Public Health Service Publication No. 1000-Series 22-No. 10

For ssle by the Superintendent of Documents, U.S. Government Printing Office

Washington,D.C., 20402-Price 60cents
NATIONAL CENTER Series 22

For HEALTH STATISTICS Number 10

VITAL and HEALTH STATISTICS

DATA FROM THE NATIONAL VITAL STATISTICS SYSTEM

Health Insurance

Coverageof Adults

WhoDied in 1964 or 1965

United States

Statistics on hospital and surgical insurance coverage for

persons who died during 1964 and 1965, by age, sex, color,

geographic region, family income, living arrangements, family

size, and marital status. Based on data collected in a mail

survey with questionnaires sent to the informant for the death

certificate.

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

Public Health Service

Health Services and Mental Health Administration

wash ington, D.C. October 1969
—

NATIONAL CENTER FOR HEALTH STATISTICS

THEODORE D.WOOLSEY, DiTectoT

PHILIP S. LAWRENCE, SC. D., Associate Director

OSWALD K. SAGEN, PH.D.,, Assistant Director for Health Statistics Development

WALT R. SIMMONS, M. A., Assistant Director for Research and Scientific Development

ALICE M. WATERHOUSE, M. D., Medical Consultant

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

EDWARD E. MINTY, Executive 0//icer

MARGERY R. CUNNINGHAM, In/orrnation O//icer

DIVISION OF VITAL STATISTICS

ROBERT D. GROVE, Ph. D.,, Director

ROBERT A. ISRAEL, M.S., Deputy Director

ROBERT A. ISRAEL., M.S., Acting Chief, Mortality Statistics Brunch

JOHN E. PATTERSON, chief, Natazity Statistics Branch .

LOREN E. CHANCELLOR, Cbie/, Registration Methods Branch

ALICE M. HETZEL, Cbz’eh Marriage and Divorce Statistics Branch

ARNE B. NELSON, M.A., Chief, Vital Records Survey Branch

MICHAEL J. ZUGZDA, chic/, statistical Resources Section

Public Health Service Publication No. 1000-Series 22-No. 10

Library of Congress Catalog Card Number 79-602405
CONTENTS

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

Selected FMdings -----------------------------------------------------

Sources and Limitations ofData -----------------------------------------

Nature of the Population ------------------------------------------------

Extent of Coverag~----------------------------------------------------

Age and Sex--------------------------------------------------------

Color and Age------------------------------------------------------

Geographic Region --------------------------------------------------

Family Income, Living Arrangements, and Family Size -----------------

Marital Status-----------------------=---:--------------------------

References-----------:-----------------------------------------------

Detailed Tables-:-----------------------------------------------------

Appendix I. Techical Notes on Methods -------------------------------

Background of ~isReport -------------------------------------------

Sources ofData -----------------------------------------------------

Sample Desi~-----------------------------------------------------

Death Cer:ificate,andQuestionnaires----------------------------------

Collection of the Data -----------------------------------------------

Processing of the Data -----------------------------------------------

*Nonresponse and Imputation for Missing Data --------------------------

Weighting Procedures for National Estimates--:-- ---------------------

Reliability of Esttiates ---------------------------------------------

Standardization Procedure -------------------------------------------

Roundtig ofNumkrs ------------------------------------------------

Appendix II. Definitions of Certain Terms Used in This Report -----------

Information From the Death Certificate -------------------------------

Information From the Questionnaires--------------,------------------

Appendix 111, Source Forms --------------------------------------------

Death Certificate ---------------------------------------------------

Informant QuestioMaires --------------------------------------------

Death Outside hstitution -------------------------------------------

Deathinh stitution ------------------------------------------------

rage

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43

...

Ill
iv

IN THS REPORT statistics ave pvesented ofi ho.s}itul and suvgical

insuvance covwage of adults aged 26 and ouw who died duti”ng 1964 OY

1965, the last 2 yeavs before the introduction of Medicave.

These statistics are based on duta collected in a mail suvvey by ques -

tionmires sent to the pwson who @ovided the finwal divecior with the

decedent’s pwsonal infovmaiion for vecording on the death c~t~icate.

The decedents about whom information is pesented in this vepovt ave

classified by age, CO1OV,sex, maritil stitv.s, geo~aphic vegion, living

awan~ements, family size, and family income duvi~ the last full calen-

&Y yeav befove death.

About 48 pwcent of the decedents wwe veported to have hospital ifisurance and 37 pwcent w@e vepovted to hue suvgical itistivance, The

levels of coverage wwe highw fov white decedents and fov decedents

who wwe mawied at the time of their death than fov othw decedents.

Decedents in the Novtheast and North Cefitval Regions hud highm levels

of covera~e for both kinds of health insuvance thn decedents in the

South and West. Of all the variables included in this vepovt, the single

most influential one was family incotie. Only 30 p~cent O; the decedents who wwe membws offamilies with incoties less than $2,000 were

vepovted to have hospitil insuvance while the hospihl itiuvance coverage rate for decedents in families with incomes of .$7,000 and oveY was

73 pwcent.

SYMBOLS

Data not a~ailable ----------------------- ..- “

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

Quantity zero------~ --.------- . ---------- .

Quantity more than O but less than 0,05 ----- 0,0

Figure does not meet standards. of

reliabili~ or precision -------- ---------= *
HEALTH INSURANCE COVERAGE OF ADULTS

WHO DIED IN 1964 OR 1965

Elaine J. Timmer, Division of Vitil Shtistics

lNT,RODUCTfON

The data presented in this report were obtained from The National Mortality Survey which

Was based on a probability sample drawn from

the file of death certificates representing all

deaths registered in the ‘United States during 1964

and 1965.

‘This report is concerned with the amonnt and

kinds of healti insurance coverage tie decedents

had in the 12-month period before. death, Thepur.

pose of this Teport is twofold, Fifst, since the

data presented here measure IhehealthMsurance

coverage of decedents in 1964 and 4965 j they can

be used as a baseline measure df the ement of

cove~age during the 2-year period before the lntrodtiction of the Me&care program. Ntiough aU

decedents Included fi ttiis report would not have

been eligible ‘for Medicare, a substantial ~oportion of them were age 65 or over at the time

of death and .fierefore, many would have been

eligible if Medicare had been in effect at the

time, Seeond, previously published data on health

insurance coverage in the United States refer ~nly

to the noninstitutional, fiving population. me data

k this Yeport, however, present coverage Iortwo

segments o’f~he population not usually covered in

othef estimates of health insurance coverage.

me population from which the sample for the

National Wrtality Swvey was drawn ticlude~

those individu~s who Were kesidents of institutions .~t the time of their death. Mso, .ss will he

shown later in the ~eport, .Wecoverage levels .uf

persons hear dearh were ditierent from.fielerels

for persons who did not die during the reference

period.

Protection against the costs of medical care

is provided by many ~es of health insurance

plans. Only formal plans with defined membership ad benefits were considered insurance in

this survey,. me insuring organization could be

either a nonprofit or a commercial group.

In this report, data are presented for only

two ~es of health insurance. me first is hospital insurance which ~ay.s all or part of the hospital bill for-;the hospit~zed person; the second is

-surgical insurance which pays all or part of the

bill for a physician performing .an operation

either in a hospital or in his office.

In :gesieral, tie pattern~ .o’fcoverage were

s“mllar for hospital and surgical insurance al-

$hough the proportion of ‘the population covered

by hospital insurance was greater than that

covered by sm,gical insurance. For this reason,

and ‘because ‘hos,pital insurance is the more basic

we of coverage,, much of thb discussion which

XOUOWSis litited to hospital insurance.

Mthough the National MortaHty Survey collects Worrnation for decedents of ali ages, this

m.epont ptesents data only for those persons who

‘died at :age ’25 or older. ‘Wls age Bmitation was

selected shice the ‘q~estion~ on health Insurance

for persons who died durtig Chiidhood referredto

tie .covefage of the patent rather than of the deG~dent, :~Mldren are ,usually covered as dependents ‘under theit parents” policies until they

establish their :own households or reach an age

s,petiified h the individual poficy. Since the ages

1
.

at which children normally leave their parents’

households vary, the data for this report isrestrictedto decedents 25 years and over.

Decedents under age 25 represented only 3.6

percent of the total number of decedents aged 1

year and over in 1964 and 1965; thus, omission

of these decedents does not distort the overall

picture of health insurance coverage among all

decedents. Also, such variables as marital status

and income have meaning only for adults.

The questions on health insurance coverage

in this survey referred tothedecedent’s coverage

during the 12-month period before his death.

Since most of the decedents were aged 65 and

over, and since it may have been difficult to obtain or to continue insurance at these older ages,

it should be pointed out that the figures presented

here may also reflect the levels of insurance

coverage of times prior to 1964 and 1965. For

example, those decedents aged 65-74 would probably have had to initiate their coverage from at

least 1 to 10 years before their death, i.e., while

they were under age 65. Therefore, the following

statistics on hospital and surgical insurance for

persons dying during 1964 and 1965 may be viewed,

in part, as a measure of the patterns of coverage

during the 1950’s and earlier.

SELECTED FINDINGS

Of the annual average of 1,648,691 adults

aged 25 years and over who died in the United

States during 1964 and 1965, 48 percent were

reported’ to have hospital insurance and 37 percent were reported to have surgical insurance.

The highest levels’ of coverage were reported

for decedents under age 65, and the levels of

coverage were lower in each succeeding age

group after age 65. For decedents aged 65-74,

the hospital insurance coverage rate was 51 percent; for decedents aged 75-84 the rate was 40

percenq and for decedents aged 85 or older, the

rate was 27 percent.

Fifty percent of the white decedents hadhospital insurance coverage while only 26: percent

of the nonwhite decedents had such coverage.

There was wide variation in the proportion

of decedents covered by hospital and surgical

insurance when they were classified by family

income. For decedents in families with incomes

less than $2,000, the coverage rates were 30 and

21 percent for hospital and surgical insurance,

respectively; for decedents in families with incomes between $2,000 and $3,999 the rates were

50 and 38 percent; for decedents in families with

incomes between $4,000 and $6,999, the rates

were 65 and 51 percent; and fox decedents in

families with incomes of $7,000 or more, the

rates were 73 and 60 percent.

Persons who were married at the time of

death were moie frequently covered by health

insurance than other decedents. The rate of hos.

pital insurance coverage for married decedents

was 59 percent; for widowed decedents the rate

was 36 percent, while for single and divorced

decedents the rates were 35 and 34 percent

respectively.

The patterns in the coverage rates among

the four regions varied for hospital and surgical

insurance. Fifty-three percent of the decedents

in the Northeast and 51 percent in the North

Central Region had hospital insurance coverage,

while for the South and West the reported coverage

rate for hospital insurance was 42 percent. The

rates for surgical insurance coverage were 41

percent in the Northeast, 40 percent in the North

Central, 34 percent in the West, and 31 In the

South.

SOURCES AND LIMITATIONS

OF DATA

The 10,408 decedents who were included in

the National Mortality Survey were selected from

the death certificates filed by each State and

registration area. me decedents are a 1 in 330

probability sample of persons aged 1 year and over

who died in the United States during 1964 and 1965.

The statistics presented in this report were ob.

tained from the responses to a mail questionnaire sent to the death record informant, i.e.,

the person who provided the funeral director with

the personal information about the deceased for

recording on the death certificate. The informant,

who was usually a close relative of the decedent,

was asked to provide information on health insurance coverage and socioeconomic characteristics of the decedents, as well as to identify the

hospitals or institutions which may have provided

care to the decedent during the year before his

death.

2
A description of the survey procedures for

the National Mortality Survey as well as a description of the estimation procedures is in

appendix 1. Since the data in this report are

estimates based on a sample, they are subject

to sampling error. Tables of approximate sampling error and instructions for their use are

also presented in appendix I.

In addition to sampling error, the quality of

survey data can be affected by other sources of

error. One of these is the amount of knowledge

the respondent has. Since the information about

the decedent was provided by another person,

the informant may not have known the answers

to specific questions concerning the decedent

or may only have been able to estimate some

answers. However, the reporting of hospital

insurance coverage for decedents may be good

since 73 percent of the decedents had had one or

more hospital episodes during the 12 months before death, and would have had occasion to use

their hospital insurance. In addition, as in any

survey, it is possible that the respondent may

have misunderstood some of the questions and

therefore may have reported erroneous data.

Another possible source of error is that

associated with nonresponse. Of the 10,408 decedents aged 1 year and over included in the

survey, there was no response for 938 cases

(9.0 percent of the total sample). For decedents

aged 25 and over, the nonresponse rate was 8.7

percent. For these cases, information about the

decedent was imputed utilizing a computer. A

discussion of the imputation procedures, and of

some measures relating to bias in the survey

procedures for the National Mortality Survey are

also discussed in appendix 1.

Definitions of the terms used in this report

are given in appendix II; facsimiles of the Standard Certificate of Death and the questionnaire are

shown in appendix III.

NATURE OF THE POPULATION

An annual average of 1,648,691 adults aged

25 years and over died in the United States during

1964 and 1965. Two-thirds of these decedents

were 65 years or older. Because of their advanced ages, the decedents differed from the

living population with respect to several characteristics discussed in this report. Table A compares the decedent population included in this

report with the civilian, noninstitutional population of the United States for January 1, 1965.

The decedent population consisted mainly of individuals from the older age groups, Ofthe adults

aged 25 and over who died during 1964 and 1965,

about 66 percent were 65 years or older at the

time of their death. Of the noninstitutionalized,

living persons aged 25 or older, only 17 percent

were of comparable age.

Among the decedents, a higher proportion

were either married or. widowed than was observed in the living population. These differ&nces

are related to the differences in the age distributions of the two populations. Since the decedents were from an older population, it is expected that more of them would have been widowed

or married. The proportions widowed were 35

percent for the decedents and 6 percent for the

living population. About 52 percent of the decedents as compared with 46 percent of the living

population were married.

Of all decedents considered in this report,

19 percent were residents of institutions at the

time of their death. These decedents, as well as

those persons who lived alone or with nonrelatives,

are classified as one-person families. As defined,

35 percent of the decedents were members of oneperson families. About 27 percent of the decedents lived with their spouses and no other relatives at the time of death and an additional 37

percent were living with other relatives.

There was a marked difference between the

two populations when family income was considered. The median family income for the living

population ($6,109) was more than twice as high

as the median income for the decedents ($2,590).

The low family income reported for the decedents

may be due, in part, to their advanced age, illness, and the generally low incomes associated

with retirement.

The decedent population also differed from

the living population as to the amount of hospital

experience. A substantially higher proportion of

the decedents (73 percent) had at least one hospital or institutional episode in the year preceding

death than was observed during a year for the

living population (10 percent).

3
Table A. Pe~cent distribution af decedent

population and Ctvi.lianX moninscimtLonal population, by selecte& characteris~ics: United Statics,. 1964-65

CharacterLst5c

Age

All ages, 25+ years--

25-64 years --------

65+ years ----------

MaritaL status

Total ----------------

Married ------------

Wi.dewed------ ------

Other-----=--------

Hospital episodes

Total ----------------

None ---------------

One or more --------

Medf.an income --------

$2.8

17..2

lUnpublisheddaCa fEom&eHealth lneerview Swvey for fi.sca~ year 1965..

2Based on pezsons of a~~ ages.

Tbe following ana~ysis of the extent of heaIth

insurance coverage amQng perso~s dying during

1964 and 19657 then, becomes rnoremeaningf@

because tie population under co~sideration lsav

high risk oibeing hospitalized.

EXTENT OF COVERAGE

Age and Sex

Among aIIadults aged25andolderwho died

during 1964 and 1965, thelast2 years before the

introduction of Medicare= 48 percent had some

type of insurance which paid all orpart oftheir

hospital eqmse and 37 percent had insurance

which paid al~ or part of their surgical expense,

Althou@thesefi@res arelowerthanthe coverage

races fiomthe Healtblntervfew Survey~ reported

for ~he~iving popu~ation in 1962 and1963 (table

R}, theditierentid betweentheproportfon ofthose

decedents covered by bospita~insuran~e andthose

covered by surgical insurances Sfrnilarto that

reported for the living population.

Of the annual averagemnnber ofadultdecedents, 56percent werernales and 44pexcentwere

females. Altkough fewer females died during1964

and 1965, in the older age groups there were

more females than males. There was a signifi.

cant difference between the median age atdeath

for males and females. The median age of tk~

male decedents 25 yearsandolderwas 69 years,

whiIe for females the median ?gewas 74 years,

Table 1 shows that the levels uf coverage

for both kaspital and surgical insurance were

higher in each successiveage groupup to age

65. Above age 65, however, thelevels of coverage were Io,wer in each successive age group,

Among deceden~s under age 65, the coverage

rates fo~ hospital insurance ranged from 53

percent for decedents aged 25-44 to 61 percent

for decedents aged 55-64. SimiIarincreaseQ were

observed in the surgicaI ffisurancerates forage

WOUPSunder 65. The high levels ofcoveragein

these agegraupsmay reflect the fact that during

these year~in&viduals axe more likely tobeem+

ployedandbave better acce~sta healthirisurari~e

through their place of employment.

me rates of hospital and surgical coverage

for decedents aged 65 andover were significantly

Iowerthaa the rates for the younger clecedents.

Ahuc60 percent of the decedents undexage65

ha@ kos@tal insuraneesnd 49 percent hadsur.

xcalinsuran~e, whflefor decedents aged 65and

over, tie rates were 42 and 30p@centforfiospital ati surgica~ insurance respectively, Inthe

oldest age group (85 years and over) the rat.e~

for fiospital and surgiczl inw~xaacc were about

one-haIfashf@ asthe ratesfor personswbodfed

beforeage 65.

Several factors can contribute totlifs lackof

coverage among the elderIy. Perhaps theprirnary

factor is the retjra~t sfatus among those persons aged 65 and aver, It is probabIe that many

persons wbmhad healthjnsurance coveragebefore

4
I

retirement were unable to retain the coverage

after retirement either because the policy was

available only to employed persons or because

the retired person could not afford the premiums. Also, because health insurance was less

camon 10 to 20 years ago, many of these

people who were last employed at that time may

not have been covered even during their employment years. After retirement, these individuals

may not have been able to obtain health insurance,

even if they had chosen to do so, because of their

advanced age.

Secondly, income is low at the older ages

and it has beep shown in other reports ~/2that low

income is associated with low rates of insurance

coverage. Thirdly, persons aged 65 and over have

Table B. Percent of persons with hospi.ta 1 and surgica 1 insurance coverage for decedents 25 years and over and civilian, noninstitutional population, by sex and age:

United States

1

Sex and age

Both sexes

All ages, 25 years and over---

25-44 years----------= --------” -----

45-54 yea~s -------------------------

55-64 years -------- -------- -------- -

65 years and over -------------------

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

75 years and over -----------------

Male

All ages, 25 years and over---

25-44 years -------------------------

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

55.64 years----------------=--------

65 years and over-------” -----------

65.74 years----*-----------=-----=

?5 years @nd oven..-.-.---... --”~-

Female .

Al,l ages, 25 years and over---

years. -------- . . . . . . . r..-.=-. -e--

years -------------------------

years----------’ --------------

2,5-44

45-54

55-64

65 yeaks and Qver--------=”-------p65-74 years-” - .-- - em-mP- - - sP- - - ---- F

75 years and over .=----- ------- ---

.

With hospital insurance With surgical inswance

Civilian,

noninstitutional

po~9~2t;n,

70.3

76.3

77.5

73.2

54.0

60,8

41.1

70.8

77,2

77.7

74,3

54.6

60.7

42*2

b9,8

75.4

77:3

72,2

53.5

I

I Civilian.

Decedents, noninkgitG1964-65 tional

population,

1962-63

Decedents,

1964-65

I I

“Percent of persons

47.8

53,0

59.5

61.2

42.0

51.4

35.9

50.1

50.5

.%.1

60.9

43.1

52.9

38.7

A&.7

57.*1

62.1

61.6

38.6

49,0

33,3

65.2

71.8

72.2

,66.7

45.7

52.3

33.1

65.8

72.7

72.7

68.3

h7,2

53.5

34.5

64.6

71.1

71,7

65.1

44.5

51..4

32.0

36.6

46.9

.50.7

49.4

30.2

38.9

24.5

39.6

44.2

50.1

49,6

34.0

$;:$

32.8

51.4

51.7

49.0

26.1

35.1

21.5

5
Tabl& C. Effect of age adjustment on the

rates of hospital aridsurgical insurance

coverage by sex: United States, 1964-65

Hospital Surgica 1

insurance insurance

“XAdjusted

I

Percent

Male ----- 50.1” 48.7 39.6 38.2

Female--- 4A.7 46.9 32.8 34.9

a high prevalenceofchronicillness3which may

cause extensive hospitalization. These elderly

persons who were knownrisks mayhave foundit

difficult to obtain health insurance or ridersin

thepo~cy may have precluded payment.

Males had higher rates ofcoverage for both

hospital and surgical insurance than did females.

Part of this difference isdueto the age distribution of male and female decedents. About 72

percent of the female decedents as compared with

only about 62 percent of the male decedents were

aged 65 or older. Older age is associated with low

insurance coverage. In the age groups under. 65

years, the rates for males and females were

comparable except in the youngest age group; for

decedents aged 25-44 the ,coverage for hospital

insurance was higher for females than for males.

However, for decedents aged 65 and over, the

hospital insurance rate for males was significantly higher than the rate for females. me rates

of coverage for hospital and surgical insurance

were 45 and 34 percent respectively for males

aged 65 and over, but only 39 and 26 percent for

females of comparable age.

Table C shows the effect of age adjustment

on the rates of insurance coverage for each sex.

The rates of hospital and surgical insurance

coverage were adjusted to the standard population

of decedents aged 25 and older. After adjustment

the rates for males remain higher than the rates

for females. However, the differences between

the. levels of coverage for males and females decreased.

Color and Age

The extent of hospital and surgical insurance

coverage differed greatly between the white and

nonwhite decedents (table 2). About one-half of

the white decedents as compared with only about

one-fourth of the nonwhite decedents had insurance which helped pay for hospital expenses.

For surgical insurance, the coverage rates were

39 and 19 percent for the white and nonwhite decedents respectively.

The lower coverage for nonwhite decedents is

not a result of their age distribution. Table D

shows that the nonwhite decedents were younger

than the white decedents. Only 47 percent of the

nonwhite decedents as compared with 69 percent

of the white decedents were 65 years or older at

the time of death. There was also a significant

difference between the median age at death for

the two groups. The median age at death for white

decedents was 72 years while the median age for

nonwhite decedents was 56 years.

Table E shows the proportions of decedentg

with hospital and surgical insurance that would be

expected if the white and nonwhite decedents had

the same age distributions. The age-adjusted

rates for the nonwhite decedents were even lower

than the reported rates. Even though the nonwhite

decedents represented a younger population, their

levels of coverage were below those for the white

Table D. Percent distribution of decedents 25 years and over, by age according to color: United States, 1964-65

Age

All ages, 2fi--

25-44 years --------

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

55-64 years --------

65+ years ----------

65-74 years ------

75-84 years ------

85+ years --------

-

Percent distribution

100.0

6.6

1;::

66.3

26.2

27.3

12.8

100.0 I 100.0

5.6 14!5

15.5

1::; 22.7

68.7 47.2

26.3 25.3

28.7 15.7

13.6 6.3

6
I

Table E. Effect of age adjustment on the

rates ofhospital and surgical insurance

coveraze. by color: United States,

.

1964-65 -

Colnr

White----

Nonwhite-

=

Percent

Adjusted

50.4 51.0

!

38.8 39.5

26.4 24.2 19.0 16.8

decedents. Other factors, then, besides age must

be responsible for the significantly lower coverage rates for nonwhite decedents.

One of these factors may be the employment

status of the nonwhite decedents. In 1964, the

proportion of the civilian, noninstitutional population who were members of the labor force

were 56 and 60 percent for white and nonwhite

persons respectively.4 However, among thosein

the labor force, the rate of unemployment for

nonwhite persons was twice ashighastherate for

white persons. About 10 percent ofthe nonwhite

labor force was unemployed but forwhitepersons

the unemployment rate was only 5 percent.

Not only was the employment rate lower for

the nonwhite population, but theproportion of nonwhite persons employed inoccupations which usually do not offer group health insurance coverage

to employees was’also higher for nonwhite than

for white workers. Table F showa the percent

distribution of employed persons by occupation

Igroup and color. About 22 percent of the nonwhite

workers as compared with only 8 percent of “the

white workers were employed on farms or in private households. It is unlikely that persons in these

occupations would have health insurance available

through their place of employment.

Geographic Region

Comparisons of health insurance coverage

among the four regions (table 3) show the highest rates for the Northeaat and the North Central

Regions. About 53 percent ,of the decedents in the

Northeast and 51 percent in the North Central

Regions were covered by hospital insurance. In

the South and the West, the coverage rates for

hospital insurance were 42 percent.

The low coverage in the South is due partly

to the high concentration of nonwhite decedents in

this region. Of the 181,265 nonwhite persons who

died during 1964 and 1965, 57 percent were in the

South. The low rates of coverage in the South, then,

reflect to some degree the low coverage reported

for nonwhite decedents. The low levels of coverage

for health insurance were evident throughout the

entire South; coverage for both hospital and surgical insurance was low in all three divisions included in this region.

The low rates of health insurance coverage .

in the West have been noted in earlier statistics

on health insurance. 15‘ It would appear from table

3 that the low level of coverage reported for decedents in the West was centered in the Pacific

States—Alaska, California, Hawaii, Oregon, and

Washington—rather than throughout the entire

region. In the Pacific Division only 39 percent

of the decedents had hospital insurance while

in the Mountain Division, the level of hospital

insurance coverage (52 percent) closely resembled the level of coverage reported for decedents

in the Northeast and the North Central Regions.

Table F. Percent distribution of employed

persons, by occupation group according

to color: United States, 1964

I I

Occupation group White ~;e

Percent

distribution

All occupations ------

%

Farmers and farm managers-- 3.5

Farm laborers -------------- 2.6 :::

Private household workers -- 13.5

Other ---------------------- 9::; 77.8

Source: U.S. Department of Labor,

$pecial Labor Force Rep-, No. 52, Apr.

1965, Table C-7, p. A-22.

7
This lowcoverage inthe Westdoesnotappear

to be associated with the age distribution of the

decedents in this region. Figure 1, based’ on

table 4, shows that only about 64 percent of the decedents in the West were aged 65 and older as

compared with 69 percent in the Northeast, the region which had the highest rates of coverage for

hospital insurance.

Since the West had fewer old decedents as a

proportion of all decedents in the region, the

rates should be higher than reported if age were

the determining factor in the amount of health

insurance coverage among decedents. Other factors, then, must influence the health insurance

coverage rates in the West.

One possible factor affecting the rates of

coverage for health insurance in the West might

be the types of plans that are available. Although

data on types of plans were not collected in this

survey, some indication as to the distribution of

the various plans by region and age are available

from the Health Interview Survey. 2 The figures in

table G refer to hospital insurance coverage for

the civilian, noninstitutional population of the

United States in 1962 and 1963. The data show that

the proportion in the West covered by non-Blue

plans was about twice as high as in the Nor&east;

for persons aged 65 and over, the differential was

higher still. Similar figures released by the Blue

Gross Association G showed that the West comprised only 7 percent of the total Blue Plan membership in 1965 although it had about 17 percent

of he totai U.S, population.

It would appear from these data that private

insurance companies provide relatively more

coverage in the West than in the East. One study

in California 7 reported that “the mechanism of

voluntary health insurance with the largest enrollment in California is private insurance.”

Many of the insuring agencies described in this

study were medical society groups affiliated with

private industries. Wthough the Yules governing

membership in tiese various plans differed,

many of tie plans indicated that they insured

udy employed persons and ‘tieir families. Since

the population for the National Mortality Survey

is primarily comprised of elderly persons who

were probably not employed, the problems of

cancellation and conversion of policies at retiremefit -may .t*e on great importance in the West

I

68.s

GEoGRAPHI

1

-

IC REGION

Figure 1. Percent of decedents 65 years and over, by

geographic region,

and thus contribute more to the low coverage rates

observed there.

Another reason for the lower coverage in the

West might be the high prevalence of militafy

services personnel and their dependents in this

region. Because uniformed services’ dependents

a~e covered by the Dependent Medical Care Program, they are not likely to have any other health

insurance. However, the impact of the Dependent

Medical Care Program on the reported health

insurance coverage rates for decedents maynot be

great since most of the decedents were old and it is

unlikely that they would be eligible for such care.

Family Income, Living Arrangements, and

Family Size

The income referred to in this repo~t is the

total money income received during the last calendar year by all persons in the decedents

family who lived in the same household. Decedents who lived alone or who w“ere residents of

institutions at the time of death are classified

as one-person families.
I

The adultswho diedduring1964 and 1965

had low famfiyincomes.About 44 percenthad’

incomes under $2,000,22 percenthad incomes

between $2,000and $3,999,18 percentiiadincomes between$4,000and $6Y999,,. and 16 percenthad incomes of $7,000o,rmore;.For each

demographic characteristicshom~ in tableH,

the largestproportionof the decedentswere

chose who were members offamilieswithin~

comes lessthan$2,000..

The leveIof health.insurancecoveragehas

been shown in earlier~eportsfrom the’HeaIti

Intmview Survey to be relatedco the levelof

income ofUhepopulation. 12~ When familyincome

fs law,an individualmight not considerhealth

insurancecobe important.

For adultsdyingin1964or 1965,thelevels

ofhealthinsuyancecoveragewere higherineach

successiveincome level(cable5).Only30percent of the-decedentsin familieswirhin”comea

less than $2,000’had hospital“insurance.“For

decedentsin’familieswith incomes between

$2,000anti?$3,999theratewas 50 percen~.for

decedenxsin familieswith incomes between

Table G.. Nuinberand percent dis~r~bution,of persons with hosp”~talinsurance coverage,

by type of plan accord~ng to geographic re-gfonand &ge: Un5ted.Sta”tes,1962’-63

Region and age

AII regions

AIl ages------------------

65 years and over---------

Northeast

All ages-------------------

65 years and over---------

North Central

All ages------------------

65 years and.over----—----

—.South

All ages------------------

65 years’and over--------=

West.

All ages---------------=---

65,years and over--:-------

AIE pe~son’s, ; Persons with hospZcaL instirance

Tjpe.of plan

L

Blue

Plan,

w~ch or ‘Other

wi-ehout

other

45.2

50.0

64-.1

71,5

43’.7

49;2

35.2

36.1

3T.1.

26..8.,

Source:.PHS Publfcat20m.No:10”QO~,Sexies~10”;.No.%.16:,.Eables U5”:and.16.

47.5

45.8

3V.2

26.1

; 49”,0

46.3’

I54.6

: 58”.0,’

: 61..9

\ 64.7

Un.

knom

-.

7.3

4.2

4.7

2.4

7.2

4.5

10.3

,.

5.-9~

6.9

4.4

~.
~able. H. Percent distribution of decedents 25 years and over, by family income according to selected characteristics: United States, 1964-65

Characteristic

All decedents, 25 years and over--

Age

25-64 years -------- -------- -------- -----

65 years and over-----------------------

Sex

Male -------------------------------------

Female ----------------------------------

Color

White -------- -------- .------------------

Nonwhite -------. -.------ ----------.-----

Region

Northeast ---------------- ........-------

North Central -------- -------- -----------

south-----------------------------------

West --.----.----------------------------

$4,000 and $6,999 the rate was 65 Tercent;.and

for decedents in families with incomes of$7,000

or more the rate was 73 percent. Coverage for

surgical insurance was s~ilar.

Table Jshows the percentageofthe decedents

having hospital insurance within eachincomecategory and the distribution of the population byincome. Decedents in families with incomes less

than $2,000 represented over 40 percent of all

adults dying during 1964 ;and 1965, yet only 30

percent ofthese decedentshadhospital insurance.,

Decedents infamilies with incomesof $7,000 and

over were reported tohavehigh”rates ofhospital

insurance coverage (73 percent), buttheyrepresented only 16 percent o~thetdtal populationof

persons dying.

In each income category, the nonwhite decedents had significantly lower coverage rates than

the white decedents. This white-nonwhite differential was greatest?at the lower ineome levels.

Family income

All

incomes

100.0

100.0

100.0

100.0

100.0

100.0

100”00

100.0

100.0

100.0

100.0

Under ;:,:;:-

$2,000 ,

$4,000-

$6,999

Percent distribution

43.5

27.9

51.4

39.3

48.9

41.5

60.0

40.0

43.0

48.0

42.3

22.0

20.5

22.8

24.2

19.2

21.9

23.0

21.8

21.3

22.9

22.0

18.2

26.7

13.9

19.5

16.6

18.9

13.0

19.4

19.3

16.6

17.1

16.2

24.9

11.8

16.9

15.3

17.8

4.0

18.8

16.4

12.4

18.6

The hospitalinsu”rancecoverage forwhitedecedents was almost twice as high as the rate for

nonwhite decedents in the two lowest income categories (table 5).

The influence of income on the differences

in the amount of coverage for white and nonwhite

decedents can beseenititabIe K.

A disproportionately large number of nonwhite decedents (60 percent as compared with42

percent for white decedents) were members of

families with incomes less than $2,000 (table EI}.

When” health insurance coverage is adjusted for

income, however, the adjusted rates for nonwhite

decedents were still lower than the adjusted rates

for”whitedecedents (table K).

When comparing the levels of health insurance

coverage between maIes and females within each

income class (table 6) it must be remembered

that, in general, the females were older and

coverage was generally lower for older decedents
Table J. Percent distribution of decedents 25 years and over and percent of

decedents with hospital insurance, by

family income: United States, 1964-65

I I

I Percent I Percent

,distribu- Of

Family income tion of decedents

decedents with

I

25 years hospital

and over insurance

All incomes--

~

Under $2,000-------

!

43.5 29.5

2,000-$3,999------ 22.0 50.4

4,000-$6,999------ “18.2 65.4

7,000 and over---- 16.2 73.0

regardless of income. The rates of coverage for

males were higher than for females in each income level except for decedents in the lowest

income level (less than $2,000). The higher rates

of coverage for males rnaybedue, in part, to the

fact that since males are more likely to have

been members of the working force thanfemales,

they may have had better access tohealthinsurance plans through their place of employment.

Table 7shows the health insurance coverage

for decedentsby whether they lived withrelatives

or alone, and income. The highest rates ofcoverage for hospital insurance (62 percent) were

observed for those decedents who lived only

with their spouses. About 51 percent of the

decedents who lived with relatives other thanjust

their spouses had hospital insurance while only

41 percent of those decedents who either lived

alone or with nonrelatives were covered byhospital insurance. Fordecedentswho wereresidents

of institutions at the time of their death, the proportion having hospital insurance coverage was

only 28 percent. Within each of these living

arrangements, the level of coverage increased

with each successive income level.

Because coverage is related to income, the

median incomes within each living arrangement

by hospital insurance coverage have been cornputed and are shown in figure 2. Although the

decedents who were living only with their spouses

at the time of death were reported to have the

highest rate of hospital insurance coverage, they

did not have the highest median income. The

decedents who lived with relatives other than

spouses had the highest median income—$4,788.

[t would appear that other factors besides the

level df income may influence the rate of health

insurance coverage among decedents. However,

it must be remembered that the income used in

this report refers to the income of all members

of the decedent’s household. The high median

income for decedents who lived with relatives

other than spouse may reflect several different

sources of income but does not necessarily indicate the amount of money available to the decedent for use for health insurance.

Family income becomes a more useful

measure when the size of the family sharing the

income is considered (table 8). Among all decedents, the highest rates of health insurance

coverage were observed for the two-person

family. As family size increased to three and

four or more persons, the proportion covered by

health insurance decreased slightly. The lowest

coverage was among those decedents classified

as one-person families. The coverage rates for

these single individuals was about one-half as

great as for the two-person family. However,

53 percent of these single individuals were residents of institutions at the time of their death.

Within each of the income categories there

were some variations in the patterns of coverage

by family size. The two-person family had the

highest health insurance coverage in all income

Table K. Effect of income adjustment on

the rates of hospital and surgical insurance coverage, by color: United

States, 1964-65

I I

I

Hospital I

Surgical

insurance insurance

I Color t I

Unad - Ad- 1

Unad - Adjusted justed justed justed

I

Percent

White---- 50.4 49.5 38.8 38.1

Nonwhite- 26.4 33.0 19.0 24.3
$7,000

[

m in.sured

:- Not,insurerl

$6,000

w

:$4,000

0

$5,000 11 z

s $3,000

c1

w

z

$2,000

$1,000

0

All Decedent Other

decedents and spouse

‘~n$’j$~ lostit ution

rel.at ives

LIVING ARRANGEMENTS

Figure 2. Median femi 1Y income ~f decedents 25 yean

and over, by hosp i t,a.1- insurance coverage and. 1; v i.ng,

arr.angemenls,

categories. The lowest coverage in the middle

income classes ($2,000 -’$6,999) was observed for

decedents. who were members of a family with

four or more pers~ns.. H~wever, the l~w.est coverage for. he.slth insurance in the lowest and highest income categories was. observed fox perso~s

who lived alo.ue who weze: instit~tionalized at the

time of death.

For decedeuts in the bwes~. mc~m.e category

(less than $-2,000) there was, no appreciable d~.

fere.nce. between the hospital ~ksu~ance coverage

for- single decedents (26 pex.cent) and decedents

in families of three and fouu. or more members

(25 and 28. percent respectively). It appears that

families in this lowest income @Cegory did not

have money available. for health insurance regardless of the size of the family.

In all- regions,, the proportion of the decedemts with health insurance increased in succes,-.

sive levels of income (table 9).. Ir is, interesting

to note that in the West the level of coverage in

each income category was lower thap the c~ver+ge

reported for decedents in the same income cat.-.

egory in each of the other regions. The low coverage in the West is not due, therefore, to the

income distribution of the decedents within the

regio.% me West did not differ significantly from

the other regions with respect to the proportion

& the decedent popdation withti each income

category.

Not only did each income leveI in the West

have a Iower rate of coverage than was observed

in the other regions, but the difference in hospital insurance coverage between the lowest and

highest income groups was also larges~ in the

West. The coverage for decedents in families

with the highest incomes in the West was almost

three times greater than the coverage for decedents. in families with incomes less than $2,000.

In the Northeast, the rates for decedents in

families with incomes of $7,000 and over was only

about, twice as high as the rates for decedents in

fam~ies with incomes less than $2,000.

Of the adults dying during 1964 and 1965,

about 9 percent were single, 52 percent were

married,, 34 percent were widowed, and 5 percent

were divorced. Table 10 shows that health insurance coverage was highest for married persons.

A@ost 60 percent of those individuals who were

~zried at- the time of death had insurance for

hos.pitsl expenses, while 46 percent had insurance

for surgical eqenses. ~ose decedents who were

Table L. Effect of age adjustrnen~ orI race

of hospital and surgical insurance

c~v@rag~, by ~rital status: ~ited

Stat.~s ,, 1964-65

Maxital

status

Sing~e-=-

Married--

Widowed- -.

DivorcedHospital I

Surgical

insurance, insurance

Uriad- ] Ad- ~ Unad- Ad.

II I

juste.d justeci justed jus6ed

Percent

34.8 ~ 34.9

59.0 55.,2

35..9 ‘ 37.4

33.8 32,9

I

27,4

46.3

25.8

26.2

27. J.

42.1

29:0

24.7

12
widowed were covered at the rate of 36 and 26

percent for hospital and surgical insurance respectively. The groups with the lowest health insurance coverage were the single and divorced.

Only about one-half as many single or divorced

decedents had hospital or surgical insurance as

decedents who were married.

The age distribution within each marital

status affected the rates of coverage for health

insurance (table 11). Married decedents again

showed higher rates of coverage in allagegroups

than was reported for decedents in all other marital statuses. The amount of coverage was similar

for single, widowed, and divorced decedents aged

65 and over.

Table L shows the effect of age adjustment

on the rates of hospital and surgical insurance

coverage by marital status.

Even after adjustment the rates for hospital

and surgical insurance coverage are higher for

married decedents than. for single, widowed, or

divorced decedents.

Patterns of coverage for males and females

within each marital status were somewhat different from the coverage pattern for all decedents.

Single females showed .a significantly higher rate

of coverage than single males. ‘Abut 43 percent

of the single females as opposed to only 29 percent ‘of the single males had hospital insurance.

Table M, based on table 12, shows the proportion of decedents in each income level by

marital status. The high rates of coverage for

married decedents may be due in part to their

higher incomes. Only 32 percent of the married

decedents had incomes less than $2,000; 55 percent of the widowed decedents, 60 percent of the

single decedents, and 56 percent of the divorced

decedents were in this lowest income catego~y.

Married decedents also had thehighestproportion

‘in the, $7,000 and over income category (20 -percent) as compared with 1.4 pe~cent for widowed

decedents and about 9 percent ,for single and

divorced decedents.

Table M. Percent distribution of decedents 25 years and over9by family income ac.coed.

ing to marital status: United States, 1964-65

Family income

All incomes-------- ---------...---p---------

-------------------,-----,--------------

K’i$!$!?

-------------------,------------------

----------.-----------.----,------------

$7$000 and over-- -“------ -p------ -------- --------- -

Marital status

:.-

Married Widow,ed SingLe D5vprc.ed

Percent di-stri;but~on

100.0 100.0. 100..0 100.0

.

;,;.;; 55.,.3 ‘ 60.1 56,.3

26.-7: ,:~;; .ty...2

21:8 14. ‘2‘.. lb .6

19.6 13.8 , ‘9..’4; ‘9.*’Q

J;3
. .

,,

14

REFERENCES

lNs,tional Center for Health Statistic: Health insurance

coverage, United States, ” July 196 2-June 1963. VitaZ and

Heuzth Statistics. PHS Pub. No. 1000-Series 1O-NO. 11.

Public Health Service. Washington. U.S. Government Printing

Office, Aug. 1964.

2National Center for Health Statistics: Health irrSUranCe:

type of insuring organization and multiple coverage, United

States, July 1962-June 1963. VitaZ and Heazth Statistics.

PES Pub. No. 1000-Series 1O-NO. 16. Public Health Service.

Washinghn. U.S. Government Printing Office, Apr. 1965.

3National Center for Health Statistics: Chronic conditions caueing activity limitation, United States, July 1963-

June 1965. VitaZ and HeaZth Statistics. PHS Pub. No. 1000-

Series 1O-NO. 51. Public Health Service. Waebingtou. U.S.

Government Printing Office, Feb. 1969.

4U.S. Department of Labor: Labor force and employment

in 1964. SpeciaZ Labor Force Report, No. 52. Apr. 1965.

5U.S. National Health Survey Interim report on health insurance, United States, July-December 1959. Heazth Statistics. PHS Pub. No, 584-B26. Public Health Service, Washington. U.S. Government Printing Office, Dec. 1960.

6Blue Cross Association: Blue Cros; Reports, Vol. VI,

No. 6. Chicago. Dec. 1962.

7Bureau of Research and Planning, California Medical

Association: Financing and Provision of MedicaZ Care in

California. San Francisco. Sept. 1962.

8National Center for Health Statistic: VitrzZStatistics

of the United States, 196J. Vol. II, Mortality. Public Health

Service. Washington. U.S. Government Printing Office, 1964,

and National Center for Health Statistics: Vitat Statistics of

of the U,nited States, 1965. Vol. II, Mortality. Public Health

Service. Washington. U.S. Government Printing Office, 1965.

‘National Center for Health Statistics: Replication: an

approach to the analysis of data from complex surveys. Vitaz

and ‘He azth Statistics. PHS Pub. No. 1000-Series 2-No. 14.

Public Health Service. Washington. U.S. Government Printing

Office, Apr. lg66.

000”
Table 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

DETAILED TABLES

m.—.

Average annual number and percent distribution of decedents 25 years and over,

by hospital and surgical insurance coverage according to sex and age: United

Stgtea, 1964-65 National Mortality Survey---------------------------------------

Average annual number and percent distribution of decedents 25 years and over,

by hospital and surgical insurance cove”rageaccording to color and age:

States,

United

1964-65 National Mortality Survey---------------------------------------

Average annual number and percent distribution of decedents 25 years and over,

by hospital and surgical insurance coverage accoyding to geographic region and

division: United Statea, 1964-65 National Mortality Survey----------------------

Average annual number and percent distribution of decedents 25 years and over,

by hospital and surgical insurance coverage according to geographic region and

agq ahd color and age for all regions and the South Region: United States, 1964-

65 National Mortality Survey----------------------------------------------------

Average annual number and percent distribution of decedents 25 years and over,

by hospital and surgical insurance coverage according to family income, color,

and age: United States, 1964-65 National Mortality Survey-----------------------

Average annual number and percent diatrkbution of decedents 25 years and over,

by hospital and surgical insurance coverage according to family income, sex, and

age: United States, 1964-65 National Mortality Survey---------------------------

Average annual number and percent distribution of decedents 25 years and over,

by hospital and surgical insurance coverage according to living arrangements and

family income: United States, 1964-65 National Mortality Survey-----------------

Average annual number and percent distribution of decedents 25 years and over,

by hospitaland surgical insurance coverage according to family income and family

size: United States, 1964-65 National Mortality Survey--------------------------

Average annual number and percent distribution of decedents 25 years and over,

by hoapital and surgical insurance coverage accordingtoregion and family income:

United States, 1964-65 National Mortality Survey--------------------------------

Average annual number and percent distribution of decedents 25 years and over,

by hospital and surgical insurance coverage according to sex and marital status:

United States, 1964-65 National Mortality Survey--------------------------------

Average annual number and percent distribution of’decedents 25 years and over,

by hospital and surgical insurance coverage according to marital status and age:

United Statea, 1964-65 National Mortality Survey--------------------------------

Average annual number and percent distribution of decedents 25 years and over,

by hoapital and surgical insurance coverage according to marital status and family

income: United States, 1964-65 National Mortality Survey------------------------

rage

16

17

18

19

21

23

25

26

27

28

29

30

15
Table 1, Average annual number and percent distributionof decedents25 years and over, by hospitaland

~mg~,cal ins~ance coverageaccordingto aex and age: United States,1964-65NationalMortalitySurvey

—

All

decedetits

I

Hospital

insurance

Surgica1

insurance

Hospital ~urgica1

insurance insurarice All

decedents

Sex and Age

Ineured in:~ted Insured in~~ted Insured fn;&ted

I

Both SeXeS

All ages,

29 yeats23-44 years----

45-5& years----

55-64 yeate----

6~ years------

65-7h years--

75-84yeafs--

8> yeara----

MaIe

All ages,

25-I-yeara25-44 yearS----

45-54 years---~

55-64 years----

6* yeaes------

65-74 years--

75-84 yeara.-~

89 years---~

Female

All ages,

2S yeers25-44 years----

45-54 years----

55-64 yeara----

6R yeafs------

65-74 yesrs~-

75-84 yeats--

85+ years----

Average number of decedentsin thousands Percentdistributioti

1J649 36,6 63,4

—

53.1

49,3

50,6

69,ti

61,1

71’6

03.6

78? 861 604 1,045 100.0 47,8 52.2

108

162

2%5

1,094

432

450

212

928

67

103

185

572

258

228

86

721

58

96

174

459

222

181

57

465

3h

60

113

258

136

96

25

323

51

65

111

634

210

269

155

L63

33

43

72

314

121

132

61

399

51

82

141

330

168

128

35

368

30

52

92

i94

107

70

17

236

58

80

144

763

264

322

177

560

38

51

93

377

151

158

69

485

100.0

100,0

100.0

100.0

100,0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

LOO*O

100.0

100$0

LOOJO

53,0

59.5

61.2

42,0

51.4

40,2

26.7

50’1

50,5

58.1

60.9

45.1

52.9

42.2

29.3

44,7

57,1

62.1

61.6

38,6

49,0

38.1

25,0

47’0

40.5

38.8

58.0

48.6

59.8

73.3

49.9

49.5

41.9

39.1

54.9

47.1

57.8

70.7

55,3

42.9

37.9

28.4

61.4

51*O

61.9

75.0

46,9

50’7

h9,4

30.2

38.9

28,4

16,4

39,6

44,2

50.1

49,6

34.0

4i.4

30,9

1~.9

32.8

60.4

55,8

49,9

50.4

66,0 I

58,6

69,1

80;1

67’,Q

48.6

48,3

51,0

41

59

99

522

174

222

126

23

36

61

201

h6

84

31

18

22

38

321

89

137

94

21

30

49

i36

61

57

1$

20

28

51

386

113

165

108

100.0

100.0

100,0

100.0

100JO

100,0

L~O.O

51.4

51,7

49’0

26.1

35,1

25,8

13.9

,

73,9

~

64,9 r

I

7442

86.0

1

I

i
Table 2. Average annual number and percent distributionof decedents25 years and over, by hospitaland

surgicalinsurance coverageaccordingto

Survey

color and age: United States, 1964-65NationalMortality

Color and age

Total -

All ages,

25+ years25-44 years----

45-54 years----

55-64 years----

65+ years------

65-74 years--

7’5-84years--

85+ years----

White

All ages,

25+ years25-44 years----

45-54 years----

55-64 years----

65-I-years------

65-74 years--

75-84 years--

85+ years----

Nonwhite

All ages,

25+ years25-44 years----

45-54 years----

55-64 years----

65+ years------

65-74 years--

75-84 years--

85+ years----

Average number of decedentsin thousands

1,649

_

108

162

285

1,094

432

450

212

1,467

82

134

244

1,008

386

421

200

181

26

28

41

86

46

28

11

787

58

96

174

459

222

181

57

739

50

88

159

442

212

175

54

48

8

8

15

18

10

5

*

861

—

51

65

111

634

210

269

155

728

32

45

84

566

174

246

146

133

19

20

26

68

36

23

*

604

51

82

141

330

168

128

35

569

44

75

132

319

161

123

34

35

7

7

9

12

7

4

*

1,045

58

80

144

763

264

322

177

898

38

58

112

689

225

298

167

147

19

21

32

74

39

24

*

Hospital Surgical

All insurance insurance

decedents

Insured Not Insured Not

insured insured

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

Percent distribution

47.8

—

53.C

59.5

61.2

42.C

51.4

40.2

26.7

50.4

60.9

66.1

65.4

43.8

54.9

41.6

27.1

26.4

28.6

28.5

36.0

20.5

21.7

L9.O

*

52.2

47.0

40.5

38.8

58.0

48.6

59.8

73.3

49.6

39.1

33.9

34.6

56.2

45.1

58.4

72.9

73.6

71.4

71.5

64.1

79.5

78.3

81.0

*

36.6

—

46.9

50.7

49.4

30.2

38.9

28.4

16.4

38.8

53.5

56.2

54.1

31.6

41.8

29.3

16.8

19.0

26.5

24.5

21.8

13.6

14.2

14’.7

*

63.4 —

53.1

49.3

50.6

69.8

61.1

71.6

83.6

61.2

46.5

43.8

45.9

68.4

58.2

70.7

C3.2

81.0

73.5

75.5

78.2

86.4

85.8

85.3

*

17
Table 3. Average annual number and percent distribution of decedents 25 years and over, by hospital and surgical insurance coverage according- geographic region and division:Un3.CedStates~

1964-65 National Mortality Survey

Geographic region and division

All regions------------------------------------

Northeast--------------------------------------------

New England ----------------------------------------

Niddle Atlantic ------------------------------------

North Central----------------------------------------

East North Central---------------------------------

West North Central---------------------------------

South------------------------------------------------

South Atlantic-------------------------------------

East South Central---------------------------------

West South Central---------------------------------

West -------------------------------------------------

Mountain -------------------------------------------

Pacific--------------------------------------------

All regions------------------------------------

Northeast--------------------------------------------

New England----------------------------------------

Middle Atlantic------------------------------------

North Central----------------------------------------

East North Central---------------------------------

West North Central---------------------------------

south------------------------------------------------

South Atlantic -------------------------------------

East South Central---------------------------------

West South Central---------------------------------

West -------------------------------------------------

Mountain-------------------------------------------

Pacific--------------------------------------------

All

decedents

Hospital

insurance

Surgical

insurance

Average number of decedents in thousands

1,649

—

462

104

358

476

331

145

474

226

105

142

237

1:;

100.0

—

10.0.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

Loooo

100.0

LOO.O

787

246

1:?

241

175

66

201

861[ 604, 1,045

a ,

235

156

79

t

188 288

138 l;~

50

Percent diatribueion

47.8

53.1

52.8

53.2

50.7

52.9

45.5

42.3

43.7

38.1

43.4

42.3

51.7

39,3

52.2

46.9

47.2

46.8

49.3

47.1

54.5

57.7

56.3

61.9

56.6

57.7

48.3

60.7

+

t

41.0 59.0

43,9 56.1

40.2 59.8

-

39.5 60.5

41.8 58.2

34.1 65.9

z

30.7 69,3

32.1 67.9

25.6 74.4

32.3 67.7

34.1 65.9

40.4 59,6

32.2 67.8

18
Table 4. Average annual number and percentdistributionof decedents25 years snd over, by hospitaland

surgicalinsuranceCOTer?geaccordingto geographicregion and age; and color and age for all regions

and the South Region: Un~tedStates, 1964-65NationalMortalitySurvey

Geographic

region, color,

and age

ALL REGIONS

All agea,

25t yeara25-64 yeara----

65+ years------

All agea,

23+ years25-64 years----

65+ years------

Nonwhite

All ages,

2% yeara25-64 yeara----

6% years------

NORT~AST

All ages,

2’5+yeara25-64 years----

65t years------

NORTH CRNTRAL

All ages,

25+ yeara25-64 yeara----

65-I- yeara------

-

All

leceIent a

Insured in~~ed Insured Not

insured

Average number of decedentsin thousands

&

555

L,094

L.467

459

L,008

181

96

86

462

144

318

476

144

332

787

328

459

7’39

298

442

48

30

18

246

95

150

241

93

148

861

227

634

728

162

566

133

65

68

217

49

168

235

51

184

604

274

330

569

251

319

35

23

12

190

83

107

188

79

109

1.045

281

763

898

209

689

147

73

74

273

61

211

288

66

223

Hospital Surgica1

All insurance insurance

iece-

~ents

Insured in:::ed Insured Not

insured

I

percentdistribution

LOO.O

LOO.O

LOO.O

100.0

100,0

100.0

100.0

100.0

100.0

100.G

100.0

100.0

100.0

100.0

100.0

47.8

59.1

42.0

50,4

64,8

43.8

26.4

31.7

20.5

53.1

66,0

47.3

50,7

64,8

44.5

52.2

40.9

58.0

49.6

35,2

56.2

73.6

68.3

79.5

46.9

34.0

52,7

49.3

35.2

55.5

:

36.6

49.3

30.2

38.8

54.6

31.6

19.0 ~

23.9

13.6

41,0

57.3

33.7

39.5

54.5

32.9

63,4

50.7

69.8

61.2

45.4

68.4

81.0

76.1

86.4

59,0

42,7

66.3

60.5

45.5

67.1

19
Table 4. Av?rage annual number and P?rcent distribu~iOnO? decedents25 years and Over, by hospital and

surgicalInsurancecoverageaccordingtO geOgraphlcregion and age; and color and age for all regions

and the South Region: United States, 1964-65NationalMortslitySurvey-Con.

Geographic

region, color,

and age

All

decedents

100.0

I

Average number of decedentsin thousands

I I I

ma

All ages,

25+ yeara25-64 years----

65-I-years------

-H

Total

All ages,

2% years25-64 yeara----

65+ years------

m

Ail.,ages,

25+ years25-64 years----

65+ yeara------

Nonwhite

All ages,

2% yeara25-64 years----

6fi years------

Percent distribution

237

85

152

474

100 136 81 156 42.3 57,7 34,1 65,9

46

54

201

39

98

273

41

39

146

43

113

328

100.0

100.0

100.0

54.3

35.6

42.3

—

51.4

36.7

47.2

45.7

64.4

57.7

48,9

25.9

30.7

51,1

74*L

69,3

100.0

100,0

100.0

48.6

63.3

52.8

39,0

25,6

35.3

61,0

74,5

64,7

182

292

371

130

241

103

52

51

94

107

175

89

185

196

71

75

131

111

217

240

62

69

15

68

172

88

100.0

100.0

100.0

59.3

40.8

24.7

47.5

28.7

14,2

17.9

10.5

52,5

71.3

85,8

82,1

89,5

77

98

25

53

143

78

40,7

59.3

75.3

17

9

36

42

9

5

43

46

100.0

100.0

31.7

17.5

68.3

82.5

20
distributionof decedents25 year% qnd over, by haspital anti

family income,color, and age: Unieed States,1964-.65National

Table 5. Average apnuql number and percent

surgicalinsurancecoverageqccordingto

MortalitySurvey

I

Hospita1 Wrgica 1

All insurance insurance All

decedenta

Fawtly incomq,

color, and age

II 1 1 1 11 I [ ,

ALL INCONES

-l

AII.ages,25+-

Averagenumber of decedentsin thousands percentdistribution

1,649

_

555

1,094

k,467

604

—

274

330

569

25L

319

35

23

12

152

34

118

139

28

112

13

1,045

—

281

763

898

100.0

100.0

100.0

100.0

787

—

328

459

739

86&

227

634

728

16?

566

133

47.8

—

59,1

42.0

50,4

32.2

25-64 years----

6R yeara------

40.9

58.0

49.6

35.2

56*?,

73,6

68.3

79,5

70.5 .

72,7

69,8

68.3

68+3

68.3

82.7

49.3 } 50,7

30.2 69,8

I W*

Ali ages,25-!--

25-64 years---- 64.8

A

h3,8

26,4

54,6 45.4

31.6 68,4

459

L,Q08

181

298

442

48

3C!

18

212

42

17a

193

33

160

19

9

10

209

689

L47

73

74

565

121

4k5

h69

76

393

96

45

51

100.0

100,0

100,0

QH years------

Nonwhite

All ages,25+.

25-6A years----

651-years------

UNom $2,000 .—

Tots1

All a~es,251--

25-64 years----

6W yeara------

*ite

All ages,25+.

25-64 yeqrs----

~5t yearq------

Ntmwhite

All ages,25+-

25.64 yeara----

6~ yeara-*----

23.9 76,1

13,6 86.4

96

86

717

155

563

609

1.04

5Q5

109

.

51

58

65

68

505

112

393

416

71

345

90

100,0

100.0

100,0

Loo .0

100,0

100,0

100,0

Loo.o

100.0

31,7

20.5

29,5

27.3

30.2

31.?

31.7

31,7

17.3

t

21,9 78.L

21.0 79.0

&

22.1 7?*P

42

48

6

7

100.0

LOO.O

18.3

16.5

81.7

83.5

12,5 87,5

11.$ 88.7

21
Table 5. Average annua1 number and percentdistributionof decedents25 years and over, by hoapita1 and

surgicalinsurancecoverageaccordingto family incom% color, and age: United States,1964-65National

MortalitySurvey— COn.

Hospital Surgical

All insurance insurance

decedents.

Insured in:::ed Insured ~ng;;ed

II Hospital I

Surgical

All insurance insurance

~omi~y income,

, and ag~

$2,000-$3,999

Tots1

All age% 25+-

Average number of decedentsin thousands Percentdistribution

50.4

50.6

50.4

52.8

54.2

52.3

32.0

36.7

*

65.4

74.,3

56;8

66.9

76.9

58.0

48.1

49.6

49.4

49.6

47.2

45.s

47.7

68.0

63.3

*

34.6

25.7

43.2

33.1

23.1

42.0

51.9

37.9

41,3

36.3

39.7

44,6

37.8

23,6

28.6

*

50.9

60.3

41.8

52.2

62.8

42.7

36.1

62.1

58.7

63.7

60.3

55.4

62,2

76.4

71,$

49.1

39,7

58.2

47.8

37.2

57.3

63.9

36?

114

249

321

2:;

42

183

12!

170

137

47

90

128

226

l:J

194

100. (

100. (

100.(

100.c

25-64 yeara----

65+ years------

White

All agea,25+-

25-64 yeara----

6H yeara------ 1:!

13

9

*

197

1000C

100. C

100. C

100.C

Ioo.c

100.C

Nonwh<te

All agea,25+-

25-64 yeara----

6% yeara------

23

18

301

148

152

277

131

146

24

$4,000-$6.999

Total

All agea,25-1--

25-64 yeara----

6fi years------

110

87

185

101

85

11

59

89

132

49

84

15

100. C

100. C

100.C

100.C

1000C

100.C

White

All agea,25+-

25-64 yeara----

6% yeare------

Nonwhite

All agea,25+-

25-64 yeara----

65+ years------

17

6

268

*

*

196

*

*

72

9<

*

106

100.0

100.0

100.0

*

*

60.3

74.7

44.8

60.7

. *

*

39.7

*

*

27.0

$7,000+

Total

All agea,25+-

25-64 yeara ----

6% yeara------

138

130

261

118

78

191

103

58

158

35

72

102

100.II

100.0

100.0

85.4

59.8

73.4

14.6

40.2

26.6

25.3

55,2

39.3

White

All agea,25+-

25-64 years----

65+ yeara------

134

126

7

115

76

*

101

57

*

100.0

100.0

LOO.O

85.8

60.3

*

14,2

39.7

*

75.1

45.4

*

24,9

54.6

*

Nonwhite

All agea,25+-

22

/--
,.. -

Table 6. Average annual number and percent distribution of decedents 25 years and over, by hospital and

I surgical insurance coverage according to family income, sex, and age: United States, 1964-65 National

Mortality Survey

/

Hospital Surgical

All insurance insurance

Hospital Surgical

All insurance insurance

Family income,

sex, and age

dece- 1~

dents IIInsured in~~~ed Insured in~~~ed

dents IIInsured in~~~ed .Insured in~~~ed

ALL INCOMES

Both sexes

All ages, 25+-

Average number of decedents in thousands Percent distribution

1,045

—

281

763

560

183

377

485

3::

565

1.649 861 604 100.0 _

100.0

100.0

100.0 -

100.0

100.0

100.0

100.0

100.0

100.0

52.2 36.6 63.4 —

50.7

69.8

787 47.8 —

59.1

42.0

,, 50.1

58.1

45.1

44.7

60.8

38.6

29.5

27.3

30.2

28.3

23.0

30.0

30.8

33.4

30.3

50.4

50.6

50.4

52.6

49.4

54.2

46.9

53.1

44.5

-

25-64 years ----

65+ years ------

-

Ali ages, 25+-

555

1,094

.?.?8

356

572

721

199

522

717

155

563

364

2?;

353

63

290

363

328

459

465

227

634

463

274

330

368

173

194

236

100

136

152

40.9

58.0

49.9

;;.:

.

55.3

39.2

61.4

70.5

72.7

69.8

71.7

77.0

70.0

69.2

66.6

69.7

49.6

49.4

49.6

47.4

50.6

45.8

53.1

-

46.9

55.5

49.3

30.2

39.6

;:.;

.

32.8

50.3

26.1

21.2

21.9

21.0

21.2

19.8

21.6

21.2

25.0

20.4

37.9

60.4 -.

51.3

66.0

25-64 years ----

65+ years ------

Female

All ages,25+-

25-64 years ----

65+ years ------

207

258

323

121

201

212

149

314

399

3;!

505

UNDER $2,000

Both sexes

All ages,25+-

25-64 years ----

65+ jears ------

78.8

1$:

103

21

82

109

21

88

183

112

393

261

70

191

244

42

202

180

121

445

287

73

214

278

47

230

226

100.0

100.0

100,0

100.O

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

-

100.0

100.0

100.0

100.0

100.0

78.1

79.0

Male

All ages, 25+- 78.8

80.2

78.4

25-64 years ----

65+ years ------

Female

All ages,25+-

25-64 years ----

65+ years ------

$2,000-$3,999

Both sexes

All ages, 25+-

78.8

75.0

79.6

62.1

25-64 years ----

65+ years i-----

Male

All ages, 25+-

114

249

225

47

90

90

12;

135

45

89

91

21

70

41.3

36.3

40.1

39.3

40.5

34.2

45.3

29.8

58.7

63.7

59.9

25-64 years ----

65+ years ------ 1::

138

39

99

38

69

73

18

55

29

61

47

18

30

60.7

59.5

Female

All ages, 25+- 65.8

25-64 years ----

65+ years ------

54.7 “

70.2

23
Table 6. Average annual number and percent distributionof decedents25 years and over, by hospitaland

surgicalinsurancecoverageaccordingto family income, sex, and age: United States,1964-65National

Mortality Survey—Con.

Hospital

insurance

Surgical

insurance All

decedents

Family in@ome,

sex, and age

$4,000-$6,999

Both sexes Average number of decedentsin thausands Percent distribution

All ages,25+-

25-64 years----

65+ years------

301

148

152

181

99

82

119

49

70

268

138

130

157

91

66

111

48

63

197

110

87

123

_

72

51

74

104

38

66

58

153

89

64

99

59

40

54

147

59

89

82

39

42

66

100.0

100.0

100.0

100.0

65.4

74,3

56.8

67.8

34.6

25,7

43,2

32.2

50.9 .

60.3

41.8

54.8

4941

39.7

.38,2

All ages,25+- 45,2

25-64 years----

65+ years------

27

32

46

100.0

100.0

100.0

100,Q

100,0

100.Q

72.9

61.6

61.9

77.0

51.2

73.0

85.4

59,8

76,8

84.7

66.1

67.7

86.9

53.3

27.1

38.4

38.2

23,0

48.8

27.0

14,6

40.2

23,2

15,3

33.9

32.3

13.1

46.7

.

60.1

48.4

45,1

60.7

34.2

60.3

74.7

44,8

64,4

73.3

52,1

54.4

77*4

37.0

39,9

51.6

54,9

39,3

65,8

29.7

Female

All ages,25+-

25-64 years----

65+ years------

38

36

196

118

78

121

-

77

44

75

41

34

11

34

72

20

52

36

14

23

36

6

29

30

24

161

103

58

101

67

35

60

37

23

19

46

106

35

72

56

24

32

50

11

40

$7,000+

Both sexes

All ages,25+-

25-64 years----

65+ years------

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

25.3

55$2

35,6

26,7

47VY

45.6

22.6

62.9

Male

All ages,25+-

25-64 years----

65+ years------

Female

All ages,25+-

25-64 years----

65+ years------

24
distributionof decedents25 years and over, by hospitaland

living arrangementsand family income:United States,1964.65

Table 7. Average annual number and percent

surgicalinsurancecoverageaccordingto

NationalMortality Survey

-

Averagenumber of decedentsin thousanda

Living

arrangements

and

family income

All

decedents

Insured Not

insured Insured in~~ed

I I I

All liVitl~

arrangements Percent distribution

All incomes- 787 604 1,045

—

565

226

147

106

237

105

78

35

19

375

104

98

96

77

188

100.0

_

100.0

100.0

100.0

100.0

100.0

47.8

—

29.5

50,4

65.4

73.0

61.5

52.2

—

70.5

49.6

34.6

27.0

38.5 -

57.9

37.5

23.0

17.1

49.2

73,6

63.0

41,2

29.4

59.5

70.1

43.7

25.7

*

72.2

76.6

54.8

*

*

36.6

—

21.2

37.9

50.9

60,3

47.5

63.4

—

78.8

62.1

49.1

39.7

52.5

70.5

52.8

39.Q

28.9

60.9

82.3

72.1

55.4

42.6

68.5

77.1

58.4

37.2

*

79.8

83.3

67.0

*

*

86L

Under $2,000---

$2,000-$3,999--

$4,000-$6,999--

$7,000+--------

212

183

197

196

278

505

180

104

72

173

87

55

21

11

303

93

86

72

53

164

133

19

7

*

221

193

20

*

*

152

137

153

161

214

Decedentand

spouse only

All incomeaUnder $2,000---

$2,000-$3,999--

$4,000-$6,999--

$7,000+--------

14$

14;

9(

64

616

63

92

69

53

313

33

50

102

127

111

44

69

55

46

241

22

38

78

103

86

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.O

100.0

100.0

100,0

100.0

100.0

100.0

42.1

62.5

77.0

82.9

50..8

26.4

37.0

58.8

70.6

40.5

29.9

56.3

74.3

*

27.8

23.4

45.2

*

$C

29.5

47.1

61.0

71.1

39.1

17.7

27.9

44.6

57.4

31.5

22.9

41.6

62.8

*

20.2

16.8

33.0

*

*

Lived with

other

rel-s

All incomesUnder $2,000---

$2,000-$3,999--

$4,000-$6,999--

$7,000i.---.p---

126

136

174

180

275

Lived with

nonrelative

or alone

All incomesUnder $2,000---

$2,000-$3,999--

$4,000-$6,999--

$7,001J+--------

190

43

26

16

306

252

37

11

7

57

24

19

*

85

59

17

*

*

43

18

16

*

62

42

12

*

*

146

25

10

*

244

210

25

*

*

Institution

All incomes.

Under $2,000---

$2,000-$3,999--

$4,000-$6,999--

$7,000+--------

100.0

100.0

100.0

100.0

25

.
number and percent distribution of decedents25 years and over, by hospital

coverageaccordingto family income and family size: United States, 1964-65

Table 8. Average annual

and surgical insurance

National Mortality Survey

II Hospital I

Surgical

All insurance insurance Family income

and

family size

decedents

Insured in~~~ed Insured Not

insured

II I I I

All incomes Average number of decedents in thousands Percent distribution

All families- 52.2

—

66.2

42.6

46.5

47.5

70.5

.—

73.8

61.6

74.8

72.2

49.6

48.9

41.4

57.9

69.3

34.6

1,649 787 861 604 36.6 63.4

—

148

250

95

110

152

86

53

8

6

137

30

77

17

13

153

21

65

34

33

161

12

55

36

58

1.045 100.0 47.8

581

568

228

27L

717

442

194

41

41

363

80

176

55

52

301

37

116

69

79

268

23

82

63

99

197

326

122

142

212

116

75

10

11

183

385

242

106

129

505

433

318

133

161

565

356

141

34

34

226

50

99

38

39

147

16

51

34

46

106

11

27

27

41

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100,0

100.0

100.0

33.8

57.4

53.5

52.5

29.5

25.5

44.0

41.7

40.7

21.2

19.4

27.1

18.3

15.5

37.9

37.7

43.9

31.3

24.7

50.9

56.o

56.3

50.1

41.3

60.3

52.4

66.5

57.0

59.0

74.5

56.o

58.3

59.3

78.8

80.6

72.9

81.7

84.5

62.1

62.3

56.1

68.7

75.3

49.1

44.0

43’7

49.9

58.7

39.7

47.6

33.5

43.0

41.0

one person-----

Two persOns ----

Three persons --

Four or more

persOns -------

Under $2,000

All families326

119

31

29

180

26.2

38.4

25.2

27.8

50.4

51,1

58.6

42,1

30.7

65.4

One persOn -----

Two persOns ----

Three persons --

Four or more

persOns -------

$2,000-$3,999

All familiesOne persOn -----

Two persOns----

Three persons --

Four or more

persOns -------

41

103

23

16

197

25

84

45

43

196

15

65

44

72

39

73

32

36

104

12

33

24

36

72

8

17

19

27

$4,000-$6,999

All families100.0

100.0

100.0

100.0

LOO.O

100.O

100.0

100.0

100.0

68.6

72.0

65.1

54.6

73.0

64.4

79.1

69.2

72.5

31.5

28.0

34.9

45.4

27.0

35.6

20.9

30.8

27.5

One persOn -----

Two per,sons----

T~ree pere’ons--

Four or more

persOns -------

$7,000+

All fsmiliesOne persOn -----

Two persons ----

Three persons --

Four or more

persons -------

26
Table 9. Average annual number and percent distribution of decedents 25 years and over, by hospital

and surgical insurance coverage according to region and family income:

Mortality Survey

United States, 1964-65 National

Surgical

insurance

=

Hospital

insurance

I

Surgical

insurance

I

Hospital

insurance

I

All

3eceients

All

3ecelents

Region and

family income

Insured I

Not

insured Insured in~u~ed

II 1 t I

Average number of decedents in thousands

II 1 1 ,

All regions Percent distribution

63.4

—

78.8

62.1

49.1

39.7

59.0

75.3

57.7

43.2

41,8

60.5

604 1,045 LOO.O

_

100.0

100.0

100,0

100.0

100.0

47.8

29.5

50.4

65.4

73,0

53.1

33.1

58.4

68.5

73.7

50.7

31.4

56.3

66.0

75.7

42.3

27.3

42.0

65.2

70.5

42.3

24.1

41.4

58.1

70.5

~

52.2

—

70.5

49.6

34.6

27.0

46.9

66.9

41.6

31.5

26.3

49.3

68.6

43.7

34.0

24.3

57.7

72.7

58.0

34.8

29.5

57.7

All incomes -- L,649 36.6

-

717

363

301

268

462

787 7

861

505

180

104

72

217

-

124

42

28

23

235

140

44

31

19,

273

165

63

27

17

136

76

31

17

13

152

137

153

161

190

46

43

51

50

188

48

45

46

48

146

40

32

37

36

81

18

17

19

27

21.2

37.9

50.9

60.3

41.0

24.7

42.3

56.8

58.2

39.5

23.7

44.5

50.4

61.3

30.7

212

183

197

196

246

61

59

61

64

241

64

57

60

59

201

565

226

147

106

273

J

139

58

39

36

288

156

56

45

30

328

187

76

41

23

156

82

35

22

17

Under $2,000 ---

$2,000 -$3,999--

$4,000 -$6,999--

$7,000+--------

Northeast

All incomes --

Under $2,000 ---

$2,000 -$3,999--

$4,000 -$6,999--

$7,000+--------

185

101

90

87

476

205

101

92

78

474

228

109

79

59

237

100

52

40

44

.00.0

Loo. o

100.0

LOO. O

100.0

LOO.0

100.0

100.0

LOO,O

100.0

North Central

All incomes --

76.3

55.5

49.6

38.7

69.3

82.3

70.2

52.5

39.5

65.9

82.4

66.8

54.2

37.8

Under $2,000 ---

$2,000 -$3,999--

$4,000 -$6,999--

$7,000+--------

South

All incomes --

Under $2,000 ---

$2,000 -$3,999--

$4,000 -$6,999--

$7,000+--------

62

46

51

42

10C

100.0

100.0

100.0

100.0

100.0

17.7

29.8

47.5

60.5

34.1

West

All incomea --

LOO.O

LOO.O

LOO.O

LOO.O

75.9

58.6

41.9

29.5

17.6

33.2

45.8

62.2

Under $2,000 ---

$2,000 -$3,999--

$4,000 -$6,999--

$7,000+--------

24

22

24

31

27
over, by hosStdtes, 1964-

Table 10. Average annual number and percent distribution of decedents 25 years and

pital and surgical insurance coverage according to sex and marital s’catus:Ufiited

65 National Mortality Survey

—

All

decedents

Hospital

instirance

Surgical

inSurance

Sex and marital status

Insured Not

insured insured tfi~;;ed

Both sexes

All statuses-----------------------------------

Married ----------------------------------------------

Widowed ----------------------------------------------

Single--------------------------------.-----------k-.

Divorced ---------------------------------------------

U

All statuses-----------------------------------

Married ------------------------........--------------

Widowed ----------------------------------------------

Single-----------------------------------------------

Divorced ---------------------------------------------

Female

All statuses-----------------------------------

Narried ----------------------------------------------

Widowed ----------------------------------------------

Single-----------------------------------------------

Divorced ---------------------------------------------

Both sexes

All statuses-----------------------------------

Married ----------------........-------------.--------

Widowed ............&..-................--------------

Single..................-----------......4------------

Divorced ---------------------------------------------

Male

All skattises--.-.-.--..........................

Married ..................-----------b----------------

Widowed ----------------------------------------------

Single--------------------------- ..................-=

Divorced ---------------------------------------------

Female

All statuses --------........-------------------

Married ----------------------------------------------

Widowed --------........------------------------------

Single--.+-...----------------.------.---.------------

Divorced ---------------------------------------------

Average number of decedents in thousands

1,649 787 861 604 1,045

859

568

147

74

928

507

204

51

25

465

358

69

25

13

323

352

364

::

463

398

146

40

19

368

461

422

107

55

560

610

183

:?

721

249

385

60

28

100.0

—

100.0

100.0

100.0

100.0

100.0

252

115

2:

399

100

2::

16

281

53

21

12

236

149

136

26

12

132

292

41

20

63.4

;;.;

72:6

73.8

60.4

;;.;

;::;

.

67.2

Percent distribution

47.8 52.2 36.6

59.0

35.9

34.8

3~.8

41.0

64.1

65.2

66.2

49.9

:;.;

71:0

71.6

55.3

40.1

64.8

56.7

57.1

46,3

25.8

27.4

26.2

39.6

46.1

29.1

24.3

25.5

32.8

46.8

24.2

32.0

27.2

50.1

100.0

100.0

100.0

100.0

100.0

58.6

37.4

29.0

28.4

44.7

100.0

100.0

100.0

100.0

59.9

35.2

43.3

42.9

53.2

75.8

;;.:

“

28
Table 11. Average annual ntimberand percent distributionof decedents25 years and over, by hospital

and surkicalinsurancecoverageaccordingto marital status and age: United States, 1964-65National

Mortali~ySurvey

Hospital Surgical

.All insurance insurance

Mafital status

atidage

decedents

Insured ~n:$ed Insured ~n::ed

II I I I

Average number of decedentsin thousanda Percent distribution

All ages,

23t years- 1,649 787 861 604 1,045 100.0 47.8 52.2 36.6 63.4

25-44 yeara----

45-54 yeata----

55-64 years----

6N years------

65-74 years--

75-84 yeara--

8% years----

108

162

285

l,:;~

450

212

859

58

96

174

459

222

181

57

507

51

65

111

634

210

269

155

352

;;

141

330

168

128

35

398

58

1!!

763

264

322

177

461

100,0

100,0

100.0

100.0

100.0

100.0

100.0

100,0

100.0

100,0

100.0

100.0

100,0

100,0

100.0

100’0

-

100.:

100,0

100.0

100,0

100Ao

100,0

100.0

53.0

59.5

61.2

42.0

51.4

40,2

26.7

59.0

47,0

40,5

38.8

58,0

48.6

59.8

73.3

41.0

46.9

50,7

49,4

30,2

38,9

28.4

16,4

46.3

53.5

56,0

55.1

38.7

44.6

34.4

19,4

25.8

*

39.:

24.2

32,5

25.1

15.5

27.4

Y<

33.:

24,2

28.9

23,3

*

26,2

*

*

*

23.2

25.8

J<

*

53.1

49,3

50.6

69,8

61.1

71.6

83.6

53,7

46.5

44,0

44.9

61.3

55.4

65.6

80,6

74,2

*

60.;

75.8

;:.;

84;5

72.6

-

9<

#t

66.4

75.8

71.1

76.7

*

?3.8

*

*

76.;

74.2

*

+

29

Married

All ageaj

25+ years25-44 years----

45-54 years----

55-64 Yeara----

65+ yetirs------

65-74 yeara--

75-84 yeare--

8% years----

1?:

201

458

248

170

40

568

4

::

506

127

230

150

147

50

1;?

241

145

83

13

204

*

*

I?i

57

81

38

51

;;

2??

103

87

27

364

9C

2;

330

1::

111

96

44

66

lil

177

111

59

8

146

*

7’<

1;;

41

58

23

40

61,2

66,3

68.3

52,7

58.5

48,8

32.8

35.9

~:

48.:

34.8

44.6

35.3

25.7

34.g

38.8

33,7

31.7

47.3

41.5

51.2

67.2

64.1

*

51.;

65.2

55,4

;:.;

65.2

Widowed

All agea,

25t years25-44 years----

45-54 yeare----

55-64 years----

6B yeafs------

65-74 y&ars--

75-84 yearb--

89 yeatis----

Single

All ages,

23+ years25.44 years----

45-54 years----

55-64 yearb---~

6% years------

65-74 years--

75-84 yearti--

85i-yeara----

*

*

10

29

13

12

9,

25

*

*

::

24

24

*

49

*

9<

A

26

13

*

*

100.0

10U, O

100,0

100,0

lob,o

100‘u

100.0

100,0

-

ioo,o

100.0

ioo,0

100.0

100,0

100,0

dt

*

41,:

32,3

36,0

34.3

*

33,8

Y<

9<

32.;

34,7

*

*

9<

58.:

67,7

64,0

65.7

9<

66,2

4<

9,

67.;

65.3>!<

*

Divorced

All ages,

25+ years25-44 years----

45~54 years----

55-64 yeara----

651-years------

65-7’4years--

75-84 yeara~-

85t yearg----
Table 12. Average annual number and percent distribution of decedents 25 yeara

and surgical insurance coverage according to marital status and family income:

National Mortality Survey

and over, by hoapftai

United Statea, 1964-65

—

All

decedents

Hospital Surgica 1

insurance insurance

All

Hospita 1

insurance

Surgica 1

insurance

+

Marital status

and

family income

Insured Not

insured

II I r I

All statusea Average number of decedents in thousands Percent distribution

All incomes-- 1,649 787 861 604 1,045

565

226

147

106

461

100. [

_

100. (

100 .(

100. C

100. C

LOO.C

47.8

—

29.5

50,4

65.4

73.0

59.0

36.6

56.3

73.8

82,5

35.9

27.5

38,8

47.1

54.9

34.8

19.7

47.2

62.9

*

33.8

19.9

*

*

7’<

52.2

—

70.5

49.6

34.6

27.C

41.0

63.4

43.7

26.2

17.5

64.1

72.5

61,2

52.9

45.1

65,2

80.3

52.8

37.1

f<

66.2

36.6 63.4

Under $2,000 ---

$2,000 -$3,999--

$4,000 -$6,999--

$7,000+--------

717

363

301

268

859

272

231

187

168

568

315

95

81

79

147

88

24

21

14

74

212

183

197

196

507

100

130

138

139

204

86

37

38

43

51

505

180

104

72

352

173

101

49

29

364

152

137

15:

161

398

70

99

109

119

146

63

26

27

31

40

21,2

37.9

50,9

60.3

46.3

78,8

62.1

49,1

39.7

53,7

74’4

57.1

41,5

29.1

74.2,

79.9

72.6

67.0

60.9

72.6

85.2

65.7

45.3

*

73.8

85,8

*

*

*

Married

All incomes --

Under $2,000 ---

$2,000 -$3,999--

$4,000 -$6,999--

$7,(Jo~--------

203

132

78

49

422

100.0

LOO.0

LOO.0

LOO.O

100.0

25.6

42.9

58.5

70.9

25.8

20.1

27,4

33.0

39.1

27.4

14.8

34.3

54.7

*

26.2

Widowed

All incomes--

Under $2,000 ---

$2,000 -$3,999--

$4,000 -$6,999--

$7,00&--------

228

58

43

35

96

251

69

54

48

107

100. (

100. (

100. c

100. C

100. c

Single

All incomes--

Under $2,000 ---

$2,000 -$3,999--

$4,000 -$6,999--

$7,000+--------

17

11

13

*

25

71

13

8

*

49

13

8

11

*

19

75

16

9

*

55

36

9<

*

‘k

LOO.C

100,0

LOO.O

100.0

100.0

LOO.O

LOO.0

LOO.O

LOO.O

Divorced

All incomes--

Under $2,000 ---

$2,000 -$3,999--

$4,000 -$6,999--

$7,000+--------

42

13

12

7

14.2

*

*

*

30
APPENDIX I

TECHNICAL NOTES ON METHODS

Background of This Report

The data presented in As report were collected in

the 1964 and 1965 National Mortality Surveys (NMS).

These surveys, conducted by the National Center for

Health Statistics, were designed primarily to provide

information about the decedent’s hospital or institutional episodes during his last year of life, the costs

of this care, and how these costs werepaid. In addition,

certain socioeconomic anddemographic datawhichwere

thought to be relevant to the study were collected.

Sources o“f Data

The first source of data in the surveys was the

death certificate. Additional sources were a questionnaire mailed to the person who provided the funeral

director with the personal information for recording

on the death certificate, and a questionnaire mailed to

the hospital o,r institution in which the decedent ~ed.

These sources of information, which were identified

on’ the death record, are referred to as primary

sources,

Each primary source was requested to identify

other individuals who might be able to complete the

questionnaire if the respondent was unable to do so

and other medical facilities which provided care to the

decedent during the year prior to his death. These additional sources of information are referred to as secondary sources. Identical questionnaires were sent to

these secondary sources requesting information concerning the decedent.

The data shown in this report are based on information obtained from the death certificate and from

the responses to the questionnaire sent to the death

certificate informant. Age, sex, color, and region were

tabulated from entries on the death certificate; hospital

and surgical insurance, marital status, living arrangements, family size, and family income were tabulated

from information on the questionnaire.

Sample Design

The sample design for the National Mortality Survey takes advantage of the virtually complete registration of deaths in the United States. Each month, the

54 registration areas forward a 10 percent systematic

sample of all registered deaths to the Division of Vital

Statistics, National Center for Health Statistics. This

systematic sample is called the Current Mortality

Sample (CMS). me sample for the National Mortality

Survey is a probability sample subselected from the

CMS at a rate of 1 out of 33 deaths. This procedure

yields an overall selection rate of 1 out of 330 deaths.

There were 5,153 deaths of persons aged 1 year and

over in the 1964 sample and 5,255 deaths, in the 1965

sample. Because the samples are independent they can

be combined, giving a total sample size of 10,408.

Death Certificate and Questionnaires

Facsimiles of the Standard Certificate of Death

and of the questionnaires used in this survey are shown

in appendix III. Although not all States use the standard

certificate, all States do include on their certificates

items requesting the basic information used in this

report. The questionnaire sent to the death record informant was designed to obtain information on health

insurance coverage, and the names and addresses of

hospitals and institutions which provided care to the

decedent during the year before his death. Additional

questions concerned the amount of the hospital bill,

household composition, assets, and familY income.

In 1964 and 1965, three questionnaires were used

for decedents aged 1 year and over depending on the age

at death and place of residence of the decedent. Similar

information was collected with each questionnaire.

However, the reference individual for certain questions

on socioeconomic status differed.

31
When the decedent was age 14 or over and ws not

a resident of an institution at the time of death, the

socioeconomic questions referred to the decedent’s

status.

When the decedent was age 14 oroverand wasa

resident of an institution at the time of death, the

questions pertaining to the decedent’s household

composition were omitted.

When the decedent was age 1-13 the socioeconomic

question referred to the status of the decedent’s

parents. Only theinformation obtained from questionnaires 1 and 2 were used for this report.

Collection of the Data

Data for the 1964-65 NMS were collected primarily

by mail. If the address was given on the certificate,

questionnaires were sent by reflar mail to the person

providing the funeral director with the d~cedent’s personal information for recording on the certificate. For

those cases where the address of the informant was not

available on the death certificate, a letter. was first

sent to &e funeral tirector requesting the address of

the informant and then a questionnaire was mailed to

the informant.

If no response to the questionnaire was received

after 2 weeks, a second questionnaire was sent by certified mail. If there was no response to the certified

mail after 3 weeks, a third questionnaire was sent by

regular first-class mail. If there was no response to the

third questionnaire and if the informant was a resident

of one of the primary sampling units (PSU’S) designated

by the Bureau of the Census, a final attempt to collect

the information was made by personal interviews conducted by the Bureau of the Census.

In addition, special letters were sent to the respondGot to clarify the information when the reported data

were inadequate for certain essential items.

These procedures resdted in a response rate in

1964-65 of 91 percent (table I). In general, the rates

of responses were higher for all characteristics from

the death certificate for white decedents than for nonwhite decedents. In each color group the response rates

were higher for older decedents than for young ones.

Included among the 938 nonrespondent cases are

cases where the respondent refused to answer the questions, where it was impossible to locate an informant,

and where no questionnaire was sent because the decedent’s usual place of residence as reported on the

death certificate was outaide the United States, even

though the death occurred in the United States. In addition, New Mexico did not participate in the 1964-65

National Mortality Survey.

Processing of the Data

The completed questionnaires were edited and coded

in accordance with predetermined specifications. The

questionnaires were checked both for completeness and

for consistency of response. After the edited and coded

data had been transcribed onto punchcards, the data

were processed on electronic computers. The computer processing included range edits, consistency

checks, assignments of weights, and imputation f~f

missing data.

Nonresponse and Imputation for M~s$ing Ddta

Failure to obtain a response represents one of the

biggest problems in any survey. Out of the 10,408

decedents aged 1 year and over who were included in

the survey during 1964 and 1965, no information was

available after all attempts to contact the respondent for

only 938 decedents or 9 percent of the sample. These

are referred to as “unit nonresponses. ” Table I shows

the percent responding by selected characteristics.

In addition to unit nonresponse, there is also item

nonresponse, i .e,, the respondent returned the questionnaire but omitted part of the information. The following table shows the nonresponse rates for the items

from the questionnaire which are presented in this reperk

Hospital insurance ----- ---------1.0 percent

Surgical insurance ----- --------- 1.S percent

Family income -----------------1.6 percent

Item nonresponse cannot be shown for family size and

living arrangements since these were not specific items

on the questionnaire. They were derived from entries

in the household listing on the questionnaire.

In general, item nonresponse was low, reflecting

no more than 1.6 percent of the respondents for any

particular item. The highest item nonresponse rate

among those items included in this report was observed

for questions on income.

Statistics derived from the National Mortality Survey were adjusted for both types of nonresponse ~

imputing to nonrespandents, on an item basis, the

characteristics of similar respondents, An array of

known values from respondents was created in the corn.

puter using 40 age, sex, and color groups to establish

similarity between respondents. The groups used fod

imputations are as follows:

32
GYOUD

1---------- -----

2--------------

3-------------.

4----------------

5---------------

6---------.----

7---------------

8----------------

9-----.--------

1o---------------

Sex, CO1OV,and age

Male, white:

Underlyear

l-14years

15-24years

25-34years

35-44years

45-54years

55-64years

65-74years

75-84years

85yearsandover

Male, nonwhite:

11-20------------ Same agegroupsasformale,white

Female, white:

21-30------------ Sameagegroupsasformale,white

Female, nonwhite:

31-40------------ Same agegroupsasformale,white

Other variableswere addedto thearrayin the

imputationofcertainitemsinordertomaintaininternalconsistencywithintherecord.Forexample,inorder

to imputetheinformationon thenumber ofchildrenin

thedecedent’shousehold,itwas necessarytocontrol

forsuchcharacteristics as thefamilysizeandthetype

offamily.

Valuesin thecellsof thearraywere continually

replacedby successiveknown valuesas thefilewas

processed.The valuesfrom theIastcompleterecord

in eachwere thenimputedtothenonresponserecord.

Thismethodofimputationispossiblebecauseage,

sex, and colorare recordedon thedeathcertificate

andareknownforeachdecedentregardlessofwhether

therewas aresponsetothequestionnaire.

weighting Procedures for National Estimates

Statisticsshown in thisreportare nationalestimates preparedby use of a poststratified ratioesti--

mation procedure.This estimationprocedure,which

takesthetotalnumber ofregistereddeathsintoaccount

in theestimationprocess,reducesthesamplingerror

by making thesamplemore closelyrepresentativeof

thepopulationof alldeathsthanwouldbe expectedly

random methodsalone.

Table I. Response rates for 1964-65 NationalMortality Survey, by selected characteristics:

United Statea, decedentslaged1 year and over

Characteristic

Total-------------------------

Age

1-14 years --------------------------

15-24 yea~q -------------------------

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

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

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

55-64 years-------------------------

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

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

85i-years---------------------.-----

~%

Male.......--------------------- -----

Female --------- --l------- ---------- .-

Region

Northeast---------------------------

~yu;~ Central-----------------------

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

West-------------------”--------.---

Number

in

sample

10,408

202

187

197

$;;

1,730

2,627

;,;;:

,.

5,885

4,523

2,874

3,002

3,014

1,518

Total

Percent

responding

91.0

81.7

86.6

89,3

88.9

88.5

88.3

91,8

93.0

93.6

90.6

91.5

90.5

92.1

91.8

88.1

White

Number

in

sample

9,222

153

159

143

359

784

1,484

2,354

2,559

1,227

5,219

4,003

2,676

2,800

2,338

1,408

Percent

“eaponding

91.4

81.7

86,2

90.9

90,5

88.6

88,1

92.4

;;,$

.

91.0

92.0

91.3

92.5

92.3

88.2

Nonwhite

Number

in

sample

1,186

49

:;

120

152

246

273

195

69

666

520

198

202

676

110

Percent

responding

87.6

81.6

89,3

85.2

84.2

87.5

89.8

86:8

88.2

92.8

87.7

87.5

79.8

87.1

90.2

86.4

33
For each of the 40 cells that wereused for imputation, the national count of deaths for the appropriate

year was obtatied from\ Vitul Statistics of the United

States, Vol. II, Mortality.g

A weight for each cell was then calcdated by dividing the number of sample deaths into the number of

registered deaths for each year of the survey.

The product of the weight and the sample count

equaled the national total for the cell. The national

estimates for 1964 and 1965 were averaged to produce tbeaverage annual estimates shown intbis report.

Reliability of Estimates

Since the statistics derived from this survey are

based on a sample, they may differ from the restdts

that would have been obtained had a census covering

all decedents been undert&en using the same questionnaires and procedures. In addition to sampling errors,

results from any data-collection system are subject

to errors in conceptual formulation, ambiguities in

definitions and in the questionnaire construction, coding

errors, biases due to nonresponse or incomplete response, mistakes in edit~g, and tabdation errors.

The probability design of the sample for the National Mortality Survey m~es possible the calculation

of sampling errors. The sampling error isa measure

of the sampling variation that occurs by chance because ordy a sample rather than the entire population

is surveyed.

Estimates of sampling variability for the statistics

derived from this survey were computed by creating

20 random half-sample replications. This technique

yields a measure of overall variability through observation of variability among random subsamples of

the total sample. It reflects tie error that arises from

sampling and a part of the measurement error, but it

does not measure any systematic biases in the data. A

general discussion of the development and evaluation of

the replication technique for estimating variance hss

been published elsewhere. g

Using the same questionnaire and collection procedures, chances are about 68 out of 100 that an estimate from the sample differs from the value for the

entire population by less than the standard error. The

chances are about 95 out of 100tiatthedifference is

less than twice the standard error.

Rules to determine the approximate standard error

for estimates presented in this report are as follows:

1.

2.

3.

Estimates of ag~egates. —Approximate standard errors of estimates of the number of decedents with a given characteristic are given

in table II.

Estimates ofP@centuges.-Approximate standard errors for percentages are determined in

one of the following ways, depending on the

source of the base of the percentage:

a.

b.

Where both the numerator and denominator

are estimates from the sample data, the approximate standard errors are shown in

table III.

Where the denominator is a value found in

one of the cells used in the imputation

and estimation procedures, the relative

standard error of the percent is equivalent to

the relative standard error of the numerator

since the denominator is not subject to sampling error. These are given In table II,

Diffwence between two sample estimutes.-fie

standard error of a difference between two sample estimates is approximately the square root

of the sum of the squares of each standard

error considered separately. This formula will

represent the actual standard error quite accurately for the difference between separate

and uncorrelated characteristics, although it

is only a rough approximation in other cases,

Standardization Procedure

The age and income standardized rates of health

insurance coverage shown in this report were calculable II. Approximate standard errors for est~-

mated numbers shown in this report

Size of estimate I

Standard

error

5,000----------------

10,000----------------

25,000----------------

50,000----------------

100,000----------------

250,000----------------

500,000----------------

750,000----------------

1,000,000----------------

61o

900

1,550

2,350

3,100

4,900

6,300

6,900

7,500

Relative

standard

error

12,2

9.0

6,2

4.7

3.1

2.0

I*3

::;

34
Table III. Approximate standard errors for percentages shown in this report

Baae of percentage

lo,ooo -----------

25,000-----------

50,000-----------

loo,ooo -----------

250,000-----------

5oo,ooo -----------

750,000-----------

1,000,000 -----------

2

or

98

1.8

1.0

0.8

0.6

:::

::;

Estimate&percent

5

or

95

2.4

1.8

1.3

;::

0.4

0.3

0.3

10

or

90

—

3.4

2.2

1.7

1.2

0.8

0.5

0.4

0.4

25

or

75

4.9

3.2

2.5

?::

0.8

0.7

0.6

50

5.7

3.6

;::

.1.3

0.9

0.8

0.6

lated by the direct method of standardization, me age

and income apecific rates ofcoverage for hospital and

surgical insurance were applied to the estimated population of all decedents aged 25 years andover to produce the standardized rate.

Rounding of Numbers

Altiough the published tables show aggregates

rounded to the nearest thousands, the tabulations on

which the ta~les are based show figuresto the nearest ;i.

unit. All computations were made using the unrounded “’

data. Therefore, the reader making computations using

the published tables may not be able to reproduce the

computations exactly.

Qoo

35

I
APPENDIX II

DEFINITIONS OF CERTAIN TERMS USED IN THIS REPORT

Information From the Death Certificate

Color. —For purposes of classification for this survey, the category “white” includes those individuals

reported on the death certificate as white, Mexican,

Puerto Rican, and Cuban. The category “nonwhite”

includes those reported as Negro, American Indian,

Chinese, Japanese, Hawaiian, Part-Hawaiian, and “other

nonwhite.;’

Age. —The age recorded on the death certificate

under age or date of birth is the decedent’s age at last

birthday.

Rep”on Division

Northeast ------------------New England -----------

Middle Atlantic ---------

North Central -------------- East North CentraI -----

West North Central -----

South----------------------South Atlantic ----------

East South Central -----

West South Central -----

West ----------------------Mountain---------------

Pacific -----------------

Sex.—Sex is coded as recorded on the death certificate.

Instifutioml Yesidence.-Irimates of institutions

were identified by the entry on the death certificate

under usual place of residence. If the decedent’s USUZI

residence was reported as a hospital, nursing home, or

other resident institution the decedent was considered

to be an inmate of an institution.

Re@”onand division. -The Statesin whfchthe desdts

occuwed are classified into four regions which are

further subdivided into 9 divisions corresponding to

those used by the Bureau of the Census, These redons

and divisions are as follows:

Stites Included

Maine, New Hampshire, Vermont,

Massachusetts, Rhode lsIand, ConnecticW

New York, New Jersey, PentisyIvania

Ohio, Indiana, Illinois, Michigan,

Wisconsin

Minnesota, Iowa, Missouri,, North Dakota,

South Dakota, Nebraska, Kansafi

Delaware, MaryIand, District of CoIumbiar

Virginia, West Virginia, Norfi Carolina,

South Carolina, Georgia, Florida

Kentucky, Temessee, AIabama,

Mississippi

Arkansas, Louisiana$ OkIahoma, Texas

Montana, Id*o, Wyoming, Colorado,

New MeXi@, Arizona, Utah, Nevada

Washington, Oregon,, CaEfornia, Alaska,

Hawaii

36
Information From the Questionnaires

Health in.suvance. -For purposes of this survey,

health insurance was defined as any plan specifically

designed to pay all or part of themedical or hospital

expenses of the insured individual. The plan, in order

to be considered insurance, must have been a formal

one with defined membership and benefits. The insuring

organization may have been either a nonprofit group or

a commercial group. If the question arose, the medical

care which is provided to uniformed services personnel

and their dependents (DependentMedical Care Program)

was not considered to be health insurance.

Hospitil insuYance.-Plans included as hospital

insurance were those which pay all or part of the bills

for hospital care.

Suv@cal irtsuvance.-Plans included as surgical

insurance were those which pay all or part of the surgeon’s bill.

Living amangements. —For those decedents who

were not residents of institutions, the household listing

which included space for entries on marital status and

the relationship of each member to the decedent was

used to determine the living arrangements used in this

report. Living arrangements refer to whether the decedent lived with spouse, with other relatives, alone

or with nonrelatives ,or lived in an institution at the

time of death.

Family size. —Family size refers to the total number of individuals related to the decedent who resided

in the same household. This includes head of family

and all persons related to him by blood, marriage, or

adoption. Decedents who were residents of institutions

were classified as being members of one-person families.

Family income. —Family income refers to the total

of all income received during last full calendar year by

all persons related to the decedent by blood, marriage,

or adoption and living in the same household as the decedent at the time of his death. If the decedent lived alone,

lived with nonrelatives, or was institutionalized, the income refers only to his individual income. For persons dying in 1964, the income shown here was that

received in 1963; for those dying in 196S, the income

was that received in 1964.

Mavital status .-Although this item is reported on

the death certificate, the marital status used in this report was coded from the entries in the household listing

on the questionnaire. The decedents classified as married include decedents who were reported to be separated.

,)

I

37

~ ,..

.,
APPENDIX 111

SOURCE FORMS

Death Certificate

I

t

b.CITY. TOWN. ORWIION t.tiNGTHOF 5rAY IN lb . . CITY, TOWN. OR WATWN

I I I

3. FA~CRS NAME 14. MOTIIER’S MAIEN NAME

x I I

~ &. mub -m. m ME

I

WMWN(SW”J,l

=. NAME OF GMET2RV OR CREMATORY m. LCUTWN (w,, I@”. 0, ,mlnf”, (#d*)

~

f “24. mew DIRE~OR ADDRESS 25. OA= RECD. BY LCCAL R2G. 26. REGIS?RAR’S SIGNATURE

38
—.

Informant Questionnaires

Death Outside Institution

@

,*,

,,+’ %%

~ *2

;

. .

: DEPAWMENT OF HEALTH, EDUCATION, AND WELFARE

$

.,O *+$ PUBLIC HEALTH SERVICE

u..

wASHINGTON, ❑ .C. 20201

NATIoNAL CENTER FOR

HEALTH STATISTICS

r

L

The U. S. Public Health Service is

about people who died during 1965.

conducting a survey to obtain information

me survey is being conducted as part of

a progrsm to co~ect urgently needed information about the health problems

of the Nation. This study will provide information about the health of the

Americen people. What is learned may help to reduce the hazards of disabling

illness and avoidable deaths.

For one out of every 330 deaths occurring throughout the covntry,.facts are

being collected about health insurance coverage, use of hospit~s and

institutions, snd finances during the year prior to death. me ssnrplefor

this survey was scientifically designed so that every person dying during

1965 hd the same chance of being selected.

The person nemed below is in the s~le end our records indicate that you

are most likely to have the information we need. If you do not have the

exact answer to a question, give your best estimate. Your reply will be

held strictly confidential and will be used to get total figures only. The

identity of individuals will not be disclosed for any purpose.

The success of this study depends upon our hating information about every

death. Your reply is important. men if you have not answered all the.

questions, please mail the completed form within five days in the enclosed

envelope which requires no postage. Your cooperation and prompt attention

to this request will be appreciated.

39

Nsme of Deceased Person File Number

US-5
40

cONFIDENTIALIU has bee. as..rFd *. indiYid..!s? published ia the F.dc{d Rcgiswr ‘I(.Y X, 1959 FOm Apmwcd

Bud$q\3!w,,u N., 68.R783

NATIONAL MORTALITY SAMPLE SURVEY - 1965

PART !. HFAITH lNSURANCE

. .

we are intercepted in finding out if the deceased @raOnwas covered byhealth insurance" at anytime

during the lZ.tnonth priti befare death, Please report oneachkind ofhealth insurance pr~te~~ion

vhe#her or Got the iwravce was vied,

deceased p~son have health insurance to pay for peri~d &fore death, did the deceased person have

hospital cgre ? health insurance to pay surge%’ bills?

~ Yes Q No Q Yew QNo

PART 1!. HO$PITAL AND INSTITUTION “CARE IN LAST YEAR OF LIFE

In fiis part, we ag? fnteres!ed in findhg out

?@qt the hospitals, nursing hqrnes, eanatoriume, and similar places which provided

medical or pereonal care services tq @ede.

ceased persQn during the l?-rnon~ period

before death. Weare aleo interested in finding

out shut the bills and who paid them.

.-

l,Si~ce. _. . . . .

(includipg the

time just before death), was the deceased w?-

soq a pstient in any ltQspita!, nQrsing home,

home far the aged, or other type of institution that provided medical or peraoqal care?

Write name and location Qf e?cb place

~ime. . . . .

city ~nc! State -‘-

.. ..

1

-. . . . . . . . .

I I

,. :... . .—.

2, DuTin~ the 12=monthperid before @ath, about

how much did the hoapita! bi~s for ttis care

come tm ~h?t is, amounts paid by the deceased

person, by health insurance; or by relatives

or friends of the deceased Person? (m not

inplvde any part provided by public or private

agencies.)

m ~gx .

U“ $l,P@andaver

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

3, What par? of the ho@pitalbills”far me deceased

Derso~ was paid by health insurance?

❑ None. •1 1/2 up IQ3[4

a Less Ma 1/? ~ 3/4 or more

. . . . . . . . . .

pH&*79->(page2)

sev.?-62

4, Was 2uy part ~f the bills paid by the de~eaaed

personls children or other relatives (other than

.?Puse, if married) who usually lived in the

household with the deceased prson?

SJ Ye5 ~ No

5. Wae any psrt of the bills paid by the deceased

per8Qn’s chil~en Qr other relatives NOT liVin~

in the househ~ld with the deceased person, or by

frimqs?

~Yes QNo

6, Dfd the de~eaaed person receive car~ ftt pIaGes

during the 12.men@ period before death which

was provided free, or which was paid for by any

of the fQ~lQWiOg?

(check a$ m~ny ag apply]

~ VeteTans Admfnistratfon

~ Medical assistance for the aged

or other public assistaq~e

‘~ Public Health Department

~ Non-profit health agency, $uch ae

I!polio Foundation~,

~ Other welfare organization

D Workmena’ Cotnpensaaon

~ A public hospital, tmrsfng home,

or clinic

~ Some other hospital, nursing

home,or clinic

o other

‘What waa that? (Write in)

7. Were any Operations perf~rmed on th~ decaa~ed

pers~n during the 12-month periQd Mfore death?

❑ yes u No

+

Wbst part of the surgeon’s (doctor’a) bill waa

paid by any kind of fnsuranqe?

❑ NQne ❑ 1/2 up to 3~4

DLesa than lf2 ❑3j4 Q?,’mQre
.....

..

FART tlI. HOUSEHOLDcoMposiTloti ,.,. . ..

nis part is concerned with everyone who UI lived in the same household with the decewed

person at the time of death, (Include infants and small children)

1. HOW many people were living together in the 2, Who was head of this household?

same household as the deceasecl at the time

of death, including the depeaaed person? { ❑ me deceased person

R

Number ❑ Another person (Write in name of head)

—.

3. @ the following lines, enter tbe names and provide the information requested below for all persons who usually lived in the ssme household ss the deceased ,~rson at the time of dcsth,

Relaffonship to Marital status st \ime

the deceased of deceaqed personls

person (son, deathmother= in=law, Male Birth Dste Msrried Divorced

step-daughter, Widowed Spparated

(LAST NAME)” (FIRST NAME) lodger, etc.) ~e~ale Month Year Single (never m?rr~sd)

--

(1) Deceased person

(2)

(3)

(4)

i5)

;)

(7)

(8)

(9)

(10)

(11)

(If more space is needed, continue on a pepar~te sheet)” - ‘”

4

. . ,..

P&RT IV: ASSETS “ ““ -

Thi6 part is concerned with the totsl value 9f

thingsowqed by me decea~ed person, If the

deee?~ed person was married and was liying

with spouse, answer for hth husband and wife

together.

1, Did the deceaaecl person and FPouse, if marr~e~ and living together, owo a home (include

buying) at the time of death?

CIYP8 •1 No

2, Did the deceased person (and fiwufie) have any

money in banks, credit unions, saviogs and loan

associations, etc,?

❑Yes g No

3, Did rhe deceased person (and spouse) own a

business or farm?

c1Yes n No

4, Did the deceased person (and spouse) have OtlIFr

asse~q such as stocks qnd hondp, bus~neq~ or real

es!ate investments, etc,, qt the time of death?

~Yes ~No

. . .

5, ~ld the deceseed (snd SPU69) have any other

kind of assets such ap an automobile, jeWelry,

etc. P

~ Yes D No

. .

6. What would YOUjudge tO be the total valve Of

~hfngs owned by the decessedprson (and sPo~se)

after any debts or mortgages were paid off?

(check the item which afleae withymv e8t$~atG)

❑ None D $5,000.$9,999

❑ Under $1,000 ❑ $10,000-$24,999 0$1,000.$4,999 ❑ $25,oOO and over

,. ., .,..

41
PART v. INCOME

‘Ibis part is about the income of the deceased person and other related persons living with the deI

I

ceased at the time of death.

1. State whether the deceased person (and spouse,

if married and living together) received income

during 1964 froml any of the following sources:

(chec~ “yes” or “no” for each item)

Yes

❑

❑

•1

❑

•1

•1

❑

❑

•1

No

•1

❑

❑

❑

•1

❑

•1

•1

❑

Wages, salary, or commission

Own business, professional

practice or partnership, or

working on own farm

Dividends, interest on savings

accounts or bonds, or income

from annuities, estates, or trusts

Rental of property, or boarders

or lodgers

Social Security

Veterans payments or other

government or private pensions

Welfare payments

Other sources including unemployment or sickness benefits,

regular contributions from nonresident relatives, alimony, etc.

_Other

& what was that? (Write in)

2. What waa tbe total money income of the deceased

person (and spouse, if married and living together) from all sources in 1964? (Check the box

that agrees with your best estimate)

❑ None •1 $3,000-$3,999

❑ Under $I,OW •1 $4,000-$4,999 ‘

•1 $1,000-$1,499 ❑ $5,000-$6,999

❑ $1,500-$1,999 0$7,000-$9,999

❑ $2,000-$2.999 ❑ $10,000 and over

3a. Were there family mem&rs who usually

lived in the same household with the deceaaed person (not counting the spouse of

the deceased person) who had money income in 1964?

IJ Yes (continue ❑ No (skip to Part

1

below) VIklow)

3b. How much did the income of the family

members amount to in 1964?

❑ Under $2,000

❑ $2,000-$3,999

❑ $4,M0-$6,999

•l $7,0000r over

3c. Taken together then, what waa the total money

income of the family from all sources in 1964?

(Check the box which agrees with your best

estimate)

I )IncIude income of the, ❑ ‘nder$lOOO

w :=::::9

deceased person, spouse, •l $1,000-$1,499

•1 $3,W0-$3,999

•1 $4,000-$4,999

0$5,000-$6,999

❑ $7,000-$9,999

❑ $10,000and over

PART V1. SOURCES OF INFORMATION

Please answer tbe questions in this part about

yourself and about snother person who could

provide additional information about the deceased person.

1. Who completed this form? I

Name

/StreetAddresa I

/City and State I

Telephone Number

L

Was the decea~ed person related to you?

I

~ceajed person was Yoor I

2. Is there another person whomight be able to add

to the information you have provided?

Name

Street Address

\CityandState

Was tbe deceaaed person related to tbte person?

OYes ❑ No

/ @ceased ~rson was

this person’s

(relationship) I

(relationship)

PHSti70-5(PageO

Enter your additional comments on the front of tbe form.

42 Rev.365

wo aa9. nz
Death In Institution

@

*,. i% ,+

i

j

: : DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

“%., *4C

“ “,.

PUBLIC HEALTH sERv[cE

Washington, D.C. 20201

NATIONAL CENTER FOR

HEALTH STATISTICS

r

L

The U. S. Wblic Health Service is conducting a survey to obtain inform-a.

tion about people who died during 1965. The survey is being conducted

as p“artof a program to collect urgently needed info-tion about the

health Of the herice.u people. What is learned may help to reduce the

hazards of disabling illness and avoidable deaths.

For one out of every 330 deaths occurring throughout the country, facts

are being collected.about health insurauce coverage, use of hospitals

and tistitutions, and finances during the year prior to death. me

smple for this survey was scientifically desi~ed so that every person

d.ying’during 19S5 has the same chance of being selected.

!Cheperson named below is in the sample and our records indicate that

you am most likely”to have the ~o~tion we need. If you do not have

the exact answer to a question, give your best estimate. Your reply will

be held strictly confidential and will be used to get total figures only.

me identity of individuals will not be disclosed for any purpose.

The success of this study depends upon gettiug information on every

death. Your reply is important. Even if you have not answered all the

questions, please mail the completed form within five days in the

enclosed envelope which requires no postage. Your cooperation and prompt

attention to this request will be appreciated.

T:;:gk

/ ‘6

M roe G. Sirk , Ph. D.

ief, Difisi of Health

; Records Statistics

Name of Deceased File Number

14-1-5

43
CONF~ENtiL1~ k.sb.m6sstid &ei.divid..i zsP=blisb.d i.tie F=d.r.lkcgtster May 20, 19S9 Fom Avgm,ed

Bmd86tBu,mti No, 6&R783

NATIONAL MORTALITY SAMPLE SURVEY - 1965

PART!. HEALTHINSURANCE

We are interested in finding out if the deceased person was covered by health insurance at any time

during the lZ-irionth pericd before death, Pleage report on each kind of health insurance protection

whether or tiot the in~ratie wae used.

1, Wing the 12-mofith period before death, did the 2. What about the surgeon’s hill? ~ring the 12-

deceaded person have health fnsurance tapay for month periud before death, did the deceased per-

‘hoepital care? son have healti insurance to paysuvgeone !bills ?

n Yes ❑ No •l YeS ❑ No

PART Il. HoSPiTAL AND iNSTITUTION CARE IN LAST YEAR OF LIFE

k this psrt, we are interested in finding out about the hospitals, nursing homes, smitoriurns,

and simf.iar places which provided medical or personal care Services to the deceased person

during tie 12-xxiontb period hefore death. We are also interested in finding out about the bills

and who paid them.

1. Complete the idfomatidn below abut tbe institution in which the deceased person was a patient

at fie time of death,

lName“f‘nstimtion

Ci~ State

men did the deceased enter this fristitution?

I

Month Day Year

I

2, ~rkg the iz.motdh period prior to death, was

the deceased person a p~tierit in any other hospital, tiursfi2g home, home for the aged, br other

type of institution that provided medicai or personal care?

+

Write name and location of each piacc

3. ~ing the 12-month period before death. about

how much did the bills for c4re fn these places

come to, not countf2tg any part provided by public

or private agencies? (Include amounts paid by the

deceaaed person and s~use, byhealtb insurance,

or by relativea or friends of the deceased person)

If exact amount tiot known, ❑ Less than $100

please check youf best ❑ $100-$299 estimate. Include bills

for tare ifi hospitals, a $300-,$499

nursirig homes, hoines

for the aged, and other

inst.itutiona providing I

•1 $500-$999

❑ $1,000 and aver

heaIth or uersonal c~e I

I

4, What part df fiese hospital bills was paid by

health insdrdnce?

D None

❑ Less than 1/2

❑ 1/2 up to 3/4

❑ 3/4 or mdre

5. Was any part of the bills pafd by the deceased

personfs children or other relatives [other than

spouse, if married), or by friends?

•l Yes ❑ No

PH*%?a8 (page 2)

44 Rd. >65
d

. i\,

PART 11, HOSPITAL AND INST[TUTION CARE IN LAsT YEAR OF LIFE (co~tinued)

6. Mrlng the 12-month period before death, did the

decea6ed person receive hdspital care which was

prbvided bee, or which was paid for, by any of

the following?

(Check as mtiy USapply)

❑ Veterafis Administration

❑ Medical assistance for tbe aged or other

public assistance

n public Health Department

U Non-profit health agency

u Other Welf=e organization

Cl Workmens’ Compensatkm

a A ptiblic ho6pit~, nursing home or clinic

n Scime other hospital, nursing home, or clinic ❑ly

What waa that? (Write tn)

7. Were any operations performed on the deceased

person during the 12-inonfi period before death?

lJYes ~No

I

Whst part of the surgeon’s (doctorts) bill was

paid by any kind of fistifance?

❑ None

❑ Less than 1/2

U 1/2 up to 3/4

Cl 3/4 or tiore

PART Ill. INFoRMATIoN ABOUT THE DECEASED PERSON

1, When was the deceased person born? \ 2..At tbe time of death, was the deceased person:

Mon& “[ Veer ❑ Married D Oivorced

a Widowed •l LegsIly aepsrated

U Single (fie~e~rn~rried)

t

,., ,

PART’ IV. ASSETS

.

This part is Concerned with the totai valtie of 4, &d tbe deceased peraoti (and s@tise) have otbsr

things owned by the deceased persoti (and aggetfi such ag gtocks and bund$, bttaiiesa or real

spouse; if married), estate investments, etc., at die tinie of death?

‘No w

1. Did the deceased person (and spouse) dwn

a home (include buying) at t3ie time of death?

a Yes

5, D1d die deceaged (and spottse) have ahy other

kind of agaets su~b as an autotiobilef jeWI

.--r 2, Did the deceased person (and sputiae) have any

mdney in banks, credft ufiions, savings and Ioafi

associations, etc.? 6. mat wotilti y61J jtidge to be die totaI value of

•l Yes

thmgd oWded by thedeeeaaedperadri (ad fipbuse)

after any debts ox’ tiorfgages were paid off?

3. Did the deceaged person (and spotis~ own a

business or farm?

Uyes ❑NO

...

❑ None ❑ $5,000=$9,999

~ Lktder $1,000 a $10,OW.$24,999

❑ $1,000=$4,999 U $25,000 aitd over

PH94G7d.#(page3)

Rev, 3.65
PART V. INCOME

~is part is about tbe income of the deceased

person.

1. State whether the deceased person received

income during 1964 tiom the following sources:

(Check “----” ‘-- “---” ‘--- ‘--’- “----’

Yes No

❑ 0

no

❑ n

❑ n

❑ n

❑ n

❑ n

❑ o

Wages, salary or commission

Own business, professional

prsctice or partnership, ?r

wortdng on own farm

Dividends, interest on savings

accounts or bonds, or income from

annuities, estates or trusts

Rental of proper~, or karders

or lodgers

Social Security

Veterans payments or other

government or private pensions

Welfare payments

Other eources including unemployment or sicknees benefits,

regtiar contributions from rel.

atives, alimony, etc. I

2. What was the total money income of the deceased

person from all sources in 1964?

(Check the box thata=ees withyour best estimate)

❑ None

❑ Under $i,ooo

❑ $1,000-$1,499

❑ $1,500-$1,999

❑ $2,000-$2,999

❑ $3,000-$3,999

❑ $4,000-$4,999

❑ $5,000-$6,999

IJ $7,000-$9,999

❑ $10,000and over

PART V1. SOURCES OF INFORMATION

Please answer the questions in this part about

yourself and about another person who could

provide additional information about the deceased person.

1. who completed this form?

Name

Was the deceased person related to YOU? I

❑iYes ❑N. I

I

Deceased person was your

(relationship) I

2. Is there another person who might be able to add

to the information you have provided?’

❑lYe5 ❑No

Name

Street Address

City and State

Was the deceased person related to this person?

❑ Yes oNo

1

Deceased person was this

person’s

(relationship)

Use the space below for additional comments.

46

* “. s. OOV=RNMENTPRINT,NQ OFFICE - 1*.O - SSS~SS p-o. 10
Se}’ies 1.

Sevies 2.

Sevies 3.

SeVies 4.

Se)-ies 10.

SeVies 11.

Sevies 12.

Seyies 13.

Serzes 14.

Series 20.

Seyies 21.

Sevies 22.

OUTLINE OF REPORT SERIES FOR VITAL AND HEALTH STATISTICS

Public Health Service Publication No. 1000

P1-ogvams and collection pYoceduyes.— Reports which describe die general programs of the National

Center for Health Statistics and its offices and divisions, data collection methods used, definitions,

and other material necessary for understanding the data.

Data evaluation ad methods )-esearch. —Studies of new statistical methodology including: experimental tests of new survey methods, studies of vital statistics collection methods, new analytical

techniques, objective evaluations of reliability of collected data, contributions to statistical theory.

Analytica[ studies. — Reports presenting analytical or interpretive studies based on vital and health

statistics, carrying the analysis further than the ex~sitory types of reprts in the other series.

Documents and committee vepovts. — Final reports of major committees concerned with vital and

health statistics, and documents such as recommended model vital registration laws and revised birth

and death certificates.

Data fvom the Health Intevvieu’ Suvvey. —Statistics on illness, accidental injuries, disability, use of

hospital, medical, dental. and other services, and other health-related topics, based on data collected

in a continuing national household interview survey.

Data f~-om the Health Examiwtion Suvue~. —L)ata from direct examination, testing, and measurenlent of national samples of the population provide the basis for two types of reports: (1) estimates

of the medically defined prevalence of specific diseases in the United States and the distributions of

the population with respect to physical, physiological, and psychological characteristics; and (2)

.~nalysis of relationships among the various measurements without reference to an explicit finite

universe of persons.

Data f)om the Institutional Population Sz~vveys. — Statistics relating to the health characteristics of

persons in institutions, and on medical, nursing, and personal care received, based on national

samples of establishments providing these services and samples of the residents or patients.

Data f}-om the Hospital Disc/za~ge Survey .—Statistics relating to discharged patients in short-stay

hospitals, based on a sample of patient records in a national sanlPle of hospitals.

Data on health ~-esouvces: manpoz~’ev and facilities. — statistics on the numbers, ~eo~raphic distribution, and characteristics of health resources including physicians, dentists, nurses, other health

manpoiver occupations, hospitals, nursinz homes, and outpatient and other inpatient facilities.

Data on mortality. — J’arious statistics on mortality other than as included in annual or monthly

reports —special analyses by cause of death, age, and other demographic variables, also geographic

and time series analyses.

Data O)Znatality, ma~-riage, and diuovce. — Various statistics on natality, marriage, and divorce other

than as included in annual or monthly reports— special analyses by demographic variables, also

geo~raphic and time series analyses, studies of fertility.

Data ,f)rom tile National Natality and i)~o]”tality SllvLeys. —Statistics on characteristics of births and

deaths not available from the vital records, based on sample surveys stemming from these records,

includin~ such topics as mortality by socioeconomic class, medical experience in the last year qf

life, characteristics of pregnanc~r, I’t’.

k~or a list of titles of reports published in these series, write to: office of lnforrn.~tion

NT.ltion:~lCenter for Health St,ltistics

U.S. I’ublic IIealth Service

V/ashington, 11.C. 20201