NCHS Data Brief ■ No. 88 ■ March 2012

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

75 Years of Mortality in the United States, 1935–2010

Donna L. Hoyert, Ph.D.

Key findings 

•	 Although single year 

improvements in mortality 

were often small, the ageadjusted risk of dying dropped 

60 percent from 1935 to 2010.

•	 Heart disease, cancer, and 

stroke were among the five

leading causes every year 

between 1935 and 2010.

•	 The risk of dying decreased 

for all age groups but was 

greater for younger age groups 

with a 94 percent reduction 

in death rates at 1–4 years 

compared with a 38 percent 

decline at 85 years or more.

•	 Age-adjusted death rates 

were consistently greater 

for males than females (for 

example, 65 percent higher 

than those for females between 

1975 and 1981 compared with 

40 percent higher in 2010) as 

each decreased substantially 

between 1935 and 2010.

•	 The risk of dying decreased 

for all race subgroups of the 

U.S. population from 1935 to 

2010; however, differences 

persisted between groups (the 

gap was the widest between 

1988 and 1996). 

Reductions in deaths and death rates are often used as an indicator of the 

success of public health initiatives to improve the health and well-being of the 

U.S. population, as well as to set national goals for reducing disparities in the 

burden of mortality across groups. Anti-tobacco campaigns, AIDS prevention 

programs, and cancer screening promotions all use lives saved as a measure of 

success. About 80 of the Healthy People 2020 objectives are about death (1). 

Since mortality statistics do not change markedly from year to year, one might 

not appreciate the progress in reducing mortality when looking at short-term 

change. This report uses data from the National Vital Statistics System (NVSS) 

over a 75-year period, including preliminary data for 2010, to examine longterm trends in mortality in the United States by age, sex, and race.

Keywords: death • death rate • leading cause of death • National Vital 

Statistics System 

Although the number of deaths increased over the 75 years, 

the risk of dying decreased. 

NOTES: 2010 data are preliminary. Crude death rates on an annual basis are per 100,000 population; age-adjusted rates are per 

100,000 U.S. standard population. Rates for 2001–2009 are revised and may differ from rates previously published.

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.

Figure 1. Number of deaths, crude and age-adjusted death rates: United States, 1935–2010 Number of deaths (millions)

0

1.0

1.2

1.4

1.6

1.8

2.0

2.2

2.4

1940 1950 1960 1970 1980 1990 2000 2010

1935

0

Deaths per 100,000 population

800

1000

1200

1400

1600

1800

2000

Age-adjusted

death rate

Number of

deaths

1,860.1

1,094.5

1,392,752

1,314.8

919.0

967.9

1,304.5

798.7

2,465,936

746.2

Crude death

rate
NCHS Data Brief ■ No. 88 ■ March 2012

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While the total number of deaths increased by 1.1 million between 1935 and 2010, the risk of 

dying decreased. The crude death rate fell 27 percent from 1,094.5 to 798.7 deaths per 100,000 

population between 1935 and 2010. The improvement in the risk of dying was actually larger than 

27 percent because the U.S. population was getting older over this time period. When the effect 

of the aging of the population is removed by calculating an age-adjusted death rate to examine 

the risk if the population age distribution was like that in 2000 for all years, the risk of dying 

decreased by 60 percent from 1935 to 2010.

Although there were year to year exceptions, the last 75 years witnessed sustained declines in 

the risk of dying in the United States. As seen in Figure 1, the age-adjusted death rate declined 

29 percent from 1935 to 1954, slowed to 2 percent from 1955 to 1968, and decreased 41 percent 

between 1969 and 2010.

Heart disease and cancer remained the 1st and 2nd leading causes of 

death, respectively, over the 75-year period.

Figure 2. Percentage of all deaths due to five leading causes of death by year: United States, 1935–2010

NOTE: 2010 data are preliminary.

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.

0

20

40

60

Percent

80

100

1935 1940 1950 1960 1970 1980 1990 2000 2010

Heart disease

Cancer

Stroke

Chronic lower respiratory diseases

Certain diseases of early infancy

Accidents (unintentional injuries)

Kidney disease

Influenza and pneumonia

All other causes
NCHS Data Brief ■ No. 88 ■ March 2012

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A 75-year perspective points to both stability and change in the leading causes of death: stability 

because three causes (heart disease, cancer, and stroke) remained among the five leading causes

each year between 1935 and 2010; and change because other causes moved into or dropped out 

of the five leading causes at different points over the past 75 years (Figure 2). There were also 

changes in the proportion of all deaths that were due to each of the leading causes. For example, 

heart disease and cancer were the leading causes of death from 1935 to 2010, but it was in 1983 

that these two conditions accounted for the highest percent (60 percent) of all deaths. In 2010, 

they constituted 47 percent of all deaths.

Other conditions have all occupied spots within the five leading causes for some but not all years

between 1935 and 2010. Specifically, chronic lower respiratory diseases entered the five leading

causes of death in 1979; certain diseases of early infancy was among the five leading causes only

from 1949 to 1962 and 1964; accidents entered the five leading causes of death in 1946; kidney

disease was among the five leading causes only from 1935 to 1948; and influenza and pneumonia

was among the five leading causes between 1935 and 1945, again in 1963, and between 1965 and

1978.

The decrease in death rates over the 75 years varied by age. 

-100

-80

-60

-40

-20

0

 85 and

under 1 1–4 5–14 15–24 25–34 35–44 45–54 55–64 65–74 75–84 over

Percentage change

NOTE: 2010 data are preliminary.

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.

Figure 3. Percentage change in death rates by age: United States, 1935–2010

Age in years
NCHS Data Brief ■ No. 88 ■ March 2012

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For all but the oldest age group (85 years and over), mortality risk fell more than 50 percent 

between 1935 and 2010 (Figure 3). The greatest reduction was among persons 1–4 years of age 

where the death rate declined from 440.9 to 26.6 deaths per 100,000 population, a decrease of 94 

percent. Declining death rates were seen among the over 65 population, although not of the same 

magnitude as among the younger ages. For example, for persons 65–74 years of age, death rates 

declined by 62 percent, while death rates decreased by 58 percent for those 75–84 years of age, 

and declined 38 percent for persons 85 years or more.

The male and female gap in death rates peaked in 1975–1981 and has 

narrowed since then.

Figure 4. Age-adjusted death rates and ratio of rates by sex: United States, 1935–2010

NOTES: 2010 data are preliminary. Age-adjusted rates are per 100,000 U.S. standard population. Rates for 2001–2009 are revised and may differ from rates 

previously published.

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.

0

0.8

1.0

1.2

1.4

1.6

1.8

0

500

1,000

1,500

2,000

2,500

1935 1940 1950 1960 1970 1980 1990 2000 2010

Male

Ratio of 

male/female rate

Female

Rate per 100,000 standard population

Ratio of male to female rate

1.4

2,031.2

1,690.6

1.2

1.7

886.2

634.3

Between 1935 and 2010, age-adjusted death rates decreased by 56 percent for males and 62 

percent for females (Figure 4). Female age-adjusted death rates declined from 1,690.6 in 1935 

to 634.3 per 100,000 in 2010 while the age-adjusted death rate for males fell from 2,031.2 to 

886.2 deaths per 100,000 population. Although males had consistently higher age-adjusted death 

rates than females throughout the 75 years, the ratio of male to female rates has fluctuated. For 

example, in 1935, the male to female death ratio was 1.2, rising to 1.7 in 1975–1981, and falling 

to 1.4 in 2000–2010.
NCHS Data Brief ■ No. 88 ■ March 2012

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The gap in death rates by race was widest between 1988 and 1996.

Figure 5. Age-adjusted death rates and ratio of rates by race: United States, 1935–2010

NOTE: 2010 data are preliminary. Age-adjusted rates are per 100,000 U.S. standard population. Rates for 2001–2009 are revised and may differ from rates 

previously published.

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality. Rate per 100,000 standard population

Ratio of rate to white rate

All other races

Black

White

Ratio of 

black/white

rate

Ratio of all

other/white rate

0

500

1,000

1,500

2,000

2,500

0.0

0.8

1.0

1.2

1.4

1.6

1.8

19401935 1950 1960 1970 1980 1990 2000 2010

2,316.0

1,809.9

1.3

1,577.5 1,615.6 1.4

1.2

897.7

741.0

Between 1935 and 2010, age-adjusted death rates decreased by 59 percent for the white 

population (Figure 5). Death rates for the black population were first reported in 1960. Prior to

that, rates were reported for “all other races.” Since the black population made up 96 percent 

of those of all other races prior to 1960, it is possible to approximate the trend for the black 

population from 1935. Using this approximation, age-adjusted death rates decreased by 61 

percent for the black population (35 percent for the all other races group between 1935 and 1959 

and 43 percent for the black population between 1960 and 2010). Although the white population 

had consistently lower age-adjusted death rates than the all other races and the black populations 

throughout the 75 years, the ratio of the age-adjusted death rates fluctuated somewhat. For

example, the all other races to white population death ratio was about 1.3 between 1935 and 1942 

and 1.2 between 1943 and 1959. The ratio of black to white population death ratio was 1.2 in 

1960, rose to 1.4 between 1988 and 1996, and then declined to 1.2 where it has remained since 

2008.

Summary

While the overall risk of mortality decreased 60 percent over this 75-year period, there were 

fluctuations in the rate of decline most likely associated with changes in the broader environment.

For example, the 29 percent decline in age-adjusted mortality in the earlier period from 1935 

to 1954 was probably influenced by the introduction of various drugs such as antibiotics (2). 

In contrast, in the period 1955 to 1968, age-adjusted death rates decreased by only 2 percent, 

influenced in part by increases in diseases linked to tobacco use such as cancer and chronic lower

respiratory diseases (3,4). In the most recent period from 1969 to 2010, significant progress in the

prevention, diagnosis, and treatment of cardiovascular diseases (5) likely contributed to the 41 

percent decline in age-adjusted mortality despite cancer continuing to increase from 1969 to 1990 

and chronic lower respiratory diseases continuing to increase from 1969 to 1998. 
NCHS Data Brief ■ No. 88 ■ March 2012

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Because year-to-year changes in death rates are often small, one might not appreciate the full 

extent of progress in reducing mortality in the United States over the past 3⁄4 of a century. For 

example, the 2010 age-adjusted death rate of 746.2 deaths per 100,000 population was just 0.5 

percent lower than in 2009. However, the 2010 rate represented a 60 percent decrease from the 

1935 age-adjusted death rate of 1,860.1 deaths per 100,000 population signaling significant

progress in reducing the overall risk of death in the United States across all groups.

Definitions

Death rate: Total deaths per 100,000 population for a specified period. This rate represents the

average chance of dying during a specified period for persons in the entire population. Ageadjusted death rates are useful when comparing different groups or over time because they 

remove the potential bias that can occur when the populations being compared have different 

age structures. NCHS uses the “direct” method of standardization using the projected year 2000

population. See the “Technical Notes” of “Deaths: Final Data for 2008” (6) for more detail.

Leading causes of death: Causes of death are sorted into rank order according to the number of 

deaths beginning with the largest number. See the “Technical Notes” of “Deaths: Final Data for 

2008” (6) for more detail.

Data source and methods

Data presented in this report were based on information from death certificates filed in states

and the District of Columbia and subsequently compiled into national data, also known as the 

National Vital Statistics System, by the National Center for Health Statistics (NCHS) for years 

1935–2010. The data for 2010 are preliminary (7). With respect to race, the population subgroups 

for which statistics were available expanded over time; however, there are known reporting issues 

for some subgroups. This report shows data for white, all other races, and black populations that 

are available for long spans of time and are of good quality. Rates for 2001–2009 are revised 

to reflect updated intercensal population estimates; the rates may differ from rates previously

published (7). See the “Technical Notes” of “Deaths: Final Data for 2008” (6) for more discussion 

of the data. 

About the author

Donna L. Hoyert is a health scientist at the Centers for Disease Control and Prevention’s NCHS,

Division of Vital Statistics, Mortality Statistics Branch.

References

1. U.S. Department of Health and Human Services. Healthy People 2020. Available from:

http://www.healthypeople.gov/2020/default.aspx 2010. Accessed on January 5, 2012. 

2. Moriyama IM. The change in mortality trend in the United States. National Center for Health 

Statistics. Vital and Health Stat 3(1). 1964.

3. Shopland DR. Tobacco use and its contribution to early cancer mortality with a special 

emphasis on cigarette smoking. Environ health Perspect 103(Suppl 8): 131–42. 1995.
NCHS Data Brief ■ No. 88 ■ March 2012

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4. Akinbami LJ. Chronic obstructive pulmonary disease among adults aged 18 and over in the 

United States, 1998–2009. NCHS data brief, no 63. Hyattsville, MD: National Center for Health 

Statistics. 2011.

5. Ford ES, Capewell S. Proportion of the decline in cardiovascular mortality disease due to

prevention versus treatment: Public health versus clinical care. Annu Rev Public Health 32: 5–22.

2011.

6. Minino A, Murphy SL , Xu JQ, Kochanek KD. Deaths: Final data for 2008. National Vital 

Statistics Report; vol 59 no. 10. Hyattsville, MD: National Center for Health Statistics. 2011.

7. Murphy SL, Xu J, Kochanek KD. Deaths: Preliminary data for 2010. National Vital Statistics

Report; vol 60 no. 4. Hyattsville, MD: National Center for Health Statistics. 2012. 
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NCHS Data Brief ■ No. 88 ■ March 2012

Suggested citation

Hoyert DL. 75 years of mortality in the 

United States, 1935–2010 NCHS data brief, 

no 88. Hyattsville, MD: National Center for 

Health Statistics. 2012.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Vital Statistics

Charles J. Rothwell, M.S., Director

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