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.     

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 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 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: final data for 1999.

OBJECTIVES: This report presents final 1999 data on U.S. deaths and death rates according to demographic and medical characteristics. Trends and patterns in general mortality, life expectancy, and infant and maternal mortality are also described. A previous report presented preliminary mortality data for 1999. METHODS: In 1999 a total of 2,391,399 deaths were reported in the United States. This report presents tabulations of information reported on the death certificates completed by funeral directors, attending physicians, medical examiners, and coroners. Original records are filed in the State registration offices. Statistical information is compiled into a national data base through the Vital Statistics Cooperative Program of the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention. For the first time in a final mortality data report, age-adjusted death rates are based upon the year 2000 population and causes of death are processed in accordance with the Tenth Revision of the International Classification of Diseases (ICD-10). RESULTS: The 1999 age-adjusted death rate for the United States was 881.9 deaths per 100,000 standard population, a 0.7 percent increase from the 1998 rate, and life expectancy at birth remained the same at 76.7 years. For all causes of death, age-specific death rates rose for those 45-54 years, 75-84 years, and 85 years and over and declined for a number of age groups including those 5-14 years, 55-64 years, and 65-74 years. Aortic aneurysm and dissection made its debut in the list of leading causes of death and atherosclerosis exited from the list. Heart disease and cancer continued to be the leading and second leading causes of death. The age-adjusted death rate for firearm injuries decreased for the sixth consecutive year, declining 6.2 percent between 1998 and 1999. The infant mortality rate, 7.1 infant deaths per 1,000 live births, was not statistically different from the rate in 1998. CONCLUSIONS: Generally, mortality continued long-term trends. Life expectancy in 1999 was unchanged from 1998 despite a slight increase in the age-adjusted death rate from the record low achieved in 1998. Although statistically unchanged from 1998, the trend in infant mortality has been of a steady but slowing decline. Some mortality measures for women and persons 85 years and over worsened between 1998 and 1999.     

Trends in preterm-related infant mortality by race and ethnicity, United States, 1999-2004.

Trends in preterm-related causes of death were examined by maternal race and ethnicity. A grouping of preterm-related causes of infant death was created by identifying causes that were a direct cause or consequence of preterm birth. Cause-of-death categories were considered to be preterm-related when 75 percent or more of total infant deaths attributed to that cause were deaths of infants born preterm, and the cause was considered to be a direct consequence of preterm birth based on a clinical evaluation and review of the literature. In 2004, 36.5 percent of all infant deaths in the United States were preterm-related, up from 35.4 percent in 1999. The preterm-related infant mortality rate for non-Hispanic black mothers was 3.5 times higher and the rate for Puerto Rican mothers was 75 percent higher than for non-Hispanic white mothers. The preterm-related infant mortality rate for non-Hispanic black mothers was higher than the total infant mortality rate for non-Hispanic white, Mexican, and Asian or Pacific Islander mothers. The leveling off of the U.S. infant mortality decline since 2000 has been attributed in part to an increase in preterm and low-birthweight births. Continued tracking of preterm-related causes of infant death will improve our understanding of trends in infant mortality in the United States.     

Deaths: leading causes for 2000.

OBJECTIVES: This report presents final 2000 data on the 10 leading causes of death in the United States by age, race, sex, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the annual report of final mortality statistics. METHODS: Data in this report are based on information from all death certificates filed in the 50 States and the District of Columbia in 2000. Causes of death classified by the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. RESULTS: In 2000 the 10 leading causes of death were (in rank order) Diseases of heart; Malignant neoplasms; Cerebrovascular diseases; Chronic lower respiratory diseases; Accidents (unintentional injuries); Diabetes mellitus; Influenza and pneumonia; Alzheimer's disease; Nephritis, nephrotic syndrome and nephrosis; and Septicemia and accounted for nearly 80 percent of all deaths occurring in the United States. Differences in the rankings are evidently by age, sex, race, and Hispanic origin. Leading causes of infant death for 2000 were (in rank order) Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birthweight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Newborn affected by complications of placenta, cord and membranes; Respiratory distress of newborn; Accidents (unintentional injuries); Bacterial sepsis of newborn; Diseases of the circulatory system; and Intrauterine hypoxia and birth asphyxia. Important variation in the leading causes of infant death is noted for the neonatal and postneonatal periods.     

Deaths: leading causes for 1999.

OBJECTIVES: This report presents final 1999 data on the 10 leading causes of death in the United States by age, race, sex, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the annual report of final mortality statistics and responds to an increasing volume of requests by data users for leading-cause tables with more age and race detail than previously published. METHODS: Data in this report are based on information from all death certificates filed in the 50 States and the District of Columbia in 1999. Causes of death classified by the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Age categories used to present leading causes of death in this report represent a substantial expansion from the age categories previously used to present leading-cause data in the annual report of final mortality statistics. RESULTS: In 1999 the 10 leading causes of death were (in rank order) Diseases of heart; Malignant neoplasms; Cerebrovascular diseases; Chronic lower respiratory diseases; Accidents; Diabetes mellitus; Influenza and pneumonia; Alzheimer's disease; Nephritis, nephrotic syndrome, and nephrosis; and Septicemia and accounted for nearly 80 percent of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 1999 were (in rank order) Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birthweight, not elsewhere classified; Sudden infant death syndrome; newborn affected by maternal complications of pregnancy; Respiratory distress of newborn; Newborn affected by complications of placenta, cord, and membranes; Accidents; Bacterial sepsis of newborn; Diseases of the circulatory system; and Atelectasis. Important variation in the leading causes of infant death is noted for the neonatal and postneonatal periods.     

Comparability of cause of death between ICD-9 and ICD-10: preliminary estimates.

OBJECTIVES: This report presents preliminary results describing the effects of implementing the Tenth Revision of the International Classification of Diseases (ICD-10) on mortality statistics for selected causes of death effective with deaths occurring in the United States in 1999. The report also describes major features of the Tenth Revision (ICD-10), including changes from the Ninth Revision (ICD-9) in classification and rules for selecting underlying causes of death. Application of comparability ratios is also discussed. METHODS: The report is based on cause-of-death information from a large sample of 1996 death certificates filed in the 50 States and the District of Columbia. Cause-of-death information in the sample includes underlying cause of death classified by both ICD-9 and ICD-10. Because the data file on which comparability information is derived is incomplete, results are preliminary. RESULTS: Preliminary comparability ratios by cause of death presented in this report indicate the extent of discontinuities in cause-of-death trends from 1998 through 1999 resulting from implementing ICD-10. For some leading causes (e.g., Septicemia, Influenza and pneumonia, Alzheimer's disease, and Nephritis, nephrotic syndrome and nephrosis), the discontinuity in trend is substantial. The ranking of leading causes of death is also substantially affected for some causes of death. CONCLUSIONS: Results of this study, although preliminary, are essential to analyzing trends in mortality between ICD-9 and ICD-10. In particular, the results provide a means for interpreting changes between 1998, which is the last year in which ICD-9 was used, and 1999, the year in which ICD-10 was implemented for mortality in the United States.     

The life expectancy of nonsmoking men and women

The pronounced difference in life expectancy between men and women in the United States and other industrialized countries has been attributed to a variety of causes, among them, differential rates of cigarette smoking. A study was undertaken to eliminate the confounding factors of imprecision in the taking of smoking histories and exaggeration of early traumatic deaths in life expectancy calculations. Survey data were collected on the lifetime smoking habits of adults in Erie County, Pa., as of 1972-74. In the survey interviews, careful distinctions were made between respondents who had formerly smoked and respondents who had never smoked. The survey data were combined with data collected from surviving relatives about the smoking habits of people who had died in Erie County during the years 1972-74. After deaths attributable to traumatic causes (accidents, suicides, and homicides) were removed, life tables were calculated for male and female nonsmokers over age 30. The resulting life expectancy figures for nonsmoking men and women of parallel age were virtually identical. Thus, differential rates of cigarette smoking are apparently the overwhelming cause for the male-female longevity difference. Actuarial tables should be divided by smoking behavior to reflect this finding. The results of the study suggest that the present longevity difference between men and women will disappear.     

Time series analysis of injuries

We used time series models in the exploratory and confirmatory analysis of selected fatal injuries in the United States from 1972 to 1983. We built autoregressive integrated moving average (ARIMA) models for monthly, weekly, and daily series of deaths and used these models to generate hypotheses. These deaths resulted from six causes of injuries: motor vehicles, suicides, homicides, falls, drownings, and residential fires. For each cause of injury, we estimated calendar effects on the monthly death counts. We confirmed the significant effect of vehicle miles travelled on motor vehicle fatalities with a transfer function model. Finally, we applied intervention analysis to deaths due to motor vehicles.