Data from the

NATIONAL VITAL STATISTICSSYSTEM

Mortality Trendsf“or

leading Causesof Death

United States- 1950-69

.

A study of the trends during 1950-69 for the 15 leading causes

of death which accounted for 89 percent of the 1,921,990

deaths occurring in the United States in 1969.

DHEW Publication No. (Hi?A) 74-1853

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

Public Health Service

Series 20

Number 16

Heaith Resources Administration

Nationai Center for Heaith Statistics

Rockviiie, Md. March 1974
I

Library of CongressCataloging in Publication Data

Mortahty trends for leading causes of death: United States, 1950-69.

(National Center for Health Statistics. Data from the national vital statistics system,

Series 20, no. 16) (DHEW publication no. (HRA) 74-1853)

Bibliography: p.

Supt. of Dots. no.: HE20.6209: 20/16

1. United States-Statistics, Vital. 2. Death–Causes. 3. Mortality. I. Title. II. Series:

United States. National Center for Health Statistics. Vital and health statistics. Series 20:

“Data from the national vital statistics system. Data on mortality, no. 16. III. Series: United

States. Dept. of Health, Education, and Welfare. DHEW publication no. (HRA) ?’4-1853,

[DNLM: 1. Mortalky–U.S. W2 A N148vt no. 16 1974/ HB1335 K63m 1974]

HB1335.A18 no. 16 312’.2’0973s [312’.2’0973] 73-20401

For sale by tbe Snperfntendent of Dammed+ U.S. Government Pintfng 05cc, Wmhfrgton, D.C. 2Mfi2- Price $1,16
NATIONAL CENTER FOR HEALTH STATISTICS

EDWARD B. PERRIN, Ph.D., Director

PHILIP S. LAWRENCE, SC.D., Deputy Dtrector

GAIL F. FISHER, Assistant Director for Health Statistics Development

JAMES E. KELLY, D.D.S., Dental Adukor

EDWARD E. MINTY, Executive Officer

ALICE HAYWOOD, Information Officer

DIVISION OF VITAL STATISTICS

ROBERT A. ISRAEL, M.S., Director

JOHN E. PATTERSON, Assistant Director for Demographic Affairs

ROBERT J. ARMSTRONG, M..$ ChieJ Mortality Statistics Branch

Vital and Health Statistics-Serie# 20-No. 16

DHEW Publication No. (HRA) 74-1853

Libray of Congress Catalog Card Number 73-20401
CONTENTS

Page

Introduction ----------------------------------------------------------

Summary -------------------------------------------------------------

Leadiog Causes With Upturn in Mortality: 1950-69 ----------------------

Leading Causes With Downturn inMortaIity: 1950-69--------------------

I.

II.

111.

IV.

v.

VI.

VII.

VIII.

Ix.

x.

x I.

XII.

XIII.

XIV,

xv.

Diseases of Heart ------------------------------------------------

Malignant Neoplasms ---------------------------------------------

Cerebrovascuk Diseases ----------------------------------------

Accidents ----------------------------------------------__:------

Influenza and Pneumonia ------------------------------------------

Certain Causes of Mortality in Early Infancy ------------------------

Diabetes Mellitus ------------------------------------------------

Arteriosclerosis -------------------------------------------------

Bronchitis, Emphysema, and Asthma -------------------------------

Cirrhosis of Liver ------------------------------------------------

Suicide ----------------------------------------------------------

Congenital Anomalies --------------------------------------------

Homicide -------------------------------------___--J----------:-

Nephritis and Nephrosis--------"----------------.--l--------------

Peptic Ulcer -----------------------------------------------------

1

3

3

5

7

10

18

21

29

31

32

36

39

40

44

46

48

52

53

.

...

111
CONTENTS-Con.

.. “

Page

References -----------------------------------------------------------

List of Deta~edTables -------------------------------------------------

Appendix I. Technical Notes -----------------------------------------

Appendix II. The United States Standard Certificate of Death, as Revised

l968----------------------------------------------------------------

Appendix III. Components of Comparability Ratios for 15 Leading Causea of

Death and Their Major Subcategories for Comparing Assignments by Eighth

Revision With Those by Seventh Revision, Based on Deaths Occurring in

l966----------------------------------------------------------------

Appendix IV. Technical Note on Assignments to Accidents With Category

Numbers E916-E921, E923-E928--------:-----------------------------

56

57

68

71

72

74

SYMBOLS

Data not available ------------------------ ---

Category not applicable ------------------- . . .

Quantity zero ---------------------------- -

Quantity more than O but less than 0.05---- 0.0

Figure does not meet standards of

reliability or precision ------------------ *
MORTALITY TRENDS

LEADING CAUSES OF DEATH:

UNITED STATES, ‘1950-69

A. JoenKlebba,M.A.,JeffreyD. Maurer,B.S.A.,andEvelynJ.Glass,B.S.,

Divisionof ViAzlStatistics

INTRODUCTION by age,sex,and color.1This reportexamines

mortalitytrendsfor 1950-69for the 15 leading

causesof deathby age,color,andsex.These 15

Thisisthesecondreportina serieson mor- causesaccountedfor89 percentofthe1,921,990

talitytrendsin theUnitedStates.The firstre- deathsthatoccurredintheUnitedStatesin1969

portanalyzedtrendsin deathratesfor1950-69 (tableA).

Table A. Deaths and death ratea for the 15 leading causes of death: United States,

1969

[Rates per 100,000 estimated population]

.—

Rank Cauae of death (Eighth Revision, InternationalClaasification of Diseasea, Adapted, 1965)

. . .

I

All cauaea---------------------------------------------

1 Diseaaes of heart---------------------39O-398,4O2,4O4,4lO-429

2 Malignant neoplasms, including ~eoplasms oflymphaticand

hematopoietic tissues--------------------------------140-209

3 Cerebrovasculardiseases

4 Accidents

------------------------------430-438

-------------------------------------------E8OO-E949

Motor vehicle accidents---------------------------E810-E823

All other accidents---------------------E800-E807,E825-E949

5 Influenza and pneumonia-----------------------470-474,480-486

6 Certain causea of mortality in early

infancy--------------------------76O-769.2,769.4-772,774-778

7 Diabetes mellitus-----------------------------------------250

8 Arteriosclerosis------------------~----------------------44O

9 Bronchitis, emphysema, and as‘&ma---------------------490-493

10 Cirrhosis of liver----------------------------------------57l

11 Suicide---------------------------------------------E95o-E959

12 Congenital:anomalies

13 Homicide

----------------------------------740-759

--------------------------------------------E96O-E978

14 Nephritis and nephrosis-------------------------------580-584

15 Peptic ulcer------------------------------------------53l-533

... All other causes--------------------------------------Residual

Number

1,921,990

739,265

323,092

207,179

116,385

55,791

:5,;:;

,

43,171

38,541

33,063

31,144

29,866

22,364

17,008

15,477

9,417

9,312

218,341

Rate

951.9

366.1

160.0

102.6

;;,:

30:0

33.9

21.4

19.1

16,4

“15.4

14.8

11.1

8.4

::;

10::!

1
TOTAL DEATH RATE3 AGE ADJUSTED DEATH RATES

Raviions Of Ihe rmematianal Clammatim of DMMS?S Rewsto.s of the !nlermumal Cfaslfmtmn of Dmeaw

s-tail *,”* Eighth .siX,h seventh Eighth

4W —. ~~

k,.,

3m m

mm. of

\ “.”

m 2W

—.—-

--- %=

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- 16,1,m,,n

_._. — .— -- . -. —-— .—. — - ..-

.. . . . . . . . . . . .. . . .. . . . . . . . . . ..- . . . . . . . . . . . . . . . . . . . . . .. . . . .. . . . . . . . . .

. . . . . . =s.b-* ,m

100

90 90

-“----- . . . . . . . . . . . . . . . .. . . . . . . . . . . .

80 — 60

5 70

. . . . . . . . . . . . . . . . . . . . . . . .. , .. .. . _=b,

70

.-

G

---., - __~ 5W _- -. ~ —-----

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8

40 :.

40

e

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f~ .- —---- — s .\ . ,..hq-----

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19SU 1955 1960 1965 7970 1950 1955 1960 7%5 1970

YEAR WAR

%ft.’. ,9.** ..* c.d=fm.” Em.k.m- “.?.1. .,,---- a..- byw.-... - “-” . . -MA

Figurs 1. Fiftsen leading causesof death: tota[ and age-adjusted death rates for 1950-69.

Deaths and death rates for 1969 for the major components of these 15 leading causea are

shown in table 1 (69 cauae list); death rates for

1950-69 for a shorter list of these components

are shown in table 2 (48 cause list); and the corresponding numbers of deaths for these causes

are shown in table 3. (A description of the sources

of data, the definitions of rates and other terms,

and the method of ranking cause of death are given

in appendix I—Technical Notes. A copy of the

stsndard certificate of death adopted with some

modifications by most States is shown in appenciix H.)

During 1900-1969 causes of death were classified according to eight revisions of the International Classification of Dfseases (lCD). These

revisions are made about every 10 years to reflect progress in medical knowledge. The Revision in use in the United States beginnhtg with

data year 1968 is the Eighth Revision of the Znter-

.“

2
Reuki.I!s oft6e Imrnationd C[asification of Dmea%

sixth SYmel Eighth

2,000

~ -ma” .“=

.,htid,”;.

,.,,my

:

:

; I,occl

900

Y

: 800

~ 7MI =

~ Boo

: boo

u

?

c 400 .. . . .. . . . . . .. . . . . . . .. . . . . . . .. . .

.. . . . .. . . . . . . .. . . . . . .. . . . . . . . ...

Cmm,ld c

:

.. . . . ... . ..;-..yb

, 300

200

160 1 1 I 1 1 1 1 I r 1 I I 1 1 I I I

1950 1955 1860 1865 1970

YEAR

Figure 2. Infant mortality rates for Congenital anoma[ies

(ICDA Nos. 740-759) and for Cartain esuses of mortalitv

in early infancy (ICDA NOS. 760-769.2, 769.4-772, 77&

778): 1950-69.

national Ckzssification of Diseases, Adapted fov

Use in the United Stites, 1965 (hereinafter cfenoted by ICDA).

Deaths occurring during 1950-69, the period

covered by this report, were classified according to three Revisions—the Sixth, Seventh, and

Eighth.

The important breaks in continuity of mortality statistics for causes in tables 2 and 3 resulting from the introduction of the Eighth Revision are shown in appendix III. Some of the major

cbsnges in classification and coding procedures

that brought about these breaks in continui~ are

presented in another National Center for Health

Statistics (NCHS) report.2

Introduction of the Seventh Revision for data

year 1958 also resulted in some breaks in the

continuity of mortality statistics in tables 2 and

3. But for the most part these breaks were not

so large as those resulting from the introduction

of the Eighth Revision. These breaks between the

Sixth and Seventh Revisions are described in a

study published in 1965.3

The direction of 13 of 15 of these leading

causes—that is, whether mortality from the cause

is increasing or decreasing during 1950-69—is

measured by age-adjusted death rates (see figure

1 and the age-adjusted death rate tables in the

text). The other two leading causes occur almost

‘entirely among infants, and, for these two causes

the direction is measured by infant mortality

rates (figure 2 and tables 4 and 5).

For each of the 13 leading causes for which

deaths occur at all ages, age-adjusted death rates

are used to compute mortality differentials by

color end sex. Trend tables of age-specific rates

used in the construction of the age-adjusted rates

are available upon request from the National

Center for Health Statistics. For each separate

year these age-specific rates are shown in the

annual report entitled Vihz,lStatistics of the United

States.

A summary of the principal findings in this

study is presented in the following section for

the reader’s convenience. T%is is followed by 15

separate sections presenting detailed findings on

the leading causes of death.

SUMMARY

Leading Causes With Upturn in Mortality: 4

1950-69

As measured by age-adjusted death rates for

the total population, there were increases between

1950 and 1969 for the followfng six leading causes

of death (in order of the magnitude of their total

death rates for 1969): (1) Malignant neoplasma,

including neoplasms of lymphatic and hematopoietic tissue~ (2) Diabetes mellitus; (3) Bronchitis, emphysema, and asthm%, (4) Cirrhosis of

live~ (5) Suicide; and (6) Homicide.

iWaligrtant neopiksms, including neopfasms

of lymphatic and hemntopoietic tissues. —As

measured by age-adjusted death rates, the increase between 1950 end 1969 in mortrdi~ for

malignant neoplasms amounted to only 3.4 percent.

This moderate increaee resulted tiom tbe

offsetting of substantial increases in the age-
adjusted death rate” for male persons (16.2 and

54.9 percent, respectively, for white and all other

male persons) by decreases for female persons

(10.3 and 2.5 percent, respectively, for white and

all other female persons).

These disparate changes in mortality for

malignant neoplssms are reflected in both the

higher mortality sex ratio’ for this cause (from

1.08 for 1950 to 1.43 for 1969) and the bigher mortality color ratiob (from 1.03 for 1950 to 1.25

for 1969).

Diabetes metlitus. -The nominal increase in

the age-adjusted death rate for Diabetes mellitus

between 1950 and 1969 (an increase of only 1.4

percent) reflects even more disparate changes

in mortality from this cause for the four colorsex groups than occurred for malignant neo -

plasms.

The decrease in the age-adjusted death rate

for diabetes for white female persons (18.9 percent) almost offset the substantial increases in

mortality from this cause for the other three

color-sex groups: increases of 13.3, 80.5, and

46.9 percent, respectively, for white male, other

male; and other female persons.

Diabetes mellitus is the only one of the 15

leading causes for which -mortality for male

persons was lower then that for female persons;

but during 1950-69 the steep increase in mortality from this disease for male persons has

narrowed the gap between their rate and that for

female persons. The mortality sex ratio for diabetes increased from 0.67 for 1950 to 0.90 for

1969.

The mortaliq color ratio also increased—

from 1.24 for 1950 to 2.10 for 1969.

Bronchitis, emphysema, and asthma. —The

age- adjusted death rate for these three diseases

taken together more than doubled between 1954

(the earliest year for whfch these data are avsflable) and 1969. The increase of 106.9 percent

reflects increases in the age-adjusted death rate

for these diseases for each of the four colorsex groups. But the rise in mortality was greater

‘Age-adjusteddeathratefor the mde population divided

by thecorrespondingracefor thefemalepopulation.

bAge-adjusteddeathratefor thepopulationof racesother

“&anwhite dbided by the cortesponttingrate for the white

population.

for both white’ and other real; persons (with increases of 145.5 and 121.1 percent, re$pectfw?ly)

than for their female counterparts (wfth increases

of 53.3 and 37.8 percent, respectively, for white

female and other female persons).

‘fI-ds steep rise for male persons resulted

in a large increase for the mortality sex ratio

for these diseases-from 2.81 for 1954 to 4.49

for 1969.

This cause of death is one of only four of the

15 leading causes for which mortality for 1969

was higher for white than for other persous.

(The other three causes are Suicide, Arteriosclerosis, and Congenital anomalies.)

Ciwhosis of liver, -The age~adjusted death

rate for this disease increased 67.1 percent beaveen 1950 and 1969. Although there were substantial fncreases in mortality from tbfs cause

for each of the four color-sex groups, the percent

increase for persons of races other than white

was by far greater than that for white persons.

The percentage increases in the age-adjusted

death rates for cirrhosis for white male, white

femaIe, other male, and other female persons

were, respectively, 55.2, 46.6, 248.9, and 198.3.

As a result of these greater increases for

persons of races other than white, the mortality

color ratio for Cirrhosis of liver increased from

0.86 for 1950 to 1.86 for 1969.

The excess mortalfty for this disease among

males over that among females remained about

the same—with a mortality sex ratio of 1.97 for

1950 and 2.04 for 1969.

Suicide. -“f’be trend of the age-adjusted death

rate for this cause was slowly downward during

1950-57, but for 1958-69 the trend was upward.

The 1969 age-adjusted death rate for Suicide was

7.6 percent higher than the corresponding rate

for 1958. This increase was recorded despite the

fact that for 1968 and 1969, for which years deaths

were classified by the Eighth Revision, 5.3 percent fewer deaths were assigned to Suicide than

would have been assigned to dds cause if the

Sevetith Revision had been used, as it was for the

years 1958-67,

TMs relative increase in Suicide for the

total population reflects very large relative increases in the age-adjusted death rates for Suicide for female persons (38.0 and 52.4 percent,

respectively, for white and other female persons);

4
a substantially smaller relative increase for

other male persons (21.4 percent); and a decrease

for white male persons (1.1 percent).

As mentioned earlier Suicide is one of only

four of the 15 leading causes of death for which

mortality for persons of races other than white

is lower than that for white persons. For 1950

the color mortality ratio for Suicide was 0.41;

and for 1969, 0.55.

Male persons continue to have by far higher

mortality for Suicide than female persons; but

the mortality sex ratio for Suicide is decreasing,

dropping from a ratio of 3.53 for 1950 to 2.57 for

1969.

Homicide. —After turning downward and then

leveling off during the 1950’s, the death rate for

Homicide continued upward throughout the 1960’s.

The relative increase of 75.5 percent in the total

Homicide rate between 1958 and 1969 reflects the

following increases for the four color-sex groups:

white male, 83.3 percenv, other male, 74.0 percent; white female, 50 percent; and other female,

:31.4 percent.

Despite the larger relative increases in the

age-adjusted death rate for Homicide for white

persons,the 1969 rate for other persons was 9.60

times the corresponding rate for white persons.

This 1969 mortality color ratio for Homicide,

however, was somewhat lower than the corresponding mortality color ratio for 1950 (11 .35).

For 1969 the age-adjusted death rate for

Homicide for male persons was 3.97 times the

corresponding rate for female persons. This 1969

mortality sex ratio for Homicide showed a slight

increase over that for 1950 (3.36).

Leading Causes With Downturn in

Mortality: 1950-69

The following nine causes of death with decreases in mortality during 1950-69 are also

presented in order of the magnitude of their total

death rates for 1969.

Diseases of keavt.-The age-adjusted death

rate for Diseases of heart decreased between

1950 and 1969 about 15 percent. This reduction

reflects lowering of this rate for each of the four

color - sex groups—but especially for female persons. For white female persogs the reduction

amounted to about 22 percent, and for other female persons, to about 25 percent. The corresponding reduction for wKlte male persons was

only about 7 percent and for other male persons,

also only about 7 percent. As a result of this unequal reduction for male and female persons, the

mortality sex ratio increased; the 1969 ageadjusted death rate for Diseases of heart for

male persons was about 1.95 times the correspcmding rate for female persons. For 1950 this

mortality sex ratio was only 1.64.

The mortality color ratio for Diseases of

heart (the age-adjusted death rate for the population of races other than white &lvided by the

corresponding rate for the white population) was

lower than the corresponding mortaliW sex ratio,

and remained quite stable during 1950-69, decreasing slightly from 1.25 for 1950 to 1.22”for

1969. (See downturn of Ischemic beart disease,

pages 9-10.)

Ce-rebvouoscukw diseases.-The percentage

decrease in the age-adjusted death rate for Cerebrovascular diseases between 1950 and 1969

(about 23 percent) was even greater than that for

Diseases of heart. Again, as for Diseases of heart,

this reduction reflects decreases in mortali~

from Cerebrovascular diseases for each of the

four color-sex groups-but particularly for white

and other female persons.

The long- established mortality differential

by color for Cerebrovascular diseases became

even greater between 1950 and 1969. For tbe

latter year the age-adjusted death rate for these

dise?ses for persons other than wtite was 1.84

times the corresponding rate for white persons.

For 1950 this ratio was 1.79.

The mortality sex ratio for Cerebrovascular

diseases was much lower than the mortality color

ratio through the first half of this century, but

this mortslity sex ratio increased somewhat between 1950 (with a ratio of 1.07) and 1969 (with

a ratio of 1.18).

Accidents.—A word of caution is in order

about including Accidents under the title’ ‘Leading

Causes With Downturn in Mortality: 1950-69.”

While it is true that the age-adjusted death rate

for Accidents for 1969 (55.3 deaths per 100,000)

is 3.8 percent lower than the corresponding rate

for 1950, Accidents is one of several of the 15

leading causes for which during 1950-69 there

was first a downturn in mortality (during the

5
1950’s)and then an upturn (during the 1960’s). But

by 1969 the age-adjusted death rate for Accidents

‘had not yet reached the level recorded for 1950.

The comparability ratio for Accidents between

the Seventh and Eighth Revisions indicates that

about 4.3 percent fewer deaths were assigned to

accidents for 1968 and 1969. Adjusting the 1967

rate by this ratio reduces it from 54.8 deaths to

52.4 deaths per 100,000 population. This adjusted

1967 figure, together with the rates for 1968 and

1969 (55.1 and 55.3 deaths per 100,000 population),

shows that over this 3-year period mortality

from Accidents was clearly upward.

For 1969 the age-adjusted death rate for Accidents for male persons was 2.83 times the corresponding rate for female persons. This mortality sex ratio was somewhat greater than that

for 1950 (2.64).

The mortality color ratio for 1969 for Accidents (1.44) was also greater than that for 1950

(1.29).

Infi!uensa and pneumonia. —For these dlseasea there appears to be a moderate decrease

(about 6 percent) between the age-adjusted death

rates for 1950 end 1969—both nonepidemic years

for influenza. The level of mortality from these

diseases is, of course, greatly affected by the

occurrence of epidemics.

Since the year 1968 had a severe epidemic,

it may be more useful to compare mortality from

Influenza and pneumonia for the two nonepidemic

years 1967 and 1969. Increasing the 1967 ageadjusted death rate (20.8 deaths per 100,000) to

what it would have been if the Eighth Revision bad

been in use for that year raiees it to 21.7 deaths

per 100,000. Comparing this age-adjusted rate

with that for 1969 (24.6 deaths per 100,000) shows

that mortality from Influenza and pneumonia was

appreciably upward during 1967-69.

The mortality color ratio for these diseases

remained greater during 1950-69 than the mortaf.fty sex ratio; but the former ratio decreased

between 1950 and 1969 (from 2.48 to 1.88), while

the mortali~ sex ratio increased (from 1.39 for

1950 to 1.64 for 1969).

CeYtoin causes of mwikzlity in eavly infancy.—

The 1969 infant mortality rate for the group of

diseases brought together under the Eighth Revision title “Certain causes of mortality in early

infancy” was about 30 percent lower than the 1950

infant mortality rate for the nearly comparable

group of diseases under the Sixth and Seventh

Revision title “Certain diseases of early infancy.f’

Part of this reduction proceeds from thqfact

that about 8 percent fewer deaths were assigned

to the Eighth Revision title ~han were assigned to

the Seventh Revision title. The 30 percent reduction in mortali~ from these causes between

1950 and 1969 reflects lowering of the death rate

for these diseases for each of the four colorsex groups of infants, the reduction for white

infants being somewhat greater than that for other

infants.

The 1969 mortality color ratio for these

diseases of early infancy (1.66) was somewhat

greater than the 1969 mortality sex ratio (1.35).

Whereas the mortality sex ratio for infants dying

from these diseases remained fairly constant

between 1950 and 1969, the corresponding mortality color” ratio incressed—from 1.46 for 1950

to 1.66 for 1969.

“-‘t ‘?~?~h~ias~~~”~ti~ e.~edutiti of about 43

per&nt’ hi”’the age%djwsted death rate for Arteriosclerosis is attributable to a considerable extent to the changes in coding procedures introduced with the Eighth Revision, as indicated by the

low comparsf.ility ratio between the Seventh and

Eighth Revisions (0.8963). But the major part of

this reduction may have resulted from the following two developments: (1) an actual decrease in

or better control of Arteriosclerosis in the population as a condition contributing to death and (2)

more complete reporting by physicians of Mormation about the specific manifestations of this

generalized disease of Arteriosclerosis. According to present coding procedures, more specffic

conditions are usually preferred for tabulation as

the underlying cause of death.

Very similar patterns are found when the

color ratios for mortality from this cause are

examined separately for th~ male population (with

a mortality color ratio of 0.98 for 1950 and 0.99

for 1969) and for the female population (with a

mortality color ratio of 0.96 for both 1950 and

1969).

The sex ratio for mortality from Arteriosclerosis was higher than the corresponding color

ratio during 1950-69, but the trend for the sex

ratio appears to be downward-from 1.29 for 1950

to 1.20 for 1969.

I

i

,

I

6
Congenial anomalies. —The 1969 infant mortal.fty rate for Congenital anomalies was about

21 percent lower than the 1950 inftit mortality

rate for this group of causes. The true reduction

for these causes may be even greater, because

about 3.6 percent more deaths were assigned to

these diseases by the Eighth Revision than had

been assigned to the comparable causes by the

Seventh Revision.

This lowering of the infant mortality rate for

Congenital anomalies results primarily from the

dropping of the death rate for these conditions

for white infants, both male and female. Actually

a slight increase in mortali~ from Congenital

‘anomalies between 1950 and 1969 was recorded

for both male and female infants of races other

than white. White infants, however, still had a

hfgher infant mortality rate for these conditions

for 1969 than did infants ,of races other than

white.

For white infantK thfi~excx~s~:mo~tality for

these conditions decreased considerably between

1950 and 1969—the mortality color ratio chsnging from 0.67 for 1950 to 0.93 for 1969.

Nephvitis and nephvosis. —The greatest relatfve decrease in mortal.fty for any one of the 15

leading kauses of death occurred for Nephritis

end nephrosis—for which the age-adjusted death

rate was about 77 percent lower for 1969 (3.9

deaths per 100,000) than for 1950 (16.6 deaths”

per 100 ,000). Although part of this reduction results from the assignment of about 11 percent

fewer deaths to this cause by the Eighth Revision

than were assigned by the Seventh Revfsion, the

steady decline in mortality from these diseases,

year after year, during 1950-69, is believed to

represent for the most part a true decrease in

their death rate.

The 1969 mortality color ratio for Nephritis

and nephrosis (3.52) was higher than that for any

of the 15 leading causes of death except Homicide

@.6o) and also was higher than the color ratio for

Nephritis and nepbrosis for 1950 (2.98). The sex

ratio for mortality from this cause was lower for

both white and other populations than was the

corresponding color ratiq but for both groups

the mortality sex ratio was somewhat upwsrd—

increasing for the white population from 1.30 for

1950 to 1.52 for 1969 and increasing for the other

population from 1.08 for 1950 to 1.30 for 1969.

Peptic WZCW.—Mortality from Peptic ulcer

as measured by age-adjusted death rates decreased about 28 percent between 1950 and 1969.

For the most part this reduction represents an

actual lowering of mortality from this cause—and

proceeds only in small measure from changes

in coding procedures.

The reduction reflects, however, the dropping

of tbfs death rate only for male persons (both for

white male and for other male persons). For white

female persons the 1969 age-adjusted death rate

for Peptic ulcer was 17.6 percent higher than the

corresponding rate for 1950, and for other female persons, 4.5 percent higher than the rate

for 1950.

The 1969 mortality sex ratio for Peptic ulcer

(2.70) was more than twice the 1969 mortality ,

color ratio for this cause (1.14). But as a result

of the decrease in the death rate for Peptic ulcer

for male persons and the concomitant increase

for female persons, the 1969 mortality sex ratio

dropped far below the corresponding ratio for

1950 (4.61).

1. DISEASES OF HEART

Diseases of heart (ICDA Nos. 390-398, 402,

404, 410-429). —Based on the sample of deaths

occurring in 1966, the introduction of the Eighth

Revision resulted in an estimated net increase

of 3,259 deaths assigned to Diseases of heart,

givfng a comparability ratio of 1.0045. There

were an estimated 10,711 deaths transferred to

this title by the Eighth Revision and an estimated

7,452 deaths transferred from this title (appendix

III).

The net effect of these changes, based on

coding the sample of deaths occurring in 1966 by

both the Seventh and the Eighth Revisions, resulted in increasing the number of deaths assigned to Dkeases of heart from 727,002 by the

Seventh Revision to 730,261 deaths by the Eighth

Revision.

During the period 1950-67 the total death rate

for Dkeases of heart rose from 356.8 deaths per

100,000 population for 1950 to 364.5 deaths for

1967 (table 2 and figure 1). The rise in this total

death rate for 1968 to 372.6 deaths per 100,000 is

attributable in part to the above-mentioned

7
changes in classification and coding mocedures marked declines for this cause for younger men

used with ~he Eighth Revision. Apply%g the comparability ratio of 1.0045 to the 1967 death rate

for Diseases of heart raises it from 364.5 to

366.1, an adjusted rate that is closer to the 1968

rate, based on coding deaths by the Eighth Revision (372.6 deaths per lC0,000). The fact that

even after adjustment the 1968 death rate is higher

than the 1967 rate reflects the serious influenza

epidemic in 1968. For 1969 the total death rate

for D@eases of heart fell to 366.1.

As measured by age-adjusted death rates,

however, mortality from Diseases of heart was

clearly downward during 1950-69 (table B and

figure 1). These age-adjusted death rates reflect

“and women. The decrease in this age-a-dj&ted

death rate (from 307.6 per 100,000 for 1950 to

262.3 per 100,000 for 1969) reflects substantial

decreases in the corresponding age-adjusted death

rates for each of the four color-sex groups,

For 1969 the sex ratio for this cause of death

(the age-adjusted death rate for the male population divided by the corresponding rate for the

female population) was 1.95. The trend for this

ratio was upward during 1950-69, increasing from

1.64 for 1950.

The mortality color ratio for Diseases of

heart (the age-adjusted death rate for the population of races other than white divided by the

Table B. Age-adjusted death rates for Diseases of heart, by color and sex: United

States, 1950-69

[For 1968 and1969rates are basedon deathsassignedto categorynumbers390-398,402,404; 410-429of theEighth ReuiJon uj

the International CLmi&tion o~l)kemes, Adapted for Use in the United Sfatss, adoptedin1965;for 1950-67ratesare based

on deathsassignedto categorynumbers400402, 410J143 of the>iq~ #~e& R&~q~~~dg~~~dfi$~~:f~$+,in1948=d

1955.Formethodof ageadjustment,seeappendix1] 4’- I

c.r,, r,r,,,,,-,,,, .,. cd-r ,,.

Year

1969 ---------------

1968 --------------

W67--------------

1966 --------------

1965 --------------

1964--------------

1963 --------------

1962? -------------

;;: :1 -------------

---------- ----

1959 --------------

195$ --------------

1957 --------------

1956--------------

1955 --------------

1954 --------------

1953--------------

1952 --------------

1951 --------------

1950: ,-------------

Total II White I All other

Both Male ‘e -Both Male ‘e -

Both

sexes male sexes male saxes

Male male ‘e -

Rate per 100,000 population

262.3

270.0

267’.7

275.8

275.6

276.9

285.4

282.7

278.6

286.2

283.3

289.3

293.0

288. i’

287.5

284.7

298.9

299.6

302.9

307.6

356.8

‘365.6

362.6

371.6

369.7

369.0

379.2

373.4

367.5

375.5

369.9

374.7

377.4

371.2

368.4

363.4

379.2

377.8

380.6

384.2

182.6

189.1

186.8

193.4

194.1

196.6

203.1

202.3

199.2

205.7

204.8

211.6

215.5

212.6

212.5

211.3

223.6

225.6

229.1

234.4

257.1 ‘

264.1

263.1

270.5

270.6

271.7

277.9

275.5

273.8

281.5

278.7

284.0

286.9

283.4

282.6

279.6

292.7

292.9

296.3

300..5

354.8

362.9

361.6

369.8

368.6

367.7

375.7

370.3

367.3

375.4

369.4

373.7

.;;:;

367:4

362.2

376.5

374.7

378.0

381.1

174.9

180.5

;;; .;

185:9

187.9

192.3

191.6

190.5

197.1

196.6

202.4

205.8

203.5

204.0

202.6

214.1

215.7

218.9

223.6 1

312.8

326.5

310.1

324.3

319.4

323.0

333.8

326.8

318.4

324.2

326.7

335.4

Mpg

330:3

328.5

355.8

362.1

364.4

375.1

378.1

391.4

370.7

385.5

376.1

375.2

387.0

376.4

362.7

368.3

365.9

377. r

387.2 :,

372.7

369.2

367.0

398.3

402.8

400.5

407.5

256.8

271.4

257.8

270.5

269.2

276.4

286.9

283.0

278.0

283.3

279.2

‘W

298.7

293.0

292.1

314.6

323.0

329.5

342.9

1 “

Figures by color exclude data for residents of New Jersey because this State did

not2require reporting of the item for these years.

Based on enumerated populatf.on adjusted for age bias in the population of races

other ehan white.
corresponding rate for the white population) was

lower than the correspondhtg morta@y sex ratio,

and remained quite stable during 1950-69, decreasing slightly. from 1.25 for 1950 to 1.22 for

1969.

For 1969 themortality aexratiofor Diseases

of heart for thewhite population wassubatantially

greater than the corresponding sexratio for the

population of other races (based on age-adjusted

death rates in table B). The 1969 age-adjusted

death rate for Diseases of heart for the white

msle population was 2.03 times thecorresponding

age-adjusted death rate for thewbite female populatton. The 1969 mortality aexratiofor Diseases

of heart for the population of races other than

white was 1.47. The trend for these mortality sex

ratios was upward during 1950-69 for both color

groups, increasing forthewhite population from

1.70 for 1950 t02.03 andincreasing for the other

population from 1.19 for 1950 to 1.47 for 1969.

For these diseases the 1950 color ratio for

the male pOpUlWi-On%%S-1:07anthremainedquite

stable during 1950-69. ~e_corJrespc@gtg rnQrtality color ratio for the female-population was

greater-l.53 for 1950 andl.47 for 1969.

Although the comparability ratio for the entire group of Diseases ofhesrt isclosetol.00,

some major components of this group have comparability ratios that differ substantially from

1.00. The breaks in trends measured by these

ratios for five components of Diseases of heart

shown in tables 2 and 3 are discussed below.

Active rheumatic fever and chronic rhsu.

matic heart disease (ICDA Nos. 390-398).—A

change in interpretation resulted intbe transfer

by the Eighth Revision tothisgroup of diseases

of almost all deaths that by the Seventh Revision

procedures were assigned to Chronic endocarditis

of aortic valve, not specified asrhemnatic (ICD

No. 421.1). With the Seventh Revision, these diseases of_the:aprtic:~:ly~ .~~:e:a@U~edlto, be

nonrheumattc unless specified as ‘rheumatic,

whereas in the Eighth Revision such diseases

are assumed to be rheumatic uniess specified

as nonrheumatic.

During theperiod 1950-67 thedeath rate for

Rheumatic fever and chronic rheumatic heart

disease (ICD Nos. 400-402, 410-416) declined

from 14.8 deaths per 100,000 population to 7.2

deaths per 100,000. The rise in this death rate

for 1968 to 8.2 is attributable in great part to

the above-mentioned change in interpretation.

Applying the adjustment factor of 1.1519to

the 1967 death rate of 7.2raises it to 8.3 deaths

perlOO,OOO, an adjusted rate that is very close

to the 1968 rate of 8.2. The downward trend continued through 1969, for which year the rate was

7.6 per 100,000.

Hypertensive heavt disease with w without

ve~ldismse (ICDA Nos. 402, 404). -During the .

period 1950-69 there were two major breaks

in the continuity of the death rate for this group

of diseases. The first break occurred between

1957 and 1958 with the introduction of the Seventh Revision (in use during 1958-67). There

were about 11 percent more deaths assigned to

this group of causes by the Seventh Revision thsn

had been assigned to the same csuses by the

Sixth Revision.a

The second break incontinuity occurred between 1967 and 1968. The comparability ratio

for Hypertensive heart disease with or without

renal disease (ICDA Nos. 402, 404) is 0.3941,

obtained by dividing the estimated number of

deaths in 1966 assigned by the Eighth Revision

to this group of causes (21,350 deaths) by the

number assigned by the Seventh Revision to the

most nearly comparable title Hypertensive heart

disease (ICD Nos. 440-443) (54,176 deaths) (appendix III).

During 1958-67thedeath rate for Hypertensive heart disease (ICD Nos. 440-443) declined

from 42.7 to 25.3 deaths per 100,000. Applying

the comparability ratio of 0.3941 to the 1967 death

rate of 25.3 lowers it to 10.0, an adjusted rate

that is very close to the 1968 rate of 8.8 deaths

per 100,000.

The downward trend for this cause continued

through 1969, for which year the rate was 8.1

deaths per 100,000.

Ischernic hsai-t disesse (ICDA Nos. 410-

413).—During tbeperiod 1950 -69there were two

breaks, one major and one minor, inthecontinutty of the death rate for this group of causes.

The most nearly comparable title in the Sixth and

Seventh Revisions is Arteriosclerotic heart disease, includiig coronary disease (ICDNO. 420).

The first break in continuity occurred between

1957 and 1958 with the introduction of the Seventh Revision. About 2 percent fewer deaths (an

9
estimated 7,780) were assigned to Arteriosclerotic heart disease, including coronary disease

(ICD NO. 420), by the Seventh Revision thanhad

been assigned to the same title bytbe Sixth Revision.3”

The second break in continui~ was in the

opposite direction. Based on the 1966 comparably study, an estimated 14.57 percent more

deaths (totaling about 83,500) were assigned by

the Eighth Revision totheone mostnearlycomparable title Ischemic heart disease (ICDA Nos.

410-413) then had been assigned by the Seventh

Revision to Arteriosclerotic heart disease, including coronary disease (ICD No. 420) (appendix III).

Adjusting the 1967 death rate for Arteriosclerotic heart disease, includiig coronary disease (ICDNo. 420) (289.7 deaths perlOO,OOOpopulation), to the level it would have been if the

1967 deaths had been coded by the Eighth Revision raises it to 331.9 deaths per 100,000 (289.7

multiplied by 1.1457). This adjusted rateiscloser

to the 1968 rate of 337.6 deaths per 100,000,

based on coding deaths by the Eighth Revision.

For 1969 the total death rate for this cause is

331.7 deaths per 100,000.

The trend of theage-adjusted death rate for

Arteriosclerotic heart disease, including coronary disease, was in general upward during

19s0-63, rising from 185.2 in1950t0221.2deaths

per 100,000 in 1963. Since that year the trend

has been downward. By 1967 it was down to 213.3

deaths perlOO,OOO. Theage-adjusted death rates

for 1968 and 1969 for Iscbemic heart disease

(ICDA Nos. 410-413) are, respectively, 243.0 and

23.5.9 deaths per 100,000 population. That these

rates for 1968 and 1969 arehlgher than the correspon$mg age-adjusted rate for 1967 reflects

not an actusl upturn inmortali~ from thiscause,

but the transfer, described above, ofabout 14.6

percent more de&hs to Ischemic heart dtsesse

by the Eighth Revision thanhad been assigned by

the Seventh Revision to the nearly comparable

title Arteriosclerotic heart disease, including

coronary disease (ICD No. 420). Thus the force

of mqtal!q,for Ischemic heart disease reached

apeakin 1963 andtben finsl.ly started downward.

Chvonic disease of ertdocardium andothw

myocavdtil insufficiency (EDA iTos. 424,4zZ?).—

The -Seventh Refisiori ti;le Nom.h%matic chronic

endocarditis and other myocartilal degeneration

(ICD Nos. 421, 422), for which figures are shown

in tables 2 and 3 for 1950-67, sounds similar to

the above Eighth Revision title. The comparability

ratio for these two closely sounding titles, however, is only 0.1823.

Adjusting the 1967 death rate for Nonrheumatic chronic endocarditis and other myocardial

degeneration (ICD Nos. 421, 422) (26.6 deaths per

100,000 population) to the level it wouid have been

if the 1967 deaths had been coded by tbe Eigbtb

Revision reduces it to 4.8 deaths per 100,000

(26.6 multiplied by 0.1823).

This adjusted rate is close to the 1968 rate

of 3.9 deaths per 100,000, based on codfng deaths

by the Eighth Revision. For 1969 the total death

rate for this cause dropped to 3.7 deaths per

100,000.

All othq f-rrms of,hea@_dissase (ICDA Nos.

420-423, 425-427, 4-2kiJ._-iltring the period 1950-

69 there were two breaks in the continuity of the

‘q’%$’r7t’’3wJT2’’~fu!-@’’’’’”’meme ne@y ‘Os’ co~pa~a . ,q,Qt.q fo -tia. group m the Sixth

akd “Sevenfi’%kmioris is Other diseases of heart

(ICD Nos. 430-434).The first break in continuity

occurred between 1957 and 1958. About 10 percent more deaths (an estimated 2,300) were assigned to Other diseases of heart (ICD Nos. 430-

434) by the Seventh Revision than had been

assigned to the same tttle by the Sixth Revfsion.8

Most of the 2,300 additional deaths were

transferred to Functional dieease of heart (ICD

No. 433) as a result of the priority given by the

Seventh Revision to this cause over Other myocardial degeneration (ICD No. 422) and over General arteriosclerosis (ICD No. 450). (For other

transfers, see the study of comparability ratios

for the Sfxth and Seventh Revisions.)3

The comparability ratio between the Seventh

and Eighth Revisions for this residual group of

heart di:ea<es % ‘otily @13104 (appendix 111),‘fhe

r r..

&&KtSUt Iransfer”s’invdved till be covered in a

report in preparation.2

II. MALIGNANT

NEOPLASMS

Malignant neopfasms,includingneopihms oj

lymphatic and hsmatopoietic tissues (ICDA Nos.

140-209).-The introduction of the Eighth Re1

I
Table C. .Age-adjusted death rates-for Malignant neoplasms, including neoplasms of lymphatic and hematopoiettc tissues, by color end eex: United States, 1950-69

[For 1968 and1969rates am based on deaths assigned to category numbers 140-209 of the Eighth Reuisicm.~the Infernatimaf

Classificationo~Diseases, Adapted for Use in the United .Wtes, adopted in 1965; for 1950-67 rates are based on deaths assigned

to categorv numbers 140-205 of the Sixth and Seventh Revitions adopted, respectively, in 1948 and 1955. For method of age adjustme~t, &?eappendix I]

Year

1969 --------------

1968 -------------7

1967 --------------

1966 --------------

1965 --------------

--------------

lW!-------------

Ii9621 ----=:~:--=:=

1961 --------------

1960--------------

1959----:~~~fW:~

1958 -------’J---’-L

1957 --------------

1956 --------------

1955 --------------’

1954 --------------

1953 --------------

1952 --------------

1951--------------

1950~-------------

129.7 155.9

130.2 155.9

129.1 153.6

128.4 151.9

127.9 150.2

126.7 147.9

126>.7 147.1

“1~~!6 14GZ6

125.4 143.5

+?& ,. :$;.?

~~.?J~6-: f139<g

126.4 140.9

126.3 139.7

125.8 137.7

125.8 136.6

125.9 135.6

125.7 133.7

124.3 130.9

125.4 130.8

II

All other

=

Rate per’ 100,000 population

109.1

109.9

109.7

109.6

109.9

109.3

109.9

109.9

110.2

1$1.%.2

1 lib-.%

~TfNz.:2

114.0

114.8

115.5

116.4

117.5

118.8

118.7

120.8

126.8 152.1

127.4 152.3

126.6 150.3

125.9 148.9

125.8 148.0

124.6 145.6

123.7 143.8

123.0 142.0

123.7 142.0

124.2 141.6

123.1 139.4

123.2 138.2

125.2 139.9

125.1 139.1

124.9 137.4

124.8 136.0

125.3 135.5

125.0 133.7

123.8 131.1

124.7 130.9

II II

107.1

lo;.;

107:6

108.1

107.6

107.3

107.4

108.5

109.5

109.4

110.6

112.6

113.2

114.3

115.1

116.4

117.6

117.5

119.4

158.6

158.3

154.3

152.7

147.7

145.7

145.1

140.9

140.3

139.3

136.2

135.3

136.7

136.2

131.5

133.0

129.2

128.8

125.9

128.6

194.9

193.3

.186.6

182.3

173.3

170.1

168.7

159.1

157.9

154.8

152.5

146.4

149.2

145.0

138.7

140.6

133.2

130.7

125.3

125.8

127.7

128.8

126.6

127.0

125.2

124.0

124.4

124.7

124.3

125.0

121.3

125.3

125.2

127.8

124.7

125:9

125.1

126.8

126.4

131.0

I ~iWeG by ~oloz exclude data for residents of New Jersey because this State did

not rei@re reporting of the item for these yeare.

%ased on enumerated Romlation adjusted for age bias in the population of races

other than white.

vision reetdted in en estimated net increase of

less than 0.2 of 1 percent in the number of deaths

aesigned to this group of causes (appendix III).

Based on the sample of deaths in 1966 coded by both

the Seventh and,the, Eighti.R.qvisiona@ere ,Wqe

2,342 deaths tralisfei-red to this title by the Eighth

Revision and 1,816 deaths transferred from this

title.2

During tbe period 1950-67 the total death rate

for malignant neoplasms rose almost uninterruptedly from 139.8 for 1950 to 157.2 deaths per

100,000 population for 1967 (table 2 and ffgttre 1).

Lees then 0.2 of 1 percent of the rise in the total

death rate to 159.4 deaths per 100,000 for 1968

is attributable to the change to the Eighth Revision.

For 1969’ this death rate wae 160.0 deaths per

100,000 population, representing a total number

of 323,092 deaths from this complex of causes

(table 3).

The age-adjusted death rate for these dis -

eases grouped under malignant neoplaeme showed

an increase of from 125.4 deaths per 100,000 for

1950 to 129.7 for 1969 (table C and figure 1).

This increase was moderate because the substantial increases in the age-adjusted death rates

for these diseaees for the male population of both

white” and all other races were offset by the decreases in the corresponding rates for the female’

population of both white and all other races (table

c).
The sex differenti~ for this cause (based on

age-adjusted death rates in table C) increased

from 1.08 for 1950 to 1.43 for”1969.

Throughout 1950-69 the age-adjusted death

rate for malignant neoplasms was higher for the

population of races other thanwhite thanfor the

white population. The mortality color ratio also

increased, from 1.03 for 1950 to 1.25 for 1969.

An upturn in the mortality color ratio was recorded for both male ‘and female populations.

The rise in the mortali~ sex differential for

the total population reflects marked increases in

the sex differential for this cause, for both the

white population and the population of races other

than white-but especially for this latter population. For them the mortali~ sex ratio for malignant neoplasms increaaed from 0.96 for 1950

to 1.53 for 1969.

The trends for the major components of the

diseases brought together under the title “Malignant .neoplasms, including neoplasms of lymphatic and hematopoietic tissues” (ICDA Nos.

140-209) are considered in thefollowing sections.

Malignant ?wopbwns of buccal cavity and

@avynx (ICDA ivos. 140-149).-Based on the

above-mentioned sample of deaths in 1966, there

was a net increase of 405 deaths assigned by the

Eighth Revtsion to this group of causes? Asaresult the comparability ratio is 1.0596 (appendix

111).

During the period 1950-67 the total death

rate for Malignant neoplasms of buccal cavity

and pharynx (ICD Nos. 140-148) remained quite

stable. The lowest rates were for 1951-53 (3.2

deaths per 100,000), and the highest rates were

for 1961, 1962, and 1966 (3.5 deaths per 100,000).

The rise in the total death rate between 1967 (3.4

deaths per 100,000) and 1968 (3.6 deaths per

100,000) is attributable to the above-mentioned

break in comparability introducedwiththeEighth

Revision. Applying the comparability ratio of

1.0596 to the 1967 death rate for this group of

causes raises it to 3.6, an adjusted rate thatis

the same as that for 1968. For 1969 the death

rate for Malignant neoplasms of buccal cavi~

and pharynx (ICDA Nos. 140-149) was 3.7 deaths

per 100,000 population.

Malignantneoplas?ns of digestive ongms and

peritoneum (ICDA Nos. 150-159).—me ~%hth

Revision assigned to ICDA Nos. 150-159 only an

estimated 96.6 percent of the deaths thatbadbeen

assigned to the comparable Seventh Revision title

“Malignant neoplasm of digestive organs and

peritoneum, not specified as secondary” (ICD

Nos. 150-156A, 157-159) (appendix III).

The death rate for groups of causes entitled

in the Eighth Revision “Malignant neoplasms of

digestive organs and peritoneum” (ICDA NOS.

150-159) rose almost steadily from 1900through

1945, for which year the rate was 60.5 deaths per

100,000 population. Since 1945,however, thetrend

has been generally downward,falling to48.2 deaths

per 100,000 population in 1967. The deathrate for

1968 was 46.8 per 100,000 (table 2). Butinasmitch

as onIy an estimated 91,848 deathsz in 1966 were

assigned to ICDA Nos. 150-159 by the Eighth Revision and 95,079 deaths in 1966 were assigned

to ICD Nos. 150-156A and 157-159 by the Seventh Revision, an adjustment factor of 0.9660

(91,848 divided by 95,079 deaths) should be applied to the 1967 death rate (48.2 deaths per

100,000) to lower it to thelevel it would have been

(46.6 deaths per 100,000) if deaths in 1967 had

been coded by the Eighth Revision.

It appears thatthe downwardtrend may have

leveled off in recent years: in 1968thedeathrate

for this group of causes was’ 46.8; and in 1969,

46.5 deaths per 100,000. This deceleration reflects the opposite trends of the principal components of this group of causes. Malignantneoplasms of stomach, biliary passages, and liver

continued downward through the 1960’s, wtdle

malignant neoplasms of the intestines continued

to rise. The upward trend for malignant neoplasms of the pancreas during 1914-68 may also

have begun to level off for both 1968 and 1969

the death rate for this cause was 8.7 per 100,000

population.

Malignant neoptasms of respiratory system

(fCDA Nos. 160-163).-During the period 1950-

69 there was a break ~ continuity for thk group

of cauaes between 1967 and 1968resulting from

the introduction of the Eigbtb Revision. The compsrabtlfty ratio is 1.0316 (appendix III) (56,668

deaths when tabulated by the Eighth Revision

divfded by 54,934 deaths when tabulated by the

SeventhRevfsion).2

Dm.ing the period 1950-67 the total death

rate for Malignantneoplasms of respiratory system (ICD Nos. 160-164) rose from 14.1 deaths

b.
per 100,000 population for 1950 to 29.4 fo~ 1967

(table 2).

Applying the above-mentioned comparability

ratio of 1.0316 to the death rate for 1967 (29.4

deaths per 100,000 population) raises this rate

to 30.3 deaths per 100,000 population, the level

at which the 1967 death rate would have been if

deaths for that year had been classified by the

Eighth Revision. This adjustment of the 1967 rate

reduces the percentage rise between 1967 and

1968 from 8.16 percent to 4.95 percent. For 1969

the death rate for Malignant neoplasms of respiratory system (ICDA Nos. 160-163)was 32.7

deaths per 100,000 population.

‘Malignant neopkzsm of beast gCDA No.

174L-There were no serious breaks during

1950-69 in the comparability of mortali~ statistics for this cause. The comparability ratio

for the Seventh and Eighth Revisions is 0.9913

(appendix 111).

Tbe trend figures (table 2) for mortsli~

from Malignant neoplasm of breast (ICDA No.

174) show a slight but quite steady increase during

1950-69. The rate rose over this 20-year period

from 12.6 deaths per 100,000 population for 1950

to 14.4 deaths for 1969. These figures are based

on the total population-male and female. inasmuch as this cause of death occurs almost entirely among female persons, a more useful rate

is that based only on female persons.

As shown in the table at right, for white

female persons the age-adjusted death rate for

this cause declined slightly, from 22.5 deaths per

100,000 in 1950 to 22.1 deaths per 100,000 for

1963. But since 1963 the age-adjusted death rate

for this cause for white female persons appears

to be upward, with a rate of 23.0 for 1969.

Ttds higher mortality reflects an upturn in mortality for this cause during the 1960’s for the

three 10-year age groups in the span 45-54

through 65-74 years. The only age groups of

whfte female persons that experienced appreciable declines in mortality from this cause were

75-84 years and 85 years and over.

The 1969 death rates for Mal@mnt neoplasm

of breast for each 10-year age group of white

women in the span 15-24 through 45-54 years

were somewhat lower than the corresponding

rates for all other women. The absolute increase

in mortality for thk cause during 1950-69 was

Year

1969 ---------------

1968 ---------------

1967 ---------------

1966 ---------------

1965 ---------------

1964 ---------------

19632 --------------

19622 --------------

1961 ---------------

1960 ---------------

1959 ---------------

1958 ---------------

1957 ---------------

1956 ---------------

1955 ---------------

1954 ---------------

1953 ---’ ------------

1952 ---------------

1951 ---------------

19503 --------- -----

Age-adjusted death

rate for Malignant

neoplasm of breast

(ICDA No. 174)1

White

female

persons

All

other

female

persons

Rate per 100,000

population

23.0

23.4

23.2

23.1

23.0

22.8

22.1

22.2

22.4

22.4

22.1

22.2

22.6

22.6

22.9

22.2

22.5

22.4

21.9

22.5

22.7

23.0

22.6

21.2

21.3

21:1

21.2

20.2

20.4

20.7

19.5

19.2

19.8 ,

20.4

19.6

19.8

18.7

18.9

18.8

19.0

1

For 1968 and 1969, rates are based on

deaths assigned to category number 174 of

the Eighth Revision of the International

Class if icati.on of Dis eas es. Adapted for

Use in the United States, adopted in 1965

for 1950-67, rates are based on deatlu!

assigned to category nutnber 170 of the

Sixth and Seventh Revisions, adopted, respectively, in 1948 and 1955. For method

of age adj ustmsnt, see appendix 1.

2F@mes by color exclude data for residents of New Jersey because this State

did not require reporting of the item for

these years.

3Based on enumerated population adjuated for age biaa in the population of races

other than whit e.

greater at these ages for all other women than

for white women. For example, for all other

women for the age group 45-54 years the death

rate increased from a low of 41.9 deaths per

100,000 population for 1952 to 52.6 deaths for

1969. The corresponding increase for white women
.

was from a low of 45.6 deaths per 100,00”0

for 1951 to 51.5 deaths for 1969.

iWalig7Unt neopihsms of .s&nital%vga?ts(ICDA

Nos. 180-187). —During the period 1950-69 there

were two breaks in the comparability of mortali~

statistics for this group of causes. The fikst break

occurred between 1957 and 1958 with the ‘ktroduction of the Seventh Revision. The comparability

ratio for this title for the Sixth and Seventh Revisions is 0.98.3 But there was no serious break

in continuity of mortalfty statistics for ‘Malignant

neoplasms of genital organs with the introduction

of the Eighth Revision. The comparability ratio

is 1.0034 (appendix III).

Inasmuch as the trend figures in table 2 are

based on the total population (mate and female),

they are of limited use. In the table below data

are provided for Malignant neoplasms of female

genital organs from the comparability study of

deaths in 1966. From these data tbe comparability ratio for this group of neoplasms has been

The corresponding comparability ratio for

Malignant neoplssms of the male gerkal organs

is 1.0133 (see table at top of page 15 for pertinent

data).

As shown in the table at bottom of page 15,

the trend of the age-adjusted death rates for female genital organs was generally downward

during 1950-69 for both white and all other women.

The age-adjusted death rate for Malignant

neoplasms of male genital organs fell slightly

during 1950-69 for white male persons, but the

corresponding rate for male persona of races

other than white rose aubstentielly. As shown in

the table on page 16, for this latter group the

rate increased from 18.2 deaths per 100,000

for 1950 to 24.7 deaths per 100,000 for 1969.+

Most of this ris; reflects the higher level of mortality from Malignant neoplasm of prostate

(ICDA N&-185): h““--- ‘--- ‘“J”JI

calculated to be 0.9963. ‘ - ——

, -!+:~,~.:–--?~,~i I

.. ....

Seventh Revision

Cause of death end category numbers

All causes -------------------001 -E999

Malignant neoplasma of female genital

organs ----------------------------l7l-l76

Of cervix uteri ----------------------171

Of other and unspecified parts of

uterus -------------------------- 172-174

Of ovary, fallopian tube, and broad

ligament----------------------------l75

Of other and unspecified female

genital organs ----------------------176

Other causes --:---------”----------Residual

Deaths in

1966

(1)

l;863,1~9a

-. 23,424

7,665

5,731

9,163

865

1,839,725

Eighth Rev;s ion -

Estimated

ieatbs in CO1-

mm (1) that

7ent to Malig -

Iant neoplasma

of female

~enital organs

(ICDA ttos .

180-184).

(2)

j :23,-337

23,169

1- 7,562

5,680

9,092

835

168

Estimated

deaths in

:Olumn (1)

:hat went to

>ther causes

(3)

1,839,812

255

103

51

71

1,839,5%

1
Seventh Revision I

Eighth Revision

Cause of death and category numbers

Deaths

1 1966

in

Estimated

deaths in

column (1)

that went to

Malignant neoplasms of male

genital organs

(ICDA Nos.

185 -187)

(1)

I

(2)

Estimated

deaths in

Collmnl (1)

that went to

other causes

(3)

All causes--------------.----OOl-E999 I 1,863,1491 17,1791 1,845,970

--------------

Malignant neoplasms of male genital

organs ---.-------------------------177-179

Of prOstate--------------------------l77

Of all other and unspecified male

genital organs

Other causes ----------------------Residusl

—.

Year

1969--------------------

1968--------------------

1967--------------------

1966--------------------

1965--------------------

----------------------

:%-------------------

19622-------------------

1961--------------------

Age-adjusted

death rate for

Malignant neoplasms of female

genital organs

(ICDA NOS. 180-

184)1

White All

female other

female

persons persons

1

Rate per 100,000

population

17.2

17.4

17.8

18.4

19.0

==49.2

19.6

20.0

20.2

20.7

28.1

;;.;

31:4

31.6

_3.2.O

32.8

33.4

34.6

34.2

Year

1959-----------------

1958-----------------

1957-----------------

1956-----------------

1955-----------------

1954-----------------

1953-----------------

1952-----------------

1951-----------------

L9503----------------

Age-adjusted

death rate for

Malignant neoplasms of female

genital orgsns

(IcDA NOS. 180-

184)1

White All

female other

female

Persons persons

1

Rate per 100,000

population

20.9

21.6

22.1

21.9

22.8

23.1’

23.7

23.7

24.1

25.3

1

35.0

37.4

38.1

;;.;

39:6

41.6

41.7

41.3

44.0

IFO= 1968 and 1969, rates are based on deaths assigued to category numbers 180-184

of the Eighth Revision of the International Classification of Diseases, Adapted for Use

in the United States, adopted in 1965; for 1950-b~ , rates are based on deaths assigned

to category numbers 171-176 of the Sixth and Seventh Revisions, adopted, respectively,

in 1948 and 1955. For method of age adjustment, see appendix I.

‘Figures by color exclude data for residents of New Jersey because this State did

not require reporting of the item for these years.

3Based on enumerated population adjus ted for age bias in the population of racea

other than white.

15
Year

1969-------------------

1968-------------------

1967-------------------

1966-------------------

1965-------------------

1964-------------------

19632-------------------

19622------------------

1961-------------------

1960-------------------

Age-ad justed

death rate for

Malignant neovlasms of male

genital organs

(1-1% jl185-

White All

male other

male

persons persons

1

Rate per 100,000

population

13.3

13.4

13.2

13.4

13.5

13.5

13.6

13.4

13.6

13.5

24.7

25.5

24.3

22.4

22.3

23.0

22.7

23.7

22.3”

21.8

Age-adjusted

death race for

Malignant neoplasms of male

genital organs

(ICDA NO. 185-

187)1 .

1959-----------------

1958-----------------

1957-----------------

1956-----------------

1955-----------------

1954-----------------

1953-----------------

1952

Ig5r~l~~l~~GlIIl;lZ;;

T950$--------- .. .. . ..-. -----------------

. ------- . ...-.

Nhite All

male other

male

Persms persons

I

Rate per 100,000

population

14.4

14.0

14.3

1.4.5

14.5

14.6

14.3

14.3

----IA:I

-- 14.4

22.5

21.1

22.2

21.3

20.6

20.9

19.0

18.7

18.2

18.2

lFor 1968 and 1969, rates are based on deaths assigned to category numbers 185-187 of

th~ EightK Revision of the International Classification of Diseases. Adapted for Use in

the United States, adopted in 1965. for 1950-67, rates are based on deaths assigned to

category numbers 177-179 of the S&th and Seventh Revisions, adopted, respectively, in

1948 and 1955. For method of age adjustment, sea appendix I. .

ZFiggres bY ,..oIorexclude data for residents of New Jersey because this State did nOt

require reporting of the item for these years.

3Based on enmerated population adjusted & age

than white.

Malignant neoplasms of wrinwy organs (TCDA

Nos. 188, 189). —There were two breaks during

1950-69 in the comparability of mortality statistics for this group of causes. The comparability

ratio between the Sixth and Seventh Revisions is

0.98~ The comparability ratio between the Seventh end Eighth Revisions is 1.0171 (appendix

III).

The mortality trend for the total death rate

for Malignant neoplasms of urinary. organs was

upward during 1950-69, ricing from 6.7 deaths

per 100,000.for 19s0 to7.-Ideathsfor 1969 (table

2). Thfs upturn reflects pritmrcily increasing

death ratesfor thisgroup of causes for the male

population.As shown in the tableon page 17,t%e

age-adjusteddeath rate for thtscause for white

male ‘personsrose ‘tYom 8.2 deathsper 100,000

for 1950 to 8.6 deaths per 100,000 for 1969.

!L6-

bias in the population of races other

The age-adjusted death rate for all other --

male Demons continued lower than the corresponding rate for whitemalepersone during19SO69. But the increase in mortality from this cause

was much greater for male persons of races

other thanwhite.

-The age-adjusted death rate for whitefemale

persons was not only much lower. in 1950 (3.8

deathe per 100,000) then the corresponding rate

for white male per:onsJ8.2 deaths per 100,OOO),

but, as shown in the table on page 17, during

1950-69 this rate declined for white female persons. The pattern for the age-adjusted death rate

for female persons of races other than white

fluctuated during 1950-69. This irregular variation may result from the small numbere of deaths

for some of the age-specific rates on which the

age-adjusted rates are k-seal.

I
ige-adjueted death rate for Malignant neoplasme of urinary,organs

(ICDA NOS. 188, 189)

Year

l969---------------------------------------------

l968---------------------------------------------

l967---------------------------------------------

l966---------------------------------------------

l965---------------------------------------------

l964--:------------------------------------------

;;%;;--------------------------------------------

.-------------------------------------------

1961-------y:~-.----~z--.=?=----=--,=--------------

1960---------------------------------------------

l959---------------------------------------------

1958---------nT----------------------------------

1957-------~;-*+----~-----------------::::-------

1956

----------------~+tel ,’

-----------<-------===-=-.===-.=--.-a ---------

l955-------------------------------z--------------

l954---------------------------------------------

l953---------------------------------------------

l952---------------------------------------------

1951---------------------------------------------

19503--------------------------------------------

White ‘#r White All

male female other

?ersons male female

persons Pera‘ns persons

1 J 1

Rates per 100,000 population

8.6

8.7

8.7

8.6

8.4

8.4

8.5

8.3

8.4

8.5

8.4

8.2

8.4

8.3

- :::

8.3

M

8.2

7.6

7.9

7.7

7.1

*6.9

*6.8

6.8

*6.7

6.8

*6.4

*6.4

6.5

*6.5

u

6.1

*5.8

,*5.9

*5.7

*5.6

:::

3.2

3.3

3.4

3.3

3.3

3.4

3.4

3.4

3.5

3.5

3.7

3.6

3.8

3.6

3.7

3.7

3.7

3.8

*3.8 “

3.7

*&.4

3.8

*4.O

3.8

*3.7

4.4

*3.8

*4:2

*3.7

*3.8

*3.9

.3.8

3.3

3.8

*4.O

*3.6

*3.5

*4.O

lFor 1968 and 1969? rates are baeed on deaths assigned to category numbers 188 and

189 of the Eighth Revxsion of the InternationalClassificationof Diseases, Adapted for

Use in the Umted States, adopted In ; or O-67, ratea are based on deatha aasigned to category numbers 180 and 181 of the Sixth and Seventh Rwis ions, adopted,

respectively, in 1948 end 1955. For method of age adjustment, see appendix 1.

‘Figures by color exclude data for residents of New Jersey because this State did

not require reporting of the item for these years.

%aa ed onen~erated population adjusted for age bias in the populationOf races other

than white.

NOTE: Asterisk indicates age-adjustedrates based on age-specific rates where more

than half of the rates were based on a frequency of less then 20.

,., : ,, .,, ~!c , M;,. ,, nQ :1

M@&nant neoplusms of all otherand w.ns#ecified sites (ICDA Nos. 170-173, 190-199). —About

2 percentmore deathswere assigned~othistitle

by the EighthRevisionthanhadbeenassigmedto

itby theSeventhRevision(appendix111).Thisie,

ofcourse,a residu~lcategory.

Lewbnia (ICDA Nos. 204-207).-There has

been no appreciablebreakin compsrabili~of

mortalitystatisticsfrom thiscauseduring1950-

69.The comparabilityratiobetweentheSeventh

and EighthRevisionsis 0.9974(appendirIII).

The totaldeathrateforthiscausecontinued

in generalupward during1950-69(table2).As

shown in the—tableon page 18 by age-adjusted

deathrates,mortalityfrom thisdiseaseishigher

forwhitemale personathenfor allothermale

persons.

Also the age-adjustedeathrateforwhite

femalepersonsfor thiscause continuedhigher

than;he correspondingrateforall%her female

17
Age-adjusted death rate for

Leukemia (ICDA Nos. 204-207)1

Year

;;:; ---------------------------------------------

----------------- ------- ------ ------ ---------

l967---------------------------------------------

l966---------------------------------------------

l965---------------------------------------------

l964---------------------------------------------

l9632--------------------------------------------

l9622--------------------------------------------

1961---------------------------------------------

1960---------------------------------------------

l959---------------------------------------------

l958---------------------------------------------

l957---------------------------------------------

l956---------------------------------------------

l955-------------------------------------------:=

l954---------------------------------------------

l953---------------------------------------------

l952---------------------------------------------

1951---------------------------------------------

19503-------------------------------------------

White All

male other

male

persons persons

White All

female other

female

persons persons

Rate per 100,000 population

7.5

7.5

7.7

7.7

7.5

7.5

7.6

7.5

7.7

7.8

7.6,

7.5

7.4

7.3

“%

7.0

;::

6.5

2;

6.1

5.2

5.6

5.6

6.0

5.2

M

, 5.0

5.1

5.4

.=,;:;

4:4

4.2

4.4

3.8

3.9

4.1

3.7

3.9

3.5

$:

3:4

3.7

H

3.2

3.6

3.0

:::

3.3

2.8

2.8

lFor 1968 and 1969, rates are based on deaths assigned to category numbers 204-207

of the Eighth Revision of the InternationalClassificationof Disease% Adapted for Use

in the United States, adopted in 1965; for 1950-67, rates are based on deaths assigned

to category number 204 of the Sixth and Seventh Revisions, adopted, respectively, in

1948 and 1955. For method of age adjustment, see appendti 1.

‘F’i$zures —–.. .;-. bv color exclude data for residents of New Jersey because this State did

not requme reporting of the item for these years. s~ased on enwerated ROPulat%On adjusted for age bias in the population of races

other than white.

persons.For bothgroupsoffemalepersonsthe

earlier(1950-60)upwardtrendinmortalityfrom

thiscause appearstohaveleveledoffduringthe

1960’s,as sh~= inthetableabove.

Other neo@asms of lympha?ic asd hemati- o

poietic tissues (ICDA Nos. 200-203, 208, 209). -

About 5 percentmore deathswere assignedby

the EighthRevisionto thisgroupofcausesthan

were assignedby the SeventhRevisionto the

comusrabletifie‘Lvmuhosarcomaandotherneom. iEREBROVASCULAR DISEASES

., : , T,L.. i, <.9 .- . ..- -----

Cerebrouzscuiar disssses [ICDA Nos. 430-

438). —The, comparable SeventhRevisiontftle

forCerebrovasculardiseaseswas Vascularlesionsaffectingcentralnervoussyet’em(ICDNos.

330-334).In the SeventhRevisionthistitlewas

inclndedin SectionVI”’‘Diseasesofthenervous

systemand senseorgans.”Buthy theEighthKevisionthetitleCereb’rovasculardiseases(ICDA

plas~s of“lymphatic-and hemacopoietictissues NOS. 430-438)

(ICDNos.200-203,205)(appendixIII). to SectionVII

was transferredfrom Secti’onVI

“Dfseasesofthecirculatoryays-

---iu
tern.”The Eighth Revision reserved Section VI -

rlDiseases of the nervous system and sense organs” for hereditary end familial diseases of

nervous system, including hereditary neuromus -

cular disorders.

The comparability ratio between these comparable titles for Cerebrovascular diseases is

0.9905 (appendix III).

The total death rate for Cerebrovascular diseases (ICDA Nos. 430-438) appears to have declined only slightly during 1950-69, from 104.0

deaths per 100,000 to 102.6 (table 2 and figure 1).

But the age-adjusted death rate for this group of

causes shows that substantial progress in the

conwol of mortality from these diseases was made

during thk 20-year period (table D and figure

1),

The age-adjusted death rate for Cerebrovascnlar diseases decreased quite steadily-from

88.8 deaths per 100,000 for 1950 to 68.5 deaths

for 1969. T&’ decrease reflects lowering of the

age-adjusted rates for each of the four colorsex groups. But the excessively highMortality

colorratio that characterized morta@ from this

cause throughout the first half of tbe century

increased even further during 1950-69. For 1950

the age-adjusted death rate for Cerebrovascular

diseases for the population of ‘races other than

‘Yable D. Age -adjusted death rates for Cerebrovasculardiseases, by color and sex:

United States. 1950-69

[For 1968in/1969rated ak’ b.sed onl dea(hs assizsed to catezorv &mbers 430-438 of the HoW! Revision of the Intemdimkd

Classijbtion of Diseases, .

&~=J%b=3iY

Year

dapted for Use in f?-z;United S%&s,’adopted in 1965; for 1950-6? rates are based’on deaths assigned

~f the Six:! :nd Seventh Revisions adopted, respectively, in 1948 and 1955. For method of age ad-

,1 T

, ~:z::::.

[~:~ I :--:

Total White All other

Both Male ~;

Both Male Fe- Both Male Fesexes sexes male sexes male

68.5 74.9

71,5 78.1

70.0 76.2

72.6 78.8

73.1 79.1

73.9 .79.7

76.6 82.5

76.8 82.1

76.7 82.0

79.7 85.4

80.7 85.8

83.0

;’;:< ,..~~;$;)

83:0 87:4

83.0 86.7

86.9 90.5

87.8 91.3

89.0 92.0

88.8 91.9

Rate per 100,000 population

63.3

66.0

64.9

67.3

67.9

69.1

71.6

72.2

72.1

74.7

76.2

78.4

“79.5

78.2

79.0

79.5

83.6

84.6

86.2

86.0

1969 --------------

1968 --------------

1967 --------------

;;:; :--: -:--------

- --------

1964 -::-----------

19631 -------------

19621 -------------

y

1961 --------------

1960 --------------

1959 --------------

1958 --------------,

1957 --------+ ----

1956 --------------

1955 --------------

1954 --------------

1953 --------------

1952 --------------

1951 --------------

19502 -------------

I~iWes by color exclude data for residents of New Jsrsey because this State”did

not “requirereporting of the item for these years.

‘2Based on enwerated population adjusted for age bias in the population of races

other than white.

63.8 70.1

66.3 72.9

65.2 71.5

67.3 73,6

67.5 73.8

68.5 74.6

71.3 77.6

7’1.5 77.4

71.4 77.3

74.2 80,3

75.3 80.9

77.4 82.9

78.6 84.4

77.0 82.1

77.7 82.7

77.6 82.0

81.5 85.6

82.3 86.4

83.6 87.3

83.2 87.0

58.6

60.9

59.9

62.0

62.1

63.3

65.9

66.5

66.3

68.7

70.2

72.5

73.4

72.3

73.2

73.5

77.7

78.4

80.1

79.7 1

117.1

124.4

118.8

125,5

129.6

128.3

133.4

132.5

128.8

134.8

135.7

140.0

141.1

136.8

137.8

139.0

143.9

146.9

147.3

148.8

124.1

132.2

124.4

131.5

134.2

131.1

135.7

133.4

127.5

135.2

134.8

141.2

140.2

134.3

136.2

136.0

141.7

143.9

142.6

144.0

111.1

117.9

114.1

120.3

125.5

125.8

131.7

132.2

130.2

134.4

136.5

139.4

142.2

139.1

139.3

142.0

145.7

149.9

152.1

153.4
white was 1.79 times the correspondhg rate for

the white population and by 1969 this ratio had

increased to 1.84.

The mortality sex ratio for Cerebrovascular

diseases was much lower than the mortsli~ color

ratio through the first half of this century, but

this mortali~ sex ratio increased somewhat between. 1950 (with a ratio of 1.07) and 1969 (with

a ratio of 1.18).

During 1950-69 the age-adjusted death rate

for Cerebrovascular diseases for women of races

other than white was about 1.9 times the corresponding rate for white women. The corresponding ratio of the age-adjusted death rate for men

of races other than white over that for white men

was somewhat lower, but the trend for this ratio

atweas to be slowly upward— 1.66 for 1950 and

1.77 for 1969.

For both the white population and the population of races other than white the mortali~

sex ratio for Cerebrovascular diseases increased

during 19S0-69—for the white population, from

1.09 for 1950 to 1.20 for 1969; and for the other

population, from 0.94 for 1950 to 1.12 for 1969

(based on age-adjusted death rates in table D).

For both male and female persons of races

other than” white, the death rate for Cerebrovascular diseases continued through 1950-69 to

be substantially bigher for most age groups than

the corresponding rates for white persons.

TYsnds for mojor components of Ceretrroo%sculor d&oses.-Although the introduction of

the Eighth Revision for data year 1968 did not

produce any appreciable break in the comparability of mortality etatietics for the entire group

of Cerebrovascular diseases, it did produce a

considerable degree of discontinuity for the components of this group of diseases. One of the reasons for the lack of comparability for the components ie that while the Sixth and Seventh

Revisions were in use (1949-67), Cerebrovascular ctiseases were dktributed among only five

components, but according to the Eighth Revision

they are distributed among nine components.

To lessen the degree of discontinuity the

nine components of Cerebrovascukr diseases

according to the Eighth Revision have been

divided for the purpose of this report into the

following four subgroups: Subarachnoid hemorrhage (ICDA No. 430), Cerebral hemorrhage (ICDA

No. 431), Cerebral thrombosis (ICDA No. 433),

and a residual group-All other cerebrovascular

dkeases (ICDA Nos. 432, 434-438). The category

numbers of the Sixth end Seventh Revisions that

are most nearly comparable to the caregory nnmbers of the four subgroups of the Eighth Revision

are shown together with the mortality trend during 1950-69 for each of these four major subgroups in figure 3.

Re.imm of the lmrnatmd C1.wfmtm of simas

200 Sixth Savmth E,$)th

r

I I C..t.o”-a.!.

I

4cr

t L J

I

1.0 m

-— --- *.,

-. r.”, 4

6

11”

9,*,*”.,.

5

&;$mw

CDm . . . . .

4

.“......-,”

, . . . . . . .

./a3

l,. =, ,,,,., ”

. . . . ...’

,“

/’

,~

1 I I I I !,,,

1950 19a5 19an 1%5 1070

YEAR

Figure 3. Death retes for major components of Cerebrovaecular

diseaaes United Statea, 1950-69,
IV. ACCIDENTS parability ratio for Motor vehicle accidents is

1.00, and that for All other accidents, 0.95.3

Accidents (ICDA Nos. E800-E949). —There The comparability ratio for Accidents (with

were two breaks in continuity for mortali~” sta- motor vehicle and other accidents taken together)

tistics for this group of causes during 1950-69. be~een the Seventh and Eighth Revisions is

The first break occurred as the result of the 0.9570 (appendix III). Again, as was the case reintroduction of the Seventh Revision, in use 1958- tween the Sixth and Seventh Revisions, this re67. The comparability ratio for Accidents (ICD duction in the number of deaths assigned to Ac -

Nos. E800-E962) between the Sixth and Seventh cid~nts by the Eighth Revision over the number

Revisions was 0.97.3 This reduction in the num- assigned by the Seventh Revision resulted pri -

hers of deaths assigned m accidents by the Sev- marily from transfers from accidents other than

enth Revision over the number assigned by the motor vehicle accidents. The comparability ratio

Sixth Revision resulted primarily from transfers for Motor vehicle accidents between the Seventh

of some deaths attributed to falls and to a num - and Eighth Revisions was close to 1.00— actually

ber of other categories for accidents, excludfng 0.9921; while the comparability ratio for All

motor vehicle accidents, The corresponding com - other accidents was 0.9250 (appendix III).

Table E. Age -adjusted death rates for Accidents, by color and sex: United states,

1950-69

[For 1968 and 1969 ratesare based on deathsassignedto category numbers E800-E949 of theEighth Revisiono~fhe Iniemational

Classificationo~Diseases, Adapted for Use in the United Stafss, adopted in 1965;for 1950-67 ratesare based on deathsassi ned

to category numbers E800-E962 of the sith and SeventhRmi.4onsadopted, respectively,is 1948 and 1955. For method o! age

adjustment,seeappendix I] --

Year

1969 --------------

1968 --------------

1967 --------------

1966 --------------

1965 --------------

1964 --------------

1963i-------------

19621 -------------

1961 --------------

1960 --------------

1959 --------------

1958 --------------

1957 --------------

1956 --------------

1955 --------------

1954 --------------

1953 --------------

1952 --------------

;%~===:

Total II White I All other

Both Male ‘e -Both Male ‘e -Both

sexes male sexes. ruale sexes

Male male ‘e -

1

55.3

55.1

54.8

55.6

53.4

52.1

50.9

49.7

48.1

49.9

49.8

49.8

53.4

54.4

54.4

53.1

57.3

58.8

59.4

57.5

82.9

82.5

81.8

82.6

79.1

76.8

75.0

73.2

71.4

73.9

74.3

74.1

79.3

81.2

80.7

78.9

85.3

86.8

87.5

83.7

——

Rate per 100,000 population

i

29.3

29.2

29.3

30.0

28.8

28.3

27,8

27.2

25.8

26.8

26.3

26.5

28.5

28.7

29.0

28.4

30.5

32.0

32.0

31.7

52.6

52.2

52.4

53.0

51.0

49.9

49.1

48.0

46.1

47.6

47.7

47.7

51.2

52.2

52.3

51.1

54.9

56.4

57.3

55.6

78,5

77.7

77.8

78.5

75.4

73.4

72.4

70.7

68.5

70.6

71.2

71.1

76.1

77.8

77.7

75.9

81.8

83.2

84.5

81.0

28.1

28.1

28.2

28.7

27.7

27.3

26.7

26.2

24.5

25.4

25.1

25.1

27.0

27.4

27.6

27.1

29.1

30.6

30.7

30.6 1

75.5

77,0

73.2

75.8

70.8

68.4

68.2

66.5

63.2

67.3

66.1

66.6

71.0

72.0

71.2

69.7

76.4

78.4

76.4

72.0

118.9

122:1

114.7

116.4

109.3

105.2

103.4

100.5

95.1

101.1

100.2

100.2

106.5

109.7

106.5

104.6

116.2

118.2

114.1

107.1

36.9

36.8

35.9

39.1

35.8

34.9

36.1

35.4

33.9

36.1

34.6

35.8

38.4

37.3

38.5

37.8

39.8

41.6

41.0

38.8

11

lFi.~res by CO1O: exclude data for residents of New Jersey becauae this State did

not require reporting of the item for these

2Based on en&nerat~d population adjusted

other than white.

years.

for age bias in the population of races

21
Mortality from’ Accidents (motor ve~lcle and

other accidents taken together), as measured by

the total death rate for this group of causes, fell

during 1950-60, reaching a low of 50.4 deaths

per 100,000 for 1961, and then rose during 1961-

69 (table 2 and figure 1). A similar pattern is

found for the trend of mortality from Accidents

when measured hy age-adjusted deathrates (table

E and figure 1). The total age-adjusted deathrate

for this group of causes decreased from 57.5

deatha per 100,000 for 1950toalowof 48.1 deaths

for 1961, and then rose during 1962-69 to 55.3

deatb~per 100,000.

This trend for the total age-adjusted death

rate reflects similar patterns for the four colorsex groups, except that for the male population

of races other than white,-the increase during

1962-69 was far greater than the increase for

the other three groups. For the other-than-white

male population the age-adjusted death rate rose

to 118.9 deaths uer 100.000 for 1969. a level of

27.6 deaths per 100,000 for 1969, representing

55,791 deaths in that year (tables 2 and 3).

The 1969 age-adjusted deathrate for themale

population was ahout2.9 times the corresponding

rate for the female population (tabIe G). The

highest age-adjusted rate for 1969,by color and

sex was for the male population of races other

than whke (54.4 deaths per 100,000 population).

For 1969, as for most years during 1950-69,

the mortality curve by age for this cause is bimodal, reaching the first peakatages 15-24yesrs

(51.0 deaths per 100,000 population) and the second peak at ages 75-84 years (42.9 deaths per

100,000).

During 1950-69 the death rate for Motor vehicle accidents increased for each of the four

color-sex groups (table H). Inasmuch as thedeath

rate changed direction during the period, declining to a I?w,,for 1961{~imdther,e,afterturning

upward, the amount“&f‘“increase in the rate is, of

course. much wrester for the ueriod 1961-69.

mortality that was hizher than even thatfor 1950 v j I [.!f+o~eale~ ~e@tiv+@cre&e-Huring 1961-

(107.1 d~athsper 100~000)(table E).

For the population aa a whole tbe mortality

sex ratio for Accidents is much higher thanthe

corresponding color ratio (based on age-adjusted

death rates in table E). The 1950 age-adjusted

death rate for Accidents for the male population

was 2.64 times the corresponding death rate for

the female population-by 1961 this mortality

sex ratio had increased to 2.77 and by 1969 tn

2.83. The mortsii~ sex ratio for Accidents increased during 1950-69 for both the white population and the population- of races other than

white—with by far the largest increase for the

latter population. For 1950 for the male population of races other thanwhfte the age-adjusted

death rate for Accidents was 2.76 times the corresponding rate for the female populationof races

other than wbit~ and by ‘1969this sex ratio bad

risen to 3.22. Deaths and death rates by external

cauae of injury are shown in table F.

Mo@Y vehicle accidests (ICDA Nos. E810-

Jf828).-As stated ahove there were no substantial breaks incomparability of mortaii~ statistics

for Motor vebfcle accidents during 1950-69.

The death rate for this cauae decreased from

23.1 per 100,000 in 1950 (representing 34,763

deaths) to a low of 20.8 deatha per 100,000 in

1961 and then rose in subsequentyesm, reaching

6~ in the deakh r~te for iblotdrvehicle sccidents

waa for infants in each of the following three

color-sex groups: white male, all other male,

and all other female. For the white female population the greatest relative increase in the rate

was for the age group 15-24 years (table H).The

relative increase for these women was S7.1 percent betweeti 1961 and 1969. The corresponding

increaae for wpmen of races other thanwhite at

ages 15-24 years (54.8 percent) was almost as

great as thatfor white women. White menat ages

15-24 years had a htgher death rate for Motor

vehicle accidents in 1969 thandid any other agecolor-sex group (82.0 deaths per 100,000 population).

An unexplained phenomenon is that men of

races “other thaq white experienced their b~ghest

rqo~tali~’ ~,qm,‘this,,cayse’ at older ages (25-34

yest’s}tWnWfdwhit& then (15-24,@v%J. ‘11-iepeak

death rate from this cause for menof races other

than white at these ages (72.2 deatha per 100,000)

was lower than the peak deathrate for white men

(82.0 destbs per 100,000 at ages 15-24 years].

Another outstanding difference among men,

in this case a difference thatis unfavorable for

men of other races, is thatthroughoutthe middle years of life (35-44, 4S-54, and 55-64 years)

the motor vehicle death rates for men of races

Q2-
Table F. Deaths and death rates for Accidents, by external cause of injury: Umlted state., 1958, 1966, 1967, 1968, and 1969

[Satesw 100,000p.p.hti.n. Nunkrs k. .WSSSof death .r~catego~ ,n.rnkrs of theEghtkRam.. of ih. klemtm..l f%u$..twn of JJ.cmm, Ad.[ted for k m d,. Unit.d stats,

.d. tcd in 1965. ~or1968and 1969ratmarc&d.. dc,dfia+wd ,.d,m E,@h R“..,.” catcgmy .u”dm,, f., 1958md 1967ratesam bos.d.“dear,as,g..dm ,hm,cgc.ry.undmrs

.f ,r,. S.,.”,1, Rmm”, ,dmted ,“ 1955.2%- G,,.!ZOW ..,,,brs areshown,.nextm d,.1s,CL&m d d,. rabl.1 —.

Eighth Revisim

cause of death 1969 1968

Number

1

L

All accidents-E800-E949 116 385

... ...

accidente----------EE1O -E823

Accidemal falls----E8E887887

Acciderus caused by fires

and f lanms---------E890 -E399

Accidental drming and

subriersion--------------E9lO

Accidents assigned t. fol10Wing3--E916-E921, E923-E928

Accident caused by cutting

or piercing i“struLnenL------------------E920

Accidemt caused hy exploSi”. makcr2al---------E923

55,791

17,821

7,163

6,181

6,095

156

553

Accident caused by hot

substance, corrosive

M uid steam, or

r. ! i8.tk--------E9Z4, E,926

1

288

Accident .attded- bw elec tiic ~‘- b L

currmt--------------E925 1,148

Other eccidents of ab.a”e

Ermp-----EE919E9 l9, E921

E927, l192?f 3,930

‘?~=~~,~~~~~~Z&?0~3&7 Vtitift

Xnhalatim and ingest+n, .f, ,} 7 -,.3 ~

. . . . .- . . . . . a.. ”.-.

xzir~ xFtxGi-or suf -

focation-----------E9 ll, E912 ‘&3,712

Surgical and medical cmPliCatiom a-~ –~ -

adventure

Accident c

mimile--

.,— --- --

ill. m,, -

ZS---------E93O-E936 52,572

:tmsed by fireimr,

.---------------E92Z 2,309

n.. -u. .pac. transp.rt

accidents----------ES4O-ES43 1,77s

water transport

amid emts ----------E830-E838 1,743

ltnilway accidetWs---E8OE80707 884

Other mad vehicle

accident s----------ES25 -E827 236

All other acciderm-----E900-

E909, E913-E915 , E929, E940-

E9491 5.578

E

ate Number

;7. 6 1X, S64

!7. 6 54,862

8.8 18,651

3.5 7,335

3.1 5,950

3.0 3,?28

0.1 178

0.3 642

0.1 278 :,! , ,

0.6

2.0

1

3,782

M fi97J,qo!5

; rl mb gr

‘1.8 ““I3,;1OO

;1.3 2,023

1.1 2,394

0.9 1,904

0.9 1,62;

O.r

0.1 264

2.8 5,s70

1

.

late —

i7.3

!7.5

9.3

3.7

3.0

3.0

0.1

0.3

0.1

0.3

1.9

E.1

f’fi

1.6

1.0

1.2

1.0

M

0.1

2.9

1967

r“tier

.13,169

52,924

20,120

7,423

5,724

---

149

---

376

992

---

4,080

i

1,980

1,530

2,896

1,799

1,545

997

2S8

6,909

—

at,

—

7.2

—

6.7

0.2

3.8

2.9

---

0.1

0.2

0.5

..-

2.1

1.0

0.s

1.5

0.9

0.8

0.5

0.1

3.3

Seventh Revision

1966

.

Ihnber

,13,563

53,041

20,066

8,084

5,687

---

137

---

409

1,025

.-.

3,931

1,s31

1,411

2,538

1,510

1,630

1,027

292

7,001

58. C

—

:7.1

LO.2

4.1

2.9

---

0.1

0.2

0.5

.-.

2.0

0.9

0.7

1.3

0.8

0.8

0.5

0.1

3.6

1958

OJy

6,98]

8,24f

7,291

5,065

---

104

---

3S2

951

---

2,616

2,191

1,023

2,172

1,511

1,653

1,164

304

i,723

—

ate

5.3

—

0.8

0.5

4.2

2.9

0.1

..-

0.2

0.5

---

1.5

1.3

0.6

1.3

0.9

1.0

1.1

0.2

3.3

E800-E962

E81O-E835

E900-E904

E916

E929

---

E913

---

E917,E918

E914

---

E870-E888,

ES90-E893

E921, E922

E940-E959

E919

E860-ES66

E850-E85S

E800-E802

E840-E845

911, E913, E915,

E920, E923-E928

930, E932-E936

E960-E962f

he List .f 258 causes .f Deat

ent cam ed by mmchi”ery, lCD

mh Revision co the first m<

E927, E928. The third cicle

ed with the Seventh 8evisim.

f .I1.wing residual title in

929, E940-E949.

D the Seventh Revision.

nbers , E916-E921, E923-E928.

Erom charwes in c.dine i“tenz

mv2.-

ional

m arbifity

ati. z

0.9370

0.9921

0.8344

0.922s

0.9755

---

---

0.7647

1.0240

---

0.9123

1.4415

1.1714

0.8767

1.0017

0.9634

1.0081

0.8S89

---

,re “. t

. E912;

E these

:e.ssive

B“c the

the List

Etation.

23
Table G. Age-adjusted death rates for Motor vehicle accidents, by color and sex:United

States, 1950-69

[For1968and1969ratesarebasedon deathsassigned to category numbers E81O-E823oftbeEighthRevision of the Mem.tfond

Classificationofl)iseates, Adaptedfor use in the UnitedSMss,adopredin1965;for1950-67rstesarebasedon deatk assigned

to category numbersE81O-E835oftheSixthandSeventhRevisions adnpted,respecthw]y, in1948and1955.Formethodofage

adjustment, seeappendir

Year

Total - II White

Both Male ‘e- Both

sexes male sexes

Male ‘e- male

1

28.5 42.9

28.4 43.1

27.8 41.9

28.3 42.7

26.6 40.1

25.8 38.6

24.3 36.9

23.1 35.1

22.1 33.8

22.5 34.5

22.8 35.1

22.5 34.9

24.1 37.4

25.2 39.4

24.6 38.4

23.0 36.0

24.8 38.9

25.0 39.2

24.6 38.5

23.3 36.4

All other

1, ,

Rate per 100,000 population

1969--------------

1968--------------

1967--------------

1966--------------

1965--------------

1964--------------

19631-------------

19621-------------

1961--------------

1960--------------

1959--------------

1958--------------

1957--------------

1956--------------

1955--------------

1954---’-----------

1953--------------

1952--------------

1951--------------

19509-------------

lFi@res by color excludedata

not requirereportingof the item

2Basedon enumeratedpopulationadjusted~or age bias in the populationof races

other than white.

14.9 27.9 41.6

14.6 27.8 41.8

14.5 27.4 41.1

14.7 28.0 41.9

13.7 26.2 39.4

13.4 25.6 38.1

12.3 24.4 36.7

11.8 23.2 34.9

10.9 21.9 33.4

11.0 22.3 34.0

11.0 22.5 34.5

10.7 22.3 34.3

11.4 23.8 36.8

11.6 24.7 38.5

11.6 24.3 37.8

10.7 22.6 35.4

11.6 24.4 38.0

11.7 24.6 38.4

11.4 24.2 37.8

10.7 23.1 35.9

14.8

14.5

14.4

14.7

13.7

13.6

12.6

12.0

10.8

11.1

11.0

10.8

11.2

11.5

11.4

10.6

11.5

11.6

11.2

10.6 1

33.7 54.4

33.3 53.9

31.1 49.4

31.6 50.1

29.2 46.4

27.5 44.2

26.5 42.7

25.2

23.9 :fi::::

24.4 39.5

25.0 40.5

;$:# :;”;

29:5 47:9

28.1 45.1

26.5 42.6

29.3 47.8

28.9 46.9

28.3 45.2

25.7 41.2

or residentsof New Jerseybecause this S1

or these vears.

15.3

14.9

14.6

15.0

13.7

12.5

11.8

11.4

11.0

10.6

10.8

10.2

12.5

&5

11:8

12.3

12.4

12.5

11.1

-

:edid

Table H. Percentagechange in the death rate for Motor vehicleaccidents,by age, sex,

and color: United States,1950-69and 1961-69

1961-69 1950-69

Age

All ages-------

Under 1 year---------

1-4 years-------y----

5-14 years-----------

15-24 years----------

25-34 years---: ------

35-44 years----------

45-54 years----------

55L64 years----------

65-74 years----------

75-84 years---------

85 years and ove~----

Male

*

+29.9! +43.3

+48.6 +60.0

+13.8 +34.2

+20.4 -I-41.1

4=35.3 +44.5

+29.2 +41.9

+24.1 -1-52.3

+15.8 +48.7

+13.5 +44.3

4-7.6 +28.4

+4.0 +25.1

-3.1 -69.5

I

Female Male Female

I I I

I I I I I

Percentagechange

+37.3 I +$0.8

1

I

+4:.; +62.5

+51.9

+40:8 +42.4

+57.1 +54.8

+39.8 +33.6

+43.5 +35.3

+21.1 +45.6

+15.5 +21.9

-1-25.4+50.7

-I-16.0 -21.4

+16.6 +108.3

I

+14.0I +23.0 I

I

+17.6 +7.9

-6.1 +41.0

-1.7 +46.3

+$0.7 +51.7

i-26.6’+30.3

+14.9 +39.0

+9.2 +21.0

-9.5 +21.8

-18.3 +16.2

-22.5 -1.8

-17.2 -69.4

I

+38.5

+44.9

+%;

+83.3

+44.4

+63.O

+27.8

+14.o

+13.4

+8.7

-8.5

+34.3

+13.o

+30.9

4-31.3

+58.7

-1-39.5

+36.5

+49.6

+26.6

+40.9

-29.8

-73.8

.24
I

100

90

80

7a

6a

50

I

4a

3C

2C

Ic

c

u

)

Allah- p L.armns

I I I I I I I I I I I I I I I I I

I se 10.14 25-19 20-24 25= 3034 35S9 4044 4549 5M4 5539 ~ =- 7&74 7573 8C-S4 :,g

ASE IN YEARS

i Flmm farallotiw femalepm.m 65 yea. a.d crier isnotshown beeaa d smallfmww.

Figure 4. Percentof all pemons dying from Motorvehicleaccidentsreportedto be pedestrians,byW, color, andsex UnitedStates,

1969.

oth:r th~ w~te we ::,8%times the ~orr:~~onding

rates~afof whi@khenL.+For kh@a@~ )groups~~-39 1,

and 40-44 years, the proportion of deaths from

Motor vehicIe accidents that Wiq.$ r~pg~te~ go be

deaths to pedestrians was more than two times

the corresponding proportion for white mem, and..

for the age groups 45-49, 50.54, 55-59, and 60-

64 years, this proportion for men of races other

than white was 1.5 or more times the corresponding proportion for white men (figure 4).

It should be stressed, however, that ~he

decedent injtired was not identified for 28.4 percent of the 55,791 deaths from Motor vehicle

accidents that occurred in 1969. The Eighth

Revision classification provided fourth-digit categories for specifying whether a decedent from a

Motor vehicle accident was a driver, passenger,

pedestrian, etc. About 70.6 percent of the 48,303

white persons who died in Motor vehicle accidents

were thus identified (figure 5). The corresponding

percentage identified of the 7,488 persons of races

other than white who”- died ~-Motor vehicle

accidents was 78.6 percent.

Younger persons in rhe population of races
All

,=7

14

5.34

15-24

Z5.?d

3544

45.54

5564

ES.74

, .

? I

76s4 1 I

a5+ 1 t 1

ml other male

J&

14

5.14

15.24

z

s 2=?4

>

g 3544

; 45=4

S5w

66-74

75a4

85+

,

0 10 20 30 40 50 60 70 ao 90 100

PERGENT DISmlBUT1ON OF ALL MOTOR VEHICLE FATALITIES

other than white who were reported to have for, mortality statistics, which occurred between

died from Motor vehicle accidents were rela- 1957 an’if’’’lk$d, resulted in the assignment of

tively more often reported as pedestrians than about 3.000 fewer deaths to All other accidents

I

I

I

were younger persons in the white population by the Seventh Revision than had been assigned

(&ure 5). At ages 1-4 yesrs sbout56.3 percent of to these causes by the Sixth Revision.8

all children who died from Motor vehicle accidents The trend during 1950-57 for the death rate

were reported to be “pedestrians.” for All other accidents (ICD NOS. E800-E80Z,

All other accid%ts (ICbA Nos. E800-E807, E840-E962) was in general slowly downward

E825-_E949).-The first break in comparability (table 2). About 74 percent of the drop from

26
All other female

-..

ml

14

5.14

U,*4

26-W

=&i+

466!

6544

-ti.74=

75s4

.-......-.:..................

—=;-., . ...y.v~ q .... .?.,;s.%:.:.: J .1< t===

. .. ,. :.,.: !=

I

,. .:. $-:4 r

0 10 20 m .s0 60 60 70 80 90 100

PERCEN7 D15TRIBUTION OF ALL MOTOR VEHICLE FATALITIES

illll Iii .97? ~_wr i. M.W v.hi.!eOam am.M~rw~. Driwr of Motor Vehkle Othw ihz. M. fnwde

Motorqdii ., Pase”wr o“ Mowcycle Pedtirian

~ Stifbd Pm,m52 Unsp6&iwJ Pemc.m

WerCOr@W are bamxl.. dwIJu assiwd to h fc.llowhwfourth dwircdlewy numb?. for w with rstewne4 E81O.E823 of the Hghth Rwisio. of the

tntwd.od cI=mIti.. of m-, Named for w i. the United stntas Driver of motor vchml. .emr *.. m.mwda {.0); PasseIw+,. ~mr ~fide

other thm nmmrwla (.11; MtiorcvdisI ❑ P=-WW.. motowde (.2, Sk Pcde$QIa. L71: *I SW,fiti Fmm IA..5.5 .ek WJKIf~ -m {91.1

1F,mnu far am .ni d includti in “T.td- but not d,stnbutcd .IIW”9 am maw

%ikzr speclmd -. includes“Occamantof $umccar L41,”Rider of ..imaldm$vn aid.” (51, “P6dal CY.IW [.6). and ‘,O*r SF6413EZ+wmm” 1.8).

“Pe&l cqdkts,< m4wa up WE 94% of the tmd for *IIIs Utba

33.2 for 1957 to 30.9 deaths per 100,000 popula-.

cion for 1958, however, was attributable to the

changes introduced with the Seventh Revision.

An even greater break than that between

the Sixth and Seventh Revisions in the continuity

of mortality statistics for these accidents (all

accidents excluding motor vehicle accidents)

occurred with the introduction of the Eighth

Revision for data year 1968. As stated above,

the comparability ratio for this group of accidents

was only 0.9250 (representing an estimated 4,539

fewer deaths assigned to this group of actidents

by the Eighth Revision).2

The age-adjusted death rate for accidents

other than motor vehicle accidents declined

from 34.2 for .1950 .to a low of 26.1 for 1961 and

then rose to 27.0 for 1967 (table J). The ageadjusted death rate remained at a high level for.

2?
Table J. Age-adjusted death rates for All other accidents, by color and sex: United

States, 1950-69

Total

[For 1968 and 1969 rates are based on deaths assigned to category numbers E800-E807, E825-E949 of the Eighth Rtwfsiorto~fhe

Intemafiona[ Cks~ication o~Dsema, Adapfedjor Use in the Unifed States, adopted in1965; for1950-67 rates are basedon

deaths Mgaed to category numbers E800-E802, E840-E962 of the Sith andSeventhRevisionsadopted,respectively,in 1948

snd 1955. Formethodof ageadjustment,seeappendixI]

Year

=

Rate per 100,000 population

1969 --------------

1968 --------------

1967 --------------

1966 --------------

1965 --------------

1964 --------------

1963? -------------

1962~ -------------

1961 --------------

1960 --------------

1959 --------------

1958 --------------

M57--------------

1956 --------------

1955 --------------

1954 --------------

1953 --------------

1952 --------------

1951 --------------

19502 ------------- 1

26.8

26.7

27.0

27.3

26.8

26.3

26.6

26.6

26.1

27.4

27.1

27.3

29.3

29.2

29.7

30.1

32.4

33.8

34.8

34.2

—

39.9

39.4

39.9

39.9

39.0

38.2

38.2

38.1

37.6

39.3

39.2

39.3

41.8

41.8

42.3

42.9

::.:

49:1

47.3 1

14.4

14.7

14.8

15.3

15.1

14.9

15.5

15.4

14.9

15.8

:;.$

17:1

17.0

17.4

17.7

18.8

20.3

20.7

21.0 1

24.8

24.4

25.0

25.1

24.8

24.3

24.7

24.8

24.2

25.3

25.2

25.4

;;.;

27:9

28.4

30.6

31.8

33.0

32.5

36.8

35.8

36.7

36.6

36.0

35.3

35.6

35.7

35.2

36.5

36.6

36.7

39.2

39.4

40.0

40.6

43.8

44.8

46.7

45.0

13.3

13.6

13.8

14.0

14.0

13.7

14.1

14.2

13.6

14.4

14.1

14.3

15.8

15.8

16.2

16.6

17,6

19.0

19.5

20.0

41.8 64.5

43.7 68.2

42.1 65.3

::.; 66.2

63.0

40:8 61.0

41.7 60.8

41.3 60.2

39.3 ::.;

42.9

41.1 59:7

42.0 59.7

43.7 63.0

42.5 61.7

43.0 61.5

43.3 62.0

47.2 68.4

49.5 71.4

48.1 68.8

46.3 66.0

FeIsle

21.6

21.9

21.3

24.1

22.1

22.5

24.3

24.0

23.0

25.5

23.8

25.6

25.9

24.8

25.8

26.0

27.5

29.2

28.6

27.7

—_-_—.

_

i~iwre~b~ color exclud. dam for residents of New Jersey because this State did

not require reporting o.f the item for these years. s~ased on en-rated ~oPUlation adjusted for age bias in the Population of ‘aces

other than white.

1968 and 1969 (26.7 end26.8deaths per 100,000)

despite the fact that about 7.5 percent fewer deaths

were aesigned to this group of cauees by the

Eighth Revision, which was used for 1968 and 1969,

than had been assigned by the Seventh Revision

(in use 1958-67).

me five major causes of these accidental

fatalities (other than motor vehicle fatalities)

in 1969 were accidental falls, accidents caused

by fires and flamea, accidental drowning and

submersion, accidental poisoning, and inhalation

and ingestion of food or other objects causing

obstruction or suffocation (table F).

There were 17,827 deaths from falls in 1969,

with a rate of 8.8 deaths per 100,000 population.

For the same year there were 7,163 deaths

from fires end flames,, with arateof 3.5 deaths

per 100,000 population. About 2.5 percent of

these fatalities from fires and flames (182 deaths)

occurred among infants, anti about 11.6 percent

(830 deaths) occurred among children l-4 years

of age. The risk of death by fires and flsmes

was about 4.1 times greater among children

of races other than white under 5 years of age

(15.2 deaths per 100,000 poptdetion)t ftanamong

white children at these ages (3.7). This differential reflects a slight improvement over the

situation in 1960, forwhichyear thecorrespondiug

differential was 5.7 (with a rate of 4.3 per

100,000 white children at these ages and 24.4

per 100,000 children of races other than white).

The highest risk of death from Inhalation and

ingestion of food or other object causing obstructionor suffocation (ICDANos. E911, E912)occurs

28
during infancy (with 768 deaths in 1969, giving

a rate of 22.0 deaths per 100,000 at ages under

1 year). The risk of death from this cause is

also substantial at ages 1-4 years (with 244

deaths in 1969, giving a rate of 1.7 deaths per

100,000 at these ages). For these accidents the

risk of death in 1969 was about 2.0 times greater

among infants of races ot,her than white (whose

rate was 37.7 deaths per 100,000) than among

white infants and about 1.7 times greater among

children of races other than white at ages I-4

years (whose rate was 2.5 deaths per 100,000)

than among white children at these ages,

V. INFLUENZA AND

PNEUMONIA

InfLuenza and gmsumonia (ICDA Nos. 470-474,

480-4t36).-Durtng the period 1950-69 there were

two breaks in comparability of mortality statistics

for this group of diseases. The first break,

which occurred between 1957 and 1958, with the

introduction of tbe Seventh Revision, resulted in

assigning about 6 percent fewer deaths to these

diseases than had been assigned by the Sixth

Revision (in use 1949-S7).3 The second break,

which occurred between 1967 and”1968, with the

introduction of the Eighth Revision, resulted in

assigning about 4 percent more deaths to these

diieases than had been assigned by the Seventh

Revision (appendix III).

Between 1967 and 1968 the death rate for

Influenza and pneumonia (ICDA Nos. 470-474,

480-486) increased from 28.8 to 36.8 deaths per

100,000 population-an increase of 27.8 percent

(table 2 and figure 1). Applying the factor 1.0440

(appendix III) to the 1967 death rate for this

group of causes raises it to the level that it

would have reached (30.1 deaths per 100,000) if

deaths in 1967 had been coded by the Eighth

Revision rather than by the Seventh Revision. The

remaining increase in this death rate for 1968,

.6.7 deaths per 100,000 population, may be attributable to the widespread influenza epidemic in 1968.

Throughout the period 1950-69 the fluctuations in the mortality trend for these diseases

reflect tbe occurrence of influenza epidemics.

Age-adjusted death rates, however, indicate some

improvement during the 19601s in mortality from

these diseases, especially for persons of races

.

other than white who have by far the highest

rates (table K and figure 1).

Mortality from Influenza and pneumonia by

age, for each year throughout 1950-69 followed

the J-curve: the death rates were very high for

infants, dropped to a low for the age group 5-14

years, and then rose with advance in age throughout

the remainder of life. This pattern held for each

of the four color-sex groups.

The male population of persons other than

white had greater mortality from these causes

than did any one of the other three color-sex

groups.

The very moderate decline in the age-adjusted

death rate for the total population between 1950

and 1969 (from 26.2 deaths per 100,000 to 24.6)

(figure 1) reflects the offsetting to some extent of

the increase in mortality from this cause for

the white male population by decreases for the

other three color-sex groups (table K).

In 1950 the age-adjusted death rate for this

cause for the population of races other than white

was 2.48 times the corresponding,rate for the white

population, but by 1969 this mortality color ratio

hid dropped to 1.88. On the other band, although

as in the past the mortality sex ratio for this

cause still remains lower than the color ratio,

the sex ratio has been increasing: for 1950 the

age-adjusted death rate for btfluenza and pneumonia for male persons was 1.39 times the

corresponding rate for female persons, and by

1969 this sex ratio had increased to 1.64.

The above-mentioned improvement in the

mortality color ratio for this disease was experienced by both the male and the female populations. For the former group the mortality color

ratio decreased between 1950 and 1969 from

2.34 to 1.93; and for the female population the

mortality color ratio decreased from 2.68 to 1.79

(with all ratios based on age-adjusted death rates

in table K).

For 1969 excess mortality from Influenza and

pneumonia for the male population of races other

than white over that for their female counterparts

was greater than the corresponding differential

for the white population. For the population of

racek other than white the age-adjusted death rate

for the male group was 1.25 times the corresponding rate for the female group. By 1969 this

mortality sex ratio had increased to 1.77.

2$!
Table K. Age-adjusted death rates for Influenza and pnaumoniq by color and se~-United

States, 1950-69

[For 1968and1969rates are based on deathsassignedto categorynumbers470-474,480486 of the Eighth Rsviu’.rr of t%.lnterrurtional Cftmification of Diseases, Adapted for Use in the United States, a&pted in 1965; for 1950.67 ratesarebased on deaths

assignedto category numbers 480483, 490493 of the Sixth and Seventh Revisionsadopted, respectively,in 1948 and 1955.

For method of age adjustment, see appendix I]

Total White All other

Year

Both Male ‘e- Both Male ‘e- Both

sexes male sexes male sexes

Male q;

Rate per 100,000 population

1969--’------------

1968--------------

1967--------------

1966--------------

1965--------------

1964--------------

19631-------------

;;%;1-------------

--------------

1960--------------

1959--------------

1958--------------

195i’--------------

1956--------------

1955--------------

1954--------------

1953--------------

1952--------------

1951--------------

19509------------- 1

24.6

26.8

20.8

23.8

23.4

22.8

27.7

23.7

22.1

28.0

23.4

25.1

27.9

21.6

21.0

19.9

26.3

24.0

25.7

26.2

31.3

34.0

26.8

30.2

29.8

28.8

34.5

29.4

27.6

35.0

28.9

31.2

34.1

26.2

25.3

24.1

31.6

28.5

30.2

30.6 1

19.1

:;.;

18:5

18.2

17.7

21.8

18.9

17.4

21.8

18.5

19.6

22.3

17.3

17.1

16.1

2L 3

19.7

21.5

22.0

22.3

24.1

18.8

21.2

21.0

20.3

24.4

21.2

19.8

24.6

20.7

22.1

24.5

19.1

18.4

17.4

22.7

20.7

22.5

22.9

28.4

30.7

24.2

27.1

26.9

25.9

30.7

26.5

24.8

31.0

25.8

27.7

30.5

23.5

22.3

21.2

27.5

24.8

26.6

27.1

17.3

18.8

14.3

16.4

16.1

15.7

19.0

16.7

15.5

19.0

16.2

17.2

19.3

15.1

14.9

13.9

18.2

16.9

18.6

18.9

41.9

47.3

36.4

43.3

41.7

40.8

55.3

43.4

39.6

55.2

44.1

49.7

55.3

41.6

42.2

41.3

58.6

52.1

54.6

56.9

54.8

60.7

47.6

55.2

52.3

51.2

66.6

52.1

49.6

68.0

53.6

61.4

65.o

:;.;

:;::

60:6

62,3

63.4

30.9

35.8

26.6

32.8

32.3

31.4

45.1

35.4

30.5

43.3

35.2

39.0

46.4

34.6

33.9

33.8

49.1

44.0

47.2

50.6

lFiakres bv. color exclude data for residents of New Jersey because this State did

not rehire reporting of the item for” these years.

~ Based on enuerated population adjusted for age bias in the population of races

o,ther than white.

32 32

23 28

24 24

g

~ ~ .20 20

m—

.=

;; 16

16

Z:,

5812 12

~~’ * k

yj

!T4 4

0

0

1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 : 1960 1~61 1962 1963 1964 1985 1966 1967 t968 1969

YEAR AN% MOi?H

Figure 6. D;ath rates for Influenza, by month: United Ststss, 1950-89.
Influenza (ICDA Nos. 4?’O-47’4).-There were

about 4 percent more deaths assigned to this

disease by the Seventh Revision than were assigned

to it by the Sixth Revision.3 The comparability

ratio for Influenza between the Seventh and Eighth

Revisions is 0.9572 (appendix III).

Tbe mortality curve for kfluenza during

1950-69, emphasizing the severe epidemics that

occurred during that 20- year period, is shown in

figure 6.

Pneumonth (lCDA Nos. 480-486).-An estimated 4.8 percent more deaths were assigned

by tbe Eighth Revision to Pneumonia (ICDA NOS.

480-486) than were assigned by the Seventh

Revision to the most nearly comparable category

Pneumonia, except pneumonia of the newborn

(ICD Nos. 490-493) (appendix III).

Most of the deaths assigned to Influenza and

pneumonia, for which the trends of age-adjusted

death rates are described above, are actually

deaths from Pneumonia. For example, for 1969

the death rate for htfluenza was only 3.0 deaths

per 100,000, while that for Pneumonia was 30.9

deaths per 100,000 (table 1),

V!. CERTAIN CAUSES OF MORTALITY

IN EARLY INFANCY

Despite the fact that during 1950-69 there

were two breaks in the continuity of the number

of deaths assigned to Certain causes of mortality

in early infancy (ICDA Nos. 760-769.2,769.4-772,

774- 778), tbe trend was clearly downward (table

3 and figure 1).

The introduction of the Seventh Revieion

(used for data years 1958-67) resulted in an

estimated increase of about 2 percent in the

number of deaths assigned to these causes over

the number assigned to the identical group of

causes during 1949-57, for which period the

Sixth Revision was in use.a

The second break in continuity resulted from

the introduction of tbe Eighth Revision, used

beginning with data year. 1968. This change in

Revisions reduced deaths assigned to this group

of causes by 8.17 percent (appendix III) (from

51,644 to 47,425 deaths, based on the coding of

the sample of deaths occurring in 1966 by both

the Seventh and the Eighth Revisions).z

It may be assumed that the 8.17 percent

reduction found for the sample of 1966 deaths

also is the percent reduction between 1967 and

1968 ~hat is attributable to the change to the

Eighth Revision.

The number of deaths in 1968 coded to this

cause by the Eighth Revision was only 43,840, and

the number for 1967 coded to the comparable

group of causes by the Seventh Revision was

48,314 deaths, a reduction of 4,474 deaths (table

3).

Inasmuch as 8.17 percent of the 48,314 deaths

in 1967 is 3,947 deaths, the difference between

4,474 and 3,947 deaths (527 deaths) is the estimated maximum number that may be attributed

to an actual lowering of the death rate for this

group of causes.

A more precise measure of the true decline,

in mortality among infants from these causes may

be obtained by applying the comparability ratio of

0.9183 to the 1967 infant mortality rate from these

causes (1,371.0 deaths per 100,000 live births)

(table 4). Multiplying the rate of 1,371.0 by O.9183

gives a death rate of only 1,259.0 per 100,000

live births. The difference between the 1968 rate

(1,248.2 deaths per 100,000 live births) and the

adjusted 1967 rate (1,259.0) is 10.8, constituting

a real decrease in mortality of only 0.86 percent.

The reduction in the assignment of deaths to

the Eighth Revision title “Certain causes of

mortality in early infancy” reflects primarily the ‘

change in classification which provided that only

diseases specific for the newborn (e.g., hemolytic

disease of the newborn) be included under this

title and that conditions not different from those

classified out aide the perinatal classification,

such as pneumonia and diarrhea, be excluded..

About 2,232 of the 2,477 dearbe that were

assigned by the Seventh Revision to Pneumonia of

the newborn (ICD No. 763) were assigned by

the Eighth Revision to Pneumonia (ICDA Nos.

480-486).1 Tabulations of deaths assigned by the

Eighth Revision to this latter cause for the age

group under 1 year will give tbe number of

infants dying from pneumonia.

About 233 of the 250 deaths that were assigned

by the Seventh Revision to Diarrhea of the newborn

(ICD No. 764) were assigned by the Eighth

Revision to Enteritis and other diarrheal diseases

(ICDA Nos. 008, 009). Similarly as for the pneu-
monias, tabulations of deaths for the age group

under 1 year assigned to Enteritis and other

diarrheal diseases (ICDA Nos. 008, 009) will give

the number of infants dying from this cauae.

The decrease between 1950 and 1969 in the

infant mortality rate for these diseases (from

1,715.4 deaths to 1;196.0 per 100,000 live births)

(figure 2) reflects decreases in the corresponding

rates for each of the four color-sex groups (table

4).

For 1950 the mortality rate for infants of

races other than white was 1.46 times the

corresponding rate for white infants, and for

1969 it was 1.66 times the corresponding rate for

white infants. This increasing color differential

for mortality from these diseases reflects increases in the corresponding differentials for both

male and femaIe infants-with an especially large

increase for female infants. For female infants

of races other than white the 1950 mortality rate

for these causes was 1.56 times the corresponding

rate for white female infants, and by 1969 this

differential had increased to 1.73 times the rate

for white female infants (based on rates in table

4). ,

Male infants continued throughout 1950-69 to

have a death rate for these causes that was” about

1.35 times the corresponding rate for female infants. The stability of @is mortality sex ratio for

the total population of infants during 1950-69

was experienced by both the white population and

the population of races other than white: but the

mortality sex ratio for” white infants (about 1.38)

continued higher during 1950-69 than the corresponding ratio for inf=ts of races other thanwhite

(1.29 for 1969).

“VII. DIABETES MELLITUS

Jn 1968 Diabetes mellitus (ICDA No. 250)

moved up to become the seventh Ieading cause of

death. This disease held this rank throtigh 1969,

during which 38,541 persons died from this condition. (Data from a 10-percent sample show that

diabetes continued to rank as the seventh leading

cause of death for 1970 and 1971.) In 1950

diabetes ranked only as the 10th leading cause and

in 1“951, as the ninth leading cause. It reached the

rank of eighth leading cause in 1952 and maintained

that rank for each year during 1953-67. During

the same period, Arteriosclerosis (ICDA No. 440)

ranked as the seventh leading cause of deat~ and

in 1968 it exchanged rank with Diabetes mellitus,

primarily as a result “of the assignment of about

10.4 percent fewer deaths to Arteriosclerosis

with the introduction of the Eighth Revision than

had been assigned to this cause by the Seventh

Revision.

There were no serious breaks in continuity

for mortality statistics for Diabetes mellitus

(ICDA No. 250) during 1950-69. The comparability

ratio between the Sixth and Seventh Revisions is

1.01.3 Tbe comparability ratio between the Seventh

and Eighth Revisions for Diabetes mellitus is

0.9971 (appendix 111).

During the period in which the Seventh Revision was in uae (1958-67), the death rate for

Diabetes mellitus increased from 15.9 to 17.7

deaths per 100,000 population, representing 27,501

deaths for 1958 and 35,049 deaths for 1967

.(tables 2 and 3). The rate continued at a bigb level

for 1968 (19.2 deaths per 100,000) and 1969

(19.1 deaths per 100,000).

Age-adjusted death rates also show a rise in

mortality from this cause during 1958-69 (table L

and figure 1). Although the death rate for the

female population continued somewhat higher than

that for the male population, the absolute increase

in the death rate for the latter group was higher

than that for the female population;.

A glance backward over the age-adjusted

death rates by sex and color for the entire period

for which such rates are available (1914-69)

shows an unusual sex-differential morrality pattern ‘for this disease. The ratio of the ageadjusted death rate for this cause for the male

population divided by the corresponding rate for

the female population was 0.80 for 1914.4 This sex

differential decreased to an even more favorable

level for the male population between 1914 and

the early 1940’s. By 194S the above-described

ratio Was down from 0.80 to 0.62, but since that

time the gap between the age-adjusted death rate

for this cause for the male population and that

for the female population has been steadily

closing. For 1969 the ratio of the age-adjusted

death rate for diabetes for the male population

divided by the corresponding rate for the female

population was 0.90 (with ratios for 1950-69 based

on rates in table L). This first widening of the

32
Table L. Age-adjusted death rates for Diabetes mellitus, by color and sex: Un;ee.d

States, 1950-69

[For 1968 and 1969 ratu are based on deathsassignedto categorynumber 250 of the Eighth Rsvisio. oftfze InternationalCkssifCdh”on of Diseases,Adaptedjor Use in the United States,adopted in 1965; for 1950-67 rates are based on deathssssignedto category number 260 of the Sixth and SeventhRevisionsadopted, respectively,in 1948 and 1955. For method of age adjustment,see

appendix I]

Year

1969--------------

1968 --------------

1967--------------

1966 --------------

1965--------------

1964--------------

19631 ------- ------

19621 -------------

1961 --------------

1960 --------------

1959 --------------

1958 --------------

1957 -------------

1956 --------------

1955 --------------

1954 --------------

1953 --------------

1952--------------

1951 --------------

19509 .-------- ----

Total

Both

sexes

14.5

14.7

13.7

13.9

13.5

13.5

13.8

13.5

13.3

13.6

13.0

13.0

13.2

13.0

13.0

13.1

13.9

14.1

14.2

14.3

Male

13.6

14.0

12.9

12.8

12.5

12.4

12.4

12.3

11.7

12.0

11.3

11.3

11.1

11. O

10.9

10.9

11s2

11.5

11.3

11.4

Female

White All other

Both Male ‘e- Both

sexes male Male ‘esexes male

Rate per 100,000 population

I

15.1

15.3

14.4

14.6

14.4

14.4

14.9

14.5

14.6

15.0

14.5

14.6

15.2

14.8

14.8

15.2

16.3

16.4

16.9

17.1

13.2

13.4

12.7

12.7

12.5

12.5

12.7

12.5

12.5

12.8

12.4

12.5

12.7

12.6

12.6

12.8

13.5

13.8

13.9

13.9

12.8

13.2

12.4

12.3

11.9

11.8

11.9

11.8

11.4

11.6

11.0

11.1

10.9

10.9

10.9

10.9

11.2

11.5

11.2

11.3

13.3

13.5

12.8

13.0

12.9

12.9

13.3

13.1

13.3

13.7

13.5

13.6

14.3

14.0

14.1

14.5

15.6

15.8

16.4

16.4

27.7

28.0

24.5

24.8

23.6

23.6

23.1

21.8

21.0

21.6

19.4

18.8

18.2

17.1

16.5

16.4

17.2

16.5

16.6

17.2

21.3

21.3

18.5

18.3

18.1

17.6

16.6

16.1

14.9

16.1

14.1

13.0

12.5

11.7

11.2

11.3

11.3

11.5

11.8

11.8

33.2

33.7

29.7

30.5

28.6

29.0

29.1

27.1

26.7

.26.8

24.2

24.3

23.6

22.2

21.6

21.2

22.9

21.5

21.3

22.6

this State did lFiWre~ by color exclude data for residents of New Jersey becauee

not require reporting of the itetn for these years.

2Based on en~erated population adjusted for age bias in the pOpUhItiOtI Of races

other than white.

gap between the sexes formortalityfromdiabetes

for the total population (until the early 1940’s)

and then the subsequent narrowing of the gap are

shown also for the white population and for the

population of races other than white. But the gap

continued through 1969 to be much narrower

for the white population (with a mortality sex

ratio of 0.96) than for the population of races

other than white (with a mortality sex ratio

for 1969 of 0.69). For the white population this

narrowing of the gap between the sexes for

mortality from diabetes occurred as a result

of the concomitant decline in the sge-adjusted

death rate for the white female population and the

maintenance of a relatively stable age-adjusted

,

death rate for the white male population (with

a very slow decline for this latter rate until

about 1957, followed by a very slow rise from

that year to 1969).

This narrowing of tbe sex differential for

mortality from diabetes during 1950-69 reflects

on the one band almost steady increases for the

white male population in the death rate for

diabetes for the age groups 35-44, 45-54, and

55-64 years andonthe other hand almost steady

decreases in the &orresponding death rate for

tbe age groups 55-64 and 65-74 years of the

white female popuf.etion.

Focus~g on the age-adjusted death rates for

tbe population of racee other than white for this
period shows adifferent pattern than that for the

white population. Instead of being a relatively

stable rate, the age-adjusted death rate for the

male population of races other than white rose

rapidly during 1950-69, reaching a level for

1969 (21.3 deaths per 100,000) that was 1.8

times the corresponding rate for 1950 (11.8

deaths per 100,000) (table L). These rapidIy increasing age-adjusted death rates for these men

reflect substantial rises in mortality for this

cause for each age group in the span 45-54 years

through 85 years and over, with a smaller rise

for the age group 25-34 years.

Data from the Health Interview Survey of the

National Center for Health Statistics show that

the percentage increase between July 1964 and

June 1965 and July 1966 and June 1967 in the

number of reported diabetics in the population

is also grearer for these men of racea :fier

than white than “for the other three color-sex

~oupSaM (See table at right.) Further studies

areneeded todetermine the cause for therapidly

increasing death rate for diabetes among men

of races other thsnwbite.

For female persons other than white the

curve of the age-adjusted death rate for this

cause continued for each year during 1950-69

at a substantially higher level than the corresponding curves for the other three color-sex

Se., colmj ma age

at death from

Diabetes m.llitus

Female persons

of racesother

than white

20-24 years------

25-29 Tears------

20-34 yea.rs------

35-39 years------

40-44 years------

45-49 yeaIs------

50-34 years------

55-59 years------

60-66 years-----

65-69 yx?.r, ------

70-74 wars ------

75-79 yea.ts------

80-94 years---=-

Sex and

color

Male

WhLte -----

All otherFemale

White -----

All otherNumber of diabetics

in thousands

July

1966 -

Jnne

1967

(1)

1,145

128

1,558

261

July

1964-

;U&

(2)

873

89

1,12$

208

?ercent

kmrease

(:);of2)

(3)

31.2

43.8

38.0

25.5

Iu.sc civilian, noninstitutiona lized

population reported in health interviews.

(See references 5 and 6.)

groups. Buttberelative increase during 1950-69

in the death rate for these female persons (46.9

-percent) was lower than the corresponding increase in the death rate for male persons of

races other than white (80.5 percent).

An examination of the age-color-sex specific

mortality trends for 1950-69 for diabetes shows

,-

Cohortand period of birth

9.S5- 1940- KE5- 1950- 1925- 1’320- 1915- lslO- 1905- 1900- 1295- 1.890- M8s- 18&)- ~,y7~- ~~,,j949 1944 1939 1934 1929 1824 1919 1914 1209 3.S04 1899 1894 1889 1884 1879 1874

.

1.8

1

1.3 1.2

2.9 2.8

3.5

1.0

3.1

4.2

9.2

Ikdh. ates per KX3,CO0 poplaticm i. age gr.atig

2.9

2.5

3.7

6.’!

16.8

3.3

3.5

6.7

15.9

28.0

5.3

5.9

16.5

33.3

55.5

8.9

M .2

29.4

53.6

90.3

20.0

28.8

47.8

91.3

63.5

35.3

56.4

86.4

.53.7

!26.8

56.4

82.1

19.9

.74.6

Isl.1

73.9

93.3

!Z5.6

!76.0

;14.4J

95.s

88.1 KM.7

129.1 12S.3

183.0 157.4

230.6 130.0

,20.4

11.8

39.6

126.2

80.0

lK7T8:‘f& first fisure in each row, moving from right ‘m left,2s the aeath rate for data year 1949; the .emnd figure,for 1934;

the third fime, for 1959; the fourth fime, for 1964; end tbe f12th Zi@re, for 1969.

Tor data years 1948,1954,1928,and 1964 these rates are based on deaths assigned to categozy number 260 or the Sixth and Seventh

Revisions of the Intermtional Lists, adopted,respectively,in 1348 and1S55;f0r data year 1969 rates are based on deaths assfgmd

to category number 230 of the Eighth Revision of the Intemtatimal Lists, wlmpt:d in 1965.

34
that for women of races omer than white, th~

level of mortality for the age groups under 55

years remained quite stable. But for older age

groups the death rate for this cause among

these women increased markedly. Part of this

increase in mortality at older ages may be

, attributable to the prolongation of the life of

diabetics by increased frequency of early diagnosis and successful treatment programs (including the use of insulin therapy beginning in

the 1920ts, followed by antibiotics, diet, andother

therapeutic measures).

Cohort analysis shows that for women of

races other than white mortality from diabetea

increased. rapid~- wfth adv&ce–in age ‘during

1949-69. (See table at Lmttom of page 34.). This

method of analysis also shows that the cohort

of women of raceq other than white born in

the period 1900-1904 had death rates for diabetes

at ages 45-49, 50-54, and 55-59 years that were,

respectively, 4.7, 4.2, and 3.3 times the corresponding rates for the cohort ofwhitewomenborn

in the same period.: (see ~bleb~ow.)

For women born in 1910-14 the color differential in mortality from diabetes was even

greater than that for the above-considered cohort

of women (1900-1904): for women of races other

than white born in 1910-14 the death rates for

diabetes at ages 45-49: 50-54, and 55-59 years

were, respectively, 5.3, 4.6, and 4.2 times the

Color,se&aud age

at 6e.zthfrom

Diabetesmellltvs

Whitefemale

persons

20-24 yeara------

25-29 ysars------

30-34years------

35-39 years------

40-44 yeal’e-------

45-49 ye8rs------

m-s.l yeal’-------

55-59tiars----

60-6kyears------

65-69”years------

70-74WWXs------

75-79years-----

20-84 ym,-------

correspondhg rates for wrote women horn in

1910-14.

This widening of the female color differential

for diabetes may reflect lass satisfactory results

from diabetes control programs for these women

than for white women. The same data referred to

above from the Health Interview Survey of the

National Center for Health Statistics suggest that

this widening of the female color differential is

not attributable to’s faster rising prevalence rate

of the disease among women of races other than

whi_te.5.6

l%e estimated number of white female diabetics increased fram 1,129,000 for July 1964-

June 1965 to 1,558,000 for July 1966-June 1967,

representing an increase of about 38.0 percent;

whereas the corresponding increase for women of

races other than White was from 208,000 to

261,000, representing an increase of only about

25.5 percent.

Part of tbe increase in the number of diabetics

reported in the Health Interview Survey is believed

by personnel of the survey to be attributable to

increasing awareness of the presence of the

disease by those interviewees who have the

condition and to better interviewing techniques to

obtain the reporting of the disease.

Age-adjusted death rates hy geographic divisions for 1950, 1960, and 1969 show that the East

North Central and Middle Atlantic Divisions had

I

,945- 1940-

949 1944

1

1.1 0.9

1.7

—

.933-

.939

1.0

1.5

2.7

.

930-

934

1.0

1.5

2.3

3.2

Cohortand pericdof birth

,923- 1920- 1915- 1910- 1905- 1900- 1895- 1890- 1685- 18’eo-1.275-1870-

.929 1924 1919 1914 1909 1904 1899 1894 1889 1824 1879 1874

Death rates $er 1S0,000Fpulati.n in age @YJUP

1.5

1.5

2,4

2.5

4.1

1.6

2.0

1.9

3.8

6.9

1.5

2.3

3.2

5.4

U .4U

2.1

2.9 3.7’

5.6 5.4 7.5

3.3..612.2 13.5 18.3

21.5 23.9 26.0 30.8

, 40.6 42.7 57,.0

70.5 75.7

121..1 1

42.0

57.9

83.4

122.6

174.3

77.5

96.1

130.7

162.8

2SL.1 1114.o

136.3 165.9

163.5 169.2

197.5 188.2

189.3

191.7

NOT8: The Zl?mt figure in each row, movingfrom rigb%toleft, is the death rate for data year 1949;the secondfigure,for 1954;

the third figure,for 1959; the fourthfigure,fc.r1964; ana the fifth figure,for 1969.

For data years 1949, 1954, 1959,and 1961 these rate6 are based on .ieatb.aassi2nedto categorynumber 260of the Sixth and Seventh

RtiBio.s 02bhe intern’a.WLomal. 14.6ts,aciopted,respecti%? ely,in1949 8n6.1955; for 6ata year 1969 rates are b.se6 on &.ths assigmed

to categorynumber 250 of the Eighth Retisi.nof the InternationalIi+s, =&pbe& in 1965.
Table M. Death rates.for Diabetes mellitus,by broad age groups,and correspondingage.

adjusted rates: United States and each geographic division, 1940, 1950, 1960, and

1969

[Deathsarethose-attributed tocategory number61oft] FifdtRevki.noftheInternational L~ts,1938;tocategory number260

oftheSixthandSeventhRevisions. ado,d,respectivein194Sand1955:andtocatezorv number25ooftheEighthRe.vk~on,

adopteditt1965.Formethodofa& ad nnent,seeq

Geographic division

and year

United States

1969-----------------------

1960-----------------------

1950-----------------------

1940-----------------------

New England

1969-----------------------

1960-----------------------

1950-----------------------

1940-----------------------

Middle Atlantic

1969------L----------------

1960-----------------------

1950--:--------------------

1940-----------------------

East North Central

1969-----------------------

1960-----------------------

1950-----------------------

1940-----------------------

West North Central

1969-----------------------

1960-----------------------

1950-----------------------”

1940-----------------------

All

ages

19.1

16.7

16.2

26.6

20.9

19.7

21.0

35.6

22.1

21.1

20.5

38.4

21.6

19,9

20.6

30.5

20.5

17.3

17.9

26.5

:ndix I]

a

Rate

---

;;;

1.7

---

0.4

0.5

L 2

---

:::

1.4

---

0.5

0.8

1.8

---

::!

2.1

,er100,000 population

---

3.5

:::

P--

3.5

:::

---

3.6

;:;

---

::2

4.8

---

3.4

:::

23.6

23.3

25.4

50.2

21.0

20.8

27.2

55.8

23.5

26.8

31.3

73.7

24.8

27.0

31.3

54.4

20.9

18.8

21.7

37.7

136.2

118.0

120.3

211.8

141.7

132.8

142.3

254.1

151,5

140.8

146.1

301.2

162.3

144.3

148.2

225.2

128.6

110.9

122.8

201.8

-

Ageadjusted

rates

;;.;

14:5

26,6

14,9

14.4

16.2

30.3

16.3

16.2

17.3

37.1

lRates are not shown for 1969 for the age groups under 25 and 25-44 years because

‘thepopulation bases for these particular broad age groups are not available. 2The 1969 age-adj us ted rates are based on age grOups under 20 years, 20-44 years,

45-64 years, and 65 years and over.

.

the highestmortalityfrom thiscauseand the Vlll. ARTERIOSCLEROSIS

Mountain and PacificDivisionshad the lowest

mortality(tableM).A similargeographicpattern ItappearsthatthetrendforArteriosclerosis

was found in an earlierstudyfor theaverage (ICDA No. 440)was downwsrd between1950and

&nual ratesfortheyears1950-51and1959-61.7 1969 (tables2 and3 andfigure1).Buttheactual

M
Table M. Death rates for Diabetes mellitus,by broad age groups,and correspondingageadjusted rates: United States and each geographic division, 1940,

1969—Con.

1950, 1960, and

. [Deaths are those attributed to category number 61 of the Fifth Revision of the Internationst Lsts, 1938; to category number 26o

oftbeSixthandSeventh Revisions, adopted, respectively, in 1948 and 1955; snd to category nuinber 250 of the Eighth Reti]on,

adopted in 1965. For method of age adjustment, see appendix I]

Geographic division

and year

South Atlantic

1969-------------------------

1960-------------------------

1950-------------------------

1940-------------------------

Eaet South Central

1969-------------------------

1960-------------------------

1950-------------------------

1940-------------------------

West South Central

1969-------------------------

1960-------------------------

1950-------------------------

1940-------------------------

Mountain

1969-------------------------

1960------------=------------

1950-------------------------

1940------------------------:

Pacific

1969-------------------------

1960-------------------------

1950-------------------------

1940-------------------------

All

ages

I

Under

25 25-44

years I

years1

45-64

years

I

65

ye&s Ageadjusted

over

rate 2

I I I

Rate per 100,000 population

18,1

14.1

12.6

18.2

18.2

13.1

10.2

13.9

17,5

15,1

11,6

14,4

13.5

10.6

10.3

16.1

13.8

10.i’

10.0

25.1

---

:::

1.7

---

0.6

0.9

1.9

---

0.5

0.8

1.7

---

0.5

0.6

1.9

---

0.5

0.6

2.0

---

$;

---

3.6

3,3

5.5

---

3.3

3,0

4.6

---

2.9

3.1

2.5

---

;:?

3,3

-

30.5

26.6

25.6

44.3

27.0

21.7

18.9

30.3

26,0

23.9

20.1

33.3

16.1

16.9

17.0

28.2

16.4

14.3

13.1

35.7

123.8

98.3

99.6

157.0

122.0

89.6

79.1

115.9

126.8

111.6

93.8

119.9

113.6

86.8

85.5

153.7

107.4

78.9

73.5

185,0

15.9

13.3

13.4

21.9

15.3

11.7

10.5

16.4

15.1

13.5

11.6 .

16.9

12.3

10,3

10.4

17.6

11.7

9.2

2!:2

—

lRates are not shown for 1969 for the age groups under 25 and 25-44 years because

the populationbases for these particular broad age groups are not available.

~The 1969 age-adjusted rates are baaed on age gxotIPS

45-64 years,

under 20 years, 20-44 years,

and 65 years and over.

amount of declbe isnotevidentfrom theannual the latterrevisionusedbeginningw;thdatayear

deathratesfor theperiod1950-69owingtothe 1958)thecomparabilityratjowas 1.02.3Thebreak

factthatthere were two breake in thecom- intrendbetweentheSeventhandEighthRevisions,,

parabilityofmortalitystatisticsforthisdisease. introducedfordatayear 1968,was much more

Between the Sixthand SeventhRevisions(with serious,resultingina comparabilityratioforthe
Seventh and Eighth Revisions of only 0.8963

(appendix III).

During 1950-69 the almost halving of the ageadjusted death rate for Arteriosclerosis (ICDA

No. 440) @om 16.2 deaths per 100,000 population

for 1950 to 9.2 deaths for 1969) (figure 1)

reflects sizable reductions in the death rate for

this cause for each of the four color-sex groups

(table N).

Because this disease is associated with the

aging process, it is not surprising that about 95-

percent (31,535 deaths) of thetotsldeaths (33,063)

from Arteriosclerosis in 1969 occurred at ages 65

years and over.

The age-adjusted death rate for this cause

for 1969 was about the same for the white popiilatfon as for the population of other than white

races-the color ratio being 0.99 .This color ratio

had remained quite stable since 1950, when it was

0.98. Very “similar patterns are found when t$e

color ratios for mortality from this cause are

examined separately for the male population (with

a mortality color ratio of 0.98 for 1950 and

0.99 for 1969) and for the female population

(with a mortality color ratio qf 0.96 for both

1950 and 1969).

The sex ratio for mortali~ from Arteriosclerosis was higher than the corresponding color

ratio during 1950-69, but the trend for tbe sex

ratio appears to he downward—from 1.29 for

1950 to 1.20 for 1969. For 1969 the sex ratio

for this disease for the white population (1.20)

Table N. Age-adjusted death rates for Arteriosclerosis, by color and sex: United SCates,

1950-69

[For1968 and 1969 ratesarebasedon deathsassignedtocategorynumber440 oftheEighfh Revision o~the Itztematimml Ch@-

cation o~Dfseases, Adapted for Use in the United States, adoptedin 1965; for 1950-67ratesarebasedon deathsassignedto categorynumber450 oftheSixthandSeventhRevisionsadopted,respectively, in194Sand 1955. Formethodot%ge~djm.tment,see

appen~ 11

I

Year

Total

II I

9.2

1?:?

11.9

12.0

12.1

12.5

12.6

12.4

13.2

13.0

13.4

13.3

13.3

13.9

13.5

15.0

15.3

16.0

16.2

10.1

10.5

12.2

13.2

13.4

13.2

13.9

13.8

13.8

14.8

14.5

15.0

14.8

14.8

15.7

14.9

16.8

16.9

17.9

18.4

White I All other

Both Male ‘e- Both

sexes male sexes

Tide male ‘e’

Rate per 100,000 population . .

8.4

8.8

10.2

10.9

11.0

11.2

11.5

11.6

11.3

11.8

11.8

12.1

12.1

12.0

12.4

12.2

13.5

13.9

14.4

14.3

1969 --------------

1968 --------------

1967 --------------

1966 --------------

1965 ------------”--

1964--------------

19631 -------------

19621 -------- .-----

1961--------------

1960 --------------

1959 --------------

1958 --------------

1957 --------------

1956 --------------

1955--------------

1954--------------

1953 --------------

1952 --------------

1951--------------

19502 . . . . . . . . . . . . .

1~iWre~ by color exclude data f Or residents of New Jersey because this State did

aot require reporting of the item for these years.

2Based ou enumerated population adjusted for age biae in the population of races

other than white. .

9.2

9.6

11.2

11.9

12.0

12.0

12.5

12.5

12.4

13.1

12.9

13.3

13.3

13.2

13.9

13.4

14.9

15.3

L6.1

16.2

10.2

10.6

12.3

13.2

13.4

13.1

13.8

13.7

13.7

14.7

14.4

14.9

14.8

14.7

15.6

14.8

16.7

16.8

17.9

18.4

8.5

1;::

10.9

10.9

11.1

11.4

11.5

11.2

11.7

11.7

11.9

11.9

11.9

12.4

12.1

13.4

13.9

14.5

14.3

9.1 10.1

9.9 ‘“”14.0

10.7 ‘11.8

;;.: - “13.2

‘.13.6

12:6- ‘13.6

13.4- ““14.7

;;;; : --15.0

‘--14.2

13%- --15.5

13;7- 7.15.2

14:7- ‘.16.0

Uira - “‘-15.2

i.3X-- “- 14.8

14,3 16.2

13.9 15.5

15.5 17.7

15.0 17.1

15.1 17.1

15.8 18. (J

1 II

8.2

9.0

1?:1

11.3

11.8

;;.:

11:5

12.3

12.3

13.7

13.1

12.5

12.5

12.6

13.5

13.1

13.1

13.7

-za
was close to the corresponding sex ratio for the

population of races other than white (1.23); and

the trend for E&h of these groups was downward

during 1950-69, decreasing from 1.29 for the

white population and from 1.31 for the population ‘

of races other, than white.

IX. BRONCHITIS, EMPHYSEMA,

t~ND ASTHMA

Bronchitis, emphysema, and asthma (ICDA’

Nos. 490-493).--During 1950-69 there were two

breaks in the continuity of mortality statistics

for this group. The first break occurred between

1957 and 1958. The introduction of the Seventh

Revision reduced the number of_deaths assigned

to these causes by about 6.2 percent over the

number assigned to the same titles by the Sixth

Revision.3

The comparability ratio for this group of

causes between the Seventh and Eighth Revisions

is 1.0034 (appendix III). Although this ratio is

close to 1.00, the corresponding factors for the

three components of this group of diseases, as

shown below, vary considerably from 1.0,0.

The trend of the age-adjusted death rate

for this entire group of causes was steeply

upward during 1954-69 (table O and figure 1).

Table O. Age-adjusted death ratee for Bronchitis, emphysema, and asthma, by color and

eex: United States- 1950-69

[For 1968and1969rates

Ck.wification of Diseases

%%R$::;::::

.,,’ It

Year r

..

1969 --------------

1968 --------------

1967 --------------

1966 --------------

1965 --------------

1964 --------------

19631 --- ----------

19621 --------J-7--

1961 --------------

1960 ---------~-T--

1959 ---------+ -----

1958 -----------=;T

1957 ---------

1

1956 --------- =;:$

1955 ---------

1954 --------- =:

;;;; :-- -----------

-------------

19519 -----------: -

u)5d~~3------------

basedon deaths.assignedto categorynumbers 490~93 of the Eighth Revision of the International

dapted for Use in the United State+ adopted in 1965; for 1950-67 rates are bssed on deaths assigned

02, 527.1, and 241 of the Sixth and Seventh Revisions adopted, respectively, in 1948 and 1955. For

:. appendix I]

11’ I

Total

12.0 21,1

12.9 22.8

12.1 21,4

12.2 21.4

11.6 20.4

10.5 18.1

10.6 18,3

9.2 15..6

8.2 13,7

8.2 13.7

12.1

i:: 11.4

11.7

::: 9.9

9.1

r ;:; 8.7

4.8 6.6

4.9 6.7

5.0

3.7 :::

II White I All other

Fe- Both Nale ‘e -

Both

Dale eexes male sexes

Male

Rate per 100,000 population

&.7

1

::+

4.6

:::

:.;

H

3.0

2.9

3.3

2.9

::!

3.1

3.2

3.3

2.7

—

12.0

-

13,0

12.2

12.3

11.7

10.5

10.7

9.2

8.1

8.2

::;

;:;

2::

4.7

4.8

4.9

3.6

21.6

23.2

21.8

21.9

20.7

18.5

18.8

16.0

13.9

13.8

12.2

11.5

11.7

10.0

9.2

8.8

6.6

6.7

::$

4.6

1

4.9

4.5

:::

3.9

3.9

3.5

3.2

3.3

2.8

2.7

3.1

2.8

2.9

3.0

2.9

3.1

3.2

2.6

10,0

-

11.3

10.3

10,0

9.8

9.0

9.7

8.4

7.9

8.0

::;

7.9

5.9

5.6

5.3

5.0

5.5

::;

15.7

17.7

15.9

15.6

15”.2

13.9

14.2

12.1

11.5

11.2

9.9

1%;

8.-0

7.5

N

6.3

::;

Fe -

nale

1Figwes by color exclude data for residents of New Jersey because this State did

not require reporting of the item for these yeare.

2Excludes data for ICD No. 527.1, because for these years data were not available

by age, color, and sex.

S,Based on enumerated population ad-jus ted for age biae in the population of races

other than white.

.4
(The base line 1954 instead of 1950 is used bemuse

the number of deaths for one componefit-Emphysema without mention of bronchitis (ICD No.

527.1)—for the years 1950-53 is not available.)

These age-adjusted death rates” show that

for 1969 mortality for the male population from

these causes was 4.49 times the corresponding

mortality for the female population. This mortality sex ratio had increased considerably over

the ratio of 2.81 for 1954. The mortality sex

differential in 1969 was large for both color

groups, but higher for the white group (4.70)

than for the other group (3.08). For both color

groups the mortality sex diierentials increased

during 1954-69. .

On the other hand the mortality color ratio

for Bronchitis, emphysema, and asthma appears

to have been relatively stable during 1954-69.

The 1969 age-adjusred death rate for these

diseases for the population of races other than

white was only 83 percent of the corresponding

rate for the white population. This obtains because

of the relatively low mortality color ratio for

these diseases for the male population: for 1969

the age-adjusted death rate for the male population of races other than white was only 73 percent

of the corresponding rate for the male population

of the white races; while for the femsle population

of races other than white, this rate was 1.11

times that for the white female population.

The death rate for Bronchitis, emphysema,

and asthma, taken as a group of diseases, is

higher for older th~ fOr younger age 90UP%.

This is true for each of tbefour color-sex groups.

For both the white male and the other male

populations the death rate for the age group

65-74 years is more than double that for the

age group 55-64 years.

Chronic andungualified bronchitis (ICDANoe.

490, 491).—The introduction of rhe Seventh Revision resulted in the assignment of about 7

percent more deaths to Chronic and unqualified

bronchitis than had been assigned by the Sixth

Revision to these causes.a

On the basis of the sample of deaths in

1966 coded by the Seventh and Eighth Revisions, 2

there were 5,484 deaths assigned to this cause

by “the Eighth Revision and s,164 deaths asaigned

to the comparable title by the Seventh Revision,

a ratio of 1.0620 (appendix III).

The death rate for Chronic &d unqualified

bronchitis (ICDA Nos. 490, 491) rose durfng

1958-67, when the Seventh Revi~%n W~S in use,

from 1.5 to 2.7 deaths per 100,000 (table 2).

Applying the comparability ratio of 1.0620 to this

latter rate raised it to 2.9, the magnitude this

rate would have had if the 1967 deaths had been

coded by the Eighth Revision.

Emphysema (ICDA No. 492).-About 2 percent -

more deaths were assigned by tlfe Seventh Revision to Emphysema, without mention of bronchitis (ICD No. 527.1) than were assigned by the

Sixth Revision to this causes

On the basis of the sampIe of deaths in 19661

coded by both the Seventh and Eighth Revisions,

there were 21,350 deaths assigned by the Seventh

Revision to the nearly comparable title Emphysema, without mention of bronchitis (ICD No.

527.1)? a ratio of 1.0542 (appendfx HI).

Applying the factor 1.0542 to the 1967 death

rate for Emphysema (10.6) -sises it td 11.3

that is, to the level it would have been if the

deaths in 1967 had been coded by the Eighth

Revision. This is another respiratory disease for

which the death rate was clearly upward during

1950-69 (table 2).

Asthma (ICDA No. 493).—Th;&troduction of

the Seventh Revision for data year 1958 resulted

in about 20 percent fewer deaths being assigned

to asthma than had been assigned by the Sixth

Revision.3

On the basis of the sample o~deaths in 1966

coded by the Seventh and Eighth-Revisions, there

were only 3,007 desths assigned tb this cause by

-------

the Eighth Revision and 4,324 .dea.@ assigned to

it by the Seventh Revision,%+- ratio of 0.6954

(appendix HI). . ----

-– ..”

.----- -

X. CIRRHOSIS-W--LIVER

, -“------

----------

For 1969 Cirrhosis ‘of liver (ICDA No. S71)

ranked as the 10th leading cause of death+he

rate being 14.8 deaths per 100,000 population,

representing 29,866 deaths. Its rank for each

of the four color-sex groups was even higher.

For 1969 this disease ranked ninth for the white

female population and eighth for each of the other

three color- sex populations.

There were no serious breaks in comparability of mortality. statistics for cirrhosis

4iQ
during1950-69.The comparabilityratiois0.99 color-sexgroups.The 1969 age-adjusteddeath

between the Sixthand SeventhRevisions~ and rateforthe male populationofracesotherthan

1.0055betwe~ theSeventhandEighthRevisions white (31.4deathsper 100,000population)was

(appendixIII).! 3.5 times their correspondingrate for 1950

Between 1950 and 1969 thedeathratefor (9.0deathsper 100,000)(tableP). Increasesin

cirrhosisincqeased,from 9.2to14.8deathsper mortalityfrom this cause were even greater for

100,000 (table 2 and figure 1). This represents an men of races other than white in the early

increasefrom 13,855deathsfor 1950 to29,866 middleyearsoflife.Forexample,formen atages

deathsfor1962(table3). 35-44years,thedeathratefor thiscausewas

Althoughan increasein mortalityfor this almoatseventimeshigherfor1969(66.8deaths

cause occurredforeach of thefourcolor-sex per 100,000)than for 1950 (10.0deathsper

groups,age-adjusteddeathratesshow thatboth 100,000).

the absoluteand relativeincreaaesinmortality The mortalitysexdifferential forthiscause

were by far greaterfor the male population (basedon age-adjusteddeathratesin tableP)

ofracesotherthanwhitethanfortheotherthree was somewhat greaterfor1969thanthecorreT.ableP. Abe-adjusted death rates for Cirrhosis of liver, by color and sex: United

States. 1950-69

[For 196S and 1969 rates are basedondeathsassignedto cate&y number 571 of the Eighth IZe.kion of the InternationalCfa.w&

cationoflheases, Adapted for Use in the United States,ado ted in 1965; for 1950-67 rates are based on deaths assigned to category number 581 of the %tb and Seventh Revisions adopte J , respectively, in 1948 and 1955. For method of age adjustment, see

append~ 11

fi?l hl

I iJ_

Year,t

i

-r -

1969-------------

1968------+’F ------

1967--------------

1966--------------

1965------J -------

1964------+------

19631----- .(77-. ---

19621-------------

1961--------------

1960-------s ------

1959--------------

1958--------------

1957--------------

1956------- F&%--

1955--------------

1954--------------

1953--------------

1952--------------

1951--------------

19502-------------

Total White All other

Both Male ‘e- Both Male ‘e- Both

sexes male sexes male sexes

Male male ‘e14.2

14.0

13.5

13.0

12.1

11.5

11.2

11.0

10.6

10.5

10.1

1::?

9.9

;.;

9:5

9.5

9.1

8.5

19.4

19.0

18.3

17.8

16.5

15.5

15.1

15.1

14.5

14.5

13.8

13.6

14.4

13.3

12.7

12.6

12.8

‘ 12.8

12.1

11.4

Rate per 100,000 p

9.5

9.5

9.1

8.7

S.3

;:;

7.4

7.1

6.9

::;

6.8

6.6

6.2

6.1

6.4

6.2

6.2

5.8

12.9 18.0

12.9 17.8

12.5 17.2

12.1 16.8

11.4 15.6

11.0 15.0

10.7 14.7

10.5 14.6

10.3 14.2

10.3 14.4

10.0 13.7

13.7

1::: 14.4

9.8 13.4

9.4 12.9

12.8

M 13.0

9.5 13.0

9.2 12.3

8.6 11.6

relation

8.5

8.5

8.4

7.9

7.6

;:;

6.8

:::

:::

6.6

6.5

6.1

6.0

6.4

6.2

6.2

5.8

24.0

22.9

20.7

20;4

18.0

15.2

13.9

13.8

12.8

11.9

11.3

9.9

10.8

9.7

8.5

8.1

:::

8.1

7.4

31.4

29.8

27.2

26.6

23.3

19.6

17.1

16.8

1s.9

14.9

13.7

12.5

13.4

11.8

10.3

1::;

10.6

9.9

9.0

.--. —

17.6

17.0

15.0

15.0

13.4

11.3

*11. O

11.0

9.9

9.1

9.1

7.4

*8.4

;::

6.5

*6.3

*5.7

6.3

*5.9

-

lFigures by color exclude data for residents of New,Jersey because this State did

not require reporting of the item for these,years.

~Baeed on enumeratedpopulation adjusted for age bias in the population of races

other than white.

NOTE: Asterisk indicatesage-adju&ed rates where more than halfof the age-epecific

rates are based on fewer than 20 deaths.

4i

.
spending mortality color differential. Fo~ 1969

the age-adjusted death rate forcirrhosis for the

male population was 2.04 times thecorresponding

rate for the female poptdation. Thismortality sex

ratio was quite stable during 1950-69; for 1950

this ratio was 1.97.

The mortality color ratio for cirrhosis shows

increasing excess mortality for the population of

races other than white. Actually for 1,950 their

age-adjusted death rate for this cause was only

86 percent of that for the white population. But

by 1958 both groups had the same age-adjusted

death rate forthis cause (9.9deathsper 100,000),

and by 1969 the age-adjusted death rate for

cirrhosis for the population of races other than

white (24.0 deaths per 100,000) wasl.86timesthe

corresponding rate-for the white population (12.9

deafis per 100,000).

For this disease tbemortality color ratio is

greater for the female populationthanfor the male

population; but for each of thesexes the excess

mortality from cirrhosis for persons of races

other than white (as measured hy age-adjusred

death rates) more than doubled between 1950 and

1969 (table P).

The age-adjusted death rate for the white

male population continued during 1950-69 to be

shout twice the corresponding rate for the white

female population. This mortality sex differential

was lower duFing 1950-69 for the population of

races otber than-white than for the white population, butincreased between 1950 and 1969, rising

from a ratio of 1.53 for 1950 to 1.78 for 1969.

For 1969 the death rate for cirrhqsis for the

total population increased for each succeeding

age group up through ages 55-64 years and then

declined for the age groups in Eheremainder of

the life. span~ A nearly similar pattern held for

1969 for ‘each of the four color-sex groups.

Whether the death rate for cirrhosis actually

does peak, before theendof the lifespan maybe

determined by cohort analysis. An examination of

the death rate for persons born 1895-99 shows that

for three of the four coloz-sex groups (white male,

white female, and other female) the death rate

for cirrhosis does peskatages 65-69 years (see

table at right). For the fourth group (the all

other male group), however, the death rate for

cirrhosis continues to rise for the age group 70-

74 years. This pattern for these men also

Color, sex, and

year of death from

Cirrhosis of liver

White, male

1969 ----------------

1964 ----------------

1959----------------

1954 ----------------

1949 ----------------

All other, male

1969 --”--------------

1964 ----------------

1959 ----------------

1954 ----------------

1949 ----------------

White, female

1969 ----------------

1964 ----------------

1959 ----------------

1954 ----------------

1949----------------

All other, female

1969 ------L ---------

L964----------------

1959 ----------------

1954 ----------------

1949 ----------------

Age at!

death

(in

ye&s )

cohort

born

1895-

1899

,:

70-74

65-69

60-64

55-59

50-54

70-74

65-69

60-64

55-59

50-54

-----

70-74

65--69

60-64

55-59

5044

—

Jr‘3

i

7!L 4

65- 9

60-64

55-59

5LJJ54

Death

rate per

100,000

population

57.2

62.0

46.4

40.2

29.3

49.0

42.4

35.4

35.9

22.3

21.4

22.7

18.4

16.0

13.6

11.4

20.1

17.1

16.0 e

LI.7 /

1<

differs from that for cohor~~’~df men of races

other than white bomprior~o &&i-99. Forthese

earlier born cohorts the-d~athkmte does apuear

topeak at this Iatter age &’rttit~e~tums dowuward

duriing ~he last part of the lif~gfia~$ This apparent

break in pattern for men of races other than

white should he examined again when data for

more recent years become available. Itis possible

that this broken pattern refleck the extraordinarilygreat increases during tlte1960ts in the

death rate for cirrhosis for men of races other

than white at ages 70-74 years (from 25.2 for

1960 to 49.0 deaths per 100,000 for 1969).

“The percentage of deaths from Cirrhosis of’

liver in 1969 for male persons of races other

than white for which alcoholism was mentioned

“42
on thedeathcertificate(44.4percent)was higher more completereportingof“alcoholic’’c irrhosis

thanthecorrespondingpercentagesfortheother for thesepersonsthanfortheotherthreecolorthree color-s~xgroups (table-Q).Inasmuchas sexgroups.

men of races otherthan white also have the Completenessofreportingon thecertificate

lowest percent of deathsfrom “unspecified” of death as to theetiologyof cirrhosisvaries

Cirrhosisof liver (35.7percent)t~eirhigh from Stateto State.California,which had a

percentageas “alcoholic”rrtayreflectin part lower percentagefor 1969 of“unspecified”cirTable Q.,Number and percent distribution of deaths from Cirrhosis of liver by subcategories al~oholic,other specified

States, 1969

, and unspecified,according to color and sex: United

[Deaths am those assignedto category number 571 of the Eighth R..ision of the International Classification of Diseases, Adapted

for Usein the United Statss, adopted in 1965] ,’

Color and sex

. ..!

Total------

;.1’

White, male--,----

white, female----

All other,male---

All other,femaleCirrhosis AlcoOther unOf holic speci- speciliver (p fied fied

(IJDA (ICDA (::DA

571:0) 57y&i 571.;)1 57i)

Number

29,866

n

10,520 5,404

16,517 5,988 2,633

8,634 2,533 1,786

2,863 1,;;:, “ 571

1,852 414

13,942

7,896

4,315

1,022

709

Percent distribution

T

100.0 35.2

100.0 36.3

100.0 29.3

100.0 44.4

100.0 39.4

15.9 47.8

20.7 50.0

19.9 35.7

22.4 38.3

I

lThe Eighth Revision adapted for use in the United States has the three subcategories shown in the report, whereas the Revision adopted by the World Health Organization

hae only twq-subcategories:Alcoholic (ICDA No. 571.0) and Other (ICDA No. 571.9). The

inclusion terms under the three subcategoriesin use in the United States are as follows: :-

571.0 Alcoh@ic

Alcoholic:

Cirqhosis

Hepatitis

Laennec!s cirrhosis

Any condition in 571.8 or 571.9

with pe~tio,nof alcohol or

alcohol~sm

,.,lr.,, =:.:,,

571.8 Other specified

)

Cirrhosis (hepatic) .

(liver):

Biliary

Cardiac

Congenital Without men~ion

Due to passive of alcohol or

congestion alcoholism

Portal

POstnecrotic

Fatty degeneration

of liver

571.9 Unspecified

Banti’a disease

Chronic hepatitis

Cirrhosis (hepatic)

(I&er) :

1

Without mention of

alcohol or-alcoholism

Hepatolienal

Splenomegalic

Hepatolienal fibrosis

.43
rhosison deathcertificates(30.5percent)than

the percentagefor thenationas a whole (46.7

percent),also reports for 1969 thatmen of

races other than white have the highestpercentage of reported deaths from “alcoholic”

cirrhosis(52.2percent)and the lowestpercent

of deaths from “unspecified”cirrhosis(21.6

percent).

Xl. SUICIDE

During 1950-69therewere twoappreciable

breaksin continuityin theassignmentofdeaths

to Suicide(ICDA Nos. E950-E959). me first

break occurredbetween1957 and 1958 withthe

introductionof the SeventhRevision.The comparabilityratiobetween the Sixthand Seventh

Revisionsis 1.03.3The secondbreakoccurred

between1967and 1968,withtheintroduction ofthe

EighthRevision.The comparabilityratiobetween

theseRevisionsis0.9472(appendix111).

Afteradjustingforthesetwobreaksincomparabilityof mortality.statistics, itisfoundthat

the totaldeathrateforSuicideturneddownward

during1950-57and thenincreasedslightlyduring

1958-69(tables2 and 3 andfigure1).

Age-adjusteddeath ratesfor Suicideshow

thatthisupturnresultedfrom appreciableincreasesinthedeathrateforthiscauseforthree

of the four color-sexgroups.For the fourth

group-the white male population-theage-adjustedrateremainedrelativelystableduringthe

1960’s,hutat a verymuch higherlevelthanthe

levelsfortheotherthreecolor-sexgroups(table

R).

Table R. Age-adjusted death rates for Suicide,by color and sex:united States,I!150-69

[For 1968 and 1969 rates are basedondeathsresigned tocategmynumbersE95C-E959 of the Eighth Rsvkion of the Int.rn.t/ona/

Cksification of Diseases, Adapted for Us. in the UnitedStates,adoptedin1965; for 1950-67 rates are basedondeathsassigned

to category numbers E963, E970-E979 of tbe Sixth andSeventhRevisions adopted, respectively, in 1948 and 1955. For method

of am adjustment. see annendix 11

Year

1969--------------

1968--------------

1967--------------

1966--------------

1965--------------

1964--------------

19631-------------

1962i-------------

1961--------------

1960--------------

1959--------------

1958--------------

1957--------------

1956--------------

.1955-------?------

1954--------------

1953--------------

1952--------------

1951--------------

19502.........--..

Total II White I

All other

&oth Male ‘e- Both Male ‘e- Both

sexes male sexes male sexes

Male ‘e- male

Rate per 100,000 population

11.3

11.0

11.1

11.1

11.4

11.0

11.3

11.0

10.5

10.6

10.5

10.5

9.6

9.7

9.9

9.9

9.8

1::;

11.0

I

16.7

16.4

16.4

16.7

16.9

16,6

17.0

16.8

16.4

16.6

16.6

16.8

15.3

15.5

15.7

16.0

15.7

15.3

15.8

17.3 I

6.5

6.1

6.3

::;

5.8

6.0

5.6

5.0

:;;

4.7

4.2

4.4

4..5

4.1

4.2

4.3

4.6

4.9

11.9

11.5

11.7

11.7

11.9

11.6

11.9

11.7

10.9

11.1

11.0

11.1

10.0

10.3

10.4

10.4

10.3

10.2

10.5

11.6

17.4

17.1

17.1

1.7.4

17.7

17.4

17.9

17.9

17.1

17.5

17.4

17.6

16.0

16.3

16.5

16.8

16.5

16.1

16.5

18.1

6.9

6.5

6.7

6.5

6.7

6.2

6.4

6.0

5.3

U

::2

4.6

4.8

4.3

!:2

;.;

.

10.2

9.3

9.7

;:?

H

;:;

8.7

9.1

8.4

8.1

7.1

7.1

7.8

::;

7.3

7.8

3.2

::;

3:0

2.6

2.7

2.7

2.2

2.3

2.3

*2.1

>YL.6

1.8

1.7

1.7

*1.4

*1.4

1.9

1.8

iF@xes “by color exclude data fox residents of New Jersey because this State did

not require reporting of the item for these years.

~Based on en~erated population adjusted for age bias in the Population of races

ot_h.er. than white.

NOTE: Asterisk indicates age-adjusted rates where more than half ofthe age-specific

rates are based on fewer than 20 deaths.

44
Table S. Death rates for suicide. by color, sex. bf.rthof cohort, and am at death: united states. 5-fear intervals d..im 1949.69

[R%cs Pcr 100,000 PO mm. m +wafiedagmior.six group. FCU 196; rams am bad am H&igp,d ,;c,mgmy..ndmsE950.E959 .f the E&I km. of,he l.,miw,d Ci+,tim ~,.,

ofIMaws,Adqm far U,. m he United Slates, adopted m 196S; for 1949, 1954, 1959, and 1964 rams am bed on death, assbgned to catepry “mnbm E963, E970.P.979 of the Srxth and

Smemh Rm+s&.s doped, r.,pmivdy, in 1948 and 1955]

color, sex, and age

at death

white, male

E-u wars— ----------------

2C-24 years ----------------

2!3-29 win. --... - . . . . . -------

SC-34 jear -------------------

35-.39 war-------------------

4C-44 ye . . ..------------—-.

45-49 mm------------------

50.54 Fws------------------

55-59 years ------------------

6M& years . . . . . . . . . ..-. -----

65- E&l .YeU1’s--------------....

70-’74 WM-------------------

75.79 Y.2nrs----------------

8C-84 year.-------------—----

All ‘+bm., male

B-B W-8------------------

20-24 war, -----------------

23.23 yee.re -----------------

30-s4 W,=- . . . . . . . ----------

35-39 W,,B ------------------

40-44 ve8rn ------------------

dE-43 bm-Li------------------

5*54 year, ------------------

55-59 year, ------------------

6*64 yet.m ------------

35.39 pm-------------------

7*7* Yee.1’s------------------

75-79 year -------------------

BO-E4 year -------------------

mite, femnle

E-19 Yee.l’, ------------------

W-24 yecxe ------------------

25-29 Warn ------------------

W-34 war-------------------

S5-39 ram------------------

4644 Yeun ------------------

G-49 Win, ------------------

5C-54 .veU,---.--..--..--—————

55-59 yem’B------------------

m-m rearm -----------------

3%63 be ....- . .. .. --------

7C-74 Yeal’, -----------------

75-79 war, ------------------

8*8L w-,------------------

.411 mm., final,

3.5-IS .vear, ------------------

2*2d We,------------------

25.29 years ------------------

3*34 pm,------------------

35-32 Year, ------------------

4D-44 Yec,rs ----------------

43.49 Vein...---.:----------

5C-54 Yeara -----------------

55.59 Fu....---------------

6C-64 year -----------------

ES-69 were ------------------

7D-74 Jearn-.. -----.----. +-

75-79 year, --------------

80-04 yearn ----------------

L3m

L954

v

9. c

5.8

2.6

3.2

L345.

s 49

s.6

17.0

k:

1.7

5.0

1.8

5.2

—

,34C

.944

—

5.,

la{

18..

3.(

m.:

L7. [

1.(

4.:

7.(

1.7

2.?

G. 4

.

3.1

u. #

s.:

18. Z

1.1

m. e

67

w 6

1. z

2. E

6.2

e.9

1.8

2.9

5.2

5.8

930

934

—

3. E

LD.:

L2. f

La. s

?0. 4

2.4

.0.1

.3.7

5.6

.6.7

1.5

2.4

5.4

8.3

L9

::

&. o

4.1

s. o

—

1925.

Isa

—

9.9

13. C

15.9

20. c

24.2

7.0

B. 3

I.& 1

la 4

14.9

3.7

4.2

5.9

10.9

I.& 4

2.4

3.5

3.5

4.5

4.6

—

W*

L924

l% 0

14.1

19.3

24.5

27.8

9.8

u. 7

u. 0

B. 1

u. 5

4.2

4.1

6. e

Lo, 9

Is. 1

2.0

2.0

2.9

3.7

4.6

A

Period of Wrth or cohort

,915-

.918

14.7

11.2

24.0

50.0

?9. 6

Lo. 1

u. 4

u. D

u. 1

L2. 8

6.0

5.6

8.2

La 2

L% 4

3.0

1.6

2.5

3.2

2.6

910.

914

?D. 9

?2. 7

?9. 8

53.8

53.4

m 0

9.7

E. 3

La 5

m 3

7.7

8.2

a ‘f

2.9

2.2

2:9

2.4

s. 0

.%6

2.4

J

—

9E9C9

—

!7. 3

m 5

56.2

19. s

n. 3

.0.6

.09

.4,6

.Ck7

Lo

8.9

7.8

::

1.4

2.2

1.9

2. !3

4.5

2.1

—

13mL20i

—

3L31

35.9

40.7

37.5

33.5

12.5

Il. 9

E. 7

14-2

1.4.0

9.9

8.8

m7

9.9

Lo. 6

2.2

3.9

.5. s

s. 4

2.7

_

—

L395

L3B9

—

37.5

38.4

4.3.1

37. a

37.7

u. 4

9.6

13.5

E. 4

15. s

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9.3

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1694

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43. I

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17.:

la 1

9.7

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9.7

7.7

2.5

3.3

3.8

1.4

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—

a8?-

#a9

—

k9. 6

L4.7

$7.4

L7. 7

;0. 6

D. 6

B. 8

u. .3

u.. 2

!4. 5

0.9

8.7

s. o

7.0

1.1

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—

880

BB4

il. 5

la z

;3. :

!5. s

5.8

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4.8

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—

B75

879

—

iO 7

i2. 6

i?. e

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63.0

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—

No!% : me ff.mtI’igure in each m, moving flnm l.lght to kft, 1. the deem! rate for 3.’349 ; tie second figure, ml’ 1254; the W rigul.e, for B52; the

fmrtb fiSIUW, for 196* and thefifthfl&me, for 3.269.

45
These surnma&fig&es (both the total and the

age-adjusted death rates for Suicide) result from

the offsetting of decreases in Suicide for persons

45 years and over by increases for the age groups

under 45 years. Increases at these younger ages

occurred for each of the four color-sex groups. ”

The data in table S (excluding the age group

85 years and over) show that the death rate for

Suicide for 1969 reached peaks for each of tbe

four color-sex groups as follows:

Color and sex

White *le--------

White female---Y--

All other male----

All other female--

Age in

years

80-84

40-44,50-54

:;-::

.

Peak

death

rate per

100,000

50.6

13.4

18.6

6.4

k should be emphasized that thes? peaks are

for data year 1969 only and therefore &e not

related to the peak for cohorts of persons born

in” given periods. That the suicide’ rates increase.

with advance in age (at least up to about ages

50-54 years) is indicated for almost all cohorts

(for each of the four color-sex groups) born since

about 1915 (table S). ,

Age-specific death rates for Suicide for the

three cohorts of white men horn during 1900-1904,

1895-99, and 1890-94 suggest that these older

cohorts may have experienced their highest rates

for Suicide (at about 55-59 and 60-64 years)

considerably before the end of the usual life

span. (The reader should be reminded that the

comparability ratio for the Seventh and Eighth

Revisions of 0.9472 for Suicide may be applicable

to the age-specific rates for 1964 and 1959 in

table S). Similarly for about three cohorts of

men ‘of races other than white (those born. in

1910-14, 1905-09, and 1900-1904) theage-specific

death rates in table S appear to indicate that

they also experienced their highest rate for

Suicide before the usual end of the life epan.

Based on data collected by the United Nations,

one country (Hungs@) has a total Suicide rate ihar

is about three times the rate for the United

States; and five countries (Czechoslovaki~; Austi%q Finlsn@ Swedem, Federal Republic of Germany, excluding West Berlin; and Denmark) have

rates that are about two times the rate for the

United States (table T).

The moderate upturn in the age-adjusted

Suicide rate between 1957 and 1969 reflects much

greater increases in mortality for this cause

for the other three color-sex groups than for the

white male group (table” R). But for none of the

other three groups did the level of mortality from

Suicide reach anywhere near the high level as that

for.the white male group.

The excess mortality from Suicide for the

total male population over that for the total female

population decreased between 1950 and 1969. For

1950 the male Suicide rate was 3.53 times tbe

corresponding female Suicide rate, hut by 1969

the male Suicide rate was down to 2.57 times the

female Suicide rate. This decrease in the sex

differeritial for Suicide between 1950 and 1969

reflects substantial decreases in this differeritial

for both white and races other than white.

,. The white population continues to have by far

higher Suicide rates than the p~puJation of races

other than white. But t-his color differential is

aiso ‘decreasing for 1950- the Suicide rate for

races other than white was only 41 percent of

the corresponding rate for the white population,

but by 1966 this percentage had reached 55. This

decrease in the color differential for Suicide

reflects decreases -in this differential for each

of the sex groups.

X11. CONGENITAL

ANOMALIES

During the period 1950-69 there were two

breaks in the continuity of the death rate for

Congenital anomalies (ICDA Nos. 740-759). The

first break resulted in tbe assignment of about

2 percent fewer deaths to this group of causes by

the Seventh Revision than had been assigned to it

by the Sixth Revieion.3 The comparability ratio

between the Seventh and Eighth Revisions is

1.0204 (appendix 111).

A more precise measure of the true decline

in mortality may be obtainable by limiting consideration to only’ those deaths occurring at ages

u-rider 1 year from Congenital anomalies. (Deaths

at ages tinder 1 year assigned to Congenital

I&

-.
Table T. Deaths rates for Suicide, by rank, selected countries, revision of International Classification of Diseases, and data year

[Deaths are those attributed to category numbers E963, E970-E979 of the Seventh Rwismn of the International Classification of

Diseases, 1955, and to category numbers E950-E959 of the Eighth Revision of the International Classification of Dkeases, 1965.

Rates are deaths per 100,00~ population]

I

Rank Country Rwi.sion

1 Ireland

2 Chile

3 Costa Rica

4 Greece

5 Guatemala

6 Italy

7 Israel

8 Trinidad and Tobago

9 Netherlands

10 Norway

11 Portugal

12 United Kingdom

13 Singapore

14 New Zealand

15 United States

16 Canada

17 Poland

18 Bulgaria

19 Australia

20 Japan

21 Belgium

22 France

23 Switzerland

24 Denmark

25 Federal Republic of Germany

(excluding West Berlin)

26 Sweden

27 Finland

28 Austria

29 Czechoslovakia

30 Hungary

lProvisional.

Eighth

Eighth

Seventh

Eighth

Seventh

Seventh

Seventh

Seventh

Eighth

Seventh

Seventh

Eighth

Eighth

Eighth

Eighth

Eighth

Seventh

Eighth

Eighth

Eighth

Seventh

Eighth

Seventh

Seventh

Seventh

Seventh

Seventh

Eighth

Seventh

Eighth

Data year

1969

1968

1967

1969

1968

1967

1969

1968

1969

1968

1969

1969

1969

1969

1968

1969

1969

1969

1969

196S

1968

1969

1968

1968

1967

1968

1968

1969

1967

1969

Rate

1$;

5.4

6.4

7.3

;:;

8.2

8.6

W

10.7

10.9

11.2

11.3

12.2

14.4

15.5

115.6

17.0

20.5

121.3

121.5

21.6

22.3

23.9

33.1

NOTE : This table is limited to soverei~ countries with “reliable’! :s:.~?ted POPuT

lations of 1 million or more and with “complete” counts of deaths by cause lists that

include Suicide, as shown in table 19 in the 1970 Demographic Yearbook of the United

Nations.

anomalieeconstituteahout 66 percentof total

number assignedtothiscause.)

On thebasisof thedualcodingstudy,using

deathsoccurringin 1966,itwaa foundthatan

estimated12,644infantdeathswere assignedby

the Eighth Revisionto Congenitalanomalies

(lCDANos.740-759)and12,200infantdeathswere

assignedby tbe SeventhRevisionto Congenital

malformations(lCD Nos. 750-759).2Use ofthe

comparabilityratio1.0364(obtainedby dividing

the12,644deathsfor1968by the12,200for1967)

to adjustthe 1967infantmortalityrateforCongenitalmalformations(330.4per 100,000live

births)to theleveltheratewouldhavereached

if the EighthRevisionhad been used for 1967,

resultsinan adjustedrateof342.3.Thedifference

between the 1968 rate (315.6per 100,000live

births)and the adjustedratefor 1967 is 26.7

deathsper 100,000livebirths,constituting areal

decreaeeof 7.8percentbetween1967and 1968

in the infantmortalityrate for thisgroup of

causes.
Measured over the entire” period 1950-69

infant mortality from Congenital anomalies was

downward-from 396.0 deaths per 100,000 live

births for 1950 to 314.1 deaths per 100,000 live

bfrths for 1969 (figure 2). This decline reflects

substantial lowefing of this mortality rate for

white infants (both male and female). For white

male infants the rate dropped from 438.5 deaths

per 100,000 live births for 1950 to 338.6 for 1969,

and for white female infants it dropped from

390.2 deaths per 100,000 live births for 1950 to

296.3 for 1969. For other infants, however, there

was little change in the death rate for Congenital

anomalies between 1950 and 1969: for male infants

in this group the rate for this cause increased

from 298.5 deaths per 100,000 live births for

1950 to 313.5 deaths for 1969, and for their

female counterparts this rate increased from

255.5 deaths per 100,000 live births to 275.2

(table 5).

For 1950 the death rate for Congenital malformations for other infants was only 67 percent

of the corresponding rate for white infants. But

by 1969 this percentage- had increased to 93.

The mortality sex ratio for this cause remained stable between 1950 and 1968, with both

years having” a ratio of 1.13. For 1969 total

infants and both white and other infants had

a mortality sex ratio for this cause of 1.14.

X111.HOMICIDE

There was no sizable disruption in the

comparability of statistics for Homicide (ICDA

Nos. E960-E978) either w~ththe introduction of the

Seventh Revision (with a comparability ratio of

1:00) 3 or with tbe introduction of the Eighth

Revision’ (&th a comparability ratio of 0.9969)

(appendix 111).

An examination of the death rates for Homicide during this century shows that both the total

rate end the age-adjusted rate increased from

1900 to about 1933. (For 1933 the total rate was

9.8 deaths per 100,000 and the age-adjusted rate

was 10.0 deaths per 100,000.) Then both rates

declined slowly through the 1940’s and. 1950’s.4

But the trend in the 1960’s was again clearly

upward—4.7 deaths per 100,000 for 1960 to 7.7

deaths for 1969 (tables 2 an~ 3 and figure 1).

Age-adjusted death rates for Homicide show

that a rise in these violent deaths occurred during

tbe 1960;s for each of the four color-sex groups

(table U). For men of races other than white

both the absolute and relative increases in the .

Homicide rate between 1960 (41.9 deaths per

100,000 population) and 1969 (72.4 deaths per

100,000 population) were higher than for each

of the other tltree color-sex groups. But since

1962 this color differential for Homicide has

again been upward. The color mortality ratio -

for this cause for 1969 (9.60) was, however,

stilI not so great as it was for 1950 (11.35).

The color differential by sex continued

through 1950-69 to be much higher for male persons than for femaIe persons. For both groups

the color differential for Homicfde was smaller

for 1969 thenfor 1950 (based on age-adjusted death

rates in table U).

For 1969 the sex differential for Homicide

was less than half the color differential for this

cause of death. The mortality sex ratio (based -

on age-adjusted death rates for Homicide in

table U) decreased from 3.36 for 1950 to 3.00

for 1958; but between 1958 and 1969 this ratio

again increased, reaching 3.97 for 1969. For

1969 white male persons had a Homicide rate

(age-adjusted) that was 3.14 times the corresponding rate for white female persons, and other

male persons had a Homicide rate that was 5.25

times, the corresponding rate for their female

counterparts.

The 1969 death rate for Homicide was high

for infants (4. 3 deaths per 100,000 population),

then dropped to 1.6 deaths for children 1-4

years, anti to 0.7 deaths for children 5-14 years.

Then the rate rose from 11.0 deaths for the age

group 15-24 years to a peak of 15.9 deaths for ‘

the age group 25-34 years. For succeeding age

groups the 1969 Homicide rate was downward.

The 1969 death rate for Homicide reached the

following peaks for each of the four color-sex

groups:

—. +.

Peak

Color and sex Age in death

years rate per

100,000

!4Q
Table U. Age-adjusted death rates for Homicide, by color and sex: United States,

1950-69

[For1968and1969ratesarebased on deathsassignedto categorynumbersE960-E978 of the EighthRevisionojthe International

Classificationo~Diseasss, Adaptedjor Usein the UnitedStates,adopted in 1965; for 1950-67 ratesarebasedon deaths assigned

to cate~ory numbersE964, E980-JS985of the Sixthand SeventhRevisionsadopted, respectively,in 1948 and 1955. For method

of age~dj&tment, seeappendix I]

Year

1969--------------

1968 --------------

1967 --------------

1966 --------------

1965 --------------

1964--------------

19631 -------------

1962 ~-------------

1961--------------

1960--------------

1959 --------------

1958 --------------

1957 --------------

1956 --------------

1955 --------------

1954 --------------

1953 --------------

1952 --------------

1951--------------

1950~-------------

Total

II I

Both

sexes I

Male ‘e- nmle

-

1

8.6

8.2

;:;

6.2

5.7

5.5

;:$

5.2

:::

4.9

2::

;:;

5.4

5.0

5.4

13.9

13.4

12.1

10.4

:::

::;

8.0

7.9

7.7

7.5

7.6

7.6

:::

M’

i::

. . ,

Nhite

Both

sexes

Male Female

Rate per 100,000 population

All other

EzlEIPE

1

:::

3.5

3.2

2.9

2.7

2.6

;::

2.6

H

;::

2.3

2.4

;:2

2::

4.3

4.2

3.9

3.4

3.2

3.0

2.9

2.9

::;

2.6

;:;

2.4

2.4

2.5

N

;::

6.6

6.5

;:;

4.8

4.3

4.2

;.;

3:9

3.8

3.6

3.5

3.5

3.5

3.6

::;

3.6

3.9

N

2.0

1.9

1.7

1.7

::!

1.6

1.5

1.5

1.4

1.4

1.3

1.3

1.4

1.3

1.3

1.4

1.4

41.3

39.6

36.9

32.4

30.1

27.9

26.7

26.5

25.0

25.7

25.8

25.3

25.9

26.5

25.7

27.4

27.4

29.9

27.5

29.5

72.4

68.9

62.7

54.8

50.7

47.1

44.8

44.4

41.5

41.9

42.3

41.6

43.1

43.2

42.6

46.2

46.5

50.4

45.3

49.1

13.8

13.6

14.0

12.4

11.7

10.6

10.5

10.3

10.1

11.2

*IO .7

10.5

10.3

11.3

*lo .3

*lo .3

*1O. 2

11.3

11.1

*11. 5

l)?igu-res by color exclude data for residents of New . rsey because ibis State did

not reqoire reporting of the item for these years.

~Based on enumerated population adlusted for age biaa in the DODUlatiOn Of races

other than white.

NOTE: Asterisk indicates age-adjusted rates where more than half of the age-specific

rates are based on fewer than 20 deaths.

Iti ehould be stressed, however, that this 1969

mortality pattern, with the peaking of the death

rate at agee 25-34 years, results from the

admixture of differing mortality experience for

cohorts of pereons born in successive years.

When the mortality experience for Homicide

for separate cohorts (with cohort defined aga~ as

a group of persons horn during the same 5-year

period) was examined over successive 5-year

fmervals, beginning with the ear~est year’ for

which data by age, color, and eex are available

(1914), it wae found that the death rate for Hom~”

icicle for 5-year age groups did not alwaya peak

either at ages 25-29 or 30-34 years (table W). The

pattern of peaking & various ages was, in fact,

very different from that for a nufiher of diseasee,

including tuberculosis, which peaks most frequently at ages 20-24 years of age and at other

times at ages 25-29 years (table 12 in Series 20,

No. 8ag ).

Consider, for example, the pattern of available death rates for Homicide for cohorts of

white men born in successive 5-year intervals

from 1865-69 through 1950-54 (table W). For the

four cohorts horn from 1895-99 through 1910-14,

it appears that the peaking of the death rate for
Table w. Death rates for Homicide, by color, sex, birth cohort, and age at death: United States, S-year intervals &urinc 1914-69

color, .ex, end

age at death

white> male

—.—— 20-24 yenl’s...—--------

25-29 years------—---

m-u yeal’s--------------

35-39 yenrs------—------

40-44 Yenrs--------—---

45-49 >Er6 ....-------—----

W-54 Yenl’s--——-——------

55-59 Yemrs—--—-— -----

En-w yeal’s----------------

65-69 .—— .remrs...---- --------

?0-74 YWS---------------

75-79 yeu’s----------——---

So-w Wiire----------------

All mer, male

M-M years--— ----------

20-24 yeara---—-— --------

25-29 years----------------

m-w Ye@.rs---------------

=-= Y=s-— -----------

40-44 yea.r,-----—————

45-49 -s-------— -------

50-54 bs-..— -----------

55-59 year9------------

60-64 years-------------

S5-69 years---------------

70-74 Years---------------

15-79 yeerB----—-——-————

m-e4 yeez5-------------

White, fmde

154.9 ye@.rs----— --------

20-24 yeers-----—---————

25-29 yeErs-— -----------

,0-s4 -s---..-.— ----------

3.5-39kam—----—-— ------

40-44 years----—-----------

45-49 Years-------------

50-54 years-------------

55-59 yenm-----------—---

60-34 Yee.rs-----------------

65-69 years-------— ------

70-74 year.-------—-------

7s79 year.---------——------

aO-@4 Veai-s----------------

All owl., female

ls-ls years----------------

ZC-Z4 yenrs——-—-——----

25-29 years------------

30-34 years--------------

3s39 yee.rs------------

40-44 years------------------

45-49 Ye@.Te-------------

50-% yeaH+-------------

55-59 yEar@-------------

W-64 yeP.l’s--——------

65-69 years--------—------

70-74 yam--—-— ------------

75-79 yenTs--—-----------

S0-84 yeaIs-------------

fada@colo,.scx PUP. For 1969 rat,,arebased.. deaths ass~ed teca,.gcry .umf,eu E960-E978ofA. Eglih Revis,om oftlmf”tem”flonakd ,cdIio”

J- lhited Stafq ,d+md in 1965;for1949,1954,ad 1959,“tcgmy numf,,ra S964,E980.E985ofthes,x,h,ndSmm,h F.evmns..dopted, r,fm+,,”

cmcewrynumbers 165-168 of ‘he F,fth Rev”,.”, .dop,ed m 1938, for 1934, cs.,.~,y ..rnbers 172-175 c.( the Fourth Rews, o”, ,dop,ed in 192% f.. 19i4

Iof d,. Third R,risi.”, ,dopkd i“ 1920; and for 1914 and 1919. UW,Y ,,wnbe,, 182.184 of AC Second F.ev,.m,, Aped m 1909. ?,,., to 1930 f@m!

1930 such &a& a.mntcd for 2 prcent of homicides for whm rm.,with a h@ of 4 percent at w 2w4pars, md for 2 perccnf for all c&r mm, wxh

—

350-

354

4.9

59.7

1.9

U.o

—

145- .w40-

349 1944

2.9 2.7

LO.9 6.4

12 .C

Y3.a 23.2

!6 .1 75.1

U!a .1

1.4 1.C

3.0 1.1

3.C

7.7 8.5

21.7 15.5

2S.E

.

&-

339

2.3

6.0

7.2

11.o

28.2

73.1

90.2

2+9.1

1.3

1.8

2.5

3.5

7.2

16. E

21.E

28.0

—

930-

934

—

2.6

5.8

5..?

;::

=.3

75.6

83.3

89.0

29.0

1.1

1.6

2.5

2.s

2.5

9.1

3.6. c

21.6

19.2

25.0

F.erIc.l of bZrth of cohort

1

925- l.920-

929 X+24

2.5 ,..

5.3 5.6

5.6 6.2

5.1

:: 5.7

9.5 5.9

7.7

I

35.e 39.3

B7 .1 84.8

97.1 102.4

85.2 92.6

9a.1 16.1

16.7 15.5

SO.2

0.8 1.0

1.7 1.3

1.9 1.9

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2.8

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2.2

7.8 14.8

24.5 22.1

22.0 22 .s

24.2 3.9:5

20.6 2.I..7

22.6 M .1

17.1

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U.6

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14.5

14.6

14.1

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3.3

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130.1

L16.2

70.8

42.0

4X.8

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22,4

17.3

10.2

5.3

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3.7

3.8

2.6

1.9

0.9

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0.8

1.1

1.4

1.4

21.9

25.3

28.8

23.2

14.2

8.5

4.2

6.1

1.3

3.4

3.6

4.0

ea5-

599

—

15.4

1s.7

14.3

13.0

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4.6

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2.6

4.3

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66.9

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10.9 II ,1 lZ.Z

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56.6 59. s 55.3

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1.6 1.7 1,6

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1.0 1.Z 1.s

1.7 1.7 0,9

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z ,3

2.6

XW33: ~ first fiwre in each -, mmlne, h left t. rieht, %8 the death rate Z=.r 1969; the second ff.wre> for 1964; the third f imm, for 1959, et. a

50
Homicide occurred, in general, at successively

younger age groups: for example, the highest

death rate for Homicide for white men born in

1895-99 shown in table W occurred for the age

group 35-39 years; the highest death rate for this

cause for white men born in the next 5-year

interval (1900-1904) occurred for the next youngest age group (30-34 years); and the pattern of

highest rates at successively younger age groups

continued up to the cohort born in 1910-14. For

this latter cohort the death rate for Homicide is

shown for the age group 20-24 years (with a rate

of 12.8 deaths per 100,000) (table W). The pattern

that may be emerging from the recorded data for

the four cohorts of white men born between 1895-99

and 1910-14 is that for each cohort the death

rate for Homicide tends to peak at the oldest

age reached by the cohort in the period of upturn

in mortality (the period’ of upturn it will he

remembered ended about 1933-34).

For the cohort born in 1880-84 and for those

born prior to those years, this pattern of peaking

at the oldest age reached by the,cohort as of 1934

is less regular. This may be due in part to the

fact that mortality data for these earlier years

are less reliable tbsn for later years. But in any

event, even for each of these cohorts the death

rate reached at the end of the period of upturn

in mortality from Homicide (1934) was about

twice the death rate for the succeeding age group,

and, moreover, the death rate continued to

decline throughout the remaining years lived by

these cohorts. These remaining years, it Ml be

recalled, were lived in a period of downturn in

mortality from Homicide.

As indicated earlier the cohort of white men

born in 1895-99 lived about their first 40 years

in a period of rising mortality from Homicide.

Their peak mortality occurred for the age group

35-39 years. On the other hand the cohort born

in 1910-14 lived only about their first 20 years in

a period of rising mortality from Homicide, and

their peak mortality occurred for a much younger

age group-+t ages 20-24 years (with a rate of

12.8 deaths per 100,000).

Available data show that, in general, a rise

in the death rate for Homicide for any given

color-sex group reflects rises in mortality from

this &use for almost every age group for that

CoI&r-sex group, and conversely a drop in

mortality for any given color-sex group reflects

decreases for almost every age group for tha~

color-sex group.

The following table showa tb.e changes in the

specified death. rates for Homicide for the white

male population between the years 1933 and 1959

(when the trend waa downward):

Age 1959 1933

I

All ages -------------- L&ll_-J?2z

15-19

20-24

25-29

30-34

35-39

4.0-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

go -84

years ---------------- -2.7

years:--------------- ;.;

years ---------------- .

years ----------------

years ---------------- ;::

years ---------------- 5.1

years ---------------- 5.3

years ---------------- :.;

years ---------------- .

years ---------------- 4.5

years ---------------- 3.8

years ---------------- 3.0

years ---------------- 3.5

years ---------------- 2.1

—4: 9

12.4

16.7

15.9

16.3

15.6

;;. $

11:1.

9.8

7.7

;::

7.4

The corresponding levels of mortality from Homicide for the male population of races other than

white are higher at every age than tbe corresponding rates shown above for the white male

population. 4

The rise in the Homicide rate for the elderly

in the population during the 19601s, together with

tbe rise for all other age groups, shows as

commented upon by many persons studying the

problem, including Coombs#O that “no age group

is spared in the on-going upturn in mortality

from Homicide.

The period of the first upturn covered by

available data lasted only from 1914 through 1933.

If the pattern of peaking that occurred around

1933-34 occurs again and if. the present period of

upturn in the death rate for Homicide continues

through 1974, one may expect that the peak ages

for Homicide mortality in 1974 for all birth

cohorts will occur in the next higher age group

than in 1969. For example, the cohort of men of

races other than white who were born in 1935-39

may be expected to have a death rate for Homicide

in 1974 (when they are at ages 35-39 years)

51
that will be higher then their death rate of 138.7

per 100,000, in 1969, when they were in the age

group 30-34 years.

XIV. NEPHRITIS AND NEPHROSIS

Between 1950 and 1967 the number of deaths

attributed to Nephritis and nephrosis (ICD Nos.

590-594 of the Sixth and Seventh Revisions)

dropped from 28,147 to 10,941 (table 3). Mortality

from this cause continued to fall between 1967

and 1968, from 10,941 to 9,311 deaths. Part ofthis reduction of 14.9 percent between these 2

years, however, is attributable to the introduction

of the Eighth Revision.

The dual coding study of deaths occurring in

1966 showed that en estimated 10,227 deaths were

assigned to Nephritis and nephrosis (ICDANos.

580-584),whereas the number assigned by the

Seventh. Revision to this group of causes was

11,540 deaths,z giving a comparability ratio of

only 0.8860 (appendix III). If the 10,941 deaths

in 1967 were decreased by applying this factor,

the adjusted figures for 1967 would be 9,696,

a reduction between 1967 and 1968 of only 4.0

percent.

Because of the increase in the population,

a more precise measure of the amount of reduction in mortality may be obtained by applying the

comparability ratio to the death rate rather than

Table Y. Age-adjusted death rates for Nephritis and nephrosk, by color and sex: United

States, 1950-69

[For 1968 and 1969 rates are based on deaths assigned to category numbers 580-584 of the Eighth Revision of fhe Inf.rnafional

Classification of Diseases, Adapfed for Use in theUnited Stats-$ adoptedin 1965; for 1950-67 rates are based on deaths assigned

to category numbers 590-594 of the Sith and seventh Revisions adopted, respectively, in 1948 and 1955. For method of age adjustment, ;ee appendix1]

Year

1969--------------

1968--------------

1967--------------

1966---------------

1965--------------

--------------

:;%1 -------------

19621-------------

1961--------------

1960--------------

1959--------------

1958--------------

1957--------------

1956--------------

1955--------------

1954--------------

1953--------------

1952--------------

1951--------------

19509-------------

. . .

Total White All other

Both Male ‘e- Both Male ‘e- Both

sexes male sexes male sexes

Male male ‘e3.9 4.6

3.9 4.7

4.7 5.7

5.0 6.0

5.2

H

;:: 6.9

6.0 7.2

H ;:;

6.9 8.1

U 1:::

9.1 10.3

9.6 10.9

10.6 12.0

11.9 13.4

13.4 15.3

14.7 16.4

16.6 18.6

Rate per 100,000 population

3.2 3.1

3.2 3.1

3.8

4.0 :::

4.3 4.4

::;” :::

;.;

5:1

5.5 5:6

5.8 5.8

6.8 6.7

7.6 7.5

7.9 7.8

8.3 8.3

1%2 1::;

11.8 11.4

13.3 12.7

14.9 14.4

I I II

3.8

:::

5.1

5.4

:::

.

H

6.9

8.0

8.8

9.0

9.7

10.4

11.8

1“3.3

14.4

16.3

2.5 10.9

2.4 11.1

2.9 12.8

3.3 13.3

3.4 13.7

3.7 14.3

14.9

i:; 14.9

4.2 15.1

4.5 16.5

4.7 17.7

5.6 20.1

6.3 22.1

6.6 23.2

6.9 23.6

7.9 25.7

8.8 29.9

35.7

1?:: 38.3

12.5 42.9

12.5

12.5

14.3

15.5

15.7

15.9

:;.;

16:9

18.4

19.3

21.6

23.2

24.5

24.2

28.3

31.1

37.7

39.4

44.5

1::;

11.7

11.4

12.0

12.9

13.0

13.4

13.3

14.8

16.3

18.8

21.2

22.0

22.9

23.4

28.8

33.8

37.2

41.3

lFigUes by color exclude data for reside?ts of New Jersey because this State did

not require reporting of the item for these years.

2Based on enumerated population adjusted fOr age bias in the population of races

other than white.

52
to the number of deaths. Using the adjusted death

rate for 1967 (4.9 deaths per 100,OOO)gives a

reduction between 1967 ?nd 1968 of 4.1 percent.

The total death rate for Nephritis and nephrosis remained the same for 1969 as for 1968

(4.7 deaths per 100,000).

The age-adjusted death rate for Nephritis

and nephroais also shows a steep decline-from

16.6 deaths per 100,000 for 1950 to 3.9 for 1969

(table Y and figure 1). This downturn for the

age-adjusted death rate for the total population

reflects reductions in mortality from this cause

for each of the four color-sex groups. Moreover,

each of the color-sex groups experienced reductions in mortality from this cause for every age

group.

For 1969 the mortality color ratio for

Nephritis and nephrosis (the age-adjusted death

rate for 1969 for the population of races other

than white over the corresponding rate for the

white population) was 3.52. The trend of this color

ratio’ was upward during 1950-69, increasing from

2.98 for 1950.

The mortality sex ratio for Nephritis and

nephrosis for 1969 (the age-adjusted death rate

for 1969 for the male population over ‘the corresponding rate for the female population) was much

lower than the color ratio. The sex ratio also

increased between 1950 and 1969, from 1.25 to

1.44.

The color ratio for mortality from Nephritis

and nepbrosis for the male population increased

from 2.73 for 1950 to 3.29 for 1969; and the

corresponding colbr ratio for tbe female population also increased-from 3.30 for 1950 to 3.84

for 1969. The sex ratio for mortality from this

cause was lower for both white and other populations than was the corresponding color ratiq

but for both groups the mortality sex ratio

was somewhat upward—increasing for the white

population from 1.30 for 1950 to 1.52 for 1969

and increasing for the other population from 1.08

for 1950 to 1.30 for 1969.

XV. PEPTIC ULCER

Despite the fact that the mortality trend for

Peptic ulcer (ICDA Nos. 531-533) moved slowly

downward during the 1960tst this disease moved

up from the 17th leading cause of death for 1967”

to the 14th for 1968 (with 9,460 deaths, a rate

of 4.7 deaths per 100,000 population). Then this

disease moved down again to the 15th leading

cause for 1969 (with 9,312 deaths, giving a rate

of 4.6 deaths per 100,000).

One reason for the move from 17th to 14th

place for Peptic ulcer between 1967 and 1968

was (as described in appendix I) that the rules

for ranking causes of death were changed between

1967 and 1968.

Another reason that Peptic ulcer moved up

to the 14th place for 1968 (despite the fact

that the rate was declfning) is that the following

two causes, whose nearly comparable causes

according to the Seventh Revision ranked higher

in 1967 than did Peptic ulcer, had substantial

reductions in the number of deaths assigned-to

them by the Eighth Revision from the number

that had been assigned for 1967 to their nearly

comparable Seventh Revision titles’ ‘Nephritis and

nephrosis” (ICD NOS. 580-584) and “Hypertensive disease” (ICD Nos. 400, 401, 403). The

ranks for 1968 for these two causes were,

respectively, only 16 and 17.

Part of the reported higher level of the death

rate for Peptic ulcer for 1958-63 and part of

the downturn for this rate during the latter half

‘ of the 1960~s (table 2 and figure 1) are attributable

to changes fn coding procedures for selecting the

underlying cause of death from the medical entities

on the death certificate.

The comparability ratio for Ulcer of stomach

and duodenum (ICD Nos. 540, 541) for the Sixth

and Seventh Revisions was 1.01.3

A reduction in the assignments of death to

the Eighth Revision title “Peptic ulcer” (ICDA

Nos. 531-533) from the number that had been

assigned to the comparable cause, Ulcer of

stomach and duodenum (ICD Nos. 540, 541), resulted in a comparability ratio of 0.9856 (appendix

III).

Both multiple cause and prevalence data

indicate that this disease is wider spread in the

population than mortality statistics alone may lead

one to believe. Gn the basis of the study of

multiple causes of death fox 1955, while the group

title Ilulcer of stomach and duodenum” (ICD

Nos. 540, 541) was selected as the underlying

cause of 9,784 deati,a, this disease was entered

16,413 times on the death certificates for that

year.li
Surveys of the prevalence of Peptic ulcer in

the United States ‘conducted by the National

Center for Health Statistics show thatthis disease

is quite common as reported in health interviews.

Following are unpublished data from the Health

Interview Survey, NCHS, showing for four periods

the prevalence of Peptic ulcer, by age, for the

civilian noninstitutionalized population.

I

Prevalence of Peptic ulcers

in thousands

July-Dee ember 1968--

Jdy 1965-

‘June 1967-

JUIY 1963-

June 1965-

JUIY 1961-

June 1963-

3,360

3,752

3,499

3,079

1,481

1,672

1,524

1,382

1,344 535

1,516 ’564

1>471 505

1,284 413

I

Prevalence of Peptic ulcers

per 100 persons

July -Decem-”

ber 1968--

July-1965 -

June 1967-

July 1963-

June 1965-

July 1961-

June 1963-S

1.7

2.0

1.9

.1.7

:

1.1

1.2

1.2

1.1

3.3 2.9

3.9 3.2

3.9 2.9

3.5 2.5

It should be mentioned that chronic conditions

reported inhousehold interviews may redescribed

as those of which the respondent is aware and is

willing to report to the interviewer. Thus these

estimates may differ from estimates based on

medical records or clinical examinations.

The above figures indicate that the prevalence

of this diseaie rose from July 1961 through June

1967. But for July-December 1968 tbeprevalence

of Peptic ulcer was lower (3,360,000 cases)

than it had been for the previous 4 years.

Estimates for July-December 1968, however,

may not be so reliable as forthe prior periods”

because of the smaller size of the sample.

The age-adjusted death rate for Peptic ulcer

(ICDA Nos. 531-533) declined, as did the total

death rate for this cause, during most of the

1960’s (table Z and figure l).l’bi sdownturnfor

the total population reflects declines in the ageadjusted death rates for both the white male and

the white female populations and for the male

population of races other than white. The frequencies of deaths from this cause for the female

population of races other than white are too small

for some years to give a reliable indication of

the mortality trend forti.is group.

Each of the color-sex groups experienced

reductions immortality from this cause for most

age groups during the 1960?s. Deaths from

Peptic ulcer occur much more frequently at ages

45 years and over (with 8,661 deaths for 1969) ‘

than at ages under 45years(with 651 deaths for

1969).

For 1969 the mortality sexratio for Peptic

ulcer (the age-adjusted death rate for 1969 for

the male population over the corresponding rate

for tbefemale population) was2.70. The trend of

this sex ratio was downward during 1950-69,

decreasing from 4.61 for 1950 (based on ageadjusted death rates shown in table Z). The color

ratio for Peptic ulcer (theage-adjusted death rate

for 1969 for the population of races other than

white over the corresponding rate for the white

population) was 1.14. The trend for this color ratio

was slightly upward during 1950-69, increasing

from 1.04 for 1950.

The color differential for the male population

was also upward (from 0.98 for 1950 to 1.11)

for 1969, while the color differential for the

female population was downward (from 1.29 for

1950 to 1.15) for 1969.

The gap between the excess death rate for

Peptic ulcer for the white male population and the

corresponding rate for the white female population

narrowed substantially between L950 and 1969;

the sex ratio for this cause of death for the white

population decreased from 4.82 for 1950 to 2.70

for 1969.

There was also a sizable reduction in the

sex ratio for this death rate for the population of

races other than white—from 3.64 for 1950 to

2.61 for 1969.

54
Table Z. Age-adjusted death rates for ;;;~9ulcer, by color and sex: United States,

-

[For 1968and 1969 rates are based on daths assigned to category numbers 531-533 of the Eighth Revision of the Intematimz.d

Ck-ifcation of Diseases, Adapted for Use in the C6tited States, adopted in 1965; for 1950-67 rates are based on deaths assigned

to category numbers 540-541 of the Sixth and Seventh Revtilons adopted, respectively, in 1948 and 1955. For method of age adjustment, see appendix 1]

I

Year

1969--------------

1968--------------

1967--------------

1966--------------

1965--------------

1964--------------

;;;;:......-------

-------------

1961--------------

1960--------------

1959--------------

1958--------------

1957--------------

1956--------------

1955--------------

1954--------------

1953--------------

1952--------------

1951--------------

1950~-------------

Both

sexes

3.6

3.7

2:;

M

5.2

5.4

5.2

:::

5.3

5.1

5.1

H

5.1

5.0

5.0

5.0

Total

Male

5.4

5.7

6.1

6.5

6.8

;::

8.5

8.3

;::

8.4

8.3

8.4

8.4

8.4

8.6

8.3

8.3

8.3

Female

Rate per 100,000 population

2.0

2.1

2.1

2.2

2.2

M

2.6

2.5

2.4

2.3

2.4

2.3

2.1

2.1

2.0

1.9

1.8

1.8

1.8

3.5

3.6

H

4.3

4.6

5.2

5.3

H

5.0

;::

5.1

5.1

5.1

5.1

5.0

;::

22

6.0

6.4

6.8

;::

8.4

8.3

8.5

8.1

8.5

8.4

8.5

8.4

8.5

8.6

8.4

8.3

8.2

2.0

2.0

2.1

2.2

2.2

2.3

2.5

2.6

2.4

2.4

H

2.3

2.1

2.0

1.9

1.8

1.8

H

4.0

4.4

4.3

4.7

4.4

;:!

5.3

5.2

i:!

:::

4.6

4.8

4.9

:::

4.8

5.1

6.0

6.8

6.5

7.3

6.7

M

8.3

7.8

7.8

7.4

;:;

6.8

7.2

7.4

;:;

HI

Female

2.3

2.3

2.3

2.5

:::

*2.8

2.6

2.8

*2.4

2.2

2.9

2.2

;;;

*2.5

*2.3

*1.9

*2.5

*2.2

lFi~res by color exclude data for residents of New Jersey because this State did

not ?equire reporting of the item for these years.

ZBased on enumerated population adjusted for age bias in the pOPUlatiOn of races

other than white. \

NOTE: Asterisk indicates age-adjusted rates where more than half of the age-specific

rates are based on fewer than 20 deaths.

_s5.
REFERENCES

lNational Centw for Health Statistics: Mortality trends:

age, color, and sex, United States, 1950-69. vitalmd Health

.stafistics. %ties 20-NO- 15. DHEW Pub. No. (HRA) 74-1852.

Health Resources Administration. Washington. U.S. Govenmem Printing Office, Nw. 1973.

2Natio~af ~nter for Heafth” Statistics: Comparab&ty of

mortality statistics for the Seventh and E@th Revisbs of the

International Classification of Diseases: United States. V?tal

and Health Statistics. Series 2. Health Resources Admini*

tration, DHEW, RockviUe, Md. To be published.

3Nationaf Center for Heaftb Statistic* Comparabfity of

mortality statistics for the Siith and Seventh Revisions, United

States, 1958, by M. M. Faust and A. B. Dobmn. V&[

Statisfi.s-Special Repoti, VOL 51, No. 4. public Health Service. Wasbii6n, D.C., Mar. 1965.

4NatiIxMd Office of Vital Statistics: Death rates by age,

race, and sex, United States, 190 G1953, selected causes. Vital

Statistics-Special Reports, Vol. 43, Nos. 1-31. Public Health

Service. Wasbiigton, D.C., Oct. 1956.

5 NatioIIaI Center for Health Statistics: Characteristics of

persons with diabetes, United States, July 1964-June 1965.

V7fd ond Health Statistics. PHS Pub. No. 1000-Sties 1O-NO.

40. Public Health Service. Washington. U.S. Government Printing Office, Oct. 1967.

6Heakh Interview Survey, National Center for Health

Statistics: Prevalence of diabetes by race and sex: United

States, July 196&June 1967. Unpublished data.

7National Center for Heahh Statistics Diabetes melks

mortality in the United States: 1950-67. Vital and Heafth Sfa.

fistics. PHS Pub. No. 1000-Series 20-No. 10. Pubfic Health

Se+e. Washington. U.S. Government Printing Office, July

1971.

8National Center for Health Statistics: I.eadmg components of upturn in mortality. for men: United States,

195>67. Vital and Healfk Statistics. Series 20-No. 11. DHPW

Pub. No. (HSM) 72-1008. Health Services and Mental Health

Administration. Washington. U.S. Government Printing Office,

Sept. 19~1.

9Nationa( Center for Heakb Statistics: Mortality from

selected causes by maritaf status, United States–Part A. Vifaf

and Healfk Statistics. PHS Pub. No. 1000-Series 20-No. 8*.

pubfic Health Service. Washington. U.S. Government Priming

Office, Dec. 1970.

10coombs, o.: It,s Blacks Who Must Stop Crime, New

York &aziie, Nov. 20, 1972.

11Nafiomd Center for Health Statistic~ Vital Sfafistics of

fhe United Sfafes, 1955 .%tpple”menf, Mortality Data, Multiple

CUuses ofDeafk. Public Heafth Setvice. Washington. U.S. Government Printing Office, 1965.

5.!5.
- LIST OF DETAILED TABLES

Page

Table 1. Deaths and death rates for 6Y selected causes: United States, 1969-------------- 59

2. Death rates for 48 selected causes: United States, 1950-69---------------------- 60

3. Deaths for 48 selected causes: United States, 1950-69--------------------------- 62

4. Deaths and death rates for Certain causes of mortality in early infancy, and estimsted number of live births, by color and sex: United States, 1950-69--------- 64

5. Deaths and death rates for Congenital anomalies, and estimated number of live

births, by color and sex: United States, 1950-69-------------------------------- 66

d
Table 1. Deaths and death rates for 69 selectedcauses:United States,1969

-100,000p.pulatmn Numbers aNcr causes of dealb arc category numbers of lbc Sigh!h Rcvkmn of the Imtcm.ti.nal Classik,tion of DIsmscs, Adapted,19651

C?”., of death

All Ca"S~S -----------------------------------------------------------------------------------

Ba.ilhw Ws.nf=w and aebtisti-----------------------------------------------------------00&,0o6

Enteritisand c.kherdtarrhealdiseases----..------------.----------...---.--.-------------.Oo8,oog

‘I’ubercul.sis? a11 fO~S---------------------------------------S-----------------------------010-O19

‘zubercul.s,s.f respiratorysysta----------------------------------------------.------.--olo-ol2

Tubcrculwis, other foms-----------------------------------------------.-.----.-.---.----0l~-olg

Whoopingc.ugh--------------------------------------7------------.------.----------------.------o33

StrePt.x.accalsore throatand scarletfewer----------.--..----.----.------.-.-.--------------.--o3~

lfeninwco==l ~fe.ti~s-----------------------------------------------------------------------.o36

Septic~a--------------------------------------------------------------------------------------o38

A=te e0li.myeliris-----------------------------,-------------------------------------------o4o-o&3

Measles---------.---------------------------------------------------------.--..-.----...-----.--0~~

Sy hilis and its seq"elae---------.....-.-------------------. -.-..---.-------.....---.--.---• 9O-O97

otE.r infectiveand P.r~5itiC disease.-----------------------------------------Rmi"der of 000-136

ilali ant ne.plasms,includingneoplasmsof lymphaticand bemat.p.ietictissues-------------140-2og

MS‘F’is”$+”t“eOP1asw Of bnccalcavity and pti_------------------.--.-...---.-.--..-.-.--I4O-1&9

Malignantne.aplasu,sOf digestive.rgansand petiConm.---------------------.----.--------l5O-l59

Malignant“MPlaSMS Of respiratorySySt~.-.--.-.-..--.--------------------------_--------l6o-l63

Mali@ant Qeopla.nof hreasc------------------------------------------------------------------l74 Malignantneoplasm of genitalOrganS--------------------.-.--.--------------_------------I~O-L~7

Malistra”tneqlasn!sof urinay organs----------------------------------------------------1S8,1S9

Malignantne.plas!ns.afall .x er and unspecifiedsiEes------.-------.----....-.--_I7o_I73.190-lw

L=k~*a-----------------------------------------------------------------------.----------zM-2o7

Other neoplasm. of I.pmphaticand hematopoietictissues----------------------------200-203,8209

Benignneoplasm and neqlasms of unspecifiedMture-.----------.-------.-------------------2 lO-23g

Diabetesme11itus-------------------------------------------------------------------------------25o

AVfUmillOS.S a“d othernutritionald@ficiencies-----.----.----------------------------------26o-269

An&s--------------- ....--------------.-------..-.-----.--...-......-------....--.---.-.--Z~D-283

M-ingitis----------.....-.------------------..------------.--.----------.-........-------------32o

fJ@oz ca~iovas.=ler disea.es---------------------------------------------------------------39O-448

Diseasesof heart---------------------------------------------------------39O-398,4O2,4O4,4lO-429

Active rhmtic fev,rand cbr.nicrheumaticheart disease------------------------------390-398

Rppertensiveheart disease--------------. ---.--------------..---..--.-.--.....-.------------402

Hypertensiveheart and renal dis.a.e----------------..--....-.-..-.-.---------------.-------4o4

Isch.=fcheart disease-----------------------------------------------------------------41o-413

Acute a+meardialinfarctim------------.-----.---------.---...--------.....--.....-.--.---4lo

Other acute and stibactiteform. .f is.bemic heart disease--..------------.-----------.-----4l1

Chroniciachemicheart dis~se-------.------------------------------------.--..---.-.-----4l2

@i= pect0tis--------------------------------------------------------------------------4l3

Chr.nicdiseaseof e“docardiwnand other ray.cardialinsufficiency-----------------------424,428

All Other fornlsof heart disease------.---.---------------------------------42O-&23 ,425-427,42$!

Byp..tensi~------------------------------F-------------------------------------------400,401,403

Cerebrov$wwtirdisea.es------------------------------------------------------------------430-438

Cerebralh.rno=haEe----------------------------------------------------------------------.--431

Cer.bralthrnrnb.sis-------------------------------------------------.-----------------------433

cerebral~bolism---------------------------------------------------------------------------434

All other cerebrowascu2ardiseases----------------------------------------------43O,432,435-438

Artcrioscler.sis------------------.-------------------------------.---------.-.------------.--440

Other diseasesof arteries, arterioles,and .apillaries------------- .-----..--.--.-.------til-Ms

A.”te bronchitisand br.nchi.1itis--------------...--------.----.---__--------.--------------.--466

lnflue=a and Pneu~Uia-------------------------------------------------------------47O-474,48O-486

Influe=a---------------------------------------------------------------------------------47o-47&

pneu~nia---------------------------------------------------------------------------------480-486

BrOn=biti.,emphysew and asti-----------------------------------------------------------49o-493

~xo.lc and unwQ1ifiiedbrnnchitis--------------------------------------------------------490,491

Emphysema-------------------------------------------------------------------------------------

Asthma-------------------------------......-..-------------.-...-.---.------------_-_----.---~;;

PepticU1c-----------------.------------.......---.------.---..-...--...-..-----_----------53 I-533

Appendicitis------------------y7.-......---.-------.-.-----.---------------------.-----------54o-543

Hernia and intestinalObszrWtX~------------....----.--------..--.-..-.-----..--------.53o.553.360

cirrhosisof 1iver-----------------------------.------------..-.-.---.--...-----..---.-..--.----STI

Ch.lelitbia.is,.h.lecystitisand cb.langitis---------...-.-.------.-....-.-.--.....--------5T4.STE,

Nephritisand nepbr.si.--------------------------------------------:------------------------58o-584

Acnte nephritisa“d nephr.ti.s~drme---.-.-.--.--.....-..--.---..-------------.---------58o.581

skr.n~.a-d unqualifiednephritisand renal sclex0sis-------------------------------------5SZ-584

Infectionsof kidney-------------------------------------------------------------.-.------------~go

WPer@asia .f prostate----.---.------------------------------------.--------..-----...---------6oo

Complicationsof pregnancy,childbirth,a“d the p"eqerim----------------------------------630-678

Ab.rtians-------------.------.--------.-.--...---.--------.--.-.-.------------------- .---.64o-64~

Other complicationsof pregnancy,childbirth,a“d the ~eqerium------------------63O-639,63o-678

c-s~tal an~l%e.------------------------------------------------------------------------740-759

Certaincausesof mortalityin early infancy---------------------------- 760-769.2,769.4-772,774-778

Birth injury,dtfficulclabor,and ocher a“c.xic-“d hyp.xicc.”ditio”s------------764-768,772,776

Other CaUSESOf ~Ortalityillearly infaacy-----------------. ---------.-------Rmind,r of 760-778

W@= and iii-definedc.nditt0n.---------------------------------------------------------78o-796

All other diseeses-----------------..----------------.---.-.--..--..------.-.---.---..-.---Re,idua1

Accidents-----------------------------------------.----------------.-----..---------------E800-Eg4g

MOtOC vehiclea.cidents-----------------------------------------------------------------E8lO-E823

All otbec accident,-----------------------..-----------------------------.-...E8OO-ESO7,E825-Eg4g

S"icide--------------------.--.--.---------------------_---------.....-....-.-----.-.-----E93o-E95g

H0ticidC----------------------------------------------------------------------------------E960-E978

Other exteml aUSeS---------------------------------------------------------------------E9S0-E999

Number

1,921,99(

z,6?

5,56;

4,49:

1,07!

1:

41

3,;:

1:

41

SC

4,1L~

323,092

7,55:

93,98f

66,036

29,0s?

41,00f

14,89;

37,82!

14,45C

18,252

4,67i

38,541

2,534

3,318

1,719

1,286

68,365

3,971

62,394

31,144

5,843

22,939

2,362

9,312

1,407

7,500

29,866

4,262

9,417

1,392

8,025

8,750

2,499

801

132

669

17,00S

43,171

21,939

21,232

26,160

97,982

116,385

55,791

60,594

22,364

15,477

5,L47

Rate

0.0

0.0

0.4

::;

160.0

3.7

46.5

32.7

L4.4

20.3

7.4

1S.7

7.2

9.0

2.3

19.1

1.3

1.6

0.9

501.7

366.1

z::

3.6

331.7

179.1

15:::

0.1

3.7

15.0

4.2

102.6

21.4

2:.;

51:6

16.4

12.4

0.6

33.9

3:::

4.3

1.2

0.4

0.1

0.3

2?::

10.9

10.5

13.0

4s.5

57.6

27.6

30.0

11.1

7.7

2.5

59
Table 2. Death rates for 48 selected cases: Cnited states. 1950-69

. [Rat., W. 100.000.omladom Numbers mfluaum ofdcah me ciucww mmb.xs d ,hcE;,kt6Ro,iw,

in1965.Far196i&d 1969rala= basedm,deathstip,d ,.th;x“fi-~h,h Rc,kio.<.+

cnfiltctisims. admtcd.resmcmdv.in1942and1955.- catemmv.umbm areshownk

l!ause m?death S.@ .tqory — e Ecghth F.evision

1 All .Mls.s-------—------—-----——---------—---

2 Ihteritia ad other diarrhealtiseBes--..-.------008,m9

3 Itbenwlosis,e.11fmms-_-----—-------------------Ol0-0l9

4 %mhi~. ~ it..ewek-—---—---—-------------o=97

5 otherfnr.ti,eallapl’aaitscdfa.se.---wlaina.m? Ooo-x

6 Ma3&mllt neaplnsms, ~ ~a .f~i. ma

hcmtoroietictissues—------—--—-------14O-209

=liW=Ut =OPkSMS d ~~1 CWIW M ghawnx---1414949

: !fSlimar.tneomams e dizesti.Orgensma

WXt—--.-------——-.-—-—--—--------lmm

Msli_ mecmlammof reqirat,,ryw.k-.------..--16D-1E3

2 I@.lib’rallt ..*. M *,———-——-—174

U Me.l%lmlltneomaslnsof ger.MalOrgens—--------1ma.97

MaligmmtIleoPlamsof UrilmryOrgans---------------lz%,lw

: Malignant.OIMSMS of allotk d Unsl=ifiti

siteS-------------------------------l70-173,190-l99

14 _..---..----- ....----...------------...---2O4.207

ls Othermwlnsm of Wwhatie andbend.ar-aletic

tiEs.e*--—-------—---——----—--<m-203,208,2O9

16 Belli@mqlam, an&m%ti W llnqwifie.il18tllr.-ZMJ-239

17 DiabetesmlHtm-------.----—-—--------.----25O

18 AmMiaS---------------------------..------------2S0-285

19 -@tl*—-.----—----——.----...-.-..-..---zo

2D

21

22

23

2

z

28

29

30

km, -.- ~m---—-—--——-—-----W-448

mseases of hear%--———-------32O-S38>429,YM,4l0-429

A.*1w rheumaticseverandcbzwic rheumaticheart

~s=+----—------.-———-- .....----S598

m-l= heartdiseasetitbor without,-

a.-*---—--------——-----_-.--_m,M4

I.ched.hesrtdi6_e———--—.—-—-..-----4l@-4l3

-. sise.e or elma— eraO- WraCa’dial

ir@fSiCieW---—-----------------424,428

AU othexZ- .2 heartdisease-----4Z3,4Z5,427,427, 429

mwim------._----.__-_-----_.-4m,4ol,@5

Cerebmwculax fisewes..-----.-.-.-.-...-....--430.G0

Ar&riasc1msis---------------------------------440

other w.-,, of arkrle., al-k+.ole., and

.@ue.—-—-—-—---———-—-------.a-449

31 acutebm.chitisd lJrnncbi01iti6--------------------46s

32 nwlIleMZaand.Pnemvllie—-—---—---—----------470-474,4?0-4%

33 Ir.t---—--------—-------------47c-474

34 ——---—---------—--—------4-426

35 Emnchlti., E@ryseua, ad, asti---——----—.--42Q-493

36 Chl.anieallaUlqual.ifled —tti-..----..------49o,e1

37 m----.-.--------–-------------_---.-_--.-4gz

38 Ast2ma------------—--——-----------—------493

33 Pepticti=—--..—----.-.------—__---__--m-ss

40 _ andintestinal.abstictim—-—--------.5S3-5S3,560

41 Cil’rhc.sis or Mva...---------------——-.--—-------5m

4Z ChOlelithiil.is, clolec@.itJand.hda@.ti.---_---s74,57s

43 MIU’lti$allammsl*..-..-- ....-.--- ....-..-5m-m

44 Mectiams of aw---—---——-__.---_-—-_5m

45 -man or m.a5tate—--—----————---------6Lw

46 congenital—s-—---—-------—----—-------740-759

47 Cerbainc@Jlnes0? mrtalitJJin ,.W

~-----------------—-----76~769.2, 769.4-772,774-778

* Sw@m8 an.3W-M!.nea .OnditfOns------..-----7m-796

49 Allotherss-es.-----——----...----—~stil

~

vator.ehicleaccident.s----—--——--------=0-W3

AU otheracXtitS-=.--__-----_-.=-W7>=5.~~

s mci&------------------.----.-—.--—..mw-m59

54 Hm@ide--------------—-----------------E960-E978

55 u 0*hE7ertema ._e*—-— .....-——--—ma&m99

.969

95L9

1.3

2.8

0.s

4.0

m.o

3.1

46.s

32.7

14.4

20.3

7.4

12.7

1.2

9.0

2.3

I-9.1

1.6

0.9

sol.?

366.1

1.6.

8.1

5m..7

3.7

1.5.o

4.2

10Z.6

x.4

Iz.4

0.6

33.9

3.0

30.9

15.4

z.9

n.4

1.2

.!.6

3.7

14.8

2.1

.2.7

4.3

1.2

8.4

21.4

3.3.0

S3.9

57.6

27.6

r.’).0

H..1

7.7

2.5

“uInk

elan.

L968

1.5

3.1

0.3

4.0

15s.&

3.6

46.0

=.8

14.6

20.5

1.+

18.6

7.2

8.9

2.5

19.2

1.7

0.9

az .1

312.6

9.2

6.9

537.6

3.9

14.0

10G

16.8

E-.4

0.7

36.8

3.s

33.2

16.6

3.1

Zz.1

i.3

4.7

3.s

14.6

2.2

4.7

4.7

1.3

8.4

21.9

11.a

=.1

57.5

2T.5

30.0

10.7

1.3

2.2

—

tic r.f.

,,1950.

m ofth!

1967

935.7

3.8

S.5

1.2

3.5

157.2

3.4

42.2

29.4

14.3

20.4

7.4

18.6

7.2

8.5

2.5

17.7

1.7

1.0

S6.5

364.5

1.2

25.3

289.7

26.6

15.8

5.8

102.2

19.0

3.5.1

0.5

20.8

0.7

28.0

15.3

z.7

10.8

2.1

5.0

5.D

14.1

2.2

5.5

4.6

1.6

8.B

24.4

12.2

54.4

57.2

26.7

3’3.4

10.8

6.8

--

966

951.3

3.s

3.s

1.1

3.8

M-5.1

5.5

4a.5

28.0

14.1

20.6

7.2

17.9

-i.z

e.1

1:

1.8

1.2

5N .1

sn.2

1.1

27.7

m .7

27.4

u .8

5.8

104.6

18.9

14.6

0.5

32.5

1.4

%.0

.15.2

Z.6

10.3

2.2

5.3

s.1

1.3.6

2.3

5.9

..8

1.6

9.5

26.4

32.2

34.7

58.0

27.1

3.2.s

10.9

5.9

—

L96S

945.2

.

4.1

4.1

1.3

3.9

LS?..5

3.4

48.7

26.8

14.0

2Q.9

1.2

17.9

7.0

7,8

1:::

1.8

1.2

5M.9

367.4

8.0

28.4

2M.6

27.4

u .1

6.0

103.7

19.7

14.1

0.5

31.9

1.2

W3.8

14.4

2.5

9.6

2.3

5.4

5.2

12.8

2.4

6.2

5.1

1.8

10.1

28.6

3.2.1

34.1

SS.7

25.4

.50.4

11..1

5.5

---

.

-1- 1964 L96S

9S9.6 961.5

4.3 4.4

4.3 4.9

1.4 1.4

&.0 4,1

1S..3 151.3

3.4 3.4

48.7 49.7.

25.7 24.9

I?.7 13.5

20.9 21.2

7.1 ,.2

I

17.2 11.0

7.0 7.2

7.7 1.6

In 1::

1.0 1.8

1.3 1.2

sm.=

365.7

8.?

521.3

375.2

e.8

27.8 29.7

14.5 14.5

6.4 6.7

10s.6 106.6

12.4 U3.8

13.5 12.9

0.5 0.E

.U.1 37.5

0.9 3,8

33.2 32.8

12.9 13.0

2.3 z.3

8.3 8.0

2.3 2.7

5.7 6.4

5.2 5.3

1’2.1 rL.9

2.4 2.5

6.5 6.7

5.2 4.7

z.0 z.3

10.6 n .0

?J.5

13.Z H

34.1 54.7

54.3 53.4

24.5 23.1

2s.7 33.3

10.8 11.o

5.1 4.9

L9&2

—

‘245.0

=

4.4

5.1

1.5

4.0

149.9

3.5

49.5

24.0

ls.4

21.3

1.2

16,6

1.0

7.4

2.5

16.8

1.8

1.2

515J

370.1

9,5

33.4

2ss.8

29.4

13.9

6.7

106.2

B. 8

12.2

0.6

S2.3

1.8

33.4

11..z

1.9

6.7

2.6

G.G

5.2

12.7

2.6

7.0

4.7

2.3

11.4

H

34.0

52.3

22.0

2D.3

J.O.S

4.0

4.3

6.4

1.6

4.0

149,4

5.5

=.1

23.1

13.4

21.4

1.1

16.4

7.0

7.4

2.C

16.4

1.%

1.2

9X.1

352.$

9.8

.54.6

274.4

29.8

13.8

6.1

105.4

19.3

11.3

O.G

30.1

1.2

29.0

9.9

1.7

5.s

2.7

6,5

5.0

II.3

2.6

7.2

4.4

2.s

12.0

~~.$

10.4

3.2

sO.4

ZO.B

23.s

10.4

4.7

---

4.4

!:;

4,Z

14’3.2

3.4

W.q

2*.2

13.4

21.E

1.1

1C,5

7.1

7,2

z.7

led?

1,9

1.3

513.1

363.0

ZO.3

37A

27.5.6

31,9

14.3

7.1

108.0

20,0

11.0

0.7

37,s

4.4

Z2,Y

9.9

1.9

5.2

3.0

6.3

5.1

I&$

Z.f)

7.6

4.3

2.5

lZ.Z

37.4

Il.&

35,3

52,3

21.5

31.0

lCI.G

4.1

,.,

.

60
mm -.m:l.””p.=., r.>p=.c.”.ly, u .=.! u!. J . . . . :rr.s m,.,.. , . ..”.”=.. a. =..”... “. . . . . . . . . . . . . . . . . . . . . .,

category mbem

19s7 E= 1.957 H56 ~= 1954 1953 -= 1951 1950 accc.rdliwto the

Sw allaseventh

Re-ioms

936.6 950.0 9=.6 9=-1 =43.4 9=.9 959.0 9Q .4 966-7 963*E ...

4.5 *.7 4.5 4.7 4.9 5.4 5.6 5.2 5.1 54S,S71,572

2: 7.1 7.B 8.4 9.1 10.Z 12.4 15.8 20.1

1.7

22.5 001-019

2.0 z.Z 2.3 2.3 3.0 3.3 3.7 4.1

4.5 4.4 4.2

5.0 020-029

4.5 4.8 5.3 5.0 7.4 6.7 6.7 031-!.33,nenllinlk’

of

147.s 146.8 148.6 3.47.8 146.5 145-s 14~n M3.4 140.6 139.s 140-205

3.4 3.3 3.4 3.3 3.4 3.3 3.2 3.2 3.2 3.4 140-148

50.7 sm.9 51.7 S2.4 == = -0 =.~ =.5 5-3.4 54.2 1%156A,157-15S

23..2 20.4 Is.9 19.2 18.2 17.1 y.: g:: ~2.5 14.7 14.1 160-1E4

13.1 =.1 1-3.3 =.3 3’3.4 =-0 12.6 lm

21.6 22.1 22.6 22.6 =.8 2::; z= 22.7 22.5 23.1 171-119

7.1 7.0 ‘1.L 7.0 7.0 6.9 6.6 6.7 Mv,lm

16.2 1.6.1 16.7 l.s.s 16.4 1s.5 16.3 =.6 16.1 14.7 3.56E,165,19.l-199

1.0 6.9 6.9 6.8 6.6 6.5 6.s 6.3 6.1 5.9 m4

1.1 6.9 7.0 6.8 6.5 6.3 6.1 5.8 5.s 5.2 2C0-ZIX,205

.

2.0 2.9 3.0 2.9 3.1 3.2 3.3 5.3 3.4 3.8 21O-K52

1.5.9 25.9 16.0 y.: 15.5 15.13 16.3 1::; ~:j

1.8

16.2 Zw

1.8 1.8 1.9 z.0 2.5 2.7 290-293

1.3 1.3 1.2 1.2 1.1 1.1 1.3 1.2 1.2 1.2 340

%8.s 51.5.5 =4.6 501.4 496.3 484.6 503.0 498.5 ;:4: 494.4 333-334,4C0-468

363.2 367.7 369.4 3::: 356.5 W:; s% =;; 14.1 356.8 400-402,410-443

10.4 lo.a 1.1.8 12.0 14,8 4MM02,410-416

38.6 42.7 42.5 4.3.s 45.0 46.6 ~.3 53.9 55.6 56.5 440>441>44Z> 443

268.6 Z66.2 ?.85.6 255.5 247.0 ._ .L=27_ __ 236 J 226-2 =9% .

m> 422

31..O 33.0 s.a 31.1 39.9 41.0 ~ 46.3 49,3 52.6 56.5 a, 422

13..9 lb-z X2.8 7.2.6 12.6 3X6 14.3 14.J ‘15.1 ls.sl 450-434

7.s 8.s 8.s 444-447

10U ULW s 1~ 10::: M;:: 101.3 10J:: =7 104.9 :’-=4

1s.6 19.9 U.5 19.1 19.8 la.: ZQ.4 20.8 20.4

10,3 9.9 9.0 0.4 7.s 6.0 5.7 5.4 4.9 451-i68

0.6 O.e - 0.7 0.7 0.7 0.6 0.6 0.7 0.6 0.7 S20

31-.Z 33.1 ss.a 28.2 27.1 ’25.4 33.0 29.1 3L4

1.7 1.7

m..s ‘MD-495

6.0 3.6 4.5

2?6 ::: ::: 2E 25.4 23.8 27.0 26.1 =.9

4.4 4ao-4a3

26.9 480-4s3

8.7 B.3 a.7 7.5 6.8 7.2 6.9 6.9 5.0

1.5 1.5 1.4 1.2

501,W+S7.1,2U

E 1.2 1.s 1.2 1..5

*.* 3.9 .3.4

1.3 531,502

2.7 2.2 1.s 1.6 1.2 1.1

2.8

0.8 527.1

2.9 3.9 3.6 3.6 3.8 4.s 4.5 4.5 z.9 al

6.0 6.2 6.1 6.0 5.9 5.8 5.8 5.6 5.5 5.5 w,541

5.1 5.0 5.1 5.3 5.3 5.5 5.4 5.6

;::

5.9 560,S61,570

I&2 U-.3 10.7 10.2 10.1 10.4 10.2 9.8 9.2 ml.

2.s 2.7 2.9 3.1 3.6 3.5 3.5 3.8

8.0

3.7 3.9 584,585

9.2 10.2 10.6 11.1 3.2.2 13.6 15.3 16.8 18.7 550-594

3.9 4.0 3.1 3.4 3.0 2.7 2.8 2.4 2.1

2.6

2.1 m

2.7 3.0 3.Z 3.1 3.8 S.9 4.0 4.2 4.2 m

12.3 r2.4 12..8 U >6 ls.s r?.s 1’2.6 p: g.: 32.2 750-759

3a.5 39.0 39.1 38.6 39.0 39.4 ~.1 40.5 760-776

M.8 1.1.4 1.L2 SL.5 =.1 1.S.5 13.7 14.I 14.8 14.9 7tW-195

54.8 34.1 33.8 S2.5 32.2 32.0 33.6 =.8 35.1 35.4 Reslaml

52.7. 52.3 55.9 56.7 56.9 55.9 ~ =.8 62.5 EO.6 EXO-E362

21.5 21.s 22.7 23.7 23.4 22.1 24..5 24.1 23.1 mO-E335

33.7 =0.s 33.2 33.0 33.5 33.0 36.1 37-5 ~-:

10.6 10.7

~ Eaw-re02,m40-lt362

9.8 10.0 10.2 3.0.1 m -1 ~.o

4.6 4.5 4.5

W63>E97C-B379

4.6 4.s 4.8 4.8 5.2 4.9

..-

5.3 E964,ES80-ES=

-. -. ..- --- --- --- -- -- --

Table 2. Death rates for 4S selected causes: United States, 1950-69--con.

@CS per100,oooPWIAII. N.mbm after mm OEdeath m-mtcgov numbers if h EidIth .%-i.. oftheI.tmtimd CIastfi..,C.. .fn~-$=sAtit.df..USC,.:JI.u~@s~@ ~v~d

in1965.For1968and1969rataor<bad ondeathsasiwedtothe F@th llevkoncak~rym,nbus;f.,1950.67ratesarebad MI deathsaswyd to the catesmy numks of the SAmndScv-

.. . . .. ... . . . . . . .. . ——... . .. ... ,- , . . . . . ...=. -..-—..——. -..—..— .- .!----- :.. .!-. ,...-,...””. . d..= . . . .. .

61
Table 3. Deaths for 48 selected causes: United States, 195D-69

asahtrauxs of4catharccakgorynumb-sofIh,.&&b Reuirim of tie In . ..OIIUI cLZ@..1.m of %.-.s. A4ipt.J forusei. the LJmf=dstate.. .ilopkdm 1965.For196$ad

Ideaih.arctboscasiwd m ih.scEighthRevisio,:g.w.~~Is. f..1951 t.atluarchostasigmd t. the.ateg.xynumbersoftheSixthandScvmlhRcviions,=d.pkd,msFc-

“,lF1948ad 1955.TIKSCcategory number, arc u in the last column d *bI.]

7

1

1960

,711,98Z

7,93Z

Io,e&F,

2,945

7,576

267,627

6,175

91,0Z5

39,733

23,970

- 38,6ss

E’,3M

1966 1965 calm. of death 6n& category mmbers

M Ei@h Revision .967 1964

798,D51

8,178

8,503

2,61.9

7,5’30

2.99,577

6,571

93,l%

49,U7

26,16z

39,95C

x$,w

3Z,E3E

1.3,4s

1.,7*

4,9%

32,275

.5,51f

2,46!

973,m

699,SS

E, 9’Z

57,4X

545,49!

53,2X

27,74

lz,w

198,20

.57,171

25,74:

99!

59,45

1,6E

57,76.

24,64!

4,4X

Is,7s1

4,44

10,96,

2; z

$ a

U, 41

9,m

3,64

20,28

60,3Z

25,25

65,35

la3,84

46,93

56,91

20,58

9,m

..

1963

313,549

8,246

9,311

2,666

7,756

205,362

1961

701,522

7,@o

9,938

Z,@so

T,mu

WI,’390

z>612

5,561

s

e,c69

323,032

7,553

93,9e6

66,030

29,0s.

m3,0@2 151,323 ,86.5,149

_

7,552

7,625

2,lx

7,4%

%, 736

6,X4

95,079

54,934

27,5.33.

40>378

14,Es

35,cm

U,ol.z

15,em

4,225

54,591

3,452

2,324

L,OIO,W?

727,W2

WOK?

54,176

573,191

53>581

x, 042

m.,WI

204,EAI

38,901

28,682

987

6S,6=

2,850

60,7.95

29>740

Q64

20,252

4,324

10,?.2I

m, 07P

Ze,6s2

+92

II,%(

9,*9E

3,21>

U, 15[

51,644

23,s6<

67,94>

IIS,m

53,041

60>52:

21,2e1

u, 60!

-—

8Z8, U6 756,1m

8,194

9,m

2,ml

7,457

278,562

6,4al

02,(347

44,644

24,958

39,590

1.3,299

3$::

>

33,755

4,ml

31,22’2

3,598

2,322

951,431

63%039

17,751

62,176

527,%1

54,645

25,S/6

1.Z,497

197>451

56,SK

2Z,632

1,1X

59,9’35

3,431

5.5,564

20,8U

3,m

12,361

4,w

n, 22(

9,72?

21,82”

4,s

U.,94:

8,74,

4,ZE

21,2’3

34,2LT

19,731

65,14

97,15!

.46,20

56,33

20,2V

9,01

-,

hterltis MM other .liarrhcal

aisea.es---—..——------------CQ8,QX

WmrmlO,is, au fame-.---—-- Omcm

Wuhilisma m, ..QU-—-—--D9C-O9

7,5C4

6,901

Z>ml

6,964

31a,9e3

6,‘ID

95,320

s, D%

2s,21-7

40,408

14,656

%7=

14,336

IL7,”m

5,013

35,049

3,%0

2,045

002,ul

721,268

u, 176

49>915

573,m

52>691

31,267

n, la

202,U34

37,564

29,?44

95e

56>@92

1,475

55,417

30,SE

5,30f

20,87:

4,H

9,82:

S,814

2?,elf

4,3a!

10,94]

9,acf

3,13f

17,3ZC

48>W

24,03[

68,16?

m, 3S

52>924

60>2C

21,32:

m, 42!

-.

7,899

7>934

2,434

7,465

297,580

6,501

94,31x

52>0?$

27,0U

40,454

33,9D1

34,644

13,62c

ls,cm

5,051

33>17!

3,53!

2,36

9%?,1%

Tlz,ox

E,.7

54,w

559,2s

53,11)

29,17

11,66

201,05

38,10

27,27<

1,O(I

61>Ba

2,29!

59,613

27,9s

4>16

12,66

4,52

ln,42

10,w

24,71

4,86

u> 92

9,al

3>41

19,51

55,39

23,41

66,35

lQe@3

49,16

58,89

21,5C

3.0,71

2,940

6,292

586

7,958

310,547

7>2s4

S3,563

63,4a5

29,Oal

40,936

14,792

37,247

14,375

i7,774

4,948

38,352

32494

1,707

023,399

744,65@

ls,35s

11,698

674,147

7,asfi

2*,03s

9>C63

ZIL,3SC

33,s+3s

24,72C

1,-2

T3,492

7*W

66,43C

ii-mIm?ectiv.a.u-wr-iti. di.ea.es——---—--mmailm=- m? Dm-lst

111.m.tImPlamS, incluafng moplams

of Qn@m.tic ma h~ktlc

ti.sue-————————----lm-zo,

MEJigr,amzl.Ple6m6of‘eucCalCevi+w

ma PharYnx——------140-14!

w-t .ep=. ~ ~ge~s=

‘n’Ws alaE.entOnem——_..KcK1$l$

Mal@e.ntny,lasmsof re5@rc.tQIY

aystm——--------—------ lw.H3

Wm@nt neoplasmd bren6*..----H

W-* ..@== .f g~+~

orgen,-———-------—---mla

MalipentWollasmsd? Ursnuay

-.m=----_-__.._.—-—---mB.m

6,322

91,727

4z,zll

24,S43

39,2X

l$om

29,977

Elan

13,s’S4

4,751

50,098

3,2@2

2,265

924,622

663,391

97.,914

45,913

25,401

39>933

13,5S

32,0%

13,s07

14,407

4,905

32,465

3,409

Z,343

953,X!4

707,@3c

X3,61$

61,b91

546,eE

55,WC

27,32?

U> 694

201,161

37,4X

Z4,3E

1,13s

70,761

7,w

.53,S7C

24,501

4,3Z

E, la

3,DS

E> m

9,m’

22,451

4,61(

12,.w

8,95

4,24

20,8T

62,68!

22,42<

65,454

103,66

43,S3.

57>NI

20>82!

!3,22’

--

u, 897

37,825

14,4=

u, 252

4,677

38,W

3,318

1,719

013,0=

739,265

Is,432

16,206

669,62S

7,47C

30,24?

8,4ze

207,17s

33,052

Z5,0G

l,zet

68,365

5,911

6Z,394

n. 144

5,8.K

22,93s

2,365

9,311

1,w

29,w

4,2%

9,4X

E!,751

2,49!

17,Cal

43,1?:

26,Id

m.m

U6,3U

55,79

60,59

22,30

15,&1

5,1U

.... ..

*UIt .wl.=. ~ U .~= =~

Ullswcifled sites—----173,173, 190-l!+

mti.-----—-------—--.---2w20

29,WI

E, 725

other neOP1.a6m8 of lymphatic and hmtoEOieti.tis5ne.—---2m203,208,20 .IZ,9s9

4,093

29,971

3,330

Z,316

lenigm llenplc.sm ma nfmplmns of

unspecified llature-----..---2lc-239

Hahete, rwllibus---—--------—-----z50

bmnu.as----——-——-—-—-----2ec-2a5

923,6s5

661,71e

18,4U

JP.@ c@a@iOvascm=alseasew---39&448

Disease,M

h,al-t---—----34LE,9a.4LE, 40%41c-4’29

Active rheme.ticfeveima chiati.

r-atic heartdiGeas—----S9E-S9E

~ert-i.e henrtdiseasewithor

tith.autrenalLlleen6e—----40z,404

16chemieheartdise=sa=-------41C- W?

Chronicdiseaaeof enanmtilnnma

at%. IEvcC.aiel

insufficiency-------------~4,42C

Au O*= i- of heart

di.eas—--—---e& 423,4=-427,429

gw!tmlan.——— ---400,401, 4Cf

Ceremowa,dq aiseases--.---uwus

Arteri.ascl=osf s----------——----44C

Otmerai,eaae.or arteries,Ua+erifl.s,

alaea@uarie,--—---------44G&4e

63,262

502,351

54,632

25,Z64

lZ,E

192,951

35,388

20,7m

l,CC.1

% 175

2,U31

53,036

Wzll

‘5%

4,9X

ll,w

9,lZ

20,7X

4,7C

IS.,la

B,crs!

4,lw

Z1,5Z?

65,67$

19,C9’

62,57!

9Z,Z4!

38,03

54,151

18,9Y

8,571

--

&5,3ca

494,292

57,029

Z5,682

u+,cez

193,23s

S5,816 ,

!

1

19,?97

I

1,1?0

66,WJ2

7,W/z

59,951

mute mwnchitisma brunmt.i6---46E

—a andpl-a--47c-474, 4a0-4@f

Ir,fl”er+J.--—---———--------41-474

PnwxOri.——----—-----.----4m-4e4

11,820 mvn’=hitis,mpmseme,alla.tJx4a-49c-493

mronie andunqualified

%rMIchltW—-—---------490,491

--.-———-——-—-—------492

I

3,173

9,ZS3

5,394

=,%0

9,081

z0,z96

4,619

13,6e4

6,ZIX

24,1=

2,68C

9,46<

7,75!

29,131

4,3=

9,3U

9,39:

2,64;

B, 1%

G, 84(

23,651

102,1%

114,H

z,%

.50,m

21,w

14>691

4,3X

PertieuIce>-—-—---——---531-5X

I&i. .< titestm

.kh’uCti--,-—---55c-553,56l

cirrhosisof 1.iTez---—---------5m

Cholelitl!lasis, Chok?ystitisfad

Cl,olnngit.1. ———--.-—-—-—----5,4,57:

Ikphritisallampflrusis-——------mc-mi

?,645

4,449 ‘

21>860

6?,b’34

Ineecti.sor 2idluY—-----591

Ir.merplasi. of p-ost.te----- .. ..m.

Colwnitel-es------—---74c-75!

certainme. of mart.as.vin ealw

iPfancY----76&72,16% 4617Z,7Z,‘f74r77f

Sgmptcm andill-defined

COn.3itions------------------nc-nl

All other.5iSease—----—---nesiauti

20,385

63,314

93,em

38,151

55,669

19,041

0,464

-.

AceldentE-—----——-—---E@JX-ESE

Wtm’ vehicleac.idellts----mz,mz,

AllotheraccideIIt,-B3DW3397,EBZ5-133ti

slad@-----———-------mw=!

-*---—————--E960_E97$

~ Otk= e=th .cuse.—---E98wE39!

,
Luse, of dead

t III- as,m

and 1955. ~

ls5s

Table 3. 1

. ..” . . ...-.. m. ear *, se.ect.d Ca.ls=s , united states> L!),”- by-- con.

Illlb.” arm

969 dcak

My, h 19

,crs of the

R.*.,.. .“

X5 arc she!

).956

:.m-~i.m

1950.67 dead

, of ,hm tabk]

195.4

kn~c.ztio. .flhmar.s, Aa%pted for UK! {. the Umt.d ~tntes, adopted m 1965. For 1968 ad

K -m,,~cd m d,. mmgorj mnnbms of the Sixth ““d Swenth l+rwsv=”s, adqmi. r.qm.

h R&o. ,

y ..IUIIUS;

Ill. last ml

1

2

33

4

5

6

7

e

9

10

II

12

13

L4

E

16

17

m

19

20

21

22

23

2.

25

26

27

28

29

m

31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

46

47

4=3

49

50

51

52

5’3

54

55

—

Ce.t%ory numbers

.mra511g to the

sixth end seventh

revisions

1959 19s5 1353 1352 1951 ?.950

,356,3M 1,347,806 1, 3.33,3.2( 1,5.5+47( 1,528,717

7 ,7s%

1,431, Cel 1,517,541 1,496,832

a, 743

24,321

5>713

1.1,499

22.3,217

5, U23

33,2%

24,350

19,89Z

55,319

10,679

25,783

S,ul

9,1.C6

5,1S3

35,414

3,987

1,9W

776>114

556,724

21,337

33,911

S52,1.55

76,69.

a?> 657

12,5L!6

166>331

31, E35

8,863

1>038

46,235

4%2

10,7.99

1,932

1,914

6,943

8,770

a, Ml

13,934

5,903

23,899

3,6$1

6,286

19,739

G, E59

21,950

54J38

963172

37,794

S3,378

15,561

e,c64

---

1,432, m! 1,453,45

7,33

33,95

7,56

10, u?

210,73,

5,13(

31,121

21,21

19,9?:

34,7.#

10,04

22J3:

a, 64!

7,93-’

5,37,

24,4=

4, mz

1, ax

743,074

537,629

22, se

85,133

321, Om

a5,15s

23,958

12.S63

U56,751

30.734

7,ss7

1,(J36

47,120

6,597

40>525

7,479

1,953

1,2C4

4,322

8>214

8,894

1.3,255

5,670

28,141

3,1.29

$R

60,989

32,S17

33,3@l

91,249

34>163

56,436

17,145

7,942

... .

7,Km 54S, 571,572

12,361

3,469

7,577

7,971

13,s’24

3,82:

7,1m

253,13?

5,s61

00, W

33,895

22,72C

30,472

12,1&7

28,425

11,713

ll,lM3

5,066

27,1n0

2,987

2,CQ5

876,793

EC29,4LW

20,174

72,372

452,507

E2,61E

21,733

U, 128

MJ1,1C3

3s,272

E,290

1,2C2

Ll,ool

7,4E3

53,5ss

14,813

2,379

5,757

6,377

10,323

8,511

19,317

4,%4

17,3u7

6,?,43

2?S

66,563

19,124

51,571

95,307

S8,7L?2

56, 6C6

16,632

7,641

7,5CI

14,ffi

3,87(

7, 44;

247, .35i

5,56+

07,74(

32, El

22,26]

37,741

ll,71f

e7,271

n, 39[

11,444

4,807

26,E4

3,143

1,9?2

838,843

6M, CQ3

20,a29

12>393

427>516

93, Ce8

21,00?

10,943

177,843

.32, w

14, 0G3

1,W3

47, M3

2,323

44,7a0

u?, 500

2,m1

$%

10, C28

6,453

17,924

5,262

17, em

5,737

< 3E3

’213065

64,546

lB, 913

54,586

94,7a0

39,628

1?%

7,.923

--

7,892 8,510

19,344

5,273

9,145

a,cin

30,69?

6,274

10,26I

215,5E

4, 89C

81,807

22,3E

19,179

34,491

10,I.58

24,632

9,357

8,439

5,166

25,047

4> WE

1,8e1

764>281

541,325

21,336

35,257

33%, 619

eo, 635

23,176

).3.256

163,550

31,8!34

8,266

980

43,1.39

6,946

41,223

10,531

1,943

1,714

6,871

9,4s7

8,327

E,075

5,724

25,732

3,261

6,417

16,835

63,C86

22,647

53,81.I.

95,871

36,996

58,875

33,9G3

7,435

---

U.+56

3,W9

7,aB6

14,94!2

3,834

7.S21

1.3,392

4,855

8, W?

COLO19

K2C-C29

001-13S , I@mmde,

of

260,047 254,426 240,331 254,663 323,079 14C-2C6

6, !F3

89>4’30

37,413

23,c95

33,1m

5,322

a5,872

29,914

21,945

31,5m

ll,5ce

26,958

5,382

85,433

27,621

5,m9

84,444

26,m3

20,5.%

36,241

14c-14E

15c-153A,157-159

16’2-134

170

173A79

88,1.44

S5,423

22,375

38,330

20, 9m

36,941

u?, 495 12,1.32 l?.> 133 m,915 130,131

28,663 2’7,978 +561 25,870 J.56B,165,H?-M9

12,270

lZ,411

11,980

U.,943

10,916

10,6#3

10,443

10,114

9,919

9, 6s3

2C4

2CC-2C6,2C5

4,949

20,030

3,244

Z,W9

4,9m 5, m4

25,1.51

3,3CJ

1,829

5,2!33

25,7s6

3,580

2,c69

27,5!3J.

3,195

2,24’/

25>423

3,107

1,873

26o

29+293

340

33C-334,40L?-469

4GC-4@,4W4a

4LXWC2,4JWJ6

440, Ml, 442,443

E:,42-2

898,336

643.,M

13,!290

68,!69

895,489

637,246

13,796

B15,533

LW5,751

13,757

73,883

4S,030

65,622

7a1, OM

SG,371

19,553

75,039

319,788

.5E,CE!1

795, e88

1571,798

2JJI0

2133.49

373,597

73>330

‘H,93L

474,143

56, cs9

461, s73

S+5s5

24,355 20, 35s 20;905 23,313 43%434

U!E34, m

18,175

13,798

190,150

34,435

17,204

1%=

32,42.9

11,991

II,S93

167,777

so, 225

10, E59

12,3m

139,800

32,551

9,552

444447

33*334

450

451-4ea

5:%2,845

53,194

l,ceo

44,51a

2,755

41,753

990

40,991

2,630

s, 3U

1, Ilo

32,23B

9,460

.2,778

500

4m?-49s

46C-43S

49!2-493

ls>al

2,11n

14,363

2,621

1.1,576

1, 97’/

U., 013

1,832

2,995

6,136

11,394

2,C63

2,594

6,7s’/

5@l,5ce,5z7. 1,2.U

5@l,5c2

527.1

241

7,7Z8

4,984

6,7($I

s, m

3,639

5,960

10,674

9,103

19,242

4,497

14,120

m, 801

.9,833

13,338

4,720

16, LED

9,750

8,654

9,391

8,498

16>2Dl

5,630

1.3,588

9,240

0,121

540,541

560,591,570

501

5!34,533

59C-594

13,763

5,939

13>214

16>399

5,6cQ

21,563

600

610

75C-759

76+776

6,L%3

4,533

~1,71J0

rl,s.m

6,=9

2, z

63,960

4,3C0

6,095

20, Cal

63,486

4,62

6>173

20, @m

63,444

3.3,0?.6

m, 484

19,72a

60,072

M, 914

53,900

20,2m

51,642

m, 633

53,23B

78!2-795

Re.,aunl

92, mO

37,910

54,170

u, 633

8,=9

. . .

90,60$

36,981

53,623

le,w

7,835

93,443

m, 426

55, OrI

16,76o

7,4M

---

9C,,032

35,586

54,446

16,356

7,735

95,032

57,255

57,077

15,947

7,640

Eecc-E952

Ee10-3835

F8LWE9C2,E34C-F.W

.G923-ES7’X+379

E964, H3c-K3ffi

---
Table 4. Deaths and death rates for Certain causes of mortality in early infanty, and estimated

nuder of live births, by color and sex: United States, 1950-69

[wtesarcdeathsunder 1 year per 100,000 I& b%. Beginning with1968deathsand deathratis are basedon deathsassignedto category numbers

760-769.2,769.4772,774778 of the Eighth Rt-ui-ionofthe International Ck.m@tfon ofDkues, Adaptedfor Use ti the United States, adopted

h 1965; for 1950-67 rates are based on deaths assigned ~ Cateww numbc~ 760-776 of tie giifi ~d .3menthR~~w adopted. resp@ive”

ly in 1948 and 1955]

Year

1969--------------

1968--------------

1967--------------

1966--------------

1965--------------

1964--------------

19631-------------

. 196z~--------”-..--

1961--------------

1960--------------

1959--------------

1958-------------:

1957--------------

1956--------------

1955--------------

1954--------------

1953--:-----------

1952--------------

1951--------------

1950--------------

Deaths

Both

5 axes

43,171

43,840

48,314

51,644

55,39,8

60,322

62,688

64,205

65,679

67,094

67,934

68,960

56,569

54,546

54,043

53,486

53,444

63,659

63,096

60,989

Total

Male

White

19,201

19,814

21,231

22,637

24,279

26,470

27,112

28,058

29,579

30,211

30,640

30,928

30,145

29,546

29,558

29,557

30,024

30,102

30,266

29,326

All

other

6,168

6,065

7,030

7,589

8,225

8,852

8,535

8,478

8,809

8,892

9,061

9,114

5,632

8,334

7,845

7,579

7,3.88

7,145

6,917

6,481

Female

White

13,132

13,206

i4,472

15,462

16,587

18,148

18,494

19,059

20,409

21,065

21,157

21,686

20,995

20,429

20,516

20,435

20,424

20,854

20,711

20,086

‘Figuresby color exclude data for New Jersey.

All

other

4,670

4,755

5,581

5,956

6,307

6,852

6,434

6,573

6,882

6,926

7,076

7,232

6,797

6,237

6,124

5,915

5,808

5,558

5,202

5,096

Under 1 year

Both

3exes

$3,060

k3,707

k8,271

51,608

55,375

60,298

62,664

64,185

65,662

67,074

67,916

68,939

j6,552

54,515

54,016

?3,450

53,423

53,632

53,044

60,967

Male

White

19,148

19,761

21,206

22,624

24,268

26,459

27,102

28,050

29,573

30,201

30,627

30,915

10,141

?9,530

29,546

Z9,537

30,013

30,088

30,245

29,311

All

other

6,163

6,047

7,027

7,585

8,223

8,851

8,53L

8,477

8,807

8,890

9,061

9,114

3,630

3,333

7,843

7,578

7,188

7,145

6,912

6,4S0

Fam

White

13,091

13,160

14,462

15,445

16,578

18,140

18,486

19,050

20,401

21,059

21,153

21,679

20,984

20,417

20,505

20,422

20,414

20,844

20,689

20,080

All

>thef

4,658

4,739

5,576

5,954

6,306

6,848

6,433

6,571

6,881

6,924

7,075

7,231

6,797

6,235

6,122

5,913

5,808

5,555

5,198

5,096

I

[

I

k4
Table 4. Deaths and death rates for Certain causes of mortality in early infancy, and es timsted

number of live births, by color and ssx: United States, 1950-69-con.

[Rates aredeathskder 1 yearper 100,000 k births.Beginningwith 1968 deathsand deathratesarebased on deathsassk+ne~to categorynumbers

760.769.2,769.4772,774-778 of theEi~hth Revuion of the Intematt”on.1 Chmific.ti”on of Diseases,Aakpted for Use in.the United States, adopted,

Iin ‘I 9,55; f.~ 1950.67 ,IW m bad on death. assigned to category numbers 760.776 of the .%xthandSeventhRevisions,adopted, ,esp.ctiveiy, in 1948 and 1955]

Both

saxes

3,600,206

3,501,564

3,520,959

3,606,274

3,760,358

4,027,490

4,098,020

4,167,362

4,268,326

4,257,850

4,244,796

4,203,812

4,254,784

4,163,090

4,047,295

4,017,362

3,902,120

3,846,986

3,750,850

3,554,149

Live births

I

Male

White

1,539,420

1,497,612.

1,501,228

1,535,486

1,604,422

1,727,416

1,709,174

1,740,358

1,848,794

1,848,192

1,846,240

1,833,238

1,859,148

1,820,740

1,776,355

1,769,246

1,725,958

1,707,656

1,663,782

1,575,309

All

other

307,152

298,714

302,160

310,376

322,632

332,746

324,206

324,572

337,480

331,516

327,398

319,308

320,812

312,848

297,364

289,822

275,840

263,606

259,238

248,246

Famale

White

1,454,194

1,414,612

1,421,274

1,457, J44

1,519,438

1,641,744

1,617,170

1,653,710

1,752,070

1,752,552

1,751,190

1,739,06S

1,762,308

L,724,61O

1,682,093

1,674,384

L, 630,814

L,615,002

L,573,290

L,488,318

All

other

299,440

290,626

29.6,297

302,668

313,866

325,584

314,722

317,008

329,982

325,590

319,968

312,198

312,516

304,892

291,483

283,910

269,508

260,722

254,540

242,276

Both

sexes

1,196.0

1,248.2

1,371.0

1,431.1

1,472.6

1,497.2

1,529.1

1,540.2

1,538.4

1,575.3

1,600.0

1,639.9

1,564.2

1,549.7

1,581.7

1,579.4

1,625.3

1,654.1

1,680.8

1,715.4

Rate

Male

White

1,243.8

1,319.5

1,412.6

13473.4

1,512.6

1,531.7

1,585.7

1,611.7

1,599.6

1,634.1

1,658.9

1,686.4

1,621.2

1,621.9

1,663.3

1,669.5

1,738.9

1,761.9

1,817.8

1,860.7

All

other

2,006.5

2,024.3

2,325.6

2,443.8

2,548.7

2,660.0

2,631.4

2,611.7

2,609.6

2,681.6

2,767.6

2,854.3

2,690.0

2,663.6

2,637.5

2,614.7

2,605.9

2,710.5

2,666.3

2,610.3

White

900.2

930.3

1,017.5

1,059.5

1>091.1

1,104.9

1,143.1

1,152.0

1,164.4

1,201.6

1,207.9

1,246.6

1,190.7

1,183.9

1,219.0

L,219.7

1,251.8

L,290.6

L,315. O

1,349.2

All

other

1,555.6

1,630.6

1,881.9

1,967.2

2,009.1

2,103.3

2>044.0

2,072.8

2,085.3

2,126.6

2,211.2

2,316.2

2,174.9

2,045.0

2,100.3

2,082.7

2,155.0

2,130.6

2,042.1

2,103.4
Table 5. Deaths and death rates for Congenital anomalies, and estimated number of live births,

by color and sex: United States, 1950.69

~tes aredeathsunder1yearper100,000livebirths. B.egintingwkb 1968deathsanddembratesam basedondeaths assigned to category numbers

740-759 of tbe Eighth Reuirion of the International C1as@catim ofDiseases, Adapted for Useinthe United States, adopted in 1965; for 1950.67,

rates are bwd cm deaths assigned to category numbem 750-759 of tbe Sixth and Seventh Revisions, adopted, respectively, in 1948 and 1955]

Year

1969 --------------

1968 --------------

1967 --------------

1966--------------

1965--------------

1964--------------

19631-------------

19621-------------

1961--------------

1960--------------

1959--------------

1958--------------

1957--------------

1956--------------

1955--------------

1954--------------

1953--------------

1952--------------

1951--------------

1950--------------

. . .

Deaths

Total

““,,I=T=1

17,008 7,763 1,384

16,793 7,740 1,335

17,328 7,959 1,387

18,158 8,265 1,456

19,512 8,825 1,550

20,288 9,308 1,532

20,817 9,344 1,490

21,192 9,671 1,519

21,922 10,389 1,530

21,860 10,392 1,573

21,780 10,428 1,468

21,411 10,070 1,514

21,818 10,347 1,464

21,065 10,105 1,358

20,502 9,839 1,291

20,081 9,762 1,207

20,012 9,780 1,172

19,768 9,667 1,108

18,865 9,138 1,042

18,425 9,042 984

II I

Female

Osite

6,627

6,590

6,783

7,199

7,822

8,175

8,008

8,141

8,691

8,664

8,632

8,583

8,794

8,505

8,283

8,167

8,175

8,152

7,901

7,579

All

)ther

L,234

L,128

L,199

L,238

L,315

1,273

L,302

1,192

L,312

L,231

L,252

L,244

L,213

L,097

L,089

945

885

841

784

820

Both

exes

11,309

11,052

11,632

12,200

13,443

14,197

14,581

14,832

15,515

15,389

15,579

15,555

15,801

15,676

15,356

L5,116

15,166

15,185

14,721

14,074

Under 1 year

Male

bite

5,213

5,122

5,345

5,636

6,062

6,537

6,603

6,835

7,439

7,383

7,497

7,327

7,588

7,558

7,4Q9

7,433

7,484

7;449

7,170

6,907

All

,ther

963

885

962

989

.,116

.,079

!,067

.,096

.,103

.,122

.,072

!,131

L,063

,,018

983

894

870

854

805

741

Female

?bite

4,309

4,283

4,507

4,762

5,358

5,692

5,570

5,618

6,034

6,043

6,097

6,185

6,267

6,271

6,131

6,074

6,154

6,260

6,125

5,807

All

mher

824

762

818

813

907

889

866

829

939

841

913

’912

883

829

833

715

658

622

621

619

$?igures by color exclnde data for New Jersey.

,f)6-
Table 5.

.

Deaths and death rates for Congenital anomalies, and estimsted number of live births,

by color and SSX: United States, 1950-69,—.Con.

[Rateswe deathsunder1 yew per100,000livebirths.Begi.ningwhh 1968 deathsand deathratesarebasedon deathsassignedtocategorynumbers

740.759oftheEighthRevision of the Intimation.1 Clmif7.at!on of Diseases,Adapted for Use in the Unzted.St.tes, adoptedk 1965;for1950.67,

ratesarebmsedon &aths assignedtocategorynumbers750-759oftheSixthandSeventhRevisions,adopted,respectively, in 1948 and 1955]

Live births

Both

sexes

3,600,206

3,501,564

3,520,959

3,606,274

3,760,358

4,027,490

4,098,020

4,167,362

4,268,326

4,257,850

4,2.44,796

4,203,812

4,254,784

4,163,090

4,047,295

4,017,362

3,902,120

3,846,986

3,750,850

3,554,149

Male

White

1,539,420

1,497,612

1,501,228

1,535,486

1,604,422

1,727,416

1,709,174

1,740,358

1,848,7!?4

1,848,192

1,846,240

1,833,238

1,859,148

1,820,740

1,776,355

1,769,246

1,725,95S

L,707,656

L,663,782

L,575,309

All

other

307,152

298,714

302,160

310,376

322,632

332,746

324,206

32.4,572

337,480

331,516

327,398

319,308

320,812

312,848

297,364

2893822

275,840

263,606

259,238

248,246

Female

White

1,454,194

1,414,612

1,421,274

1,457,744

1,519,438

1,641,744

1,617,170

1,653,710

1,752,070

1,752,552

1>751,190

1,739,068

1,762,308

1,724,610

1,682,093

1,674,384

1,630,814

1,615,002

1,573,290

1,488,318

All

other

299,440

290,626

296,297

302,668

313,866

325,584

314,722

317,008

329,982

325,590

319,968

312,198

312,516

304,892

291,483

283,910

269,508

260,722

254,540

242,276

Both

sexes

314.1

315.6

330.4

338.3

357.5

352.5

355.8

355.9

363.5

361.4

367.0

370.0

371.4

376.5

379.4

376.3

388.7

394.7

392.5

396.0

Rate

Msle

White

338.6

342.0

356.0

367.0

377,8

378.4

386.3

392.7

402.4

399.5

406.1

399.7

408.1

415.1

417.1

420.1

433.6

436.2

430.9

438.5

All

other

313.5

296.3

318.4

318.6

345.9

324.3

329.1

337.7

326.8

338.4

327.4

354.2

331.3

325.4

330.6

308.5

315.4

324.0

310.5

298.5

Femsle

White

296.3

302.8

317.1

326.7

352.6

346.7

344.4

339.7

344.4

344.8

348.2

355.7

355,6

363.6

364.5

362.8

377.4

387.6

389,3

390,2

All

)ther

275.2

262.2

276.1

268.6

289.0

273.0

275.2

261.5

284.6

258.3

285.3

292.1

282.5

271.9

285.8

251.8

244.1

238.6

244.0

255.5

67.
APPENDIX I

TECHNICAL NOTES

Death Statistics

Tabulations of deaths used is this report are based

on information obtained from microfilm copies of the

origiual certificates. These copies were received tlom

the registration offices of all Stares, certain cities,

and tbe District of Columbia. The statistical information on these records was edited, classified, transferred to a tape for computer processing, and tsbulatsd in the National Center for Health Statistics

(NCHS).

The rates showu in this report are basedon deaths

tabulated by place of occurrence, that is, all deaths

occurring in the death-registration States from 1900

to 1932 and all deaths occurring is the contirmmal

United States thereafter, wftb Alaaka added beginning

1959 and Hawaii, 1960. Deatba among ‘armed forces

overseas and among U.S. nationals living abroad are

excluded for atl yeara.

Ranking Causes of Death

The ranking of diseases and accidents among tbe

leading causes of death is based en the number of

deaths sssigned to causes iscluded in specffied fiats

of causes of death (for example, us the List of 60

Selected Causes of Death for the years 1949-67 ssd on

the List of- 69 Selected Causes ox Death for 1968 and

1969). Two group titf.es, “Major cardiovascular-resal

diseases” and “Symptome and ill-deflmed ceuditiuns,”

are not ranked. bI addftion, beginning with data year

1968, category titles that begin with the worde “Otherr’

or “All other” are not ranked.

The only cause dropped as a reeult of this procedure that othsrwise would have appeared as one of

the 15 leading caueee was the Eighth Revfeion cauae,

Other dieeaaes of arteries, arterioles, and capillaries

(lCDA Nos. 441-448). Its level of morteli~ in 1968

(12.4 deatbe per 100,000) would have placed it as the

llth leadisg cause of death for that ysar. The droppisg

of this cause resultad, of course, in the moving up

into the next places tbe succeeding six causes that had

fewer deaths attributed to them tbas did the dropped

cause.

For 1967 there were, is all, three causes h“ the

Sevsnth Revision list of 15 leading causes whose titles

began with tbe word “other,” as follows:

W/..

1. Other diseaaes of circulatory system (ICDNOS.

451-468) ,

2. Other bronchopnlmonfc dfseases (ICD Nos.

525-527), and

3. Other hypertensive diseases (ICD Nos. 444-

447).

The most nearly comparable titles in the Eighth Kevision Iist of 69 causes for these three causes wsre,

respectively, as follows

1. Other diseasee of arteries, arterioles, and

capillaries (ICDA Nos. 441-448),

2. Bronchitis, emphysema, and aathma (ICDA Nos.

490-493), and

3. Hypertension (ICDA Nos. 400,401, 403).

Consequently, as indicated above, the first of these

meet nearly comparable titles was dropped because

the comparable Eighth Revisian tftte also began with

“other.” But inaemucb ae the remaising two comparable Eighth Revision titles no longer bagin with the

word “other,” they are included in the list of 15 Ieading cauaee.

Race

The category “white” includes in addition to persons reported as “white,” persone reported to be

Mexican or Puerto Rican. The categories “races other

than white” or “all bther” consist of persona reported

as Negro, American Isdias, Chinese, and Japaneee;

othsr numerically small racial groups; and per~ons

of mixed white and other races.

Population Bases

Rstes were computed on the bases of population

ststistice made available ky the U.S. Bureau of the

C&eus. Rates for demnufal years are based on the

populations enumerated in cessuees of those years,

which are taken as of April 1. Rates for alt other years
are based on midyear (July 1) estimates. Sources of

the populations used, publfshed by the Bureau of the

Census, are given below.

VW1 SfMstics Rates in the United Stafes, 1900-

1940, Wssbfngtnn, U.S. Government Printfng Office,

1943. CuWent Population Repovts, Series P-25

No. 98.

No. 265.

No. 276.

No. 310.

No. 321.

No. 352.

No. 385.

,,Estimates of the- population of the United

States and of the Components of Change,

by Age, Color, end Sex: 1940 to 1950,”

1954.

ilEetfmates of the Population of the United

Statee, by Age, Color, and Sex July 1,

1950 to 1962 ,“ 1963. (Used only for data

years 1961 and 1962.)

,,Estfmstee of the Population Ofthe Utlfted

States, by Age, Color, snd Sex July 1,

1963,”1963.

,,Estimates of the population of the United

States and Components of Change, by

Age, Color, end Sex 1950 to 1960,”1965.

,,Es~mates of the Popsladon of the United

Statea, by Age, Color, and Sex July 1,

1960 to 1965,” 1965. (Used only for data

yeSrS 1964 and 1965.)

“Estimates of the Population of the United

States, by Age, Color, and Sex July 1,

1966,”1966.

“Estimates of the Population of th~ United

Statee, by Age, Color, and Sex July 1,

1964 to 1967,” 1968. (Used only for data

year 1967.)

No~416.

No. 441.

“Estimates .of the Population of the United

States, by Age, Color, and Sex: July 1,

1968,”1969.

,,Estimates of the Pomdation of the United

States, by Age, Col&, and Sex July 1,

1969,”1970.

The population estimates by color used for 1962

and 1963 exclude New Jersey. The birtb, death, and

fetal death records of the State of New Jersey did not

contais the race item in the beginning of 1962. The

certificate revision without this item was used for most

of 1962 as well as for 1963. Therefore the National

Center for Health Statistics estimated a population

base by color for these years which excluded New

Jersey. The estimates for 1963 are shown fn table 6-5,

Part A, Volume 11, of Viffd SWf.sties ofthe United

Stales, 1963. Thoee for 1962 are ehown in the comparable report for that yesr.

Age-Adiusted Rates

The sge-adjusted rates presented in this report

were computed by the direct method, that is, by applying the age-specific death rates for a given cause of

death to the standard population distributed by age. The

total population as enumerated in 1940 was selected as

the standard. The rates for the total population and for

each color- sex group were adjusted separately, using

the same stsndsrd population.

Age-adjueted rates are shown with an aeterisk

where more than half of the age-specific death rates

are based on fewer than 20 deaths.

.
APPENDIX II

THE UNITED

Standard Certificates

STATES STANDARD CERTIFICATE OF DEATH, AS REVISED 1968

certificates of most States, however, conform closely

Standard certiflcatea of death iaaued by the National Center for Health Statfatics and its predecessor

offices have served for mauy years as the principal

means of attaining uniformity in the content of the documents used to collect information on these events.

They have been modified in each State to the extent

necessitated by the particular needs of the State or by

special proviaiona of the State vital statistics law. The

in content and arrangement to the standard certificates.

The most recent revision of the standard certificate of death is sfIown below. It was made in close

collaboration with State health officers and regiatrara;

federal agenciea concerned with vital atatiatica; national, State, and county medical societies; and others

worKmg in the fields of public health, social welfare,

demography, and insurance. It waa recommended to the

Statea for adoption as of January 1, 1968.

row #m.0.l.

.“-” .“..A” “o .,-.,.0, (..”9.!..) “ . Go”E,H”mT ,1,.,, ”..,,,,, ,“, .,-m,.,,

r 1

“.s srANDAR.

CERTIFICATE OF DEATH r 1

,“,,, ORP,!., IN ma . . “w,,. ,,.. FM W,,.

‘[mMANENr INK LKCEASm--

!5 HINOIOOK Fo!

,,., Mw. l-m .m DAm 0, OEATH i.... .....r-.,

Inmnm ,

I % .. I

J JMlutm ADmss-,m,,w ..,,:, F D . .

.

m. . . w. ,,.,, .,,

~

0.0, m S,..

g

.

? .Am ,-!.. 0“,, “M, ,“.,,. “+WE mm MnRFsl

:

, ,,,,!, . . E ‘,. . . . am .! m.., ‘,.,,, .,!

, m+lna-slmu.,, DA. ,.””En ,“ Ucu WG”,u..

.

z]
APPENDIX Ill

COMPONENTs OF COMPARABILITY RATlOS FOR 15 LEADING CAUSES OF

DEATH AND THEIR MAJOR SUBCATEGORIES FOR COMPARING ASSIGNMENTS

BY EIGHTH REVISION WITH THOSE BY SEVENTH REVISION, BASED ON

DEATHS OCCURRING IN 1966

Data shown in the foZlowing table are from a study

of tie comparability between the Seventh and Eightb Revisions of the Zntemationsl Classification of Diseases.

Provisional estimates of selected comparability ratios

and a brief summary of the statistical design of the

compsrabiliry study have heen published in MonfhZy

WoZ .Wfiafics Ra@-f, Vol. 17, No. 8, Supplement, Octokr 25, 1968.

The set of comparability ratios sbowq here was

computed to assess the degree of discontinuity between

1967 and 1968 for the 15 leading causes of death and

their subcategories aa shown in detailed tables 2 and 3.

For each of these 15 causes and their subcategories, a

comparablZity ratio was especisZZy computed for this

present report by dividing the estimated number of

deaths ia 1966 assigned to the Eighth Revision category

numbers corresponding to the title shown in the stubs

of tahZea 2 and 3 by the numkr of deaths in 1966 assigned to the nearly comparable category numbers of

tie Sixth and Seventh Revisions shown in the last column of tables 2 sud 3.

This particular set of category numbers according

to the Sixth and Seventh Revisions was used in the construction of these comparability rati~s because trend

data for 1950-67 were available for the titles correspondittg to these category numbers. It turns out that,

with few exceptions (which are f?o;nqted in the table

below), this set of category numbersjfor the Sixth and

Seventh Revisions is the same as the set used to compare for these same Eighth Revision tit~es for the abovementioned pubfished provisions comparability ratios.

It wiZZ be observed that even for those Eighth Revision titles for which the set of Sixth,and Seventh Revision categories used for the present report are identical with tbe aet used for the pubf%bed provisional

rat:oa, the provisional ratios are sometimes slightly

lower than the ratios ahown in this tieport. This difference results from a better computational procedure

used to compute the ratios for tb:i present report.

-$

.. >

-----

I

1

k%
\

List title according to the Eighth Revision Category numbers accordof the International Classification of ing to the Eighth

Diseases, Adapted, 1965 Revision

1.

11.

Diseases of heart------------------------- 390-398,402,404,410429

Active rheumatic fever and chronic

rheumatic heart disease------------------ 390-398 “

Hypertensive heart disease with or

withoui?crenaldisease----:--------------- 402,404

Ischemic heart disease-------------------- 410-413

Chronic disease of endocardium and other

myocardial insufficiency----------------- 424,428

All other forms of heart disease---------- 420-423,425-427,429

Malignant neoplasms, including neoplasms

of lymphatic and hematopoietic tissues--- 140-209

Malignant neoplasms of buccal cavity

and pharynx------------------------------ 140-149

Malignant neoplasms of digestive organs

and peritoneum--------------------------- 150-159

,.

Malignant neoplasms of respiratory

system-----------------------------------160-163

Malignant neoplasm of breast-------------- 174

Mali~a#%&plasnw of genital organs----- 180-187

Malignan: neoplasms of urinary organs----- 188,189

lkalignan~‘ieopIasmsof all other and

unspeci’kiedsites------------------------ 170-173,190-199

Leukemia----------------------------------204-207

Other neoplasms of lymphatic and

hematopoietic tissues-------------------- 200-203,208,209

III. Cerebro;asculardiseases------------------“430-438

IV. Accidents---------------------------------E800-E949

Motor vehicle accidents------------------- E81O-E823

All othe!raccidents----------------------- E800-E807,E825-E949

v. Influenza and pneumonia------------------- $70-474,480-486

Influenza---------------------------------470-474

Pneumonia---------------------------------480-486

VI. Certain causes of mortality in early

infancy----------------------------------;;;60;;;.2,769.4-772,

VII. Diabetes mellitus------------------------- 250

‘VIII.Arteriosclerosis-------------------------- 440

IX. Bronchitis, emphysama, and asthma--------- 490-493

Chronic and unqualified bronchitis-------- 490,491

Emphysema---------------------------------492

Asthma------------------------------------493

x. Cirrhosis of liver------------------------ 571

XI. Suicide-----------------------------------E950-E959

XII. Congenital anomalies---------------------- 740-759

XIII.Homicide----------------------------------E960-E978

XIV. Nevbr%tis and nevhrosis------------------- 580-584

xv. Peptic ulcer------------------------------ 531-533

Category numbers

according to the

Seventh Revision,

adopted in 1955

400-402,410-443

400-402,410-416

440-443

420

421,422

430-434

140-205

140-148

150-156A, 157-159

160-164

170

171-179

180,7.81

156B,165,190-199

204

200-203,205

330-334

E800-E962

E81O-E835

E800-ES02,E840-E962

480-493

480-483

490-493 :

760-776

260

450

241,501,502,527.1

501,502

527.1

241

581

E963,E970-E979

750-759

E964,E980-E985

590-594

540,541

Yovi -

,ional

.ompar-

!bility

ratio

1.0045

11.1519

0.3941

11.1457

10,1823

0,8104

11.0017

“1.0596

10.9660

1.0316

0.9913

1.0034

1.0171

11.0212

0.9974

11.0506

0.9905

0.9570

0.9921

0.9250

1.0440

0.9572

11.0480

10.9183

0.9971

0.S963

1.0034

1.0620

1.0542

0.6954

1.0055

0.9472

1.0204

0.9969

0.8860

0.9856

*For reasons described in the foreword to this table, the set of Seventh Revision category numbers

uaed to consmuc.t this ratio is different from the set used to construet the published provisional comparability ratio for this same Eighth Revision title.

73
APPENDIX IV

TECHNICAL NOTE ON ASSIGNMENTS TO ACCIDENTS WITH CATEGORY

NUMBERS E916-E921, E923-E928

The World Heskb Organization (WHO) in its List

A (List of 150 Causes @v Tabukztion of Morbidity and

MortaMy) introduced with the Eighth Revision of the

International CWssification of Diseases, 1965, included

as the 145tb title, AE145 Accidents mainly of industrial

type, E916-E921, E923-E928.

There are no figures available to substantiate that

the deaths assigned to the category numbers under this

title are actually “mainly of industrial type.” To avoid

possibly misleading the reader, therefore, although

1968 and 1969 figures (bmh deaths and death rates) are

shown for these catego~ numbers (E916-E921, E923-

E928), the WHO group title “Accidents mainly of industrial type” is “not shown.

Ca.s. of death (with fourth digits)

E925 Accident caused by electric current----

Include,: burn by elec- exposed wize

tic current faulty appliante -”

electric shock from bighvoltege cable

.Iactrocution live rail

00F=osocket

Excludes: bum by heat from elecuical

a##nce fs924), lightning

E925.O

E925.1

E925.8

. .

Hame wiring .. appliances ------

Imdustrial wiring.. appliancesrnclndes: wiring and appliances

illor on,

farm (not farmhouse)

outdoor,

public btildi.gs

.esidemt instit=tims

sChc.ols

E925.9 Specified --------------------

Includes: bum b. electric c.rrent Nbs

electric shock N02

electmctlti.mIKE

All

eaths

1,148

222

L52

653

121

Both for accideqts assigned to E916-E921 and E923-

E928 and for-a number of other nontransport accidente,

fourth-digit subdivisions have been provided by the

Eighth Revision. fn addition, beginning with data year

1969, the United States has made special tabukitions

showing “place of accident” by fntrcifuction of fifth

digits ueing the epecial fourth-digit codes introduced

with the Seventh Revision. For example, the cross-tabulation of Accident caused by electric current (lCDA

No. E925) by fourth and fifth subdivisions is as follows

for data year 1969:

—

me

0)

18

22

96

—

a.rnl

- 1)

71

71

—

Mine

md

Uarry

:.2)

6

6

Place of accfdent (with fifth digits)

[:fi -

lace

and

remises

(.3>

146

146

P~=e

ecretf.”

*“d

part

(.4)

13

13

-C&et

ighWay

(.5)

134

134

Ublic

uildi“g

(.6)

49

“ 49

-,re: ;

mti -

“t ion

(.7)

3

3

Wher

yi:jlIace*

(.8)

137

137

-lace

not

l~c -

(,9)

271

150

121
A word might be said about 96of the 318 accidental facilities such as “private garden to home,” “home

deaths caused by electric current that are shown above swimming pool,” etc. These same terms are, however,

as occurring at home, but are not class ified as Home inclusion ‘terms under the fifth subdivision “home.”

wiring and appliances (ICDA Nos. E92.5.0). This results Tfie specisl tabulation made by the United States

from the fact that the inclusion term “outdoors” under by fifth-digit subdivisions shows the following distriAccidem caused by electric current—other (lCDA No. bution of deaths in 1969 assigned m tbe so-called “AcE925.8) is interpreted as covering home premises snd cidents mainly of industrial type, ” by place of accident:

All

deaths

6,09!

J

I

Home Farm

(.0) (.1)

*

Mine

and

quarry

(.2)

180

Industrial

pl&Je

pramises

(.3)

1,252

Plsce of accident

I I I

Other

specified

places

(.8)

718

Place

not

specified

(.9)

781

,-, ii:’

, . . , ,,.,-,

:lt.L

1!

--
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