COVID-19 Death Rates in Urban and Rural Areas: United States, 2020.

Death rates in the United States are higher in rural than urban areas, and the difference has grown over the last 2 decades (1). Death rates for all of the 10 leading causes of death in 2019 were higher in rural than urban areas (1). In 2020, deaths due to COVID-19 became the third leading cause of death in the United States (2). This report presents COVID-19 death rates for rural and urban areas in 2020 by sex and age group (under age 65 and 65 and over). Rates are presented for the six categories of urbanicity according to the decedent's county of residence (3). Urban areas include large central metropolitan, large fringe metropolitan, medium metropolitan, and small metropolitan; rural areas include micropolitan and noncore (nonmetropolitan).

Deaths: Leading Causes for 2019.

Objectives-This report presents final 2019 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 2019," the National Center for Health Statistics' annual report of final mortality statistics.

Deaths: Leading Causes for 2018.

Objectives-This report presents final 2018 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2018," 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 2018. Causes of death classified by the International Classification of Diseases, 10th Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. Race and Hispanic-origin data are based on the Office of Management and Budget's 1997 standards for reporting race and Hispanic origin. Results-In 2018, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Accidents (unintentional injuries); Chronic lower respiratory diseases; Cerebrovascular diseases; Alzheimer disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 73.8% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2018 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Newborn affected by maternal complications of pregnancy; Sudden infant death syndrome; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Diseases of the circulatory system; Respiratory distress of newborn; and Neonatal hemorrhage. Variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.

Comparability of Race-specific Mortality Data Based on 1977 Versus 1997 Reporting Standards.

Objectives-This report presents findings on the effects of fully implementing the Office of Management and Budget's 1997 standards for collecting, tabulating, and reporting race and ethnicity in the National Vital Statistics System mortality data across all vital statistics reporting areas. It compares bridgedrace death counts and rates based on the 1977 standards with single-race death counts and rates based on the 1997 standards, overall and by age (categories), sex, and state. Methods-Mortality statistics in this report are based on information from all death certificates filed in the United States and the District of Columbia in 2018. Crude and age-adjusted death rates are calculated with bridged-race and single-race death counts and population estimates then compared using rate ratios. Results-In 2018, single-race death counts were lower than bridged-race counts for all major racial and ethnic groups, overall and by age and sex. This is expected because in bridged-race data, multiple-race decedents are reassigned to single-race categories. The single-race age-adjusted death rate was higher than the bridged-race rate by 0.4% for the non-Hispanic white population (748.7 per 100,000 U.S. standard population versus 745.7) and by 1.5% for the non-Hispanic black population (892.6 versus 879.5). State-specific differences between bridged-race and single-race age-adjusted death rates were significant only for the non-Hispanic Asian or Pacific Islander (API) population in Hawaii, for whom the single-race rate (488.9) was 10.3% lower than the bridged-race rate (545.3). Generally, at the national level, the transition to single-race mortality data seems to have minimal impacts for all major racial and ethnic groups on age-adjusted death rates; however, impacts vary by state.

Healthy People 2020: Rural Areas Lag In Achieving Targets For Major Causes Of Death.

For the period 2007-17 rural death rates were higher than urban rates for the seven major causes of death analyzed, and disparities widened for five of the seven. In 2017 urban areas had met national targets for three of the seven causes, while rural areas had met none of the targets.

Death Rates Due to Suicide and Homicide Among Persons Aged 10-24: United States, 2000-2017.

Deaths due to suicide and homicide, often referred to collectively as violent deaths, have consistently been a major cause of premature death to persons aged 10-24 in the United States (1-3). In 2017, suicide was the second leading cause of death for persons aged 10-14, 15-19, and 20-24, and homicide ranked third for persons aged 15-19 and 20-24 and fifth for persons aged 10-14 (4). This report presents trends for 2000-2017 in suicide and homicide death rates for all persons aged 10-24 and for age groups 10-14, 15-19, and 20-24.

Deaths: Leading Causes for 2017.

Objectives-This report presents final 2017 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2017," 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 2017. Causes of death classified by the International Classification of Diseases, 10th Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. Results-In 2017, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Accidents (unintentional injuries); Chronic lower respiratory diseases; Cerebrovascular diseases; Alzheimer disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2017 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Newborn affected by maternal complications of pregnancy; Sudden infant death syndrome; Accidents (unintentional injuries); Newborn affected by complications of placenta, cord and membranes; Bacterial sepsis of newborn; Diseases of the circulatory system; Respiratory distress of newborn; and Neonatal hemorrhage. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.

Deaths: Leading Causes for 2016.

This report presents final 2016 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2016," the National Center for Health Statistics' annual report of final mortality statistics.

Recent Increases in Injury Mortality Among Children and Adolescents Aged 10-19 Years in the United States: 1999-2016.

This report presents numbers of injury deaths and death rates for children and adolescents aged 10-19 years in the United States for 1999-2016. Numbers and rates are presented by sex for 1999-2016, by injury intent (e.g., unintentional, suicide, and homicide) and method (e.g., motor vehicle traffic, firearms, and suffocation). Numbers and rates of death according to leading injury intents and methods are shown by sex for ages 10-14 years and 15-19 years for 2016. Mortality statistics in this report are based on information from death certificates filed in all 50 states and the District of Columbia. Injury deaths are classified by the International Classification of Diseases, Tenth Revision; underlying cause-of-death codes *U01-*U03, V01-Y36, Y85-Y87, and Y89. Death rates are calculated per 100,000 population. Ranking of the three leading intents of injury deaths and methods are based on numbers of deaths. The total death rate for persons aged 10-19 years declined 33% between 1999 (44.4 per 100,000 population) and 2013 (29.6) and then increased 12% between 2013 and 2016 (33.1). This recent rise is attributable to an increase in injury deaths for persons aged 10-19 years during 2013-2016. Increases occurred among all three leading injury intents (unintentional, suicide, and homicide) during 2013-2016. Unintentional injury, the leading injury intent for children and adolescents aged 10-19 years in 2016, declined 49% between 1999 (20.6) and 2013 (10.6), and then increased 13% between 2013 and 2016 (12.0). The death rate for suicide, the second leading injury intent among ages 10-19 years in 2016, declined 15% between 1999 and 2007 (from 4.6 to 3.9), and then increased 56% between 2007 and 2016 (6.1). The death rate for homicide, the third leading intent of injury death in 2016, fluctuated and then declined 35% between 2007 (5.7) and 2014 (3.7) before increasing 27%, to 4.7 in 2016.

Deaths: Leading Causes for 2015.

Objectives-This report presents final 2015 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2015," 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 2015. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. Results-In 2015, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Accidents (unintentional injuries); Cerebrovascular diseases; Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2015 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; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); 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. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.

United States Life Tables, 2014.

Objectives-This report presents complete period life tables for the United States by race, Hispanic origin, and sex, based on age-specific death rates in 2014. Methods-Data used to prepare the 2014 life tables are 2014 final mortality statistics; July 1, 2014 population estimates based on the 2010 decennial census; and 2014 Medicare data for persons aged 66-99. The methodology used to estimate the life tables for the Hispanic population remains unchanged from the methodology developed for the publication of life tables by Hispanic origin for data year 2006. The methodology used to estimate the 2014 life tables for all other groups was first implemented with data year 2008. Results-In 2014, the overall expectation of life at birth was 78.9 years, a 0.1-year increase from 2013. Between 2013 and 2014, life expectancy at birth increased by 0.1 year for both males (76.4 to 76.5) and females (81.2 to 81.3) and for the black (75.5 to 75.6) and white (79.0 to 79.1) populations. Life expectancy at birth increased by 0.2 years for the Hispanic (81.9 to 82.1) and non-Hispanic black (75.1 to 75.3) populations. Life expectancy at birth remained unchanged for the non-Hispanic white population (78.8).

United States Life Tables, 2013.

Objectives-This report presents complete period life tables for the United States by race, Hispanic origin, and sex, based on agespecific death rates in 2013. Methods-Data used to prepare the 2013 life tables are 2013 final mortality statistics; July 1, 2013 population estimates based on the 2010 decennial census; and 2013 Medicare data for persons aged 66-99. The methodology used to estimate the 2013 life tables was first implemented with data year 2008. The methodology used to estimate the life tables for the Hispanic population remains unchanged from that developed for the publication of life tables by Hispanic origin for data year 2006. Results-In 2013, the overall expectation of life at birth was 78.8 years, unchanged from 2012. Between 2012 and 2013, life expectancy at birth remained the same for both males (76.4) and females (81.2), for the black population (75.5), the Hispanic population (81.9), and the non-Hispanic black population (75.1). Life expectancy at birth declined for both the white population (79.1 to 79.0) and the non-Hispanic white population (78.9 to 78.8).

United States Life Tables, 2012.

Objectives-This report presents complete period life tables for the United States by race, Hispanic origin, and sex, based on agespecific death rates in 2012. Methods-Data used to prepare the 2012 life tables are 2012 final mortality statistics; July 1, 2012, population estimates based on the 2010 decennial census; and 2012 Medicare data for persons aged 66-99. The methodology used to estimate the 2012 life tables was first implemented with data year 2008. The methodology used to estimate the life tables for the Hispanic population remains unchanged from that developed for the publication of life tables by Hispanic origin for data year 2006. Results-In 2012, the overall expectation of life at birth was 78.8 years, increasing from 78.7 years in 2011. From 2011 to 2012, life expectancy at birth increased for both males (from 76.3 to 76.4) and females (81.1 to 81.2), for the white population (79.0 to 79.1), the black population (75.3 to 75.5), the Hispanic population (81.8 to 81.9), the non-Hispanic white population (78.7 to 78.9), and the non- Hispanic black population (75.0 to 75.1).

Changes in the Leading Cause of Death: Recent Patterns in Heart Disease and Cancer Mortality.

KEY FINDINGS: Data from the National Vital Statistics System •Heart disease has consistently been the leading cause of death in the United States and remained so in 2014. •The gap between the number of heart disease and cancer deaths generally widened from 1950 through 1968, narrowed from 1968 through 2012, and then slightly widened again from 2012 through 2014. •The mortality burden of cancer has surpassed that of heart disease in several states. In 2000, there were only 2 states where cancer was the leading cause of death; in 2014, there were 22. •Heart disease remained the leading cause of death for the non-Hispanic white and non-Hispanic black populations in 2014. •Cancer is now the leading cause of death for the non-Hispanic Asian or Pacific Islander and Hispanic populations. The timing of the leading-cause crossover varied by group. For the total U.S. population, heart disease has been the leading cause of death for decades, with cancer the second leading cause (1). However, the ranking of these causes has varied across demographic group and geographic unit over time. Rankings are based on the number of deaths and reflect mortality burden rather than risk of death (2). This report highlights changes in the mortality burden of heart disease and cancer and presents findings by state, race, and Hispanic origin.

Deaths: Leading Causes for 2014.

Objectives-This report presents final 2014 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2014," the National Center for Health Statistics' annual report of final mortality statistics.

Deaths: Leading Causes for 2013.

OBJECTIVES: This report presents final 2013 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2013," 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 2013. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD­10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. RESULTS: In 2013, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Accidents (unintentional injuries); Cerebrovascular diseases; Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2013 were, in rank order: Congenital malformations, deformations and chromosomal abnormalities; Disorders related to short gestation and low birth weight, not elsewhere classified; Newborn affected by maternal complications of pregnancy; Sudden infant death syndrome; Accidents (unintentional injuries); 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. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.

The Validity of Race and Hispanic-origin Reporting on Death Certificates in the United States: An Update.

Objectives This report presents the findings of an updated study of the validity of race and Hispanic-origin reporting on death certificates in the United States, and its impact on race- and Hispanic origin-specific death rates. Methods The latest version of the National Longitudinal Mortality Study (NLMS) was used to evaluate the classification of race and Hispanic origin on death certificates for deaths occurring in 1999­2011 to decedents in NLMS. To evaluate change over time, these results were compared with those of a study based on an earlier version of NLMS that evaluated the quality of race and ethnicity classification on death certificates for 1979­1989 and 1990­1998. NLMS consists of a series of annual Current Population Survey files (1973 and 1978­2011) and a sample of the 1980 decennial census linked to death certificates for 1979­2011. Pooled 2009­2011 vital statistics mortality data and 2010 decennial census population data were used to estimate and compare observed and corrected race- and Hispanic origin-specific death rates. Results Race and ethnicity reporting on death certificates continued to be highly accurate for both white and black populations during the 1999­2011 period. Misclassification remained high at 40% for the American Indian or Alaska Native (AIAN) population. It improved, from 5% to 3%, for the Hispanic population, and from 7% to 3% for the Asian or Pacific Islander (API) population. Decedent characteristics such as place of residence and nativity affected the quality of reporting on the death certificate. Effects of misclassification on death rates were large for the AIAN population but not significant for the Hispanic or API populations.

Deaths: Leading Causes for 2011.

OBJECTIVES: This report presents final 2011 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements ''Deaths: Final Data for 2011,'' 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 2011. Causes of death classified by the International Classification of Diseases, 10th Revision (ICD­10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. RESULTS: In 2011, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). They accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2011 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; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); 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. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.

Mortality among US-born and immigrant Hispanics in the US: effects of nativity, duration of residence, and age at immigration.

OBJECTIVES: We examined the effects of duration of residence and age at immigration on mortality among US-born and foreign-born Hispanics aged 25 and older. METHODS: We analyzed the National Health Interview Survey-National Death Index linked files from 1997-2009 with mortality follow-up through 2011. We used Cox proportional hazard models to examine the effects of duration of US residence and age at immigration on mortality for US-born and foreign-born Hispanics, controlling for various demographic, socioeconomic and health factors. Age at immigration included 4 age groups: <18, 18-24, 25-34, and 35+ years. Duration of residence was 0-15 and >15 years. RESULTS: We observed a mortality advantage among Hispanic immigrants compared to US-born Hispanics only for those who had come to the US after age 24 regardless of how long they had lived in the US. Hispanics who immigrated as youths (<18) did not differ from US-born Hispanics on mortality despite duration of residence. CONCLUSIONS: Findings suggest that age at immigration, rather than duration of residence, drives differences in mortality between Hispanic immigrants and the US-born Hispanic population.

Deaths: Leading Causes for 2012.

OBJECTIVES: This report presents final 2012 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements "Deaths: Final Data for 2012," 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 2012. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD-10) are ranked according to the number of deaths assigned to rankable causes. Cause-of-death statistics are based on the underlying cause of death. RESULTS: In 2012, the 10 leading causes of death were, in rank order: Diseases of heart; Malignant neoplasms; Chronic lower respiratory diseases; Cerebrovascular diseases; Accidents (unintentional injuries); Alzheimer's disease; Diabetes mellitus; Influenza and pneumonia; Nephritis, nephrotic syndrome and nephrosis; and Intentional self-harm (suicide). These causes accounted for 74% of all deaths occurring in the United States. Differences in the rankings are evident by age, sex, race, and Hispanic origin. Leading causes of infant death for 2012 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; Newborn affected by maternal complications of pregnancy; Accidents (unintentional injuries); 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. Important variations in the leading causes of infant death are noted for the neonatal and postneonatal periods.