Source: National Vital Statistics System
Source: National Vital Statistics System
Questions for Joyce A. Martin, M.P.H., Demographer, Statistician, and Lead Author on “Births: Final Data for 2015”
Q: Was there a result in your study’s analysis of births in the United States that you hadn’t expected and that really surprised you?
JM: Although small, (from 9.57% to 9.63%) the rise in the preterm birth rate (births of less than 37 completed weeks of gestation) was unexpected. This rate had been declining steadily since 2007.
Also of note is the decline in the triplet and higher-order multiple birth rate, down 9% from 2014 to 2015, and a decrease of 46% since 1998. The year 2015 also is the third straight year of declines in the rate of cesarean delivery (rate of 32.0% in 2015).
The continued, large decline in the teen birth rate (down 8% from 2014 to 2015) was also somewhat surprising, although not unprecedented. From 2007 through 2014, the teen birth rates had declined 7% annually.
Q: What is the difference between this new births report and the other reports your office produced on 2015 birth data, like the preliminary data report on 2015 births and the Data Brief on teen births?
JM: The annual report “Births: Final Data for 2015” offers substantially more detail (e.g., age, race and Hispanic origin of mother, state) on key topics, than does the report on preliminary birth statistics (“Births: Preliminary Data for 2015”). The final report also includes information on topics not included in the preliminary reports such as multiple births, attendant and place of birth, birth order and birth rates for fathers.
Q: How has the number of births in the United States changed in 2015 from previous years?
JM: The number of births in the United States declined slightly in 2015 (by 9,579 births to 3,978,497) from 2014. The decline for 2015 followed an increase in births for 2014, which was the first increase since 2007.
Q: What differences, if any, did you see among race and ethnic groups, and among various ages?
JM: Of continued concern are the higher risks of poor birth outcomes as measured by levels of preterm birth and low birthweight among non-Hispanic black mothers compared with total births and other race and Hispanic origin groups. For example, in 2015 the preterm birth rate for births to non-Hispanic black mothers was more than 50% higher at 13.41% than for non-Hispanic white women (8.88%) and nearly 50% higher than the rate for births to Hispanic mothers (9.14%).
Q: Did you observe any regional or state differences in this study on births?
JM: Differences by state were observed for many of the demographic and medical/health items included in the 2015 final birth report. For example, from 2014 to 2015, the general fertility rate–which is the number of births per 1,000 women aged 15–44–declined in eight states and was essentially unchanged in the 42 states and the District of Columbia (DC). In 2015, the general fertility rate ranged among states from 51.1 births per 1,000 women aged 15–44 in Vermont to 78.2 in South Dakota.
Also, increases in preterm birth rates were limited to four states from 2014 to 2015: Arkansas, California, Nebraska, and North Carolina. Rates declined in four states: Montana, New York, Texas and Wyoming. Nonsignificant differences were reported for the remaining states and DC.
Questions for Jiaquan Xu, Epidemiologist and Lead Author on “Mortality in the United States, 2015.”
Q: Is it true that death rates in the U.S. have been increasing over the past few years?
JX: Not exactly. The age-adjusted death rate for total US population increased 1.2% from 724.6 per 100,000 standard population in 2014 to 733.1 in 2015. This was the first significant increase since 1999. We have seen the decrease in mortality for most race/ethnic groups in most of years since 2006. Especially the rates decreased significantly for all male, all female, non-Hispanic white male, non-Hispanic white female, non-Hispanic black male, non-Hispanic black female, Hispanic male, and Hispanic female in 2014 from 2013.
Q: What are some of the reasons why the death rate increased between 2014 and 2015?
JX: We don’t know exactly what caused the increase in mortality in the United States from 2014 to 2015. The results have shown that the age-adjusted death rates increased for 8 (heart disease, chronic lower respiratory, unintentional injuries, stroke, Alzheimer’s disease, diabetes, kidney disease, and suicide) of the 10 leading causes of death. Only decrease in mortality among 10 leading causes of death in 2015 from 2014 was for cancer. Death rates increased significantly for 20 states and decreased for 1. The change for the rest of states were not significant.
Q: Do your findings for 2015 suggest we have reached a peak as far as increases in life expectancy goes?
JX: We don’t think we have reached a peak in life expectancy. Many people died of non-age-related causes because they have aged. Those deaths are preventable. For example, there are 146,571 deaths caused by accidents which accounted for 5.4% of total deaths in 2015. About 65% of deaths from these unintentional injuries were those aged under 65. Among accidental deaths, unintentional poisoning accounted for 32.4 % and motor vehicle traffic accidents accounted for 24.5%. We also don’t know if the increase in mortality in 2015 will continue in 2016. But preliminary data have shown that the mortality for most of the 10 leading causes of death in 2015 went down in second quarter from first quarter, 2016 (http://www.cdc.gov/nchs/products/vsrr/mortality-dashboard.htm#trends). But it is too early to say that the mortality in 2016 will go down or continue going up. We will see what happens when the 2016 final file is available.
Q: What accounts for the decline in life expectancy at birth in 2015 from 2014?
JX: For the total US population, life expectancy decreased 0.1 year from 78.9 years in 2014 to 78.8 in 2015, mainly because of increases in mortality from the 13 causes of death among the 15 leading causes of death, such as heart disease, chronic lower respiratory disease, unintentional injuries, stroke, Alzheimer’s disease, diabetes, kidney disease, suicide, septicemia, , chronic liver disease, hypertension, Parkinson’s disease, and pneumonitis due to solids and liquids. From 2014 to 2015, life expectancy decreased 0.1 year for females largely because of increases in mortality from 12 of 15 leading causes of death such as heart disease, chronic lower respiratory disease, stroke, Alzheimer’s disease, unintentional injuries, influenza and pneumonia, septicemia, hypertension, chronic liver disease, Parkinson’s disease, suicide, and pneumonitis due solids and liquids. The deaths from those 12 leading causes of death accounted for 52.9% of total female deaths.
Life expectancy declined 0.2 year for males largely because of increases in mortality from 11 of 15 leading causes of death such as unintentional injuries, chronic lower respiratory disease, stroke, diabetes, suicide, Alzheimer’s disease, chronic liver disease, septicemia, Parkinson’s disease, Homicide, and hypertension. And about 65% of accidental deaths were under 65 years old, while 81% of suicides were aged 15-64, and 95% of homicides were under 65 years. More young people dying from preventable causes drags life expectancy down.
Q: Is it unusual that mortality rates for so many leading causes of death increased in 2015?
JX: We haven’t seen the increase in mortality from so many leading causes of death for a long time. The age-adjusted death rates increased significantly for 3 of 10 leading causes of death in 2014, 2 in 2013, 1 in 2012, and 5 in 2011. It is an unusual year. Again we don’t know why.
Q: Does the increase in mortality among white females suggest another drop in life expectancy for that group?
JX: We don’t have life expectancy numbers for white females yet. It is possible that the life expectancy numbers in 2015 for white women will drop again in 2015 since the life expectancy decreased 0.1 year for all females in 2015 from 2014 and mortality from 12 of 15 leading causes of death for white females increased significantly in 2015 from 2014 (heart disease, chronic lower respiratory diseases, Alzheimer’s disease, stroke, unintentional injuries, diabetes, influenza and pneumonia, hypertension, chronic liver disease, Parkinson’s disease, suicide, pneumonitis due to solids and liquids).
Questions for Donna L. Hoyert, Ph.D., Health Scientist and Lead Author on “Cause of Fetal Death: Data from the Fetal Death Report, 2014”
Q: Why did you conduct this study?
DH: We wanted to provide background regarding what information has become available recently through vital statistics data on the cause of fetal death. The National Vital Statistics System is an example of intergovernmental sharing of public health data, and in the United States, State laws require the reporting of fetal deaths, and Federal law mandates national collection and publication of the data. There is much we can learn from the statistics in this study.
Q: Why focus on fetal deaths of 20 weeks gestation or more in your report – versus fetal deaths of any and all gestation?
DH: Because the States typically require reporting of these events, we focused on fetal deaths of 20 weeks gestation or more. These spontaneous intrauterine deaths are sometimes referred to as stillbirths. While there are a few states that report fetal deaths at all gestation periods, consistent national data is found at 20 weeks or more.
Q: What are the most common selected causes of fetal death?
DH: There are five most common selected causes of fetal death, one of which is listed as an unspecified cause. Placenta, cord, and membrane complications is another one. There are also congenital malformations, maternal complications, and maternal conditions unrelated to pregnancy.
Q: What variations by maternal demographics, if any, did you observe in the fetal death data you examined?
DH: The same five causes of fetal death were among the most common selected causes for many maternal characteristics. The characteristics of delivery weight and gestation period were different, and for these two, diabetes mellitus emerged, and maternal complications dropped below the top five selected causes for fetuses with longer gestation and heavier delivery weights.
Q: What do you think is the most significant finding in your new study?
DH: Probably that the variations observed across maternal and fetal characteristics are consistent with those documented in other research. This represents an important expansion of what is available from vital statistics on fetal death.
NCHS has released new data visualization that depicts injury mortality in the United States from 1999 through 2014.
This storyboard allows the user to select subcategories of injury deaths based on intent and mechanism of injury.
Numbers and rates are provided for the subcategory selected by the user.
The storyboard includes six dashboards. Deaths can be grouped or separated by mechanism of injury, intent of injury, and selected demographics (sex, age group, race and Hispanic origin).
Drop-down boxes across the top of the dashboard control the display of the entire visualization. The dashboards feature:
Rates: Line charts displaying trends for injury death rates. Both fixed and dynamic scale line charts are provided. The fixed scale line chart allows the user to see changes in rates relative to a predefined y-axis, while the dynamic scale line chart adjusts to maximize the visualization of the trend for the options selected. A dialog box on the left of the dashboard allows the user to select among several options for the range of y-axis values used in the fixed scale line chart.
Numbers of deaths: A table describes numbers of injury deaths for selections made at the top of the visualization.
Gestational weight gain was within the recommended range for 32% of women giving birth to full-term, singleton infants in 2015, with 48% gaining more weight and 21% less weight than recommended.
Approximately 44% of women who were underweight before pregnancy gained within the recommendations, compared with 39% of women who were normal weight, 26% of women who were overweight, and 24% of women with obesity before pregnancy.
Weight gain above the recommendations was highest among women who were overweight (61%) or had obesity (55%) before pregnancy.
Questions for Jill Daugherty and Gladys Martinez, Health Statisticians and Lead Authors on “Birth Expectations of U.S. Women Aged 15–44”
Q: There is a perception that fewer women are interested in having children compared with in the past. Does your study reflect that?
JD GM: No, our data do not support this perception. In 2013-2015, 50% of women aged 15-44 expected to have a child in the future. This percentage has significantly increased from 46% of women, seen in 2002.
Q: What was the most surprising finding in your study?
JD GM: There were a couple of findings in our study that went somewhat against expectations based on prior research:
Q: Are there economic factors related to birth expectations for women?
JD GM: This data brief did not examine economic factors related to birth expectations for women. Previous reports using NSFG data have looked at birth expectations by poverty status (http://www.cdc.gov/nchs/data/series/sr_23/sr23_026.pdf), and this type of analysis could be done again using the 2013-2015 public use data. However, in this data brief we did examine how age and number of biological children was associated with women’s birth expectations. In general, we found that younger women and women with no biological children were more likely to expect to have children in the future than older women and women who already have biological children.
Q: What are the differences, if any, among race-ethnic groups as far as birth expectations?
JD GM: This data brief did not examine differences between racial and ethnic groups in birth expectations. Previous reports have look at differences by race-ethnicity (http://www.cdc.gov/nchs/data/series/sr_23/sr23_026.pdf), and again this type of analysis could be done using the 2013-2015 public use data.
Q: Are there similar data available about birth expectations among men?
JD GM: Although the NSFG collects similar data among men, we did not include data on men in this brief report. These data are part of our public use data files that were released on October 13, 2016.