Increasing ethnic differences in mortality in Estonia after the collapse of the Soviet Union

STUDY OBJECTIVE: This study examined the change in ethnic differences in mortality in Estonia 1989-2000. DESIGN: Two unlinked cross sectional census based analyses were compared. Total and cause specific mortality was analysed for ethnic Estonians and Russians. The absolute differences in mortality were evaluated through life expectancy at birth and age standardised mortality rates. Relative differences were assessed by mortality rate ratios with 95% confidence intervals, calculated using Poisson regression. SETTING: Estonia before and after the fall of the Soviet Union. PARTICIPANTS: Individual cause specific death data for 1987-1990 (69549 deaths) and for 1999-2000 (33809 deaths) came from the national mortality database. Population denominators came from the population censuses of 1989 and 2000. MAIN RESULTS: In the period 1989-2000, ethnic differences in life expectancy increased from 0.4 years to 6.1 years among men and from 0.6 years to 3.5 years among women. In 2000, Russians had a higher mortality than Estonians in all age groups and for almost all selected causes of death. The largest differences were found for some alcohol related causes of death especially in 2000. CONCLUSIONS: Political and economic upheaval, increasing poverty, and alcohol consumption can be considered the main underlying causes of the widening ethnic mortality gap.