QuickStats: Age-Adjusted Rates of Firearm-Related Suicide, by Race, Hispanic Origin, and Sex — National Vital Statistics System, United States, 2019

October 15, 2021

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In 2019, among males, non-Hispanic White males had the highest age-adjusted rate of firearm-related suicide at 15.8 per 100,000 population, followed by non-Hispanic American Indian or Alaskan Native males (11.2), non-Hispanic Black males (6.9), Hispanic males (4.6), and non-Hispanic Asian or Pacific Islander males (3.2).

Among females, non-Hispanic White and non-Hispanic American Indian or Alaskan Native females had the highest rates (2.6 and 2.2, respectively), followed by non-Hispanic Black females (0.8), Hispanic females (0.6), and non-Hispanic Asian or Pacific Islander females (0.4).

Males had higher rates than females across all race and Hispanic origin groups.

Source: National Vital Statistics System, Mortality Data, 2019. https://www.cdc.gov/nchs/nvss/deaths.htm

https://www.cdc.gov/mmwr/volumes/70/wr/mm7041a5.htm


PODCAST: The Record Increase in Homicide During 2020

October 8, 2021

https://www.cdc.gov/nchs/pressroom/podcasts/2021/20211008/20211008.htm

HOST: When analyzing trends among leading cause of death (as well as other health measures), it’s important to note that a statistically significant change from year-to-year, whether it be a percent increase or a percent decrease, usually ranges somewhere in the single digits.  So, for example in 2019, death rates from Septicemia dropped nearly 7 percent from 2018, making it the second biggest decline among all leading causes of death.

Occasionally, the one-year change will hit the low double digits.  Death rates from influenza and pneumonia fell 17 percent in 2019, the result of a mild flu season in comparison with a severe flu season the year before.  A double-digit change really stands out as significant when analyzing trends from year to year.

This is why the 30 percent increase in the U.S. homicide rate during 2020 is so remarkable.  The increase itself was not unexpected – after all, the FBI’s Uniform Crime Report had documented a similar increase just days before NCHS released its provisional quarterly estimates on October 6.  But the 30 percent jump in homicide in 2020 was the biggest one-year increase in over a century, with the lone bigger increase coming way back in 1905, essentially a statistical blip that was likely the result of changes to the national death registry at a time when the National Vital Statistics System was first being constructed.

Prior to 2020, the biggest increase in the national homicide rate came in 2001, the year of the September 11 attacks, when the rate increased 20 percent.

Joining us today to discuss this somewhat stunning increase, is Robert Anderson, Chief of the NCHS Mortality Statistics Branch.

Dr. Anderson, thanks for joining us.  When you first saw the number – the 30 percent increase in homicide – what was your reaction?

ROBERT ANDERSON: Well it was it was a pretty big surprise overall.  Now, not as big a surprise it might have been – as you know the FBI had recently released information that suggested nearly a 30% increase, so from that perspective we expected that the increase would be large but 30% is still sort of huge increase in terms of mortality.

HOST:  In terms of statistical history, how does this one-year change historically with other one-year changes, either major increases or major declines, in leading causes of death?

ROBERT ANDERSON:  Well for homicide we did see a pretty substantial increase in 2001 and of course that was directly due to 9/11, to the terrorist attacks that year.  Generally, we don’t see large increases like this for mortality.  You have to go back to when infectious diseases were really prevalent to see large increases for causes of death. I mean, in terms of homicide prior to 2001 you had to go all the way back to the early 1900s – 1904 to 1905 – to find a larger increase than what we saw from 2019 to 2020.  Although that’s likely, at least partly, artifactual due to increases in reporting in the number of states reporting and there’s some other things going on as well at that time that could explain the increase, but mainly it’s an artifact of reporting.

HOST:  So then that 1905 increase – is that even comparable to what we’ve seen here in 2020?

ROBERT ANDERSON:  Not really.  At the time there were maybe 20 states reporting and the number of states reporting was increasing at that time.  Not only the number of states but also the completeness of reporting was increasing in the states that were already reporting as well.  We didn’t have all states reporting in the United States with regard to vital statistics until 1933.  So anything prior to 1933 we would be missing some records and ideally the rate would be sort of reasonably representative for the United States but we know that some of the states coming on board at that time had higher homicide rates overall than the states that were already in the system.

HOST:  So while the increase in 2020 was probably the largest in history the actual rate itself – the number of homicides per 100,000 – is lower than at other points in history more recently.  Could you expand on this?  What period was the peak homicide rate in the country?

ROBERT ANDERSON:  Sure.  So the homicide rate that we’re seeing for 2020 is about 7.8 per 100,000 and it’s a big increase from 6 per 100,000 and 2019 but if you go back to the early 80s and actually in the 70s, you had rates of higher than 10 per 100,000, so at those times you had a higher homicide rate.  Not the big increases or big decreases at that time but the overall level was much higher.

HOST: Death certificate data don’t provide any details about societal issues that may have contributed to the increase, so there’s no way to look at the role the pandemic played in this, if any, correct?

ROBERT ANDERSON:  Yeah that’s essentially correct. With the death certificate data, you really would need to bring in more information.  And I know that there are folks currently looking at this issue to try to understand better the role of the pandemic in this increase, but with death certificate data solely then we really can’t make those determinations.  You really have to look at other patterns and there certainly seems to be a correlation between the two but as we know correlation is not causation.  It’s going to require some I think fairly intensive research to try to sort it all out.

HOST:  In the past, there have been some other studies that have drawn a link between economic downturns and increases in homicide.  What can you tell us about that?

ROBERT ANDERSON: Well there certainly has been some research and the argument is that when economic times get tough, people – crime rises and along with property crime rises, violent crime as well. The correlation though between economic downturns and increases homicide isn’t a perfect one – the correlation is actually fairly weak. It seems to be more correlated with activities that tend to foster violence.  So you saw fairly large increases during prohibition. In the mid 70’s and early 80’s you had big increases and in the drug trade so I think that the connection is more with illegal activity in general rather than economic downturns per se although that does seem to definitely have an impact.

HOST:  And to reiterate, nothing like that on the death certificate?

ROBERT ANDERSON:  No.  The research, they’re looking at patterns using multiple data sets so they can use the final statistics datasets to look at homicides, but they are also using economic data and other sort of social data to model increases and decreases.

HOST:  Could you talk a little bit about the differences between the data released by NCHS and the data in the Uniform Crime Report released by the FBI recently?

ROBERT ANDERSON:  Sure.  So the FBI data is a system where the FBI asks law enforcement agencies across the country to report certain types of information.  Homicides are part of that.  It’s a voluntary system, not all law enforcement agencies report.  The vital statistics data, of course, is coming from the death certificate.  Death certificates have to be filed for every death that occurs in the United States, so vital statistics data are more complete than the data that come out in the Uniform Crime Report.  That said, the trends match pretty closely between the UCR and the vital statistics data so you know when we see something come out in the UCR – like a big increase like we saw with homicide, – there’s a good bet that the vital statistics data will show that as well.  And that’s indeed what we’ve seen.

HOST: Do you expect these provisional numbers to hold up when the 2020 are finalized in the next couple months?

ROBERT ANDERSON:  Yeah the data are complete enough at this point that we’re confident that there won’t be any significant changes between now and when we release the final data.  So the numbers will be pretty close – they are pretty close to final now.

HOST: Is it too early to get a sense of whether this increase in homicide has continued into 2021?

ROBERT ANDERSON:  Yeah it really is because homicides typically require a death investigation.  Information on the cause of death comes to us later than is typical for deaths.  Generally, we get the fact of death and the cause of death in a reasonably timely fashion, within a few weeks at most of the date of death, but with homicides – and this is true for suicides as well and for drug overdoses generally, since an in-depth investigation has to be done and the cause of death may not come till months later and some jurisdictions may take six months for things like toxicology to be complete and the full investigation to be done.  So there’s necessarily a greater lag for causes such as homicides and suicides and drug overdoses, and things like that – deaths that require a lengthy death investigation. And so at this point we have data through the end of 2020 and those data are reasonably complete, but the data for 2021 are really not very complete at this point. We will be releasing some information for 2021 in the coming months but we just don’t have a sense yet for whether homicides are continuing to rise in 2021.

HOST:  Any other things you’d like to add?

ROBERT ANDERSON:  Well I think it is interesting that we’ve seen this large increase in homicides, large increase in drug overdose deaths, and that those seem to be correlated with this big increase in COVID-19 – of course, well COVID-19 was going from zero to 700,000 deaths.  I think for 2020 it’s you know about 350,000 or 370,000,000.  But this is sort of a strange time, I guess, from the standpoint of mortality statistics, I mean, this is just not the sort of thing that we typically see.  We’re usually talking about relatively small increases in mortality or small decreases in mortality.  We don’t normally see these big jumps.  As we go and as we calculate the official mortality statistics for 2020, we’re going to have a lot more work than we normally have to describe what’s going on.  We’re going to need to spend some significant time on these conditions, and these diseases that have increased so much during the pandemic.

HOST:  Strange days.

ROBERT ANDERSON:  Yeah.

HOST:  Thanks very much, Dr. Anderson.

ROBERT ANDERSON:  Alright – thank you.

HOST: The new data on homicide show there was a wide difference in the 2020 rates based on geography.  The states with the highest homicide rates were:  Mississippi, Louisiana, Alabama, Missouri, Arkansas, South Carolina, Tennessee, and Maryland.  The District of Columbia had a higher homicide rate  than any state.  The states with the biggest rate increase in 2020 were Montana, South Dakota, Delaware and Kentucky, while only two states, Alaska and Maine, had definitive declines in homicide rates.

Homicide is one of 21 leading causes of death that are included in the quarterly provisional data release that posted this week.  The new numbers are featured on a data visualization dashboard on the NCHS web site.  Some of the significant findings include:

  • A nearly 17% increase from 2019 to 2020 in death rates from accidents or unintentional injuries.
  • Death rates from Diabetes also increased nearly 17%, from the one year period ending in March 2020 to the same point in 2021.
  • Hypertension mortality increased nearly 16% in the one-year period ending in Quarter 1 2021.
  • And death rates from Influenza/Pneumonia dropped 17% during this period.

In other news, this week NCHS also released a report on mortality and marital status in the United States.  The report focused on adults age 25 and up, covering the period 2010 though 2019.  The study found that death rates for married adults during roughly the last decade  have declined by more than three times that of never-married or divorced adults.  Suicide was found to be among the ten leading causes of death for never-married and divorced people, but not among the leading killers for married or widowed people.  Cancer is the number one cause of death for married adults whereas heart disease is the leading killer for unmarried adults.

There are a number of other data releases in the queue for NCHS this month as well.  The National Health Interview Survey is releasing two new reports on October 20th, on mental health treatment among adults and social and emotional support among adults.  Both reports feature data from 2020.

In the area of vital statistics, the latest quarterly provisional estimates on infant mortality, featuring data through 2020, will be released on October 14.  The day before that, the NCHS vital statistics team will release the lastest monthly estimates on drug overdose deaths in the U.S., though March of 2021.  Later in the month, on October 26, there will be a study on 2019 data on fetal mortality  in the United States.  And the following day there will be the latest in the series of rural-urban health studies, this one focusing on rural-urban differences in death rates from unintentional injuries among children.

Also, two methodological studies from the National Health Care Survey will be released on October 18, one focusing on “enhancing identification of opioid-related health outcomes,” and another on “machine learning for medical coding.”

Finally, October is dedicated to several health observances, including Sudden Infant Death Syndrome Awareness.  SIDS is the 4th leading cause of infant death in the United States, according to the latest final data from NCHS.

October is also Breast Cancer Awareness Month.  Over 42,000 women died from breast cancer in the United States in 2019, according to the latest NCHS data.

Join us next month for another NCHS “Statcast,” which will include new studies on suicide by month and demographic characteristics for 2020, as well as a study on mortality among the American Indian/Alaskan Native population.


Fact or Fiction – Homicide Rates

October 6, 2021

Source: National Vital Statistics System

https://www.cdc.gov/nchs/nvss/vsrr/mortality-dashboard.htm


QuickStats: Age-Adjusted Death Rates for Female Breast Cancer, by State — National Vital Statistics System, United States, 2019

October 1, 2021

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In 2019, the age-adjusted rate of female breast cancer deaths in the United States was 19.4 per 100,000 population.

Jurisdictions in the highest category for breast cancer death rates were DC (24.5), Nevada (23.7), Nebraska (22.4), Kentucky (22.2), Louisiana (22.0), and Mississippi (22.0).

Those in the lowest category were North Dakota (14.8), Massachusetts (15.3), Vermont (16.2), Connecticut (16.8), Wyoming (17.2), Minnesota (17.5), Colorado (17.6), Wisconsin (17.6), and Maine (17.7).

Source: National Vital Statistics System, Mortality, 2019. https://www.cdc.gov/nchs/nvss/deaths.htm

https://www.cdc.gov/mmwr/volumes/70/wr/mm7039a6.htm


QuickStats: Age-Adjusted Death Rates for Cancer, by Urban-Rural Status and Sex — National Vital Statistics System, United States, 1999–2019

September 17, 2021

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Cancer death rates declined among males and females during 1999–2019 in urban areas from 249.6 per 100,000 to 168.4 for males and from 168.2 to 123.9 for females.

Rates also declined in rural areas from 262.4 to 195.6 for males and from 165.4 to 139.2 for females.

Throughout the period, cancer death rates were higher for males than females and in rural compared with urban areas, and the urban-rural differences widened over the period for both males and females.

Source: National Center for Health Statistics, National Vital Statistics System, Mortality Data. https://www.cdc.gov/nchs/nvss/deaths.htm

https://www.cdc.gov/mmwr/volumes/70/wr/mm7037a8.htm


QuickStats: Death Rates from Colorectal Cancer by Age Group — United States, 1999–2019

September 7, 2021

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During 1999–2019, deaths per 100,000 persons from colorectal cancer decreased among persons aged 55–64 years (from 33.5 to 24.4), persons aged 65–74 years (from 77.4 to 41.5), and persons aged 75–84 years (from 146.7 to 77.9).

The death rate from colorectal cancer among persons aged 45–54 years generally increased from 1999 (11.1) to 2019 (12.0).

In each year during 1999–2019, the death rate was highest among persons aged 75–84 years and lowest among persons aged 45–54 years.

Source: National Center for Health Statistics, National Vital Statistics System, Mortality Data, 1999–2019. https://www.cdc.gov/nchs/nvss/deaths.htm


QuickStats: Injury Deaths as a Percentage of Total Deaths, by Age Group — National Vital Statistics System, United States, 2019

August 6, 2021

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Injuries accounted for the majority of deaths among persons aged 15–39 years, with the highest percentages among those aged 15–19 (76.0%) and 20–24 years (78.2%).

The percentage of injury deaths was lowest among those aged <1 year (7.9%), 60–64 years (7.5%), and ≥65 years (3.4%).

Source: National Center for Health Statistics, National Vital Statistics System, Mortality Data, 2019. https://www.cdc.gov/nchs/nvss/deaths.htm

https://www.cdc.gov/mmwr/volumes/70/wr/mm7031a3.htm


Latest Quarterly Infant Mortality Rate Estimates

July 20, 2021

NCHS released the latest quarterly estimates of infant mortality rates in the U.S.

The data shows infant mortality rate in the United States was 5.43 infant deaths per 1,000 live births in the one-year period ending in September 2020, no significant change from the year before.

The data is featured in a web-based interactive dashboard at: https://www.cdc.gov/nchs/nvss/vsrr/infant-mortality-dashboard.htm


PODCAST: Drowning Deaths Among U.S. Children

July 16, 2021

https://www.cdc.gov/nchs/pressroom/podcasts/2021/20210716/20210716.htm

podcast-iconHOST:  We’re joined today by Merianne Spencer, the author of a new study on accidental drowning deaths among children in the United States.

HOST:  So briefly describe to us the scope of the problem.

MERIANNE SPENCER:  Sure.  So unintentional drowning deaths are the second leading cause of injury death among children, those aged zero to 17, and is also the leading cause of unintentional injury deaths for those ages one to four, so for this study we wanted to look at national trends from 1999 to 2019 by demographic characteristics and also by urban-rural status to see what the patterns were over the past two decades among children.

HOST:  So you say that drowning deaths are the second leading cause of unintentional death among kids – what was the leading cause of unintentional injury deaths in that age group?

MERIANNE SPENCER:   The leading cause of death for unintentional injuries is motor vehicle traffic deaths, followed by drowning and then poisoning and then suffocation.  But it’s important to note that motor vehicle traffic deaths are much higher.  In 2019, there were almost 2000 deaths whereas for drowning there were pretty much half the amount.  Motor vehicle traffic deaths is much higher.

HOST:  How has this problem changed over time?

MERIANNE SPENCER:   So over the past two decades drowning deaths have decreased – roughly a 38 percent decline over the past two decades.

HOST:  Do we have any idea why drowning deaths have declined over the past two decades?  Are there any CDC programs that are targeting this problem?

MERIANNE SPENCER:  Looking at prevention programs, the National Center for Injury Prevention and Control – they provide a lot of information about the prevention of drowning, including pool safety, swimming safety tips and other considerations for water safety within the home. I would also look to prevention resources such as “Safe Kids Worldwide” and the “World Safety USA Network” but there are various programs that have been looking at improving safety for drowning among children and targeting that public health issue.

HOST:  Now one would assume that drowning deaths tend to spike during the summer months – is that an accurate assumption?  What did the data tell us about seasonality?

MERIANNE SPENCER:  There’s definitely a seasonality with respect to driving death.  So typically, the number of unintentional drowning deaths are lowest during colder months such as January or December, as well as in the Fall.  The number of deaths tend to rise sometime in April and they peak around June and July and decrease as it goes towards September.  So yes, it is an accurate assumption that there is a spike in around the warmer months when children might be swimming or going to the pool.

HOST: So which groups are more at risk for drowning deaths?

MERIANNE SPENCER:   Our study found that males are definitely at greater risk for unintentional drownings – they had higher rates of unintentional drowning deaths over the past two decades compared to females.  We also saw that those aged one to four had the highest rates of drowning compared to other age groups.  So much higher among those aged one to four years of age.  We also saw that rates were higher among non-Hispanic black children compared to non-Hispanic white children and Hispanics over the study period. And also we saw children were at higher risk for unintentional drownings in rural areas compared to urban areas.

HOST:  And what did the data tell us about places that are most risky for kids in terms of being a potential drowning risk?

MERIANNE SPENCER:  Our study found that death varied by age groups.  So those that were less than a year of age had a higher percentage that died in a bathtub, whereas those that at age 1 to four or five to 13 had the greatest percentage of deaths in swimming pools and those aged 14 to 17 were more likely to die in natural water such as lakes, rivers, streams, or oceans.  So there is definitely a difference by age group in the places where drowning deaths occurred.

HOST:  Are there any plans for further studies on this topic?

MERIANNE SPENCER: We are interested in looking at those places of drowning by looking at the literal text or the written information on the death certificate records to see if we can get a little bit more information.  Currently the study is focused on using the ICD-10 codes to look at places of drowning but maybe we can get some more insight about this finding in a future study.

HOST:  You mentioned the literal text – that’s the same kind of technique that’s been used on some studies looking at the types of drugs involved in overdose deaths is that correct?

MERIANNE SPENCER:  Yes that’s correct.  So by looking at the written information by medical examiners and coroners we might be able to tease out some information beyond the coding on ICD-10 codes or get more specificity on the place of drowning or some context around the drowning deaths so that’s something we might be looking into for a future study for this topic.

MUSICAL BRIDGE

HOST:  This week, NCHS released the first, full-year provisional data from 2020 on drug overdose deaths in America.  The new release shows a nearly 30% increase in deaths, from over 72,000 estimated deaths in 2019 to more than 93,000 deaths in 2020.

Three-quarters of all overdose deaths involve opioids – or nearly 70,000 deaths.  Much of the 2020 spike was the result of increases in deaths from synthetic opioids, primarily fentanyl.  Deaths from psychostimulants such as methamphetamine also continued to increase in 2020, as did deaths from cocaine and from natural and semi-synthetic opioids such as prescription pain medication.

The first 2021 data on overdose deaths will be released in August of this year.


Drug Overdose Deaths in the U.S. Up Nearly 30% in 2020

July 14, 2021

drug_OD_2020The CDC’s National Center for Health Statistics has released full-year 2020 provisional drug overdose death data that estimates 93,331 drug overdose deaths in the United States during 2020, an increase of 29.4% from the 72,151 deaths predicted in 2019.

The data featured in an interactive web data visualization estimates overdose deaths from opioids increased from 50,963 in 2019 to 69,710 in 2020. Overdose deaths from synthetic opioids (primarily fentanyl) and psychostimulants such as methamphetamine also increased in 2020 compared to 2019. Cocaine deaths also increased in 2020, as did deaths from natural and semi-synthetic opioids (such as prescription pain medication).