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May 2006

Deaths: Preliminary Data for 2004

by Arialdi M. Miniño, M.P.H.; Melonie Heron, Ph.D.; and Betty L. Smith, B.S. Ed., Division of Vital Statistics

This report from the Centers for Disease Control and Prevention’s  National Center for Health Statistics (NCHS) provides selected key findings from 2004 preliminary mortality data for the United States. The findings come from a substantial portion of the records of deaths that occurred in calendar year 2004 and were received and processed by NCHS as of September 12, 2005. Mortality records are based on information reported on death certificates as completed by funeral directors, attending physicians, medical examiners, and coroners.

A report that includes a more complete analysis of the preliminary data is forthcoming (1). Key findings from this report, as illustrated in Tables 1-3 and Figures 1 and 2, follow.

Highlights from Preliminary Mortality Data, 2004

The preliminary, estimated number of deaths in the United States for 2004 was 2,398,343 (Table 1).

The estimated age-adjusted death rate, which accounts for changes in the age distribution of the population, reached a record low of 801.0 per 100,000 U.S. standard population. The preliminary crude death rate for 2004 was 816.7 per 100,000 population (Table 1).

The preliminary estimate of life expectancy at birth for the total population in 2004 reached a record high of 77.9 years (Table 1).

The 15 leading causes of death in 2004 (Table 2) were:

Diseases of heart (heart disease);

Malignant neoplasms (cancer);

Cerebrovascular diseases (stroke);

Chronic lower respiratory diseases;

Accidents (unintentional injuries);

Diabetes mellitus (diabetes);

Alzheimer’s disease;

Influenza and pneumonia;

Nephritis, nephrotic syndrome and nephrosis (kidney disease;

Septicemia;

Intentional self-harm (suicide);

Chronic liver disease and cirrhosis;

Essential (primary) hypertension and hypertensive renal disease (hypertension);

Parkinson’s disease; and

Pneumonitis due to solids and liquids.

The preliminary infant mortality rate for 2004 was 6.76 infant deaths per 1,000 live births (Table 1).

The 10 leading causes of infant mortality for 2004 (Table 3) were:

Congenital malformations, deformations and chromosomal abnormalities (congenital malformations);

Disorders related to short gestation and low birth weight, not elsewhere classified (low birthweight);

Sudden infant death syndrome (SIDS);

Newborn affected by maternal complications of pregnancy (maternal complications);

Newborn affected by complications of placenta, cord and membranes (cord and placental complications);

Accidents (unintentional injuries);

Respiratory distress of newborn;

Bacterial sepsis of newborn;

Neonatal hemorrhage; and

Intrauterine hypoxia and birth asphyxia.

Trends

The age-adjusted death rate reached a record low 801.0 per 100,000 U.S. standard population (Figure 1). This value is 3.8 percent lower than the 2003 rate of 832.7 (Table 1). All the sex, race, and Hispanic origin groups described in this report showed significant decreases in the age-adjusted death rate between 2003 and 2004. The relative magnitudes of these decreases were:

Non-Hispanic white males (3.5 percent);

Non-Hispanic white females (3.2 percent);

Non-Hispanic black males (4.4 percent);

Non-Hispanic black females (3.9 percent);

American Indian males (5.9 percent);

American Indian females (5.9 percent);

Asian or Pacific Islander males (5.1 percent);

Asian or Pacific Islander females (3.5 percent);

Hispanic males (6.1 percent); and

Hispanic females (6.3 percent).

Life expectancy at birth for the total population in 2004 reached a record high of 77.9 years. This represents an increase of 0.4 year relative to 2003. Record-high life expectancies were reached for white and black males, as well as for white and black females (Figure 2).

The trend toward convergence in mortality figures across the sexes continued in 2004. The difference in life expectancy at birth between male and female has decreased an average one-tenth of a year every year since 1980. The difference between male and female life expectancy was 5.2 years in 2004, the smallest such difference since 1946.

The trend toward convergence in mortality figures across the major race groups also continued in 2004. The trend that began between 1993 and 1994 has meant an average decrease of one-fifth of a year every year since 1993. The difference between white and black life expectancy in 2004 was 5.0 years.

The 15 leading causes of death in 2004 (Table 2) remained the same as in 2003 with the exception that Alzheimer’s disease and Influenza and pneumonia swapped positions with each other relative to their previous placement in 2003. The age-adjusted death rate declined significantly for 10 of the 15 leading causes of death. Long-term decreasing trends for heart disease, cancer, and stroke (the three leading causes of death) continued. Increases occurred for hypertension and Alzheimer’s disease.

The slight decrease (1.3 percent) in the infant mortality rate between 2003 and 2004 was not statistically significant.

Technical Notes

Nature and sources of data
Preliminary mortality data for 2004 are based on a substantial (about 90 percent) proportion of death records for that year. The data for 2004 are based on a continuous receipt and processing of statistical records through September 12, 2005, by NCHS. NCHS received the data from the states’ vital registration systems through the Vital Statistics Cooperative Program. In this report, U.S. totals include only events occurring within the 50 states and the District of Columbia. Data for Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Marianas are shown in the table showing data by state included in the forthcoming full report (1).

For 2004, individual records of infant deaths (deaths under 1 year of age) and deaths of persons aged 1 year and over are weighted (when necessary) to independent counts of deaths occurring in each state. These state-specific counts serve as control totals and are the basis for the record weights in the preliminary file.

For this report, two separate files are processed: the medical file, or cause of death file, containing records that include demographic and medical information that is used to generate tables showing cause of death; and the demographic file that includes records from the medical file, as well as additional records containing demographic information only and is used to generate tables showing mortality by demographic characteristics only. A state-specific weight is computed for each file by dividing the state control total by the number of records in the preliminary sample. Because there are two separate files, with two separate sets of weights, slight inconsistencies might occur between the demographic and medical tables in this report.

For certain causes of death such as unintentional injuries, homicides, suicides, and respiratory diseases, preliminary and final data differ because of the truncated nature of the preliminary file.

For selected variables in the mortality file, unknown or not stated values are imputed. Detailed information on reporting completeness and imputation procedures can be found in Technical Appendix, Vital Statistics of the United States: Mortality, 1999 (2).

2003 revision of the U.S. Standard Certificate of Death, multiple race data, and Hispanic origin
The U.S. Standard Certificate of Death—which is used as a model by the states—was revised in 2003 (3). Prior to 2003, the U.S. Standard Certificate of Death had not been revised since 1989 (4). This report includes data for 12 areas (California, Idaho, Michigan, Montana, New Hampshire, New Jersey, New York City, New York State, Oklahoma, South Dakota, Washington, and Wyoming) that implemented the 2003 revision of the U.S. Standard Certificate of Death in 2004 and for the remaining states and the District of Columbia, which collected and reported death data in 2004, based on the 1989 revision of the U.S. Standard Certificate of Death. The 1989 and 2003 revisions are described in detail elsewhere (3,5,4). Because most of the items presented in this report appear largely comparable despite changes to item wording and format in the 2003 revision, data from both groups of states are combined unless otherwise stated.

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 (3). The new standards of the Office of Management and Budget mandate the collection of more than one race for federal data (6).

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. 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 at: http://www.cdc.gov /nchs/data/dvs/Multiple_race_docu_5-10-04.pdf.

Population bases for computing rates
The rates in this report use population estimates based on the 2000 census and estimated as of July 1, 2003, and July 1, 2004. These population estimates are available from: http://www.cdc. gov/nchs/about/major/dvs/popbridge/popbridge.htm.

Reflecting the new guidelines issued in 1997 by the Office of Management and Budget (OMB), the 2000 census included an option for individuals to report more than one race as appropriate for themselves and household members (6). 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 section “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 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 (6), it is expected that use of the “bridged” populations can be discontinued.

Availability of mortality data
Mortality data are available in publications, unpublished tables, and electronic products as described on the mortality website at the following address: http://www.cdc.gov/nchs/deaths. htm. More detailed analysis than provided in this report is possible by using the Mortality public-use data set issued each data year. Since 1991, the data set is available through NCHS in CD-ROM format.

References

1. Miniño A, Heron M, Smith B. Deaths: Preliminary data for 2004. National vital statistics reports, Hyattsville, MD. National Center for Health Statistics. Forthcoming.

2. Technical Appendix. Vital statistics of the United States: Mortality, 1999. National Center for Health Statistics. Available from: http://www.cdc.gov/nchs/datawh/statab/ pubd/ta.htm.

3. 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.

4. 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.

5. Report of the Panel to Evaluate the U.S. Standard Certificates. National Center for Health Statistics. 2000. Available from: http://www.cdc.gov/nchs/data/dvs/ panelreport_acc.pdf. 2000.

6. Revisions to the standards for the classification of Federal data on race and ethnicity. Federal Register 62FR58782-58790 (58790): Office of Management and Budget. 1997. Available from: http://www.whitehouse.gov/omb/fedreg/ombdir15.html.

7. Ingram DD, Parker JD, Schenker N, et al. United States 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. Stat Med 22 1571-87. 2003.

Suggested citation
Miniño AM, Heron M, Smith BL. Deaths: Preliminary data for 2004. Health E-Stats. Released April 19, 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 report was edited by Demarius V. Miller, graphics produced by NOVA contractor Kyung Park, and assembled for Internet release by Christine Brown, Office of Information Services, Information Design and Publishing Staff.

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This page last reviewed October 15, 2008