In that same time, the United States as a whole had only 19.6 annual cases of AIDS per 100,000 population, or a total of 643,350 cases. Equally disturbing as the AIDS rate in the District is the rate of Tuberculosis. The District ranks second nationally in number of annual Tuberculosis cases per 100,000 population, behind only Hawaii. In 1999 the District had 13.5 annual cases of Tuberculosis per 100,000 population. The United States in 1999 had an average of 6.4 annual cases of Tuberculosis per 100,000 population.
Infant mortality is another alarming health problem in the District.
Infant mortality is an indicator of numerous other problems including substance abuse, physical abuse, disease, high rates of teen pregnancy and a lack of accessible healthcare. In 1997 the infant mortality rate was 12.1 deaths per 1,000 live births, which is 70 percent higher than the national average of 7.1 deaths per 1,000 live births. The root of many of the Districts health problems can be traced back to substance abuse. It has been estimated that there are 70,000 District residents with an addiction problem. All of the above health issues create the most important and alarming health indicator in the District, life expectancy.