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.


NCHS Releases Latest Quarterly Provisional Mortality Data Through Full-Year 2020

June 8, 2021

NCHS has released the latest quarterly provisional mortality rates for the U.S., through full-year 2020 for most causes of death. 

Estimates are presented for 15 leading causes of death plus estimates for deaths attributed to coronavirus disease 2019 (COVID-19), drug overdose, falls for persons aged 65 and over, firearm-related injuries, human immunodeficiency virus (HIV) disease, and homicide. 

The data is featured on an interactive web site dashboard at: https://www.cdc.gov/nchs/nvss/vsrr/mortality-dashboard.htm.

NCHS has also released state maps showing COVID-19 death rates for provisional quarter 4 mortality data. You can access the 12-month ending map here and quarterly map here.


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

March 26, 2021

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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


2017 Final Deaths, Leading Causes of Death and Life Tables Reports Released

June 24, 2019

NCHS released a report that presents the final 2017 data on U.S. deaths, death rates, life expectancy, infant mortality, and trends, by selected characteristics such as age, sex, Hispanic origin and race, state of residence, and cause of death.

Key Findings:

  • In 2017, a total of 2,813,503 deaths were reported in the United States.
  • The age-adjusted death rate was 731.9 deaths per 100,000 U.S. standard population, an increase of 0.4% from the 2016 rate.
  • Life expectancy at birth was 78.6 years, a decrease of 0.1 year from the 2016 rate.
  • Life expectancy decreased from 2016 to 2017 for non-Hispanic white males (0.1 year) and non-Hispanic black males (0.1), and increased for non-Hispanic black females (0.1).
  • Age-specific death rates increased in 2017 from 2016 for age groups 25–34, 35–44, and 85 and over, and decreased for age groups under 1 and 45–54.
  • The 15 leading causes of death in 2017 remained the same as in 2016 although, two causes exchanged ranks.
  • Chronic liver disease and cirrhosis, the 12th leading cause of death in 2016, became the 11th leading cause of death in 2017, while Septicemia, the 11th leading cause of death in 2016, became the 12th leading cause of death in 2017.
  • The infant mortality rate, 5.79 infant deaths per 1,000 live births in 2017, did not change significantly from the rate of 5.87 in 2016.

NCHS also released the 2017 U.S. Life Tables and Leading Causes of Death Reports.


Mortality in the United States, 2017

November 29, 2018

Questions and Answers from the authors of the recently released 2017 mortality data.  The data can be found in the following reports, “Mortality in the United States, 2017, ” “Drug Overdose Deaths in the United States, 1999–2017, ” and “Suicide Mortality in the United States, 1999–2017.”

Q: Why did life expectancy decline in 2017?

A: Mortality rates increased for 7 out of the 10 leading causes of death in the U.S., including a 5.9% increase in the flu/pneumonia death rate, a 4.2% increase in the accidental/unintentional injury death rate, and 3.7% in the suicide rate. Many of the accidental/unintentional deaths were from drug overdoses, which continued to increase in 2017.


Q: Isn’t this the third straight year that life expectancy declined?

A: Estimated life expectancy at birth in 2017 was 0.3 years lower than in 2014 and 0.1 years lower than in 2016. The 2016 life expectancy estimate was revised to 78.7 years, up from an estimated 78.6 years, which was reported a year ago. This means that the 2016 life expectancy estimate is the same as the 2015 estimate, which also was revised to 78.7 years, down from an estimated 78.8 years, originally reported two years ago. As a routine matter, for the highest degree of accuracy, NCHS blends Medicare data for people ages 66 and over with our vital statistics data to estimate life expectancy. However, the two data sets are released on different schedules. When Medicare data for a year aren’t available at the time we release our final mortality statistics, we use the most recent Medicare data available at the time. We later revise life expectancy estimates when updated Medicare data become available.


Q: How many deaths in 2017 were attributed to opioids?

A: In 2017, 47,600 drug overdose deaths mentioned involvement of any type of opioid, including heroin and illicit opioids, representing over two-thirds of all overdose deaths (68%).


Q: Why is the 70,237 number of overdose deaths smaller than what CDC has previously reported for 2017?

A: The 70,237 number is a final, official number of overdose deaths among U.S. residents for 2017 whereas the previously reported (and slightly higher) numbers were provisional estimates. In August of 2017, CDC began calculating monthly provisional data on counts of drug overdose deaths as a rapid response to this public health crisis, in order to provide a more accurate, closer to “real-time” look at what is happening both nationally and at the state level. These monthly totals are provisional counts, and they include all deaths occurring in the U.S. – which include deaths among non-residents (i.e., visitors here on business or leisure, students from abroad, etc). These counts also do not include deaths that are still under investigation. As a result, the monthly numbers are provisional or very preliminary, and the final 2017 number of 70,237 deaths is an official number that only include deaths among U.S. residents and account for any previously unresolved deaths that were under investigation.


Q: Does this mean that the 70,237 total does not include deaths to undocumented immigrants here in the U.S.?

A: We don’t get immigration status off the death certificates, so we wouldn’t know how many of the deaths were to undocumented immigrants.


Q: In comparing the 2017 numbers with 2016 and past years, is the crisis of drug overdose deaths growing or about the same?

A: From 2016 to 2017, the number of drug overdose deaths increased from 63,632 deaths to 70,237, a 10% increase, which is a smaller increase compared to the 21% increase from 2015 to 2016, when the number of drug overdose deaths increased from 52,404 deaths to 63,632 deaths. Over a longer period of time, from 1999 through 2017, the age-adjusted rate of drug overdose deaths increased on average by 10% per year from 1999 to 2006, by 3% per year from 2006 to 2014, and by 16% per year from 2014 to 2017. So the trend is continuing, although the increase in 2017 was not as large as in previous years.


Q: Are there any other trends of significance when looking at the types of drugs attributed to overdose deaths?

A: The rate of drug overdose deaths involving synthetic opioids other than methadone, which include drugs such as fentanyl, fentanyl analogs, and tramadol, increased 45% in one year, from 6.2 per 100,000 in 2016 to 9.0 per 100,000 in 2017. In 2017, 40%(?) of all drug overdose deaths mentioned involvement of a synthetic opioid other than methadone.


Q: Has fentanyl overtaken heroin as the major cause of overdose death?

A: The data brief on drug overdose deaths does not specifically address fentanyl. However the rate of drug overdose deaths involving synthetic opioids other than methadone, which includes fentanyl, increased 45% 2016 and 2017 whereas the overdose death rate from heroin did not change (4.9 deaths per 100,000).


Q: There is a lot of stark news in these three reports. Are there any positives to report?

A: The cancer mortality rate declined between 2016 and 2017, and although estimated life expectancy declined in 2017, life expectancy for people at age 65 actually increased. Also, regarding drug overdose deaths, the rate of increase in drug overdose deaths slowed between 2016 and 2017, although the increases that occurred were still very significant.


Health, United States, 2017

September 20, 2018

Renee Gindi, Ph.D., Chief, Analytic Studies Branch, Office of Analysis and Epidemiology

Questions for Renee Gindi, Ph.D., Chief, Analytic Studies Branch, Office of Analysis and Epidemiology, who led production of “Health, United States, 2017

Q: Why did you produce this report?

RG: We produced this report for a number of reasons. Health, United States, 2017 with Special Feature on Mortality is the 41st edition of the Congressionally-mandated annual report on the health of the nation from the Secretary of the Department of Health and Human Services to the President of the United States and to Congress.

This report benefits the public health community and the general public by bringing key national health data from different sources into one location. In this wide-ranging report, users can find graphs, tables, and descriptions of trends and current information on selected measures of health and disease. The Special Feature section of the report more closely examines a topic of public health interest and policy relevance.

Q: What made you decide to focus on deaths in the United States as the Special Feature for this study?

RG: It was the recent decrease in life expectancy at birth that caused us to want to look more deeply into what groups were most affected by this marked change. Life expectancy at birth decreased for the first time since 1993 by 0.2 years between 2014 and 2015 and then decreased another 0.1 years between 2015 and 2016. We found that between 2000 and 2016, death rates for 5 of the 12 leading causes of death increased: unintentional injuries, Alzheimer’s disease, suicide, chronic liver disease, and septicemia.


Q: Was there a finding in this edition of “Health, United States” that you hadn’t expected and that really surprised you?

RG: In addition to the decrease in life expectancy at birth, we found several trends that were particularly noteworthy. Here are a few of them:

  • The increases (and acceleration of those increases) in death rates for specific causes of death in specific age groups:
    • In particular, drug overdose death rates among men aged 25–34 increased by an average of 26.7% per year during 2014-2016. For women aged 15-24, drug overdose death rates increased by an average of 19.4% per year during 2014-2016.
    • The suicide rate among children and young adults aged 15-24 has been increasing since 2006, with a recent increase of 7.0% per year during 2014-2016.
    • The rate of deaths from Alzheimer’s among adults aged 65 and older has also been increasing, by an average of 6.9% per year during 2013-2016.
  • Current cigarette smoking has been decreasing among adults (18+), with declines observed in every age group in recent years.
  • Among adolescents, cigarette smoking in the past 30 days has decreased between 2011 and 2016, but e-cigarette use in the past 30 days has increased more than seven-fold, from 1.5% in 2011 to 11.3% in 2016.
  • The rate of births to teen mothers has been decreasing in recent years among all races and ethnic groups examined.

Q: What is new in the report this year?

RG: There are a couple of new items worth highlighting from this year’s edition of Health, United States. The Special Feature on mortality, with its look at when, why, and where individuals are dying in the United States, is a new focus this year.

Also new this year is the examination of trends in disability and functional limitation using a new data source, the Washington Group Short Set on Functioning (WG-SS). These questions are considered the international standard and replace the questions used to describe disability in previous editions of Health, United States.

Health, United States, 2017 includes information on the functional status of civilian noninstitutionalized adults. Level of difficulty in six basic, universal domains—seeing, hearing, mobility, communication, cognition (remembering or concentrating), and self-care—identify the population with disability, namely those at greater risk than the general population for participation restrictions due to these, if appropriate accommodations are not made. Functional status is summarized using three mutually exclusive categories: “a lot of difficulty” or “cannot do at all/unable to do” in at least one domain; “some difficulty” in at least one domain but no higher level of difficulty in any domain;  and those with “no difficulty” in all domains.


Q: What does this publication tell us about the health of our nation?

RG: This year’s Health, United States publication tells us a lot about the health of our nation. The overall age-adjusted death rate has decreased between 2006 and 2016 by 8%, from 791.8 to 728.8 deaths per 100,000 resident population. However, the majority of deaths (73%) are among persons aged 65 and older. The death rates for nearly all of the leading causes of death in this age group have been decreasing since 2006, including heart disease and cancer, the two leading causes of death in this age group.

However, the death rates in other age groups paint a different picture. Among persons aged 15-24, 25-44 and 45-64, death rates for several causes have been increasing in recent years—including unintentional injuries, suicide, homicide, and chronic liver disease.


STAT OF THE DAY – November 15, 2017

November 15, 2017


Stat of the Day – October 23, 2017

October 23, 2017


QuickStats: Number of Deaths from 10 Leading Causes by Sex — National Vital Statistics System, United States, 2015

April 24, 2017

In 2015, a total of 1,339,226 deaths among females and 1,373,404 deaths among males occurred.

Heart disease and cancer were the top two causes of death for both females and males; other leading causes varied in rank by sex.

The 10 leading causes of death accounted for approximately three-quarters of all deaths.

Source: https://www.cdc.gov/mmwr/volumes/66/wr/mm6615a8.htm


State by State Health Data Source Updated on NCHS Web Site

April 19, 2017

CDC’s National Center for Health Statistics has updated its Stats of the States feature on the NCHS web site.  This resource features the latest state-by-state comparisons on key health indicators ranging from birth topics such as teen births and cesarean deliveries to leading causes of death and health insurance coverage.

Tabs have been added to the color-coded maps to compare trends on these topics between the most recent years (2015 and 2014) and going back a decade (2005) and in some cases further back.

To access the main “Stats of the States” page, use the following link:

https://www.cdc.gov/nchs/pressroom/stats_of_the_states.htm