Is there progress toward eliminating racial/ethnic disparities in the leading causes of death?

OBJECTIVES: We examined changes in relative disparities between racial/ethnic populations for the five leading causes of death in the United States from 1990 to 2006. METHODS: The study was based on age-adjusted death rates for four racial/ethnic populations from 1990-1998 and 1999-2006. We compared the percent change in death rates over time between racial/ethnic populations to assess changes in relative differences. We also computed an index of disparity to assess changes in disparities relative to the most favorable group rate. RESULTS: Except for stroke deaths from 1990 to 1998, relative disparities among racial/ethnic populations did not decline between 1990 and 2006. Disparities among racial/ethnic populations increased for heart disease deaths from 1999 to 2006, for chronic obstructive pulmonary disease deaths from 1990 to 1998, and for chronic lower respiratory disease deaths from 1999 to 2006. CONCLUSIONS: Deaths rates for the leading causes of death are generally declining; however, relative differences between racial/ethnic groups are not declining. The lack of reduction in relative differences indicates that little progress is being made toward the elimination of racial/ethnic disparities.

Deaths: final data for 2004.

OBJECTIVES: This report presents final 2004 data on U.S. deaths; death rates; life expectancy; infant and maternal mortality; and trends by selected characteristics such as age, sex, Hispanic origin, race, marital status, educational attainment, injury at work, state of residence, and cause of death. Previous reports presented preliminary mortality data for 2004 and summarized key findings in the final data for 2004. METHODS: This report presents descriptive tabulations of information reported on death certificates, which are completed by funeral directors, attending physicians, medical examiners, and coroners. The original records are filed in the state registration offices. Statistical information is compiled into a national database through the Vital Statistics Cooperative Program of the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS). Causes of death are processed in accordance with the International Classification of Diseases, Tenth Revision (ICD-10). RESULTS: In 2004, a total of 2,397,615 deaths were reported in the United States. The age-adjusted death rate was 800.8 deaths per 100,000 standard population, representing a decrease of 3.8 percent from the 2003 rate and a record low historical figure. Life expectancy at birth rose by 0.4 year to a record high of 77.8 years. Age-specific death rates decreased for all age groups. (The decrease for children aged 5-14 years was not statistically significant.) The 15 leading causes of death in 2004 remained the same as in 2003. Heart disease and cancer continued to be the leading and second leading causes of death, together accounting for over one-half of all deaths. In 2004, Alzheimer's disease surpassed and swapped positions with Influenza, relative to their previous placements in 2003. The infant mortality rate in 2004 was 6.79 per 1000 births. CONCLUSIONS: Generally, mortality patterns in 2004 were consistent with long-term trends. Life expectancy in 2004 increased again to a new record level. The age-adjusted death rate declined to a record low historical figure. Although not statistically significant, the decrease in the infant mortality rate is typical of recent trends; except for 2002, the infant mortality rate has either decreased or remained level each successive year from 1958 to 2004.

Deaths: leading causes for 2003.

OBJECTIVES: This report presents final 2003 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 2003. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. RESULTS: In 2003, 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 about 78 percent of all deaths occurring in the United States. Differences in the ranking are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2003 were (in rank order): Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Newborn affected by maternal complications of pregnancy; Newborn affected by complications of placenta, cord and membranes; Accidents (unintentional injuries); Respiratory distress of newborn; Bacterial sepsis of newborn; Neonatal hemorrhage; and Diseases of the circulatory system. Important variation in the leading causes of infant death is noted for the neonatal and postneonatal periods.

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: final data for 2003.

OBJECTIVES: This report presents final 2003 data on U.S. deaths; death rates; life expectancy; infant and maternal mortality; and trends by selected characteristics such as age, sex, Hispanic origin, race, marital status, educational attainment, injury at work, State of residence, and cause of death. A previous report presented preliminary mortality data for 2003 and summarized key findings in the final data for 2003. METHODS: This report presents descriptive tabulations of information reported on death certificates, which are completed by funeral directors, attending physicians, medical examiners, and coroners. The original records are filed in the State registration offices. Statistical information is compiled into a national database through the Vital Statistics Cooperative Program of the Centers for Disease Control and Prevention's, National Center for Health Statistics (NCHS). Causes of death are processed in accordance with the International Classification of Diseases, Tenth Revision (ICD-10). RESULTS: In 2003, a total of 2,448,288 deaths were reported in the United States. The age-adjusted death rate was 832.7 deaths per 100,000 standard population, representing a decrease of 1.5 percent from the 2002 rate and a record low historical figure. Life expectancy at birth rose by 0.2 years to a record high of 77.5 years. Considering all deaths, age-specific death rates rose only for those 45-54 years and declined for the age groups 55-64 years, 65-74 years, 75-84 years, and 85 years and over. For the most part, the 15 leading causes of death in 2003 remained the same as in 2002. Heart disease and cancer continued to be the leading and second leading causes of death, together accounting for over half of all deaths. Homicide became the 15th leading cause in 2003, dropping from the 14th leading cause in 2002. Pneumonitis dropped out of the top 15 altogether, and Parkinson's disease entered the list as the 14th leading cause of death. The infant mortality rate in 2003 was 6.85 per 1,000 births. CONCLUSIONS: Generally, mortality patterns in 2003 were consistent with long-term trends. Life expectancy in 2003 increased again to a new record level. The age-adjusted death rate declined to a record low historical figure. The infant mortality rate decreased significantly in 2003; except for 2002, it either decreased or remained level each successive year from 1958 to 2003.