Data & Trends

Diabetes Surveillance System

1999 Surveillance Report

Chapter 3: Mortality

Mortality in the general population. Diabetes remains a leading cause of mortality, and the number of deaths are increasing. Increased death rates are seen for all ages and races, and the highest rates are seen among minority populations and older Americans.

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 females than among males and was the 4th leading cause of death among females who were black, American Indian, or Filipino. Similar trends are 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 females (Table 3.3). Also in 1996, 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, 3.10; Tables 3.4, 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, respectively).

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, age-adjusted death rates for diabetes as the underlying cause and any listed cause of death were higher among males than females and male rates increased at a greater rate (Figures 3.5, 3.6; Tables 3.16, 3.17, 3.30, 3.31). Blacks had higher rates than whites and the greatest rate of increase was seen for black males (Figures 3.7, 3.8; Tables 3.18, 3.19, 3.21, 3.32, 3.33, 3.34, 3.35). Among all race and ethnic groups, death rates for diabetes as the underlying and as any listed cause increased dramatically with age (Figure 3.11, 3.12; Tables 3.4, 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 underlying and any listed cause of death were notably less (Figures 3.20, 3.21; Tables 3.43, 3.44, 3.45, 3.46; 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 for blacks than for whites, however, and were highest for black males.

In contrast to 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 that 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.

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.

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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