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


Monthly Provisional Drug Overdose Counts through February 2021

September 15, 2021

Monthy_Drugs_Feb21

NCHS has released the next set of monthly provisional drug overdose death counts.  The monthly counts are released under the Vital Statistics Rapid Release program as an interactive data visualization.

Findings: 

  • Provisional data show that the predicted number of drug overdose deaths showed an increase of 30.4% from the 12 months ending in February 2020 to the 12 months ending in February 2021, from 74,234 to 96,801.
  • The predicted number of opioid-involved drug overdose deaths in the United States for the 12-month period ending in February 2021 (72,689) increased from 52,712 in the previous year.

NCHS Releases Latest Quarterly Birth Data Through Q1 2021

September 1, 2021

The data is available at the interactive web dashboard below:

Quarterly Provisional Data for Selected Birth Estimates: Q1 2020 – Q1 2021 Vital Statistics Rapid Release Web Data Visualization

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

Q1_2021_Births


PODCAST: The 2020 Decline in Life Expectancy

July 21, 2021

https://www.cdc.gov/nchs/pressroom/podcasts/2021/20210721/20210721.htm

podcast-iconHOST:  In February, we had a discussion with Elizabeth Arias with the NCHS Division of Vital Statistics about life expectancy in the United States during the first half of 2020, right as the pandemic was taking hold.  Americans lost a full year of life expectancy during that first part of 2020.  Today we feature the sequel to that conversation, as this week NCHS is releasing full-year life expectancy estimates for 2020.

HOST:  Can you tell us if life expectancy dropped more in the second half of 2020 than in the first half?

ELIZABETH ARIAS: Yes it did – life expectancy declined an additional amount during the second half of 2020 and it did so more for some groups than for other groups.  For example, for the Hispanic population it declined an additional 1.1 years.  For the non- Hispanic white population it declined an additional .4 years and for the non-Hispanic black population it declined an additional .2 years.

HOST:  So overall what was the total decline in life expectancy for 2020?

ELIZABETH ARIAS: It was 1 1/2 years.

HOST: So it’s another half year of decline from the first half then?

ELIZABETH ARIAS: That’s right.

HOST:  Were you surprised it didn’t drop more than 1.5 years given how bad the pandemic became near the end of 2020?

ELIZABETH ARIAS:  No. I was not surprised because the number of excess deaths would have had to be even larger than they were for the decline to have been greater.  And in addition half a year is a substantial amount – it sounds like a small change, but in terms of the way that mortality changes over time which is rather gradual, and it has been gradual and consistent ever since the 1940s, for example.  We have seen an increase gradually increase in life expectancy year to year, and of course a gradual decrease in mortality year to year.  So a half a year is substantial, so if we would have added another year of decline that would have meant that the number of deaths were even greater than what we saw.

HOST: OK so you mentioned some of the declines among race Hispanic groups- what about declines among men versus women?

ELIZABETH ARIAS:  We have seen the gap in life expectancy between men and women decline over the decades.  It started out rather large at the beginning of the 20th century, with women having higher mortality and lower life expectancy than men – that was mainly due to high rates of maternal mortality.  And then we saw over time men having higher mortality and women having greater advantage in terms of life expectancy.  Over time we’ve seen that this change and particularly during the latter part of the 20th century and early part of the 21st century.  The main reason for the decline in the gap, in the difference between the two, has been that life expectancy has been increasing at a faster pace or rate for men.  In other words, men had been catching up to women, and what happened in 2020 with the pandemic is that men experienced higher mortality than women did, and so they basically lost some of what they had achieved during the previous decades.

HOST: Now are you planning to release mid-year 2021 estimates like you did with 2020?

ELIZABETH ARIAS: That’s a good question and I believe we are. I don’t know definitively.

HOST: With 200,000 plus deaths from COVID-19 so far in 2021, would we expect to see another drop in life expectancy?

ELIZABETH ARIAS: No actually, I think what we would see is a small increase in life expectancy in comparison to what we saw in 2020.  In order for us to see another decline in life expectancy we would have to have a greater number of excess deaths than what we have seen so far.  So I would say that we would probably see life expectancy go up but it won’t return to what it was in 2019.

HOST: Now the drop in life expectancy for 2020 was 1.5 years, and yet way back 100 years ago plus, the Spanish flu pandemic resulted in an 11.8 year decline in 1918.  Why the huge difference?

ELIZABETH ARIAS:  Well, you have to think about number of deaths during the Spanish influenza.  So there were over 600,000 deaths, and also you have to think about the size of the population then.  It was a significantly smaller population than what we have today. So you know in 2020 we had 385,000 deaths and a population of over 330 million and back in 1918 we had over 600,000 deaths and – I don’t remember the number of the population at the time – but it was a lot smaller than it is so that translates into much larger death rates and as a result a greater decline in life expectancy.

HOST:  Are there any plans to down the road look at vaccination and deaths from COVID or vaccination and life expectancy?  Anything planned along those lines?

ELIZABETH ARIAS:  That would be really interesting and I don’t know if we would have the data for that. I think if the National Health Interview Survey asks that question – if people, you know, were vaccinated – or the NHANES… And since we link those surveys to our mortality data, we may be able to look at mortality by vaccination status.  But from our data, from vital statistics – in other words from the death certificate – we would not be able to see that.  We would have to have some sort of data that’s linked to our mortality data.

HOST:  OK well thanks for talking to us again Elizabeth.

ELIZABETH ARIAS:   You’re welcome.  Thank you.

MUSIC BRIDGE

HOST:  Through the week ending on July 14, there have been 213,413 COVID-19 deaths recorded on death certificates in the United States during this year.  Deaths occurring in nursing homes or other long-term care facilities have declined from 22% of all COVID deaths in 2020 to 13% of the total so far in 2021.  81% of deaths in 2020 were among people age 65 and up; that percentage has dropped slightly in 2021 to less than 77%.  Deaths in the 45-64 year age group have risen from 16.6% of all deaths in 2020 to over 20% in 2021.  Total excess deaths in the U.S. since February 1, 2020 have topped 663,000, with approximately 80% or more of those deaths due to COVID-19.


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).


Declines in Births by Month: United States, 2020

June 23, 2021

NCHS released a report that presents provisional 2020 and final 2019 and 2018 data on changes in the number of U.S. births by race and Hispanic origin of mother and by month of birth and state.

Findings:

  • From 2019 to 2020, the number of births for the United States declined for each month, with the largest declines occurring in December (8%), August (7%), and October and November (6%).
  • Larger declines in births were seen in the second half of 2020 (down 6%) compared with the first half (down 2%) of 2020.
  • The number of births declined in both the first and second 6 months of 2020 compared with 2019 for nearly all race and Hispanic-origin groups, with larger declines in the second half of 2020 compared with the first half of the year.
  • Births declined in 20 states in the first half of 2020, and in all states in the second half of 2020 (declines in 7 states were not significant).
  • Changes in births by race and Hispanic origin and by state were less pronounced from 2018 to 2019; the number of births declined for 9 months by 1%–3%.

 


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.


NCHS Releases Latest Provisional Drug Overdose Data

June 16, 2021

NOV2020_Overdose

NCHS released the latest monthly preliminary counts of drug overdose deaths in the United States, covering the one-year period ending in November of 2020.  The data is now available in a web-based interactive dashboard at:  https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm.

Provisional data show that the reported number of drug overdose deaths occurring in the United States increased by 28.9% from the 12 months ending in November 2019 to the 12 months ending in November 2020, from 70,357 to 90,722. After adjustments for delayed reporting, the predicted number of drug overdose deaths showed an increase of 29.4% from the 12 months ending in November 2019 to the 12 months ending in November 2020, from 71,672 to 92,751.

The reported number of opioid-involved drug overdose deaths in the United States for the 12-month period ending in November 2020 (67,574) increased from 49,488 in the previous year. The predicted number of opioid-involved drug overdose deaths in the United States for the 12-month period ending in November 2020 (69,287) increased from 50,504 in the previous year.


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.