Data & Trends

Diabetes Surveillance System

1999 Surveillance Report

Chapter 1: The Public Health Burden of Diabetes Mellitus in the United States

Mortality

In 1996, diabetes was the 7th leading cause of death in the United States (Table 3.1). When leading causes of death were examined by race, diabetes ranked as the 7th leading cause among whites, Chinese, and Filipinos; as the 6th leading cause among blacks and Japanese; as the 5th leading cause among Hawaiians; and as the 4th leading cause among American Indians (Table 3.2). In general, diabetes ranked higher as a leading cause of death among women than among men and was the 4th leading cause of death among women who were black, American Indian, or Filipino. Similar trends were seen among persons of Hispanic origin; diabetes ranked as the 6th leading cause of death overall and as the 4th leading cause of death among women (Table 3.3). Also in 1996, the age-adjusted death rates for diabetes as the underlying cause of death and for diabetes as any listed cause of death were higher among American Indians, blacks, and persons of Hispanic origin than among whites (Figures 3.9 and 3.10, Tables 3.4 and 3.5)

The annual number of deaths for which diabetes was the underlying cause of death increased from 34,851 in 1980 to 61,767 in 1996 (Figure 3.1, Table 3.8). Throughout most of the 1980s, the age-adjusted death rate for diabetes as the underlying cause of death remained relatively constant (Figure 3.2, Table 3.15). However, in 1989 (the year a new standard death certificate was implemented in the United States), the age-adjusted death rates increased 14% and continued to increase in the l990s, although at a slower rate. By 1996, the age-adjusted death rate for diabetes as the underlying cause of death was 35% higher than in 1980 (20.6 per 100,000 vs. 15.3 per 100,000).

The annual number of deaths for which diabetes was recorded as any cause increased from 135,931 in 1980 to 193,141 in 1996 (Figure 3.3, Table 3.22). In contrast to the age-adjusted death rate for diabetes as the underlying cause, the age-adjusted rate for diabetes as any listed cause did not display a large increase in 1989 and only increased 7% between 1980 and 1996 (Figure 3.4, Table 3.29).

Between 1980 and 1996, the age-adjusted death rates for diabetes as the underlying cause and as any listed cause of death were higher among men than women, and rates among men increased at a greater rate (Figures 3.5 and 3.6, Tables 3.16, 3.17, 3.30, and 3.31). Blacks had higher rates than whites, and the greatest rate of increase was seen among black men (Figures 3.7 and 3.8, Tables 3.18, 3.19, 3.20, 3.21 and 3.32, 3.33, 3.34, 3.35). Among all race and ethnic groups, death rates for diabetes as the underlying cause and as any listed cause increased dramatically with age (Figure 3.11 and 3.12, Tables 3.4 and 3.5).

Mortality in the diabetic population
When the prevalence of diabetes is adjusted for by using estimates of the diabetic population in calculating death rates, differences in death rates between whites and blacks for diabetes as the underlying cause and as any listed cause of death were notably less (Figures 3.20 and 3.21, Tables 3.43, 3.44, 3.45, 3.46 and 3.50, 3.51, 3.52, 3.53). This finding indicates that a substantial proportion of the disparity in death rates among the general population resulted from the greater prevalence of diabetes among blacks. Death rates for diabetes as the underlying cause of death among the diabetic population remained higher among blacks than among whites, however, and were highest among black men.

In contrast to the age-adjusted diabetes death rates in the general population that increased 35% between 1980 and 1996, corresponding death rates in the diabetic population only increased 10% (Figure 3.14, Table 3.40). Similarly, in contrast to diabetes-related death rates in the general population, which increased 7% between 1980 and 1996, corresponding death rates in the diabetic population actually decreased 13% (Figure 3.15, Table 3.47), indicating that diabetes-related deaths are declining among persons with diabetes.

The age-adjusted diabetes death rates among both the general population and the diabetic population increased in 1989, which may be attributed, in part, to the 1989 revision of the U.S. Standard Death Certificate (16). However, the continued increase in diabetes death rates in the general population after 1989, compared with the lack of increase in the diabetes death rates among the diabetic population, suggests that the increasing prevalence of diabetes explains the increasing rates in the general population.

Return to Chapter 1 Contents

Privacy Policy | Accessibility

Home | About the Program | Site Map | Contact Us

CDC Home | Search | Health Topics A-Z

This page last reviewed January 18, 2005.

United States Department of Health and Human Services
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Diabetes Translation