The State of Mortality

For the last few days, in my spare time (HA HA HA HA ) I have been reviewing that document I mentioned to you a few posts ago - National (USA) Vital Statistics Reports, Volume 57 Number 14, which was published by the DHHS and others on April 17, 2009. When comparisons are made in the report they are from 2005 to 2006. This report is on mortality issues from 2006. The best race comparisons are blacks and whites. Though Hispanics, Asians and Pacific Islanders are included, the data collection and analysis is such that the information has to be interpreted with some caution. Therefore, I may not point out many of those discrepancies, but discrepancies do exist between both genders and all races. I am not finished reviewing the report, as I only found out about its existence in the last week, but have decided to get started with another multi parter. There are SO many directions to go with the information, so much to explore and to learn more about - which is why I should be working in one of those "think tanks" in Washington DC and not a community health education center - but alas - we are where we are....

Today I will do bullet points on some things that got a highlight out of me.

• In the USA there are 15 leading causes of (adult) death which kill over 80% of our population. The 15 causes are the same as in 2005 and 13 of them saw a decrease in deaths, with the two exceptions being unintentional injuries and kidney disease. There is a separate section on the definition and classification of unintentional injuries (accidents). To note, in 2006, over 2.4 million people died. Over half of those deaths were attributed to heart disease and cancer. In 2006, 28,527 infants died.
• Almost every age group had a decline in deaths from all cause EXCEPT for those aged 25-34. With some exploration, I may learn that those are also the ages of the persons dying from the unintentional injuries.
• The life expectancy for Americans continues to rise and some gaps are closing. The overall life expectancy or LE is 77.7 years, which is a very slight increase of .3 years. Interestingly, blacks LE increased more - .4 years. The difference between blacks and whites gets interesting when you factor in gender. Women out live men by about 5 years. When you break it down in that way, the longest living to shortest living are - white women, black women, white men, black men. But when you compare white women to black men the difference is, in my opinion, unacceptable and one of the issues that I want to spend more time exploring. Here are the numbers in the order just explained : 80.6, 76.5, 75.7, 69.7.
• LE at birth, which is described above, is different from LE from a certain age. In this document it explains that a person who has reached age 65 can expect to live 18.5 more years while a person who is 50 or was in 2006, could expect to live only 30.7 more years, and would actually die at a younger age. An 85 year old could live to 91. Pretty cool.
• Living longer does NOT mean the same as living with limited morbidity. The morbidity report is separate and usually the CDC releases weekly mortality and morbidity reports. But as has been said here many times, we need to compress the years of disease into the last five of life, not the last twenty, as is now the case. For today's children, the diseased years could out number the healthy ones.
• One of the reasons that the numbers for the Mexican, Cuba, Puerto Rican and other Hispanic speaking populations are not considered valid has to do with two concepts proposed in this document. Both regard migrant populations. One is that only the healthiest of these groups travel to the states for work etc - this is referred to as the "healthy migrant effect". The other is that many will return home to die if they become ill, which is referred to as the "salmon bias."
• Infant deaths are calculated per 1000 live births - infant meaning under age one. In 2006 a slight decrease was noted and the rate is 6.69. There are 10 leading causes of death in infants which are responsible for almost 70% of all infant deaths. The second one has to do with low birth weight which has many causes, including, exposure to tobacco smoke.

I think I will stop here for today. I do want to look at the age and or race specific disparities in death rates and type as well as some other causes of death, like alcohol, that were not in the top 15. Tobacco use is not singled out in this report, but do understand, tobacco use and obesity cause most of the deaths in this country - heart disease and cancer.