Deaths: Leading Causes for 2020.

Objectives-This report presents final 2020 data on the 10 leading causes of death in the United States by age, race and Hispanic origin, and sex. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2020," the National Center for Health Statistics' annual report of final mortality statistics. Methods-Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2020. Causes of death classified by the International Classification of Diseases, 10th Revision (ICD-10) are ranked according to the number of deaths. Cause-of-death statistics are based on the underlying cause of death. Race and Hispanicorigin data are based on the Office of Management and Budget's 1997 standards for reporting race and Hispanic origin. Results-In 2020, many of the 10 leading causes of death changed rank order due to the emergence of COVID-19 as a leading cause of death in the United States. The 10 leading causes of death in 2020 were, in rank order: Diseases of heart; Malignant neoplasms; COVID-19; Accidents (unintentional injuries); Cerebrovascular diseases; Chronic lower respiratory diseases; Alzheimer disease; Diabetes mellitus; Influenza and pneumonia; and Nephritis, nephrotic syndrome and nephrosis. They accounted for 74.1% of all deaths occurring in the United States. Differences in the rankings are evident by age, race and Hispanic origin, and sex. Leading causes of infant death for 2020 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Sudden infant death syndrome; Accidents (unintentional injuries); Newborn affected by maternal complications of pregnancy; Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Respiratory distress of newborn; Diseases of the circulatory system; and Neonatal hemorrhage.

U.S. State Life Tables, 2020.

Objectives-This report presents complete period life tables for each of the 50 states and the District of Columbia (D.C.) by sex based on age-specific death rates in 2020.

Death Rates by Marital Status for Leading Causes of Death: United States, 2010-2019.

Objectives-This report presents age-adjusted death rates by marital status (married, never married, widowed, and divorced) among adults aged 25 and over. Rates for all-cause mortality are presented for 2010-2019 and for the 10 leading causes of death for 2010 and 2019.

Deaths: Final Data for 2018.

Objectives-This report presents final 2018 data on U.S. deaths, death rates, life expectancy, infant and maternal mortality, and trends by selected characteristics such as age, sex, Hispanic origin and race, state of residence, and cause of death. The race categories are consistent with 1997 Office of Management and Budget (OMB) standards, which are different from previous reports (1977 OMB standards). Methods-Information reported on death certificates is presented in descriptive tabulations. The original records are filed in state registration offices. Statistical information is compiled in a national database through the Vital Statistics Cooperative Program of the National Center for Health Statistics. Causes of death are processed according to the International Classification of Diseases, 10th Revision. As of 2018, all states and the District of Columbia were using the 2003 revised certificate of death, which includes the 1997 OMB revised standards for race. The 2018 data based on the revised standards are not completely comparable to previous years. Selected estimates are presented in this report for both the revised and previous race standards to provide some reference for interpretation of trends. Results-In 2018, a total of 2,839,205 deaths were reported in the United States. The age-adjusted death rate was 723.6 deaths per 100,000 U.S. standard population, a decrease of 1.1% from the 2017 rate. Life expectancy at birth was 78.7 years, an increase of 0.1 year from 2017. Age-specific death rates decreased in 2018 from 2017 for age groups 15-24, 25-34, 45-54, 65-74, 75-84, and 85 and over. The 15 leading causes of death in 2018 remained the same as in 2017. The infant mortality rate decreased 2.2% to a historically low figure of 5.66 infant deaths per 1,000 live births in 2018. Conclusions-The age-adjusted death rate for the total, male, and female populations decreased from 2017 to 2018, and life expectancy at birth increased in 2018 for the total, male, and female populations.

U.S. State Life Tables, 2018.

Objectives-This report presents complete period life tables for each of the 50 states and the District of Columbia by sex based on age-specific death rates in 2018. Methods-Data used to prepare the 2018 state-specific life tables include 2018 final mortality statistics; July 1, 2018 population estimates based on the 2010 decennial census; and 2018 Medicare data for persons aged 66-99. The methodology used to estimate the state-specific life tables is the same as that used to estimate the 2018 national life tables, with some modifications. Results-Among the 50 states and the District of Columbia, Hawaii had the highest life expectancy at birth, 81.0 years in 2018, and West Virginia had the lowest, 74.4 years. Life expectancy at age 65 ranged from 17.5 years in Kentucky to 21.1 years in Hawaii. Life expectancy at birth was higher for females in all states and the District of Columbia. The difference in life expectancy between females and males ranged from 3.8 years in Utah to 6.2 years in New Mexico.

Mortality Profile of the Non-Hispanic American Indian or Alaska Native Population, 2019.

Objectives-This report presents a mortality profile of the U.S. non-Hispanic American Indian or Alaska Native (AIAN) population for 2019. Standard mortality statistics, adjusted for race and Hispanic-origin misclassification on death certificates, are provided along with comparisons with the three major U.S. populations: non-Hispanic white, non-Hispanic black, and Hispanic.

U.S. State Life Tables, 2019.

Objectives-This report presents complete period life tables for each of the 50 states and the District of Columbia (D.C.) by sex based on age-specific death rates in 2019.

Differential impact of the COVID-19 pandemic on excess mortality and life expectancy loss within the Hispanic population.

BACKGROUND: The impact of the COVID-19 pandemic on the Hispanic population resulted in the almost complete elimination of the long-standing Hispanic mortality advantage relative to the non-Hispanic White population. However, it is unknown how COVID-19 mortality affected the diverse Hispanic subpopulations. OBJECTIVE: We estimate life expectancy at birth in 2019 and 2020 by select Hispanic country/region of origin and explore how changes in age-specific all-cause and COVID-19 mortality affected changes in life expectancy between 2019 and 2020 for each group. METHODS: We use final 2019 and 2020 mortality data from the National Center for Health Statistics and population estimates based on the 2019 and 2020 American Community Survey. We calculate life tables and apply decomposition techniques to explore the effects of changes in age- and cause-specific mortality on life expectancy. RESULTS: Patterns of age- and cause-specific excess deaths and their impact on declines in life expectancy due to the COVID-19 pandemic differed substantially by Hispanic subgroup. Life expectancy losses ranged from 0.6 to 6.7 years among males and from 0.6 to 3.6 years among females. CONCLUSIONS: Our findings highlight the heterogeneous impact of the COVID-19 pandemic within the Hispanic population. CONTRIBUTIONS: Our findings contribute new information that will help future researchers identify the causes of the disproportionately severe impact of the COVID-19 pandemic on the Hispanic population. Our study underscores the importance of population disaggregation in endeavors to identify the multiple pathways by which the pandemic affected the Hispanic population.

U.S. Decennial Life Tables for 2009-2011, Methodology of the United States Life Tables.

Objectives-This report describes the methodology used in the preparation of the 2009-2011 decennial life tables for the United States by race, Hispanic origin, and sex based on the age-specific death rates for the period 2009-2011, appearing in the report, "U.S. Decennial Life Tables for 2009-2011, United States Life Tables" (1). Methods-Data used to prepare these life tables include population data by age on the census date April 1, 2010; deaths occurring in the 3-year period 2009-2011 classified by age at death; births for each of the years 2007-2011; and Medicare data for ages 66-99 for the 3 years 2009-2011. The methods used differ from those applied to the 1999-2001 decennial life tables in the estimation of mortality for ages 66 and over. For the total, white, black, non-Hispanic white, and non-Hispanic black populations, the method developed for the U.S. annual life tables beginning with data year 2008 was used. It consists of the application of the Kannisto logistic model to smooth death rates in the age range 85-99 and predict death rates for ages 100-120 (2,3). For the Hispanic population, which is added to the decennial series for the first time with the 2009-2011 set, the method developed for the U.S. annual life tables beginning with data year 2006 was used. This method consists of using the Brass relational logit model to estimate mortality for ages 80-120 (4).

U.S. Decennial Life Tables for 2009-2011, United States Life Tables.

Objectives-This report presents period life tables for the United States, based on age-specific death rates for the period 2009-2011. These tables are the most recent in a 110-year series of decennial life tables for the United States. Methods-This report presents complete life tables for the United States by race, Hispanic origin, and sex, based on age- specific death rates during 2009-2011. This is the first set of life tables by Hispanic origin presented in the U.S. decennial life table series. Data used to prepare these life tables include population estimates based on the 2010 decennial census; deaths occurring in the United States to U.S. residents in the 3 years 2009 through 2011; counts of U.S. resident births in the years 2007 through 2011; and population and death counts from the Medicare program for years 2009 through 2011. The methodology used to estimate life tables for the Hispanic population is based on the method first implemented with the 2006 annual U.S. life tables by Hispanic origin. The methodology used to estimate the life tables for all other groups is based on the method first implemented with the 2008 annual U.S. life tables. Results-During 2009-2011, life expectancy at birth was 78.60 years for the total U.S. population, representing an increase of 29.36 years from a life expectancy of 49.24 years in 1900. Between 1900 and 2010, life expectancy increased by 42.88 years for black females (from 35.04 to 77.92), by 39.21 years for black males (from 32.54 to 71.75), by 30.15 years for white females (from 51.08 to 81.23), and by 28.26 years for white males (from 48.23 to 76.49). During 2009-2011, Hispanic females had the highest life expectancy at birth (84.05), followed by non-Hispanic white females (81.06), Hispanic males (78.83), non-Hispanic black females (77.62), non-Hispanic white males (76.30), and non-Hispanic black males (71.41).

Dementia Mortality in the United States, 2000-2017.

Objectives-This report presents data on mortality attributable to dementia. Data for dementia as an underlying cause of death from 2000 through 2017 are shown by selected characteristics such as age, sex, race and Hispanic origin, and state of residence. Trends in dementia deaths overall and by specific cause are presented. The reporting of dementia as a contributing cause of death is also described. Methods-Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia. Using multiple cause-of-death data files, dementia is considered to include deaths attributed to unspecified dementia; Alzheimer disease; vascular dementia; and other degenerative diseases of nervous system, not elsewhere classified. Results-In 2017, a total of 261,914 deaths attributable to dementia as an underlying cause of death were reported in the United States. Forty-six percent of these deaths were due to Alzheimer disease. In 2017, the age-adjusted death rate for dementia as an underlying cause of death was 66.7 deaths per 100,000 U.S. standard population. Age-adjusted death rates were higher for females (72.7) than for males (56.4). Death rates increased with age from 56.9 deaths per 100,000 among people aged 65-74 to 2,707.3 deaths per 100,000 among people aged 85 and over. Age-adjusted death rates were higher among the non-Hispanic white population (70.8) compared with the non-Hispanic black population (65.0) and the Hispanic population (46.0). Age-adjusted death rates for dementia varied by state and urbanization category. Overall, age-adjusted death rates for dementia increased from 2000 to 2017. Rates were steady from 2013 through 2016, and increased from 2016 to 2017. Patterns of reporting the individual dementia causes varied across states and across time.

Tuberculosis Surveillance and Control, Puerto Rico, 1898-2015.

The World Health Organization recognizes Puerto Rico as an area of low tuberculosis (TB) incidence, where TB elimination is possible by 2035. To describe the current low incidence of reported cases, provide key lessons learned, and detect areas that may affect progress, we systematically reviewed the literature about the history of TB surveillance and control in Puerto Rico and supplemented this information with additional references and epidemiologic data. We reviewed 3 periods: 1898-1946 (public health efforts before the advent of TB chemotherapy); 1947-1992 (control and surveillance after the introduction of TB chemotherapy); and 1993-2015 (expanded TB control and surveillance). Although sustained surveillance, continued care, and use of newly developed strategies occurred concomitantly with decreased incidence of reported TB cases and mortality rates, factors that may affect progress remain poorly understood and include potential delayed diagnosis and underreporting, the effects of government debt and Hurricane Maria, and poverty.

COVID-19 Mortality in Adults Aged 65 and Over: United States, 2020.

COVID-19 was the underlying cause of death for a total of 350,381 deaths in the United States in 2020 (1). Although COVID-19 can affect people of any age, older adults were especially impacted during the first year of the pandemic: 81% of COVID-19 deaths in 2020 (282,836) occurred among those aged 65 and over. In this age group, COVID-19 was the third leading cause of death, after heart disease and cancer (1). This report describes COVID-19 mortality in 2020 by selected characteristics in the population aged 65 and over.

Drug Overdose Deaths in Adults Aged 65 and Over: United States, 2000-2020.

In 2020, 5,209 drug overdose deaths in adults aged 65 and over were recorded (1). Drug overdose death rates for older adults were lower than for other age groups but have increased in the past 2 decades (1,2). This report presents age-adjusted trends in drug overdose death rates, including trends in the type of opioid drug involved, for adults aged 65 and over for 2000-2020 using mortality data from the National Vital Statistics System (NVSS). Age- and sex-specific death rates for adults aged 65-74 and 75 and over are shown by race and Hispanic origin for 2019 and 2020.

Estimating and Characterizing COVID-19 Deaths, Puerto Rico, March-July 2020.

OBJECTIVES: Using the Council of State and Territorial Epidemiologists (CSTE) classification guidelines, we characterized coronavirus disease 2019 (COVID-19)-associated confirmed and probable deaths in Puerto Rico during March-July 2020. We also estimated the total number of possible deaths due to COVID-19 in Puerto Rico during the same period. METHODS: We described data on COVID-19-associated mortality, in which the lower bound was the sum of confirmed and probable COVID-19 deaths and the upper bound was excess mortality, estimated as the difference between observed deaths and average expected deaths. We obtained data from the Puerto Rico Department of Health COVID-19 Mortality Surveillance System, the Centers for Disease Control and Prevention's National Electronic Disease Surveillance System Base System, and the National Center for Health Statistics. RESULTS: During March-July 2020, 225 COVID-19-associated deaths were identified in Puerto Rico (119 confirmed deaths and 106 probable deaths). The median age of decedents was 73 (interquartile range, 59-83); 60 (26.7%) deaths occurred in the Metropolitana region, and 140 (62.2%) deaths occurred among men. Of the 225 decedents, 180 (83.6%) had been hospitalized and 93 (41.3%) had required mechanical ventilation. Influenza and pneumonia (48.0%), sepsis (28.9%), and respiratory failure (27.1%) were the most common conditions contributing to COVID-19 deaths based on death certificates. Based on excess mortality calculations, as many as 638 COVID-19-associated deaths could have occurred during the study period, up to 413 more COVID-19-associated deaths than originally reported. CONCLUSIONS: Including probable deaths per the CSTE guidelines and monitoring all-cause excess mortality can lead to a better estimation of COVID-19-associated deaths and serve as a model to enhance mortality surveillance in other US jurisdictions.

Motor Vehicle Traffic Death Rates Among Adolescents and Young Adults Aged 15-24, by Urbanicity: United States, 2000-2018.

Deaths due to motor vehicle traffic (MVT) injury are a leading cause of death for adolescents and young adults aged 15-24, with death rates higher than for adults aged 25 and over (1). Adolescent and young adult drivers are less experienced, and they tend to be passengers in cars with less experienced drivers (2). This report presents trends in death rates due to MVT among persons aged 15-24 from 2000 to 2018 by sex, urban-rural classification, and urbanicity of county of residence.

Drug Overdose Deaths Among Adolescents Aged 15-19 in the United States: 1999-2015.

Drug overdose deaths in the United States are a pressing public health challenge (1­3). In particular, drug overdoses involving opioids have increased since 1999 (1). This report focuses specifically on drug overdose deaths for older adolescents aged 15­19. In 2015, 772 drug overdose deaths occurred in this age group. Rates for 1999­2015 are presented and trends compared for both females and males. Percent distributions of drug overdose deaths for 2015 by intent (e.g., unintentional, suicide, homicide) are presented. Trends in drug overdose death rates by type of drug involved are also presented.

Deaths: Final Data for 2014.

Objectives-This report presents final 2014 data on U.S. deaths, death rates, life expectancy, infant mortality, and trends, by selected characteristics such as age, sex, Hispanic origin, race, state of residence, and cause of death.

Mortality from Alzheimer's disease in the United States: data for 2000 and 2010.

In 2010, Alzheimer's disease was the underlying cause for a total of 83,494 deaths and was classified as a contributing cause for an additional 26,488 deaths (1). Mortality from Alzheimer's disease has steadily increased during the last 30 years. Alzheimer's disease is the sixth leading cause of death in the United States and the fifth leading cause for people aged 65 years and over (1). An estimated 5.4 million persons in the United States have Alzheimer's disease (2). The cost of health care for people with Alzheimer's disease and other dementia was estimated to be 200 billion dollars in 2012, including 140 billion dollars in costs to Medicare and Medicaid and is expected to reach 1.1 trillion dollars in 2050 (2). Alzheimer's disease mortality varies by age, sex, race, Hispanic origin, and geographic area. This report presents mortality data on Alzheimer's disease based on data from the National Vital Statistics System from 2000 through 2010, the most recent year for which detailed data are available.

United States life tables eliminating certain causes of death, 1999-2001.

OBJECTIVES: This report presents abridged cause-elimination life tables and multiple-decrement life table functions for 33 selected causes of death, by race (white and black) and sex, for the total United States. It is the fourth in a set of reports that present life table data for the United States and each state for the period 1999-2001. METHODS: The life table functions presented in this report represent the mortality experience of a hypothetical cohort assuming that a particular cause of death is eliminated. The report includes a description of the methodology used to estimate the life table functions shown in four sets of tables. Each set contains seven tables, one each for the total population, total males, total females, white males, white females, black males, and black females. RESULTS: From birth, a person has a 31% chance of dying of Diseases of heart (heart disease) and a 22% chance of dying of Malignant neoplasms (cancer). In contrast, the probabilities of dying from Accidents (unintentional injuries), Diabetes mellitus (diabetes), and Septicemia--3 of the 10 leading causes of death in 1991-2001--are much smaller. Likewise, elimination of heart disease would increase life expectancy at birth by almost 4 years, and elimination of cancer by more than 3 years. Other leading causes of death have a much smaller impact.