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.

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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


Top 10 Leading Causes of Death: United States, 1999–2013

August 4, 2015

DA1_Leading Casues_State_Year

A new chart presents the age-adjusted death rates for the top 10 leading causes of death in the United States, including mortality patterns from 1999 through 2013, and by state of residence for selected year and cause of death.

Top 10 Leading Causes of Death: United States, 1999–2013

Data Visualization Gallery