VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX ACKNOWLEDGMENTS The technical appendix preparation was coordinated by Sherry L. Murphy in the Division of Vital Statistics under the general direction of Harry M. Rosenberg, Chief of the Mortality Statistics Branch. The vital statistics computer file on which it is based were prepared by staff from the Division of Vital Statistics, Division of Data Processing, Division of Data Services, and the Office of Research and Methodology. The Division of Vital Statistics, Mary Anne Freedman, Director, and James A. Weed, Deputy Director, managed the Vital Statistics Cooperative Program, through which the vital registration offices of all States, the District of Columbia, New York City, Puerto Rico, Virgin Islands, and Guam provided the data to the National Center for Health Statistics. This Division also processed computer edits, designed and programmed the tabulations, reviewed the data, and prepared documentation for this publication. The following staff provided overall direction: Ronald F. Chamblee, George A. Gay, Nicholas F. Pace, and Harry M. Rosenberg. Important contributors were Robert N. Anderson, Judy M. Barnes, Thomas D. Dunn, Donna E. Glenn, Brenda A. Green, Donna L. Hoyert, Christina K. Jarman, Millie B. Johnson, David W. Justice, Virginia J. Justice, Kenneth D. Kochanek, Julia L. Kowaleski, Jeffrey D. Maurer, Sherry L. Murphy, Gail A. Parr, Adrienne L. Rouse, Charles E. Royer, Jordan Sacks, George C. Tolson, Mary M. Trotter, Mary H. Wilder, JoAnn Wiley, and Francine D. Winter. The Division of Data Processing, David L. Larson, Acting Director, and Charles E. Sirc, Acting Deputy Director, was responsible for receipt and processing of the basic data file. The following staff provided overall direction: Tanya W. Pitts, Dan M. Shearin, and Elizabeth Walston. Important contributors were Tyringa L. Ambrose, Rosalyn R. Anderson, Joyce L. Bius, Karen M. Bridges, Brenda L. Brown, Frances E. Carter, Shirley Carter, Linda P. Currin, Celia Dickens, Patricia W. Dunham, Clara Edwards, Connie M. Gentry, Lillian M. Guettler, Donald Jessup, Audrey S. Johnson, Mary Susan Lippincott, Janet L. McBride, Susan L. McBroom, Rodney Pierson, Frank Rawls, Julia E. Raynor, Eldora Smith, Pamela A. Stephenson, Leslie J. Stewart, Susan Temple, Betsy B. Thompson, Teresa M. Watkins, Faye L. Webster, Mary Whitley, Cynthia Williams, and James G. Williams. The Office of Research and Methodology was responsible for the application of mathematical statistics methods to the development and implementation of quality assurance procedures. Important contributions in this area were made by Van L. Parsons. The National Center for Health Statistics acknowledges the essential role of the vital registration offices of all States and territories in maintaining the system through which vital statistics data are obtained and for their cooperation in providing the information on which this publication is based. A copy of the technical appendix may be obtained by contacting the National Center for Health Statistics, Mortality Statistics Branch at 301-436-8884. VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX For a list of reports published by the National Center for Health Statistics contact: Data Dissemination Branch National Center for Health Statistics Centers for Disease Control and Prevention Public Health Service 6525 Belcrest Road, Room 1064 Hyattsville, MD 20782 (301) 436-8500 Internet: http://www.cdc.gov/nchswww/ VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Sources of data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Death statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Standard certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Classification of data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Classification by occurrence and residence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Geographic classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 State or country of birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Hispanic deaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Marital status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Educational attainment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Injury at work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Occupation and industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Place of death and status of decedent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Mortality by month and date of death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Report of autopsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Cause of death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Maternal deaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Infant deaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Quality of data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Completeness of registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Quality control procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Computation of rates and other measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Population bases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Net census undercount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Age-adjusted death rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Life tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Random variation and sampling errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Statistical tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 17 18 20 21 21 29 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Figures 7-A. U.S. Standard Certificate of Death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Text tables A. Comparison of percent agreement and ratio of deaths for census or survey record to deaths by race for matching death certificate: 1960 and 1979-85 . . . . . . . . . . . . . . . . . . . . . . . . 35 Infant mortality rates by race of infant from the death certificate and by race of mother from the birth certificate, and ratio of rates, 1995-96 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Infant mortality rates by Hispanic origin of infant from the death certificate and by race of mother from the birth certificate, and ratio of rates, 1996 . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Numbers of deaths and ratios of deaths for selected causes as tabulated by State of occurrence and NCHS, 1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Population of birth- and death-registration States, 1900-1932, and United States, 1900-95 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Source for resident population and population including Armed Forces abroad: Birth- and death-registration States, 1900-32, and United States, 1933-95 . . . . . . . . . . . . . . . . . . 41 Estimated population of the United States, by 5-year age groups, race, and sex: July 1, 1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Estimated Population, by age, for the United States, each division and State, Puerto Rico, Virgin Islands, and Guam: July 1, 1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Estimated population by 5-year age groups, specified Hispanic origin, race for non-Hispanic origin, and sex: Total of 49 States and the District of Columbia, July 1, 1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Estimated population for ages 15 years and over, by 5-year age groups, marital status, race, and sex: United States, 1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Estimated population for ages 15 years and over, by 5-year age groups, marital status, specified Hispanic origin, race for non-Hispanic origin, and sex: Total of 49 States and the District of Columbia, 1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Ratio of census-level resident population to resident population adjusted for estimated net census undercount by age, sex, and race: April 1, 1990 . . . . . . . . . . . . . . . . . . . . . . 62 Age-adjusted death rates for selected causes by race and sex, unadjusted and adjusted for estimated net census undercount: United States, 1990 . . . . . . . . . . . . . . . . . . . . . . . . 64 Lower and upper 95% and 96% confidence limit factors for a death rate based on a Poisson variable of 1 through 99 deaths, D or Dadj . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 B. C. D. E. F. G. H. I. J. K. L. M. N. VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Sources of data Death statistics Mortality statistics for 1995 are, as for all previous years except 1972, based on information from records of all deaths occurring in the United States. The death-registration system of the United States encompasses the 50 States, the District of Columbia, New York City (which is independent of New York State for the purpose of death registration), Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands. In statistical tabulations, United States refers only to the aggregate of the 50 States (including New York City) and the District of Columbia. Data for Guam, Puerto Rico, and the Virgin Islands are presented separately from data for the United States. No data are included for American Samoa or the Commonwealth of the Northern Marianas. The Virgin Islands was admitted to the registration area for deaths in 1924; Puerto Rico, in 1932; and Guam, in 1970. Tabulations of death statistics for Puerto Rico and the Virgin Islands were regularly shown in Vital Statistics of the United States from the year of their admission through 1971 except for the years 1967-69, and tabulations for Guam were included for 1970 and 1971. Death statistics for Puerto Rico, the Virgin Islands, and Guam were not included in Vital Statistics of the United States for 1972 but have been included each year since 1973. Information for 1972 for these three areas was published in the respective annual vital statistics reports of the Department of Health of the Commonwealth of Puerto Rico, the Department of Health of the Virgin Islands, and the Department of Public Health and Social Services of the Government of Guam. Procedures used by NCHS to collect death statistics have changed over the years. Before 1971 tabulations of deaths were based solely on information obtained by NCHS from copies of the original certificates. The information from these copies was edited, coded, and tabulated. For 1960-70 all mortality information taken from these records was transferred by NCHS to magnetic tape for computer processing. Beginning with 1971 an increasing number of States have provided NCHS, via the Vital Statistics Cooperative Program (VSCP), with electronic files of data coded according to NCHS specifications. The year in which State-coded demographic data were first transmitted in electronic data files to NCHS is shown below for each of the States, New York City, the District of Columbia, Puerto Rico, and the Virgin Islands, all of which now furnish demographic or nonmedical data in electronic data files. 1971 Florida 1972 Maine Missouri New Hampshire Rhode Island Vermont 1975 Louisiana Maryland North Carolina Oklahoma Tennessee Virginia Wisconsin 1973 Colorado Michigan New York (except New York City) 1976 Alabama Kentucky Minnesota Nevada Texas West Virginia 1974 Illinois Iowa Kansas Montana Nebraska Oregon South Carolina -1- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX 1977 Alaska Idaho Massachusetts New York City Ohio Puerto Rico 1980 Arkansas New Mexico South Dakota 1978 Indiana Utah Washington 1979 Connecticut Hawaii Mississippi New Jersey Pennsylvania Wyoming 1985 Arizona California Delaware Georgia District of Columbia 1982 North Dakota 1994 Virgin Islands For Guam, mortality statistics for 1995 are based on information obtained directly by NCHS from copies of the original certificates received from the registration office. In 1974 States began coding medical (cause-of-death) data in electronic data files according to NCHS specifications. The year in which State-coded medical data were first transmitted to NCHS is shown below for the 41 States now furnishing such data. In 1995 Maine, Montana, North Dakota, and Wyoming contracted with a private company to provide precoded medical data to NCHS. Kansas provided the medical data for Alaska. The remaining 9 VSCP States, New York City, the District of Columbia, Puerto Rico, the Virgin Islands, and Guam submitted copies of the original certificates from which NCHS coded the medical data. 1974 Iowa Michigan 1975 Louisiana Nebraska North Carolina Virginia Wisconsin 1980 Colorado Kansas Massachusetts Mississippi New Hampshire Pennsylvania South Carolina 1984 Maryland New York (except New York City) Vermont 1989 Georgia Indiana Washington 1981 Maine 1983 Minnesota 1986 California Florida Texas 1988 Alaska Delaware Idaho North Dakota Wyoming -2- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX 1991 Arkansas 1992 Montana 1993 Alabama Connecticut Hawaii Nevada Oregon South Dakota 1994 Oklahoma Rhode Island 1995 New Mexico For 1995 and previous years except 1972, NCHS coded the medical information from copies of the original certificates received from the registration offices for all deaths occurring in those States that were not furnishing NCHS with medical data coded according to NCHS specifications. For 1981 and 1982, these procedures were modified because of a coding and processing backlog resulting from personnel and budgetary restrictions. To produce the mortality files on a timely basis with reduced resources, NCHS used State-coded underlying cause-ofdeath information supplied by 19 States for 50 percent of the records; for the other 50 percent of the records for these States as well as for 100 percent of the records for the remaining 21 registration areas, NCHS coded the medical information. Mortality statistics for 1972 were based on information obtained from a 50-percent sample of death records instead of from all records as in other years. The sample resulted from personnel and budgetary restrictions. Sampling variation associated with the 50-percent sample is described in "Estimates of errors arising from 50-percent sample for 1972" under "Quality control procedures". Standard certificate For many years, the U.S. Standard Certificate of Death, issued by the Department of Health and Human Services, has been used as the principal means to attain uniformity in the contents of documents used to collect information on these events. It has been modified by each State to the extent required by the particular needs of the State or by special provisions of the State vital statistics law. However, the certificates of most States conform closely in content and arrangement to the standards. The first issue of the U.S. Standard Certificate of Death appeared in 1900. Since then, it has been revised periodically by the national vital statistics agency through consultation with State health officers and registrars; Federal agencies concerned with vital statistics; national, State, and county medical societies; and others working in such fields as public health, social welfare, demography, and insurance. This revision procedure has ensured careful evaluation of each item in terms of its current and future usefulness for legal, medical and health, demographic, and research purposes. New items have been added when necessary, and old items have been modified to ensure better reporting; or in some cases, items have been dropped when their usefulness appeared to be limited. The current version of the U.S. Standard Certificate of Death was recommended for State use beginning on January 1, 1989. The U.S. Standard Certificate of Death is shown in figure 7-A (1). History The first death statistics published by the Federal Government concerned events in 1850 and were based on statistics collected during the decennial census of that year. In 1880 a national "registration area" was created for deaths. Originally, this area consisted of Massachusetts, New Jersey, the District of Columbia, and several large cities that had efficient systems for death registration. The death-registration area continued to expand until 1933, -3- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX when it included for the first time the entire United States. Tables showing data for death-registration States include the District of Columbia for all years; registration cities in nonregistration States are not included. For more details on the history of the death-registration area, see U.S. Vital Statistics System: Major Activities and Developments, 1950-95 (2). Classification of data Vital statistics data is presented in terms of both frequencies and rates which are classified according to demographic variables such as geographic area, age, sex, and race. Since the calculation of rates requires population data, both vital statistics and population data must be classified and tabulated in comparable groups. The general rules used in the classification of geographic and personal items for deaths for 1995 are set forth in the NCHS instruction manual, Part 4 (3). A discussion of the classification of certain important items is presented below. Classification by occurrence and residence Tabulations for the United States and specified geographic areas are classified by place of residence unless stated as by place of occurrence. Before 1970 resident mortality statistics for the United States included all deaths occurring in the States and the District of Columbia, with deaths of nonresidents assigned to place of death. For the United States (50 States and the District of Columbia), deaths of nonresidents refers to deaths that occur in the 50 States and the District of Columbia of nonresident aliens; nationals residing abroad; and residents of Puerto Rico, the Virgin Islands, Guam, and other territories of the United States. Similarly, for Puerto Rico and for the Virgin Islands, deaths of nonresidents refers to deaths that occurred to a resident of any place other than Puerto Rico and the Virgin Islands, respectively. For Guam, however, deaths of nonresidents refers to deaths that occurred to a resident of any place other than Guam or the United States. Beginning with 1970, deaths of nonresidents are not included in tables by place of residence. Deaths by place of occurrence, on the other hand, include deaths of both residents and nonresidents of the United States. Consequently, for each year beginning with 1970, the total number of deaths in the United States by place of occurrence was somewhat greater than the total by place of residence. For 1995 this difference amounted to 3,119 deaths. Before 1970, except for 1964 and 1965, deaths of nonresidents of the United States occurring in the United States were treated as deaths of residents of the exact place of occurrence, which in most instances was an urban area. In 1964 and 1965, deaths of nonresidents of the United States occurring in the United States were allocated as deaths of residents of the balance of the county in which they occurred. Residence error--Results of a 1960 study showed that the classification of residence information on the death certificates corresponded closely to the residence classification of the census records for the decedents whose records were matched (4). A recent review of infant mortality rates for major urban areas suggests that the problem of residence error persists in vital statistics data despite the presence of an item on the U.S. Standard certificates of birth and death that asks whether residence was inside or outside city limits. Full resolution of this problem may require the application of automated systems for assigning addresses to geopolitical units. Geographic classification The rules followed in the classification of geographic areas for deaths are contained in NCHS instruction manual, Part 4 (3). The geographic codes assigned by NCHS on birth and death records are given in another instruction manual (5). Beginning with 1994 data, the geographic codes were modified to reflect results of the 1990 census. For 1982-93 codes are based on the results of the 1980 census and for 1970-81 on the 1970 census. Metropolitan statistical areas--The Metropolitan statistical areas (MSA's) and Primary metropolitan statistical areas (PMSA's) are those established by the U.S. Office of Management and Budget as of April 1, 1990, and used by the U.S. Bureau of the Census (6), except in the New England States. -4- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Outside the New England States, an MSA has either a city with a population of at least 50,000 or a U.S. Bureau of the Census urbanized area of at least 50,000 and a total MSA population of at least 100,000. A PMSA consists of a large urbanized county or cluster of counties that demonstrate very strong internal economic and social links and has a population over one million. When PMSA's are defined, the larger area of which they are component parts is designated a Consolidated Metropolitan Statistical Area (CMSA) (7). In the New England States, the U.S. Office of Management and Budget uses towns and cities rather than counties as geographic components of MSA's and PMSA's. However, NCHS cannot use this classification for these States because its data are not coded to identify all towns. Instead, NCHS uses New England County Metropolitan Areas (NECMA's). Made up of county units, these areas are established by the U.S. Office of Management and Budget (8). Metropolitan and nonmetropolitan counties--Independent cities and counties included in MSA's and PMSA's or in NECMA's are included in data for metropolitan counties; all other counties are classified as nonmetropolitan. Population-size groups--Beginning with the 1994 data year, vital statistics data for cities and certain other urban places were classified according to the population enumerated in the 1990 Census of Population. Data are available for individual cities and other urban places of 10,000 or more population. As a result of changes in the enumerated population between 1980 and 1990, some urban places are no longer identified separately and other urban places have been added. Data for the remaining areas not separately identified appear under the heading "balance of area" or "balance of county." For the years 1982-93 classification of areas was determined by the population enumerated in the 1980 Census of Population and for the years 1970-81 in the 1970 Census of Population. Urban places other than incorporated cities include the following: ! Each town in New England, New York, and Wisconsin and each township in Michigan, New Jersey, and Pennsylvania that had no incorporated municipality as a subdivision and had either 25,000 inhabitants or more, or a population of 10,000 to 25,000 and a density of 1,000 persons or more per square mile. Each county in States other than those indicated above that had no incorporated municipality within its boundary and had a density of 1,000 persons or more per square mile. (Arlington County, Virginia, is the only county classified as urban under this rule.) Each place in Hawaii with a population of 10,000 or more. (There are no incorporated cities in the State.) ! ! Before 1964 places were classified as "urban" or "rural." Technical appendixes for earlier years discuss the previous classification system. State or country of birth Mortality statistics by State or country of birth became available beginning with 1979. State or country of birth of a decedent is assigned to 1 of the 50 States or the District of Columbia; or to Puerto Rico, the Virgin Islands, or Guam--if specified on the death certificate. The place of birth is also tabulated for Canada, Cuba, Mexico, and for the remainder of the world. Deaths for which information on State or country of birth was unknown, not stated, or not classifiable accounted for a small proportion of all deaths in 1995, about 0.6 percent. Early mortality reports published by the U.S. Bureau of the Census contained tables showing nativity of parents as well as nativity of decedent. Publication of these tables was discontinued in 1933. Mortality data showing nativity of decedent were again published in annual reports for 1939-41 and for 1950. Age The age recorded on the death record is the age at last birthday, the same as the age classification used by the U.S. Bureau of the Census. For 1995 data, 463 resident death records (0.02 percent) contained not-stated age. For computation of age-specific and age-adjusted death rates, deaths with age not stated are excluded. For life table computation, deaths with age not stated are distributed proportionately. -5- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Race For vital statistics in the United States in 1995, deaths are classified by race--white, black, American Indian, Chinese, Hawaiian, Japanese, Filipino, and Other Asian or Pacific Islander. Beginning with 1992 data, an expanded code structure was used for seven States showing five additional Asian or Pacific Islander groups. These groups are Asian Indian, Korean, Samoan, Vietnamese, and Guamanian. These groups are coded only for deaths occurring in California, Hawaii, Illinois, New Jersey, New York, Texas, and Washington. In 1990, at least twothirds of the U.S. population of each of these groups lived in this seven-State reporting area: Asian Indian, Korean, and Vietnamese, 63-66 percent; Guamanian, 74 percent; and Samoan, 84 percent (9). This additional race detail is available on the mortality public-use data tapes (10,11) and in tabular form. Beginning with 1992 data, all records coded as "other races" (0.02 percent of the total deaths in 1995) were assigned to the specified race of the previous record rather than to a separate category called "other races." Mortality data for Filipino and Other Asian or Pacific Islander were shown for the first time in 1979. The white category includes, in addition to persons reported as white, those reported in the race item on the death certificate as Hispanic, Mexican, Puerto Rican, Cuban, and all other Caucasians. The American Indian category includes North, Central, and South American Indian, Eskimo, and Aleut. If the racial entry on the death certificate indicates a mixture of Hawaiian and any other race, the entry is coded to Hawaiian. If the race is given as a mixture of white and any other race, the entry is coded to the appropriate nonwhite race. If a mixture of races other than white is given (except Hawaiian), the entry is coded to the first race listed. This procedure for coding the first race listed has been used since 1969. Before 1969 if the entry for race was a mixture of black and any other race except Hawaiian, the entry was coded to black. Race not stated--For 1995 the number of death records for which race was unknown, not stated, or not classifiable was 1,954 or 0.1 percent of the total deaths. Beginning in 1992 death records with race not stated were assigned to the specified race of the previous record with known race. From 1965 to 1991 death records with race entry not stated were assigned to a racial designation as follows: If the preceding record was coded white, the code assignment was made to white; if the code was other than white, the assignment was made to black. Before 1964 all records with race not stated were assigned to white except records of residents of New Jersey for 1962-64. New Jersey, 1962-64--New Jersey omitted the race item from its certificates of live birth and death in the beginning of 1962. The item was restored during the latter part of 1962. However, the certificate revision without the race item was used for most of 1962 as well as 1963. Therefore, figures by race for 1962 and 1963 exclude New Jersey. For 1964, 6.8 percent of the death records used for residents of New Jersey did not contain the race item. Adjustments made in vital statistics to account for the omission of the race item in New Jersey for part of the certificates filed during 1962-64 are described in the Technical Appendix of Vital Statistics of the United States for each of those data years. Quality of race data--A number of studies have been conducted on the reliability of race reported on the death certificate. These studies compare race reported on the death certificate with that reported on another data collection instrument such as the census or a survey. Race information on the death certificate is reported by the funeral director as provided by an informant, often the surviving next of kin, or, in the absence of an informant, on the basis of observation. In contrast, race on the census or the Current Population Survey (CPS) is self-reported or reported by a member of the household and, therefore, may be considered more valid. A high level of agreement between the death certificate and the census or survey report is essential to ensure unbiased death rates by race. In one study a sample of approximately 340,000 death certificates was compared with census records for a 4-month period in 1960 (12). Percent agreement was 99.8 percent for white decedents, and 98.2 percent for black decedents; but less for the smaller minority groups (table A); the net difference in the number of deaths between the census records and death certificates can be expressed as a ratio of the census to the death certificate. A ratio of 1.0 for both white and black decedents (table A) indicates that the number of deaths for these race groups was essentially the same for these two sources. In another study, the National Longitudinal Mortality Study (NLMS), a total of 29,713 death certificates were compared with responses to the race questions from a total of 12 CPS's conducted by the U.S. Bureau of the Census for the years 1979-85 (13). The ratio between the two sources for white and black decedents was 1.0 as in the earlier study, however, the ratio for American Indian was 1.22 indicating that 22 percent more decedents were identified as American Indian in the census source as compared to the death certificate. The ratio for Asians was 1.12 (table A). In 1986 the National Mortality Followback Survey, conducted -6- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX by NCHS, listed a question about the race of decedents 25 years old and over. The total sample was 18,733 decedents (14). The rates of agreement were similar to those observed in the other studies. All of these studies show that persons self-reported as American Indian or Asian on census and survey records (and by informants in the Followback Survey) were sometimes reported as white on the death certificate. The net effect of misclassification is an underestimation of deaths and death rates for the smaller minority races. Hispanic deaths Mortality statistics for the Hispanic population 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. Data for 1995 were obtained from the District of Columbia and all States except Oklahoma, which was excluded because its death certificate did not include an item to identify Hispanic or ethnic origin. Hispanic mortality data were published for the first time in 1984. Generally, the reporting States used items similar to one of two basic formats recommended by NCHS. The first format is directed specifically toward the Hispanic population and appears on the U.S. Standard Certificate of Death as follows: ! WAS DECEDENT OF HISPANIC ORIGIN? (Specify No or Yes--If Yes, specify Cuban, Mexican, Puerto Rican, etc.) 9 No ___9 Yes Specify: The second format is a more general ancestry item and appears as follows: ! ANCESTRY--Mexican, Puerto Rican, Cuban, African, English, Irish, German, Hmong, etc., (specify) Death rates --Death rates for the total Hispanic population and race for non-Hispanic origin utilize demographically-derived population estimates produced by the Bureau of the Census (15). By comparison, population estimates for Mexicans, Puerto Ricans, Cubans, and Other Hispanics are based in part on the Current Population Survey (15). Rates using the latter, therefore, are subject to sampling variation as well as random variation (see "Random variation and sampling errors"). The 49 States and the District of Columbia accounted for about 99.6 percent of the Hispanic population in the United States in 1990. This included about 99.5 percent of the Mexican population, 99.8 percent of the Puerto Rican population, 99.9 percent of the Cuban population, and 99.7 percent of the "Other Hispanic" population (9). For qualifications regarding infant mortality of the Hispanic-origin population, see "Infant deaths." In 1994 New York City instituted the use of a revised death certificate where the race and ethnic items were to be completed by the funeral director. Previously these items were completed by the physician or medical examiner. In 1995 of the 70,752 deaths occurring in New York City, only 3 percent were coded to Unknown origin. Similarly, 4 percent were coded to unknown origin in 1994 whereas 23 percent were coded to Unknown origin in 1993. Between 1993 and 1994 the number of deaths occurring in New York City decreased 69 percent for Other and unknown Hispanic and 83 percent for Unknown origin. As a result of increased specificity in reporting ethnic origin, the number of deaths increased substantially in 1994 for Non-Hispanic and for each of the specified Hispanic subgroups. Quality of data on Hispanic deaths--The NLMS examined the reliability of Hispanic origin reported on 43,520 death certificates with that reported on a total of 12 CPS's conducted by the U.S. Bureau of the Census for the years 1979-85 (13). The ratio of deaths for CPS divided by deaths for death certificate was 1.07 percent indicating net underreporting of Hispanic origin on death certificates as compared with self-reports on the surveys. The sample was too small to assess the reliability of specified Hispanic groups. Marital status Mortality statistics by marital status have been published annually since 1979. They were previously published in Vital Statistics of the United States for 1949-51 and 1959-61. Several reports analyzing mortality by marital -7- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX status have been published, including the special study based on 1959-61 data (16). Reference to earlier reports is given in the appendix of part B of the 1959-61 special study. Mortality statistics by marital status are tabulated separately for never married, married, widowed, and divorced. Deaths for which the marriage is specified as being annulled are classified as never married. Marital status specified as separated or common-law marriage is classified as married. Of the 2,267,097 resident deaths 15 years of age and over in 1995, 9,705 certificates (0.4 percent) had marital status not stated. Death rates -- Death rates for marital status use population estimates produced by the Bureau of the Census based on the Current Population Survey (15). Because these population estimates are subject to sampling variation, death rates based on them are subject to both sampling variation as well as random variation (see "Random variation and sampling errors"). Educational attainment Beginning with the 1989 data year, mortality data on educational attainment have been tabulated from information reported on the death certificate using the following item: ! DECEDENT'S EDUCATION (Specify only highest grade completed) Elementary/Secondary (0-12) College (1-4 or 5+) For 1995, mortality data on educational attainment were reported by 46 States and the District of Columbia. Georgia, Oklahoma, Rhode Island, and South Dakota did not include an educational attainment item on their death certificate. Selected mortality tables on educational attainment are based on deaths to residents of 45 States and the District of Columbia whose data were approximately 80 percent or more complete on a place-of-occurrence basis. In addition to the four States mentioned previously, data for Kentucky are excluded from these tables because more than 20 percent of their death certificates were classified to "unknown educational attainment." Injury at work Deaths for "Injury at work" were included on the 1993 public-use data tapes for the first time. These data were obtained from the following item that appears on the U.S. Standard Certificate of Death: ! INJURY AT WORK? (Yes or no) All States have this item on their death certificates. Occupation and industry Deaths by occupation and industry are included on the 1995 public-use data tapes and CD-ROM. These data have been included since 1985 and were obtained from the following items that appear on the U.S. Standard Certificate of Death: ! DECEDENT'S USUAL OCCUPATION (Give kind of work done during most of working life. Do not use retired.) KIND OF BUSINESS/INDUSTRY ! -8- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX For 1995, the occupation and industry mortality data were included for the following 19 reporting States: Colorado Georgia Idaho Indiana Kansas Kentucky Maine Nevada New Hampshire New Jersey New Mexico North Carolina Ohio Rhode Island South Carolina Utah Vermont West Virginia Wisconsin Data for 1993-95 were coded using the revised NCHS Part 19 instruction manual (17) and the Bureau of the Census 1990 occupation and industry titles and three-digit codes, which are shown in the 1990 Census of Population and Housing (18). Occupation and industry mortality data for 1984-92 were based on the 1980 Bureau of the Census occupation and industry classifications. For a listing of the changes between the 1980 and the 1990 classification systems, see Appendix D of the NCHS Part 19 instruction manual (17). In addition to the codes shown in the Bureau of the Census publication (18), the following special codes were created: Occupation 913 Retired 914 Housewife/ Homemaker 915 Student 916 Volunteer 917 Unemployed, never worked, disabled, child, infant 999 Blank, Unknown, NA Industry 961 Own Home/At Home 970 Retired 990 Blank, Unknown, NA Place of death and status of decedent Mortality statistics by type of place of death have been shown annually in Vital Statistics of the United States since 1979. Before that year they were published in 1958 (tables 1-30--1-32). In addition, mortality data also were available for the first time in 1979 for the status of decedent when death occurred in a hospital or medical center. The 1994 data were obtained from the following two items appearing on the revised U.S. Standard Certificate of Death (1): ! PLACE OF DEATH (check only one) HOSPITAL: OTHER: ! 9 Inpatient 9 ER/Outpatient 9 Residence 9 DOA 9 Other (specify) 9 Nursing Home FACILITY NAME (If not institution, give street and number) -9- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Before the 1989 revision of the Standard Certificate of Death, information on place of death and status of decedent could be determined if hospital or institution indicated Inpatient, Outpatient, ER, or DOA, and if the name of the hospital or institution, which was used to determine the kind of facility, appeared on the certificate. The change to a checkbox format in many States for this item may affect the comparability of data for 1989 and subsequent years with data for years before 1989. Except for Oklahoma, all of the States (including New York City) and the District of Columbia have this item (or its equivalent) on their certificates. For all reporting States and the District of Columbia in the VSCP, NCHS accepts the State definition, classification, or code for hospitals, medical centers, nursing homes, or other institutions. Effective with data for 1980, the coding of place of death and status of decedent was modified. A new coding category was added: "Dead on arrival--hospital, clinic, or medical center." Had the 1979 coding categories been used, these deaths would have been coded to "Place unknown." California--For the first 5 months of data year 1989, California coded "Place of death" to "other" rather than "residence". Mortality by month and date of death Deaths by month have been tabulated regularly and are available for each year since 1900. Deaths from selected causes by date of death have been published each year since 1972 and are available for 1962. Numbers of deaths by date of death are produced for the total number of deaths and for the numbers of deaths for the following three causes, for which the greatest interest in date of occurrence of death has been expressed: Motor vehicle accidents, Suicide, and Homicide and legal intervention. These data show the frequency distribution of deaths for selected causes by day of week. They also make it possible to identify holidays with peak numbers of deaths from specified causes. Report of autopsy Beginning with the 1995 data year, mortality data on autopsy are no longer collected due to budgetary constraints. Cause of death Cause-of-death classification--Since 1949 cause-of-death statistics have been based on the underlying cause of death, which is defined as "(a) the disease or injury which initiated the train of events leading directly to death, or (b) the circumstances of the accident or violence which produced the fatal injury" (19). For each death the underlying cause is selected from an array of conditions reported in the medical certification section on the death certificate. This section provides a format for entering the cause of death sequentially. The conditions are translated into medical codes through use of the classification structure and the selection and modification rules contained in the applicable revision of the International Classification of Diseases (ICD), published by the World Health Organization (WHO). Selection rules provide guidance for systematically identifying the underlying cause of death. Modification rules are intended to improve the usefulness of mortality statistics by giving preference to certain classification categories over others and/or to consolidate two conditions or more on the certificate into one classification category. As a statistical datum, underlying cause of death is a simple, one-dimensional statistic; it is conceptually easy to understand and a well-accepted measure of mortality. It identifies the initiating cause of death and is therefore most useful to public health officials in developing measures to prevent the onset of the chain of events leading to death. The rules for selecting the underlying cause of death are included in ICD as a means of standardizing classification, which contributes toward comparability and uniformity in mortality medical statistics among countries. Tabulation lists--Beginning with data year 1979, the cause-of-death statistics published by NCHS have been classified according to the Ninth Revision of the International Classification of Diseases (ICD-9) (19). -10- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Five lists of causes have been developed by NCHS for tabulation and publication of mortality data--the Each-Cause List, List of 282 Selected Causes of Death, List of 72 Selected Causes of Death, List of 61 Selected Causes of Infant Death, and List of 34 Selected Causes of Death. These lists were designed to be as comparable as possible with the NCHS lists used under the Eighth Revision. However, complete comparability could not always be achieved. The Each-Cause List is made up of each three-digit category of the WHO Detailed List to which deaths may be validly assigned and most four-digit subcategories. This list is used for the tabulation of data for the entire United States. The Each-Cause table in Vital Statistics of the United States does not show the four-digit or special fivedigit subcategories provided for Motor vehicle accidents (E810-E825). The four-digit subcategories that identify persons injured and the five-digit subcategories that identify place of accident for deaths from nontransport accidents are tabulated separately. The List of 282 Selected Causes of Death is constructed to be compatible with the recommended WHO lists for tabulating mortality data in ICD-9. This list is used for tabulating both State and national mortality data. The List of 72 Selected Causes of Death was, in part, constructed by combining titles in the List of 282 Selected Causes of Death. It is used in tabulating data for the entire United States and each State and for Metropolitan statistical areas and for ranking leading causes of death excluding infants. (See "Cause-of-death ranking".) The List of 61 Selected Causes of Infant Death shows more detailed titles for Congenital anomalies and Certain conditions originating in the perinatal period than any other list except the Each-Cause List, and is used for ranking infant causes of death. (See "Cause-of-death ranking".) The List of 34 Selected Causes of Death was created by combining titles in the List of 72 Selected Causes. This list is used for tabulating data by detailed geographic area. Beginning with data for 1987, changes were made in these lists to accommodate the introduction in the United States of new categories *042-*044 for Human immunodeficiency virus (HIV) infection. The changes are described in the Technical Appendix from Vital Statistics of the United States, 1987. To facilitate data use, beginning with data for 1994, the categories for HIV infection (*042-*044) and Alzheimer's disease (ICD-9 No. 331.0) are included separately at the bottom of tables showing the List of 72 Selected Causes of Death and the List of 282 Selected Causes of Death. They are also subsumed in categories of the list. Effect of ICD revisions--The International Classification of Diseases (ICD), used in the United States since 1900, has been revised approximately every 10 years so the disease classifications may be consistent with advances in medical science and with changes in diagnostic practice. Each revision of the ICD has produced some break in comparability of cause-of-death statistics. Cause-of-death statistics beginning with 1979 are classified by NCHS according to ICD-9 (19). For a discussion of each of the classifications used with death statistics since 1900, see Vital Statistics of the United States, 1979, Volume II, Mortality, Part A, section 7, pages 9-14. Revisions of the ICD cause discontinuities in cause of death statistics because of changes in the classification or in the rules for selecting and modifying the underlying cause of death. To measure the discontinuity, dual coding studies have been carried out since the Fifth Revision of the ICD (1940). A dual coding study was undertaken between the Ninth and the Eighth Revisions (20). For additional information about these studies, see the Technical Appendix from Vital Statistics of the United States, 1979. Significant coding changes under the Ninth Revision--Since the implementation of ICD-9 in the United States, effective with mortality data for 1979, several coding changes have been introduced that are described in detail in Vital Statistics of the United States for the years in which they were introduced. The more important changes are: In early 1983 a change that affected data from 1981 to 1986 was made in the coding of Acquired immunodeficiency syndrome and HIV infection. Also effective with data year 1981 was a coding change for Poliomyelitis. For data year 1982, the definition of child was changed (which affects the classification of deaths to a number of categories, including Child battering and other maltreatment), and guidelines for coding deaths to the category Child battering and other maltreatment (ICD-9 No. E967) were changed also. During the calendar year 1985, detailed instructions for coding Motor vehicle accidents involving all-terrain vehicles were implemented to ensure consistency in coding these accidents. Effective with data year 1986, "Primary" and "Invasive" tumors, unspecified, were classified as "Malignant"; these neoplasms had been classified to Neoplasms of unspecified nature (ICD-9 No. 239). -11- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Beginning with data for 1987, NCHS introduced new category numbers *042-*044 for classifying and coding HIV infection, formerly referred to as Human T-cell lymphotropic virus-III/lymphadenopathy associated virus (HTLV-III/LAV) infection. The asterisks appearing before the categories indicate these codes are not part of ICD9. Also changed effective with data year 1987 were coding rules for the conditions "Dehydration" and "Disseminated intravascular coagulopathy." Effective with data year 1988, minor content changes were made to the classification for HIV infection. Detailed discussion of these changes may be found in the Technical Appendix from Vital Statistics of the United States, 1988. Coding in 1995--The rules and instructions used in coding 1995 mortality medical data remained essentially the same as those used for the 1994 data. Medical certification--The use of a standard classification list, although essential for State, regional, and international comparison, does not ensure strict comparability of the tabulated figures. A high degree of comparability among areas could be attained only if all records of cause of death were reported with equal accuracy and completeness. The medical certification of cause of death can be made only by a qualified person, usually a physician, a medical examiner, or a coroner. Therefore, the reliability and accuracy of cause-of-death statistics are, to a large extent, governed by the ability of the certifier to make the proper diagnosis and by the care with which he or she records this information on the death certificate. A number of studies have been undertaken on the quality of medical certification on the death certificate. In general, these have been for relatively small samples and for limited geographic areas. A bibliography prepared by NCHS (21), covering 128 references over 23 years, indicates no definitive conclusions have been reached about the quality of medical certification on the death certificate. No country has a well-defined program for systematically assessing the quality of medical certifications reported on death certificates or for measuring the error effects on the levels and trends of cause-of-death statistics. One index of the quality of reporting causes of death is the proportion of death certificates coded to the Ninth Revision, Chapter XVI, Symptoms, signs, and ill-defined conditions (ICD-9 Nos. 780-799). Although deaths occur for which it is impossible to determine the underlying cause, this proportion indicates the care and consideration given to the certification by the medical certifier. This proportion also may be used as a rough measure of the specificity of the medical diagnoses made by the certifier in various areas. In 1995, 1.2 percent of all reported deaths in the United States were assigned to this category. The percent of deaths assigned to this category remained stable at 1.5 percent from 1981 to 1987, but has declined slightly since then. Automated selection of underlying cause of death--Before data for 1968, mortality medical data were based on manual coding of an underlying cause of death for each certificate in accordance with WHO rules. Effective with data year 1968, NCHS converted to computerized coding of the underlying cause and manual coding of all causes (multiple causes) on the death certificate. In this system, called Automated Classification of Medical Entities (ACME) (22), the multiple cause codes serve as inputs to the computer software that employs WHO rules to select the underlying cause. The ACME system applies the same rules for selecting the underlying cause as would be applied manually by a nosologist; however, under this system, the computer consistently applies the same criteria, thus eliminating intercoder variation in this step of the process. The ACME computer program requires the coding of all conditions shown on the medical certification. These codes are matched automatically against decision tables that consistently select the underlying cause of death for each record according to the international rules. The decision tables provide the comprehensive relationships among the conditions classified by ICD when applying the rules of selection and modification. The decision tables were developed by NCHS staff on the basis of their experience in coding underlying causes of death under the earlier manual coding system and as a result of periodic independent validations. These tables periodically are updated to reflect additional new information on the relationship among medical conditions. For data year 1988, these tables were amended to incorporate minor changes to the previously mentioned classification for HIV infection (*042-*044) that originally had been implemented with data year 1987. Coding procedures for selecting the underlying cause of death by using the ACME computer program, as well as by using the ACME decision tables, are documented in NCHS instruction manuals (22,23,24). Beginning with data year 1990, another computer system was implemented for automating cause-of-death coding. This system, called Mortality Medical Indexing, Classification, and Retrieval (MICAR) (25,26), automates coding multiple causes of death. Because MICAR automates multiple-cause coding rules, errors in recognizing terms, applying coding rules, and using the ICD index are eliminated. The use of the MICAR system ensures -12- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX consistent application of multiple-cause coding rules, which is especially important for rules that are complex and infrequently applied. In addition, MICAR can provide more detailed information on the conditions reported on death certificates than is available through the ICD category structure (27). In the first year of implementation, only about 5 percent of the Nation's death records were coded using MICAR with subsequent processing through ACME. This percentage increased from 26 percent in 1991 to 35 percent in 1992, 59 percent in 1993, 72 percent in 1994, and 74 percent in 1995. States whose data were coded by MICAR in 1995 included Alabama, Arizona, Arkansas, Delaware, District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Missouri, Nebraska, Nevada, New Jersey, New York (excluding New York City), New York City, North Carolina, Ohio, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, and West Virginia. For these States, MICAR processed about 88 percent of the mortality records with an average system error rate of 0.17 on an underlying cause basis, and a rate of 0.32 on a multiplecause basis. Records that MICAR was unable to process were coded manually and then processed using ACME. Beginning with data year 1993, another computer system was implemented for automating cause-of-death coding. This system, called SuperMICAR, is an enhancement of the MICAR system, which allows for total literal entry of the multiple cause-of-death text as reported by the certifier. This information is automatically coded by the MICAR and ACME computer systems. In the first year of implementation, about 9 percent of the Nation's death records were coded using SuperMICAR with subsequent processing through MICAR and ACME. This percentage increased from 9 percent in 1993 to 12 percent in 1994, and 14 percent in 1995. States using SuperMICAR in 1995 included Colorado, Connecticut, Hawaii, Idaho, Michigan, Minnesota, New Hampshire, New Mexico, Oklahoma, Oregon, Rhode Island, and Wisconsin. In 1995, for these States, SuperMICAR processed about 75 percent of the mortality records with an average system error rate of 0.59 on an underlying cause basis, and a rate of 1.17 on a multiple-cause basis. Records that SuperMICAR was unable to process were coded manually and then processed using ACME. Cause-of-death ranking--Cause-of-death ranking except for infants is based on numbers of deaths assigned to categories in the List of 72 Selected Causes of Death, Human immunodeficiency virus infection (*042-*044), and Alzheimer's disease (ICD-9 No. 331.0). Added to the list of rankable causes was HIV infection, effective with data year 1987 and Alzheimer's disease, effective with data year 1994. Cause-of-death ranking for infants is based on the List of 61 Selected Causes of Infant Death and HIV infection (added to the list of rankable causes of infant death effective with data year 1987). The group titles Major cardiovascular diseases and Symptoms, signs, and ill-defined conditions from the List of 72 Selected Causes of Death are not ranked; Certain conditions originating in the perinatal period and Symptoms, signs, and ill-defined conditions from the List of 61 Selected Causes of Infant Death are not ranked. In addition, category titles beginning with the words "Other" or "All other" are not ranked to determine the leading causes of death. When one of the titles representing a subtotal is ranked (such as Tuberculosis), its component parts (in this case, Tuberculosis of respiratory system and Other tuberculosis) are not ranked. Maternal deaths Maternal deaths are those for which the certifying physician has designated a maternal condition as the underlying cause of death. Maternal conditions are those assigned to Complications of pregnancy, childbirth, and the puerperium (ICD-9 Nos. 630-676). In the Ninth Revision, WHO for the first time defined a maternal death as follows: A maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. Under the Eighth Revision, maternal deaths were assigned to the category "Complications of pregnancy, childbirth, and the puerperium" (Eighth Revision International Classification of Diseases, Adapted for Use in the United States (ICDA-8) Nos. 630-678). Although WHO did not define maternal mortality, an NCHS classification rule existed that limited the definition of a maternal death to a death that occurred within a year after termination of pregnancy from any "maternal cause," that is, any cause within the range of ICDA-8 Nos. 630-678. This rule -13- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX applied only if a duration was given for the condition. If no duration was specified and the underlying cause of death was a maternal condition, the duration was assumed to be within a year and the death was coded by NCHS as a maternal death. The change from an under-1-year limitation for duration used in the Eighth Revision to an under-42-days limitation used in the Ninth Revision did not have much effect on the comparability of maternal mortality statistics. However, comparability was affected by the following classification change: Under the Ninth Revision, maternal causes of death have been expanded to include Indirect obstetric causes (ICD-9 Nos. 647-648). These causes include Infective and parasitic conditions as well as other conditions present in the mother and classifiable elsewhere but that complicate pregnancy, childbirth, and the puerperium, such as Syphilis, Tuberculosis, Diabetes mellitus, Drug dependence, and Congenital cardiovascular disorders. Maternal mortality rates are computed on the basis of the number of live births. The maternal mortality rate indicates the likelihood of a pregnant woman dying of maternal causes. The number of live births used in the denominator is an approximation of the population of pregnant women who are at risk of a maternal death. Race--Beginning with the 1989 data year, NCHS changed the method of tabulating live birth data by race from race of child, which was determined from the race of the parents, to race of mother. This resulted in a discontinuity in maternal mortality rates by race between 1989-95 and previous years; see "Change in tabulation of race data for live births," under "Infant deaths" in the Technical Appendix from Vital Statistics of the United States, 1990, or the series report, "Effect on Mortality Rates of the 1989 Change in Tabulating Race" (28). Infant deaths Age--Infant death is defined as a death under 1 year of age. The term excludes fetal deaths. Infant deaths usually are divided into two categories according to age, neonatal and postneonatal. Neonatal deaths are those that occur during the first 27 days of life; postneonatal deaths are those that occur between 28 days and 1 year of age. Generally, it has been believed that different factors influencing the child's survival predominate in these two periods: Factors associated with prenatal development, heredity, and the birth process were considered dominant in the neonatal period; environmental factors, such as nutrition, hygiene, and accidents, were considered more important in the postneonatal period. Recently, however, the distinction between these two periods has blurred due in part to advances in neonatology, which have enabled more very small premature infants to survive the neonatal period. Rates--Infant mortality rates are the most commonly-used indices for measuring the risk of dying during the first year of life; they are calculated by dividing the number of infant deaths in a calendar year by the number of live births registered for the same period and are presented as rates per 1,000 or per 100,000 live births. Infant mortality rates use the number of live births in the denominator to approximate the population at risk of dying before the first birthday. This measure is an approximation because some live births will not have been exposed to a full year's risk of dying and some of the infants who die during a year will have been born in the previous year. The error introduced in the infant mortality rate by this inexactness is usually small, especially when the birth rate is relatively constant from year to year (29,30). Other sources of error in the infant mortality rate have been attributed to differences in applying the definitions for infant death and fetal death when registering the event (31,32,33). In contrast to infant mortality rates based on live births, infant death rates are based on the estimated population under 1 year of age. Infant death rates, which appear in tabulations of age-specific death rates, are calculated by dividing the number of infant deaths in a calendar year by the estimated midyear population of persons under 1 year of age and are presented as rates per 100,000 population in this age group. Patterns and trends in the infant death rate may differ somewhat from those of the more commonly used "infant mortality rate," mainly because of differences in the nature of the denominator and in the time reference. Whereas the population denominator for the infant death rate is estimated using data on births, infant deaths, and migration for the 12-month period of July-June, the denominator for the infant mortality rate is a count of births occurring during the 12 months of January-December. The difference in the time reference can result in different trends between the two indices during periods when birth rates are moving up or down markedly. The infant death rate also is subject to greater imprecision than is the infant mortality rate because of problems of enumerating and estimating the population under 1 year of age (32). -14- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Change in tabulation of race data for live births--Beginning with the 1989 data year, NCHS changed the method of tabulating live-birth data by race from race of child, which was determined from the race of the parents, to race of mother. As in previous years, race for infant and maternal deaths (the numerator of the rate) is tabulated by the race of the decedent. Because live births comprise the denominator of infant and maternal mortality rates, this change resulted in a discontinuity in rates between 1989-95 data, and that for previous years. For additional information, see the Technical Appendix from Vital Statistics of the United States, 1990, or the series report, "Effect on Mortality Rates of the 1989 Change in Tabulating Race" (28). Comparison of race data from birth and death certificates--Regardless of whether vital events are tabulated by race of mother or by race of parents, studies in which race on the birth and death certificates for the same infant were compared find inconsistencies in reporting race between birth and death certificates (34). These reporting inconsistencies can result in systematic biases in infant mortality rates by specified race, in particular, underestimates for specified races other than white or black. In the computation of race-specific infant mortality rates, the race item for the numerator comes from the death certificate, and for the denominator, from the birth certificate. Biases in the rates may arise because of possible inconsistencies in reporting race on these two vital records. Race of the mother and father is reported on the birth certificate by the mother at the time of delivery; whereas race of the deceased infant is reported on the death certificate by the funeral director based on observation or on information supplied by an informant, such as a parent. Previous studies have noted the race for an infant who died and was of a smaller minority race group is sometimes reported as white on the death certificate but is reported as the minority race group on the birth certificate, resulting, in the aggregate, in understatement of infant mortality for smaller race groups, for example, American Indian (34). Estimates can be made of the degree of bias in race-specific infant mortality rates by comparing rates for which race is based on the death certificate of the infant with rates in which race is based on race of mother from the birth certificate. In table B these comparisons are made for the years 1995 and 1996 combined. A measure of reliability is the ratio of race reported on the linked file (race of mother from the birth certificate) to the race of the child reported on the death certificate. The ratio for white infants is 1.0; for black 0.97 indicating a good net correspondence in race from the two sources. However, for American Indians the ratio is 1.14 indicating that rates where race is based on the birth certificate are 14 percent higher than those based on the death certificate. Ratios among specific populations groups of Asian Americans varied greatly. Understatement was greatest for Japanese infants with a ratio of 2.04, indicating that infant mortality rates based on birth certificate information are over twice as high as those based on death certificates. The ratios for Filipinos were 1.68, and for Chinese, 1.21. The ratio for Hawaiians was 0.85, indicating a higher rate based on death certificates, possibly because on death records on which Hawaiian was reported in combination with another race, coding procedures always give preference to Hawaiian (35). Hispanic origin--Infant mortality rates for the Hispanic-origin population are based on numbers of resident infant deaths reported to be of Hispanic origin (see "Hispanic origin") and numbers of resident live births by Hispanic origin of mother for the 49 States and the District of Columbia. Data for Oklahoma were excluded, because Oklahoma did not include an item on Hispanic origin on its death certificate. In computing infant mortality rates, deaths and live births of unknown origin are not distributed among the specified Hispanic and non-Hispanic groups. Because the percent of infant deaths of unknown origin for 1995 was 1.7 percent and the percent of live births of unknown origin was 1.5 percent, infant mortality rates by specified Hispanic origin and race for non-Hispanic origin may be slightly underestimated. Small numbers of infant deaths for specific Hispanic-origin groups can result in infant mortality rates subject to relatively large random variation (see "Random variation and sampling errors"). Table C shows comparisons for infant mortality rates for Hispanic origin where Hispanic origin is based on death certificate identification of the infant or on birth certificate information on the Hispanic origin of the mother (the linked file) for 1996. For total Hispanic origin infants, the ratio was 1.05 indicating that rates are about 5 percent higher using the race of mother from the birth certificate (linked file). For Mexican and Cuban, the rates were about the same (ratios of 1.00 and 1.02, respectively), but rates for Puerto Rican infants were 12 percent higher when Hispanic origin was based on the birth certificate (35). Tabulation list--Causes of death for infants are tabulated according to a list of causes that is different from the list of causes for the population of all ages, except for the Each Cause List. (See "Cause-of-death classification" under "Cause of death.") -15- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Quality of data Completeness of registration All States have adopted laws requiring the registration of births and deaths. It is believed that more than 99 percent of the births and deaths occurring in this country are registered. Massachusetts data--The 1964 statistics for deaths exclude approximately 6,000 deaths registered in Massachusetts, primarily to residents of that State. Microfilm copies of these records were not received by NCHS. Figures for the United States and the New England Division are affected also. Amended records for Alaska--Numbers of deaths for selected causes occurring in Alaska for 1995 are in error because NCHS did not receive changes resulting from amended records. An estimate of the effect of these omissions can be derived by comparing NCHS counts of records processed through the VSCP with counts prepared by Alaska as shown in table D. Differences are concentrated among selected causes of death, principally Symptoms, signs, and ill-defined conditions (ICD-9 Nos. 780-799) and external causes. Quality control procedures Demographic items on the death certificate--As previously indicated, for 1995 the mortality data for these items were obtained from two sources--photocopies of the original certificates furnished by Guam and electronic data records furnished by the 50 States, the District of Columbia, New York City, Puerto Rico, and the Virgin Islands. For Guam, which sent only copies of the original certificates, the demographic items were coded for 100 percent of the death certificates. The demographic coding for 100 percent of the certificates was independently verified. For areas sending electronic data records, a sample of 70-80 records per month for each registration area is used to monitor quality of coding. Under this procedure, each sample record is independently coded by NCHS staff and compared to the State code assignments. NCHS/State differences are adjudicated to ascertain the source of the error and need for corrective action. The estimated average outgoing error rate for all demographic items in 1995 was 0.25 percent. The error rate is a combined measure of State coding, key entry and processing errors made in the process of preparing the statistical file. These types of errors are not necessarily randomly distributed in the file and may therefore escape detection through sample verification. To reduce some systematic errors other NCHS procedures such as detailed computer edits, tabular evaluation, and procedure review are used. Medical items on the death certificate--The same procedures used for demographic data are used for the medical items. For the 41 States sending electronic files, the average outgoing error rate in 1995 was estimated at 2.8 percent for underlying cause data, and 5.5 percent for multiple cause-of-death data. For the remaining 9 States, the District of Columbia, New York City, Puerto Rico, the Virgin Islands, and Guam, NCHS coded the medical items for all the death records. A 1-percent sample of the records was coded independently for quality control purposes. The estimated average error rate for underlying cause for these areas was 3.6 percent. Other control procedures--After coding and data entry are completed, record counts are balanced against control totals for each shipment of records from a registration area. Editing procedures ensure that records with inconsistent or impossible codes are modified. Inconsistent codes are those, for example, indicating a contradiction between cause of death and age or sex of the decedent. Records so identified during the computer editing process are either corrected by reference to the source record or adjusted by arbitrary code assignment (36). Further, conditions specified on a list of infrequent or rare causes of death are confirmed by the certifier or a State health officer. All subsequent operations in tabulating and in preparing tables are verified during the computer processing or by statistical clerks. Estimates of errors arising from 50-percent sample for 1972--Death statistics for 1972 are based on a 50-percent sample of all deaths occurring in the 50 States and the District of Columbia. A description of the sample design and a table of the percent errors of the estimated numbers of deaths by size of estimate and total deaths in the area are shown in the Technical Appendix from Vital Statistics of the United States, 1972. -16- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Computation of rates and other measures Population bases Population bases from which death rates are computed are prepared by the U.S. Bureau of the Census. Rates for 1940, 1950, 1960, 1970, 1980, and 1990 are based on the population enumerated as of April 1 in the censuses for those years. Rates for all other years use the estimated midyear (July 1) population. Death rates for the United States, individual States, and metropolitan areas are based on the total resident populations of the respective areas. Except as noted, these populations exclude the Armed Forces abroad but include the Armed Forces stationed in each area. The resident populations of the birth- and death-registration States for 1900-32, and of the United States for 1900-95 are shown in table E. In addition, the population including Armed Forces abroad is shown for the United States. Table F lists the sources for these populations. Populations for 1995--Population estimates of the United States by age, race, and sex for 1995 are shown in table G (37). The 1995 estimates are consistent with those for 1990-94. Population estimates for each State by age for 1995 are shown in table H (38). Since these population estimates are based on demographic analysis, they are not subject to sampling variability. In addition the following estimates are shown: ! ! ! Estimated population by 5-year age groups, specified Hispanic origin, race for non-Hispanic origin, and sex: Total of 49 States and the District of Columbia, 1995 (see table I) (15) Estimated population for ages 15 years and over by 5-year age groups, marital status, race, and sex: United States, 1995 (see table J) (15) Estimated population for ages 15 years and over, by 5-year age groups, marital status, Hispanic origin, race for non-Hispanic origin, and sex: Total of 49 States and the District of Columbia, 1995 (see table K) (15) Population estimates by specified Hispanic origin and by marital status groups are based on the Bureau of the Census' Current Population Survey (a sample-based survey) adjusted to control totals. As a result, these estimates are subject to sampling variation (see "Random variation and sampling errors"). Population for 1990--In the 1980 and 1990 censuses, a substantial number of persons did not specify a racial group that could be classified as any of the white, black, American Indian, Eskimo, Aleut, Asian, or Pacific Islander categories on the census form (39). In 1980 the number of persons of "Other" race was 6,758,319; in 1990, it was 9,804,847. In both censuses the large majority of these persons were of Hispanic origin (based on responses to a separate question on the form), and many wrote in their Hispanic origin (for example, Mexican and Puerto Rican) as their race. In 1980 and 1990 persons of unspecified race were allocated to one of the four tabulated racial groups (white, black, American Indian, Asian or Pacific Islander) based on their response to the Hispanic origin question. These four race categories conform with OMB Directive 15 (the standards for recordkeeping, collection, and presentation of data on race and ethnicity in Federal statistical activities and program administrative reporting) (40) and are more consistent with the race categories in vital statistics. In 1980 the allocation of unspecified race was determined using cross-tabulations of age, sex, race, specified Hispanic origin, and county of residence. Persons of Hispanic origin and unspecified race were allocated to either white or black based on their specific Hispanic origin. Persons of "Other" race and Mexican origin were categorically assumed to be white, while persons in other Hispanic categories were distributed to white and black pro rata within the county-age-sex group. For "Other race-not-specified" persons who were not Hispanic, race was allocated to white, black, or Asian or Pacific Islander based on proportions gleaned from sample data. The 20-percent sample (respondents who were enumerated on the longer census form) provided a highly detailed coding of race, which allowed identification of otherwise unidentifiable responses with a specified race category. Thus, allocation proportions were established at the State level and were used to distribute the non-Hispanic persons of "Other" race in the 100-percent tabulations. In 1990 the race modification procedure was implemented using individual census records. Persons whose race could not be specified were assigned to a racial category using a pool of "race donors" that consisted of persons of -17- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX specified race who had the identical responses to the Hispanic origin question and who were within the auspices of the same census district office. As in the 1980 census, it appeared that the underlying assumption made in the 1990 census was that the Hispanic origin response was the major criterion for allocating race. Unlike those responding to the 1980 census who could be assigned only to the racial group white or black, persons of Hispanic origin, including Mexicans, responding to the 1990 census could be assigned to any racial group. Also, in the 1990 census, the non-Hispanic component of "Other" race was allocated primarily on the basis of geography (district office), rather than detailed characteristic. The means by which respondent's age was determined were fundamentally different for the two censuses; therefore, the problems that necessitated the modification were different. In 1980 respondents reported year of birth and quarter of birth (within year) on the census form. When census results were tabulated, persons born in the first quarter of the year (before April 1) had age equal to 1980 minus year of birth, while persons born in the last three quarters had age equal to 1979 minus year of birth. In 1990 quarter year of birth was not reported on the census form, so direct determination of age from year of birth was not possible. In 1990 census publications, age is based on respondents' direct reports of age at last birthday. This definition proved inadequate for postcensal estimates as it was apparent that many respondents had reported their age at time of either completion of the census form or interview by an enumerator that could occur several months after the April 1 reference date. As a result, age was biased upward. For most respondents, modification was based on a respecification of age, by year of birth, with allocation to first quarter (persons aged 1990 minus year of birth) and last three quarters (aged 1989 minus year of birth) based on a historical series of registered births by month. This process partially restored the 1980 logic for assignment of age. It was not considered necessary to correct for age overstatement and heaping in 1990, because the availability of age and year of birth on the census form had provided for the elimination of spurious year-of-birth reports in the census data before modification occurred. Population estimates for 1981-89--Death rates for 1981-89 are based on revised populations that are consistent with the 1990 census level (39). They are, therefore, not comparable with death rates published in Vital Statistics of the United States for 1981-89, and in other NCHS publications for those years. The 1990 census counted approximately 1.5 million fewer persons than had been estimated earlier for April 1, 1990. Populations for 1980--Death rates for 1980 are based on the population enumerated as of April 1 in the 1980 census (41). The figures by race have been modified as described. Population estimates for 1971-79--Death rates for 1971-79 used revised population estimates that are consistent with the 1980 census levels. The 1980 census enumerated approximately 5.5 million more persons than had been estimated for April 1, 1980 (42). These revised estimates for the United States by age, race, and sex are published by the U.S. Bureau of the Census in Current Population Reports, Series P-25, Number 917. Unpublished revised estimates for States were obtained from the U.S. Bureau of the Census. For Puerto Rico, the Virgin Islands, and Guam, revised estimates are published in Current Population Reports, Series P-25, Number 919. Population estimates for 1961-69--Death rates for 1961-69 are based on revised estimates of the population and thus may differ slightly from rates published before 1976. Rates, life table values, and population estimates for each year during 1961-69 have been revised to reflect modified population bases as published in the U.S. Bureau of the Census, Current Population Reports, Series P-5, Number 519. New Jersey--As previously indicated, data by race are not available for New Jersey for 1962 and 1963. Therefore, for 1962 and 1963, NCHS estimated a population by age, race, and sex that excluded New Jersey for rates shown by race. The methodology used to estimate the revised population excluding New Jersey is discussed in the Technical Appendixes of the 1962 and 1963 volumes. Rates and ratios based on live births--Infant and maternal mortality rates are computed on the basis of the number of live births. Counts of live births are published annually in Vital Statistics of the United States. Net census undercount Errors can be introduced into the annual rates as a result of underenumeration of deaths and the misreporting of demographic characteristics. Errors in rates can also result from enumeration errors in the latest decennial census. This is because annual population estimates for the postcensal interval, which are used in the denominator for calculating death rates, are computed using the decennial census count as a base (39). Net census undercount -18- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX results from the miscounting and misreporting of demographic characteristics such as age. Age-specific death rates are affected by the net census undercount and the misreporting of age on the death certificate (43). To the extent that the net undercount is substantial and that it varies among subgroups and geographic areas, it may have important consequences for vital statistics measures. Because death rates based on a population adjusted for net census undercount may be more accurate than rates based on an unadjusted population, the possible impact of net census undercount on death rates must be considered. This can be done on a national basis using results of studies conducted by the U.S. Bureau of the Census on the completeness of coverage of the U.S. population (including underenumeration and misstatement of age, race, and sex). Such studies were conducted in the last five decennial censuses--1950, 1960, 1970, 1980, and 1990. From this work have come estimates of the national population that were not counted by age, race, and sex (44-47). The reports for 1990 (unpublished data from the U.S. Bureau of the Census) include estimates of net underenumeration and overenumeration for age, sex, and racial subgroups of the national population modified for race consistency with previous population counts as described in the section "Population bases." These studies indicate that, although coverage was improved over previous censuses, there was differential coverage among the population subgroups; that is, some age, race, and sex groups were more completely counted than others. Because estimates of net census undercount are not available by age, race, and sex for individual States and counties, it is not feasible to adjust for net census undercount when presenting rates in routine tabulations. Nevertheless, it is important to be aware that net census undercounts can affect levels of observed vital rates. Age, race, and sex--If adjustments were made for net census undercount, the size of denominators of the death rates generally would increase and the rates, therefore, would decrease. The adjusted rates for 1995 can be computed by multiplying the reported rates by ratios of the census-level resident population to the resident population adjusted for the estimated net census undercount (table L). A ratio of less than 1.0 indicates a net census undercount and, when applied, results in a corresponding decrease in the death rate. A ratio greater than 1.0-indicating a net census overcount--when multiplied by the reported rate results in an increase in the death rate. Coverage ratios for all ages show that, in general, females were more completely enumerated than males and the white population more completely enumerated than the black population in the 1990 Census of Population. Underenumeration varied by age group for the total population, with the greatest differences found for persons aged 85 years and over. All other age groups were overcounted or undercounted by less than 4.0 percent. Among the age-sex-race groups, underenumeration was highest (13.3 percent) for black males aged 25-34 years. In contrast, white females in this age group were underenumerated by 2.5 percent. If vital statistics measures were calculated with adjustments for net census undercounts for each population subgroup, the resulting rates would be differentially reduced from their original levels; that is, rates for those groups with the greatest estimated undercounts would show the greatest relative reductions due to these adjustments. Similar effects would be evident in the opposite direction for groups with overcounts. Consequently, the ratio of mortality between the rates for males and females and between the rates for the white population and the black population usually would be reduced. Similarly, the differences between the death rates among subgroups of the population by cause of death would be affected by adjustments for net census undercounts. For example, in 1990 for the age group 35-39 years, the ratio of the unadjusted death rate for Homicide and legal intervention for black males to that for white males is 7.54, whereas the ratio of the death rates adjusted for net census undercount is 6.92. For Ischemic heart disease for males aged 40-44 years, the ratio of the death rate for the black population to that for the white population is 1.38 using the unadjusted rates, but it is 1.26 when adjusted for estimated underenumeration. Summary measures--The effect of net census undercount on age-adjusted death rates and life table values depends on the underenumeration of each age group and on the distribution of deaths by age. Thus, the age-adjusted death rate in 1990 for All causes would decrease from 520.2 to 512.7 per 100,000 population if the age-specific death rates were corrected for net census undercount (table M). For Diseases of heart, the age-adjusted death rate for white males would decrease from 202.0 to 198.2 per 100,000 population, a decline of 2.0 percent. For black males, the change from an unadjusted rate of 275.9 to an adjusted rate of 256.7 would amount to a decrease of 7.0 percent. For HIV infection, the rate for black males would decrease from 44.2 to 39.0 and for white males from 15.0 to 14.4. If death rates by age were adjusted, the corresponding life expectancy at birth computed from these rates would change. When calculating life expectancy, the impact of an undercount or overcount is greatest at the younger -19- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX ages. In general, the effect of correcting the death rates is to increase the estimate of life expectancy at birth. For example, adjustment for net census undercount would increase life expectancy in 1990 by an estimated 0.2 years, from 75.4 years to 75.6 years for the total U.S. population. Adjustment for differential underenumeration among race-sex groups would lead to greater changes in life expectancy for some groups than for others. For males and females, increases would be 0.3 and 0.1 years, respectively; for the black population and white population, 0.6 and 0.2 years, respectively. The largest increase would be for black males, 1.2 years, followed by white males (0.3 years), black females (0.2 years), and white females (0.2 years). Age-adjusted death rates Age-adjusted death rates are used to compare relative mortality risk across groups and over time. However, they should be viewed as constructs or indexes rather than as direct or actual measures of mortality risk. Statistically, they are weighted averages of the age-specific death rates, where the weights represent the fixed population proportions by age (48). Age-adjusted death rates were computed by the direct method, that is, by applying age-specific death rates for a given cause of death to the U.S. standard population (relative age distribution of 1940 enumerated population of the United States totaling 1,000,000 (30)). By using the same standard population, the rates for the total population and for each race-sex group were adjusted separately. It is important not to compare age-adjusted death rates with crude rates. The U.S. standard population and corresponding weights (wi) are as follows: Age All ages................................... Under 1 year........................... 1-4 years................................ 5-14 years.............................. 15-24 years............................ 25-34 years............................ 35-44 years............................ 45-54 years............................ 55-64 years............................ 65-74 years............................ 75-84 years............................ 85 years and over................... Number 1,000,000 15,343 64,718 170,355 181,677 162,066 139,237 117,811 80,294 48,426 17,303 2,770 Weights (wi) 1.000000 0.015343 0.064718 0.170355 0.181677 0.162066 0.139237 0.117811 0.080294 0.048426 0.017303 0.002770 Age-adjusted death rates by marital status are computed using the age groups 25 years and over. Therefore, the United States standard population aged 25 years and over and corresponding weights (wi) are as follows: Age 25 years and over.................... 25-34 years............................. 35-44 years............................. 45-54 years............................. 55-64 years............................. 65-74 years............................. 75 years and over.................... Number 567,907 162,066 139,237 117,811 80,294 48,426 20,073 Weights (wi) 1.000000 0.285374 0.245176 0.207448 0.141386 0.085271 0.035346 -20- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Life tables U.S. abridged life tables are constructed by reference to a standard table (49). Life tables for the decennial period 1979-81 are used as the standard life tables in constructing the 1980-95 abridged life tables. Life table -21- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX values for 1981-89 are based on revised intercensal estimates of the populations for those years. Therefore, these life table values may differ from life table values of those years published previously. Life tables for the decennial period 1969-71 are used as the standard life tables in constructing the 1970-79 abridged life tables. Life table values for 1970-73 were first revised in Vital Statistics of the United States, 1977; before 1977, life table values for 1970-73 were constructed using the 1959-61 decennial life tables. In addition, life table values for 1951-59, 1961-69, and 1971-79 are based on revised intercensal estimates of the populations for those years. As such, these life table values may differ from life table values previously published. The annual abridged life table series was initiated for selected race-sex groups in 1945. Because of the increased interest in the average length of life (oeo) for years prior to 1945, estimates were prepared for the following race and sex groups and data years (50). Years Race and sex groups 1900-45................................................................................Total 1900-47................................................................................Male 1900-47................................................................................Female 1900-50................................................................................White 1900-44................................................................................White, male 1900-44................................................................................White, female 1900-50................................................................................All other 1900-44................................................................................All other, male 1900-44................................................................................All other, female The geographic areas covered in life tables before 1929-31 were limited to the death-registration areas. Life tables for 1900-02 and 1909-11 were constructed using mortality data from the 1900 death-registration States--10 States and the District of Columbia, and for 1919-21, from the 1920 death-registration States--34 States and the District of Columbia. The tables for 1929-31 through 1958 cover the conterminous United States. Decennial life table values for the 3-year period 1959-61 were derived from data that include Alaska and Hawaii for each year. Data for each year include Alaska beginning in 1959 and Hawaii beginning in 1960. It is believed that the inclusion of these two States does not materially affect life table values. Random variation and sampling errors Deaths--The number of deaths reported for an area represent complete counts of such events (except for 1972 when the data were based on a 50-percent sample because of resource constraints). As such, they are not subject to sampling error, although they are subject to non-sampling errors in the registration process. However, when the figures are used for analytical purposes, such as the comparison of rates over time or for different areas, the number of events that actually occurred may be considered as one of a large series of possible results that could have arisen under the same circumstances (51). The probable range of values may be estimated from the actual figures according to certain statistical assumptions. In general, distributions of vital events may be assumed to follow the binomial distribution. When the number of events is large, the relative standard error is usually small. When the number of events is small (perhaps less than 100) and the probability of such an event is small, considerable caution must be observed in interpreting the data. Such infrequent events may be assumed to follow a Poisson probability distribution. As a result, the numbers of deaths, death rates, and mortality rates are subject to random variation. Estimates of relative standard errors (RSE)--a measure of variability--, 95-percent confidence intervals, and tests of statistical significance under this assumption are shown below. Mortality data may also be subject to non-sampling errors. Populations-Population estimates of the United States and for each State by age, race, total Hispanic origin, and sex for 1995 are based on demographic methods and, therefore, are not subject to sampling variability. However, population estimates by specified Hispanic origin (Mexicans, Puerto Ricans, Cubans, and Other Hispanics) and by specified marital status groups (never married, married, widowed, and divorced) are based on the Bureau of the Census' Current Population Survey (CPS) adjusted to control totals and, therefore, are subject to sampling variation. As a result, death rates based on the CPS-based population estimates are subject to both -22- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX random variation of the deaths and sampling error of the population estimates. Estimates of relative standard errors, 95-percent confidence intervals, and tests of statistical significance under these assumptions are shown below. All population estimates may also be subject to non-sampling errors. Computation of population-based death rates--Death rates for a single calendar year are computed by dividing the number of deaths for a class for that year by the population of a similarly-defined class for the same year and multiplying that result by 100,000 (or 1,000). Rates thus computed are per 100,000 (or 1,000) estimated population residing in selected areas of the United States. The 3-year average death rates are computed by dividing the total number of deaths for a class for a three-year period by the sum of the population estimates of a similarly defined class for the same period and multiplying that result by 100,000 (or 1,000). Computation of live birth-based mortality rates--Maternal mortality rates and infant mortality rates are computed by dividing the number of deaths for a class for a specified year by the number of live births of a similarly defined class for that year and multiplying that result by 100,000 (or 1,000). Rates thus computed are per 100,000 (or 1,000) live births residing in selected areas of the United States. The 3-year average infant mortality rates for the three-year period are computed by dividing the total number of infant deaths for a class for that period by the sum of the live births of a similarly defined class for the three-year period and multiplying that result by 100,000 (or 1,000). Relative Standard Errors and 95% Confidence Intervals--Formulas for computing approximate RSE's and confidence intervals (CI's) for crude, age-specific death rates, and age-adjusted death rates are shown below. Beginning with 1989 data, an asterisk has been shown in place of a rate based on fewer than 20 deaths, which is the equivalent of an RSE of 22.94 percent or more. An RSE of this magnitude is considered statistically unreliable. That procedure has been used for mortality data except death rates based on CPS-based population estimates, for which sampling variation must be considered in addition to random variation. Formulas for computing RSE's for CPS population-based rates are presented below and an asterisk is shown in place of a rate when the RSE is 22.94 percent or more. RSE's for CPS population-based rates were introduced beginning with specified Hispanic-origin data for 1994 and subsequently for rates by marital status. The formulas below are shown separately for rates based on demographically estimated populations, samplebased populations, and rates based on live births. Further, separate discussions are provided for rates based on less than 100 events, and rates based on 100 events or more. Specific examples are given to illustrate the use of the formulas. -23- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX The following formulas are used for demographically-estimated population-based death rates for all races, white, black, American Indian, Asian or Pacific Islander, all origins, total Hispanic, total non-Hispanic, non-Hispanic white, non-Hispanic black for all marital status groups combined: Age-specific and crude death rates-- RSE(R) ' RSE(D) ' 100 1 D Approximate 95% Confidence Interval: 100 or more deaths Lower: R - 1.96 * S(R) Upper: R + 1.96 * S(R) Approximate 95% Confidence Interval: 1-99 deaths Lower: R * L(1- =.95,D) Upper: R * U(1- =.95,D) where R = rate (deaths per 100,000 population) D = total number of deaths upon which rate is based S(R) ' R ( RSE(R) ' standard error of rate 100 L(1- =.95,D) and U(1- =.95,D) are lower and upper 95% confidence limit factors and are shown in table N -24- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Age-adjusted death rates-- 3 wi Ri RSE R" ' 100 2 2 1 Di R" Approximate 95% Confidence Interval: 100 or more deaths Lower: R" - 1.96 * S(R") Upper: R" + 1.96 * S(R") Approximate 95% Confidence Interval: 1-99 deaths Lower: R" * L(1- =.95,Dadj) Upper: R" * U(1- =.95,Dadj) where R" = age-adjusted rate (per 100,000 population) = 3wiRi wi = ith age-specific Standard Population such that 3(wi) = 1.0 Ri = age-specific rate (per 100,000) for the ith age group Di = total number of deaths for the ith age group upon which age-specific rate is based S R" ' R"( RSE(R") ' standard error of age&adjusted rate 100 L(1- =.95,Dadj) and U(1- =.95,Dadj) are lower and upper 95% confidence limit factors and are shown in table N Dadj ' 1 RSE(R" ) 100 2 adjusted number of deaths rounded to nearest integer -25- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX The following formulas are used for CPS population-based death rates for all races, white, black, American Indian, Asian or Pacific Islander, all origins, total Hispanic, total non-Hispanic, non-Hispanic white, nonHispanic black by specified marital status group (never married, married, widowed, and divorced) OR for Mexican, Puerto Rican, Cuban, Other Hispanic for all marital status groups combined and by specified marital status group (never married, married, widowed, and divorced): Age-specific and crude death rates-- RSE(R) ' 100 1 D %f a% b P Approximate 95% Confidence Interval: 100 or more deaths Lower: R-1.96*S(R) Upper: R+1.96*S(R) Approximate 95% Confidence Interval: 1-99 deaths b P Lower: R ( L 1&á'.96, D ( 1&2.576 f a% Upper: R ( U 1&á'.96, D ( 1%2.576 f a% b P where R = rate (deaths per 100,000 population). D = total number of deaths upon which rate is based f = factor that depends on whether the population estimate is based on demographic analysis or CPS and the number of years used (see below) a and b factors are CPS standard error parameters (see below) P = total estimated population upon which rate is based (if rate is based on a 3-year average, then an approximate P would be three times the population for the most recent year) S(R)' R( RSE(R) ' standard error of rate 100 L(1- =.96,D) and U(1- =.96,D) are lower and upper 96% confidence limit factors and are shown in table N -26- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Age-adjusted death rates-- 3 wi2 ( Ri2 RSE R" ' 100 1 %f Di R" a% b Pi Approximate 95% Confidence Interval: 100 or more deaths Lower: R" - 1.96 * S(R") Upper: R" + 1.96 * S(R") Approximate 95% Confidence Interval: 1-99 deaths Lower: R" * L(1- =.96,Dadj) * (1 -2.576 * RSE(Padj)) Upper: R" * U(1- =.96,Dadj) * (1+2.576 * RSE(Padj)) where R" = age-adjusted rate (per 100,000 population) = 3wi Ri wi = ith age-specific Standard Population such that 3(wi) = 1.0 Ri = age-specific rate (per 100,000)for the ith age group Di = total number of deaths for the ith age group upon which age-specific rate is based f = factor that depends on whether the population estimate is based on demographic analysis or CPS and the number of years used (see below) a and b factors are CPS standard error parameters (see below) Pi = total estimated population for the ith age group upon which the rate is based (if rate is based on 3-year average, then combined Pi would be three times the population for the most recent year) S R" ' R" ( RSE R" ' standard error of age&adjusted rate 100 L(1- =.96,Dadj) and U(1- =.96,Dadj) are lower and upper 96% confidence limit factors and are shown in table N Padj =3(wi * Pi) = adjusted estimated population rounded to nearest integer 3 wi2 ( Pi2 ( f RSE(Padj) ' Padj a% b Pi Dadj ' smaller of 3 Di or 1 RSE R" 2 ' & RSE Padj 2 adjusted number of deaths rounded to the nearest integer If Dadj is negative, set Dadj to 3(Di) -27- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Shown below are the "a", "b", and "f" factors for various race, origin, and marital status classifications, by whether the population-based rate was based on a single year or 3-year average: Race, origin, and marital status All races, white, American Indian, all origins, total Hispanic, total non-Hispanic, non-Hispanic white; by never married, married, widowed, divorced Black, non-Hispanic black; by never married, married, widowed, divorced Rate based on 1 year f = 0.670 a = -0.000017 b= 4,786 f = 0.670 a = -0.000204 b= 6,865 f = 0.670 a = -0.000719 b= 6,865 f = 0.670 a = -0.000297 b= 6,865 Rate based on 3 years f = 0.440 a = -0.000017 b = 14,358 f = 0.440 a = -0.000204 b = 20,595 f = 0.440 a = -0.000719 b = 20,595 f = 0.440 a = -0.000297 b = 20,595 Asian or Pacific Islander; by never married, married, widowed, divorced Mexican, Puerto Rican, Cuban, Other Hispanic; all marital status groups combined, never married, married, widowed, divorced -28- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX The following formulas may be used for live birth-based mortality rates: The formulas for the RSE and 95-percent CI's of an infant mortality rate (IMR) are as follows: RSE IMR ' 100 1 1 % D B Approximate 95% Confidence Interval: 100 or more infant deaths Lower: IMR - 1.96 * S(IMR) Upper: IMR + 1.96 * S(IMR) Approximate 95% Confidence Interval: 1-99 infant deaths Lower: IMR * L(1- =.95,Dadj) Upper: IMR * U(1- =.95,Dadj) where IMR = infant mortality rate (infant deaths per 100,000 live births) D = total number of infant deaths upon which rate is based B = total number of live births upon which IMR is based S IMR ' IMR ( RSE IMR ' standard error of infant mortality rate 100 L(1- =.95,Dadj) and U(1- =.95,Dadj) are lower and upper 95% confidence limit factors and are shown in table N D(B ' D%B adjusted number of infant deaths that takes into account the RSE of the number of infant deaths and live births Dadj ' -29- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Statistical tests For testing the equality of two rates, R1 and R2, the z-test may be used (when both rates are based on 100 deaths or more) or the overlap of 95% CI's of the rates may be used (when either or both of the rates are based on less than 100 deaths). The z-test is determined as follows: z' R1 2 R1&R2 RSE R1 100 2 % 2 R2 RSE R2 100 2 to define a significance test statistic. If |z| is greater than or equal 1.96, then the difference would be considered statistically significant at the 0.05 level; and if |z| is less than 1.96, the difference is not statistically significant. As a hypothetical example, if the three-year average death rate for Mexicans, R1, is 36.4 (based on D=120 deaths and P=330,000 population for the three years combined) and the three-year rate for non-Hispanic whites, R2, is 13.8 (based on D=180 deaths and P=1,300,000 population for the three years combined), then using the formulas above the RSE's and z-test are computed as follows: RSE R1 ' 100 1 20,595 % 0.440 ( &.000297 % 120 330,000 ' 18.88% RSE R2 ' 100 1 ' 7.45% 180 and z' 36.42 36.4 & 13.8 18.88 100 2 ' 3.25 7.45 100 2 %13.82 Since |z| is greater than 1.96, the difference between the two rates is statistically significant at the 0.05 level of significance. -30- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX If either of two rates is based on less than 100 deaths, then one may determine if the 95% CI's overlap as an indication of a statistically significant or non-significant difference. As a hypothetical example, if the three-year average death rate for Cubans, R3, is 26.7 (based on D=40 deaths and P=150,000 population for the three years combined) and the three-year rate for non-Hispanic blacks, R4, is 61.5 (based on D=400 deaths and P=650,000 population for the three years combined), then the 95% CI's are computed using information from the following formulas and table N: 95% CI for R3 Lower: ' 26.7 ( 0.70266 1&2.576 0.44 ( &.000297% 20,595 150,000 ' 6.9 Upper: ' 26.7 ( 1.37991 1%2.576 0.44 ( &.000297% 20,595 150,000 ' 60.1 95% CI for R4 RSE R4 ' 100 1 ' 5.00% 400 5.00 100 5.00 100 Lower ' 61.5 & 1.96 ( 61.5 ( ' 55.5 Upper ' 61.5 % 1.96 ( 61.5 ( ' 67.5 Since the CI's overlap, the difference between R3 and R4 is not statistically significant. -31- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX References 1. Tolson GC, Barnes JM, Gay GA, Kowaleski JL. The 1989 revision of the U.S. standard certificates and reports. National Center for Health Statistics. Vital Health Stat 4(28). 1991. 2. Hetzel AM. U.S. vital statistics system: major activities and developments, 1950-95. National Center for Health Statistics. 1997. 3. National Center for Health Statistics. Vital statistics, demographic classification, and coding instructions for death records, 1995. NCHS instruction manual; part 4. Hyattsville, Maryland: Public Health Service. 1995. 4. McCarthy MA. Comparison of the classification of place of residence on death certificates and matching census records: United States, May-August 1960. National Center for Health Statistics. Vital and Health Stat 2(30). 1969. 5. National Center for Health Statistics. Vital statistics, vital records geographic classification, 1994. NCHS instruction manual; part 8. Hyattsville, Maryland: Public Health Service. 1993. 6. U.S. Bureau of the Census. Population of metropolitan areas and component geography: 1990 and 1980 (6-30-93 definitions). CPH-L-145. Washington: U.S. Department of Commerce. 1993. 7. U.S. Department of Commerce. Metropolitan statistical areas classification. Federal register; vol 45 no 2. Washington: U.S. Government Printing Office, 956-62. 1980. 8. U.S. Office of Management and Budget. Standard metropolitan statistical areas, rev. ed. Washington: U.S. Government Printing Office, 89-90. 1975. 9. U.S. Bureau of the Census. 1990 Census of population. General population characteristics; (1990 CP-1-1). Washington: U.S. Department of Commerce. 1992. 10. National Center for Health Statistics. Public use data file documentation: Mortality detail 1995 data. Hyattsville, Maryland: Public Health Service. 1997. 11. National Center for Health Statistics. Public use data file documentation: Multiple cause of death for ICD-9 1995 data. Hyattsville, Maryland: Public Health Service. 1997. 12. Hambright TZ. Comparability of marital status, race, nativity, and country of origin on the death certificate and matching census record: United States, May-August 1960. National Center for Health Statistics. Vital Health Stat 2(34). 1969. 13. Sorlie PD, Rogot E, Johnson NJ. Validity of demographic characteristics on the death certificate. Epidemiology 3(2):181-4. 1992. 14. Poe GS, Powell-Griner E, McLaughlin JK, et al. Comparability of the death certificate and the 1986 national mortality followback survey. National Center for Health Statistics. Vital Health Stat 2(118). 1993. 15. U.S. Bureau of the Census. Population estimates based on unpublished tabulations prepared by the Housing and Household Economic Statistics Division. 1996. 16. Klebba AJ. Mortality from selected causes by marital status: United States, parts A and B. National Center for Health Statistics. Vital Health Stat 20(8a) and 20(8b). 1970. 17. National Center for Health Statistics. Industry and occupation coding for death certificates, 1993. NCHS instruction manual, Part 19. Hyattsville, Maryland: Public Health Service. 1992. 18. U.S. Bureau of the Census. Classified index of industries and occupations. 1990 Census of Population and Housing. Washington: U.S. Department of commerce. 1992. 19. World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, based on the recommendations of the Ninth Revision Conference, 1975. Geneva: World Health Organization. 1977. 20. National Center for Health Statistics. Estimates of selected comparability ratios based on dual coding of 1976 death certificates by the Eighth and Ninth Revisions of the International Classification of Diseases. Monthly vital statistics report; vol 28 no 11, suppl. Hyattsville, Maryland: Public Health Service. 1980. 21. Gittelsohn A, Royston PN. Annotated bibliography of cause-of-death validation studies, 1958-80. National Center for Health Statistics. Vital Health Stat 2(89). 1982. 22. National Center for Health Statistics. Vital statistics, ICD-9 ACME decision tables for classifying underlying causes of death, 1991. NCHS instruction manual; part 2c. Hyattsville, Maryland: Public Health Service. Published annually. -32- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX 23. National Center for Health Statistics. Instructions for classifying multiple causes of death. NCHS instruction manual; part 2b. Hyattsville, Maryland: Public Health Service. Published annually. 24. National Center for Health Statistics. Nonindexed terms, standard abbreviations, and state geographic codes used in mortality data classification. NCHS instruction manual; part 2e. Hyattsville, Maryland: Public Health Service. Published annually. 25. National Center for Health Statistics. Vital statistics, data entry instructions for the mortality medical indexing, classification, and retrieval system (MICAR). NCHS instruction manual; part 2g. Hyattsville, Maryland: Public Health Service. Published annually. 26. National Center for Health Statistics. Vital statistics, dictionary of valid terms for the mortality medical indexing, classification, and retrieval system (MICAR). NCHS instruction manual; part 2h. Hyattsville, Maryland: Public Health Service. Published annually. 27. Harris KW, Rosenberg HM, Kochanek KD, et al. Evaluation of an automated multiple causes of death coding system. In: American Statistical Association. 1993 Proceedings of the social statistics section. Alexandria, Virginia: American Statistical Association. 262-5. 1993. 28. Hoyert DL. Effect on mortality rates of the 1989 change in tabulating race. National Center for Health Statistics. Vital Health Stat 20(25). 1994. 29. Guralnick L, Winter ED. A note on cohort infant mortality rates. Public Health Rep 80:692-4. 1965. 30. Grove RD, Hetzel AM. Vital statistics rates in the United States, 1940-60. National Center for Health Statistics. Washington: Public Health Service. 1968. 31. McCarthy B, Terry J, Rochat R, et al. The underregistration of neonatal deaths: Georgia 1974-77. Am J Public Health 70:977-82. 1980. 32. Linder FE, Grove RD. Vital statistics rates in the United States, 1900-40. Washington: National Office of Vital Statistics. 1947. 33. Chase HC, Weiner L, Garfinkel J. Vital signs present at birth. National Center for Health Statistics. Vital and Health Stat 2(46). 1972. 34. Frost F, Shy KK. Racial differences between linked birth and infant death records in Washington State. Am J Public Health 70:974-6. 1980. 35. MacDorman MF, Atkinson JO. Infant mortality statistics from the 1996 period linked birth/infant death data set. Monthly vital statistics report; vol 46 no 12, supp. Hyattsville, Maryland: National Center for Health Statistics. 1998. 36. National Center for Health Statistics. Vital statistics, computer edits for mortality data, effective 1989. NCHS instruction manual; part 11. Hyattsville, Maryland: Public Health Service. 1989. 37. U.S. Bureau of the Census. U.S. population estimates by age, sex, race, and Hispanic origin: July 1, 1995. Census file RESD0795. 1996. 38. U.S. Bureau of the Census. Estimates of the resident population of States by age and sex for July 1, 1995. Census file 95AG795. 1996. 39. U.S. Bureau of the Census. U.S. population estimates by age, sex, race, and Hispanic origin: 1980-91. Current population reports; series P-25, no 1095. Washington: U.S. Department of Commerce. 1993. 40. Executive Office of the President. Office of Management and Budget. Statistical Policy Directive No. 15. Race and ethnic standards for federal statistics and administrative reporting. 41. National Center for Health Statistics. Technical appendix. Vital statistics of the United States, 1980, vol II, mortality, part A. Washington: Public Health Service. 1985. 42. U.S. Bureau of the Census. Coverage of the national population in the 1980 census by age, sex, and race. Preliminary estimates by demographic analysis. Current population reports; series P-23, no 115. Washington: U.S. Department of Commerce. 1982. 43. Hambright TZ. Comparability of age on the death certificate and matching census records: United States, May-August 1960. National Center for Health Statistics. Vital Health Stat 2(29). 1968. 44. U.S. Bureau of the Census. Estimates of coverage of the population by sex, race, and age--demographic analysis: 1970 census of population and housing. PHC(E)-4. Washington: U.S. Department of Commerce. 1974. -33- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX 45. U.S. Bureau of the Census. Developmental estimates of the coverage of the population of States in the 1970 census--demographic analysis. Current population reports; series P-23, no 65. Washington: U.S. Department of Commerce. 1977. 46. Passel JS, Robinson JG. Revised demographic estimates of the coverage of the population by age, sex, and race in the 1980 Census. Unpublished memorandum, U.S. Bureau of the Census. Washington: U.S. Department of Commerce. 1985. 47. U.S. Bureau of the Census. Estimates of population of the United States by age, sex, and race: 1980 to 1985. Current population reports; series P-25, no 985. Washington: U.S. Department of Commerce. 1986. 48. Feinleib M, Zarate AO, eds. Reconsidering age adjustment procedures: Workshop proceedings. National Center for Health Statistics. Vital Health Stat 4(29). 1992. 49. Sirken MG. Comparison of two methods of constructing abridged life tables by reference to a "standard" table. National Center for Health Statistics. Vital Health Stat 2(4). 1966. 50. Greville TNE, Carlson GA. Estimated average length of life in the death-registration States. Vital statisticsSpecial reports. vol 33 no 9. National Center for Health Statistics. Washington: Public Health Service. 1951. 51. Chiang CL. Standard error of the age-adjusted death rate. Vital statistics-Special reports. vol 47 no 9. National Center for Health Statistics. Washington: Public Health Service. 1961. 52. Pearson, ES, Hartley, HO. Biometrika tables for statisticians, vol I. Cambridge University Press. 1966. -34- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table A. Comparison of percent agreement and ratio of deaths for census or survey record to deaths by race for matching death certificate: 1960 and 1979-85 Census Race Percent agreement 99.8 98.2 79.2 --97.0 90.3 72.6 Ratio census/ death certificate 1.00 1.00 1.12 ... 1.04 1.07 1.28 Percent agreement 99.2 98.2 73.6 82.4 ... ... ... NLMS1 Ratio CPS2/ death certificate 1.00 1.00 1.22 1.12 ... ... ... White............................ Black............................. American Indian............ Asian............................. Japanese........................ Chinese ........................ Filipino ........................ --- Data not available. ... Category not applicable. 1 NLMS is defined as National Longitudinal Mortality Study. 2 CPS is defined as Current Population Survey. SOURCES: Hambright TZ. Comparability of marital status, race, nativity, and country of origin on the death certificate and matching census record: U.S., May-August 1960. National Center for Health Statistics. Vital Health Stat 2(34). 1969; Sorlie PD, Rogot E, Johnson NJ. Validity of demographic characteristics on the death certificate. Epidemiology 3(2):181-4. 1992. -36- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table B. Infant mortality rates by race of infant from the death certificate and by race of mother from the birth certificate, and ratio of rates, 1995-96 [Rates per 1,000 live births in specified group] Infant mortality rate Race All races . . . . . . . . . . . . . . . . . . . . . . . . . White . . . . . . . . . . . . . . . . . . . . . . . . . . . Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . American Indian . . . . . . . . . . . . . . . . . . . Asian or Pacific Islander . . . . . . . . . . . . . Chinese . . . . . . . . . . . . . . . . . . . . . . . . . Japanese . . . . . . . . . . . . . . . . . . . . . . . . Hawaiian . . . . . . . . . . . . . . . . . . . . . . . . Filipino . . . . . . . . . . . . . . . . . . . . . . . . . Other Asian or Pacific Islander . . . . . . . Race from Race from death certificate birth certificate 7.5 7.4 6.2 6.2 14.9 14.4 8.3 9.5 4.1 5.2 2.9 3.5 2.3 4.7 7.2 6.1 3.4 5.7 4.8 5.6 Ratio birth/ death 0.99 1.00 0.97 1.14 1.27 1.21 2.04 0.85 1.68 1.17 SOURCE: Rosenberg H, Maurer JD, Sorlie PD, Johnson NJ, MacDorman M, Hoyert DL, Spitler JF, Scott C. Quality of death rates by race and Hispanic origin: a summary. National vital statistics reports (forthcoming). -37- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table C. Infant mortality rates by Hispanic origin of infant from the death certificate and by race of mother from the birth certificate, and ratio of rates, 1996 [Rates per 1,000 live births in specified group] Infant mortality rate Race All origins 2 . . . . . . . . . . . . . . . . . . . . . . . Total Hispanic . . . . . . . . . . . . . . . . . . . . . Mexican . . . . . . . . . . . . . . . . . . . . . . . . Puerto Rican . . . . . . . . . . . . . . . . . . . . . Cuban . . . . . . . . . . . . . . . . . . . . . . . . . . Other Hispanic 3 . . . . . . . . . . . . . . . . . . Non-Hispanic total 4 . . . . . . . . . . . . . . . Non-Hispanic white . . . . . . . . . . . . . . . . Non-Hispanic black . . . . . . . . . . . . . . . . 1 2 Hispanic origin Hispanic origin from from death certificate 1 birth certificate 7.3 7.4 5.9 6.2 5.9 5.9 7.8 8.7 5.1 5.2 5.3 5.9 7.6 7.7 6.1 6.2 14.7 14.4 Ratio linked file/ birth/death 1.01 1.05 1.00 1.12 1.02 1.11 1.01 1.02 0.98 Data excludes Oklahoma which did not have a question on Hispanic origin on its death certificate. Includes Hispanic origin not stated. 3 Includes Central and South American and Other and unknown Hispanic. 4 Includes races other than white and black. SOURCE: Rosenberg H, Maurer JD, Sorlie PD, Johnson NJ, MacDorman M, Hoyert DL, Spitler JF, Scott C. Quality of death rates by race and Hispanic origin: a summary. National vital statistics reports (forthcoming). -38- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table D. Numbers of deaths and ratios of deaths for selected causes as tabulated by State of occurrence and NCHS, 1995 [Data by place of occurrence include deaths of nonresidents. Numbers after causes of death are category numbers of the Ninth Revision, International Classification of Diseases, 1975] Causes All causes....................................................................................... Symptoms, signs, and ill-defined conditions....................780-799 Accidents and adverse effects.......................................E800-E949 Motor vehicle accidents..............................................E810-E825 All other accidents and adverse effects....E800-E807,E826-E949 Suicide..........................................................................E950-E959 Homicide and legal intervention...................................E960-E978 All other external causes...............................................E980-E999 Alaska 2,546 42 368 105 263 118 56 7 NCHS 2,546 43 376 96 280 105 55 11 Ratio AK/NCHS 1.00 0.98 0.98 1.09 0.94 1.12 1.02 0.64 -39- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table E. Population of birth- and death-registration States, 1900-1932, and United States, 1900-1995 [Population enumerated as of April 1 for 1940, 1950, 1960, 1970, 1980, and 1990 and estimated as of July 1 for all other years] United States1 Year Population including Armed Forces abroad Population residing in area Year United States1 Population Population including residing Armed in Forces area abroad 144,126,000 141,389,000 139,928,000 138,397,000 136,739,000 134,860,000 133,402,000 131,820,000 131,028,000 129,969,000 128,961,000 128,181,000 127,362,000 126,485,000 125,690,000 124,949,000 124,149,000 123,188,000 --------------------105,063,000 104,550,000 103,414,000 ------------143,446,000 140,054,000 132,481,000 132,885,000 134,245,000 133,920,000 133,121,000 131,669,275 130,879,718 129,824,939 128,824,829 128,053,180 127,250,232 126,373,773 125,578,763 124,840,471 124,039,648 123,076,741 121,769,939 120,501,115 119,038,062 117,399,225 115,831,963 114,113,463 111,949,945 110,054,778 108,541,489 106,466,420 104,512,110 103,202,801 103,265,913 101,965,984 100,549,013 99,117,567 97,226,814 95,331,300 93,867,814 Birth-registration States Number of States2 Population residing in area Death-registration States Number of States2 Population residing in area 1995 1994 1994 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 263,033,968 260,650,842 258,119,768 255,457,501 252,688,000 249,225,000 247,342,000 245,021,000 242,804,000 240,651,000 238,466,000 236,348,000 234,307,000 232,188,000 229,966,000 227,061,000 225,055,000 222,585,000 220,239,000 218,035,000 215,973,000 213,854,000 211,909,000 209,896,000 207,661,000 204,270,000 202,677,000 200,706,000 198,712,000 196,560,000 194,303,000 191,889,000 189,242,000 186,538,000 183,691,000 179,933,000 177,264,000 262,755,270 260,340,990 257,783,004 255,077,536 252,177,000 248,709,873 246,819,000 244,499,000 242,289,000 240,133,000 237,924,000 235,825,000 233,792,000 231,664,000 229,466,000 226,545,805 224,567,000 222,095,000 219,760,000 217,563,000 215,465,000 213,342,000 211,357,000 209,284,000 206,827,000 203,211,926 201,385,000 199,399,000 197,457,000 195,576,000 193,526,000 191,141,000 188,483,000 185,771,000 182,992,000 179,323,175 176,513,000 1947 . . . . . . 1946 . . . . . . 1945 . . . . . . 1944 . . . . . . 1943 . . . . . . 1942 . . . . . . 1941 . . . . . . 1940 . . . . . . 1939 . . . . . . 1938 . . . . . . 1937 . . . . . . 1936 . . . . . . 1935 . . . . . . 1934 . . . . . . 1933 . . . . . . 1932 . . . . . . 1931 . . . . . . 1930 . . . . . . 1929 . . . . . . 1928 . . . . . . 1927 . . . . . . 1926 . . . . . . 1925 . . . . . . 1924 . . . . . . 1923 . . . . . . 1922 . . . . . . 1921 . . . . . . 1920 . . . . . . 1919 . . . . . . 1918 . . . . . . 1917 . . . . . . 1916 . . . . . . 1915 . . . . . . 1914 . . . . . . 1913 . . . . . . 1912 . . . . . . 1911 . . . . . . ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 47 46 46 46 44 40 35 33 33 30 30 27 23 22 20 20 11 10 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 118,903,899 117,455,229 116,544,946 115,317,450 113,636,160 104,320,830 90,400,590 88,294,564 87,000,295 81,072,123 79,560,746 70,807,090 63,597,307 61,212,076 55,153,782 55,197,952 32,944,013 31,096,697 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 47 47 47 46 44 42 41 40 39 38 37 34 34 33 30 27 26 24 24 23 22 22 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 118,903,899 118,148,987 117,238,278 115,317,450 113,636,160 107,084,532 103,822,683 102,031,555 99,318,098 96,788,197 92,702,901 87,814,447 86,079,263 83,157,982 79,008,412 70,234,775 66,971,177 61,894,847 60,963,309 58,156,740 54,847,700 53,929,644 -40- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table E. Population of birth- and death-registration States, 1900-1932, and United States, 1900-1995 [Population enumerated as of April 1 for 1940, 1950, 1960, 1970, 1980, and 1990 and estimated as of July 1 for all other years] United States1 Year Population including Armed Forces abroad Population residing in area Year United States1 Population Population including residing Armed in Forces area abroad ----------------------92,406,536 90,491,525 88,708,976 87,000,271 85,436,556 83,819,666 82,164,974 80,632,152 79,160,196 77,585,128 76,094,134 Birth-registration States Number of States2 Population residing in area Death-registration States Number of States2 Population residing in area 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... 174,141,000 171,274,000 168,221,000 165,275,000 162,391,000 159,565,000 156,954,000 154,287,000 151,132,000 149,188,000 146,631,000 172,320,000 170,371,000 167,306,000 164,308,000 161,164,000 158,242,000 155,687,000 153,310,000 150,697,361 148,665,000 146,093,000 1910 . . . . . . 1909 . . . . . . 1908 . . . . . . 1907 . . . . . . 1906 . . . . . . 1905 . . . . . . 1904 . . . . . . 1903 . . . . . . 1902 . . . . . . 1901 . . . . . . 1900 . . . . . . ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 20 18 17 15 15 10 10 10 10 10 10 47,470,437 44,223,513 38,634,759 34,552,837 33,782,288 21,767,980 21,332,076 20,943,222 20,582,907 20,237,453 19,965,446 --- Data not available. ... Category not applicable. 1 Alaska included beginning 1959 and Hawaii, 1960. 2 The District of Columbia is not included in "Number of States," but it is represented in all data shown for each year. SOURCE: Published and unpublished data from the U.S. Bureau of the Census; see text. -41- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table F. Source for resident population and population including Armed Forces abroad: Birth- and death-registration States, 1900-32, and United States, 1900-95 Year 1995 1994 1993 1992 1991 1990 ...... ...... ...... ...... ...... ...... Source U.S. Bureau of the Census, Electronic Data File, RESD0795, and unpublished data. U.S. Bureau of the Census, Electronic Data File, RESD0794, and unpublished data. U.S. Bureau of the Census, Electronic Data File, RESP0793, and unpublished data. U.S. Bureau of the Census, Electronic Data File, RESP0792, and unpublished data. U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 1095, 1993. U.S. Bureau of the Census, Unpublished data from the 1990 census, 1990 CPH-L-74 and unpublished data consistent with Current Population Reports, Series P-25, No. 1095. U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 1095, 1993. U.S. Bureau of the Census, U.S. Census of Population: 1980, Number of Inhabitants, PC-80-1A1, United States Summary, 1983. U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 917, July 1982. U.S. Bureau of the Census, U.S. Census of Population: 1970, Number of Inhabitants, Final Report PC(1)-A1, United States Summary, 1971. U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 519, April 1974. U.S. Bureau of the Census, U.S. Census of Population: 1960, Number of Inhabitants, PC(1)-A1, United States Summary, 1964. U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 310, June 30, 1965. U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 499, May 1973. U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 499, May 1973, and National Office of Vital Statistics, Vital Statistics Rates in the United States, 1900-1940, 1947. National Office of Vital Statistics, Vital Statistics Rates in the United States, 1900-1940, 1947. Same as for 1930-39. Same as for 1920-29. 1981-89 . . . . 1980 . . . . . . 1971-79 . . . . 1970 . . . . . . 1961-69 . . . . 1960 . . . . . . 1951-59 . . . . 1940-50 . . . . 1930-39 . . . . 1920-29 . . . . 1917-19 . . . . 1900-16 . . . . -42- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table G. Estimated population of the United States, by 5-year age groups, race, and sex: July 1, 1995 [Figures include Armed forces stationed in the United States and exclude those stationed outside the United States] All races Age Both sexes Male Female Both sexes White Male Female Total Both sexes Male Female Both sexes All other Black Male Female All ages . . . . . . . . . Under 1 year . . . . . . . . 1-4 years . . . . . . . . . . . 5-9 years . . . . . . . . . . . 10-14 years . . . . . . . . . 15-19 years . . . . . . . . . 20-24 years . . . . . . . . . 25-29 years . . . . . . . . . 30-34 years . . . . . . . . . 35-39 years . . . . . . . . . 40-44 years . . . . . . . . . 45-49 years . . . . . . . . . 50-54 years . . . . . . . . . 55-59 years . . . . . . . . . 60-64 years . . . . . . . . . 65-69 years . . . . . . . . . 70-74 years . . . . . . . . . 75-79 years . . . . . . . . . 80-84 years . . . . . . . . . 85 years and over . . . . 262,755,270 3,848,106 15,743,042 19,219,956 18,914,532 18,064,517 17,882,118 19,005,343 21,867,796 22,248,914 20,218,805 17,448,898 13,629,862 11,084,606 10,046,478 9,927,958 8,831,205 6,681,247 4,463,733 3,628,154 128,313,798 134,441,472 1,969,872 8,055,333 9,843,300 9,685,241 9,265,025 9,087,045 9,529,765 10,902,150 11,071,207 9,990,476 8,559,836 6,621,815 5,317,251 4,726,807 4,505,822 3,836,272 2,720,385 1,609,321 1,016,875 1,878,234 7,687,709 9,376,656 9,229,291 8,799,492 8,795,073 9,475,578 10,965,646 11,177,707 10,228,329 8,889,062 7,008,047 5,767,355 5,319,671 5,422,136 4,994,933 3,960,862 2,854,412 2,611,279 218,085,421 106,993,635 3,014,707 12,436,458 15,236,617 15,039,772 14,362,303 14,317,137 15,402,702 17,984,412 18,458,496 16,929,523 14,858,289 11,725,262 9,540,786 8,723,606 8,725,874 7,918,213 6,038,810 4,069,152 3,303,302 1,547,420 6,376,721 7,818,268 7,720,711 7,390,200 7,323,846 7,795,910 9,062,225 9,282,016 8,460,555 7,370,499 5,754,226 4,625,549 4,152,335 3,993,037 3,461,716 2,470,292 1,469,402 918,707 111,091,786 44,669,849 1,467,287 6,059,737 7,418,349 7,319,061 6,972,103 6,993,291 7,606,792 8,922,187 9,176,480 8,468,968 7,487,790 5,971,036 4,915,237 4,571,271 4,732,837 4,456,497 3,568,518 2,599,750 2,384,595 833,399 3,306,584 3,983,339 3,874,760 3,702,214 3,564,981 3,602,641 3,883,384 3,790,418 3,289,282 2,590,609 1,904,600 1,543,820 1,322,872 1,202,084 912,992 642,437 394,581 324,852 21,320,163 23,349,686 33,141,148 15,721,074 17,420,074 422,452 1,678,612 2,025,032 1,964,530 1,874,825 1,763,199 1,733,855 1,839,925 1,789,191 1,529,921 1,189,337 867,589 691,702 574,472 512,785 374,556 250,093 139,919 98,168 410,947 1,627,972 1,958,307 1,910,230 1,827,389 1,801,782 1,868,786 2,043,459 2,001,227 1,759,361 1,401,272 1,037,011 852,118 748,400 689,299 538,436 392,344 254,662 226,684 621,144 2,478,716 3,025,305 2,876,972 2,821,796 2,637,568 2,594,461 2,825,366 2,787,896 2,390,339 1,854,835 1,380,983 1,137,905 988,458 920,412 696,791 509,967 318,168 274,066 314,438 1,255,910 1,534,797 1,459,558 1,430,218 1,299,324 1,239,775 1,325,134 1,307,303 1,108,770 846,389 619,729 499,639 425,295 393,354 280,476 194,449 107,311 79,205 306,706 1,222,806 1,490,508 1,417,414 1,391,578 1,338,244 1,354,686 1,500,232 1,480,593 1,281,569 1,008,446 761,254 638,266 563,163 527,058 416,315 315,518 210,857 194,861 SOURCE: Published and unpublished data from the U.S. Bureau of the Census; see text. -43- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table H. Estimated population, by age, for the United States, each division and State, Puerto Rico, Virgin Islands, and Guam: July 1, 1995 [Figures include Armed Forces stationed in each area, and exclude Armed Forces stationed outside the United States] Division and State United States . . . . . Geographic divisions: New England . . . . . . . Middle Atlantic . . . . . East North Central . . . West North Central . . South Atlantic . . . . . . East South Central . . . West South Central . . Mountain . . . . . . . . . . Pacific . . . . . . . . . . . . New England: Maine . . . . . . . . . . . . New Hampshire . . . . . Vermont . . . . . . . . . . Massachusetts . . . . . . Rhode Island . . . . . . . Connecticut . . . . . . . . Middle Atlantic: New York . . . . . . . . . New Jersey . . . . . . . . Pennsylvania . . . . . . . 18,136,081 7,945,298 12,071,842 1,359,704 577,194 784,339 3,631,631 1,577,326 2,425,714 6,990,701 3,037,472 4,444,304 3,730,227 1,663,133 2,501,371 2,423,818 1,090,173 1,916,114 1,241,382 1,148,253 584,771 6,073,550 989,794 3,274,662 74,513 76,269 37,092 412,862 67,570 227,592 262,980 245,451 124,782 1,156,540 193,057 644,405 472,162 467,324 231,079 2,444,165 385,682 1,258,292 259,582 222,709 121,369 1,199,376 187,680 677,147 172,145 136,500 70,449 860,607 155,805 467,226 13,312,412 38,153,221 43,456,141 18,347,676 46,995,266 16,066,495 28,827,781 15,645,168 41,951,110 895,898 2,721,237 3,128,414 1,264,639 3,325,490 1,135,805 2,320,898 1,244,762 3,554,005 2,627,215 7,634,671 9,409,884 4,112,086 9,509,928 3,461,262 6,706,183 3,684,177 9,053,599 5,258,704 14,472,477 16,616,553 6,831,914 18,160,132 6,101,786 11,030,113 5,897,743 16,853,554 2,667,863 7,894,731 8,729,381 3,617,041 9,555,646 3,339,026 5,560,170 3,051,888 7,794,098 1,862,732 5,430,105 5,571,909 2,521,996 6,444,070 2,028,616 3,210,417 1,766,598 4,695,854 Total 262,755,270 Under 5 years 19,591,148 15-19 years 56,199,005 20-44 years 101,222,976 45-64 years 52,209,844 65 years and over 33,532,297 -44- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table H. Estimated population, by age, for the United States, each division and State, Puerto Rico, Virgin Islands, and Guam: July 1, 1995 [Figures include Armed Forces stationed in each area, and exclude Armed Forces stationed outside the United States] Division and State East North Central: Ohio . . . . . . . . . . . . . Indiana . . . . . . . . . . . Illinois . . . . . . . . . . . . Michigan . . . . . . . . . . Wisconsin . . . . . . . . . West North Central: Minnesota . . . . . . . . . Iowa . . . . . . . . . . . . . Missouri . . . . . . . . . . North Dakota . . . . . . . South Dakota . . . . . . . Nebraska . . . . . . . . . . Kansas . . . . . . . . . . . . South Atlantic: Delaware . . . . . . . . . . Maryland . . . . . . . . . . District of Columbia . Virginia . . . . . . . . . . . West Virginia . . . . . . North Carolina . . . . . . South Carolina . . . . . . Georgia . . . . . . . . . . . Florida . . . . . . . . . . . . 717,197 5,042,438 554,256 6,618,358 1,828,140 7,195,138 3,673,287 7,200,882 14,165,570 51,616 368,055 39,909 463,688 106,460 513,888 262,833 551,180 967,861 145,089 1,023,354 85,456 1,324,642 371,332 1,476,269 787,894 1,572,524 2,723,368 287,082 2,051,902 241,384 2,733,999 656,509 2,824,410 1,430,888 2,944,887 4,989,071 142,759 1,027,382 110,267 1,358,594 414,624 1,481,113 751,769 1,414,385 2,854,753 90,651 571,745 77,240 737,435 279,215 899,458 439,903 717,906 2,630,517 4,609,548 2,841,764 5,323,523 641,367 729,034 1,637,112 2,565,328 320,664 183,794 369,321 41,830 52,310 114,141 182,579 1,048,040 622,313 1,156,726 148,246 176,704 376,888 583,169 1,778,168 1,023,882 1,979,691 236,343 258,281 599,452 956,097 889,575 579,737 1,077,359 122,192 136,919 318,954 492,305 573,101 432,038 740,426 92,756 104,820 227,677 351,178 11,150,506 5,803,471 11,829,940 9,549,353 5,122,871 772,833 407,943 920,982 682,697 343,959 2,391,427 1,245,848 2,521,591 2,099,165 1,151,853 4,215,895 2,230,373 4,564,415 3,672,566 1,933,304 2,279,935 1,186,217 2,338,816 1,913,132 1,011,281 1,490,416 733,090 1,484,136 1,181,793 682,474 Total Under 5 years 15-19 years 20-44 years 45-64 years 65 years and over -45- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table H. Estimated population, by age, for the United States, each division and State, Puerto Rico, Virgin Islands, and Guam: July 1, 1995 [Figures include Armed Forces stationed in each area, and exclude Armed Forces stationed outside the United States] Division and State East South Central: Kentucky . . . . . . . . . . Tennessee . . . . . . . . . Alabama . . . . . . . . . . Mississippi . . . . . . . . West South Central: Arkansas . . . . . . . . . . Louisiana . . . . . . . . . . Oklahoma . . . . . . . . . Texas . . . . . . . . . . . . Mountain: Montana . . . . . . . . . . Idaho . . . . . . . . . . . . . Wyoming . . . . . . . . . . Colorado . . . . . . . . . . New Mexico . . . . . . . Arizona . . . . . . . . . . . Utah . . . . . . . . . . . . . Nevada . . . . . . . . . . . Pacific: Washington . . . . . . . . Oregon . . . . . . . . . . . California . . . . . . . . . Alaska . . . . . . . . . . . . Hawaii . . . . . . . . . . . . 5,430,940 3,140,585 31,589,153 603,617 1,186,815 385,897 209,591 2,809,826 52,882 95,809 1,178,182 672,424 6,801,330 155,312 246,351 2,145,740 1,168,806 12,830,615 249,856 458,537 1,093,387 663,899 5,684,563 115,784 236,465 627,734 425,865 3,462,819 29,783 149,653 870,281 1,163,261 480,184 3,746,585 1,685,401 4,217,940 1,951,408 1,530,108 56,982 89,426 32,257 268,950 138,303 355,808 183,818 119,218 205,670 298,399 119,801 814,019 412,650 949,809 568,951 314,878 305,673 415,220 175,179 1,501,226 620,969 1,561,024 721,790 596,662 188,295 227,661 99,674 786,087 330,092 790,771 304,842 324,466 113,661 132,555 53,273 376,303 183,387 560,528 172,007 174,884 2,483,769 4,342,334 3,277,687 18,723,991 172,617 336,295 230,362 1,581,624 550,258 1,040,537 743,577 4,371,811 883,203 1,624,199 1,184,260 7,338,451 518,417 846,822 677,267 3,517,664 359,274 494,481 442,221 1,914,441 3,860,219 5,256,051 4,252,982 2,697,243 261,108 365,477 300,663 208,557 827,133 1,088,517 904,543 641,069 1,473,939 2,022,370 1,609,445 996,032 811,474 1,121,476 885,871 520,205 486,565 658,211 552,460 331,380 Total Under 5 years 15-19 years 20-44 years 45-64 years 65 years and over -46- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table H. Estimated population, by age, for the United States, each division and State, Puerto Rico, Virgin Islands, and Guam: July 1, 1995 [Figures include Armed Forces stationed in each area, and exclude Armed Forces stationed outside the United States] Division and State Puerto Rico . . . . . . . . . Virgin Islands . . . . . . . Guam . . . . . . . . . . . . . Total 3,731,006 111,950 143,855 Under 5 years 319,833 11,746 20,016 15-19 years 967,608 30,308 38,101 20-44 years 1,367,887 36,893 56,922 45-64 years 699,770 24,731 21,526 65 years and over 375,908 8,272 7,290 SOURCE: Published and unpublished data from the U.S. Bureau of the Census; see text. -47- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table I. Estimated population by 5-year age groups, specified Hispanic origin, race for non-Hispanic origin, and sex: Total of 49 States and the District of Columbia, July 1, 1995 [Figures include Armed Forces stationed in the United States and exclude those stationed outside the United States] Hispanic Sex and age All origins Total Mexican Puerto Rican Cuban Other Hispanic 1 Total 2 Non-Hispanic White Black Both sexes All ages . . . . . . . . . . . . . Under 1 year . . . . . . . . . . . 1-4 years . . . . . . . . . . . . . . 5-9 years . . . . . . . . . . . . . . 10-14 years . . . . . . . . . . . . 15-19 years . . . . . . . . . . . . 20-24 years 25-29 years 30-34 years 35-39 years 40-44 years 45-49 years 50-54 years 55-59 years 60-64 years 65-69 years ............ ............ ............ ............ ............ ............ ............ ............ ............ ............ 259,504,615 26,903,271 17,355,772 2,769,337 1,131,663 5,646,499 232,601,344 190,850,619 31,362,664 3,809,275 15,580,062 19,012,420 18,630,833 17,819,048 17,672,363 18,817,030 21,650,105 21,991,526 19,954,489 17,220,601 13,430,283 10,925,387 9,899,196 9,812,348 8,702,959 6,583,805 4,408,015 3,584,870 655,554 2,543,683 2,651,648 2,417,045 2,270,583 2,328,759 2,494,511 2,524,224 2,150,017 1,716,147 1,307,489 958,448 758,260 632,954 540,568 403,168 254,182 167,139 128,892 470,799 1,831,485 1,827,552 1,640,556 1,461,401 1,581,229 1,700,668 1,611,589 1,310,414 1,015,553 751,352 556,698 432,167 358,687 304,944 219,217 120,665 96,302 64,494 64,678 212,544 275,458 285,618 270,401 200,083 212,113 227,880 233,753 190,484 158,791 129,488 98,311 76,178 45,729 40,286 18,276 15,701 13,565 8,367 52,849 67,706 54,814 59,450 67,422 77,023 89,061 99,407 78,309 81,819 49,707 60,555 65,229 63,881 56,636 51,868 19,958 27,602 111,710 446,805 480,932 436,057 479,331 480,025 504,707 595,694 506,443 431,801 315,527 222,555 167,227 132,860 126,014 87,029 63,373 35,178 23,231 3,153,721 13,036,379 16,360,772 16,213,788 15,548,465 15,343,604 16,322,519 19,125,881 19,841,509 18,238,342 15,913,112 12,471,835 10,167,127 9,266,242 9,271,780 8,299,791 6,329,623 4,240,876 3,455,978 2,384,798 9,978,680 12,660,787 12,623,204 12,107,989 12,039,504 12,972,578 15,498,672 16,292,926 15,157,873 13,475,210 10,678,551 8,705,433 8,008,598 8,127,172 7,420,570 5,714,811 3,861,759 3,141,504 578,805 2,320,160 2,847,501 2,710,259 2,664,902 2,485,920 2,442,477 2,667,118 2,635,411 2,257,012 1,765,840 1,318,856 1,088,923 950,312 884,416 676,445 493,861 307,575 266,871 70-74 years . . . . . . . . . . . . 75-79 years . . . . . . . . . . . . 80-84 years . . . . . . . . . . . . 85 years and over . . . . . . . . Male All ages . . . . . . . . . . . . . Under 1 year . . . . . . . . . . . 1-4 years . . . . . . . . . . . . . . 5-9 years . . . . . . . . . . . . . . 10-14 years . . . . . . . . . . . . 15-19 years . . . . . . . . . . . . 126,752,625 13,628,500 1,950,448 7,974,893 9,735,795 9,536,570 9,143,122 336,434 1,302,113 1,356,198 1,233,877 1,162,112 8,974,090 1,303,169 248,742 927,676 914,348 808,092 774,039 30,711 99,554 144,442 161,091 129,647 568,949 2,782,292 113,124,125 5,199 32,451 39,111 27,560 26,834 51,782 242,432 258,297 237,134 231,592 1,614,014 6,672,780 8,379,597 8,302,693 7,981,010 93,270,479 14,828,366 1,227,497 5,121,759 6,497,997 6,486,892 6,234,908 290,941 1,175,545 1,445,807 1,372,005 1,352,603 -48- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table I. Estimated population by 5-year age groups, specified Hispanic origin, race for non-Hispanic origin, and sex: Total of 49 States and the District of Columbia, July 1, 1995 [Figures include Armed Forces stationed in the United States and exclude those stationed outside the United States] Hispanic Sex and age All origins 8,979,149 9,446,366 10,791,780 10,951,099 9,851,416 8,472,709 6,510,211 5,243,725 4,656,801 4,453,305 3,780,240 2,680,830 1,584,091 1,010,075 Total 1,227,296 1,340,052 1,328,484 1,107,376 860,573 642,933 460,474 356,245 292,546 240,855 176,596 102,125 59,655 42,556 Mexican 857,708 940,380 879,990 695,076 534,558 395,439 268,781 207,394 174,331 139,365 98,650 51,452 37,819 20,250 Puerto Rican 88,891 91,997 102,131 114,486 84,524 66,350 64,902 37,720 33,902 19,085 18,121 6,232 3,391 5,992 Cuban 36,259 44,081 45,048 54,313 37,865 35,143 26,641 34,963 27,778 31,018 27,892 21,487 5,150 10,156 Other Hispanic 1 244,438 263,594 301,315 243,501 203,626 146,001 100,150 76,168 56,535 51,387 31,933 22,954 13,295 6,158 Total 2 7,751,853 8,106,314 9,463,296 9,843,723 8,990,843 7,829,776 6,049,737 4,887,480 4,364,255 4,212,450 3,603,644 2,578,705 1,524,436 967,519 Non-Hispanic White 6,125,276 6,503,109 7,754,055 8,179,225 7,567,522 6,714,254 5,241,592 4,231,003 3,819,584 3,722,238 3,242,236 2,337,566 1,391,899 871,867 Black 1,220,795 1,160,579 1,244,394 1,229,869 1,041,341 799,865 589,922 478,799 408,331 377,203 272,714 188,359 101,425 77,869 20-24 years 25-29 years 30-34 years 35-39 years 40-44 years 45-49 years 50-54 years 55-59 years 60-64 years 65-69 years ............ ............ ............ ............ ............ ............ ............ ............ ............ ............ 70-74 years . . . . . . . . . . . . 75-79 years . . . . . . . . . . . . 80-84 years . . . . . . . . . . . . 85 years and over . . . . . . . . Female All ages . . . . . . . . . . . . . Under 1 year . . . . . . . . . . . 1-4 years . . . . . . . . . . . . . . 5-9 years . . . . . . . . . . . . . . 10-14 years . . . . . . . . . . . . 15-19 years . . . . . . . . . . . . 20-24 years 25-29 years 30-34 years 35-39 years 40-44 years ............ ............ ............ ............ ............ 132,751,990 13,274,771 1,858,827 7,605,169 9,276,625 9,094,263 8,675,926 8,693,214 9,370,664 10,858,325 11,040,427 10,103,073 319,120 1,241,570 1,295,450 1,183,168 1,108,471 1,101,463 1,154,459 1,195,740 1,042,641 855,574 8,381,682 1,466,168 222,057 903,809 913,204 832,464 687,362 723,521 760,288 731,599 615,338 480,995 33,967 112,990 131,016 124,527 140,754 111,192 120,116 125,749 119,267 105,960 562,714 2,864,207 119,477,219 3,168 20,398 28,595 27,254 32,616 31,163 32,942 44,013 45,094 40,444 59,928 204,373 222,635 198,923 247,739 235,587 241,113 294,379 262,942 228,175 1,539,707 6,363,599 7,981,175 7,911,095 7,567,455 7,591,751 8,216,205 9,662,585 9,997,786 9,247,499 97,580,140 16,534,298 1,157,301 4,856,921 6,162,790 6,136,312 5,873,081 5,914,228 6,469,469 7,744,617 8,113,701 7,590,351 287,864 1,144,615 1,401,694 1,338,254 1,312,299 1,265,125 1,281,898 1,422,724 1,405,542 1,215,671 -49- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table I. Estimated population by 5-year age groups, specified Hispanic origin, race for non-Hispanic origin, and sex: Total of 49 States and the District of Columbia, July 1, 1995 [Figures include Armed Forces stationed in the United States and exclude those stationed outside the United States] Hispanic Sex and age All origins 8,747,892 6,920,072 5,681,662 5,242,395 5,359,043 4,922,719 3,902,975 2,823,924 2,574,795 Total 664,556 497,974 402,015 340,408 299,713 226,572 152,057 107,484 86,336 Mexican 355,913 287,917 224,773 184,356 165,579 120,567 69,213 58,483 44,244 Puerto Rican 92,441 64,586 60,591 42,276 26,644 22,165 12,044 12,310 7,573 Cuban 46,676 23,066 25,592 37,451 32,863 28,744 30,381 14,808 17,446 Other Hispanic 1 169,526 122,405 91,059 76,325 74,627 55,096 40,419 21,883 17,073 Total 2 8,083,336 6,422,098 5,279,647 4,901,987 5,059,330 4,696,147 3,750,918 2,716,440 2,488,459 Non-Hispanic White 6,760,956 5,436,959 4,474,430 4,189,014 4,404,934 4,178,334 3,377,245 2,469,860 2,269,637 Black 965,975 728,934 610,124 541,981 507,213 403,731 305,502 206,150 189,002 45-49 years 50-54 years 55-59 years 60-64 years 65-69 years ............ ............ ............ ............ ............ 70-74 years . . . . . . . . . . . . 75-79 years . . . . . . . . . . . . 80-84 years . . . . . . . . . . . . 85 years and over . . . . . . . . 1 2 Includes Central and South American and Other and unknown Hispanic. Includes races other than white and black. -50- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table J. Estimated population for ages 15 years and over, by 5-year age groups, marital status, race, and sex: United States, 1995 [Figures may be subject to large sampling variability. Figures include Armed Forces stationed in the United States and exclude those stationed outside the United States] Race, sex, and marital status White, male Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . White, female Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . Black, male Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . Black, female Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . 5,138,791 4,893,415 1,424,088 1,526,366 840,458 5,999 1,265 528,317 14,155 1,389 1,129,588 188,803 1,462 18,400 805,603 460,700 2,439 85,952 620,945 698,877 16,808 163,599 460,771 732,533 23,599 263,691 267,489 697,581 37,657 278,838 183,942 572,248 47,931 204,324 5,217,613 4,701,195 319,907 917,652 869,069 6,327 420 5,620 547,531 1,253 1,165,762 122,128 11,437 810,062 386,772 42,935 620,472 615,821 1,671 87,161 477,994 698,148 4,512 126,653 286,672 620,641 10,195 191,268 154,253 560,293 8,819 123,026 18,192,353 51,742,023 10,320,547 8,572,453 4,173,426 52,788 588 5,886 2,483,742 246,917 339 8,425 4,458,856 2,306,878 10,808 216,745 2,373,723 4,675,165 16,713 541,191 1,426,763 6,540,284 40,393 914,759 901,826 6,942,335 90,459 1,241,857 616,717 6,442,465 114,322 1,295,463 417,743 5,700,667 209,813 1,159,578 23,750,005 51,250,071 2,104,997 6,425,431 4,474,440 17,889 1,189 9,449 2,809,114 75,290 315 2,509 5,787,809 1,445,577 90,457 3,792,697 3,661,405 5,229 336,578 2,346,118 5,893,078 15,259 807,768 1,692,627 6,543,111 24,800 1,021,478 1,057,271 6,326,628 36,068 1,040,588 627,638 5,730,011 50,687 962,156 15 years and over 15-17 years 18-19 years 20-24 years 25-29 years 30-34 years 35-39 years 40-44 years 45-49 years -51- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table J. Estimated population for ages 15 years and over, by 5-year age groups, marital status, race, and sex: United States, 1995 [Figures may be subject to large sampling variability. Figures include Armed Forces stationed in the United States and exclude those stationed outside the United States] Race, sex, and marital status American Indian, male Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . American Indian, female Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . Asian or Pacific Islander, male Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . Asian or Pacific Islander, female Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . 988,646 2,231,482 257,286 179,343 204,348 1,695 1,686 122,714 5,462 384 276,193 92,109 2,175 2,752 200,872 219,864 6,216 70,303 354,566 5,650 19,832 47,973 361,861 5,244 15,786 23,894 341,791 2,915 29,008 11,872 267,472 14,143 35,191 1,271,962 1,882,658 38,375 109,445 212,391 1,578 128,562 910 339,586 29,691 261,374 129,989 2,981 6,666 149,950 261,779 10,018 81,197 291,809 21,586 49,431 270,396 25,956 19,571 245,044 791 16,772 255,491 371,103 78,422 97,808 60,821 1,275 1,170 32,249 2,517 1,494 58,903 28,290 3,121 51,487 29,671 5,986 15,086 57,865 3,170 16,756 9,519 66,221 504 13,529 9,396 50,887 2,365 17,535 2,218 41,817 5,068 15,035 286,152 376,812 23,787 83,983 64,551 34,302 2,311 67,805 26,325 470 50,189 35,866 7,022 30,361 47,744 1,399 13,541 17,887 50,088 559 18,767 11,178 47,904 16,288 2,303 49,245 2,855 6,367 15 years and over 15-17 years 18-19 years 20-24 years 25-29 years 30-34 years 35-39 years 40-44 years 45-49 years -52- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table J. Estimated population for ages 15 years and over, by 5-year age groups, marital status, race, and sex: United States, 1995 [Figures may be subject to large sampling variability. Figures include Armed Forces stationed in the United States and exclude those stationed outside the United States] Race, sex, and marital status White, male Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . White, female Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . Black, male Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . Black, female Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . 77,869 413,236 92,370 177,782 64,840 353,999 123,976 95,449 54,710 274,069 158,261 76,124 38,477 213,925 193,880 80,777 31,162 148,331 196,599 40,219 11,400 74,521 208,224 21,376 10,456 31,111 157,003 12,290 12,764 13,327 162,614 6,156 106,276 388,332 12,310 112,813 58,275 358,855 14,624 67,882 47,769 280,399 39,342 57,782 20,723 254,459 76,454 41,722 17,486 190,307 44,445 28,235 20,436 112,829 48,051 13,130 5,786 60,007 33,766 7,752 9,047 44,624 25,298 236 270,307 4,522,863 281,180 896,684 202,164 3,581,871 416,694 714,500 157,323 3,199,446 662,822 551,687 168,623 2,874,328 1,286,623 403,262 164,555 2,332,948 1,664,854 294,140 152,077 1,402,859 1,844,560 169,022 94,783 635,805 1,767,488 101,682 129,725 284,404 1,912,891 57,572 303,354 4,725,765 66,695 658,417 216,138 3,829,836 84,525 495,051 165,215 3,482,112 141,186 363,831 170,503 3,280,266 267,914 274,354 138,637 2,793,139 338,555 191,383 70,242 1,932,538 363,694 103,814 53,787 1,047,438 328,760 39,412 44,415 465,988 380,121 28,186 50-54 years 55-59 years 60-64 years 65-69 years 70-74 years 75-79 years 80-84 years 85 years and over -53- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table J. Estimated population for ages 15 years and over, by 5-year age groups, marital status, race, and sex: United States, 1995 [Figures may be subject to large sampling variability. Figures include Armed Forces stationed in the United States and exclude those stationed outside the United States] Race, sex, and marital status American Indian, male Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . American Indian, female Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . Asian or Pacific Islander, male Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . Asian or Pacific Islander, female Never married . . . . . Married . . . . . . . . . . Widowed . . . . . . . . . Divorced . . . . . . . . . 10,239 177,853 17,575 21,544 3,507 136,391 16,157 19,759 2,130 98,592 36,410 17,158 6,213 84,827 39,890 5,836 2,713 50,379 44,085 4,122 1,759 25,076 33,461 1,755 3,916 10,587 19,212 2,957 18,683 6,939 182,835 1,250 11,935 5,546 141,898 1,863 8,571 4,065 112,177 2,121 3,727 1,788 85,898 8,333 2,105 6,772 60,604 8,020 2,109 2,580 34,521 8,334 23,859 2,407 2,210 9,670 2,275 5,068 29,950 9,711 3,811 3,147 23,681 5,138 6,074 784 15,634 7,907 6,621 1,814 10,843 10,522 2,297 837 7,516 7,228 5,242 4,162 2,499 6,377 1,741 2,437 7,590 60 10,178 1,720 37,235 977 4,974 3,289 24,960 1,006 4,922 1,712 19,752 646 4,977 15,595 1,582 4,132 855 10,821 2,378 2,523 3,417 6,793 2,203 4,133 3,346 1,459 50-54 years 55-59 years 60-64 years 65-69 years 70-74 years 75-79 years 80-84 years 85 years and over - Quantity zero. -54- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table K. Estimated population for ages 15 years and over, by 5-year age groups, marital status, specified Hispanic origin, race for non-Hispanic origin, and sex: Total of 49 States and the District of Columbia, 1995 [Figures may be subject to large sampling variability. Figures include Armed Forces stationed in the United States and exclude those stationed outside the United States] Hispanic origin, race for non-Hispanic origin, sex, and marital status Mexican, male Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Mexican, female Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Puerto Rican, male Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Puerto Rican, female Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . 381,157 504,684 73,505 104,311 88,517 2,096 44,689 5,446 75,968 30,619 1,126 3,478 45,798 69,279 5,042 34,808 75,260 829 14,851 26,400 71,154 2,050 19,669 21,252 64,426 3,108 17,177 15,225 64,314 3,193 9,706 352,630 428,958 17,600 68,187 81,264 46,075 2,309 72,249 14,628 2,016 47,956 41,501 2,540 35,726 60,257 6,150 29,008 72,807 12,670 14,880 54,520 15,123 9,564 47,801 8,986 1,527,024 3,270,290 316,760 396,077 397,750 16,313 222,502 49,763 1,030 338,783 365,743 703 18,291 213,449 511,615 3,663 31,561 135,568 539,485 4,430 52,118 79,024 453,673 8,781 73,856 43,925 364,736 10,153 62,180 26,901 271,323 15,657 42,029 2,322,825 3,297,451 97,547 357,424 457,701 4,766 2,058 295,170 14,340 603,495 250,615 3,599 446,087 459,330 34,963 233,563 572,445 3,866 70,119 153,949 480,813 3,890 56,433 64,788 417,848 1,393 50,526 30,410 313,727 4,244 47,059 15 years and over 15-17 years 18-19 years 20-24 years 25-29 years 30-34 years 35-39 years 40-44 years 45-49 years -55- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table K. Estimated population for ages 15 years and over, by 5-year age groups, marital status, specified Hispanic origin, race for non-Hispanic origin, and sex: Total of 49 States and the District of Columbia, 1995 [Figures may be subject to large sampling variability. Figures include Armed Forces stationed in the United States and exclude those stationed outside the United States] Hispanic origin, race for non-Hispanic origin, sex, and marital status Cuban, male Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Cuban, female Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Other Hispanic, male Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Other Hispanic, female Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . 652,747 1,152,917 155,806 216,890 138,608 2,453 647 96,065 9,687 283 150,142 79,230 162 6,056 87,517 138,913 403 14,284 55,678 212,729 1,748 24,226 33,588 178,841 5,534 44,980 28,225 160,235 2,190 37,525 14,084 114,654 8,844 31,949 811,525 1,052,273 20,520 108,327 137,554 786 204 90,555 2,493 195,234 46,322 2,880 151,429 104,886 7,283 109,091 177,503 14,720 58,023 170,945 699 13,827 27,421 151,462 24,744 14,241 118,370 474 12,916 85,168 266,532 66,612 64,993 20,684 11,199 417 317 15,642 12,810 2,712 5,958 21,520 5,469 6,385 33,535 4,095 2,857 34,489 7,749 1,122 29,803 3,275 6,245 3,595 34,845 2,459 5,777 127,649 275,402 15,165 46,410 18,460 8,374 29,216 7,043 20,293 19,810 3,977 8,986 32,399 3,663 17,857 28,346 8,108 5,421 26,224 6,218 5,160 24,246 385 5,352 15 years and over 15-17 years 18-19 years 20-24 years 25-29 years 30-34 years 35-39 years 40-44 years 45-49 years -56- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table K. Estimated population for ages 15 years and over, by 5-year age groups, marital status, specified Hispanic origin, race for non-Hispanic origin, and sex: Total of 49 States and the District of Columbia, 1995 [Figures may be subject to large sampling variability. Figures include Armed Forces stationed in the United States and exclude those stationed outside the United States] Hispanic origin, race for non-Hispanic origin, sex, and marital status White non-Hispanic, male Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . White non-Hispanic, female Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Black non-Hispanic, male Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Black non-Hispanic, female Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . 4,873,265 4,664,116 1,369,955 1,454,540 791,914 5,845 1,233 500,438 11,518 1,355 1,066,678 179,998 1,425 17,029 763,932 433,189 1,965 82,817 590,471 662,237 14,395 155,622 442,735 693,235 22,691 246,875 250,464 660,860 35,111 269,234 178,356 548,337 46,526 192,752 4,907,358 4,455,660 311,121 869,940 817,919 6,205 412 5,513 521,577 974 1,101,958 107,570 11,270 755,604 363,817 41,157 582,615 577,442 1,592 82,747 445,606 660,156 4,363 119,748 261,366 588,671 9,892 181,415 146,790 529,153 8,517 115,406 15,651,617 46,281,708 9,611,884 7,721,626 3,536,170 32,608 591 5,300 2,107,657 182,978 7,777 3,914,191 1,807,332 7,941 184,765 2,042,535 3,931,751 12,785 482,408 1,212,558 5,682,767 33,430 815,861 768,114 6,190,751 71,147 1,083,684 528,100 5,804,934 93,739 1,163,574 360,996 5,160,216 175,274 1,064,472 20,245,460 45,917,584 3,791,468 12,372 1,204 7,229 2,364,743 55,016 322 2,562 4,921,513 1,120,573 83,194 3,171,758 3,041,677 5,327 284,340 1,966,046 5,060,787 9,645 717,579 1,449,787 5,775,486 17,761 936,187 945,579 5,645,516 34,476 941,947 569,893 15 years and over 15-17 years 18-19 years 20-24 years 25-29 years 30-34 years 35-39 years 40-44 years 45-49 years 5,214,272 43,993 886,100 1,937,395 5,835,874 -57- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table K. Estimated population for ages 15 years and over, by 5-year age groups, marital status, specified Hispanic origin, race for non-Hispanic origin, and sex: Total of 49 States and the District of Columbia, 1995 [Figures may be subject to large sampling variability. Figures include Armed Forces stationed in the United States and exclude those stationed outside the United States] Hispanic origin, race for non-Hispanic origin, sex, and marital status Other non-Hispanic, male Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Other non-Hispanic, female Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . 1,110,439 2,386,733 299,185 256,594 232,766 2,501 2,417 138,648 5,746 297,934 109,426 2,012 3,027 228,728 228,818 7,286 74,581 377,255 7,829 35,580 53,086 393,806 5,369 26,281 33,765 358,167 5,296 44,247 10,519 284,324 15,319 1,396,459 2,060,114 54,000 164,061 244,585 1,542 142,916 4,455 358,637 46,344 802 278,624 149,892 2,692 11,413 168,659 276,226 1,125 18,839 90,900 310,852 506 32,374 55,942 289,723 36,315 21,431 271,561 2,390 20,277 15 years and over 15-17 years 18-19 years 20-24 years 25-29 years 30-34 years 35-39 years 40-44 years 45-49 years 46,243 -58- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table K. Estimated population for ages 15 years and over, by 5-Year age groups, marital status, race, and specified Hispanic origin, race for non-Hispanic origin, and sex: Total of 49 States and the District of Columbia, 1995 [Figures may be subject to large sampling variability. Figures include Armed Forces stationed in the United States and exclude those stationed outside the United States] Hispanic origin, race for non-Hispanic origin, sex, and marital status Mexican, male Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Mexican, female Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Puerto Rican, male Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Puerto Rican, female Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . 8,350 42,335 5,417 8,485 6,204 28,874 12,016 13,491 3,501 23,653 7,910 7,210 5,241 11,895 8,458 1,050 986 9,724 8,065 3,388 2,055 3,185 6,036 764 888 1,337 10,086 1,275 1,087 5,211 9,601 44,131 1,271 9,901 3,105 29,314 387 4,914 1,444 27,958 2,324 2,175 1,290 12,638 2,872 2,285 468 12,511 4,523 618 4,286 1,138 809 2,867 524 1,430 4,561 19,117 216,305 15,002 37,490 14,829 166,481 20,289 23,179 10,923 117,679 35,002 20,754 8,662 106,910 38,568 11,442 8,148 47,547 47,286 17,590 3,183 18,006 43,767 4,259 1,055 17,154 39,766 510 3,205 7,557 32,663 818 13,033 215,691 7,435 32,620 10,797 169,838 4,208 22,558 6,540 152,478 5,330 9,984 443 112,339 13,565 13,017 2,667 72,136 19,613 4,240 1,374 27,478 15,628 6,971 1,492 23,277 10,942 2,108 1,316 10,330 7,433 1,169 50-54 years 55-59 years 60-64 years 65-69 years 70-74 years 75-80 years 80-84 years 85 years and over -59- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table K. Estimated population for ages 15 years and over, by 5-Year age groups, marital status, race, and specified Hispanic origin, race for non-Hispanic origin, and sex: Total of 49 States and the District of Columbia, 1995 [Figures may be subject to large sampling variability. Figures include Armed Forces stationed in the United States and exclude those stationed outside the United States] Hispanic origin, race for non-Hispanic origin, sex, and marital status Cuban, male Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Cuban, female Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Other Hispanic, male Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Other Hispanic, female Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . 12,922 86,550 8,132 14,797 8,740 56,533 10,369 15,418 4,302 48,604 15,231 8,189 10,334 33,638 23,716 6,937 5,525 15,819 26,283 7,471 3,919 8,468 24,842 3,188 1,710 4,930 14,301 940 1,388 1,633 14,051 10,912 79,200 10,043 5,307 60,827 4,920 5,112 6,752 41,963 2,232 5,589 1,747 43,361 3,653 2,624 766 21,221 5,533 4,414 1,040 17,703 1,998 2,212 1,453 9,617 466 1,759 5,614 545 2,010 14,709 6,347 3,291 16,049 932 5,319 2,681 29,335 2,209 3,225 1,748 17,843 5,355 7,917 2,446 8,711 11,808 5,780 2,655 6,557 17,290 3,878 1,464 3,474 9,867 1,431 2,435 13,100 480 2,241 21,701 2,698 5,367 24,306 5,288 405 25,859 333 1,182 1,585 23,720 2,747 2,969 1,659 17,258 3,330 5,645 1,410 13,996 6,082 5,150 1,215 5,344 2,288 1,310 50-54 years 55-59 years 60-64 years 65-69 years 70-74 years 75-80 years 80-84 years 85 years and over -60- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table K. Estimated population for ages 15 years and over, by 5-Year age groups, marital status, race, and specified Hispanic origin, race for non-Hispanic origin, and sex: Total of 49 States and the District of Columbia, 1995 [Figures may be subject to large sampling variability. Figures include Armed Forces stationed in the United States and exclude those stationed outside the United States] Hispanic origin, race for non-Hispanic origin, sex, and marital status White non-Hispanic, male Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . White non-Hispanic, female Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Black non-Hispanic, male Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Black non-Hispanic, female Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . 75,195 394,359 90,194 169,182 62,307 341,342 115,516 90,957 52,547 266,416 149,294 73,729 35,516 207,257 188,306 76,135 29,585 143,074 191,525 39,544 10,524 73,496 200,401 21,079 10,295 29,678 154,083 12,100 12,308 13,275 157,290 6,130 100,207 368,346 12,048 109,319 55,756 342,800 14,311 65,935 46,579 268,571 37,299 55,880 19,504 245,912 74,146 37,643 17,247 185,192 43,243 27,031 20,022 108,401 47,074 12,865 5,714 58,578 33,353 3,779 8,894 43,872 24,871 232 230,024 4,129,325 252,262 825,342 170,109 3,286,163 372,870 645,286 135,542 2,950,324 602,457 500,702 144,467 2,684,533 1,201,982 373,951 149,188 2,215,955 1,555,852 257,351 141,215 1,344,292 1,735,208 156,523 87,966 606,109 1,677,545 98,240 122,785 271,670 1,818,801 56,390 265,431 4,319,697 191,875 3,509,268 150,639 3,196,765 165,098 3,060,082 132,961 2,635,630 66,643 1,837,941 50,033 991,877 41,993 440,625 50-54 years 55-59 years 60-64 years 65-69 years 70-74 years 75-80 years 80-84 years 85 years and over 57,619 598,845 73,973 455,883 128,368 343,804 242,289 254,767 302,201 171,442 339,713 93,266 316,175 33,805 364,329 24,924 -61- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table K. Estimated population for ages 15 years and over, by 5-Year age groups, marital status, race, and specified Hispanic origin, race for non-Hispanic origin, and sex: Total of 49 States and the District of Columbia, 1995 [Figures may be subject to large sampling variability. Figures include Armed Forces stationed in the United States and exclude those stationed outside the United States] Hispanic origin, race for non-Hispanic origin, sex, and marital status Other non-Hispanic, male Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . Other non-Hispanic, female Never married . . . . . . . Married . . . . . . . . . . . . Widowed . . . . . . . . . . . Divorced . . . . . . . . . . . 12,222 193,559 24,677 25,751 6,151 142,152 20,167 26,619 2,817 104,518 37,256 26,401 6,373 91,834 42,250 6,722 3,231 51,740 52,450 6,664 5,685 27,468 33,290 1,729 3,933 11,553 24,900 44 3,866 25,953 7,512 191,294 2,184 17,234 8,008 156,044 2,605 11,023 5,454 122,064 2,662 6,158 1,658 97,199 9,124 5,026 7,442 68,446 8,203 4,600 2,509 36,116 14,155 26,798 4,310 2,182 11,558 4,044 50-54 years 55-59 years 60-64 years 65-69 years 70-74 years 75-80 years 80-84 years 85 years and over - Quantity zero -62- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table L. Ratio of census-level resident population to resident population adjusted for estimated net census undercount by age, sex, and race: April 1, 1990 All races Age All ages . . . . . . . . . . . . . . . . Both sexes 0.9815 Male 0.9721 Female 0.9906 Both sexes 0.9802 White Male 0.9728 Female 0.9873 Both sexes 0.9432 Black Male 0.9151 Female 0.9699 Under 5 years . . . . . . . . . . . . . . Under 1 year . . . . . . . . . . . . . . 1-4 years . . . . . . . . . . . . . . . . . 0.9632 0.9686 0.9617 0.9634 0.9684 0.9621 0.9629 0.9689 0.9613 0.9677 0.9730 0.9664 0.9685 0.9734 0.9674 0.9669 0.9725 0.9654 0.9160 0.9239 0.9139 0.9139 0.9214 0.9119 0.9182 0.9264 0.9159 5-14 years . . . . . . . . . . . . . . . . . 5-9 years . . . . . . . . . . . . . . . . . 10-14 years . . . . . . . . . . . . . . . 0.9761 0.9649 0.9882 0.9768 0.9655 0.9891 0.9753 0.9642 0.9873 0.9740 0.9657 0.9830 0.9750 0.9665 0.9841 0.9730 0.9649 0.9818 0.9410 0.9241 0.9591 0.9402 0.9230 0.9586 0.9418 0.9252 0.9595 15-24 years . . . . . . . . . . . . . . . . 15-19 years . . . . . . . . . . . . . . . 20-24 years . . . . . . . . . . . . . . . 1.0081 1.0166 1.0002 1.0088 1.0198 0.9987 1.0073 1.0133 1.0017 1.0032 1.0094 0.9975 1.0053 1.0128 0.9985 1.0010 1.0059 0.9966 0.9789 0.9988 0.9593 0.9723 1.0016 0.9432 0.9855 0.9959 0.9753 25-34 years . . . . . . . . . . . . . . . . 25-29 years . . . . . . . . . . . . . . . 30-34 years . . . . . . . . . . . . . . . 0.9639 0.9591 0.9687 0.9463 0.9439 0.9487 0.9821 0.9748 0.9892 0.9614 0.9558 0.9669 0.9480 0.9441 0.9518 0.9755 0.9681 0.9828 0.9126 0.9123 0.9129 0.8666 0.8732 0.8599 0.9580 0.9510 0.9651 35-44 years . . . . . . . . . . . . . . . . 35-39 years . . . . . . . . . . . . . . . 40-44 years . . . . . . . . . . . . . . . 0.9842 0.9790 0.9901 0.9689 0.9628 0.9758 0.9996 0.9954 1.0044 0.9816 0.9764 0.9875 0.9700 0.9643 0.9764 0.9935 0.9888 0.9988 0.9350 0.9303 0.9410 0.8867 0.8808 0.8943 0.9810 0.9778 0.9850 45-54 years . . . . . . . . . . . . . . . . 45-49 years . . . . . . . . . . . . . . . 50-54 years . . . . . . . . . . . . . . . 0.9780 0.9775 0.9785 0.9628 0.9633 0.9623 0.9929 0.9916 0.9944 0.9772 0.9762 0.9784 0.9649 0.9648 0.9651 0.9894 0.9877 0.9914 0.9322 0.9302 0.9346 0.8805 0.8807 0.8802 0.9799 0.9762 0.9844 55-64 years . . . . . . . . . . . . . . . . 55-59 years . . . . . . . . . . . . . . . 60-64 years . . . . . . . . . . . . . . . 0.9824 0.9794 0.9854 0.9640 0.9609 0.9671 0.9995 0.9968 0.1002 0.9828 0.9801 0.9853 0.9684 0.9656 0.9712 0.9962 0.9941 0.9982 0.9545 0.9426 0.9675 0.8875 0.8790 0.8969 1.0138 0.9999 1.0287 -63- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table L. Ratio of census-level resident population to resident population adjusted for estimated net census undercount by age, sex, and race: April 1, 1990 All races Age 65-74 years . . . . . . . . . . . . . . . . 65-69 years . . . . . . . . . . . . . . . 70-74 years . . . . . . . . . . . . . . . Both sexes 0.9960 0.9980 0.9934 Male 0.9784 0.9776 0.9795 Female 1.0101 1.0152 1.0040 Both sexes 0.9935 0.9943 0.9926 White Male 0.9781 0.9762 0.9807 Female 1.0060 1.0096 1.0017 Both sexes 1.0211 1.0336 1.0049 Black Male 0.9704 0.9786 0.9589 Female 1.0596 1.0773 1.0376 75-84 years . . . . . . . . . . . . . . . . 75-79 years . . . . . . . . . . . . . . . 80-84 years . . . . . . . . . . . . . . . 1.0021 1.0082 0.9927 1.0046 1.0064 1.0015 1.0006 1.0094 0.9881 1.0038 1.0077 0.9978 1.0066 1.0065 1.0068 1.0021 1.0085 0.9931 0.9971 1.0258 0.9524 0.9913 1.0126 0.9547 1.0004 1.0337 0.9512 85 years and over . . . . . . . . . . . . 0.9411 0.9592 0.9342 0.9512 0.9696 0.9444 0.8503 0.8827 0.8373 SOURCE: Unpublished data from the U.S. Bureau of the Census. -64- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table M. Age-adjusted death rates for selected causes by race and sex, unadjusted and adjusted for estimated net census undercount: United States, 1990 [Based on age-specific death rates per 100,000 population in specified group. Age-adjusted death rates per 100,000 U.S. standard population. Numbers after causes of deaths are numbers of the Ninth Revision, International Classification of Diseases, 1975. Beginning 1987 includes category numbers *042-*044. See section "Cause of death"] Race, sex, and adjustment for net census undercount All races Both sexes: Unadjusted . . . . . Adjusted . . . . . . . Male: Unadjusted . . . . . Adjusted . . . . . . . Female: Unadjusted . . . . . Adjusted . . . . . . . White Both sexes: Unadjusted . . . . . Adjusted . . . . . . . Male: Unadjusted . . . . . Adjusted . . . . . . . Female: Unadjusted . . . . . Adjusted . . . . . . . Black Both sexes: Unadjusted . . . . . Adjusted . . . . . . . Male: Unadjusted . . . . . Adjusted . . . . . . . Female: Unadjusted . . . . . Adjusted . . . . . . . Human immunodeficiency virus infection (*042-*044) Malignant neoplasms, including neoplasms of lymphatic and hematopoietic tissues (140-208) Diseases of heart (390-398,402, 404-429) Homicide and legal intervention (E960-E978) All causes Diabetes mellitus (250) Cerebrovascular diseases (430-438) 520.2 512.7 680.2 664.3 390.6 387.9 9.8 9.6 17.7 17.0 2.1 2.1 135.0 133.3 166.3 162.4 112.7 112.6 11.7 11.5 12.3 12.1 11.1 11.0 152.0 149.9 206.7 202.1 108.9 107.9 27.7 27.3 30.2 29.6 25.7 25.4 10.2 10.1 16.3 15.9 4.2 4.2 492.8 485.9 644.3 631.0 369.9 367.0 8.0 7.8 15.0 14.4 1.1 1.0 131.5 129.9 160.3 156.9 111.2 110.8 10.4 10.2 11.3 11.1 9.5 9.5 146.9 145.0 202.0 198.2 103.1 102.2 25.5 25.2 27.7 27.3 23.8 23.5 5.9 5.7 8.9 8.7 2.8 2.7 789.2 760.0 1,061.3 980.8 581.6 579.4 25.7 23.9 44.2 39.0 9.9 9.7 182.0 177.0 248.1 230.9 137.2 138.4 24.8 24.1 23.6 21.9 25.4 25.7 213.5 207.2 275.9 256.7 168.1 168.2 48.4 46.9 56.1 52.3 42.7 42.7 39.5 37.4 68.7 62.9 13.0 12.7 -65- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table N. Lower and upper 95% and 96% confidence limit factors for a death rate based on a Poisson variable of 1 through 99 deaths, D or Dadj D or Dadj L(1- a =.96,D) or L(1- a =.96,Dadj) U(1- a =.96,D) or U(1- a =.96,Dadj) L(1- a=.95,D) U(1- a =.95,D) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 0.02532 0.12110 0.20622 0.27247 0.32470 0.36698 0.40205 0.43173 0.45726 0.47954 0.49920 0.51671 0.53246 0.54671 0.55969 0.57159 0.58254 0.59266 0.60207 0.61083 0.61902 0.62669 0.63391 0.64072 0.64715 0.65323 5.57164 3.61234 2.92242 2.56040 2.33367 2.17658 2.06038 1.97040 1.89831 1.83904 1.78928 1.74680 1.71003 1.67783 1.64935 1.62394 1.60110 1.58043 1.56162 1.54442 1.52861 1.51401 1.50049 1.48792 1.47620 1.46523 0.02020 0.10735 0.18907 0.25406 0.30591 0.34819 0.38344 0.41339 0.43923 0.46183 0.48182 0.49966 0.51571 0.53027 0.54354 0.55571 0.56692 0.57730 0.58695 0.59594 0.60435 0.61224 0.61966 0.62666 0.63328 0.63954 5.83392 3.75830 3.02804 2.64510 2.40540 2.23940 2.11666 2.02164 1.94553 1.88297 1.83047 1.78566 1.74688 1.71292 1.68289 1.65610 1.63203 1.61024 1.59042 1.57230 1.55563 1.54026 1.52602 1.51278 1.50043 1.48888 -66- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table N. Lower and upper 95% and 96% confidence limit factors for a death rate based on a Poisson variable of 1 through 99 deaths, D or Dadj D or Dadj L(1- a =.96,D) or L(1- a =.96,Dadj) U(1- a =.96,D) or U(1- a =.96,Dadj) L(1- a=.95,D) U(1- a =.95,D) 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 0.65901 0.66449 0.66972 0.67470 0.67945 0.68400 0.68835 0.69253 0.69654 0.70039 0.70409 0.70766 0.71110 0.71441 0.71762 0.72071 0.72370 0.72660 0.72941 0.73213 0.73476 0.73732 0.73981 0.74222 0.74457 0.74685 1.45495 1.44528 1.43617 1.42756 1.41942 1.41170 1.40437 1.39740 1.39076 1.38442 1.37837 1.37258 1.36703 1.36172 1.35661 1.35171 1.34699 1.34245 1.33808 1.33386 1.32979 1.32585 1.32205 1.31838 1.31482 1.31137 0.64549 0.65114 0.65652 0.66166 0.66656 0.67125 0.67575 0.68005 0.68419 0.68817 0.69199 0.69568 0.69923 0.70266 0.70597 0.70917 0.71227 0.71526 0.71816 0.72098 0.72370 0.72635 0.72892 0.73142 0.73385 0.73621 1.47805 1.46787 1.45827 1.44922 1.44064 1.43252 1.42480 1.41746 1.41047 1.40380 1.39743 1.39134 1.38550 1.37991 1.37454 1.36938 1.36442 1.35964 1.35504 1.35060 1.34632 1.34218 1.33818 1.33431 1.33057 1.32694 -67- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table N. Lower and upper 95% and 96% confidence limit factors for a death rate based on a Poisson variable of 1 through 99 deaths, D or Dadj D or Dadj L(1- a =.96,D) or L(1- a =.96,Dadj) U(1- a =.96,D) or U(1- a =.96,Dadj) L(1- a=.95,D) U(1- a =.95,D) 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 0.74907 0.75123 0.75334 0.75539 0.75739 0.75934 0.76125 0.76311 0.76492 0.76669 0.76843 0.77012 0.77178 0.77340 0.77499 0.77654 0.77806 0.77955 0.78101 0.78244 0.78384 0.78522 0.78656 0.78789 0.78918 0.79046 1.30802 1.30478 1.30164 1.29858 1.29562 1.29273 1.28993 1.28720 1.28454 1.28195 1.27943 1.27698 1.27458 1.27225 1.26996 1.26774 1.26556 1.26344 1.26136 1.25933 1.25735 1.25541 1.25351 1.25165 1.24983 1.24805 0.73851 0.74075 0.74293 0.74506 0.74713 0.74916 0.75113 0.75306 0.75494 0.75678 0.75857 0.76033 0.76205 0.76373 0.76537 0.76698 0.76856 0.77011 0.77162 0.77310 0.77456 0.77598 0.77738 0.77876 0.78010 0.78143 1.32342 1.32002 1.31671 1.31349 1.31037 1.30734 1.30439 1.30152 1.29873 1.29601 1.29336 1.29077 1.28826 1.28580 1.28340 1.28106 1.27877 1.27654 1.27436 1.27223 1.27014 1.26810 1.26610 1.26415 1.26223 1.26036 -68- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX Table N. Lower and upper 95% and 96% confidence limit factors for a death rate based on a Poisson variable of 1 through 99 deaths, D or Dadj D or Dadj L(1- a =.96,D) or L(1- a =.96,Dadj) U(1- a =.96,D) or U(1- a =.96,Dadj) L(1- a=.95,D) U(1- a =.95,D) 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 0.79171 0.79294 0.79414 0.79533 0.79649 0.79764 0.79876 0.79987 0.80096 0.80203 0.80308 0.80412 0.80514 0.80614 0.80713 0.80810 0.80906 0.81000 0.81093 0.81185 0.81275 1.24630 1.24459 1.24291 1.24126 1.23965 1.23807 1.23652 1.23499 1.23350 1.23203 1.23059 1.22917 1.22778 1.22641 1.22507 1.22375 1.22245 1.22117 1.21992 1.21868 1.21746 0.78272 0.78400 0.78525 0.78648 0.78769 0.78888 0.79005 0.79120 0.79233 0.79344 0.79453 0.79561 0.79667 0.79771 0.79874 0.79975 0.80074 0.80172 0.80269 0.80364 0.80458 1.25852 1.25672 1.25496 1.25323 1.25153 1.24987 1.24824 1.24664 1.24507 1.24352 1.24201 1.24052 1.23906 1.23762 1.23621 1.23482 1.23345 1.23211 1.23079 1.22949 1.22822 NOTE: Table N was generated using the SASŪ code below. Users can compute other level Confidence Intervals by changing the alpha-value. Table N is a modified version of Table 40 (52). -69- VITAL STATISTICS OF THE UNITED STATES: MORTALITY, 1995 TECHNICAL APPENDIX * Program to compute confidence intervals for expectations of Poisson variables ; * Specify alpha for alpha*100% Confidence Interval ; %let alpha = .95; data CI ; alo = (1-&alpha)/2 ; ahi = (&alpha+1)/2 ; do n = 1 to 99; L = Gaminv ( alo,n )/n ; U = Gaminv (ahi,n+1)/n ; output; end; proc print data= CI; var n L U ; run; -70-