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QuickStats: Age-Adjusted Rates of Alcohol-Induced Deaths, by Urban-Rural Status — United States, 2000–2020November 4, 2022
The age-adjusted rate of alcohol-induced deaths in 2020 was 13.1 per 100,000 standard population.
From 2000 to 2020, the rate increased in both urban and rural counties: from 7.1 to 12.7 in urban counties and from 7.0 to 15.8 in rural counties.
From 2019 to 2020, the rate increased by 26% for urban counties and 30% for rural counties, which was the largest increase for both urban and rural counties during the 2000–2020 period.
Rates were similar between rural and urban counties from 2000 to 2004, but from 2005 to 2020 rates were higher in rural counties than in urban counties.
During 2005–2020, rural rates increased at a greater pace than did urban rates. By 2020, the rate in rural counties was 24% higher than in urban counties.
Source: National Vital Statistics System, Mortality Data. https://www.cdc.gov/nchs/nvss/deaths.htm
Nearly 25 million working age adults in the United States (ages 18-64) were without health insurance in 2021, according to new data from CDC’s National Center for Health Statistics. Texas, Georgia, and North Carolina had the highest rates of uninsured among this group.
The data are captured in two new reports using data from the National Health Interview Survey: “Demographic Variation in Health Insurance Coverage: United States, 2021” and “Geographic Variation in Health Insurance Coverage: United States, 2021.”
Some of the findings from the demographic report include:
- Overall, 28 million Americans did not have health insurance in 2021, including almost 3 million children.
- Among adults ages 18-64, nearly 13% did not have health insurance.
- Almost two-thirds of people under age 65 with health insurance are covered by private health insurance, including over half with employer-based coverage.
Highlights from the geographic report include:
- Among adults under age 65, Texas (29.4%), Georgia (19.2%), and North Carolina (17.6%) had uninsured rates that were higher than the national rate of 12.6%.
- Adults ages 18-64 who live in non-Medicaid expansion states (19.1%) were twice as likely to be uninsured compared to those living in Medicaid expansion states (9.4%).
- Among adults under age 65, there were several states with uninsured rates that were lower than the national rate: Illinois (8.7%), Ohio (8.7%), Pennsylvania (8.0%), Virginia (8.0%), Washington (8.0%), Wisconsin (7.7%), New York (6.9%), Kentucky (6.5%), Maryland (6.5%), Michigan (6.1%), and Massachusetts (3.0%).
The two reports are available at the following links:
HOST: We talked this week with Ari Minino, a statistician with the NCHS Division of Vital Statistics and co-author on a new report out on October 28th on COVID-19 mortality in 2020 by occupation and industry. The report was a collaborative analysis conducted by NCHS and NIOSH – the National Institute for Occupational Safety and Health.
HOST: Before we get into what your study is all about, can you briefly tell people or caution people what your study does not cover.
ARI MININO: The study is limited to information on what the usual occupation and industry of the decedent was. That is, what was the work or usual job that the person did for most of his working life. So this is not, for example, a study on exactly where it was that the person contracted the condition – in this case COVID-19. It is a study trying to associate the co-determinant of work which is co-determinant of health and how that relates to the, in this case the risk of the person died from COVID-19. That is a delicate distinction, but I think it’s important one.
HOST: So, in this study your coauthors actually were from the National Institute for Occupational Safety and Health, is that correct?
ARI MININO: That’s correct. Yeah, it’s important to note that this is a close collaboration between the National Institute for Occupational Safety and Health and the National Center for Health Statistics and this goes back many decades ago. We used to have data on the usual occupation and at the industry of the decedent included as part of our mortality data for the years 1984 through 1998. And it was only recently – and probably I’m going to say it started in 2018 – there was a signed agreement between the two agencies that we started working towards trying to incorporate these data again into the mortality data. And so the first year that we’re including this data is for 2020 and we’re very excited, very happy that these data are finally part of the mortality, national vital statistics file, and this report that we’re discussing is kind of like our introduction to that. And my colleagues, Dr. Andrea Steege and Dr. Rachael Billock, they were the true driving force for this study, and they produced most of the coding and they did actually all of the analysis, all the analytical work. And they were with us in NCHS on a detail for the duration of the period of this study, when this study was conducted.
HOST: It’s obviously very difficult or almost impossible to determine where and how anyone gets COVID, and so that’s one of the limitations you wanted to point out, out front, correct?
ARI MININO: That is correct. One other important limitation of this work is that this is not a complete global or universal variable in the sense that it does not cover all of the decedents but has some specific limitations. We only included data for 46 States and New York City, which is a separate registration area, and we only include information for decedents age 10 years and up to 64.
HOST: And just for those who aren’t familiar with the terminology, when you say “decedent” you’re talking about the people who died, in this case from COVID-19.
ARI MININO: That is correct. This information is entirely based on information collected from the death certificate of all the diseases or in this case the decedents who died from COVID-19.
HOST: Now, turning to what your study did uncover, your study found some interesting things about mortality from COVID-19 and occupation. And what was in your view the biggest finding in your new report?
ARI MININO: Well, the biggest finding is something that was sort of expected which is that when we discuss risk, the specific occupation that the decedent had or the usual occupation of this varied quite substantially in terms of the risk of dying from COVID. For example, when we look at the death rate, which is only one of the measures that we looked at, we found that workers in protective service occupations were the ones who had the highest death rate from COVID.
HOST: And when you say “protective services” give us some examples.
ARI MININO: These are policemen, these are people working building security, that type of occupation. So the other group that had very high death rates were people who worked in accommodation and food service industries. These are people who work in, for example, hotels. These are people who work in restaurants.
HOST: OK so these are the occupational settings where you mentioned you would expect to see sort of higher mortality. Were there any surprises in looking at COVID mortality across different occupational settings?
ARI MININO: There were some surprises. In particular, when we looked at the measure that we called the “proportionate mortality ratio.” And this is not an indication necessarily of risk, but rather of a disproportionate amount of or a disproportionate count of people who died from COVID-19 relative to all the other decedents. This is not a measure that can exactly relate to risk necessarily. This particular way of looking at decedents, we found some variation when we look at deaths by race and Hispanic origin. In particular, in the way in the specific occupations that showed higher proportions of COVID-19 mortality.
HOST: I guess what you’re saying is that there were demographic groups with higher COVID mortality and some interesting comparisons along occupational lines, is that correct?
ARI MININO: Yeah and something that is important is that we used two measures. The main measure that we use, the statistical measure, is the “proportionate mortality ratio.” And we use that to analyze the differences. In particular, among the different race and Hispanic origin groups. That’s because we didn’t have a good sample size with the denominator data. And it’s very difficult to get denominator data for these occupation and industry groups because the Census is not geared exactly to look at that, and to produce good estimates for that. And so we looked at PMRs, and that is something – it’s very important to distinguish that, for example when you look at a high PMR, it does not necessarily mean that there is a higher risk for the condition, just because we found a high PMR for a particular occupation. It just means that there’s a disproportionate number of COVID-19 deaths among the decedents, and its just the numerator.
HOST: Doesn’t that sort of speak to the broader issue – that we’re not really assessing risk with this study, right?
ARI MININO: Yeah, with the measures that are done using the death rate, yes they do speak to risk because we do use a denominator that was available from census that would fit the numerators but–
HOST: The other measures, that’s a different story.
ARI MININO: It’s a different story, yeah. You see that the results when we look at PMRs and in particular when we look at PMRs by race and Hispanic origin, we find that when we look at the non-Hispanic American Indian and Alaska Native population, for example, as well as for non-Hispanic white, we find that the highest PMRs were for people with occupations in community and social services types of occupations. However, when we look at non-Hispanic Asian and non-Hispanic Black, decedents were observed among those in protective service occupations – same as we found for the overall population.
HOST: And again, that is using the “proportionate mortality ratio.”
ARI MININO: Uh-huh.
HOST: And you indicated that that isn’t necessarily a measure that defines risk but rather—
ARI MININO: A disproportionate number of COVID-19 deaths among that particular group when compared with the rest of all of the decedents in that particular group for all other occupations.
HOST: So we would close then by asking if there’s anything else you’d like to mention about your study?
ARI MININO: I think this is a good introductory study for bringing in awareness about how we have these data for 2020. Because these data, even though we had industry and occupation data for a selected number of states between 1984 and 1998, this is the first time that we’ve included these data in the mortality file. And I think – well, because of course of the pandemic situation – I think I thought that it was a very good idea to do an introductory study focusing on COVID. But this is only the first of a series of studies that we have planned. And we’re gonna be looking at drug overdose and industry and occupation on how those how those two relate in terms of mortality.
HOST: Well thanks very much for joining us Ari.
HOST: October was a busy month for NCHS, starting with the release of the latest quarterly provisional birth data in the United States on October 11th. The quarterly dashboard features data on a number of measures, including the fertility rate in the United States. The general fertility rate is the number of births per 1,000 females ages 15-44, and the rate increased from 55.2 to 56.4 in the one-year ending in Quarter 2 of 2022 compared with the previous year.
The next day, on October 12th, NCHS released the latest summary health statistics for children and adults in the United States, based on data from the National Health Interview Survey or NHIS. This dashboard features a wealth of data on a variety of measures, including smoking. The NHIS data shows the percentage of adults in the U.S. who smoke cigarettes has declined from 14% in 2019 to 11.5% in 2021.
The same day, NCHS released the latest provisional monthly estimates of drug overdose deaths in the nation. 108,022 Americans died from overdoses in the one-year period ending in May of 2022.
The following day, on October 13, NCHS released a new report on telemedicine use for 2021. The study, featuring data from the NHIS, showed that 4 in 10 adults in the United States used telemedicine in the past year.
That busy week closed out on October 14 with a new study on COVID-19 mortality among older Americans age 65 and up. The study showed that during the first year of the pandemic, the death rate from COVID for people age 85 and up was nearly three times higher than the rate for people ages 75-84, and seven times higher than the rate for people ages 65-74.
The following week, on October 19, NCHS released a new report on fetal deaths in the United States from 2018 to 2020. The study showed that there were nearly 47,000 fetal deaths at 20 weeks of pregnancy or longer during this period.
NCHS rounded out the month with three new data releases in the last week, starting with an October 25 study on COVID-19 mortality during the first year of the pandemic by urban-rural status, showing as expected that people living in the most urban areas of the country had higher mortality from COVID than in other geographic areas.
And on October 26, NCHS updated another of its quarterly dashboards, this one on leading causes of death in the country, through the one year period ending in Quarter 1 of 2022. The data show a drop in the country’s death rate during this period compared to the year before.
QuickStats: Age-Adjusted Death Rates for Stroke Among Adults Aged ≥ 65 Years, by Region and Metropolitan Status — National Vital Statistics System, United States, 2020October 28, 2022
In 2020, the age-adjusted death rate for stroke among adults aged ≥65 years was 260.5 deaths per 100,000 population with rates lower in metropolitan compared with nonmetropolitan areas (259.4 versus 265.5).
The rate was highest among those living in the South (288.2) and lowest among those living in the Northeast (199.1). In the Northeast, the death rate for stroke was lower among adults in metropolitan areas (197.4) than in nonmetropolitan areas (215.7).
In the Midwest and West, death rates for stroke were higher among adults in metropolitan areas (278.0 and 255.4, respectively) than in nonmetropolitan areas (261.4 and 236.4, respectively).
No statistically significant difference was observed between metropolitan and nonmetropolitan areas in the South (287.4 versus 290.9).
Source: National Center for Health Statistics, National Vital Statistics System, Mortality Data, 2020. https://www.cdc.gov/nchs/nvss/deaths.htm
The emergency department (ED) visit rate for infants aged <1 year declined by nearly one half from 123 visits per 100 infants during 2019 to 68 during 2020.
The ED visit rate for children and adolescents aged 1–17 years also decreased from 43 to 29 visits per 100 persons during the same period.
Decreases among adults aged 18–44 (47 to 43 per 100 adults), 45–74 (41 to 39), and ≥75 years (66 to 63) from 2019 to 2020 were not statistically significant. ED visit rates were highest for infants aged <1 year followed by adults aged ≥75 years.
Source: National Center for Health Statistics, National Hospital Ambulatory Medical Care Survey, 2019–2020.
QuickStats: Age-Adjusted Death Rates from Stroke Among Adults Aged ≥65 Years, by Race and Hispanic Origin — National Vital Statistics System, United States, 2000–2020October 14, 2022
Age-adjusted death rates from stroke among adults aged ≥65 years generally declined from 425.9 deaths per 100,000 standard population in 2000 to 250.0 in 2019 before increasing to 260.5 in 2020.
During 2019–2020, stroke death rates increased for Hispanic adults (from 221.6 to 234.0), non-Hispanic Asian or Pacific Islander adults (from 203.9 to 216.4), non-Hispanic Black adults (from 328.4 to 352.2), and non-Hispanic White adults (from 246.2 to 255.0); changes for non-Hispanic American Indian or Alaska Native adults were not significant.
Throughout the 2000–2020 period, death rates for non-Hispanic Black adults were higher than those for adults in other race and Hispanic origin groups.
Source: National Vital Statistics System, Mortality Data. https://www.cdc.gov/nchs/nvss/deaths.htm
QuickStats: Percentage of Residential Care Communities that Offer Annual Influenza Vaccination to Residents and to Employees and Contract Staff Members, by Community Bed Size — United States, 2020October 7, 2022
In 2020, 87.2% of residential care communities offered annual influenza vaccination to residents, and 77.8% offered annual influenza vaccination to all employees and contract staff members.
The percentage of residential care communities offering annual influenza vaccination to residents and to all employees and contract staff members increased with increasing community bed size.
The percentage of communities offering vaccination to residents ranged from 75.2% of communities with four to 10 beds to 91.7% with 11–25 beds, 97.0% with 26–100 beds, and 99.1% with more than 100 beds.
Communities offering vaccination to all employees and contract staff members ranged from 60.9% of communities with four to 10 beds to 80.3% with 11–25 beds, 92.9% with 26–100 beds, and 96.4% with more than 100 beds.
Source: National Post-acute and Long-term Care Study, 2020 data. https://www.cdc.gov/nchs/npals/questionnaires.htm
As part of its ongoing partnership with the Census Bureau, NCHS recently added questions to assess the prevalence of post-COVID-19 conditions, sometimes called “long COVID,” on the experimental Household Pulse Survey.
Today, NCHS released the latest round of Pulse data, collected from September 14-26, 2022. This latest release includes new data on how Long COVID reduces people’s ability to carry out day-to-day activities compared with the time before they had COVID-19.
Data on this topic is available at the following link:
WEB DASHBOARD: https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm
· 4 out of 5 people with ongoing symptoms of COVID lasting 3 months or longer are experiencing a least some limitations in their day-to-day activities.
· 1 out of 4 adults (25.1%) with long COVID have symptoms that significantly impact their ability to carry out day-to-day activities.
· Out of all U.S. adults, nearly 2% (1.8%) had COVID-19 and still have long COVID symptoms that have a significant impact on their ability to carry out day-to-day activities more than 3 months later.
· 14.2% of adults had ever experienced COVID symptoms that lasted 3 months or longer that they had not had prior to their COVID-19 infection.
· Among the 14.2% who have ever had long COVID symptoms, more than half (7.2%) currently have long COVID symptoms.
· 1 out of 3 adults in the U.S. who’d had COVID-19 (29.6%) reported ever having long COVID symptoms.
· 15% of those who’d had COVID-19 reported currently having long COVID symptoms.
HOST: The COVID-19 pandemic took a major toll on the U.S. health care system. In a new report released on September 28, data from the National Ambulatory Medical Care Survey were used to examine how COVID-19 impacted physician practices around the country.
Joining us to discuss that new study is Zach Peters, a health statistician with the NCHS Division of Health Care Statistics.
HOST: What did you hope to achieve with this study?
ZACK PETERS: This study was intended to produce nationally representative estimates of experiences at physician offices. So it’s a physician level study and we really wanted to highlight some of the important experiences physicians had due to the pandemic, such as shortages of personal protective equipment. And it highlights whether testing was common in physician, whether physicians were testing positive or people in their office were testing positive for COVID-19 given that they were on the front lines of helping to treat patients. So we really wanted to touch on a broad set of experiences faced by physicians. This certainly isn’t the first study to assess experiences and challenges faced by health care providers during the pandemic but often times those other studies are limited to specific facilities or locations or cohorts and can’t be generalized more broadly. So a big benefit of a lot of the NCHS surveys is that we can produce nationally representative estimates and this study is an example of that.
HOST: And what kind of impact has the pandemic had on physicians and their practices?
ZACH PETERS: In having done quite a bit of literature review for this project it became pretty clear – and I think just listening to the news you sort of understood a lot of the impact. A lot of research has shown that that health care providers experienced a lot of burnout or fatigue. There was a lot of exposure and what not to COVID-19. Long hours… So there’s a lot out there in in the literature that sort of cites some of the challenges. What we really, what this study highlighted was it was the level of shortages of personal protective equipment that were faced. About one in three physicians said that they had they had experienced personal protective equipment shortages due specifically to the pandemic . The study highlighted that a large portion of physicians had to turn away patients who were either COVID confirmed or suspected COVID-19 patients. And I think the last thing this really helped to show was the shift in the use of telemedicine due to the pandemic. So prior to March of 2020 there were less than half of physicians at physician offices who were using telemedicine for patient care and that number, that percentage jumped to nearly 90% of office based physicians using telemedicine after March of 2020. So this is sort of adding to the broader literature with some nationally representative estimates of experiences that providers had due to and during the pandemic.
HOST: So what sort of personal protective equipment was most affected during this study?
ZACH PETERS: It’s a good question. The way in which we asked the questions about shortages of “PPE” – I’ll call it I guess – don’t allow us from really untangling that question. We asked about face mask shortages, N-95 respirator shortages specifically, but then the second question we asked sort of grouped isolation gowns, gloves, and eye protection into one question. So physicians didn’t really have the chance to check off specifically what they had shortages of other than face masks. So it’s somewhat hard to untangle that but these results show that about one in five physicians faced N-95 respirator, face mask shortages due to the pandemic and a slightly higher – though we didn’t test significance in this in this report – a slightly higher percentage, about 25% of physicians, had shortages of isolation gowns, gloves, or eye protection or some combination of those three.
HOST: And you say that nearly four in 10 physicians had to turn away COVID patients. Now, was this due to a high volume of patients or a lack of staff?
ZACH PETERS: Again that’s another great question. I think unfortunately we weren’t able to ask a lot of these really interesting follow-ups to some of these experiences. We didn’t get to pry physicians on some of the reasons why they had these experiences, including why they had to turn away patients. So unfortunately we’re not able to answer some of the “why” questions that we would like with these data.
HOST: And do you have any data on where these patients were referred to, the ones that were turned away? Do you have any information on that?
ZACH PETERS: Again unfortunately this specific question wasn’t something that we asked in the set of new COVID questions introduced in the 2020 NAMCS we did ask a question about whether physicians who had to turn away patients had a location where they could refer COVID-19 patients. So there are a few reasons – we haven’t assessed that measure in this work so far, but it’s certainly an area we can dig into more especially as we have additional data from the 2021 NAMCS and can try to combine over time.
HOST: Does it look like the shift to telemedicine visits is here to stay?
ZACH PETERS: The broader literature sort of highlights that these changes are broad and likely indicate that physician offices and different health care settings have built up the infrastructure to allow for telemedicine use in the future. And so it’ll be interesting to see if, as waves of COVID or other infections ebb and flow, if we see that the use of telemedicine kind of ebbs and flows along with that. But I think the option for telemedicine is something that health care settings won’t get rid of now that they have them.
HOST: Sticking with the topic of telemedicine – did physicians list any benefits to telemedicine visits other than limiting exposure to COVID-19?
ZACH PETERS: The set of questions that we asked physicians were limited in scope and we didn’t really have that level of follow-up. There are some additional questions about telemedicine use that we asked and hope to be able to dig into further. We asked physicians what percentage of their visits they had used telemedicine and some other questions about just kind of the scope of use, but not necessarily the benefits that they felt they received due to using telemedicine.
HOST: Is it possible that you might be getting some data on these questions in the future?
ZACH PETERS: These questions were introduced part way through the 2020 survey year, so we were only able to ask half of our physician sample about these experiences in the 2020 survey. But we kept the exact same set of COVID related questions in the 2021 NAMCS survey year and so we’re working to finalize the 2021 data and hope to be able to look into some of the more nuanced aspects of this that we might be interested in, such as trends over time if we combine years. So we might be able to assess differences in experiences based on the characteristics of physicians. So yeah, we asked these specific questions in the 2021 survey year so hope to have some additional information to put out for folks.
HOST: You were talking a little bit about the fact that you made changes to the National Ambulatory Medical Care Survey, which this study is based on, which allowed you to collect more complete data during this period. Could you again sort of go over what sort of changes you made?
ZACH PETERS: Yes the NAMCS team with the Division of Health Care Statistics, we made changes to a few of our surveys partway through the 2020 survey year. Partly out of necessity and partly out of just interest in an unfolding public health crisis. So for NAMCS two big changes were made. The first was that we had to cancel visit record abstraction at physician offices. So historically we have collected a sample of visit records or encounter records from physicians to be able to publish estimates on health care utilization at physician offices due to sort of wanting to keep our participants safe, our data collectors safe, and patients safe. We cancelled abstraction partly into the 2020 survey year so that was an important change in that we won’t be able to produce visit estimates from the survey year. But the other change that we made – I think I alluded to it earlier – was that partway through the survey year we introduced a series of COVID-19 related questions, which is what this report summarizes. And the reason it came partway through the survey year is simply due to the fact that adding a series of new questions to a national survey takes a lot of planning and a lot of levels of review and approval. So this is partly why we were only able to ask these questions of half of our survey sample.
HOST: Are there any other changes forthcoming in the NAMCS or for that matter any of your other health care surveys?
ZACH PETERS: Historically there have been a few different types of providers that have been excluded from our sample frame. We didn’t include anesthesiologists working in office-based settings, radiologists working in office-based settings. So we had a few different types of promoting specialties that we couldn’t speak to in terms of their office characteristics and their care that they provided. In future years we are hoping to expand to include other provider types that we haven’t in the past so I think that’s the big change going forward for the traditional NAMCS. We also have a kind of a second half of NAMCS that looks at health centers in the U.S., and the big change for that survey in the 2021 survey years that we are in is instead of abstracting a sample of visit records, are we are starting to collect electronic health record data from health centers. So that’s another a different portion of NAMCS but those are a couple of the big changes at high level that are implementing in NAMCS.
HOST: What would you say is the main take-home message you’d like people to know about this study?
ZACH PETERS: I think the main strength of using data from NCHS in general is that many of our surveys allow for nationally representative estimates and NAMCS is the same in that regard. We sampled physicians in a way that allows us to produce nationally representative estimates. And so I think this study highlights how we’re able to leverage our surveys in a way that other studies that you might see in the literature can’t in that they’re more cohort-based. So I think another important aspect of this is just that it highlights an example of some of the adaptations that DHCS end and NCHS more broadly, some of the adaptations that we made during the pandemic to better collect data and disseminate data. And so outside of the topic being hopefully important to understand how physicians nationally experienced various things related to the pandemic, this highlights some of the ways in which NCHS was able to remain nimble during a public health crisis.
HOST: On September 1, NCHS released a new report looking at emergency department visits for chronic conditions associated with severe COVID illness. The data, collected through the National Hospital Ambulatory Medical Care Survey, were collected during the pre-pandemic period of 2017-2019 and serve as a useful baseline, since it is well established that chronic conditions increase the risk of hospitalization among COVID patients. The report showed that during this pre-pandemic period, hypertension was present in one-third of all emergency department visits by adults, and diabetes and hypertension were also present together in one-third of these visits.
On the 7th of September, NCHS released a study focusing on mental health treatment among adults during both the pre-pandemic and pandemic period, 2019 to 2021. It has been documented by the Household Pulse Survey and other studies that anxiety and depression increased during 2020 and the beginning of 2021, and this new study focuses on the use of counseling or therapy, and/or the use of medication for mental health during this period. The study found there was a small increase in the use of mental health treatment among adults from 2019 to 2021, with slightly larger increases among non-Hispanic white and Asian people.
Also this month, NCHS updated two of its interactive web dashboards, featuring data from the revamped National Hospital Care Survey. On September 12, the dashboard on COVID-19 data from selected hospitals in the United States was updated, and two days later the dashboard featuring data on hospital encounters associated with drug use was updated.
On the same day, September 14, NCHS released the latest monthly estimates of deaths from drug overdoses in the country, through April of this year, showing 108,174 people died from overdoses in the one-year period ending in April. This death total was a 7% increase from the year before. Over two-thirds of these overdose deaths were from fentanyl or other synthetic opioids.
On September 29, the latest infant mortality data for the U.S. was released, based on the 2020 linked birth and infant death file, which is based on birth and death certificates registered in all 50 states and DC.
Finally, September is Suicide Prevention Month, and on the final day of the month, NCHS released its first full-year 2021 data on suicides in the country. For the first time in three years, suicide in the United States increased. A total of 47,646 suicides took place in 2021, according to the provisional data used in the report. The rate of suicide was 14 suicides per 100,000 people.