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November 2006 Deaths: Final Data for 2004by Arialdi M. Miniño, M.P.H.; Melonie Heron, Ph.D.; Sherry L. Murphy, B.S.; and Kenneth D. Kochanek, M.A. Division of Vital Statistics This report from the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) provides selected, key findings for the 2004 final mortality data for the United States and announces the release of final national mortality data for 2004. The findings come from information reported on death certificates completed by funeral directors, attending physicians, medical examiners, and coroners. Key findings from this report, as illustrated in Tables 1-4 and Figures 1-3, follow: Mortality experience in 2004
Trends
Nature and sources of data
2003 revision of the U.S.
Standard Certificate of Death, multiple race data, and Hispanic origin The 2003 revision of the U.S. Standard Certificate of Death allows the reporting of more than one race (multiple races). This change was implemented to reflect the increasing diversity of the population of the United States and to be consistent with the decennial census (2). The new standards of the Office of Management and Budget (OMB) mandate the collection of more than one race for federal data (5). In addition to states reporting multiple race information via their revised death certificates, multiple race was also reported on the unrevised certificates of Hawaii, Maine, Minnesota, and Wisconsin. Refer to the “Technical Notes” of the forthcoming full report for details (1). In order to provide uniformity and comparability of the data during the transition period (before all or most of the data are available in the new multiple-race format), it was necessary to “bridge” the responses of those for whom more than one race was reported (multiple race) to one, single race. The bridging procedure of mortality data is similar to the procedure used to bridge multiracial population estimates provided by the U.S. Census Bureau (read section on population bases for computing rates, below). Multiracial decedents are imputed to a single race (either white, black, American Indian or Alaska Native, or Asian or Pacific Islander) according to their combination of races, Hispanic origin, sex, and age indicated on the death certificate. The imputation procedure is described in detail on the NCHS website.
Maternal mortality "Maternal deaths” are defined by the World Health Organization as "the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes"(6). Included in these deaths are ICD–10 codes A34, O00-O95, and O98-O99. Some state death certificates include a separate question regarding pregnancy status. A positive response to the question is interpreted as if "pregnant" was reported in Part II of the cause-of-death section of the death certificate. If a specified length of time is not provided by the medical certifier, it is assumed that the pregnancy terminated 42 days or less prior to death. Further, if only indirect maternal causes of death (i.e., a previously existing disease or a disease that developed during pregnancy that was not due to direct obstetric causes but was aggravated by physiologic effects of pregnancy) are reported in Part I and pregnancy is reported in either Part I or Part II, the death is classified as a maternal death. The 2003 revision of the U.S. Standard Certificate of Death introduced a standard question format with categories designed to utilize additional codes available in ICD–10 for deaths associated with pregnancy, childbirth, and the puerperium. As states revise their certificates, most states are expected to introduce the standard item or replace pre-existing questions (which can vary in wording and format) with the standard item, so that there will be wider adoption of a pregnancy status item across the country and greater standardization of the particular item used. A separate pregnancy status item on the death certificate results in the identification of more maternal deaths. Refer to the “Technical Notes” of the forthcoming full report for details (1).
Population bases for
computing rates Reflecting the new guidelines issued in 1997 by OMB, the 2000 census included an option for individuals to report more than one race as appropriate for themselves and household members (5). Death certificates for 35 states and the District of Columbia collected only one race in the same categories as specified in the 1977 OMB guidelines (see “2003 revision of the U.S. Standard Certificate of Death” in the “Technical Notes”) throughout 2004. In addition, those death certificate data did not report Asians separately from Native Hawaiians or Other Pacific Islanders. The death certificate data by race (the numerators for death rates) thus collected are therefore incompatible for most states with the population data collected in the 2000 census (the source of denominators for the rates). In order to produce national death rates for 2003 and 2004, it was necessary to bridge the reported population data for multiple-race persons back to single-race categories. In addition, the census counts were modified to be consistent with the 1977 OMB racial categories; that is, to report the data for Asian persons and Native Hawaiians or Other Pacific Islanders as a combined category, Asian or Pacific Islanders, and to reflect age as of the census reference date. The procedures used to produce the bridged populations are described in separate publications (7,8). It is anticipated that bridged data will be used over the next few years for computing population-based rates. As more states collect mortality data for race according to the 1997 OMB guidelines (5), it is expected that use of the bridged populations can be discontinued.
Availability of mortality
data References 1. Miniño A, Heron M, Smith B, Kochanek K. Deaths: Final data for 2004. National vital statistics reports. Hyattsville, MD. National Center for Health Statistics. Forthcoming. 2. 2003 revision of the U.S. Standard Certificate of Death. National Center for Health Statistics. 2003. Available from: http://www.cdc.gov/nchs/data/dvs/DEATH11-03final-acc.pdf. 3. Tolson G, Barnes J, Gay G, Kowaleski J. The 1989 revision of the U.S. standard certificates and reports. Vital Health Stat 4 (28): National Center for Health Statistics. 1991. 4. Report of the Panel to Evaluate the U.S. Standard Certificates. National Center for Health Statistics. Available from: http://www.cdc.gov/nchs/data/dvs/panelreport_acc.pdf. 2000. 5. Revisions to the standards for the classification of federal data on race and ethnicity. Federal Register 62FR58782-58790 (58790): Office of Management and Budget. Available from: http://www.whitehouse.gov/omb/fedreg/ombdir15.html. 1997. 6. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision. Geneva. World Health Organization. 1992. 7. Ingram D, Weed J, Parker J, Hamilton B, Schenker N, et al. U.S. Census 2000 Population with Bridged Race Categories. Vital Health Stat 2 (135): 2003. 8. Schenker N, Parker J. From single-race reporting to multiple-race reporting: Using imputation methods to bridge the transition. Statistics in Medicine 22 1571-87 2003. Suggested citation Miniño AM, Heron M, Smith BL, Kochanek KD. Deaths: Final data for 2004. Health E-Stats. Released November 24, 2006.
Acknowledgments This report was prepared in the Division of Vital Statistics under the general direction of Robert N. Anderson, Chief, Mortality Statistics Branch (MSB). Elizabeth Arias of MSB provided content related to life expectancy. Robert N. Anderson and Sherry Murphy of MSB, and David W. Justice of the Data Acquisition and Evaluation Branch (DAEB) contributed to the “Technical Notes.” David Johnson, Jaleh Mousavi, Jordan Sacks, Manju Sharma, and Charles Royer of the Systems, Programming, and Statistical Resources Branch (SPSRB) provided computer programming support and produced statistical tables. Thomas D. Dunn of SPSRB managed population data and provided content review. Steven J. Steimel and David P. Johnson of SPSRB prepared the mortality file. Staff of MSB provided content and table review. Registration Methods staff and staff of DAEB provided consultation to state vital statistics offices regarding collection of the death certificate data on which this report is based. This E-Stat was edited by Demarius V. Miller, Office of Information Services, Information Design and Publishing Staff and Laura Drescher, NOVA contractor; graphics were produced by Tommy C. Seibert, Jr., of CoCHIS/NCHM/Division of Creative Services; and formatted and posted on the Internet by Christine J. Brown, Office of Information Services, Information Design and Publishing Staff.
This page last reviewed October 15, 2008
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