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).


PODCAST: NHANES Updates, Drug Overdose Deaths, and ER Visits From Motor Vehicle Crashes

June 18, 2021

https://www.cdc.gov/nchs/pressroom/podcasts/2021/20210618/20210618.htm

podcast-iconHOST:  In March of 2020, field operations for the National Health and Nutrition Examination Survey – or NHANES – were halted due to the COVID-19 pandemic. Field operations are scheduled to restart later this summer.  But the halt in operations presented a problem, since NHANES data traditionally is released in two-year cycles in order to have a large enough sample size to be nationally representative.  Because the data collected in the cycle from 2019 thru March 2020 are ­not nationally representative, NCHS took steps to combine these “partial-cycle” data with previously released 2017–2018 data in order to produce nationally representative estimates.

This effort resulted in a new report this week that explains these “prepandemic NHANES data files,” from the period January 2017 thru March 2020, and outlines recommendations as well as limitations related to using the files.  The new report also presents prevalence estimates for selected health outcomes based on these files.

One of the health topics selected was obesity.  From January 2017 to March 2020, the data show that 1 in 5 children and adolescents in the U.S. were obese, or 19.7% of the age 2-19 population.  The report also shows that nearly half of children and adolescents – or 46% – had untreated or restored cavities in one or more of their primary or permanent teeth.

Among adults age 20 and up, the age-adjusted prevalence of obesity was more than 4 in 10, or 42%, and nearly 1 in 10 were severely obese. In addition to obesity, the new data show that diabetes prevalence among adults was nearly 15% and that nearly half of adults age 18 and over – or 45% — had hypertension.  Also, among older adults age 65 and up, complete tooth loss was present in nearly 14% of that population.

Ultimately, these new estimates are similar to those reported during the 2017-2018 cycle, but the additional year and two plus months-worth of data provide a larger sample size and thus more precise estimates.  And the release of these data mark another important milestone, in that they are the last NHANES data collected before widespread transmission of COVID-19 began in 2020.

(MUSIC BRIDGE)

HOST:  This week, the monthly provisional numbers for drug overdose deaths in the U.S. were released.  The latest round of data cover the one-year period ending in November of 2020, and show that the number of drug overdose deaths increased nearly 30% from the one-year period ending in November 2019.  Over 92,000 Americans died of drug overdoses in the year ending in November 2020, up from less than 72,000 the year before.

Three out of every four of these overdose deaths involved opioids, as the number of opioid-involved deaths topped 69,000 in this one-year period ending in November 2020, a major increase from 50,504 deaths the year before.  It’s important to note that recent trends may still be at least partially due to incomplete data.

A big factor behind the increase in overdose deaths is the continued increase in deaths involving synthetic opioids, primarily fentanyl.  But increases in deaths from other drugs are playing a major role as well.  Overdose deaths from cocaine as well as psychostimulants such as methamphetamine have shown significant increases compared to the previous year.

The next release of provisional numbers will feature full-year 2020 data for the first time.

(MUSIC BRIDGE)

HOST:  An average of 3.4 million emergency department visits occur each year due to injuries from motor vehicle crashes.  Most people who are injured or killed in motor vehicle crashes are occupants.  Studies have shown that medical care costs and productivity losses associated with motor vehicle injuries and deaths exceeded $75 billion in 2017.

Today, NCHS released a new report that presents emergency department visit rates per 1,000 for motor vehicle crashes by age, race and ethnicity, health insurance status, and census region. The data come from the National Hospital Ambulatory Medical Care Survey, an annual, nationally representative survey of nonfederal, general, and short-stay hospitals in the United States.

The report shows that in 2017–2018, the overall ER visit rate for motor vehicle crash injuries was 5.3 visits per 1,000, and was highest among patients between ages 15 and 24.  The ER visit rate for non-Hispanic black patients was several times higher than for non-Hispanic white or Hispanic patients.

Emergency department visit rates were higher for patients who had Medicaid, no insurance, or workers’ compensation insurance as their primary expected source of payment compared with patients who had private insurance or Medicare.  The ER visit rate for motor vehicle crashes at hospitals located in the South was higher than the rates at hospitals in all other census regions of the United States.


PODCAST: The 2020 Increase in Death Rates Were The Highest Ever Recorded

June 11, 2021

STATCAST, JUNE 2021: DISCUSSION WITH FARIDA AHMAD, STATISTICIAN, ABOUT LATEST PROVISIONAL QUARTERLY MORTALITY DATA.

https://www.cdc.gov/nchs/pressroom/podcasts/2021/20210611/20210611.htm

podcast-iconHOST:  Each quarter NCHS releases provisional data on mortality from leading causes of death in the U.S. on an interactive web-based dashboard.   This week the dashboard was updated to include Quarter 4 data from 2020 and gives a complete account of provisional death rates in the U.S. for the year.  Joining us to discuss some of the key findings is Farida Ahmad of the Division of Vital Statistics.

HOST: First question: how much did the death rate in the U.S. increase in 2020?

FARIDA AHMAD:  The death rate for the U.S. increased by about 16% in 2020 compared to 2019-

HOST:  Now is it safe to say that almost all of the increase can be attributed to COVID-19.

FARIDA AHMAD:  A large part of it, yes, but we also saw increases in other causes of death like heart disease, Alzheimer’s disease, and diabetes.  Unintentional injuries like drug overdose also increased throughout 2020.  This report only includes drug overdose rates for the first half of the year but you do see very large increases in the second quarter of 2020.

HOST:  Some say that certain causes of death like influenza and pneumonia declined in 2020 due to COVID – is that true?

FARIDA AHMAD:  No, not really – that’s due to influenza and pneumonia were actually higher in 2020 than in 2019.  That’s likely driven by the pneumonia more so than influenza though.

HOST:  Is there any sense whether some of those pneumonia deaths are miscategorized, that maybe they should be in the COVID category?

FARIDA AHMAD:  Yes, you know it’s definitely possible.  We don’t have hard numbers on that and to account for maybe miscategorized COVID deaths we would we would look at excess mortality.  So a different kind of measure to look at that.

HOST:  I guess then the same would be true for other causes of death, particularly those that occur at the very beginning of 2020.  Is there any chance there will be more COVID deaths added to the tally?

FARIDA AHMAD:  It’s certainly possible but we haven’t closed out the 2020 data year.  So we could still get additional changes but we don’t anticipate a significant number of deaths data will change.

HOST:  So the data aren’t final yet is that correct?

FARIDA AHMAD:   Yes that’s correct.

HOST:   So what are some of the more striking changes you saw in the death rates from 2019 to 2020 as far as certain leading causes go?

FARIDA AHMAD:  Diabetes deaths increased by almost 14%… Chronic liver disease increased by 17% … and then hypertension and Parkinson disease those increased by 12% and 11% respectively.

HOST:  So in a normal year those would be considered very large increases is that correct?

FARIDA AHMAD:  Yes, yeah shifts that large would be notable.

HOST: But there’s no way to sort of link that back to the pandemic, either directly or indirectly?

FARIDA AHMAD:   Not with the death certificate data that we have, unless these deaths – you know these deaths which were the underlying cause is what we’re looking at.  For these deaths COVID-19 might also be listed on the death certificate, in which case you could say that COVID-19 played a role in that death but otherwise we wouldn’t necessarily know if it was a direct or indirect cause of the pandemic in terms of disrupted access to healthcare or other contributing factors.  The death certificate data wouldn’t necessarily tell us that.

HOST: So in general 2020 was a very rough year for mortality but were there any declines in leading causes of death in 2020?

FARIDA AHMAD:  There were a few – there were declines in cancer, in chronic lower respiratory diseases, and pneumonitis due to solids and liquids>

HOST: Did the pandemic – did COVID-19 — have any impact on death rates at the state level?  Were there any unusual changes in 2020?

FARIDA AHMAD:  West Virginia and Mississippi had the highest death rates overall, but the largest increases in death rates were actually seen in New York and New Jersey.

HOST:  Is there anything else in this new data that you’d like to note?

FARIDA AHMAD: What this report allows us to look at is not just the deaths due to COVID-19, which have been understandably a huge focus of public health surveillance in last year, but with this report we get to look at some of the other leading causes of death that might not be in the top five, or the top ten, but these are issues of public health importance and concern.  To look at these various diseases and causes of death, so I think that’s really what this report adds is to be able to take a broader look.

MUSICAL BRIDGE:

HOST: Our thanks to Farida Ahmad for joining us on this edition of “Statcast.”

HOST:  On Wednesday of this week, NCHS also released a new report on screening for breast, cervical and colorectal cancer.  The study featured data on women age 45 and over from the National Health Interview Survey, and concluded that regular cancer screening is much more likely among women of higher socio-economic status, as well as women who are married or living with a partner, and women who engage in healthy behaviors — such as not smoking, regularly exercising, and getting a flu shot.


QuickStats: Age-Adjusted Death Rates for Four Selected Mechanisms of Injury — National Vital Statistics System, United States, 1979–2019

May 21, 2021

In 1979, of the four mechanisms of injury, age-adjusted mortality rates were highest for motor vehicle traffic deaths and lowest for drug poisoning deaths.

From 1979 to 2019, the age-adjusted rate of motor vehicle traffic deaths decreased from 22.1 per 100,000 to 11.1, and the rate of firearm-related deaths decreased from 14.7 to 11.9.

During the same period, the rate of drug poisoning (overdose) deaths increased from 3.0 to 21.6, and the rate of fall-related deaths increased from 6.2 to 10.1. In 2019, the rates were highest for drug poisoning deaths and lowest for fall-related deaths.

Source: National Vital Statistics System compressed mortality file, underlying cause of death. https://wonder.cdc.gov/mortsql.html

https://www.cdc.gov/mmwr/volumes/70/wr/mm7020a4.htm


QuickStats: Age-Adjusted Death Rates for Alzheimer Disease Among Adults Aged ≥65 Years, by Sex — National Vital Statistics System, United States, 1999–2019

April 23, 2021

mm7016a5-f

The age-adjusted death rate for Alzheimer disease increased from 128.8 per 100,000 in 1999 to 233.8 in 2019.

The trend for the total population and for men and women alternated between periods of general increase and periods of stability. Rates were stable from 2016 to 2019, and in 2019 were 263.0 for women and 186.3 for men.

Throughout the 1999–2019 period, the rate was higher for women than for men.

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


NCHS UPDATES”STATS OF THE STATES” PAGE WITH LATEST FINAL DATA

March 26, 2021

SOS_Nav_Page

The CDC National Center for Health Statistics web page “Stats of the States” has been updated to include the latest state-based final data on selected vital statistics topics, including:

  • General fertility rates
  • Teen birth rates
  • Selected other maternal and infant health measures
  • Marriage & divorce rates
  • Leading causes of death
  • Other high profile causes of death.

The site’s map pages allow users to rank states from highest to lowest or vice versa.  This latest version of “Stats of the States” also includes two new topics:  Life expectancy by state and COVID-19 death rates by state (provisional data on a quarterly basis, through Q3 of 2020).  All death rates are adjusted for age.  Rates are featured in the maps because they best illustrate the impact of a specific measure on a particular state.

The main “Stats of the States” page can be accessed at:  https://www.cdc.gov/nchs/pressroom/stats_of_the_states.htm


QuickStats: Age-Adjusted Death Rates for Influenza and Pneumonia, by Urbanization Level and Sex — National Vital Statistics System, United States, 2019

March 26, 2021

mm7012a5-f

In 2019, age-adjusted death rates for influenza and pneumonia were higher among males (14.4 per 100,000) than females (10.7) and among those who lived in rural counties (15.3) compared with those who lived in urban counties (11.7).

Among males, the age-adjusted death rate for influenza and pneumonia was 17.4 in rural counties and 13.9 in urban counties.

Among females, the age-adjusted death rate for influenza and pneumonia was 13.6 in rural counties and 10.2 in urban counties.

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

https://www.cdc.gov/mmwr/volumes/70/wr/mm7012a5.htm


PODCAST: Death Certificate Data & COVID-19, Part 3

March 26, 2021

STATCAST, MARCH 2021: DISCUSSION WITH ROBERT ANDERSON, A STATISTICIAN, ABOUT DEATH CERTIFICATE DATA & COVID-19.

https://www.cdc.gov/nchs/pressroom/podcasts/2021/20210326/20210326.htm

HOST:  In Part Three of our conversation with Dr. Robert Anderson, the chief of mortality statistics at NCHS, we discussed the subject of excess deaths in the United States during the pandemic, and also the differences between when COVID-19 is listed as the underlying cause of death on the death certificate and those occasions when it is listed as a contributing cause but not the primary cause of death.

HOST:  So now you mentioned excess deaths – what are excess deaths, how has COVID-19 contributed to these excess deaths?

ROBERT ANDERSON:  So excess deaths are defined as the difference between the observed number of deaths in a specific time period and the expected or normal number of deaths in the same time period. So with the pandemic we’re looking at the total number of weekly deaths that occurred in 2020 and so far in 2021, and we’re comparing it with what we would expect in a comparable time period, essentially based on average weekly data from previous years.  The advantage of looking at excess deaths is that it’s not dependent on the accuracy of cause of death reporting – the focus is just on the total deaths, not deaths by cause.  Now at this point COVID-19 explains about 3/4 of total excess deaths and the other quarter likely includes three components: there are deaths that should have been attributed to COVID-19 but were instead attributed to some other cause for whatever reason.  Second, indirect deaths.  And these are deaths that can be attributed to the circumstances of the pandemic but not directly to the virus.  And this may be things like people not able to get health care during a crisis not related to the virus.  Or perhaps they’re afraid to seek care because the hospitals are full of people with COVID.  And then, three: a third component is other causes of excess deaths.  So you know there may be some excess deaths not associated with pandemic.  This could include things like deaths due to natural disasters.  This is generally going to be relatively small in comparison to what we’re dealing with the pandemic but these are sort of another category of excess deaths.

HOST:  There was some other speculation out there – rumors or what have you – that 2020 might have been actually a normal year in terms of total mortality in comparison to past years despite COVID-19.  How were people getting confused about that?

ROBERT ANDERSON:   Yeah the problem was that some folks were comparing incomplete counts for 2020 with complete counts for earlier years.  And so it did look like there were about a normal number of deaths.  The problem was that they weren’t including all of the deaths that occurred for 2020.  So we’ve made some changes to our website to try to make it more clear what the total number of deaths were for 2020.

HOST:  So NCHS ranks leading causes of death according to the underlying cause of death, and you mentioned earlier that in 92%, approximately, of COVID-19 related deaths, COVID-19 was listed as the underlying cause of death. And in roughly the other 8% of COVID-19 related deaths COVID-19 was not listed as the underlying cause of death.  Could you talk about that a little bit?

ROBERT ANDERSON:  Sure.  Let me start by saying that leading causes are ranked by the total number of deaths, and it’s based on a standard cause of death tabulation list that we typically used.  And if folks are interested in that we have a publication called “Deaths: Leading Causes for… insert the year – I think the most recent one that we have published right now is for 2018 -but you get the idea of exactly how NCHS does the rankings and how all of that came about.  Now when tabulating and comparing causes of death it’s important that we assign a single cause to each death so that we don’t double count.  We don’t want to have deaths falling into multiple categories, so we select a single cause.  And as we discussed earlier, certifiers typically report more than one condition on death certificates.  Now fortunately, as we also discussed, the death certificate is designed to elicit the single underlying cause, and that’s defined as the disease or injury that initiated that sequence of events leading to death.  That sequence gets reported in Part One on the certificate, and if completed correctly the underlying cause will be at the beginning of the sequence on the lowest use line in Part One.  So as I mentioned before you could have a sequence like respiratory distress due to viral pneumonia due to COVID-19.  That’s a logical sequence starting with the immediate cause – which is respiratory distress – and then working backwards through viral pneumonia, back to COVID-19, which is the underlying cause.  So that is the condition then that we would select for tabulation when comparing causes of death.  Now if the certificate is not completed correctly – and this does happen – we actually have a set of standardized selection rules to choose the best underlying cause for among those conditions listed.  These rules are part of ICD-10, which we used to code mortality, and they’re an international standard.  So the all those rules get applied regardless of the cause of death in the same way and as a result we would select an underlying cause from among those conditions, assuming that the certificate is not completed correctly.  Now with regard to the other 8 or 9 percent – I think it’s something on the order of 91 point-something percent, underlying cause and then about 8 point-something percent not underlying cause.  In cases where COVID-19 is not the underlying cause, we’re typically seeing it reported in Part Two as a significant contributing factor.  So if reported in Part Two, it may not be the underlying cause. It should be considered a significant factor that contributed to death.  And this is an important distinction – if COVID-19 is not a factor it’s not supposed to be reported on the death certificate.

MUSIC BRIDGE

HOST:  Still to come next week in our discussion with Dr. Robert Anderson:  How COVID-19 will be categorized among the other leading causes of death in the country, as well as more complicated scenarios facing certifiers on how to list COVID-19 on the death certificate.

MUSIC BRIDGE

HOST:  The rate of multiple births in the United states declined in 2019, according to the latest final birth data released this week by NCHS.  The new report also shows that more than 3 in 4 women began prenatal care during the first trimester of pregnancy.  The percentage of women who smoke during pregnancy declined in 2019 – to 6% of all women who gave birth. Medicaid was the source of payment for over 4 in 10 births that occurred in 2019.

Another report published this week by NCHS looks at drug overdose death rates in the U.S. on a state by state basis.  The report documents that the highest death rates from overdoses in 2019 were concentrated in jurisdictions that are in fairly close geographical proximity to one another: West Virginia, Delaware, DC, Ohio, Maryland and Pennsylvania.  Nebraska had the lowest overdose death rate in the nation in 2019.