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Preliminary Data on Births and Deaths -- United States, 1995

Timely and accurate health data are essential to public health surveillance efforts for monitoring trends in vital events, diseases, injuries, and disabilities. More timely release of accurate vital statistics has been identified as a priority by health agencies at the federal, state, and local levels and in academia and the private sector. In response to the need for faster release of high-quality data, CDC's National Center for Health Statistics (NCHS), in collaboration with state vital statistics offices, has initiated a new system to speed the transmission of vital statistics from states to CDC. This initiative has resulted in the availability of near-final natality and mortality data approximately 1 year before final data usually are released. This report presents the selected findings of an analysis of preliminary birth and death records for 1995. The number of births in the United States declined for the fifth consecutive year to an estimated 3,900,089 in 1995, 1% fewer than the final 1994 total of 3,952,767 (Table_1) (1). In addition, the estimated number of deaths in 1995 totaled 2,312,180 (Table_2), 1% more than the previous record high of 2,278,994 in 1994 (3).

Detailed natality statistics, which previously have not been available before release of the final data, are based on 90% of the births registered in 1995. Mortality statistics are based on up to 90% of deaths occurring in 1995; the only mechanism previously used for releasing provisional detailed mortality statistics before the release of final data was the Current Mortality Sample, based on a 10% sample of deaths. The death certificate data are processed in two parts: estimates of demographic characteristics are based on approximately 90% of 1995 deaths and medical (cause-of-death) estimates are based on approximately 80% of deaths. CDC receives independent monthly counts of birth and death records from state vital statistics offices. To produce the estimates in this report, the records from the preliminary files were weighted to these independent counts of births, infant deaths, and total deaths registered during 1995. Differences between the preliminary estimates and the final mortality data are likely to be greatest for causes for which reporting of deaths was delayed (e.g., when the case was referred to a coroner or medical examiner for investigation). Births

In 1995, the preliminary birth rate for teenagers (56.9 births per 1000 females aged 15-19 years) declined 3% from 1994 and sustained a decline since 1991. Rates declined up to 3% for white, American Indian/Alaska Native, Asian/Pacific Islander, and Hispanic teenagers, and 9% for black teenagers. From 1994 to 1995, declines also occurred in the number and proportion of births to unmarried mothers -- the number declined 3% to an estimated 1,248,028, and the proportion from 32.6% to 32.0%. For the first time since 1976, the birth rate for unmarried women aged 15-44 years declined -- from 46.9 per 1000 in 1994 to 44.9 in 1995, a 4% decline. In addition, 1995 was the first year since 1940 (when national statistics first became available) during which concurrent declines occurred in the number, rate, and proportion of births to unmarried women. Compared with 1994, the 1995 proportions of births to unmarried women for whites and blacks declined by approximately 1%, and for Hispanics, by 5%. In 1995, the incidence of low birthweight (birthweight of less than 2500 grams [ less than 5 lb 8 oz]) was unchanged from 1994 (7.3%); the proportion of births by cesarean delivery (20.8%) declined for the sixth consecutive year, and the proportion of mothers beginning prenatal care during the first trimester (81.2%) increased for the sixth consecutive year. Deaths

In 1995, although the preliminary crude death rate (880.0 deaths per 100,000 population) increased slightly from 1994 (875.4), the age-adjusted death rate * was a record low (503.7). The overall estimated life expectancy in 1995 (75.8 years) increased slightly from 1994 (75.7) and equaled the record high for 1992. Record highs were reached for black females (74.0 years), black males (65.4), and white males (73.4). The life expectancy for white females was 79.6 years, unchanged from the previous year and slightly below the record high (79.8) in 1992.

From 1994 to 1995, the age-adjusted death rate for the two leading causes of death continued to decline -- heart disease mortality by 1.6% and cancer mortality by 1.3%. Preliminary age-adjusted death rates also declined for homicide by 14.6%, chronic liver disease and cirrhosis by 5.1%, and mortality attributed to accidents ** (including motor-vehicle and other injuries) by 3.6%. For the first time since human immunodeficiency virus (HIV) infection was included in U.S. death statistics, the age-adjusted rates for HIV-related deaths -- the leading cause of death among persons aged 25-44 years -- did not increase. Age-adjusted death rates declined for suicides, injuries from firearms, drug and alcohol-induced causes, and workplace-related injuries. Age-adjusted death rates increased from 1994 to 1995 for diabetes by 2.3% and for Alzheimer's disease by 8.0%.

From 1994 to 1995, declines occurred in overall infant mortality, neonatal mortality (age less than 28 days), and postneonatal mortality (age 28 days through 11 months) for both white and black infants. The preliminary infant mortality rate in 1995 (7.5 deaths per 1000 live births) was lower than in 1994 (8.0).

Reported by: Div of Vital Statistics, National Center for Health Statistics, CDC.

Editorial Note

Editorial Note: The data from the new system for releasing vital statistics provides an earlier indication of potential shifts in trends and has important ramifications for planning public health program policies and strategies. Preliminary data about live births and deaths for 1995 are available almost a year in advance of the release of the final data. CDC plans to improve the timeliness by releasing statistics based on these preliminary files twice a year (4). Each release will be based on data for a 12-month period beginning in either January or July. Statistics for January 1995- December 1995 were released on October 4, 1996. The next release, scheduled for April 1997, will cover July 1995-June 1996.

In previous years, full-year provisional mortality estimates released by NCHS have been based on a 10% sample of death certificates. However, the new data system combines expedited electronic transmittal of data from the states with more rapid data processing within NCHS to make available preliminary data for the full year based on 80%-90% of records. Although the preliminary data are based on substantial samples of births and deaths, statistics based on the final data will differ from the preliminary in some cases. In particular, the final 1995 infant mortality rate probably will exceed the rate based on preliminary data but will remain less than the 1994 rate (8.0). In addition, estimates based on final data for certain causes of death (e.g., homicide and unintentional injury) may be higher than estimates based on preliminary data.

Changes in methodologic procedures also can contribute to year-to-year differences. For example, approximately half of the 1995 decline in unmarried childbearing is the result of changes in reporting procedures in California, which particularly affected births to Hispanic women. Beginning in 1995, reporting procedures in California more accurately ascertain the marital status of Hispanic mothers than in 1994 and prior years. However, even when these reporting changes were taken into account, the 1995 decline is significant. Changes in diagnostic practices also may have accounted for the increase in the death rate for Alzheimer's disease. Finally, the earlier release of more accurate natality and mortality data should assist efforts to prolong and improve the quality of life and to prevent disease, injury, and premature death.

References

  1. Ventura SJ, Martin JA, Mathews TJ, Clarke SC. Advance report of final natality statistics, 1994. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, National Center for Health Statistics, 1996. (Monthly vital statistics report; vol 44, no. 11, suppl).

  2. NCHS. Vital statistics of the United States, 1987. Vol 2, mortality, part A. Washington, DC: US Department of Health and Human Services, Public Health Service, CDC, 1990; DHHS publication no. (PHS)91-1101.

  3. Singh GK, Kochanek KD, MacDorman MF. Advance report of final mortality statistics, 1994. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, National Center for Health Statistics, 1996. (Monthly vital statistics report; vol 45, no. 2, suppl).

  4. Rosenberg HM, Ventura SJ, Maurer JD, Heuser RL, Freedman MA. Births and deaths: United States, 1995. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, National Center for Health Statistics, 1996. (Monthly vital statistics report; vol 45, no. 2, suppl).

* Age-adjusted death rates adjust for differing age distributions of population groups and are more effective for comparing relative risks for mortality among groups and over time. They should be used as relative indexes rather than as actual measures of risk. The age-adjusted rates were computed using the U.S. standard million population.

** When a death occurs under "accidental" circumstances, the preferred term within the public health community is "unintentional injury."



Table_1
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TABLE 1. Total number of births, percentage of births with selected demographic and health characteristics, and birth rates
by maternal age, by race* and ethnicity of mother -- United States, final 1994 data and preliminary 1995 data
========================================================================================================================================
                                    White                 Black                Hispanic               Total &
                           ----------------------   -----------------     ------------------   ---------------------                                                     +
Births                       1994         1995       1994      1995       1994        1995       1994        1995
--------------------------------------------------------------------------------------------------------------------
Number                     3,121,004    3,105,315   636,391   598,558     665,026    671,849   3,952,767   3,900,089

                                                                   Percentage
                           -----------------------------------------------------------------------------------------
Births to mothers aged
 <20 years                     11.3%        11.5%     23.2%     23.2%       17.8%      18.0%       13.1%       13.2%
Births to unmarried
 mothers                       25.4%        25.3%     70.4%     69.5%       43.1%      40.8%       32.6%       32.0%
Low birthweight @               6.1%         6.2%     13.2%     13.0%        6.2%       6.3%        7.3%        7.3%
Births delivered
 by cesarean                   21.2%        20.8%     21.8%     21.8%       20.5%      20.1%       21.2%       20.8%
Prenatal care beginning
 during first trimester        82.8%        83.5%     68.3%     70.3%       68.9%      70.4%       80.2%       81.2%

                                                                     Rates **
Maternal age               -----------------------------------------------------------------------------------------
  10-14 years                    0.8          0.8       4.6       4.2         2.7        2.7         1.4         1.3
  15-19 years                   51.1         50.3     104.5      95.5       107.7      106.2        58.9        56.9
  20-24 years                  106.2        106.6     146.0     136.5       188.2      186.9       111.1       110.0
  25-29 years                  115.5        115.2     104.0      97.7       153.2      151.8       113.9       112.4
  30-34 years                   83.2         84.7      65.8      63.4        95.4       94.2        81.5        82.5
  35-39 years                   33.7         34.3      28.9      28.3        44.3       43.9        33.7        34.1
  40-44 years                    6.2          6.3       5.9       5.9        10.7       10.5         6.4         6.5
  45-49 years                    0.3          0.3       0.3       0.2         0.6        0.5         0.3         0.3
  15-44 years ++                64.9         64.5      76.9      71.7       105.6      103.7        66.7        65.6
--------------------------------------------------------------------------------------------------------------------
 * The full preliminary report provides birth rates for American Indians/Alaskan Natives and Asians/Pacific Islanders (3); percentages
   for these races by characteristics will be available in the final report.
 + Persons of Hispanic origin may be of any race.
 & Includes races other than white and black.
 @ Birthweight of <2500 grams (<5 lb 8 oz).
** Per 1000 population in specified group.
++ Rates computed by relating total births, regardless of age of mother, to women aged 15-44 years.
========================================================================================================================================

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Table_2
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TABLE 2. Preliminary number of deaths and death rates for the 15 leading causes of death for all ages, races, and sexes, by
rank -- United States, 1995
=====================================================================================================================================
                                                              Crude       Age-adjusted       % Change
Rank *  Causes of death (ICD-9+ code)            No.       death rate &   death rate @    1994 to 1995 **
---------------------------------------------------------------------------------------------------------
   1    Diseases of heart (390-398, 402,
         404-429)                                738,781      281.2           138.2           - 1.6
   2    Malignant neoplasms, including
         neoplasms of lymphatic and
         hematopoietic tissues (140-208)         537,969      204.7           129.8           - 1.3
   3    Cerebrovascular diseases (430-438)       158,061       60.2            26.7             0.8
   4    Chronic obstructive pulmonary
         diseases and allied conditions
         (490-496)                               104,756       39.9            21.2             1.0
   5    Accidents and adverse effects
         (E800-E949) ++                           89,703       34.1            29.2           - 3.6
   6    Pneumonia and influenza (480-487)         83,528       31.8            13.0             0
   7    Diabetes mellitus (250)                   59,085       22.5            13.2             2.3
   8    Human immunodeficiency virus
         infection (042-044) &&                   42,506       16.2            15.4             0
   9    Suicide (E950-E959)                       30,893       11.8            11.0           - 1.8
  10    Chronic liver disease and cirrhosis
         (571)                                    24,848        9.5             7.5           - 5.1
  11    Nephritis, nephrotic syndrome, and
         nephrosis (580-589)                      23,845        9.1             4.4             2.3
  12    Homicide and legal intervention
         (E960-E978)                              21,577        8.2             8.8           -14.6
  13    Septicemia (038)                          21,123        8.0             4.1             2.5
  14    Alzheimer's disease (331)                 20,415        7.8             2.7             8.0
  15    Atherosclerosis (440)                     16,781        6.4             2.3               0

        All Causes                             2,312,180      880.0           503.7           - 0.7
---------------------------------------------------------------------------------------------------------
 * Based on number of deaths.
 + International Classification of Diseases, Ninth Revision.
 & Per 100,000 population.
 @ Per 100,000 U.S. standard million population.
** Percentage change between 1995 estimated age-adjusted death rates and 1994 final age-adjusted death rates.
++ When a death occurs under "accidental" circumstances, the preferred term within the public health community is "unintentional
   injury."
&& These codes are not part of ICD-9, but were introduced by CDC's National Center for Health Statistics for classifying and coding
   human immunodeficiency virus infection (2).
=====================================================================================================================================

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