Chapter 9 1987 ADDENDUM TO 1986 TECHNICAL APPENDIX This document details the changes in processing of mortality data between 1986 and 1987. Further information on these changes can be found in the 1987 Mortality Technical Appendix, published in Vital Statistics of the United States, 1987 - Vol. II. Mortality, Part A. I. Source of data In 1987, all the States, the District of Columbia, and Puerto Rico were included in the VSCP. State coded medical data: For 1987, of the States in the VSCP, the following 22 submitted precoded medical data for all death certificates on computer tape: California, Colorado, Florida, Iowa, Kansas, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Nebraska, New Hampshire, New York, North Carolina, Pennsylvania, South Carolina, Texas, Vermont, Virginia, and Wisconsin. The remaining 28 VSCP States, New York City, and the District of Columbia submitted copies of the original certificates form which NCHS coded the medical data: Alabama, Alaska, Arizona, Arkansas, Connecticut, Delaware, Georgia, Hawaii, Idaho, Illinois, Indiana, Kentucky, Missouri, Montana, Nevada, New Jersey, New Mexico, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Dakota, Tennessee, Utah, West Virginia, and Wyoming. All States submitted precoded demographic data for all death certificates on computer tape in 1987. Data for Puerto Rico, the Virgin Islands, and Guam are not available on the mortality public-use data tapes. II. Classification of data A. Hispanic origin. Mortality statistics for the Hispanic-origin population for 1987 are based on information for those States and the District of Columbia that included items on the death certificate to identify Hispanic or ethnic origin of decedents. For 1987, the data were obtained from District of Columbia and the following 22 States: Arizona, Arkansas, California, Colorado, Georgia, Hawaii, Illinois, Indiana, Kansas, Kentucky, Maine, Mississippi, Nebraska, Nevada, New Jersey, New Mexico, New York (including New York City), North Dakota, Ohio, Tennessee, Texas, Utah, and Wyoming. The first year for which Hispanic mortality data appeared on the mortality public-use tapes was 1984. For 1987, mortality data published in Vital Statistics of the addmort.doc - Page 1 United States (VSUS) tables 1-33 and 2-18 are based on deaths to residents of all 29 reporting States and the District of Columbia. In tables 1-34, 1-41, 1-42, 2-19, 2-20, 2-21, and 2-22, mortality data for the Hispanic-origin population are based on deaths to residents of 18 reporting States and the District of Columbia whose data were at least 90 percent complete on a place-of-occurrence basis and considered to be sufficiently comparable to be used for analysis. The 18 States are as follows: Arizona, Arkansas, California, Colorado, Georgia, Hawaii, Illinois, Indiana, Kansas, Mississippi, Nebraska, New Jersey, New York (including New York City), North Carolina, North Dakota, Ohio, Texas, Utah, and Wyoming. Excluded from these tables are data for New Mexico because the format for the Hispanic item on the New Mexico death certificate departs sufficiently from that of other areas to result in noncomparable data. In addition, in tables 1-33 and 2-18 for New Mexico, no deaths are shown for the category "not stated" origin. Because of the way in which the item on the death certification for New Mexico is worded, it was not possible to determine whether a blank entry represented a response of "non-Hispanic origin" or of "unknown origin". Accordingly, blank entries were coded to "non-Hispanic". Data for the other three States--Maine, Nevada, and Tennessee--are excluded from tables 1-34, 1-41, 1-42, 2-19, 2-20, 2-21, and 2-22 because of the large proportion of deaths (in excess of 10 percent) occurring in these States for which Hispanic origin was not stated or was unknown. Infant mortality rates for Hispanic-origin population published in VSUS, 1987 are based on numbers of resident infant deaths reported as Hispanic-origin and numbers of resident live births by Hispanic origin of mother for the 18 reporting States and the District of Columbia. In computing infant mortality rates, deaths and live births of unknown origin are not distributed among the specified Hispanic and non-Hispanic groups. Because for 8.0 percent and the percent of live births of unknown origin was 2.9 percent, infant mortality rates by specified Hispanic origin and race for non-Hispanic origin may be somewhat underestimated. Small numbers of infant deaths for specific Hispanic-origin groups can result in infant mortality rates subject to relative large random variation (See section of Technical Appendix in VSUS entitled "Random variation in numbers of deaths, death rates, and mortality rates and ratios"). In 1980, the 18 reporting States and the District of Columbia accounted for about 80 percent of the Hispanic population in the United States, including about 89 percent of the Mexican population, 78 percent of the Puerto Rican population, 34 percent of the Cuban population, and 68 percent of the "Other Hispanic" population (1). Accordingly, caution should be exercised in generalizing mortality patterns from the reporting area to the Hispanic-origin (especially Cubans) of the entire U.S. addmort.doc - Page 2 C. Cause of death: HIV infection. Beginning with data for 1987, NCHS introduced new category numbers *042-*044 for classifying and coding human immunodeficiency virus (HIV) infection, formerly referred to as human T-cell Lymphotropic virus-III/lymphadenopathy-associated virus (HTLV-III/LAV) infection. The asterisk before the category numbers indicates that these codes are not part of the Ninth Revision of the International Classification of Diseases (ICD-9). They are included, but not shown separately, in the category All other infectious and parasitic diseases in the List of 72 Selected Causes of Death. Prior to 1987, deaths involving (HIV) infection were classified to Deficiency of cell-mediated immunity (ICD Nol 279.1) contained in the category All other infectious and parasitic diseases; to Malignant neoplasms, including neoplasms of lymphatic and hematopoietic tissues; and to a number of other causes. As a consequence, cause-of-death data for 1987 are not strictly comparable with data for previous years. For data years 1983-86, acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection, when reported on the death certificate, were assigned to category Deficiency of cell-mediated immunity (ICD-9 No. 279.1). Because the selection rules for underlying causes of death were developed prior to the identification of AIDS, other conditions mentioned on the death certificate and not category No. 279.1 were often selected as the underlying cause of death during this period. Also, the category ICD-9 No. 279.1 was not uniquely specific for HIV conditions; it is believed that HIV infection was involved in most of the deaths assigned to this category. References 1. U.S. Bureau of the Census: Persons of Spanish origin by State 1980. 1980 Census of Population. Supplementary Report, PC80-S1-7. Washington: U.S. Department of Commerce, 1982. addmort.doc - Page 3