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Scientific Data Documentation
Linked Birth/Infant Death File, 1983-1984
Data Set Names (DSNs) for Linked Natality 83-84 files: CC36.NATAL83.LINK CC36.NATAL83.DENOM CC36.NATAL84.LINK CC36.NATAL84.DENOM ABSTRACT LINKED BIRTH/INFANT DEATH DATA SET: 1983,1984 BIRTH COHORTS Linked Birth/Infant Death (Numerator) File and Birth (Denominator) File Table of Contents 1. Introduction, Methodology, and Classification of Data. 2. Machine used, file and data characteristics. 3. List of data elements and locations. 4. Record layout and definition of items and codes. 5. County geographic codes available on the public-use file. 6. City geographic codes available on the public-use file. 7. Titles and codes for the 61 cause-of-death list. 8. Documentation tables 1-5. 9. Technical Appendix for the Natality file. 10. Technical Appendix for the 1983 Mortality file. 11. Technical Appendix for the 1984 Mortality file. 2Symbols Used in Tables SYMBOLS USED IN TABLES Symbol Explanation --- Data not available ... Category not applicable - Quantity zero 0.0 Quantity more than 0 but less than 0.05 * Figure does not meet standards of reliability or precision 1INTRODUCTION - DESCRIPTION OF DATA 21983 Birth Cohort The Linked birth/Infant Death Data Set consists of two separate data files. The first file includes linked records of live births and infant deaths for the 1983 birth cohort -- also referred to as the numerator file. The second file is the live birth file for 1983 -- referred to as the denominator file. The files are offered as a numerator/denominator data set to give users the means to compute infant mortality rates. The 1983 linked file is comprised of deaths to infants born in 1983 who died in 1983 or 1984 before their first birthday. Infant death records were extracted from the 1983 and 1984 National Center for Health Statistics (NCHS) mortality statistical files. Linked birth records were extracted from a denominator file that contained the 1983 NCHS natality statistical file, a small number of late-filed birth certificates, and certificates from selected States that were needed to match to an infant death record. Refer to the Methodology section for a more detailed explanation of records added to the statistical file. The denominator file is not identical with the NCHS natality statistical file. 21984 Birth Cohort The Linked birth/Infant Death Data Set consists of two separate data files. The first file includes linked records of live births and infant deaths for the 1984 birth cohort -- also referred to as the numerator file. The second file is the live birth file for 1984 -- referred to as the denominator file. The files are offered as a numerator/denominator data set to give users the means to compute infant mortality rates. The 1984 linked file is comprised of deaths to infants born in 1984 who died in 1984 or 1985 before their first birthday. Infant death records were extracted from the 1984 and 1985 National Center for Health Statistics (NCHS) mortality statistical files. Linked birth records were extracted from a denominator file that contained the 1984 NCHS natality statistical file, a small number of late-filed birth certificates, and certificates from selected States that were needed to match to an infant death record. Refer to the Methodology section for a more detailed explanation of records added to the statistical file. The denominator file is not identical with the NCHS natality statistical file. The linked file of live births and infant births includes linked records for births and deaths that occurred in the United States to U.S. residents and to U.S. nonresidents. Excluded are deaths that occurred outside the United States to infants born in the U.S.; deaths that occurred in the United States to foreign-born infants; and births and deaths that occurred outside the United States to U.S. residents. Sources for denominator data and for birth records included in the numerator file are described in detail in the 83/84 Technical Appendix from the Natality Annual Volume; sources for death records included in the numerator file are described in detail in the 1983/84/85 Technical Appendices, from the Mortality Annual Volumes. Copies of these Technical Appendices are included in this tape documentation. Because of confidentiality concerns, only those counties of 250,000 or more population and only those cities of 250,000 or more population are identified in this data set. The population counts are based on the results of the 1980 census. Users should refer to the geographic code outline in this document for the list of available areas and codes. In tabulations of linked data and denominator data, events occurring in the United States to U.S. nonresidents are included in tabulations that are by place of occurrence, and excluded from tabulations by place of residence. For linked data, these exclusions are based on the usual place of residence item of the Mother. This item is contained in both the denominator file and the birth section of the numerator (linked) file. U.S. nonresidents are identified by a code 4 in location 11 of these files. 1METHODOLOGY The methodology used to create the national file of linked birth and infant death records takes advantage of two existing data sources: 1. State linked files for the identification of linked birth and infant death certificates; and 2. NCHS natality and mortality computerized statistical files, the source of computer records for the two linked certificates. Virtually all States routinely link infant death certificates to their corresponding birth certificates for legal and statistical purposes. When the birth and death of an infant occur in different States, linking the two records that are filed in different jurisdictions requires State cooperation for the exchange of records. In accordance with the terms of the "Association for Vital Records Exchange System," copies of the records are exchanged by the State of death and State of birth in order to effect a link. In addition, if a third State is identified as the State of residence at the time of birth of death, that State is also sent a copy of the appropriate certificate by the State where the birth or death occurred. The NCHS natality and mortality files, produced annually, include statistical data from birth and death certificates that are provided to NCHS by States under the Vital Statistics Cooperative Program (VSCP). The data have been coded according to uniform coding specifications, have passed rigid quality control standards, have been edited and reviewed, and are the basis for official U.S. birth and death statistics. To initiate processing, NCHS obtained computerized linked files from States that had them and extracted only the birth and death certificate numbers for linked records and State and year of occurrence. The States of Alaska, Arizona, Delaware, Indiana, and Nevada provided linkage information by posting birth certificate numbers on a computer-generated list of infant death certificate numbers that was provided by NCHS. A file that contained only State-provided identifiers for linked certificates was then matched to the NCHS mortality and natality statistical files. Individual birth and death records were selected from their respective files and linked into a single statistical record, thereby establishing a national linked record file. After the initial linkage, NCHS returned to the States of death copies or computer lists of unlinked infant death certificates for follow-up linking. If the birth occurred in a State different from the State of death, the State of birth identified on the death certificate was contacted to obtain the linking birth certificate. If the linking birth certificate from another State had been renumbered, the State of death requested the original certificate number from the State of birth. If the linked birth certificate had been filed after NCHS closed its statistical files, States provided NCHS a copy of the late-filed birth certificate. These certificates were coded, keyed, processed, added to the denominator file and then linked to the infant death record. Approximately 100 late-filed records were added to the denominator. In addition to late-filed birth records, approximately 3,000 birth records were also added to the denominator file for the five registration areas that did not participate in the VSCP. These birth records were required for matching to death records, but their addition to the denominator file did not change the total occurrence count. In 1983, the District of Columbia and the four States of Arizona, California, Delaware, and Georgia did not participate in the VSCP. For these five areas, only 50 percent of the birth certificates (the even-numbered birth certificates) were coded for the natality file. Records for odd-numbered birth certificates that were linked to infant death certificates were added to the denominator file. For the five non-VSCP areas, the addition of odd-numbered birth records to the 50-percent sample of births in the denominator had implications for record weights and sample bias. Routinely, for non-VSCP States even-numbered birth records in the sample are assigned a record weight of 2 to represent two births. For the linked file project, odd-numbered birth records were assigned a record weight of 1, and added to the denominator file. To maintain the correct total occurrence count, record weights were adjusted from 2 to 1 fr the same number of even-numbered birth records. The odd-numbered birth records that were added to the denominator were not a random sample of birth records but rather a select sample of records for infants that died. To minimize the introduction of bias to the denominator, the record weight was adjusted on even-numbered records with a similar birth weight value. Birth weight was the criterion for selecting records for adjustment, because it is strongly correlated with infant death. Record-weight adjustment was implemented by ordering the denominator file by State of occurrence, birth weight, and record number. The record weight was then changed from a "2" to a "1" fo the first even-numbered birth record following an odd-numbered birth record in the birth weight sequence. The birth record in the denominator file includes an item in tape location 1 that identifies whether or not the record is linked to an infant death. This item is included in the denominator record for users who would want to identify individual records for which the infant died in the first year of life, or survived. 1DEMOGRAPHIC AND MEDICAL CLASSIFICATION The documents listed below describe in detail the procedures employed for demographic classification on both the birth and death records and medical classification on death records. While not absolutely essential to the proper interpretation of the data for a number of general applications, these documents should nevertheless be studied carefully prior to any detailed analysis of demographic or medical (especially multiple cause) data variables. In particular, there are a number of exceptions to the ICD rules in multiple cause-of-death coding which, if not treated properly, may result in faulty analysis of the data. A. Manual of the International Statistical Classification of Diseases, Injuries, and the Cause-of-Death, Ninth Revision, (ICD-9) Volumes 1 and 2. B. NCHS Instruction Manual Data Preparation Part 2a, Vital Statistics Instructions for Classifying the Underlying Cause-of-Death, 1983. C. NCHS Instruction Manual Data Preparation, Part 2b, Vital Statistics Instructions for Classifying Multiple Cause-of-Death, 1983. D. NCHS Instruction Manual Data Preparation, Part 2c, Vital Statistics ICD-9 ACME Decision Tables for Classifying Underlying Causes-of-Death, 1983. E. NCHS Instruction Manual Data Preparation, Part 2d, Vital Statistics NCHS Procedures for Mortality Medical Data System File Preparation and Maintenance, Effective 1979. F. NCHS Instruction Manual Data Tabulation, Part 2f, Vital Statistics ICD-9 TRANSAX Disease Reference Tables for Classifying Multiple Causes-of-Death, 1982-86. G. NCHS Instruction Manual Data Preparation, Part 3a, Vital Statistics Classification and Coding Instructions for Live Birth Records, 1983. H. NCHS Instruction Manual Data Preparation, Part 4, Vital Statistics Demographic Classification and Coding Instructions for Death Records, 1983. I. NCHS Instruction Manual Tabulation, Part 11, Vital Statistics Computer Edits for Mortality Data, Effective 1979. Volumes 1 and 2 of the ICD-9 may be purchased from WHO Publication Center USA, 49 Sheridan Avenue, Albany, New York, 12210. The remaining documents may be requested from the Chief, Data Preparation Branch, Division of Data Processing, National Center for Health Statistics, P. O. Box 12214, Research Triangle Park, North Carolina 27709. In addition, the user should refer to the Technical Appendices of the Vital Statistics of the United States for information on the source of data, coding procedures, quality of the data, etc. The Technical Appendices for natality and mortality are part of this documentation package. 1CAUSE-OF-DEATH DATA Mortality data are traditionally analyzed and published in terms of underlying cause-of-death. The underlying cause-of-death data are coded and classified as described in the 1983/84/85 Mortality Technical Appendices. NCHS has augmented underlying cause-of-death data with data on multiple causes reported on the death certificate. The linked file includes both underlying and multiple causes-of-death data. The multiple cause of death codes were developed with two objectives in mind. First, to facilitate etiological studies of the relationships among conditions, it was necessary to reflect accurately in coded form each condition and its location on the certification in the exact manner given by the certifier. Secondly, coding needed to be carried out in a manner by which the underlying cause-of-death could be assigned through computer applications. The approach was to suspend the linkage provisions of the ICD for the purpose of condition coding and code each entity with minimum regard to other conditions present on the certification. This general approach is hereafter called entity coding. Unfortunately, the set of multiple cause codes produced by entity coding is not conducive to a third objective -- the generation of person based multiple cause statistics. Person based analysis requires that each condition be coded within the context of every other condition on the same certificate and modified or linked to such conditions as provided by ICD-9. By definition, the entity data cannot meet this requirement since the linkage provisions distort the character and placement of the information originally recorded by the certifying physician. Since the two objectives are incompatible, NCHS has chosen to create from the original set of entity codes a new code set called record axis multiple cause data. Essentially, the axis of classification has been converted from an entity basis to a record (or person) basis. The record axis codes are assigned in terms of the set of codes that best describe the overall medical certification portion of the death certificate. This translation is accomplished by a computer system called TRANSAX (TRANSLATION OF AXIS) through selective use of traditional linkage and modification rules for mortality coding. Underlying cause linkages which simply prefer one code over another for purposes of underlying cause selection are not included. Each entity code on the record is examined and modified or deleted as necessary to create a set of codes which are free of contradictions and are the most precise within the constraints of ICD-9 and medical information on the record. Repetitive codes are deleted. The process may (1) combine two entity axis categories together to a new category thereby eliminating a contradiction or standardizing the data; or (2) eliminate one category in favor of another to promote specificity of the data or resolve contradictions. The following examples from ICD-9 illustrate the effect of this translation: Case 1: When reported on the same record as separate entities, cirrhosis of liver and alcoholism are coded to 5715 (cirrhosis of liver without mention of alcohol) and 303 (alcohol dependence syndrome). Tabulation of records with 5715 would on the surface falsely imply that such records had no mention of alcohol. A preferable codification would be 5712 (alcoholic cirrhosis of liver) in lieu of both 5715 and 303. Case 2: If "gastric ulcer" and "bleeding gastric ulcer" are reported on a record they are coded to 5319 (gastric ulcer, unspecified as acute or chronic, without mention of hemorrhage or perforation) and 5314 (gastric ulcer, chronic or unspecified, with hemorrhage). A more concise codification would be to code 5314 only since the 5314 shows both the gastric ulcer and the bleeding. A. Entity Axis Codes The original conditions coded for selection of the underlying cause-of-death are reformatted and edited prior to creating the public-use tape. The following paragraphs describe the format and application of entity axis data. FORMAT: Each entity-axis code is displayed as an overall seven byte code with subcomponents as follows: 1. Line indicator: The first byte represents the line of the certificate on which the code appears. Six lines (1-6) are allowable with the fourth and fifth denoting one or two written in "due to"s beyond the three lines provided in Part I of the U.S. standard death certificate. Line "6" represents Part II of the certificate. 2. Position indicator: The next byte indicates the position of the code on the line, i.e., it is the first (1), second (2), third (3),... eighth (8) code on the line. 3. Cause category: The next four bytes represent the ICD-9 cause code. 4. Nature of injury flag: ICD-9 uses the same series of numbers (800-999) to indicate nature of injury (N codes) and external cause codes (E codes). This flag distinguishes between the two with a one (1) representing nature of injury codes and a zero (0) representing all other cause codes. A maximum of 20 of these seven byte codes are captured on a record for multiple cause purposes. This may consist of a maximum of 8 codes on any given line with up to 20 codes distributed across three or more lines depending on where the subject conditions are located on the certificate. Codes may be omitted from one or more lines, e.g., line 1 with one or more codes, line 2 with no codes, line 3 with one or more codes. In writing out these codes, they are ordered as follows: line 1 first code, line 1 second code, etc. ----- line 2 first code, line 2 second code, etc. ----- line 3 ----- line 4 ----- line 5 ----- line 6. Any space remaining in the field is left blank. The specifics of locations are contained in the record layout given later in this document. EDIT: The original conditions are edited to remove invalid codes, reverify the coding of certain rare causes of death, and assure age/cause and sex/cause compatibility. Detailed information relating to the edit criteria and the sets of cause codes which are valid to underlying cause coding and multiple cause coding are provided in Part 11 of the NCHS Vital Statistics Instruction Manual Series. ENTITY AXIS APPLICATIONS: The entity axis multiple cause data is appropriate to analyses which require that each condition be coded as a stand alone entity without linkage to other conditions and/or require information on the placement of such conditions in the certificate. Within this framework, the entity data are appropriate to the examination of etiological relationships among conditions, accuracy of certification reporting, and the validity of traditional assumptions in underlying cause selection. Additionally, the entity data provide in certain categories a more detailed code assignment which is linked out in the creation of record axis data. Where such detail is needed for a study, the user should selectively employ entity data. Finally, the researcher may not wish to be bound by the assumptions used in the axis translation process preferring rather to investigate hypotheses of his own predilection. By definition, the main limitation of entity axis data is that an entity code does not necessarily reflect the best code for a condition when considered within the context of the medical certification as a whole. As a result certain entity codes can be misleading or even contradict other codes in the record. For example, category 5750 is titled "Acute cholecystitis without mention of calculus". Within the framework of entity codes this is interpreted to mean that the codable entity itself contained no mention of calculus rather than that calculus was not mentioned anywhere on the record. Tabulation of records with a "5750" as a count of persons having acute cholecystitis without mention of calculus would therefore be erroneous. This illustrates the fact that under entity coding the ICD-9 titles cannot be taken literally. The user must study the rules for entity coding as they relate to his/her research prior to utilization of entity data. The user is further cautioned that the inclusion notes in ICD-9 which relate to modifying and combining categories are seldom applicable to entity coding (except where provided in Part 2b of the Vital Statistics Instruction Manual Series). In tabulating the entity axis data, one may count codes with the resultant tabulation of an individual code representing the number of times the disease(s) represented by the code appears in the file. In this kind of tabulation of morbid condition prevalence, the counts among categories may be added together to produce counts for groups of codes. Alternatively, subject to the limitations given above, one may count persons having mention of the disease represented by a code or codes. In this instance it is not correct to add counts for individual codes to create person counts for groups of codes. Since more than one code in the researcher's interest may appear together on the certificate, totaling must account for higher order interactions among codes. Up to 20 codes may be assigned on a record; therefore, a 20-way interaction is theoretically possible. All totaling must be based on mention of one or more of the categories under investigation. B. Record Axis Codes The following paragraphs describe the format and application of record-axis data. Part 2f of the vital Statistics Instruction Manual Series describes the TRANSAX process for creating recode axis data from entity axis data. FORMAT: Each record (or person) axis code is displayed in five bytes. Location information is not relevant. The Code consists of the following components: 1. Cause category: The first four bytes represent the ICD-9 cause code. 2. Nature of injury flag: The last byte contains a 0 or 1 with the 1 indicating that the cause is a nature or injury category. Again, a maximum of 20 codes are captured on a record for multiple cause purposes. The codes are written in a 100-byte field in ascending code number (5 bytes) order with any unused bytes left blank. EDIT: The record axis codes are edited for rare causes and age/cause and sex/cause compatibility. Likewise, individual code validity is checked. The valid code set for record axis coding is the same as that for entity coding. RECORD AXIS APPLICATIONS: The record axis multiple cause data set is the basis for NCHS core multiple cause tabulations. Locations of codes is not relevant to this data set and conditions have been linked into the most meaningful categories for the certification. The most immediate consequence for the user is that the codes on the record already represent mention of a disease assignable to that particular ICD-9 category. This is in contrast to the entity code which is assigned each time such a disease is reported on two different lines of the certification. Secondly, the linkage implies that within the constraints of ICD-9 the most meaningful code has been assigned. The translation process creates for the user a data set which is edited for contradictions, duplicate codes, and imprecisions. In contrast to entity axis data, record axis data are classified in a manner comparable to underlying cause of death classification thereby facilitating joint analysis of these variables. Likewise, they are comparable to general morbidity coding where the linkage provisions of ICD-9 are usually utilized. A potential disadvantage of record axis data is that some detail is sacrificed in a number of the linkages. The user can take the record axis codes as literally representing the information conveyed in ICD-9 category titles. While knowledge of the rules for combining and linking and coding conditions is useful, it is not a prerequisite to meaningful analysis of the data as long as one is willing to accept the assumptions of the axis translation process. The user is cautioned, however, that due t special rules in mortality coding, not all linkage notes in ICD-9 are utilized. (See Part 2f of the Vital Statistics Instruction Manual Series.) The user should proceed with caution in using record axis data to count conditions as opposed to people with conditions since linkages have been invoked and duplicate codes have been eliminated. As with entity data, person based tabulations which combine individual cause categories must take into account the possible interaction of up to 20 codes on a single certificate. In using the NCHS multiple cause data, the user is urged to review the information in this document and its references. The instructional material does change from year to year and revision to revision. The user is cautioned that coding of specific ICD-9 categories should be checked in the appropriate instruction manual. What may appear on the surface to be the correct code by ICD-9 may in fact not be correct as given in the instruction manuals. If on the surface it is not obvious whether entity axis or record axis data should be employed in a given application, detailed examination of Part 2f of the Vital Statistics Instruction Manual Series and its attachments will probably provide the necessary information to make a decision. It allows the user to determine the extent of the trade-offs between the two sets of data in terms of specific categories and the assumptions of axis translation. In certain situations, a combination of entity and record axis data may be the more appropriate alternative. 1MACHINE/FILE/DATA CHARACTERISTICS I. 1983 Denominator File: DSN=CC36.NATAL83.DENOM Record count: 3,341,274 Data counts: a. By occurrence: 3,643,001 b. By residence: 3,639,113 c. To foreign residents: 3,888 II. 1983 Numerator File: DSN=CC36.NATAL83.LINK Record count: 39,704 Data counts: a. By occurrence: 39,704 b. By residence: 39,683 c. To foreign residents: 21 III. 1984 Denominator File: DSN=CC36.NATAL84.DENOM Record count: 3,364,090 Data counts: a. By occurrence: 3,673,693 b. By residence: 3,669,268 c. To foreign residents: 4,426 IV. 1984 Numerator File: DSN=CC36.NATAL84.LINK Record count: 38,314 Data counts: a. By occurrence: 38,314 b. By residence: 38,294 c. To foreign residents: 20 1LIST OF DATA ELEMENTS AND LOCATIONS Denominator Numerator File Data Items File Birth Death 1. General a. Match status 1 1 - b. Year of birth 2-5 2-5 - c. Year of death - - 194-197 d. Record type 0 10 198 e. Resident status 11 11 199 f. Record weight 91 91 - 2. Occurrence a. Region 12 12 200 b. Division 13 13 201 c. Expanded State 15-16 15-16 203-204 d. State 17-18 17-18 205-206 e. County 19-21 19-21 207-209 3. Residence a. Region 22 22 210 b. Division 23 23 211 c. Expanded State 25-26 25-26 213-214 d. State 27-28 27-28 215-216 e. County 29-31 29-31 217-219 f. City 32-34 32-34 220-222 4. Infant a. Race 36-37 36-37 - b. Sex 38 38 - c. Age - - 223-227 d. Gestation 39-42 39-42 - e. Birth weight 43-49 43-49 - f. Plurality 50 50 - g. Apgar score 51-54 51-54 - 5. Mother a. Origin or descent 55-56 55-56 - b. Race 57 57 - c. Age 58-61 58-61 - d. Education 62-64 62-64 - e. Marital Status 65 65 - f. State of birth 66-67 66-67 - 6. Father a. Origin or descent 68-69 68-69 - b. Race 70 70 - c. Age 71-72 71-72 - d. Education 73-74 73-74 - 7. Pregnancy items a. Interval since last live birth 75 75 - b. Outcome of last pregnancy 76 76 - c. Interval since last pregnancy 77 77 - d. Month prenatal care began 78-80 78-80 - e. Number of prenatal visits 81-82 81-82 - f. Total birth order 83-85 83-85 - g. Live birth order 86-88 86-88 - 8. Medical data a. Underlying cause - - 231-237 b. Multiple conditions - - 238-481 9. Other items a. Place of delivery 89 89 - b. Attendant at birth 90 90 - c. Hospital and patient status - - 228 d. Autopsy performed - - 229 e. Place of accident - - 230 1RECORD LAYOUT, DENOM RECORD & NATALITY SECTION OF LINKED RECORD 21. Match Status Tape Field Location Size Item and Code Outline 1 1 Match Status 1 ... Matched Birth/Infant Death Record 2 ... Late Filed Matched Birth/Infant Death Record 3 ... Surviving infant record 22-91. Birth Certificate Data 3General Information Locations 2-91 of the linked file contain data from the Birth Certificate. Residence items in the Denominator Record and in the natality section of the Numerator (Linked) Record refer to the usual place of residence of the Mother; whereas in the mortality section of the Numerator (Linked) Record, these items refer to the residence of the Decedent. 32-5. Year of Birth Tape Field Location Size Item and Code Outline 2-5 4 Year of Birth 1983 ... Born in 1983 1984 ... Born in 1984 36-9. Reserved Positions Tape Field Location Size Item and Code Outline 6-9 4 Reserved positions 310. Record Type Tape Field Location Size Item and Code Outline 10 1 Record Type 1 ... RESIDENTS State and County of Occurrence and Residence are the same. 2 ... NONRESIDENTS State and/or County of Occurrence and Residence are different. 311. Resident Status Tape Field Location Size Item and Code Outline 11 1 Resident Status 1 ...RESIDENTS State and County of Occurrence and Residence are the same. 2 ... INTRASTATE NONRESIDENTS State of Occurrence and Residence are the same, but County is different. 3 ... INTERSTATE NONRESIDENTS State of Occurrence and Residence are different, but both are in the U.S. 4 ... FOREIGN RESIDENTS State of Occurrence is one of the 50 States or the District of Columbia, but Place of Residence is outside of the U.S. 312-21. Place of Occurrence Tape Field Location Size Item and Code Outline 12-21 10 PLACE OF OCCURRENCE Refer to the Geographic Code Outline in this document for a list of areas and codes available on the public-use file. Tape Field Location Size Item and Code Outline 12 1 Region of Occurrence Tape Field Location Size Item and Code Outline 13-14 2 Division and State Subcode of Occurrence Location 12 is Region. Location 13 is Division and Location 14 identifies States within that Division. 1 ... NORTHEAST 1 ... New England 1 ... Maine 2 ... New Hampshire 3 ... Vermont 4 ... Massachusetts 5 ... Rhode Island 6 ... Connecticut 2 ... Middle Atlantic 1 ... New York 2 ... New Jersey 3 ... Pennsylvania 2 ... MIDWEST 3 ... East North Central 1 ... Ohio 2 ... Indiana 3 ... Illinois 4 ... Michigan 5 ... Wisconsin 4 ... West North Central 1 ... Minnesota 2 ... Iowa 3 ... Missouri 4 ... North Dakota 5 ... South Dakota 6 ... Nebraska 7 ... Kansas 3 ... SOUTH 5 ... South Atlantic 1 ... Delaware 2 ... Maryland 3 ... District of Columbia 4 ... Virginia 5 ... West Virginia 6 ... North Carolina 7 ... South Carolina 8 ... Georgia 9 ... Florida 6 ... East South Central 1 ... Kentucky 2 ... Tennessee 3 ... Alabama 4 ... Mississippi 7 ... West South Central 1 ... Arkansas 2 ... Louisiana 3 ... Oklahoma 4 ... Texas 4 ... WEST 8 ... Mountain 1 ... Montana 2 ... Idaho 3 ... Wyoming 4 ... Colorado 5 ... New Mexico 6 ... Arizona 7 ... Utah 8 ... Nevada 9 ... Pacific 1 ... Washington 2 ... Oregon 3 ... California 4 ... Alaska 5 ... Hawaii Tape Field Location Size Item and Code Outline 15-16 2 Expanded State of Occurrence This item is designed to separately identify New York city records from upstate New York records. 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... New York City 35 ... North Carolina 36 ... North Dakota 37 ... Ohio 38 ... Oklahoma 39 ... Oregon 40 ... Pennsylvania 41 ... Rhode Island 42 ... South Carolina 43 ... South Dakota 44 ... Tennessee 45 ... Texas 46 ... Utah 47 ... Vermont 48 ... Virginia 49 ... Washington 50 ... West Virginia 51 ... Wisconsin 52 ... Wyoming Tape Field Location Size Item and Code Outline 17-18 2 State of Occurrence Asterisk indicates data based on a 50% sample. Late filed birth certificates and certificates from 50-percent States that were needed to match to an infant death record, have been included in this data set. 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... North Carolina 35 ... North Dakota 36 ... Ohio 37 ... Oklahoma 38 ... Oregon 39 ... Pennsylvania 40 ... Rhode Island 41 ... South Carolina 42 ... South Dakota 43 ... Tennessee 44 ... Texas 45 ... Utah 46 ... Vermont 47 ... Virginia 48 ... Washington 49 ... West Virginia 50 ... Wisconsin 51 ... Wyoming Tape Field Location Size Item and Code Outline 19-21 3 County of Occurrence Because of confidentiality concerns, counties with a population less than 250,000 cannot be identified on the public-use file. 001-nnn ... Counties and county equivalents (independent and coextensive cities) are numbered alphabetically within each State. (Note: To uniquely identify a county, both the State and county codes must be used.) 999 ... County with less than 250,000 population 322-35. Place of Residence Tape Field Location Size Item and Code Outline 22-35 14 PLACE OF RESIDENCE Refer to the Geographic Code Outline in this document for a list of areas and codes available on the public-use file. 22 1 Region of Residence 23-24 2 Division and State Subcode of Residence Location 22 is Region. Location 23 is Division and Location 24 identifies States within that Division. 000 Foreign Resident 1 ... NORTHEAST 1 ... New England 1 ... Maine 2 ... New Hampshire 3 ... Vermont 4 ... Massachusetts 5 ... Rhode Island 6 ... Connecticut 2 ... Middle Atlantic 1 ... New York 2 ... New Jersey 3 ... Pennsylvania 2 ... MIDWEST 3 ... East North Central 1 ... Ohio 2 ... Indiana 3 ... Illinois 4 ... Michigan 5 ... Wisconsin 4 ... West North Central 1 ... Minnesota 2 ... Iowa 3 ... Missouri 4 ... North Dakota 5 ... South Dakota 6 ... Nebraska 7 ... Kansas 3 ... SOUTH 5 ... South Atlantic 1 ... Delaware 2 ... Maryland 3 ... District of Columbia 4 ... Virginia 5 ... West Virginia 6 ... North Carolina 7 ... South Carolina 8 ... Georgia 9 ... Florida 6 ... East South Central 1 ... Kentucky 2 ... Tennessee 3 ... Alabama 4 ... Mississippi 7 ... West South Central 1 ... Arkansas 2 ... Louisiana 3 ... Oklahoma 4 ... Texas 4 ... WEST 8 ... Mountain 1 ... Montana 2 ... Idaho 3 ... Wyoming 4 ... Colorado 5 ... New Mexico 6 ... Arizona 7 ... Utah 8 ... Nevada 9 ... Pacific 1 ... Washington 2 ... Oregon 3 ... California 4 ... Alaska 5 ... Hawaii 25-26 2 Expanded State of Residence This item is designed to separately identify New York City records from upstate New York records. 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... New York City 35 ... North Carolina 36 ... North Dakota 37 ... Ohio 38 ... Oklahoma 39 ... Oregon 40 ... Pennsylvania 41 ... Rhode Island 42 ... South Carolina 43 ... South Dakota 44 ... Tennessee 45 ... Texas 46 ... Utah 47 ... Vermont 48 ... Virginia 49 ... Washington 50 ... West Virginia 51 ... Wisconsin 52 ... Wyoming 53-58,60 ... Foreign Residents 53 ... Puerto Rico 54 ... Virgin Island 55 ... Guam 56 ... Canada 57 ... Cuba 58 ... Mexico 60 ... Remainder of the world Tape Field Location Size Item and Code Outline 27-28 2 State of Residence 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... North Carolina 35 ... North Dakota 36 ... Ohio 37 ... Oklahoma 38 ... Oregon 39 ... Pennsylvania 40 ... Rhode Island 41 ... South Carolina 42 ... South Dakota 43 ... Tennessee 44 ... Texas 45 ... Utah 46 ... Vermont 47 ... Virginia 48 ... Washington 49 ... West Virginia 50 ... Wisconsin 51 ... Wyoming 52-57,59 ... Foreign Residents 52 ... Puerto Rico 53 ... Virgin Island 54 ... Guam 55 ... Canada 56 ... Cuba 57 ... Mexico 59 ... Remainder of the world 29-31 3 County of Residence Because of confidentiality concerns, counties with a population less than 250,000 cannot be identified on the public-use file. 001-nnn ... Counties and county equivalents (independent and coextensive cities) are numbered alphabetically within each State. (Note: To uniquely identify a county, both the State and county codes must be used.) 999 ... County with less than 250,000 population ZZZ ... Foreign residents Tape Field Location Size Item and Code Outline 32-34 3 City of Residence Because of confidentiality concerns, cities with a population less than 250,000 cannot be identified on the public-use file. 001-nnn ... Cities are numbered alphabetically within each State. (Note: To uniquely identify a city, both the State and city codes must be used.) 999 ... Entire county, Balance of County, or city less than 250,000 population ZZZ ... Foreign residents 35 1 Reserved position 336. Detail Race of Child Tape Field Location Size Item and Code Outline 36 1 Detail Race of Child 1 ... White 2 ... Black 3 ... American Indian (includes Aleuts and Eskimos) 4 ... Chinese 5 ... Japanese 6 ... Hawaiian (includes Part-Hawaiian) 7 ... Filipino 8 ... Other Asian or Pacific Islander 0 ... Other races 337. Race of Child Recode 3 Tape Field Location Size Item and Code Outline 37 1 Race of Child Recode 3 1 ... White 2 ... Races other than White or Black 3 ... Black 338. Sex of Child Tape Field Location Size Item and Code Outline 38 1 Sex of Child 1 ... Male 2 ... Female 339-40. Detail Gestation in Weeks Tape Field Location Size Item and Code Outline 39-40 2 Detail Gestation in Weeks 17-52 ... 17th through 52nd week of gestation 99 ... Gestation not stated 341-42. Gestation Recode 10 Tape Field Location Size Item and Code Outline 41-42 2 Gestation Recode 10 01 ... Under 20 weeks 02 ... 20 - 27 weeks 03 ... 28 - 31 weeks 04 ... 32-35 weeks 05 ... 36 weeks 06 ... 37 - 39 weeks 07 ... 40 weeks 08 ... 41 weeks 09 ... 42 weeks and over 10 ... Gestation not stated 343-48. Birth Weight - Detail in Grams Tape Field Location Size Item and Code Outline 43-46 4 Birth weight - Detail in Grams 0227-8165 ... Number of grams 9999 ... Birth weight not stated 47-48 2 01 ... 499 grams or less 02 ... 500 - 749 grams 03 ... 750 - 999 grams 04 ... 1000 - 1249 grams 05 ... 1250 - 1499 grams 06 ... 1500 - 1999 grams 07 ... 2000 - 2499 grams 08 ... 2500 - 2999 grams 09 ... 3000 - 3499 grams 10 ... 3500 - 3999 grams 11 ... 4000 - 4499 grams 12 ... 4500 - 4999 grams 13 ... 5000 - 8165 grams 14 ... Birth weight not stated 349. Birth Weight Recode 3 Tape Field Location Size Item and Code Outline 49 1 Birth weight Recode 3 1 ... 2499 grams or less 2 ... 2500 grams or more 3 ... Birth weight not stated 350. Plurality - Detail Tape Field Location Size Item and Code Outline 50 1 Plurality - Detail 1 ... Single Birth 2 ... Twin 3 ... Other Multiple Births 351-52. One Minute Apgar Score Tape Field Location Size Item and Code Outline 51-52 2 One Minute Apgar Score 00-10 ... A score of 0-10 99 ... One minute Apgar score unknown or not stated 353-54. Five Minute Apgar Score Tape Field Location Size Item and Code Outline 53-54 2 Five Minute Apgar Score 00-10 ... A score of 0-10 99 ... Five minute Apgar score unknown or not stated 355-56. Origin or Descent of Mother Tape Field Location Size Item and Code Outline 55-56 2 Origin or Descent of Mother The Technical Appendix contains a table that shows which States report Detail Ethnicity (codes 01-24, 99), which States report Hispanic Origin or Descent (codes 00-05, 99), and which States do not report either item (code 88). 00 ... Non - Spanish 01 ... Mexican 02 ... Puerto Rican 03 ... Cuban 04 ... Central or South American 05 ... Other and Unknown Spanish 06 ... American 07 ... American Indian 08 ... British, Scottish, Welsh, Scotch-Irish 09 ... Irish 10 ... German 11 ... French 12 ... Norwegian, Swedish, Danish 13 ... Polish 14 ... Italian 15 ... Other North, Central and South American 16 ... Other Western European 17 ... Other Northern European 18 ... Other Eastern European 19 ... Other Southern European (excluding Spain) 20 ... Southeast Asian and Pacific Islander 21 ... South Central Asian 22 ... Other Asian 23 ... North African 24 ... Other African 88 ... Origin or descent of Mother not reported 99 ... Origin or descent of Mother not classifiable 357. Detail Race of Mother Tape Field Location Size Item and Code Outline 57 1 Detail Race of Mother 1 ... White 2 ... Black 3 ... American Indian (includes Aleuts and Eskimos) 4 ... Chinese 5 ... Japanese 6 ... Hawaiian (includes Part-Hawaiian) 7 ... Filipino 8 ... Other Asian or Pacific Islander 0 ... Other races 9 ... Race of Mother not stated 358-59. Detail Age of Mother Tape Field Location Size Item and Code Outline 58-59 2 Detail Age of Mother 10-49 ... Age in single years 360-61. Age of Mother Recode 12 Tape Field Location Size Item and Code Outline 60-61 2 Age of Mother Recode 12 01 ... Under 15 years 03 ... 15 years 04 ... 16 years 05 ... 17 years 06 ... 18 years 07 ... 19 years 08 ... 20 - 24 years 09 ... 25 - 29 years 10 ... 30 - 34 years 11 ... 35 - 39 years 12 ... 40 - 44 years 13 ... 45 - 49 years 362-63. Mother's Education - Detail Tape Field Location Size Item and Code Outline 62-63 2 Mother's Education - Detail 00 ... No formal education 01-08 ... Years of elementary school 09 ... 1 year of high school 10 ... 2 years of high school 11 ... 3 years of high school 12 ... 4 years of high school 13 ... 1 year of college 14 ... 2 years of college 15 ... 3 years of college 16 ... 4 years of college 17 ... 5 or more years of college 99 ... Mother's education not stated 364. Mother's Education Recode 6 Tape Field Location Size Item and Code Outline 64 1 Mother's Education Recode 6 1 ... 0 - 8 years 2 ... 9 - 11 years 3 ... 12 years 4 ... 13 - 15 years 5 ... 16 years and over 6 ... Mother's education not stated 365. Marital Status Tape Field Location Size Item and Code Outline 65 1 Marital Status 1 ... Married 2 ... Unmarried 366-67. Mother's Place of Birth Tape Field Location Size Item and Code Outline 66-67 2 Mother's Place of Birth 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... North Carolina 35 ... North Dakota 36 ... Ohio 37 ... Oklahoma 38 ... Oregon 39 ... Pennsylvania 40 ... Rhode Island 41 ... South Carolina 42 ... South Dakota 43 ... Tennessee 44 ... Texas 45 ... Utah 46 ... Vermont 47 ... Virginia 48 ... Washington 49 ... West Virginia 50 ... Wisconsin 51 ... Wyoming 52 ... Puerto Rico 53 ... Virgin Island 54 ... Guam 55 ... Canada 56 ... Cuba 57 ... Mexico 59 ... Remainder of the world 99 ... Mother's place of birth not classifiable 368-69. Origin or Descent of Father Tape Field Location Size Item and Code Outline 68-69 2 Origin or Descent of Father The Technical Appendix contains a table that shows which States report Detail Ethnicity (codes 01-24, 99), which States report Hispanic Origin or Descent (codes 00-05, 99), and which States do not report either item (code 88). 00 ... Non - Spanish 01 ... Mexican 02 ... Puerto Rican 03 ... Cuban 04 ... Central or South American 05 ... Other and Unknown Spanish 06 ... American 07 ... American Indian 08 ... British, Scottish, Welsh, Scotch-Irish 09 ... Irish 10 ... German 11 ... French 12 ... Norwegian, Swedish, Danish 13 ... Polish 14 ... Italian 15 ... Other North, Central and South American 16 ... Other Western European 17 ... Other Northern European 18 ... Other Eastern European 19 ... Other Southern European (excluding Spain) 20 ... Southeast Asian and Pacific Islander 21 ... South Central Asian 22 ... Other Asian 23 ... North African 24 ... Other African 88 ... Origin or descent of Father not reported 99 ... Origin or descent of Father not classifiable 370. Detail Race of Father Tape Field Location Size Item and Code Outline 70 1 Detail Race of Father 1 ... White 2 ... Black 3 ... American Indian (includes Aleuts and Eskimos) 4 ... Chinese 5 ... Japanese 6 ... Hawaiian (includes Part-Hawaiian) 7 ... Filipino 8 ... Other Asian or Pacific Islander 0 ... Other races 9 ... Race of Father not stated 371-72. Detail Age of Father Tape Field Location Size Item and Code Outline 71-72 2 Detail Age of Father 10-98 ... Age in single years 99 ... Age of Father not stated 373-74. Father's Education - Detail Tape Field Location Size Item and Code Outline 73-74 2 Father's Education - Detail 00 ... No formal education 01-08 ... Years of elementary school 09 ... 1 year of high school 10 ... 2 years of high school 11 ... 3 years of high school 12 ... 4 years of high school 13 ... 1 year of college 14 ... 2 years of college 15 ... 3 years of college 16 ... 4 years of college 17 ... 5 or more years of college 99 ... Father's education not stated 375. Interval Since Last Live Birth Tape Field Location Size Item and Code Outline 75 1 Interval Since Last Live Birth 0 ... Not applicable (no previous live birth) 1 ... Zero months (plural birth) 2 ... 1 - 11 months 3 ... 12 - 23 months 4 ... 24 - 35 months 5 ... 36 - 47 months 6 ... 48 - 71 months 7 ... 72 months and over 9 ... Interval since last live birth not stated 376. Outcome of Last Pregnancy Tape Field Location Size Item and Code Outline 76 1 Outcome of Last Pregnancy 0 ... Not applicable (no previous pregnancy) 1 ... Last pregnancy was a live birth 2 ... Last pregnancy was some other termination 9 ... Last pregnancy's outcome is unknown 377. Interval Since Termination of Last Pregnancy Tape Field Location Size Item and Code Outline 77 1 Interval Since Termination of Last Pregnancy 0 ... Not applicable (no previous pregnancy) 1 ... Zero months (plural delivery) 2 ... 1 - 11 months 3 ... 12 - 17 months 4 ... 18 - 23 months 5 ... 24 - 35 months 6 ... 36 - 47 months 7 ... 48 - 59 months 8 ... 60 months and over 9 ... Interval since termination of last pregnancy not stated 378-79. Detail Month of Pregnancy Prenatal Care Began Tape Field Location Size Item and Code Outline 78-79 2 Detail Month of Pregnancy Prenatal Care Began 01 ... 1st month 02 ... 2nd month 03 ... 3rd month 04 ... 4th month 05 ... 5th month 06 ... 6th month 07 ... 7th month 08 ... 8th month 09 ... 9th month 00 ... No prenatal care 99 ... Month of pregnancy prenantal care began not stated 380. Month of Pregnancy Prenatal Care Began Recode 6 Tape Field Location Size Item and Code Outline 80 1 Month of Pregnancy Prenatal Care Began Recode 6 1 ... 1st - 2nd month 2 ... 3rd month 3 ... 4th - 6th month 4 ... 7th - 9th month 5 ... No prenatal care 6 ... Month of pregnancy prenantal care began not stated 381-82. Total Number of Prenatal Visits Tape Field Location Size Item and Code Outline 81-82 2 Total Number of Prenatal Visits 00 ... No prenatal visits 01-49 ... Stated number of visits 99 ... Number of prenatal visits not stated 383-84. Detail Total Birth Order Tape Field Location Size Item and Code Outline 83-84 2 Detail Total Birth Order 01-50 ... Total number of live births and other terminations 99 ... Total birth order unknown or not stated 385. Total Birth Order Recode 9 Tape Field Location Size Item and Code Outline 85 1 Total Birth Order Recode 9 1 ... First Child 2 ... Second Child 3 ... Third Child 4 ... Fourth Child 5 ... Fifth Child 6 ... Sixth Child 7 ... Seventh Child 8 ... Eighth Child and over 9 ... Total birth order not stated 386-87. Detail Live Birth Order Tape Field Location Size Item and Code Outline 86-87 2 Detail Live Birth Order 01-50 ... Number of children ever born alive to mother 99 ... Live birth order unknown or not stated 388. Live Birth Order Recode 9 Tape Field Location Size Item and Code Outline 88 1 Live Birth Order Recode 9 1 ... First Child 2 ... Second Child 3 ... Third Child 4 ... Fourth Child 5 ... Fifth Child 6 ... Sixth Child 7 ... Seventh Child 8 ... Eighth Child and over 9 ... Live birth order not stated 389. Place of Delivery Tape Field Location Size Item and Code Outline 89 1 Place of Delivery 1 ... Hospital Births 2 ... Nonhospital Births 3 ... En route or born on arrival (BOA) 9 ... Place of delivery not classifiable 390. Attendant at Birth Tape Field Location Size Item and Code Outline 90 1 Attendant at Birth 1 ... Physician 2 ... Midwife 3 ... Attendant specified other than physician or midwife 9 ... Attendant at birth unknown 391. Record Weight Tape Field Location Size Item and Code Outline 91 1 Record Weight Numerator (Linked) record 1 ... All records contain a 1 Denominator record Each record contains a record weight that is used to inflate totals to national birth figures. 1-2 ... Code range The denominator record ends in location 91. 292-193. Reserved for Additional Data (Numerator (Linked) Record) Tape Field Location Size Item and Code Outline 92-193 102 These positions are contained in the Numerator (Linked) Record only and are reserved for possible additional data. If data are added in the future, they will be included in both files. The record length of the Denominator file would expand, but it is expected that the Numerator record would remain constant. 1RECORD LAYOUT, MORTALITY PART OF LINKED RECORD 2194-500. Death Certificate Data 3General Information Locations 194-500 contain data from the Death Certificate. Residence items in the Denominator Record and in the natality section of the Numerator (Linked) Record refer to the usual place of residence of the Mother; whereas in the mortality section of the Numerator (Linked) Record, these items refer to the residence of the Decedent. 3194-197. Year of Death Tape Field Location Size Item and Code Outline 194-197 4 Year of Death 1983 ... Death occurred in 1983 1984 ... Death occurred in 1984 1985 ... Death occurred in 1985 3198. Record Type Tape Field Location Size Item and Code Outline 198 1 Record Type 1 ... RESIDENTS State and County of Occurrence and Residence are the same. 2 ... NONRESIDENTS State and/or County of Occurrence and Residence are different. 3199. Resident Status Tape Field Location Size Item and Code Outline 199 1 Resident Status 1 ... RESIDENTS State and County of Occurrence and Residence are the same. 2 ... INTRASTATE NONRESIDENTS State of Occurrence and Residence are the same, but County is different. 3 ... INTERSTATE NONRESIDENTS State of Occurrence and Residence are different, but both are in the U.S. 4 ... FOREIGN RESIDENTS State of Occurrence is one of the 50 States or the District of Columbia, but Place of Residence is outside of the U.S. 3200-209. Place of Occurrence Tape Field Location Size Item and Code Outline 200-209 10 PLACE OF OCCURRENCE Refer to the Geographic Code Outline in this document for a list of areas and codes available on the public-use file. 200 1 Region of Occurrence 201-202 2 Division and State Subcode of Occurrence Location 200 is Region. Location 201 is Division and Location 202 identifies States within that Division. 1 ... NORTHEAST 1 ... New England 1 ... Maine 2 ... New Hampshire 3 ... Vermont 4 ... Massachusetts 5 ... Rhode Island 6 ... Connecticut 2 ... Middle Atlantic 1 ... New York 2 ... New Jersey 3 ... Pennsylvania 2 ... MIDWEST 3 ... East North Central 1 ... Ohio 2 ... Indiana 3 ... Illinois 4 ... Michigan 5 ... Wisconsin 4 ... West North Central 1 ... Minnesota 2 ... Iowa 3 ... Missouri 4 ... North Dakota 5 ... South Dakota 6 ... Nebraska 7 ... Kansas 3 ... SOUTH 5 ... South Atlantic 1 ... Delaware 2 ... Maryland 3 ... District of Columbia 4 ... Virginia 5 ... West Virginia 6 ... North Carolina 7 ... South Carolina 8 ... Georgia 9 ... Florida 6 ... East South Central 1 ... Kentucky 2 ... Tennessee 3 ... Alabama 4 ... Mississippi 7 ... West South Central 1 ... Arkansas 2 ... Louisiana 3 ... Oklahoma 4 ... Texas 4 ... WEST 8 ... Mountain 1 ... Montana 2 ... Idaho 3 ... Wyoming 4 ... Colorado 5 ... New Mexico 6 ... Arizona 7 ... Utah 8 ... Nevada 9 ... Pacific 1 ... Washington 2 ... Oregon 3 ... California 4 ... Alaska 5 ... Hawaii Tape Field Location Size Item and Code Outline 203-204 2 Expanded State of Occurrence This item is designed to separately identify New York city records from upstate New York records. 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... New York City 35 ... North Carolina 36 ... North Dakota 37 ... Ohio 38 ... Oklahoma 39 ... Oregon 40 ... Pennsylvania 41 ... Rhode Island 42 ... South Carolina 43 ... South Dakota 44 ... Tennessee 45 ... Texas 46 ... Utah 47 ... Vermont 48 ... Virginia 49 ... Washington 50 ... West Virginia 51 ... Wisconsin 52 ... Wyoming 205-206 2 State of Occurrence 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... North Carolina 35 ... North Dakota 36 ... Ohio 37 ... Oklahoma 38 ... Oregon 39 ... Pennsylvania 40 ... Rhode Island 41 ... South Carolina 42 ... South Dakota 43 ... Tennessee 44 ... Texas 45 ... Utah 46 ... Vermont 47 ... Virginia 48 ... Washington 49 ... West Virginia 50 ... Wisconsin 51 ... Wyoming 207-209 3 County of Occurrence Due to confidentiality requirements, counties with a population less than 250,000 cannot be identified on the public-use file. 001-nnn ... Counties and county equivalents (independent and coextensive cities) are numbered alphabetically within each State. (Note: To uniquely identify a county, both the State and county codes must be used.) 999 ... County with less than 250,000 population 3210-223. Place of Residence Tape Field Location Size Item and Code Outline 210-223 14 PLACE OF RESIDENCE Refer to the Geographic Code Outline in this document for a list of areas and codes available on the public-use file. 210 1 Region of Residence 211-212 2 Division and State Subcode of Residence Location 210 is Region. Location 211 is Division and Location 212 identifies States within that Division. 000 Foreign Resident 1 ... NORTHEAST 1 ... New England 1 ... Maine 2 ... New Hampshire 3 ... Vermont 4 ... Massachusetts 5 ... Rhode Island 6 ... Connecticut 2 ... Middle Atlantic 1 ... New York 2 ... New Jersey 3 ... Pennsylvania 2 ... MIDWEST 3 ... East North Central 1 ... Ohio 2 ... Indiana 3 ... Illinois 4 ... Michigan 5 ... Wisconsin 4 ... West North Central 1 ... Minnesota 2 ... Iowa 3 ... Missouri 4 ... North Dakota 5 ... South Dakota 6 ... Nebraska 7 ... Kansas 3 ... SOUTH 5 ... South Atlantic 1 ... Delaware 2 ... Maryland 3 ... District of Columbia 4 ... Virginia 5 ... West Virginia 6 ... North Carolina 7 ... South Carolina 8 ... Georgia 9 ... Florida 6 ... East South Central 1 ... Kentucky 2 ... Tennessee 3 ... Alabama 4 ... Mississippi 7 ... West South Central 1 ... Arkansas 2 ... Louisiana 3 ... Oklahoma 4 ... Texas 4 ... WEST 8 ... Mountain 1 ... Montana 2 ... Idaho 3 ... Wyoming 4 ... Colorado 5 ... New Mexico 6 ... Arizona 7 ... Utah 8 ... Nevada 9 ... Pacific 1 ... Washington 2 ... Oregon 3 ... California 4 ... Alaska 5 ... Hawaii 213-214 2 Expanded State of Residence This item is designed to separately identify New York City records from upstate New York records. 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... New York City 35 ... North Carolina 36 ... North Dakota 37 ... Ohio 38 ... Oklahoma 39 ... Oregon 40 ... Pennsylvania 41 ... Rhode Island 42 ... South Carolina 43 ... South Dakota 44 ... Tennessee 45 ... Texas 46 ... Utah 47 ... Vermont 48 ... Virginia 49 ... Washington 50 ... West Virginia 51 ... Wisconsin 52 ... Wyoming 53-58,60 ... Foreign Residents 53 ... Puerto Rico 54 ... Virgin Island 55 ... Guam 56 ... Canada 57 ... Cuba 58 ... Mexico 60 ... Remainder of the world Tape Field Location Size Item and Code Outline 215-216 2 State of Residence 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... North Carolina 35 ... North Dakota 36 ... Ohio 37 ... Oklahoma 38 ... Oregon 39 ... Pennsylvania 40 ... Rhode Island 41 ... South Carolina 42 ... South Dakota 43 ... Tennessee 44 ... Texas 45 ... Utah 46 ... Vermont 47 ... Virginia 48 ... Washington 49 ... West Virginia 50 ... Wisconsin 51 ... Wyoming 52-57,59 ... Foreign Residents 52 ... Puerto Rico 53 ... Virgin Island 54 ... Guam 55 ... Canada 56 ... Cuba 57 ... Mexico 59 ... Remainder of the world 217-219 3 County of Residence Due to confidentiality requirements, counties with a population less than 250,000 cannot be identified on the public-use file. 001-nnn ... Counties and county equivalents (independent and coextensive cities) are numbered alphabetically within each State. (Note: To uniquely identify a county, both the State and county codes must be used.) 999 ... County with less than 250,000 population ZZZ ... Foreign residents Tape Field Location Size Item and Code Outline 220-222 3 City of Residence Due to confidentiality requirements, cities with a population less than 250,000 cannot be identified on the public-use file. 001-nnn ... Cities are numbered alphabetically within each State. (Note: To uniquely identify a city, both the State and city codes must be used.) 999 ... Entire county, Balance of County, or city less than 250,000 population ZZZ ... Foreign residents 223-227. Age Tape Field Location Size Item and Code Outline 223-227 5 AGE Age is as computed using the dates of birth and death. For ages less than 2 days and when age could not be computed, the reported age from the death certificate was used. 223 1 Infant Age Recode 5 1 ... Under 1 hour 2 ... 1 - 23 hours 3 ... 1 - 6 days 4 ... 7 - 27 days (late neonatal) 5 ... 28 days and over (postneonatal) 224-225 2 Infant Age Recode 76 00 ... Less than 1 day 01-27 ... 1 - 27 days 28 ... 4th week 29 ... 5th week 30 ... 6th week 31-76 ... 7th - 52nd weeks Tape Field Location Size Item and Code Outline 226-227 2 Infant Age Recode 38 00 ... Less than 1 day 01-27 ... 1 - 27 days 28 ... 1 month 29 ... 2 months 30 ... 3 months 31 ... 4 months 32 ... 5 months 33 ... 6 months 34 ... 7 months 35 ... 8 months 36 ... 9 months 37 ... 10 months 38 ... 11 months 228. Hospital and Patient Status Tape Field Location Size Item and Code Outline 228 1 Hospital and Patient Status 1 ... Hospital, Clinic or Medical Center - Inpatient 2 ... Hospital, Clinic or Medical Center - Outpatient or admitted to Emergency Room 3 ... Hospital, Clinic or Medical Center - Dead on Arrival 4 ... Hospital, Clinic or Medical Center - Patient status unknown 5 ... Hospital, Clinic or Medical Center - Patient status not on certificate 6 ... Other Institution providing patient care 7 ... All other reported entries 8 ... Dead on Arrival - Hospital, Clinic or Medical Center name not given 9 ... Hospital and patient status not stated 229. Autopsy Performed Tape Field Location Size Item and Code Outline 229 1 Autopsy Performed 1 ... Yes 2 ... No 8 ... Autopsy performed not on certificate 9 ... Autopsy performed not stated 230. Place of Accident for Causes E850-E929 Tape Field Location Size Item and Code Outline 230 1 Place of Accident for Causes E850-E929 Blank ... Causes other than E850-E929 0 ... Home 1 ... Farm 2 ... Mine and Quarry 3 ... Industrial Place and Premises 4 ... Place for Recreation and Sport 5 ... Street and Highway 6 ... Public Building 7 ... Resident Institution 8 ... Other Specified Places 9 ... Place of accident not specified 231-237. Underlying Cause of Death Tape Field Location Size Item and Code Outline 231-237 7 UNDERLYING CAUSE OF DEATH 231-234 4 ICD Code (9th Revision) See the "International Classification of Diseases", 1975 Revision, Volume 1. For injuries and poisoning, the external cause is coded (E800-E999) rather than the Nature of Injury (800-999). These provisions do not include the Letter E for the external cause of injury. For those causes that do not have a 4th digit, Location 234 is blank. 235-237 3 61 Infant Cause Recode A recode of the ICD cause code into 61 groups for NCHS publications. Further back in this document is a complete list of recodes and the causes included. 010-680 ... Code range (not inclusive) 238-481. Multiple Conditions Tape Field Location Size Item and Code Outline 238-481 244 MULTIPLE CONDITIONS See the "International Classification of Diseases", 1975 Revision, Volume 1. Both the entity-axis and record-axis conditions are coded according to this revision (9th). 238-239 2 Number of Entity-Axis Conditions 00-20 ... Code range Tape Field Location Size Item and Code Outline 240-379 140 ENTITY - AXIS CONDITIONS Space has been provided for a maximum of 20 conditions. Each condition takes 7 positions in the record. Records that do not have 20 conditions are blank in the unused area. Position 1: Part/Line number on certificate 1 ... Part I, Line 1 (a) 2 ... Part I, Line 2 (b) 3 ... Part I, Line 3 (c) 4 ... Part I, Line 4 (d) 5 ... Part I, Line 5 (e) 6 ... Part II Position 2: Sequence of condition within part/line 1-7 ... Code range Position 3 - 6: Condition code (ICD 9th Revision) Position 7: Nature of Injury Flag 1 ... Indicates that the code in positions 3-6 is a Nature of Injury code 0 ... All other codes 240-246 7 1st Condition 247-253 7 2nd Condition 254-260 7 3rd Condition 261-267 7 4th Condition 268-274 7 5th Condition 275-281 7 6th Condition 282-288 7 7th Condition 289-295 7 8th Condition 296-302 7 9th Condition 303-309 7 10th Condition 310-316 7 11th Condition 317-323 7 12th Condition 324-330 7 13th Condition 331-337 7 14th Condition 338-344 7 15th Condition 345-351 7 16th Condition 352-358 7 17th Condition 359-365 7 18th Condition 366-372 7 19th Condition 373-379 7 20th Condition 380-381 2 Number of Record-Axis Conditions 00-20 ... Code range 382-481 100 RECORD - AXIS CONDITIONS Space has been provided for a maximum of 20 conditions. Each condition takes 5 positions in the record. Records that do not have 20 conditions are blank in the unused area. Position 1-4: Condition Code (ICD 9th Revision) Position 5: Nature of Injury Flag 1 ... Indicates that the code in positions 1-4 is a Nature of Injury code 0 ... All other codes 382-386 5 1st Condition 387-391 5 2nd Condition 392-396 5 3rd Condition 397-401 5 4th Condition 402-406 5 5th Condition 407-411 5 6th Condition 412-416 5 7th Condition 417-421 5 8th Condition 422-426 5 9th Condition 427-431 5 10th Condition 432-436 5 11th Condition 437-441 5 12th Condition 442-446 5 13th Condition 447-451 5 14th Condition 452-456 5 15th Condition 457-461 5 16th Condition 462-466 5 17th Condition 467-471 5 18th Condition 472-476 5 19th Condition 477-481 5 20th Condition 482-500. Reserved Positions Tape Field Location Size Item and Code Outline 482-500 19 Reserved positions GEOGRAPHIC CODE OUTLINE General Information The following pages show in detail the geographic codes used by the Division of Vital Statistics in the processing of vital event data occurring in the United States. For the linked data set, counties and cities with a population of 250,000 or more are identified. When an event occurs to a nonresident of the United States, residence data are coded only to the "State" level; several western hemisphere countries or the remainder of the world are uniquely identified. The vital statistics codes are effective with the 1982 data year and are based on results of the 1980 Census. To aid the user in interpreting the geographic codes, a brief explanation of the codes and of the column headings/abbreviations shown on the following pages are: State: Each State and the District of Columbia are numbered alphabetically. In addition, several unique codes are used to identify nonresidents of the U.S. County: Counties and county equivalents (independent and coextensive cities) are numbered alphabetically within each State. City: Cities are numbered alphabetically within each State. Name: Each State, county and city name is listed along with its respective code. In addition, places used to identify nonresidents of the U.S. are also listed along with their codes. Listing of Counties Identified in the Linked Data Set Listing of Counties Identified in the Linked Data Set Vital Statistics Geographic Code Outline Effective With 1982 Data State County State and County Name 01 Alabama 037 Jefferson 049 Mobile 02 Alaska 03 Arizona 007 Maricopa 010 Pima 04 Arkansas 060 Pulaski 05 California 001 Alameda 007 Contra Costa 010 Fresno 015 Kern 019 Los Angeles 027 Monterey 030 Orange 033 Riverside 034 Sacramento 036 San Bernardino 037 San Diego 038 San Francisco, coext. with San Francisco city 039 San Joaquin 041 San Mateo 042 Santa Barbara 043 Santa Clara 049 Sonoma 050 Stanislaus 056 Ventura 06 Colorado 003 Arapahoe 016 Denver, coext. with Denver city 021 El Paso 030 Jefferson State County State and County Name 07 Connecticut 001 Fairfield 002 Hartford 005 New Haven 08 Delaware 002 New Castle 09 District of Columbia 001 District of Columbia 10 Florida 005 Brevard 006 Broward 013 Dade 016 Duval 029 Hillsborough 048 Orange 050 Palm Beach 052 Pinellas 053 Polk 064 Volusia 11 Georgia 033 Cobb 044 DeKalb 060 Fulton 12 Hawaii 002 Honolulu 13 Idaho 14 Illinois 016 Cook 022 Du Page 045 Kane 049 Lake 082 St. Clair 099 Will 101 Winnebago State County State and County Name 15 Indiana 002 Allen 045 Lake 049 Marion 16 Iowa 077 Polk 17 Kansas 046 Johnson 087 Sedgwick 18 Kentucky 056 Jefferson 19 Louisiana 009 Caddo 017 East Baton Rouge 026 Jefferson 036 Orleans, coext. with New Orleans city 20 Maine 21 Maryland 002 Anne Arundel 003 Baltimore 004 Baltimore city 016 Montgomery 017 Prince George's 22 Massachusetts 003 Bristol 005 Essex 007 Hampden 009 Middlesex 011 Norfolk 012 Plymouth 013 Suffolk 014 Worcester State County State and County Name 23 Michigan 025 Genesee 033 Ingham 041 Kent 050 Macomb 063 Oakland 081 Washtenaw 082 Wayne 24 Minnesota 027 Hennepin 062 Ramsey 25 Mississippi 025 Hinds 26 Missouri 048 Jackson 096 St. Louis 097 St. Louis city 27 Montana 28 Nebraska 028 Douglas 29 Nevada 003 Clark 30 New Hampshire 006 Hillsborough 31 New Jersey 002 Bergen 003 Burlington 004 Camden 007 Essex 009 Hudson 011 Mercer 012 Middlesex 013 Monmouth 014 Morris 015 Ocean 016 Passaic 020 Union State County State and County Name 32 New Mexico 001 Bernalillo 33 New York 014 Erie 026 Monroe 028 Nassau 029 New York City 031 Oneida 032 Onondaga 034 Orange 040 Rockland 048 Suffolk 056 Westchester 34 North Carolina 041 Guilford 060 Mecklenburg 092 Wake 35 North Dakota 36 Ohio 009 Butler 018 Cuyahoga 025 Franklin 031 Hamilton 047 Lorain 048 Lucas 050 Mahoning 057 Montgomery 076 Stark 077 Summit 37 Oklahoma 055 Oklahoma 072 Tulsa 38 Oregon 020 Lane 026 Multnomah State County State and County Name 39 Pennsylvania 002 Allegheny 006 Berks 009 Bucks 015 Chester 023 Delaware 025 Erie 036 Lancaster 039 Lehigh 040 Luzerne 046 Montgomery 051 Philadelphia, coext. with Philadelphia city 065 Westmoreland 067 York 40 Rhode Island 004 Providence 41 South Carolina 010 Charleston 023 Greenville 040 Richland 42 South Dakota 43 Tennessee 019 Davidson 033 Hamilton 047 Knox 079 Shelby 44 Texas 015 Bexar 057 Dallas 071 El Paso 101 Harris 108 Hidalgo 123 Jefferson 178 Nueces 220 Tarrant 227 Travis 45 Utah 018 Salt Lake State County State and County Name 46 Vermont 47 Virginia 040 Fairfax 088 Norfolk city 127 Virginia Beach city 48 Washington 017 King 027 Pierce 031 Snohomish 032 Spokane 49 West Virginia 50 Wisconsin 013 Dane 041 Milwaukee 068 Waukesna 51 Wyoming State County State and County Name 52 ZZZ Puerto Rico 53 ZZZ Virgin Islands 54 ZZZ Guam 55 ZZZ Canada 56 ZZZ Cuba 57 ZZZ Mexico 59 ZZZ Remainder of world Listing of Cities Identified in the Linked Data Set Listing of Cities Identified in the Linked Data Set Vital Statistics Geographic Code Outline Effective With 1982 Data State City State and City Name 01 Alabama 008 Birmingham 02 Alaska 03 Arizona 011 Phoenix 016 Tucson 04 Arkansas 05 California 112 Long Beach 115 Los Angeles 146 Oakland 186 Sacramento 194 San Diego 197 San Francisco 200 San Jose 06 009 Colorado Denver 07 Connecticut 08 Delaware 09 District of Columbia 001 Washington 10 Florida 033 Jacksonville 047 Miami 086 Tampa 11 Georgia 004 Atlanta 12 Hawaii 004 Honolulu 13 Idaho 14 Illinois 032 Chicago State City State and City Name 15 Indiana 027 Indianapolis 16 Iowa 17 Kansas 033 Wichita 18 Kentucky 016 Louisville 19 Louisiana 024 New Orleans 20 Maine 21 Maryland 003 Baltimore 22 Massachusetts 012 Boston 23 Michigan 023 Detroit 24 Minnesota 035 Minneapolis 055 St. Paul 25 Mississippi 26 Missouri 026 Kansas City 044 St. Louis 27 Montana 28 Nebraska 011 Omaha 29 Nevada 30 New Hampshire State City State and City Name 31 New Jersey 094 Newark 32 New Mexico 002 Albuquerque 33 New York 009 Bronx borough, Bronx county 010 Buffalo 043 Brooklyn borough, King county 060 Manhattan borough, New York county 077 Queens borough, Queens county 078 Staten Island borough, Richmond county 34 North Carolina 008 Charlotte 35 North Dakota 36 Ohio 028 Cincinnati 030 Cleveland 032 Columbia 126 Toledo 37 Oklahoma 023 Oklahoma City 031 Tulsa 38 Oregon 023 Portland 39 Pennsylvania 096 Philadelphia 098 Pittsburgh 40 Rhode Island 41 South Carolina 42 South Dakota State City State and City Name 43 Tennessee 026 Memphis 030 Nashville-Davidson 44 Texas 009 Austin 036 Dallas 047 El Paso 052 Fort Worth 066 Houston 121 San Antonio 45 Utah 46 Vermont 47 Virginia 021 Norfolk 032 Virginia Beach 48 Washington 030 Seattle 49 West Virginia 50 Wisconsin 032 Milwaukee 51 Wyoming State City State and City Name 52 ZZZ Puerto Rico 53 ZZZ Virgin Islands 54 ZZZ Guam 55 ZZZ Canada 56 ZZZ Cuba 57 ZZZ Mexico 59 ZZZ Remainder of world NINTH REVISION - 61 CAUSES OF DEATH ADAPTED FOR USE BY DVS Ninth Revision - 61 Causes of Death Adapted for Use by DVS ST: 1 = Subtotal Limited: Sex: 1 = Males; 2 = Females Length = Of Cause Title Age: 1 = 5 & Over; 2 = 10-54; 3 = 28 Days & Over ***** Cause Subtotals are not Identified in this File ***** 61 Limited Recode ST Sex Age Length Cause Title and ICD-9 Codes Included 010 039 Certain intestinal infections (008-009) 020 020 Whopping cough (033) 030 029 Meningococcal infection (036) 040 3 016 Septicemia (038) 050 024 Viral diseases (045-079) 060 025 Conenital syphilis (090) 070 100 Remainder of infectious and parasitic diseases (001-007, 010-032, 034-035, 037, 039-041, 080-088, 091-139) 080 089 Malignant neoplasms, including neoplasms of lymphatic and hematopoietic tissues (140-208) 090 108 Benign neoplasms, carcinoma in situ, and neoplasms of uncertain behavior and of unspecified nature (210-239) 100 030 Diseases of thymus gland (254) 110 023 Cystic fibrosis (277.0) 120 052 Diseases of blood and blood-forming organs (280-289) 130 020 Meningitis (320-322) 140 059 Other diseases of nervous system and sense organs (323--389) 150 044 Acute upper respiratory infections (460-465) 160 042 Bronchitis and bronchiolitis (466, 490-491) 170 1 033 Pneumonia and influenza (480-487) 180 021 Pneumonia (480-486) 190 017 Influenza (487) 200 061 Remainder of diseases of respiratory system (470-478, 492-519) 210 093 Hernia of abdominal cavity and intestinal obstruction without mention of hernia (550-553, 560) 220 075 Gastritis, duodenitis, and noninfective enteritis and colitis (535, 555-558) 230 067 Remainder of diseases of digestive system (520-534, 536-543, 562-579) 240 1 030 Congenital anomalies of (740-759) 250 042 Anencephalus and similar anomalies (740) 260 020 Spina bifida (741) 270 034 Congenital; hydrocephalus (742.3) 280 092 Other congenital anomalies of central nervous system and eye (742.0-742.2, 742.4-742.9, 743) 290 041 Congenital anomalies of heart (745-746) 300 056 Other congenital anomalies of circulatory system (747) 310 050 Congenital anomalies of respiratory system (748) 320 052 Congenital anomalies of digestive system (749-751) 330 056 Congenital anomalies of genitourinary system (752-753) 340 058 Congenital anomalies of musculoskeletal system (754-756) 350 025 Down's syndrome (758.0) 360 043 Other chromosomal anomalies (758.1-758.9) 370 062 All other and unspecified congenital anomalies (744, 757, 759) 380 1 064 Certain conditions originating in the perinatal period (760-779) 390 091 Newborn affected by maternal conditions which may be unrelated to present pregnancy (760) 400 063 Newborn affected by maternal complications of pregnancy (761) 410 074 Newborn affected by complications of placenta, cord, and membranes (762) 420 069 Newborn affected by other complications of labor and delivery (763) 430 048 Slow fetal growth and fetal malnutrition (764) 440 077 Disorders relating to short gestation and unspecified low birthweight (765) 450 065 Disorders relating to long gestation and unspecified high birthweight (766) 460 020 Birth trauma (767) 470 047 Intrauterine hypoxia and birth asphyxia (768) 480 051 Fetal distress in liveborn infant (768.2-768.4) 490 032 Birth asphyxia (768.5-768.9) 500 037 Respiratory distress syndrome (769) 510 047 Other respiratory conditions of newborn (770) 520 051 Infections specific to the perinatal period (771) 530 027 Neonatal hemorrhage (772) 540 094 Hemolytic disease of newborn, due to isoimmunization, and other perinatal jaundice (773-774) 550 088 Syndrome of "infant of a diabetic mother" and neonatal diabetes mellitus (775.0-775.1) 560 040 Hemorrhagic disease of newborn (776.0) 570 098 All other and ill-defined conditions originating in the perinatal period (775.2-775.9, 776.1-779) 580 1 053 Symptoms, signs, and ill-defined conditions (780-799) 590 038 Sudden infant death syndrome (798.0) 600 075 Symptoms, signs, and all other ill-defined conditions (780-797, 798.1-799) 610 1 041 Accidents and adverse effects (E800-E949) 620 118 Inhalation and ingestion of food or other object causing obstruction of respiratory tract or suffocation (E911-E912) 630 042 Accidental mechanical suffocation (E913) 640 067 Other accidental causes and adverse effects (E800-E910, E914-E949) 650 1 020 Homicide (E960-E969) 660 047 Child battering and other maltreatment (E967) 670 038 Other homicide (E960-E966, E968-E969) 680 027 All other causes (Residual) CONTROL (DOCUMENTATION) TABLES 1983 Documentation Tables 1. Live Births/Infant Deaths by State of Occurrence/Residence 1983 DOCUMENTATION TABLE 1 LIVE BIRTHS BY STATE OF OCCURRENCE AND BY STATE OF RESIDENCE AND INFANT DEATHS BY STATE OF OCCURRENCE AND BY STATE OF RESIDENCE (RESIDENCE AT BIRTH IS OF THE MOTHER; RESIDENCE AT DEATH IS OF THE DECEDENT) LIVE BIRTHS AREA OCCURRENCE RESIDENCE UNITED STATES ......................... 3,643,001 3,639,113 ALABAMA .................................. 58,106 59,064 ALASKA ................................... 11,868 11,998 ARIZONA .................................. 53,426 53,745 ARKANSAS ................................. 34,265 34,999 CALIFORNIA ............................... 436,096 436,144 COLORADO ................................. 55,015 54,662 CONNECTICUT .............................. 40,954 41,097 DELAWARE ................................. 9,546 9,232 DISTRICT OF COLUMBIA ..................... 19,078 9,332 FLORIDA .................................. 148,677 149,083 GEORGIA .................................. 91,712 90,031 HAWAII ................................... 19,164 19,122 IDAHO .................................... 18,481 18,749 ILLINOIS ................................. 175,648 178,886 INDIANA .................................. 80,815 80,816 IOWA ..................................... 43,840 43,262 KANSAS ................................... 39,409 40,400 KENTUCKY ................................. 53,855 54,702 LOUISIANA ................................ 82,455 82,515 MAINE .................................... 16,048 16,667 MARYLAND ................................. 57,936 63,956 MASSACHUSETTS ............................ 77,834 76,161 MICHIGAN ................................. 131,879 133,160 MINNESOTA ................................ 65,976 65,564 MISSISSIPPI .............................. 43,689 44,000 MISSOURI ................................. 77,065 75,602 MONTANA .................................. 13,739 14,063 NEBRASKA ................................. 26,599 26,232 NEVADA ................................... 14,166 14,312 NEW HAMPSHIRE ............................ 13,680 13,801 NEW JERSEY ............................... 96,152 99,218 NEW MEXICO ............................... 27,122 27,618 NEW YORK ................................. 249,382 248,617 UPSTATE ................................ 137,136 140,011 CITY ................................... 112,246 108,606 NORTH CAROLINA ........................... 84,577 83,894 NORTH DAKOTA ............................. 13,197 12,380 OHIO ..................................... 159,299 158,770 OKLAHOMA ................................. 55,427 56,903 OREGON ................................... 41,047 39,978 PENNSYLVANIA ............................. 159,423 158,206 RHODE ISLAND ............................. 13,092 12,595 SOUTH CAROLINA ........................... 48,484 50,759 SOUTH DAKOTA ............................. 12,517 12,528 TENNESSEE ................................ 70,159 65,480 TEXAS .................................... 299,658 295,527 UTAH ..................................... 40,613 39,474 VERMONT .................................. 7,741 7,954 VIRGINIA ................................. 77,512 80,737 WASHINGTON ............................... 68,703 68,680 WEST VIRGINIA ............................ 26,872 25,882 WISCONSIN ................................ 72,132 72,558 WYOMING .................................. 9,501 10,268 FOREIGN RESIDENTS ........................ ... 3,888 INFANT DEATHS AT BIRTH AT DEATH AREA OCCURRENCE RESIDENCE OCCURRENCE RESIDENCE UNITED STATES ............ 39,704 39,683 39,704 39,684 ALABAMA ..................... 748 767 777 770 ALASKA ...................... 139 143 125 140 ARIZONA ..................... 503 503 503 504 ARKANSAS .................... 325 360 332 364 CALIFORNIA .................. 4,142 4,149 4,157 4,150 COLORADO .................... 546 544 575 546 CONNECTICUT ................. 423 410 421 417 DELAWARE .................... 99 98 101 98 DISTRICT OF COLUMBIA ........ 298 159 332 157 FLORIDA ..................... 1,756 1,769 1,764 1,766 GEORGIA ..................... 1,203 1,172 1,189 1,174 HAWAII ...................... 180 179 178 176 IDAHO ....................... 194 195 166 198 ILLINOIS .................... 2,148 2,212 2,098 2,201 INDIANA ..................... 925 911 904 915 IOWA ........................ 379 382 360 379 KANSAS ...................... 399 404 360 408 KENTUCKY .................... 607 639 588 642 LOUISIANA ................... 1,047 1,038 1,031 1,030 MAINE ....................... 142 148 139 149 MARYLAND .................... 632 726 602 724 MASSACHUSETTS ............... 688 671 724 672 MICHIGAN .................... 1,516 1,540 1,516 1,540 MINNESOTA ................... 634 633 668 633 MISSISSIPPI ................. 627 639 604 641 MISSOURI .................... 841 803 929 799 MONTANA ..................... 118 127 99 123 NEBRASKA .................... 272 264 269 261 NEVADA ...................... 158 153 155 155 NEW HAMPSHIRE ............... 101 120 85 120 NEW JERSEY .................. 1,044 1,096 967 1,085 NEW MEXICO .................. 261 271 251 269 NEW YORK ..................... 2,720 2,695 2,760 2,701 UPSTATE .................... 1,327 1,346 1,302 1,355 CITY ....................... 1,393 1,349 1,458 1,346 NORTH CAROLINA ............... 1,101 1,090 1,108 1,095 NORTH DAKOTA ................. 129 119 127 116 OHIO ......................... 1,782 1,768 1,784 1,765 OKLAHOMA ..................... 593 597 581 588 OREGON ....................... 410 395 414 394 PENNSYLVANIA ................. 1,689 1,663 1,715 1,673 RHODE ISLAND ................. 169 155 162 154 SOUTH CAROLINA ............... 723 749 722 752 SOUTH DAKOTA ................. 143 141 139 142 TENNESSEE .................... 913 828 940 823 TEXAS ........................ 3,149 3,127 3,148 3,123 UTAH ......................... 366 346 403 350 VERMONT ...................... 67 67 63 69 VIRGINIA ..................... 923 968 909 972 WASHINGTON ................... 675 681 707 695 WEST VIRGINIA ................ 280 273 300 272 WISCONSIN .................... 705 708 699 707 WYOMING ...................... 72 88 54 87 FOREIGN RESIDENTS ............ ... 21 ... 20 2. Live Births/Infant Deaths/Mort. Rates by Race,Sex,Birth Wt. 1983 DOCUMENTATION TABLE 2 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY RACE OF CHILD, SEX, AND BIRTH WEIGHT: UNITED STATES 1983 BIRTH COHORT (RATES ARE PER 1000 LIVE BIRTHS) 500 500-749 750-999 1000-1249 RACE OF CHILD AND SEX TOTAL GRAMS GRAMS GRAMS GRAMS ALL RACES1 BOTH SEXES LIVE BIRTHS 3,639,113 4,444 7,594 9,004 10,193 INFANT DEATHS 39,683 3,937 5,815 3,762 2,145 INF. MORT. RATE 10.9 885.9 765.7 417.8 210.4 MALE LIVE BIRTHS 1,865,887 2,243 3,911 4,706 5,292 INFANT DEATHS 22,480 1,972 3,153 2,245 1,375 INF. MORT. RATE 12.0 879.2 806.2 477.1 259.8 FEMALE LIVE BIRTHS 1,773,226 2,201 3,683 4,298 4,901 INFANT DEATHS 17,203 1,965 2,662 1,517 770 INF. MORT. RATE 9.7 892.8 722.8 353.0 157.1 WHITE BOTH SEXES LIVE BIRTHS 2,904,381 2,577 4,492 5,593 6,456 INFANT DEATHS 27,094 2,295 3,549 2,476 1,545 INF. MORT. RATE 9.3 890.6 790.1 442.7 239.3 MALE LIVE BIRTHS 1,492,585 1,273 2,344 2,957 3,373 INFANT DEATHS 15,454 1,115 1,934 1,493 985 INF. MORT. RATE 10.4 875.9 825.1 504.9 292.0 FEMALE LIVE BIRTHS 1,411,796 1,304 2,148 2,636 3,083 INFANT DEATHS 11,640 1,180 1,615 983 560 INF. MORT. RATE 8.2 904.9 751.9 372.9 181.6 BLACK BOTH SEXES LIVE BIRTHS 586,085 1,749 2,874 3,146 3,393 INFANT DEATHS 11,087 1,534 2,114 1,167 526 INF. MORT. RATE 18.9 877.1 735.6 370.9 155.0 MALE LIVE BIRTHS 297,130 911 1,438 1,615 1,741 INFANT DEATHS 6,205 802 1,133 680 341 INF. MORT. RATE 20.9 880.4 787.9 421.1 195.9 FEMALE LIVE BIRTHS 288,955 838 1,436 1,531 1,652 INFANT DEATHS 4,882 732 981 487 185 INF. MORT. RATE 16.9 873.5 683.1 318.1 112.0 1 INCLUDES RACES OTHER THAN WHITE AND BLACK. 1250-1499 1500-1999 2000-2499 2500 GRAMS NOT RACE OF CHILD AND SEX GRAMS GRAMS GRAMS OR MORE STATED ALL RACES1 BOTH SEXES LIVE BIRTHS 12,049 47,325 157,209 3,385,912 5,383 INFANT DEATHS 1,378 2,688 3,438 15,357 1,163 INF. MORT. RATE 114.4 56.8 21.9 4.5 216.1 MALE LIVE BIRTHS 6,198 23,296 71,075 1,746,353 2,814 INFANT DEATHS 839 1,490 1,816 8,925 665 INF. MORT. RATE 135.4 64.0 25.6 5.1 235.4 FEMALE LIVE BIRTHS 5,851 24,029 86,134 1,639,559 2,570 INFANT DEATHS 539 1,198 1,622 6,432 498 INF. MORT. RATE 92.1 49.9 18.8 3.9 193.8 WHITE BOTH SEXES LIVE BIRTHS 7,877 31,313 106,212 2,735,714 4,147 INFANT DEATHS 1,026 1,910 2,406 11,155 732 INF. MORT. RATE 130.3 61.0 22.7 4.1 176.5 MALE LIVE BIRTHS 4,132 15,695 48,381 1,412,266 2,164 INFANT DEATHS 635 1,087 1,267 6,499 439 INF. MORT. RATE 153.7 69.3 26.2 4.6 202.9 FEMALE LIVE BIRTHS 3,745 15,618 57,831 1,323,448 1,983 INFANT DEATHS 391 823 1,139 4,656 293 INF. MORT. RATE 104.4 52.7 19.7 3.5 147.8 BLACK BOTH SEXES LIVE BIRTHS 3,750 14,362 44,379 511,416 1,016 INFANT DEATHS 308 673 892 3,485 388 INF. MORT. RATE 82.1 46.9 20.1 6.8 381.9 MALE LIVE BIRTHS 1,836 6,757 19,601 262,687 544 INFANT DEATHS 177 352 472 2,041 207 INF. MORT. RATE 96.4 52.1 24.1 7.8 380.5 FEMALE LIVE BIRTHS 1,914 7,605 24,778 248,729 472 INFANT DEATHS 131 321 420 1,444 181 INF. MORT. RATE 68.4 42.2 17.0 5.8 383.5 1 INCLUDES RACES OTHER THAN WHITE AND BLACK. 33. Live Birth/Infant Death/Mort Rate by Birth Wt.,Race,Gest. Age 1983 DOCUMENTATION TABLE 3 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND GESTATIONAL AGE: UNITED STATES 1983 BIRTH COHORT (RATES ARE PER 1000 LIVE BIRTHS) GESTATION BIRTH WEIGHT AND RACE 28 28-31 32-35 36 OF CHILD TOTAL WEEKS WEEKS WEEKS WEEKS ALL RACES1 TOTAL LIVE BIRTHS 3,639,113 26,237 38,608 160,353 109,661 INFANT DEATHS 39,683 11,329 3,692 3,833 1,309 INF. MORT. RATE 10.9 431.8 95.6 23.9 11.9 LESS THAN 2,500 GRAMS LIVE BIRTHS 247,818 19,656 25,823 66,053 22,161 INFANT DEATHS 23,163 10,663 3,451 2,821 620 INF. MORT. RATE 93.5 542.5 133.6 42.7 28.0 LESS THAN 500 GRAMS LIVE BIRTHS 4,444 3,392 153 60 12 INFANT DEATHS 3,397 3,096 130 46 6 INF. MORT. RATE 885.9 912.7 849.7 766.7 500.0 500-749 GRAMS LIVE BIRTHS 7,594 5,346 710 224 40 INFANT DEATHS 5,815 4,313 486 141 28 INF. MORT. RATE 765.7 806.8 684.5 629.5 700.0 750-999 GRAMS LIVE BIRTHS 9,004 4,889 2,083 556 59 INFANT DEATHS 3,762 2,285 711 199 22 INF. MORT. RATE 417.8 467.4 341.3 357.9 372.9 1,000-1,249 GRAMS LIVE BIRTHS 10,193 2,375 4,532 1,482 168 INFANT DEATHS 2,145 630 842 278 32 INF. MORT. RATE 210.4 265.3 185.8 187.6 190.5 1,250-1,499 GRAMS LIVE BIRTHS 12,049 984 5,476 2,945 388 INFANT DEATHS 1,378 164 597 296 38 INF. MORT. RATE 114.4 166.7 109.0 100.5 97.9 1,500-1,999 GRAMS LIVE BIRTHS 47,325 1,363 8,738 19,730 3,406 INFANT DEATHS 2,688 123 543 896 187 INF. MORT. RATE 56.8 90.2 62.1 45.4 54.9 GESTATION BIRTH WEIGHT AND RACE 28 28-31 32-35 36 OF CHILD TOTAL WEEKS WEEKS WEEKS WEEKS ALL RACES1 CONTINUED 2,000-2,499 GRAMS LIVE BIRTHS 157,209 1,307 4,131 41,056 18,088 INFANT DEATHS 3,438 52 142 965 307 INF. MORT. RATE 21.9 39.8 34.4 23.5 17.0 2,500-2,999 GRAMS LIVE BIRTHS 586,810 1,880 4,616 40,832 38,084 INFANT DEATHS 4,997 48 88 555 356 INF. MORT. RATE 8.5 25.5 19.1 13.6 9.3 3,000-3,499 GRAMS LIVE BIRTHS 1,341,151 2,398 4,812 33,583 32,708 INFANT DEATHS 5,797 40 51 236 214 INF. MORT. RATE 4.3 16.7 10.6 7.0 6.5 3,500-3,999 GRAMS LIVE BIRTHS 1,062,897 1,270 2,465 15,651 13,028 INFANT DEATHS 3,290 29 15 106 72 INF. MORT. RATE 3.1 22.8 6.1 6.8 5.5 4,000-4,499 GRAMS LIVE BIRTHS 326,599 322 599 3,312 3,027 INFANT DEATHS 930 16 4 23 23 INF. MORT. RATE 2.8 49.7 6.7 6.9 7.6 4,500-4,999 GRAMS LIVE BIRTHS 60,324 45 93 540 465 INFANT DEATHS 229 12 3 9 3 INF. MORT. RATE 3.8 266.7 32.3 16.7 6.5 5,000 GRAMS OR MORE LIVE BIRTHS 8,131 63 27 104 82 INFANT DEATHS 114 40 6 6 1 INF. MORT. RATE 14.0 634.9 222.2 57.7 12.2 NOT STATED LIVE BIRTHS 5,383 603 173 278 106 INFANT DEATHS 1,163 481 74 77 20 INF. MORT. RATE 216.2 797.7 427.7 277.0 188.7 GESTATION BIRTH WEIGHT AND RACE 37-39 40 41 42 WEEKS NOT OF CHILD WEEKS WEEKS WEEKS OR MORE STATED ALL RACES1 CONTINUED TOTAL LIVE BIRTHS 1,318,549 770,410 538,104 520,746 156,445 INFANT DEATHS 7,314 3,072 2,432 3,012 3,690 INF. MORT. RATE 5.9 4.0 4.5 5.8 23.6 LESS THAN 2,500 GRAMS LIVE BIRTHS 63,367 14,288 8,497 11,195 16,778 INFANT DEATHS 1,760 433 363 498 2,554 INF. MORT. RATE 27.8 30.3 42.7 44.5 152.2 LESS THAN 500 GRAMS LIVE BIRTHS 67 25 53 40 642 INFANT DEATHS 33 7 32 20 567 INF. MORT. RATE 492.5 280.0 603.8 500.0 883.2 500-749 GRAMS LIVE BIRTHS 163 71 68 97 875 INFANT DEATHS 55 19 29 50 694 INF. MORT. RATE 337.4 267.6 426.5 515.5 793.1 750-999 GRAMS LIVE BIRTHS 207 99 91 103 917 INFANT DEATHS 69 24 24 30 398 INF. MORT. RATE 333.3 242.4 263.7 291.3 434.0 1,000-1,249 GRAMS LIVE BIRTHS 339 121 77 144 955 INFANT DEATHS 76 20 16 30 221 INF. MORT. RATE 224.2 165.3 207.8 208.3 231.4 1,250-1,499 GRAMS LIVE BIRTHS 747 142 137 237 993 INFANT DEATHS 83 16 19 18 147 INF. MORT. RATE 111.1 112.7 138.7 75.9 148.0 1,500-1,999 GRAMS LIVE BIRTHS 7,283 1,243 853 1,268 3,441 INFANT DEATHS 453 79 61 96 250 INF. MORT. RATE 62.2 63.6 71.5 75.7 72.7 GESTATION BIRTH WEIGHT AND RACE 37-39 40 41 42 WEEKS NOT OF CHILD WEEKS WEEKS WEEKS OR MORE STATED ALL RACES1 CONTINUED 2,000-2,499 GRAMS LIVE BIRTHS 54,561 12,587 7,218 9,306 8,955 INFANT DEATHS 991 268 182 254 277 INF. MORT. RATE 18.2 21.3 25.2 27.3 30.9 2,500-2,999 GRAMS LIVE BIRTHS 272,819 90,523 51,117 58,301 28,638 INFANT DEATHS 1,963 609 419 625 334 INF. MORT. RATE 7.2 6.7 8.2 10.7 11.7 3,000-3,499 GRAMS LIVE BIRTHS 555,551 295,423 183,541 177,815 55,320 INFANT DEATHS 2,200 1,058 765 921 312 INF. MORT. RATE 4.0 3.6 4.2 5.2 5.6 3,500-3,999 GRAMS LIVE BIRTHS 336,108 271,346 201,206 182,142 39,681 INFANT DEATHS 979 684 601 642 162 INF. MORT. RATE 2.9 2.5 3.0 3.5 4.1 4,000-4,499 GRAMS LIVE BIRTHS 76,961 82,965 75,984 72,073 11,356 INFANT DEATHS 246 182 193 205 38 INF. MORT. RATE 3.2 2.2 2.5 2.8 3.3 4,500-4,999 GRAMS LIVE BIRTHS 11,328 13,794 15,516 16,390 2,153 INFANT DEATHS 44 52 39 54 13 INF. MORT. RATE 3.9 3.8 2.5 3.3 6.0 5,000 GRAMS OR MORE LIVE BIRTHS 1,531 1,598 1,905 2,462 359 INFANT DEATHS 15 8 7 14 17 INF. MORT. RATE 9.8 5.0 3.7 5.7 47.4 NOT STATED LIVE BIRTHS 884 473 338 368 2,160 INFANT DEATHS 107 46 45 53 260 INF. MORT. RATE 121.0 97.3 133.1 144.0 120.4 GESTATION BIRTH WEIGHT AND RACE 28 28-31 32-35 36 OF CHILD TOTAL WEEKS WEEKS WEEKS WEEKS WHITE TOTAL LIVE BIRTHS 2,904,381 15,095 23,781 106,514 78,221 INFANT DEATHS 27,094 6,987 2,552 2,675 899 INF. MORT. RATE 9.3 462.9 107.3 25.1 11.5 LESS THAN 2,500 GRAMS LIVE BIRTHS 164,520 11,460 16,507 44,955 15,069 INFANT DEATHS 15,207 6,622 2,403 2,001 416 INF. MORT. RATE 92.4 577.8 145.6 44.5 27.6 LESS THAN 500 GRAMS LIVE BIRTHS 2,577 1,978 91 27 7 INFANT DEATHS 2,295 1,825 79 22 3 INF. MORT. RATE 890.6 922.6 868.1 814.8 428.6 500-749 GRAMS LIVE BIRTHS 4,492 3,209 401 127 20 INFANT DEATHS 3,549 2,663 283 86 14 INF. MORT. RATE 790.1 829.9 705.7 677.2 700.0 750-999 GRAMS LIVE BIRTHS 5,593 3,017 1,339 349 36 INFANT DEATHS 2,476 1,489 488 136 10 INF. MORT. RATE 442.7 493.5 364.5 389.7 277.8 1,000-1,249 GRAMS LIVE BIRTHS 6,456 1,448 2,943 950 103 INFANT DEATHS 1,545 449 604 201 26 INF. MORT. RATE 239.3 310.1 205.2 211.6 252.4 1,250-1,499 GRAMS LIVE BIRTHS 7,877 515 3,658 1,947 271 INFANT DEATHS 1,026 112 457 229 28 INF. MORT. RATE 130.3 217.5 124.9 117.6 103.3 1,500-1,999 GRAMS LIVE BIRTHS 31,313 674 5,821 13,256 2,259 INFANT DEATHS 1,910 58 401 656 123 INF. MORT. RATE 61.0 86.1 68.9 49.5 54.4 GESTATION BIRTH WEIGHT AND RACE 28 28-31 32-35 36 OF CHILD TOTAL WEEKS WEEKS WEEKS WEEKS WHITE CONTINUED 2,000-2,499 GRAMS LIVE BIRTHS 106,212 619 2,254 28,339 12,373 INFANT DEATHS 2,406 26 91 671 212 INF. MORT. RATE 22.7 42.0 40.4 23.7 17.1 2,500-2,999 GRAMS LIVE BIRTHS 416,741 919 2,346 26,569 27,119 INFANT DEATHS 3,423 20 55 376 250 INF. MORT. RATE 8.2 21.8 23.4 14.2 9.2 3,000-3,499 GRAMS LIVE BIRTHS 1,055,839 1,259 2,648 21,082 23,284 INFANT DEATHS 4,154 22 23 145 143 INF. MORT. RATE 3.9 17.5 8.7 6.9 6.1 3,500-3,999 GRAMS LIVE BIRTHS 909,563 840 1,633 10,695 9,802 INFANT DEATHS 2,567 18 11 74 52 INF. MORT. RATE 2.8 21.4 6.7 6.9 5.3 4,000-4,499 GRAMS LIVE BIRTHS 291,730 223 456 2,480 2,428 INFANT DEATHS 751 9 3 17 15 INF. MORT. RATE 2.6 40.4 6.6 6.9 6.2 4,500-4,999 GRAMS LIVE BIRTHS 54,700 34 72 450 378 INFANT DEATHS 184 7 2 6 3 INF. MORT. RATE 3.4 205.9 27.8 13.3 7.9 5,000 GRAMS OR MORE LIVE BIRTHS 7,141 39 17 69 63 INFANT DEATHS 76 23 4 5 1 INF. MORT. RATE 10.6 589.7 235.3 72.5 15.9 NOT STATED LIVE BIRTHS 4,147 321 102 194 78 INFANT DEATHS 732 266 51 51 19 INF. MORT. RATE 176.5 828.7 500.0 262.9 243.6 GESTATION BIRTH WEIGHT AND RACE 37-39 40 41 42 WEEKS NOT OF CHILD WEEKS WEEKS WEEKS OR MORE STATED WHITE CONTINUED TOTAL LIVE BIRTHS 1,029,527 641,091 458,235 431,721 120,156 INFANT DEATHS 5,152 2,307 1,880 2,251 2,391 INF. MORT. RATE 5.0 3.6 4.1 5.2 19.9 LESS THAN 2,500 GRAMS LIVE BIRTHS 42,411 9,846 5,858 7,352 11,022 INFANT DEATHS 1,203 319 254 352 1,637 INF. MORT. RATE 28.4 32.4 43.4 47.9 148.5 LESS THAN 500 GRAMS LIVE BIRTHS 36 22 28 32 356 INFANT DEATHS 17 6 17 13 313 INF. MORT. RATE 472.2 272.7 607.1 406.3 879.2 500-749 GRAMS LIVE BIRTHS 81 35 38 56 525 INFANT DEATHS 20 10 13 37 423 INF. MORT. RATE 246.9 285.7 342.1 660.7 805.7 750-999 GRAMS LIVE BIRTHS 112 50 58 61 571 INFANT DEATHS 38 13 17 23 262 INF. MORT. RATE 339.3 260.0 293.1 377.0 458.8 1,000-1,249 GRAMS LIVE BIRTHS 198 60 57 90 607 INFANT DEATHS 55 12 12 18 168 INF. MORT. RATE 277.8 200.0 210.5 200.0 276.8 1,250-1,499 GRAMS LIVE BIRTHS 498 88 101 145 654 INFANT DEATHS 62 13 15 7 103 INF. MORT. RATE 124.5 147.7 148.5 48.3 157.5 1,500-1,999 GRAMS LIVE BIRTHS 4,830 854 567 797 2,255 INFANT DEATHS 325 60 49 74 164 INF. MORT. RATE 67.3 70.3 86.4 92.8 72.7 GESTATION BIRTH WEIGHT AND RACE 37-39 40 41 42 WEEKS NOT OF CHILD WEEKS WEEKS WEEKS OR MORE STATED WHITE CONTINUED 2,000-2,499 GRAMS LIVE BIRTHS 36,656 8,737 5,009 6,171 6,054 INFANT DEATHS 686 205 131 180 204 INF. MORT. RATE 18.7 23.5 26.2 29.2 33.7 2,500-2,999 GRAMS LIVE BIRTHS 193,144 66,662 37,998 41,910 20,074 INFANT DEATHS 1,321 418 315 445 223 INF. MORT. RATE 6.8 6.3 8.3 10.6 11.1 3,000-3,499 GRAMS LIVE BIRTHS 433,208 239,223 151,139 141,823 42,173 INFANT DEATHS 1,573 779 590 669 210 INF. MORT. RATE 3.6 3.3 3.9 4.7 5.0 3,500-3,999 GRAMS LIVE BIRTHS 281,886 236,360 177,628 157,786 32,933 INFANT DEATHS 733 554 487 523 115 INF. MORT. RATE 2.6 2.3 2.7 3.3 3.5 4,000-4,499 GRAMS LIVE BIRTHS 67,062 74,721 69,237 65,224 9,909 INFANT DEATHS 194 150 167 169 27 INF. MORT. RATE 2.9 2.0 2.4 2.6 2.7 4,500-4,999 GRAMS LIVE BIRTHS 9,889 12,503 14,348 15,111 1,915 INFANT DEATHS 33 46 32 44 11 INF. MORT. RATE 3.3 3.7 2.2 2.9 5.7 5,000 GRAMS OR MORE LIVE BIRTHS 1,285 1,385 1,742 2,243 298 INFANT DEATHS 12 5 6 10 10 INF. MORT. RATE 9.3 3.6 3.4 4.5 33.6 NOT STATED LIVE BIRTHS 672 391 285 272 1,832 INFANT DEATHS 83 36 29 39 158 INF. MORT. RATE 123.5 92.1 101.8 143.4 86.2 GESTATION BIRTH WEIGHT AND RACE 28 28-31 32-35 36 OF CHILD TOTAL WEEKS WEEKS WEEKS WEEKS BLACK TOTAL LIVE BIRTHS 586,085 10,382 13,487 46,988 26,628 INFANT DEATHS 11,087 4,032 1,023 1,020 352 INF. MORT. RATE 18.9 388.4 75.9 21.7 13.2 LESS THAN 2,500 GRAMS LIVE BIRTHS 73,653 7,653 8,479 18,745 6,136 INFANT DEATHS 7,214 3,748 941 717 175 INF. MORT. RATE 97.9 489.7 111.0 38.3 28.5 LESS THAN 500 GRAMS LIVE BIRTHS 1,749 1,324 62 30 4 INFANT DEATHS 1,534 1,189 51 21 3 INF. MORT. RATE 877.1 898.0 822.6 700.0 750.0 500-749 GRAMS LIVE BIRTHS 2,874 1,998 284 193 16 INFANT DEATHS 2,114 2,543 186 53 11 INF. MORT. RATE 735.6 772.3 654.9 569.9 687.5 750-999 GRAMS LIVE BIRTHS 3,146 1,725 692 192 19 INFANT DEATHS 1,167 725 200 59 10 INF. MORT. RATE 370.9 420.3 289.0 307.3 526.3 1,000-1,249 GRAMS LIVE BIRTHS 3,393 857 1,443 476 56 INFANT DEATHS 526 161 214 63 6 INF. MORT. RATE 155.0 187.9 148.3 132.4 107.1 1,250-1,499 GRAMS LIVE BIRTHS 3,750 442 1,639 902 97 INFANT DEATHS 308 47 123 59 7 INF. MORT. RATE 82.1 106.3 75.0 65.4 72.2 1,500-1,999 GRAMS LIVE BIRTHS 14,362 651 2,629 5,845 1,003 INFANT DEATHS 673 60 121 208 52 INF. MORT. RATE 46.9 92.2 46.0 35.6 51.8 GESTATION BIRTH WEIGHT AND RACE 28 28-31 32-35 36 OF CHILD TOTAL WEEKS WEEKS WEEKS WEEKS BLACK CONTINUED 2,000-2,499 GRAMS LIVE BIRTHS 44,379 656 1,730 11,207 4,941 INFANT DEATHS 892 23 46 254 86 INF. MORT. RATE 20.1 35.1 26.6 22.7 17.4 2,500-2,999 GRAMS LIVE BIRTHS 140,894 909 2,077 12,450 9,320 INFANT DEATHS 1,352 28 30 165 90 INF. MORT. RATE 9.6 30.8 14.4 13.3 9.7 3,000-3,499 GRAMS LIVE BIRTHS 224,341 1,066 1,966 10,797 7,929 INFANT DEATHS 1,350 17 26 80 61 INF. MORT. RATE 6.0 15.9 13.2 7.4 7.7 3,500-3,999 GRAMS LIVE BIRTHS 116,112 379 754 4,137 2,664 INFANT DEATHS 564 10 4 26 17 INF. MORT. RATE 4.9 26.4 5.3 6.3 6.4 4,000-4,499 GRAMS LIVE BIRTHS 25,355 81 123 688 469 INFANT DEATHS 143 7 1 5 8 INF. MORT. RATE 5.6 86.4 8.1 7.3 17.1 4,500-4,999 GRAMS LIVE BIRTHS 3,987 9 18 72 73 INFANT DEATHS 39 3 1 3 - INF. MORT. RATE 9.8 333.3 55.6 41.7 - 5,000 GRAMS OR MORE LIVE BIRTHS 727 22 9 25 16 INFANT DEATHS 37 16 2 1 - INF. MORT. RATE 50.9 727.3 222.2 40.0 - NOT STATED LIVE BIRTHS 1,016 263 61 74 21 INFANT DEATHS 388 203 18 23 1 INF. MORT. RATE 381.9 771.9 295.1 310.8 47.6 GESTATION BIRTH WEIGHT AND RACE 37-39 40 41 42 WEEKS NOT OF CHILD WEEKS WEEKS WEEKS OR MORE STATED BLACK CONTINUED TOTAL LIVE BIRTHS 230,072 100,630 62,130 71,222 21,546 INFANT DEATHS 1,814 640 457 652 1,097 INF. MORT. RATE 7.9 6.4 7.4 9.2 44.7 LESS THAN 2,500 GRAMS LIVE BIRTHS 18,214 3,895 2,327 3,399 4,805 INFANT DEATHS 501 102 95 129 806 INF. MORT. RATE 27.5 26.2 40.8 38.0 167.7 LESS THAN 500 GRAMS LIVE BIRTHS 29 3 25 7 265 INFANT DEATHS 14 1 15 7 233 INF. MORT. RATE 482.8 333.3 600.0 1000.0 879.2 500-749 GRAMS LIVE BIRTHS 77 27 29 35 315 INFANT DEATHS 35 8 16 13 249 INF. MORT. RATE 454.9 296.3 551.7 371.4 790.5 750-999 GRAMS LIVE BIRTHS 91 45 33 36 313 INFANT DEATHS 31 9 7 6 120 INF. MORT. RATE 340.7 200.0 212.1 166.7 383.4 1,000-1,249 GRAMS LIVE BIRTHS 125 58 19 48 311 INFANT DEATHS 18 7 4 10 43 INF. MORT. RATE 144.0 120.7 210.5 208.3 138.3 1,250-1,499 GRAMS LIVE BIRTHS 216 51 35 77 291 INFANT DEATHS 20 3 3 10 36 INF. MORT. RATE 92.6 58.8 85.7 129.9 123.7 1,500-1,999 GRAMS LIVE BIRTHS 2,181 357 257 423 1,016 INFANT DEATHS 118 17 9 20 68 INF. MORT. RATE 54.1 47.6 35.0 47.3 66.9 GESTATION BIRTH WEIGHT AND RACE 37-39 40 41 42 WEEKS NOT OF CHILD WEEKS WEEKS WEEKS OR MORE STATED BLACK CONTINUED 2,000-2,499 GRAMS LIVE BIRTHS 15,495 3,354 1,929 2,773 2,294 INFANT DEATHS 265 57 41 63 57 INF. MORT. RATE 17.1 17.0 21.3 22.7 24.8 2,500-2,999 GRAMS LIVE BIRTHS 65,548 19,699 10,797 14,002 6,092 INFANT DEATHS 550 165 86 160 78 INF. MORT. RATE 8.4 8.4 8.0 11.4 12.8 3,000-3,499 GRAMS LIVE BIRTHS 96,126 43,637 25,328 29,115 8,377 INFANT DEATHS 500 226 146 218 76 INF. MORT. RATE 5.2 5.2 5.8 7.5 9.1 3,500-3,999 GRAMS LIVE BIRTHS 41,367 26,258 17,813 18,714 4,026 INFANT DEATHS 190 103 91 92 31 INF. MORT. RATE 4.6 3.9 5.1 4.9 7.7 4,000-4,499 GRAMS LIVE BIRTHS 7,434 5,964 4,872 4,896 828 INFANT DEATHS 45 26 19 28 4 INF. MORT. RATE 6.1 4.4 3.9 5.7 4.8 4,500-4,999 GRAMS LIVE BIRTHS 1,021 966 827 874 127 INFANT DEATHS 9 6 7 8 2 INF. MORT. RATE 8.8 6.2 8.5 9.2 15.7 5,000 GRAMS OR MORE LIVE BIRTHS 189 143 129 147 47 INFANT DEATHS 3 3 1 4 7 INF. MORT. RATE 15.9 21.0 7.8 27.2 148.9 NOT STATED LIVE BIRTHS 173 68 37 75 244 INFANT DEATHS 16 9 12 13 93 INF. MORT. RATE 92.5 132.4 324.3 173.3 381.1 1 INCLUDES RACES OTHER THAN WHITE AND BLACK. 4. Live Birth/Infant Death/Mort. Rate by Wt., Race, Age at Death 1983 DOCUMENTATION TABLE 4 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND AGE AT DEATH: UNITED STATES 1983 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 1000 LIVE BIRTHS) BIRTH WEIGHT AND RACE LIVE INFANT TOTAL OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 TOTAL (ALL BIRTH WEIGHTS)...NUMBER.. 3,639,113 39,683 25,830 RATE.. 10.9 7.1 LESS THAN 2,500 GRAMS.......NUMBER.. 247,818 23,163 18,726 RATE.. 93.5 75.6 LESS THAN 500 GRAMS.......NUMBER.. 4,444 3,937 3,916 RATE.. 885.9 881.2 500-749 GRAMS.............NUMBER.. 7,594 5,815 5,411 RATE.. 765.7 712.5 750-999 GRAMS.............NUMBER.. 9,004 3,762 3,070 RATE.. 417.8 341.0 1,000-1,249 GRAMS.........NUMBER.. 10,193 2,145 1,669 RATE.. 210.4 163.7 1,250-1,499 GRAMS.........NUMBER.. 12,049 1,378 987 RATE.. 114.4 81.9 1,500-1,999 GRAMS.........NUMBER.. 47,325 2,688 1,791 RATE.. 56.8 37.8 2,000-2,499 GRAMS.........NUMBER.. 157,209 3,438 1,882 RATE.. 21.9 12.0 2,500-2,999 GRAMS...........NUMBER.. 586,810 4,997 2,068 RATE.. 8.5 3.5 3,000-3,499 GRAMS...........NUMBER.. 1,341,151 5,797 2,086 RATE.. 4.3 1.6 BIRTH WEIGHT AND RACE LIVE INFANT TOTAL OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 CONTINUED 3,500-3,999 GRAMS...........NUMBER.. 1,062,897 3,290 1,235 RATE.. 3.1 1.2 4,000-4,499 GRAMS...........NUMBER.. 326,599 930 390 RATE.. 2.8 1.2 4,500-4,999 GRAMS...........NUMBER.. 60,324 229 130 RATE.. 3.8 2.2 5,000 GRAMS OR MORE.........NUMBER.. 8,131 114 99 RATE.. 14.0 12.2 NOT STATED..................NUMBER.. 5,383 1,163 1,096 RATE.. 216.1 203.6 BIRTH WEIGHT AND RACE EARLY LATE POST OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 CONTINUED TOTAL (ALL BIRTH WEIGHTS)...NUMBER.. 21,689 4,141 13,853 RATE.. 6.0 1.1 3.8 LESS THAN 2,500 GRAMS.......NUMBER.. 16,479 2,247 4,437 RATE.. 66.5 9.1 17.9 LESS THAN 500 GRAMS.......NUMBER.. 3,889 27 21 RATE.. 875.1 6.1 4.7 500-749 GRAMS.............NUMBER.. 5,012 399 404 RATE.. 660.0 52.5 53.2 750-999 GRAMS.............NUMBER.. 2,585 485 692 RATE.. 287.1 53.9 76.9 1,000-1,249 GRAMS.........NUMBER.. 1,326 343 476 RATE.. 130.1 33.7 46.7 1,250-1,499 GRAMS.........NUMBER.. 797 190 391 RATE.. 66.1 15.8 32.5 1,500-1,999 GRAMS.........NUMBER.. 1,468 323 897 RATE.. 31.0 6.8 19.0 2,000-2,499 GRAMS.........NUMBER.. 1,402 480 1,556 RATE.. 8.9 3.1 9.9 2,500-2,999 GRAMS...........NUMBER.. 1,471 597 2,929 RATE.. 2.5 1.0 5.0 3,000-3,499 GRAMS...........NUMBER.. 1,421 665 3,711 RATE.. 1.1 .5 2.8 3,500-3,999 GRAMS...........NUMBER.. 818 417 2,055 RATE.. .8 .4 1.9 BIRTH WEIGHT AND RACE EARLY LATE POST OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 CONTINUED 4,000-4,499 GRAMS...........NUMBER.. 263 127 540 RATE.. .8 .4 1.7 4,500-4,999 GRAMS...........NUMBER.. 108 22 99 RATE.. 1.8 .4 1.6 5,000 GRAMS OR MORE.........NUMBER.. 90 9 15 RATE.. 11.1 1.1 1.8 NOT STATED..................NUMBER.. 1,039 57 67 RATE.. 193.0 10.6 12.4 BIRTH WEIGHT AND RACE LIVE INFANT TOTAL OF CHILD BIRTHS DEATHS NEONATAL WHITE TOTAL (ALL BIRTH WEIGHTS)...NUMBER.. 2,904,381 27,094 17,786 RATE.. 9.3 6.1 LESS THAN 2,500 GRAMS.......NUMBER.. 164,520 15,207 12,535 RATE.. 92.4 76.2 LESS THAN 500 GRAMS.......NUMBER.. 2,577 2,295 2,284 RATE.. 890.6 886.3 500-749 GRAMS.............NUMBER.. 4,492 3,549 3,353 RATE.. 790.1 746.4 750-999 GRAMS.............NUMBER.. 5,593 2,476 2,111 RATE.. 442.7 377.4 1,000-1,249 GRAMS.........NUMBER.. 6,456 1,545 1,261 RATE.. 239.3 195.3 1,250-1,499 GRAMS.........NUMBER.. 7,877 1,026 763 RATE.. 130.3 96.9 1,500-1,999 GRAMS.........NUMBER.. 31,313 1,910 1,336 RATE.. 61.0 42.7 2,000-2,499 GRAMS.........NUMBER.. 106,212 2,406 1,427 RATE.. 22.7 13.4 2,500-2,999 GRAMS...........NUMBER.. 416,741 3,423 1,551 RATE.. 8.2 3.7 3,000-3,499 GRAMS...........NUMBER.. 1,055,839 4,154 1,560 RATE.. 3.9 1.5 3,500-3,999 GRAMS...........NUMBER.. 906,563 2,567 985 RATE.. 2.8 1.1 BIRTH WEIGHT AND RACE LIVE INFANT TOTAL OF CHILD BIRTHS DEATHS NEONATAL WHITE CONTINUED 4,000-4,499 GRAMS...........NUMBER.. 291,730 751 308 RATE.. 2.6 1.1 4,500-4,999 GRAMS...........NUMBER.. 54,700 184 98 RATE.. 3.4 1.8 5,000 GRAMS OR MORE.........NUMBER.. 7,141 76 65 RATE.. 10.6 9.1 NOT STATED..................NUMBER.. 4,147 732 684 RATE.. 176.5 164.9 BIRTH WEIGHT AND RACE EARLY LATE POST OF CHILD NEONATAL NEONATAL NEONATAL WHITE CONTINUED TOTAL (ALL BIRTH WEIGHTS)...NUMBER.. 14,858 2,928 9,308 RATE.. 5.1 1.0 3.2 LESS THAN 2,500 GRAMS.......NUMBER.. 11,009 1,526 2,672 RATE.. 66.9 9.3 16.2 LESS THAN 500 GRAMS.......NUMBER.. 2,262 22 11 RATE.. 877.8 8.5 4.3 500-749 GRAMS.............NUMBER.. 3,139 214 196 RATE.. 698.8 47.6 43.6 750-999 GRAMS.............NUMBER.. 1,794 317 365 RATE.. 320.8 56.7 65.3 1,000-1,249 GRAMS.........NUMBER.. 995 266 284 RATE.. 154.1 41.2 44.0 1,250-1,499 GRAMS.........NUMBER.. 624 139 263 RATE.. 79.2 17.6 33.4 1,500-1,999 GRAMS.........NUMBER.. 1,101 235 574 RATE.. 35.2 7.5 18.3 2,000-2,499 GRAMS.........NUMBER.. 1,094 333 979 RATE.. 10.3 3.1 9.2 2,500-2,999 GRAMS...........NUMBER.. 1,129 422 1,872 RATE.. 2.7 1.0 4.5 3,000-3,499 GRAMS...........NUMBER.. 1,073 487 2,594 RATE.. 1.0 .5 2.5 3,500-3,999 GRAMS...........NUMBER.. 659 326 1,582 RATE.. .7 .4 1.7 BIRTH WEIGHT AND RACE EARLY LATE POST OF CHILD NEONATAL NEONATAL NEONATAL WHITE CONTINUED 4,000-4,499 GRAMS...........NUMBER.. 208 100 443 RATE.. .7 .3 1.5 4,500-4,999 GRAMS...........NUMBER.. 81 17 86 RATE.. 1.5 .3 1.6 5,000 GRAMS OR MORE.........NUMBER.. 57 8 11 RATE.. 8.0 1.1 1.5 NOT STATED..................NUMBER.. 642 42 48 RATE.. 154.8 10.1 11.6 BIRTH WEIGHT AND RACE LIVE INFANT TOTAL OF CHILD BIRTHS DEATHS NEONATAL BLACK TOTAL (ALL BIRTH WEIGHTS)...NUMBER.. 586,085 11,087 7,202 RATE.. 18.9 12.3 LESS THAN 2,500 GRAMS.......NUMBER.. 73,653 7,214 5,620 RATE.. 97.9 76.3 LESS THAN 500 GRAMS.......NUMBER.. 1,749 1,534 1,524 RATE.. 877.1 871.4 500-749 GRAMS.............NUMBER.. 2,874 2,114 1,926 RATE.. 735.6 670.1 750-999 GRAMS.............NUMBER.. 3,146 1,167 867 RATE.. 442.7 275.6 1,000-1,249 GRAMS.........NUMBER.. 3,393 526 353 RATE.. 155.0 104.0 1,250-1,499 GRAMS.........NUMBER.. 3,750 308 188 RATE.. 82.1 50.1 1,500-1,999 GRAMS.........NUMBER.. 14,362 673 384 RATE.. 46.9 26.7 2,000-2,499 GRAMS.........NUMBER.. 44,379 892 378 RATE.. 20.1 8.5 2,500-2,999 GRAMS...........NUMBER.. 140,894 1,352 429 RATE.. 9.6 3.0 3,000-3,499 GRAMS...........NUMBER.. 224,341 1,350 440 RATE.. 6.0 2.0 3,500-3,999 GRAMS...........NUMBER.. 116,112 564 209 RATE.. 4.9 1.8 BIRTH WEIGHT AND RACE LIVE INFANT TOTAL OF CHILD BIRTHS DEATHS NEONATAL BLACK CONTINUED 4,000-4,499 GRAMS...........NUMBER.. 25,355 143 70 RATE.. 5.6 2.8 4,500-4,999 GRAMS...........NUMBER.. 3,987 39 29 RATE.. 9.8 7.3 5,000 GRAMS OR MORE.........NUMBER.. 727 37 33 RATE.. 50.9 45.4 NOT STATED..................NUMBER.. 1,016 388 372 RATE.. 381.9 366.1 BIRTH WEIGHT AND RACE EARLY LATE POST OF CHILD NEONATAL NEONATAL NEONATAL BLACK CONTINUED TOTAL (ALL BIRTH WEIGHTS)...NUMBER.. 6,151 1,051 3,885 RATE.. 10.5 1.8 6.6 LESS THAN 2,500 GRAMS.......NUMBER.. 4,976 644 1,594 RATE.. 67.6 8.7 21.6 LESS THAN 500 GRAMS.......NUMBER.. 1,520 4 10 RATE.. 869.1 2.3 5.7 500-749 GRAMS.............NUMBER.. 1,752 174 188 RATE.. 609.6 60.5 65.4 750-999 GRAMS.............NUMBER.. 713 154 300 RATE.. 226.6 49.0 95.4 1,000-1,249 GRAMS.........NUMBER.. 285 68 173 RATE.. 84.0 20.0 51.0 1,250-1,499 GRAMS.........NUMBER.. 146 42 120 RATE.. 38.9 11.2 32.0 1,500-1,999 GRAMS.........NUMBER.. 304 80 289 RATE.. 21.2 5.6 20.1 2,000-2,499 GRAMS.........NUMBER.. 256 122 514 RATE.. 5.8 2.7 11.6 2,500-2,999 GRAMS...........NUMBER.. 277 152 923 RATE.. 2.0 1.1 6.6 3,000-3,499 GRAMS...........NUMBER.. 294 146 910 RATE.. 1.3 .7 4.1 3,500-3,999 GRAMS...........NUMBER.. 139 70 355 RATE.. 1.2 .6 3.1 BIRTH WEIGHT AND RACE EARLY LATE POST OF CHILD NEONATAL NEONATAL NEONATAL BLACK CONTINUED 4,000-4,499 GRAMS...........NUMBER.. 50 20 73 RATE.. 2.0 .8 2.9 4,500-4,999 GRAMS...........NUMBER.. 24 5 10 RATE.. 6.0 1.3 2.5 5,000 GRAMS OR MORE.........NUMBER.. 32 1 4 RATE.. 44.0 1.4 5.5 NOT STATED..................NUMBER.. 359 13 16 RATE.. 353.3 12.8 15.7 1 INCLUDES RACES OTHER THAN WHITE AND BLACK. 5. Live Births/Infant Deaths for 10 Leading Causes Infant Death 1983 DOCUMENTATION TABLE 5 LIVE BIRTHS BY BIRTH WEIGHT AND RACE OF CHILD AND INFANT DEATHS AND INFANT MORTALITY RATES BY AGE AT DEATH, BIRTH WEIGHT, AND RACE OF CHILD FOR 10 LEADING CAUSES OF INFANT DEATH: UNITED STATES, 1983 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 100,000 LIVE BIRTHS) CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 ALL BIRTH WEIGHTS ... ALL CAUSES...................NUMBER.. 3,639,113 39,683 25,830 RATE.. 1,090.5 709.8 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 8,568 6,326 RATE.. 235.4 173.8 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 5,271 389 RATE.. 144.8 10.7 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 3,596 3,362 RATE.. 98.8 92.4 4 PREMATURITY (765)............NUMBER.. 3,235 3,201 RATE.. 88.9 88.0 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 1,433 1,424 RATE.. 39.4 39.1 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 1,180 1,108 RATE.. 32.4 30.4 7 ACCIDENTS (E800-E949)........NUMBER.. 870 69 RATE.. 23.9 1.9 8 INFECTIONS (771).............NUMBER.. 845 808 RATE.. 23.2 22.2 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 842 838 RATE.. 23.1 23.0 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 ALL BIRTH WEIGHTS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 732 158 RATE.. 20.1 4.3 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 1,840 599 RATE.. 50.6 16.5 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 ALL BIRTH WEIGHTS (CONTINUED) ... ALL CAUSES...................NUMBER.. 21,689 4,141 13,853 RATE.. 596.0 113.8 380.7 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 5,143 1,183 2,242 RATE.. 141.3 32.5 61.6 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 38 351 4,882 RATE.. 1.0 9.6 134.2 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 2,852 510 234 RATE.. 78.4 14.0 6.4 4 PREMATURITY (765)............NUMBER.. 3,169 32 34 RATE.. 87.1 .9 .9 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 1,415 9 9 RATE.. 38.9 .2 .2 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 957 151 72 RATE.. 26.3 4.1 2.0 7 ACCIDENTS (E800-E949)........NUMBER.. 22 47 801 RATE.. .6 1.3 22.0 8 INFECTIONS (771).............NUMBER.. 557 251 37 RATE.. 15.3 6.9 1.0 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 818 20 4 RATE.. 22.5 .5 .1 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 ALL BIRTH WEIGHTS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 83 75 574 RATE.. 2.3 2.1 15.8 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 381 218 1,241 RATE.. 10.5 6.0 34.1 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 LESS THAN 2,500 GRAMS ... ALL CAUSES...................NUMBER.. 247,818 23,163 18,726 RATE.. 9,346.8 7,556.4 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 3,801 3,048 RATE.. 1,533.8 1,229.9 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 1,076 60 RATE.. 434.2 24.2 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 3,379 3,158 RATE.. 1,363.5 1,274.3 4 PREMATURITY (765)............NUMBER.. 2,912 2,880 RATE.. 1,175.1 1,162.1 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 1,286 1,279 RATE.. 518.9 516.1 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 673 648 RATE.. 271.6 261.5 7 ACCIDENTS (E800-E949)........NUMBER.. 138 23 RATE.. 55.7 9.3 8 INFECTIONS (771).............NUMBER.. 598 569 RATE.. 241.3 229.6 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 665 664 RATE.. 268.3 267.9 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 LESS THAN 2,500 GRAMS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 228 66 RATE.. 92.0 26.6 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 815 322 RATE.. 328.9 129.9 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 LESS THAN 2,500 GRAMS (CONTINUED) ... ALL CAUSES...................NUMBER.. 16,479 2,247 4,437 RATE.. 6,649.6 906.7 1,790.4 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 2,647 401 753 RATE.. 1,068.1 161.8 303.9 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 3 57 1,016 RATE.. 1.2 23.0 410.0 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 2,683 475 221 RATE.. 1,082.6 191.7 89.2 4 PREMATURITY (765)............NUMBER.. 2,853 27 32 RATE.. 1,151.2 10.9 12.9 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 1,270 9 7 RATE.. 512.5 3.6 2.8 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 590 58 25 RATE.. 238.1 23.4 10.1 7 ACCIDENTS (E800-E949)........NUMBER.. 9 14 115 RATE.. 3.6 5.6 46.4 8 INFECTIONS (771).............NUMBER.. 391 178 29 RATE.. 157.8 71.8 11.7 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 656 8 1 RATE.. 264.7 3.2 .4 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 LESS THAN 2,500 GRAMS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 37 29 162 RATE.. 14.9 11.7 65.4 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 212 110 493 RATE.. 85.5 44.4 198.9 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 2,500 GRAMS OR MORE ... ALL CAUSES...................NUMBER.. 3,385,912 15,357 6,008 RATE.. 453.6 177.4 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 4,538 3,069 RATE.. 134.0 90.6 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 4,189 329 RATE.. 123.7 9.7 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 141 129 RATE.. 4.2 3.8 4 PREMATURITY (765)............NUMBER.. 81 79 RATE.. 2.4 2.3 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 30 28 RATE.. .9 .8 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 452 407 RATE.. 13.3 12.0 7 ACCIDENTS (E800-E949)........NUMBER.. 729 43 RATE.. 21.5 1.3 8 INFECTIONS (771).............NUMBER.. 236 228 RATE.. 7.0 6.7 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 124 121 RATE.. 3.7 3.6 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 2,500 GRAMS OR MORE (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 499 90 RATE.. 14.7 2.7 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 1,005 264 RATE.. 29.7 7.8 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 2,500 GRAMS OR MORE (CONTINUED) ... ALL CAUSES...................NUMBER.. 4,171 1,837 9,349 RATE.. 123.2 54.3 276.1 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 2,300 769 1,469 RATE.. 67.9 22.7 43.4 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 35 294 3,860 RATE.. 1.0 8.7 114.0 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 102 27 12 RATE.. 3.0 .8 .4 4 PREMATURITY (765)............NUMBER.. 75 4 2 RATE.. 2.2 .1 .1 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 28 - 2 RATE.. .8 - .1 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 320 87 45 RATE.. 9.5 2.6 1.3 7 ACCIDENTS (E800-E949)........NUMBER.. 10 33 686 RATE.. .3 1.0 20.3 8 INFECTIONS (771).............NUMBER.. 156 72 8 RATE.. 4.6 2.1 .2 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 110 11 3 RATE.. 3.2 .3 .1 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 2,500 GRAMS OR MORE (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 44 46 409 RATE.. 1.3 1.4 12.1 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 159 105 741 RATE.. 4.7 3.1 21.9 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 NOT STATED BIRTH WEIGHT ... ALL CAUSES...................NUMBER.. 5,383 1,163 1,096 RATE.. 21,605.1 20,360.4 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 229 209 RATE.. 4,254.1 3,882.6 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 6 - RATE.. 111.5 - 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 76 75 RATE.. 1,411.9 1,393.3 4 PREMATURITY (765)............NUMBER.. 242 242 RATE.. 4,495.6 4,495.6 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 117 117 RATE.. 2,173.5 2,173.5 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 55 53 RATE.. 1,021.7 984.6 7 ACCIDENTS (E800-E949)........NUMBER.. 3 3 RATE.. 55.7 55.7 8 INFECTIONS (771).............NUMBER.. 11 11 RATE.. 204.3 204.3 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 53 53 RATE.. 984.6 984.6 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 NOT STATED BIRTH WEIGHT 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 5 2 RATE.. 92.9 37.2 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 20 13 RATE.. 371.5 241.5 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 NOT STATED BIRTH WEIGHT (CONTINUED) ... ALL CAUSES...................NUMBER.. 1,039 57 67 RATE.. 19,301.5 1,058.9 1,244.7 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 196 13 20 RATE.. 3,641.1 241.5 371.5 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. - - 6 RATE.. - - 111.5 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 67 8 1 RATE.. 1,244.7 148.6 18.6 4 PREMATURITY (765)............NUMBER.. 241 1 - RATE.. 4,477.1 18.6 - 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 117 - - RATE.. 2,173.5 - - 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 47 6 2 RATE.. 873.1 111.5 37.2 7 ACCIDENTS (E800-E949)........NUMBER.. 3 - - RATE.. 55.7 - - 8 INFECTIONS (771).............NUMBER.. 10 1 - RATE.. 185.8 18.6 - 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 52 1 - RATE.. 966.0 18.6 - CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 NOT STATED BIRTH WEIGHT (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 2 - 3 RATE.. 37.2 - 55.7 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 10 3 7 RATE.. 185.7 55.7 130.0 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE ALL BIRTH WEIGHTS ... ALL CAUSES...................NUMBER.. 2,904,381 27,094 17,786 RATE.. 932.9 612.4 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 6,751 5,043 RATE.. 232.4 173.6 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 3,533 247 RATE.. 121.6 8.5 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 2,561 2,414 RATE.. 88.2 83.1 4 PREMATURITY (765)............NUMBER.. 1,833 1,815 RATE.. 63.1 62.5 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 975 969 RATE.. 33.6 33.4 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 804 756 RATE.. 27.7 26.0 7 ACCIDENTS (E800-E949)........NUMBER.. 573 42 RATE.. 19.7 1.4 8 INFECTIONS (771).............NUMBER.. 589 563 RATE.. 20.3 19.4 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 599 595 RATE.. 20.6 20.5 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE ALL BIRTH WEIGHTS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 438 102 RATE.. 15.1 3.5 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 1,214 428 RATE.. 41.8 14.7 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE ALL BIRTH WEIGHTS (CONTINUED) ... ALL CAUSES...................NUMBER.. 14,858 2,928 9,308 RATE.. 511.6 100.8 320.5 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 4,118 925 1,708 RATE.. 141.8 31.8 58.8 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 24 223 3,286 RATE.. .8 7.7 113.1 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 2,034 380 147 RATE.. 70.0 13.1 5.1 4 PREMATURITY (765)............NUMBER.. 1,794 21 18 RATE.. 61.8 .7 .6 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 962 7 6 RATE.. 33.1 .2 .2 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 654 102 48 RATE.. 22.5 3.5 1.7 7 ACCIDENTS (E800-E949)........NUMBER.. 14 28 531 RATE.. .5 1.0 18.3 8 INFECTIONS (771).............NUMBER.. 386 177 26 RATE.. 13.3 6.1 .9 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 583 12 4 RATE.. 20.1 .4 .1 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE ALL BIRTH WEIGHTS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 55 47 336 RATE.. 1.9 1.6 11.6 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 276 152 786 RATE.. 9.5 5.2 27.1 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE LESS THAN 2,500 GRAMS ... ALL CAUSES...................NUMBER.. 164,520 15,207 12,535 RATE.. 9,243.3 7,691.1 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 2,936 2,401 RATE.. 1,784.6 1,459.4 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 607 31 RATE.. 369.0 18.8 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 2,415 2,276 RATE.. 1,467.9 1,383.4 4 PREMATURITY (765)............NUMBER.. 1,669 1,652 RATE.. 1,014.5 1,004.1 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 880 875 RATE.. 534.9 531.9 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 425 412 RATE.. 258.3 250.4 7 ACCIDENTS (E800-E949)........NUMBER.. 75 13 RATE.. 45.6 7.9 8 INFECTIONS (771).............NUMBER.. 395 376 RATE.. 240.1 228.5 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 479 478 RATE.. 291.2 290.5 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE LESS THAN 2,500 GRAMS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 111 33 RATE.. 67.5 20.1 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 517 224 RATE.. 314.2 136.2 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE LESS THAN 2,500 GRAMS (CONTINUED) ... ALL CAUSES...................NUMBER.. 11,009 1,526 2,672 RATE.. 6,691.6 927.5 1,624.1 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 2,104 297 535 RATE.. 1,278.9 180.5 325.2 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 1 30 576 RATE.. .6 18.2 350.1 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 1,920 356 139 RATE.. 1,167.0 216.4 84.5 4 PREMATURITY (765)............NUMBER.. 1,634 18 17 RATE.. 993.2 10.9 10.3 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 868 7 5 RATE.. 527.6 4.3 3.0 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 376 36 13 RATE.. 228.5 21.9 7.9 7 ACCIDENTS (E800-E949)........NUMBER.. 6 7 62 RATE.. 3.6 4.3 37.7 8 INFECTIONS (771).............NUMBER.. 258 118 19 RATE.. 156.8 71.7 11.5 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 472 6 1 RATE.. 286.9 3.6 .6 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE LESS THAN 2,500 GRAMS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 19 14 78 RATE.. 11.5 8.5 47.4 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 150 74 293 RATE.. 91.2 45.0 178.1 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE 2,500 GRAMS OR MORE ... ALL CAUSES...................NUMBER.. 2,735,714 11,155 4,567 RATE.. 407.8 166.9 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 3,361 2,475 RATE.. 132.7 90.5 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 2,923 216 RATE.. 106.8 7.9 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 94 87 RATE.. 3.4 3.2 4 PREMATURITY (765)............NUMBER.. 47 46 RATE.. 1.7 1.7 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 18 17 RATE.. .7 .6 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 339 306 RATE.. 12.4 11.2 7 ACCIDENTS (E800-E949)........NUMBER.. 495 26 RATE.. 18.1 1.0 8 INFECTIONS (771).............NUMBER.. 186 179 RATE.. 6.8 6.5 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 85 82 RATE.. 3.1 3.0 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE 2,500 GRAMS OR MORE (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 324 68 RATE.. 11.8 2.5 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 685 197 RATE.. 25.0 7.2 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE 2,500 GRAMS OR MORE (CONTINUED) ... ALL CAUSES...................NUMBER.. 3,207 1,360 6,588 RATE.. 117.2 49.7 240.8 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 1,858 617 1,156 RATE.. 67.9 22.6 42.3 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 23 193 2,707 RATE.. .8 7.1 99.0 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 68 19 7 RATE.. 2.5 .7 .3 4 PREMATURITY (765)............NUMBER.. 44 2 1 RATE.. 1.6 .1 .0 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 17 - 1 RATE.. .6 - .0 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 244 62 33 RATE.. 8.9 2.3 1.2 7 ACCIDENTS (E800-E949)........NUMBER.. 5 21 469 RATE.. .2 .8 17.1 8 INFECTIONS (771).............NUMBER.. 121 58 7 RATE.. 4.4 2.1 .3 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 77 5 3 RATE.. 2.8 .2 .1 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE 2,500 GRAMS OR MORE (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 35 33 256 RATE.. 1.3 1.2 9.4 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 120 77 488 RATE.. 4.4 2.8 17.8 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE NOT STATED BIRTH WEIGHT ... ALL CAUSES...................NUMBER.. 4,147 732 684 RATE.. 17,651.3 16,493.9 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 184 167 RATE.. 4,436.9 4,027.0 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 3 - RATE.. 72.3 - 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 52 51 RATE.. 1,253.9 1,229.8 4 PREMATURITY (765)............NUMBER.. 117 117 RATE.. 2,821.3 2,821.3 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 77 77 RATE.. 1,856.8 1,856.8 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 40 38 RATE.. 964.6 916.3 7 ACCIDENTS (E800-E949)........NUMBER.. 3 3 RATE.. 72.3 72.3 8 INFECTIONS (771).............NUMBER.. 8 8 RATE.. 192.9 192.9 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 35 35 RATE.. 844.0 844.0 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE NOT STATED BIRTH WEIGHT 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 3 1 RATE.. 72.3 24.1 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 12 7 RATE.. 289.4 168.8 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE NOT STATED BIRTH WEIGHT (CONTINUED) ... ALL CAUSES...................NUMBER.. 642 42 48 RATE.. 15,481.1 1,012.8 1,157.5 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 156 11 17 RATE.. 3,761.8 265.3 409.9 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. - - 3 RATE.. - - 72.3 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 46 5 1 RATE.. 1,109.2 120.6 24.1 4 PREMATURITY (765)............NUMBER.. 116 1 - RATE.. 2,797.2 24.1 - 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 77 - - RATE.. 1,856.8 - - 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 34 4 2 RATE.. 819.9 96.5 48.2 7 ACCIDENTS (E800-E949)........NUMBER.. 3 - - RATE.. 72.3 - - 8 INFECTIONS (771).............NUMBER.. 7 1 - RATE.. 168.8 24.1 - 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 34 1 - RATE.. 819.9 24.1 - CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE NOT STATED BIRTH WEIGHT (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 1 - 2 RATE.. 24.1 - 48.2 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 6 1 5 RATE.. 144.7 24.1 120.6 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK ALL BIRTH WEIGHTS ... ALL CAUSES...................NUMBER.. 586,085 11,087 7,202 RATE.. 1,891.7 1,228.8 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 1,455 1,030 RATE.. 248.3 175.7 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 1,480 122 RATE.. 252.5 20.8 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 928 853 RATE.. 158.3 145.5 4 PREMATURITY (765)............NUMBER.. 1,328 1,312 RATE.. 226.6 223.9 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 425 422 RATE.. 72.5 72.0 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 332 314 RATE.. 56.6 53.6 7 ACCIDENTS (E800-E949)........NUMBER.. 263 24 RATE.. 44.9 4.1 8 INFECTIONS (771).............NUMBER.. 218 208 RATE.. 37.2 35.5 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 212 212 RATE.. 36.2 36.2 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK ALL BIRTH WEIGHTS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 252 52 RATE.. 43.0 8.9 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 539 144 RATE.. 92.0 24.6 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK ALL BIRTH WEIGHTS (CONTINUED) ... ALL CAUSES...................NUMBER.. 6,151 1,051 3,885 RATE.. 1,049.5 179.3 662.9 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 827 203 425 RATE.. 141.1 34.6 72.5 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 12 110 1,358 RATE.. 2.0 18.8 231.7 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 739 114 75 RATE.. 126.1 19.5 12.8 4 PREMATURITY (765)............NUMBER.. 1,301 11 16 RATE.. 222.0 1.9 2.7 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 420 2 3 RATE.. 71.7 .3 .5 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 272 42 18 RATE.. 46.4 7.2 3.1 7 ACCIDENTS (E800-E949)........NUMBER.. 8 16 239 RATE.. 1.4 2.7 40.8 8 INFECTIONS (771).............NUMBER.. 141 67 10 RATE.. 24.1 11.4 1.7 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 206 6 - RATE.. 35.1 1.0 - CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK ALL BIRTH WEIGHTS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 27 25 200 RATE.. 4.6 4.3 34.1 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 88 56 395 RATE.. 15.0 9.6 67.4 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK LESS THAN 2,500 GRAMS ... ALL CAUSES...................NUMBER.. 73,653 7,214 5,620 RATE.. 9,794.6 7,630.4 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 700 517 RATE.. 950.4 701.9 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 425 26 RATE.. 577.0 35.3 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 868 798 RATE.. 1,178.5 1,083.5 4 PREMATURITY (765)............NUMBER.. 1,175 1,160 RATE.. 1,595.3 1,575.0 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 377 375 RATE.. 511.9 509.1 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 220 210 RATE.. 298.7 285.1 7 ACCIDENTS (E800-E949)........NUMBER.. 58 8 RATE.. 78.7 10.9 8 INFECTIONS (771).............NUMBER.. 171 162 RATE.. 232.2 220.0 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 166 166 RATE.. 225.4 225.4 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK LESS THAN 2,500 GRAMS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 108 32 RATE.. 146.6 43.4 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 274 89 RATE.. 372.0 120.8 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK LESS THAN 2,500 GRAMS (CONTINUED) ... ALL CAUSES...................NUMBER.. 4,976 644 1,594 RATE.. 6,756.0 874.4 2,164.2 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 432 85 183 RATE.. 586.5 115.4 248.5 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 2 24 399 RATE.. 2.7 32.6 541.7 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 694 104 70 RATE.. 942.3 141.2 95.0 4 PREMATURITY (765)............NUMBER.. 1,151 9 15 RATE.. 1,562.7 12.2 20.4 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 373 2 2 RATE.. 506.4 2.7 2.7 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 192 18 10 RATE.. 260.7 24.4 13.6 7 ACCIDENTS (E800-E949)........NUMBER.. 3 5 50 RATE.. 4.1 6.8 67.9 8 INFECTIONS (771).............NUMBER.. 108 54 9 RATE.. 146.6 73.3 12.2 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 165 1 - RATE.. 224.0 1.4 - CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK LESS THAN 2,500 GRAMS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 18 14 76 RATE.. 24.4 19.0 103.2 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 54 35 185 RATE.. 73.3 47.5 251.2 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK 2,500 GRAMS OR MORE ... ALL CAUSES...................NUMBER.. 511,416 3,485 1,210 RATE.. 681.4 236.6 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 721 481 RATE.. 141.0 94.1 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 1,053 96 RATE.. 205.9 18.8 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 42 37 RATE.. 8.2 7.2 4 PREMATURITY (765)............NUMBER.. 31 30 RATE.. 6.1 5.9 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 11 10 RATE.. 2.2 2.0 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 97 89 RATE.. 19.0 17.4 7 ACCIDENTS (E800-E949)........NUMBER.. 205 16 RATE.. 40.1 3.1 8 INFECTIONS (771).............NUMBER.. 44 43 RATE.. 8.6 8.4 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 31 31 RATE.. 6.1 6.1 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK 2,500 GRAMS OR MORE (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 142 19 RATE.. 27.8 3.7 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 260 52 RATE.. 50.8 10.2 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK 2,500 GRAMS OR MORE (CONTINUED) ... ALL CAUSES...................NUMBER.. 816 394 2,275 RATE.. 159.6 77.0 444.8 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 364 117 240 RATE.. 71.2 22.9 46.9 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 10 86 957 RATE.. 2.0 16.8 187.1 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 30 7 5 RATE.. 5.9 1.4 1.0 4 PREMATURITY (765)............NUMBER.. 28 2 1 RATE.. 5.5 .4 .2 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 10 - 1 RATE.. 2.0 - .2 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 67 22 8 RATE.. 13.1 4.3 1.6 7 ACCIDENTS (E800-E949)........NUMBER.. 5 11 189 RATE.. 1.0 2.2 37.0 8 INFECTIONS (771).............NUMBER.. 30 13 1 RATE.. 5.9 2.5 .2 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 26 5 - RATE.. 5.1 1.0 - CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK 2,500 GRAMS OR MORE (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 8 11 123 RATE.. 1.6 2.2 24.1 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 32 20 208 RATE.. 6.3 3.9 40.7 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK NOT STATED BIRTH WEIGHT ... ALL CAUSES...................NUMBER.. 1,016 388 372 RATE.. 38,189.0 36,614.2 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 34 32 RATE.. 3,346.5 3,149.6 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 2 - RATE.. 196.9 - 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 18 18 RATE.. 1,771.7 1,771.7 4 PREMATURITY (765)............NUMBER.. 122 122 RATE.. 12,007.9 12,007.9 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 37 37 RATE.. 3,641.7 3,641.7 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 15 15 RATE.. 1,476.4 1,476.4 7 ACCIDENTS (E800-E949)........NUMBER.. - - RATE.. - - 8 INFECTIONS (771).............NUMBER.. 3 3 RATE.. 295.3 295.3 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 15 15 RATE.. 1,476.4 1,476.4 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK NOT STATED BIRTH WEIGHT 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 2 1 RATE.. 196.9 98.4 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 5 3 RATE.. 492.1 295.3 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK NOT STATED BIRTH WEIGHT (CONTINUED) ... ALL CAUSES...................NUMBER.. 359 13 16 RATE.. 35,334.6 1,279.5 1,574.8 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 31 1 2 RATE.. 3,051.2 98.4 196.9 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. - - 2 RATE.. - - 196.9 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 15 3 - RATE.. 1,476.4 295.3 - 4 PREMATURITY (765)............NUMBER.. 122 - - RATE.. 12,007.9 - - 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 37 - - RATE.. 3,641.7 - - 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 13 2 - RATE.. 1.279.5 196.9 - 7 ACCIDENTS (E800-E949)........NUMBER.. - - - RATE.. - - - 8 INFECTIONS (771).............NUMBER.. 3 - - RATE.. 295.3 - - 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 15 - - RATE.. 1,476.4 - - CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK NOT STATED BIRTH WEIGHT (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 1 - 1 RATE.. 98.4 - 98.4 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 2 1 2 RATE.. 196.9 98.4 196.9 1 INCLUDES RACES OTHER THAN WHITE AND BLACK. 1984 Documentation Tables 1. Live Births/Infant Deaths by State of Occurrence/Residence 1984 DOCUMENTATION TABLE 1 LIVE BIRTHS BY STATE OF OCCURRENCE AND BY STATE OF RESIDENCE AND INFANT DEATHS BY STATE OF OCCURRENCE AND BY STATE OF RESIDENCE 1984 BIRTH COHORT (RESIDENCE AT BIRTH IS OF THE MOTHER; RESIDENCE AT DEATH IS OF THE DECEDENT) LIVE BIRTHS AREA OCCURRENCE RESIDENCE UNITED STATES ......................... 3,673,694 3,669,268 ALABAMA .................................. 58,170 59,216 ALASKA ................................... 12,324 12,455 ARIZONA .................................. 54,862 54,999 ARKANSAS ................................. 34,335 34,844 CALIFORNIA ............................... 447,609 447,754 COLORADO ................................. 54,569 54,364 CONNECTICUT .............................. 42,078 42,232 DELAWARE ................................. 9,550 9,268 DISTRICT OF COLUMBIA ..................... 19,628 9,687 FLORIDA .................................. 155,199 155,399 GEORGIA .................................. 93,774 92,023 HAWAII ................................... 18,756 18,707 IDAHO .................................... 17,805 18,030 ILLINOIS ................................. 176,088 179,275 INDIANA .................................. 80,099 80,088 IOWA ..................................... 42,921 42,367 KANSAS ................................... 38,935 40,012 KENTUCKY ................................. 52,121 53,289 LOUISIANA ................................ 81,496 81,471 MAINE .................................... 16,136 16,772 MARYLAND ................................. 59,304 65,406 MASSACHUSETTS ............................ 79,755 78,281 MICHIGAN ................................. 134,885 136,089 MINNESOTA ................................ 67,040 66,718 MISSISSIPPI .............................. 43,358 43,841 MISSOURI ................................. 76,305 74,745 MONTANA .................................. 13,866 14,141 NEBRASKA ................................. 26,449 26,127 NEVADA ................................... 14,769 14,804 NEW HAMPSHIRE ............................ 14,075 14,250 NEW JERSEY ............................... 98,214 101,333 NEW MEXICO ............................... 27,088 27,378 NEW YORK ................................. 251,863 251,054 UPSTATE ................................ 138,670 141,446 CITY ................................... 113,193 109,608 NORTH CAROLINA ........................... 86,627 86,041 NORTH DAKOTA ............................. 12,729 11,824 OHIO ..................................... 159,222 158,534 OKLAHOMA ................................. 53,081 54,477 OREGON ................................... 40,842 39,563 PENNSYLVANIA ............................. 158,559 157,117 RHODE ISLAND ............................. 13,290 12,659 SOUTH CAROLINA ........................... 48,296 50,663 SOUTH DAKOTA ............................. 12,328 12,445 TENNESSEE ................................ 69,713 65,006 TEXAS .................................... 303,579 299,036 UTAH ..................................... 39,390 38,300 VERMONT .................................. 7,805 8,020 VIRGINIA ................................. 79,365 82,712 WASHINGTON ............................... 68,081 68,926 WEST VIRGINIA ............................ 25,504 24,585 WISCONSIN ................................ 72,763 73,187 WYOMING .................................. 9,094 9,754 FOREIGN RESIDENTS ........................ ... 4,426 INFANT DEATHS AT BIRTH AT DEATH AREA OCCURRENCE RESIDENCE OCCURRENCE RESIDENCE UNITED STATES ............ 38,314 38,292 38,314 38,294 ALABAMA ..................... 735 740 753 744 ALASKA ...................... 134 137 126 136 ARIZONA ..................... 511 515 505 512 ARKANSAS .................... 365 397 358 397 CALIFORNIA .................. 4,037 4,044 4,042 4,039 COLORADO .................... 540 524 564 522 CONNECTICUT ................. 411 411 410 411 DELAWARE .................... 97 95 90 93 DISTRICT OF COLUMBIA ........ 310 200 380 197 FLORIDA ..................... 1,701 1,698 1,702 1,697 GEORGIA ..................... 1,149 1,144 1,152 1,154 HAWAII ...................... 189 186 187 183 IDAHO ....................... 162 180 137 177 ILLINOIS .................... 2,088 2,129 2,046 2,123 INDIANA ..................... 853 843 840 851 IOWA ........................ 354 365 331 367 KANSAS ...................... 370 390 337 390 KENTUCKY .................... 562 603 544 604 LOUISIANA ................... 914 913 919 913 MAINE ....................... 124 136 125 135 MARYLAND .................... 650 724 606 729 MASSACHUSETTS ............... 665 661 676 660 MICHIGAN .................... 1,562 1,572 1,553 1,569 MINNESOTA ................... 615 599 642 603 MISSISSIPPI ................. 600 617 581 619 MISSOURI .................... 817 774 882 765 MONTANA ..................... 121 123 99 122 NEBRASKA .................... 257 249 269 249 NEVADA ...................... 152 148 154 149 NEW HAMPSHIRE ............... 113 121 115 125 NEW JERSEY .................. 1,008 1,061 955 1,050 NEW MEXICO .................. 234 247 232 249 NEW YORK ..................... 2,681 2,683 2,685 2,684 UPSTATE .................... 1,267 1,322 1,240 1,307 CITY ....................... 1,414 1,361 1,445 1,377 NORTH CAROLINA ............... 1,080 1,063 1,093 1,060 NORTH DAKOTA ................. 107 90 114 92 OHIO ......................... 1,560 1,552 1,576 1,549 OKLAHOMA ..................... 568 581 557 575 OREGON ....................... 396 373 405 372 PENNSYLVANIA ................. 1,646 1,599 1,695 1,602 RHODE ISLAND ................. 142 113 147 117 SOUTH CAROLINA ............... 701 735 692 735 SOUTH DAKOTA ................. 120 115 108 116 TENNESSEE .................... 856 763 882 756 TEXAS ........................ 2,994 2,962 3,009 2,969 UTAH ......................... 355 340 396 346 VERMONT ...................... 66 66 59 65 VIRGINIA ..................... 932 976 909 981 WASHINGTON ................... 643 651 648 652 WEST VIRGINIA ................ 280 263 274 266 WISCONSIN .................... 689 712 677 709 WYOMING ...................... 98 109 76 114 FOREIGN RESIDENTS ............ ... 22 ... 20 2. Live Births/Infant Deaths/Mort. Rates by Race, Sex, Birth Wt. 1984 DOCUMENTATION TABLE 2 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY RACE OF CHILD, SEX, AND BIRTH WEIGHT: UNITED STATES 1984 BIRTH COHORT (RATES ARE PER 1000 LIVE BIRTHS) 500 500-749 750-999 1000-1249 RACE OF CHILD AND SEX TOTAL GRAMS GRAMS GRAMS GRAMS ALL RACES1 BOTH SEXES LIVE BIRTHS 3,669,268 4,471 7,888 8,927 10,307 INFANT DEATHS 38,292 3,936 5,899 3,578 1,987 INF. MORT. RATE 10.4 880.3 747.8 400.8 192.8 MALE LIVE BIRTHS 1,879,750 2,223 4,009 4,662 5,264 INFANT DEATHS 21,604 1,958 3,195 2,163 1,214 INF. MORT. RATE 11.5 880.8 797.0 464.0 230.6 FEMALE LIVE BIRTHS 1,789,518 2,248 3,879 4,265 5,043 INFANT DEATHS 16,688 1,978 2,704 1,415 773 INF. MORT. RATE 9.3 879.9 697.1 331.8 153.3 WHITE BOTH SEXES LIVE BIRTHS 2,923,627 2,559 4,663 5,469 6,632 INFANT DEATHS 26,158 2,252 3,595 2,373 1,413 INF. MORT. RATE 8.9 880.0 771.0 433.9 213.1 MALE LIVE BIRTHS 1,500,551 1,258 2,420 2,878 3,411 INFANT DEATHS 14,978 1,111 1,980 1,433 877 INF. MORT. RATE 10.0 883.1 818.2 497.9 257.1 FEMALE LIVE BIRTHS 1,423,076 1,301 2,243 2,591 3,221 INFANT DEATHS 11,180 1,141 1,615 940 536 INF. MORT. RATE 7.9 877.0 720.0 362.8 166.4 BLACK BOTH SEXES LIVE BIRTHS 592,760 1,786 2,949 3,198 3,339 INFANT DEATHS 10,630 1,573 2,110 1,105 509 INF. MORT. RATE 17.9 880.7 715.5 345.5 152.4 MALE LIVE BIRTHS 300,979 898 1,451 1,639 1,675 INFANT DEATHS 5,804 791 1,118 666 301 INF. MORT. RATE 19.3 880.8 770.5 406.3 179.7 FEMALE LIVE BIRTHS 291,781 888 1,498 1,559 1,664 INFANT DEATHS 4,826 782 992 439 208 INF. MORT. RATE 16.5 880.6 662.2 281.6 125.0 1 INCLUDES RACES OTHER THAN WHITE AND BLACK. 1250-1499 1500-1999 2000-2499 2500 GRAMS NOT RACE OF CHILD AND SEX GRAMS GRAMS GRAMS OR MORE STATED ALL RACES1 BOTH SEXES LIVE BIRTHS 11,961 47,064 155,552 3,418,022 5,076 INFANT DEATHS 1,301 2,627 3,228 14,577 1,159 INF. MORT. RATE 108.8 55.8 20.8 4.3 228.3 MALE LIVE BIRTHS 6,115 23,186 70,924 1,760,765 2,602 INFANT DEATHS 795 1,487 1,751 8,428 613 INF. MORT. RATE 130.0 64.1 24.7 4.8 235.6 FEMALE LIVE BIRTHS 5,846 23,878 84,628 1,657,257 2,474 INFANT DEATHS 506 1,140 1,477 6,149 546 INF. MORT. RATE 86.6 47.7 17.5 3.7 220.7 WHITE BOTH SEXES LIVE BIRTHS 7,674 31,192 105,028 2,756,485 3,925 INFANT DEATHS 930 1,908 2,288 10,671 728 INF. MORT. RATE 121.2 61.2 21.8 3.9 185.5 MALE LIVE BIRTHS 3,979 15,538 48,382 1,420,688 1,997 INFANT DEATHS 574 1,112 1,284 6,222 385 INF. MORT. RATE 144.3 71.6 26.5 4.4 192.8 FEMALE LIVE BIRTHS 3,695 15,654 56,646 1,335,797 1,928 INFANT DEATHS 356 796 1,004 4,449 343 INF. MORT. RATE 96.3 50.8 17.7 3.3 177.9 BLACK BOTH SEXES LIVE BIRTHS 3,843 14,163 43,878 518,692 912 INFANT DEATHS 322 631 790 3,212 378 INF. MORT. RATE 83.8 44.6 18.0 6.2 414.5 MALE LIVE BIRTHS 1,912 6,785 19,441 266,713 465 INFANT DEATHS 193 333 401 1,807 194 INF. MORT. RATE 100.9 49.1 20.6 6.8 417.2 FEMALE LIVE BIRTHS 1,931 7,378 24,437 251,979 447 INFANT DEATHS 129 298 389 1,405 184 INF. MORT. RATE 66.8 40.4 15.9 5.6 411.6 1 INCLUDES RACES OTHER THAN WHITE AND BLACK. 3. Live Birth/Infant Death/Mort Rate by Birth Wt.,Race,Gest. Age 1984 DOCUMENTATION TABLE 3 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND GESTATIONAL AGE: UNITED STATES 1984 BIRTH COHORT (RATES ARE PER 1000 LIVE BIRTHS) GESTATION BIRTH WEIGHT AND RACE <28 28-31 32-35 36 OF CHILD TOTAL WEEKS WEEKS WEEKS WEEKS ALL RACES1 TOTAL LIVE BIRTHS 3,669,268 25,972 38,354 157,768 108,341 INFANT DEATHS 38,292 11,256 3,509 3,653 1,204 INF. MORT. RATE 10.4 433.4 91.5 23.2 11.1 LESS THAN 2,500 GRAMS LIVE BIRTHS 246,170 19,532 25,505 65,817 21,788 INFANT DEATHS 22,556 10,545 3,238 2,677 592 INF. MORT. RATE 91.6 539.9 127.0 40.7 27.2 LESS THAN 500 GRAMS LIVE BIRTHS 4,471 3,340 153 68 15 INFANT DEATHS 3,936 3,066 123 41 7 INF. MORT. RATE 880.3 918.0 803.9 602.9 466.7 500-749 GRAMS LIVE BIRTHS 7,888 5,475 786 208 40 INFANT DEATHS 5,899 4,337 501 138 18 INF. MORT. RATE 747.8 792.1 637.4 663.5 450.0 750-999 GRAMS LIVE BIRTHS 8,927 4,853 2,062 559 59 INFANT DEATHS 3,578 2,182 646 164 23 INF. MORT. RATE 400.8 449.6 313.3 293.4 389.8 1,000-1,249 GRAMS LIVE BIRTHS 10,307 2,361 4,636 1,569 162 INFANT DEATHS 1,987 636 755 267 30 INF. MORT. RATE 192.8 269.4 162.9 170.2 185.2 1,250-1,499 GRAMS LIVE BIRTHS 11,961 958 5,315 3,176 319 INFANT DEATHS 1,301 163 535 303 37 INF. MORT. RATE 108.8 170.1 100.7 95.4 116.0 1,500-1,999 GRAMS LIVE BIRTHS 47,064 1,327 8,502 19,603 3,524 INFANT DEATHS 2,627 103 514 913 169 INF. MORT. RATE 55.8 77.6 60.5 46.6 48.0 GESTATION BIRTH WEIGHT AND RACE <28 28-31 32-35 36 OF CHILD TOTAL WEEKS WEEKS WEEKS WEEKS ALL RACES1 CONTINUED 2,000-2,499 GRAMS LIVE BIRTHS 155,552 1,218 4,051 40,634 17,669 INFANT DEATHS 3,228 58 164 851 308 INF. MORT. RATE 20.8 47.6 40.5 20.9 17.4 2,500-2,999 GRAMS LIVE BIRTHS 583,512 1,837 4,454 40,183 37,590 INFANT DEATHS 4,547 44 89 477 322 INF. MORT. RATE 7.8 24.0 20.0 11.9 8.6 3,000-3,499 GRAMS LIVE BIRTHS 1,345,139 2,294 5,058 32,635 32,190 INFANT DEATHS 5,548 49 44 281 182 INF. MORT. RATE 4.1 21.4 8.7 8.6 5.7 3,500-3,999 GRAMS LIVE BIRTHS 1,083,116 1,229 2,505 14,966 13,028 INFANT DEATHS 3,150 28 28 104 65 INF. MORT. RATE 2.9 22.8 11.2 6.9 5.0 4,000-4,499 GRAMS LIVE BIRTHS 335,176 299 523 3,287 3,027 INFANT DEATHS 961 18 7 22 17 INF. MORT. RATE 2.9 60.2 13.7 6.7 5.6 4,500-4,999 GRAMS LIVE BIRTHS 62,629 78 109 521 544 INFANT DEATHS 215 22 4 3 2 INF. MORT. RATE 3.4 282.1 36.7 5.8 3.7 5,000 GRAMS OR MORE LIVE BIRTHS 8,450 96 20 94 77 INFANT DEATHS 156 63 4 7 2 INF. MORT. RATE 18.5 656.3 200.0 74.5 26.0 NOT STATED LIVE BIRTHS 5,076 607 180 265 97 INFANT DEATHS 1,159 487 95 82 22 INF. MORT. RATE 228.3 802.3 527.8 309.4 226.8 GESTATION BIRTH WEIGHT AND RACE 37-39 40 41 42 WEEKS NOT OF CHILD WEEKS WEEKS WEEKS OR MORE STATED ALL RACES1 CONTINUED TOTAL LIVE BIRTHS 1,319,030 785,108 546,353 530,692 157,650 INFANT DEATHS 6,856 3,004 2,296 2,917 3,597 INF. MORT. RATE 5.2 3.8 4.2 5.5 22.8 LESS THAN 2,500 GRAMS LIVE BIRTHS 62,626 14,328 8,302 11,471 16,801 INFANT DEATHS 1,638 457 367 528 2,514 INF. MORT. RATE 26.2 31.9 44.2 46.0 149.6 LESS THAN 500 GRAMS LIVE BIRTHS 72 38 58 42 685 INFANT DEATHS 27 11 37 19 605 INF. MORT. RATE 375.0 289.5 637.9 452.4 883.2 500-749 GRAMS LIVE BIRTHS 166 93 65 117 938 INFANT DEATHS 55 36 29 56 729 INF. MORT. RATE 331.3 387.1 446.2 478.6 777.2 750-999 GRAMS LIVE BIRTHS 189 107 74 104 920 INFANT DEATHS 72 25 24 34 408 INF. MORT. RATE 381.0 233.6 324.3 326.9 443.5 1,000-1,249 GRAMS LIVE BIRTHS 331 112 90 148 898 INFANT DEATHS 44 20 17 22 196 INF. MORT. RATE 132.9 178.6 188.9 148.6 218.3 1,250-1,499 GRAMS LIVE BIRTHS 738 148 110 201 996 INFANT DEATHS 91 14 20 23 115 INF. MORT. RATE 123.3 94.6 181.8 114.4 115.5 1,500-1,999 GRAMS LIVE BIRTHS 7,100 1,286 890 1,416 3,416 INFANT DEATHS 405 91 71 121 240 INF. MORT. RATE 57.0 70.8 79.8 85.5 70.3 GESTATION BIRTH WEIGHT AND RACE 37-39 40 41 42 WEEKS NOT OF CHILD WEEKS WEEKS WEEKS OR MORE STATED ALL RACES1 CONTINUED 2,000-2,499 GRAMS LIVE BIRTHS 54,030 12,544 7,015 9,443 8,948 INFANT DEATHS 944 260 169 253 221 INF. MORT. RATE 17.5 20.7 24.1 26.8 24.7 2,500-2,999 GRAMS LIVE BIRTHS 269,815 90,783 51,111 59,297 28,442 INFANT DEATHS 1,780 596 406 556 277 INF. MORT. RATE 6.6 6.6 7.9 9.4 9.7 3,000-3,499 GRAMS LIVE BIRTHS 553,510 298,417 185,254 179,884 55,897 INFANT DEATHS 2,102 993 714 877 306 INF. MORT. RATE 3.8 3.3 3.9 4.9 5.5 3,500-3,999 GRAMS LIVE BIRTHS 341,018 278,523 205,060 186,649 40,138 INFANT DEATHS 948 666 537 615 159 INF. MORT. RATE 2.8 2.4 2.6 3.3 4.0 4,000-4,499 GRAMS LIVE BIRTHS 77,962 86,363 78,077 74,003 11,635 INFANT DEATHS 228 206 189 228 46 INF. MORT. RATE 2.9 2.4 2.4 3.1 4.0 4,500-4,999 GRAMS LIVE BIRTHS 11,703 14,607 16,197 16,658 2,212 INFANT DEATHS 46 40 35 45 18 INF. MORT. RATE 3.9 2.7 2.2 2.7 8.1 5,000 GRAMS OR MORE LIVE BIRTHS 1,597 1,697 2,067 2,440 362 INFANT DEATHS 11 10 18 22 19 INF. MORT. RATE 6.9 5.9 8.7 9.0 52.5 NOT STATED LIVE BIRTHS 799 390 285 290 2,163 INFANT DEATHS 103 36 30 46 258 INF. MORT. RATE 128.9 92.3 105.3 158.6 119.3 GESTATION BIRTH WEIGHT AND RACE < 28 28-31 32-35 36 OF CHILD TOTAL WEEKS WEEKS WEEKS WEEKS WHITE TOTAL LIVE BIRTHS 2,923,627 15,066 23,545 104,986 77,487 INFANT DEATHS 26,158 6,933 2,392 2,519 869 INF. MORT. RATE 8.9 460.2 101.6 24.0 11.2 LESS THAN 2,500 GRAMS LIVE BIRTHS 163,217 11,393 16,161 44,965 14,844 INFANT DEATHS 14,759 6,540 2,235 1,886 424 INF. MORT. RATE 90.4 574.0 138.3 41.9 28.6 LESS THAN 500 GRAMS LIVE BIRTHS 2,559 1,923 79 40 9 INFANT DEATHS 2,252 1,779 66 24 4 INF. MORT. RATE 880.0 925.1 835.4 600.0 444.4 500-749 GRAMS LIVE BIRTHS 4,663 3,263 460 111 20 INFANT DEATHS 3,595 2,658 317 77 9 INF. MORT. RATE 771.0 814.6 689.1 693.7 450.0 750-999 GRAMS LIVE BIRTHS 5,469 2,994 1,238 365 25 INFANT DEATHS 2,373 1,463 422 114 15 INF. MORT. RATE 433.9 488.6 340.9 312.3 600.0 1,000-1,249 GRAMS LIVE BIRTHS 6,632 1,484 2,998 1,039 119 INFANT DEATHS 1,413 438 545 195 21 INF. MORT. RATE 213.1 295.1 181.8 187.7 176.5 1,250-1,499 GRAMS LIVE BIRTHS 7,674 507 3,511 2,065 212 INFANT DEATHS 930 114 395 214 30 INF. MORT. RATE 121.2 224.9 112.5 103.6 141.5 1,500-1,999 GRAMS LIVE BIRTHS 31,192 627 5,676 13,132 2,347 INFANT DEATHS 1,908 57 380 650 131 INF. MORT. RATE 61.2 90.9 66.9 49.5 55.8 GESTATION BIRTH WEIGHT AND RACE < 28 28-31 32-35 36 OF CHILD TOTAL WEEKS WEEKS WEEKS WEEKS WHITE CONTINUED 2,000-2,499 GRAMS LIVE BIRTHS 105,028 595 2,199 28,213 12,112 INFANT DEATHS 2,288 31 110 612 214 INF. MORT. RATE 21.8 52.1 50.0 21.7 17.7 2,500-2,999 GRAMS LIVE BIRTHS 413,512 925 2,232 26,161 26,850 INFANT DEATHS 3,120 19 44 305 219 INF. MORT. RATE 7.5 20.5 19.7 11.7 8.2 3,000-3,499 GRAMS LIVE BIRTHS 1,055,523 1,271 2,895 20,352 23,106 INFANT DEATHS 3,993 23 28 166 142 INF. MORT. RATE 3.8 18.1 9.7 8.2 6.1 3,500-3,999 GRAMS LIVE BIRTHS 1,083,116 1,229 2,505 14,966 13,028 INFANT DEATHS 3,150 28 28 104 65 INF. MORT. RATE 2.9 22.8 11.2 6.9 5.0 4,000-4,499 GRAMS LIVE BIRTHS 335,176 299 523 3,287 3,027 INFANT DEATHS 961 18 7 22 17 INF. MORT. RATE 2.9 60.2 13.4 6.7 5.6 4,500-4,999 GRAMS LIVE BIRTHS 62,629 78 109 521 544 INFANT DEATHS 215 22 4 3 2 INF. MORT. RATE 3.4 282.1 36.7 5.8 3.7 5,000 GRAMS OR MORE LIVE BIRTHS 8,450 96 20 94 77 INFANT DEATHS 156 63 4 7 2 INF. MORT. RATE 18.5 656.3 200.0 74.5 26.0 NOT STATED LIVE BIRTHS 5,076 607 180 265 97 INFANT DEATHS 1,159 487 95 82 22 INF. MORT. RATE 228.3 802.3 527.8 309.4 226.8 GESTATION BIRTH WEIGHT AND RACE 37-39 40 41 42 WEEKS NOT OF CHILD WEEKS WEEKS WEEKS OR MORE STATED WHITE CONTINUED TOTAL LIVE BIRTHS 1,028,531 651,003 463,577 438,702 120,730 INFANT DEATHS 4,922 2,220 1,772 2,203 2,328 INF. MORT. RATE 4.8 3.4 3.8 5.0 19.3 LESS THAN 2,500 GRAMS LIVE BIRTHS 41,846 9,735 5,710 7,565 10,998 INFANT DEATHS 1,144 328 260 365 1,577 INF. MORT. RATE 27.3 33.7 45.5 48.2 143.4 LESS THAN 500 GRAMS LIVE BIRTHS 43 25 32 26 382 INFANT DEATHS 15 4 17 11 332 INF. MORT. RATE 348.8 160.0 531.3 423.1 869.1 500-749 GRAMS LIVE BIRTHS 101 49 39 75 545 INFANT DEATHS 29 20 14 30 441 INF. MORT. RATE 287.1 408.2 359.0 400.0 809.2 750-999 GRAMS LIVE BIRTHS 115 59 40 63 570 INFANT DEATHS 47 15 13 22 262 INF. MORT. RATE 408.7 254.2 325.0 349.2 459.6 1,000-1,249 GRAMS LIVE BIRTHS 210 66 64 84 568 INFANT DEATHS 33 11 15 15 140 INF. MORT. RATE 157.1 166.7 234.4 178.6 246.5 1,250-1,499 GRAMS LIVE BIRTHS 440 104 80 125 630 INFANT DEATHS 57 11 19 17 73 INF. MORT. RATE 129.5 105.8 237.5 136.0 115.9 1,500-1,999 GRAMS LIVE BIRTHS 4,713 854 580 966 2,297 INFANT DEATHS 297 67 57 88 181 INF. MORT. RATE 63.0 78.5 98.3 91.1 78.8 GESTATION BIRTH WEIGHT AND RACE 37-39 40 41 42 WEEKS NOT OF CHILD WEEKS WEEKS WEEKS OR MORE STATED WHITE CONTINUED 2,000-2,499 GRAMS LIVE BIRTHS 36,224 8,578 4,875 6,226 6,006 INFANT DEATHS 666 200 125 182 148 INF. MORT. RATE 18.4 23.3 25.6 29.2 24.6 2,500-2,999 GRAMS LIVE BIRTHS 190,864 66,427 37,630 42,534 19,889 INFANT DEATHS 1,205 418 302 409 199 INF. MORT. RATE 6.3 6.3 8.0 9.6 10.0 3,000-3,499 GRAMS LIVE BIRTHS 430,016 240,569 152,048 142,769 42,497 INFANT DEATHS 1,518 714 536 660 206 INF. MORT. RATE 3.5 3.0 3.5 4.6 4.8 3,500-3,999 GRAMS LIVE BIRTHS 285,630 241,616 180,074 161,370 33,135 INFANT DEATHS 744 519 448 494 117 INF. MORT. RATE 2.6 2.1 2.5 3.1 3.5 4,000-4,499 GRAMS LIVE BIRTHS 68,028 77,715 71,094 66,694 10,088 INFANT DEATHS 184 175 161 194 41 INF. MORT. RATE 2.7 2.3 2.3 2.9 4.1 4,500-4,999 GRAMS LIVE BIRTHS 10,236 13,158 14,901 15,321 1,975 INFANT DEATHS 37 34 28 36 12 INF. MORT. RATE 3.6 2.6 1.9 2.3 6.1 5,000 GRAMS OR MORE LIVE BIRTHS 1,306 1,479 1,890 2,216 307 INFANT DEATHS 10 8 16 16 11 INF. MORT. RATE 7.7 5.4 8.5 7.2 35.8 NOT STATED LIVE BIRTHS 605 304 230 233 1,841 INFANT DEATHS 80 24 21 29 165 INF. MORT. RATE 132.2 78.9 91.3 124.5 89.6 GESTATION BIRTH WEIGHT AND RACE < 28 28-31 32-35 36 OF CHILD TOTAL WEEKS WEEKS WEEKS WEEKS BLACK TOTAL LIVE BIRTHS 592,760 10,117 13,354 45,905 26,251 INFANT DEATHS 10,630 3,990 998 986 279 INF. MORT. RATE 17.9 394.4 74.7 21.5 10.6 LESS THAN 2,500 GRAMS LIVE BIRTHS 73,156 7,574 8,472 18,458 6,054 INFANT DEATHS 7,040 3,697 895 700 139 INF. MORT. RATE 96.2 488.1 105.6 37.9 23.0 LESS THAN 500 GRAMS LIVE BIRTHS 1,786 1,330 70 25 6 INFANT DEATHS 1,573 1,203 54 14 3 INF. MORT. RATE 880.7 904.5 771.4 560.4 500.0 500-749 GRAMS LIVE BIRTHS 2,949 2,051 298 83 20 INFANT DEATHS 2,110 1,547 167 54 9 INF. MORT. RATE 715.5 754.3 560.4 650.6 450.0 750-999 GRAMS LIVE BIRTHS 3,198 1,725 762 185 33 INFANT DEATHS 1,105 661 202 49 8 INF. MORT. RATE 345.5 383.2 265.1 264.9 242.4 1,000-1,249 GRAMS LIVE BIRTHS 3,339 799 1,499 484 35 INFANT DEATHS 509 176 186 64 8 INF. MORT. RATE 152.4 220.3 124.1 132.2 228.6 1,250-1,499 GRAMS LIVE BIRTHS 3,843 422 1,625 1,007 95 INFANT DEATHS 322 45 118 81 6 INF. MORT. RATE 83.8 106.6 72.6 80.4 63.2 1,500-1,999 GRAMS LIVE BIRTHS 14,163 653 2,540 5,772 1,040 INFANT DEATHS 631 41 124 233 31 INF. MORT. RATE 44.6 62.8 48.8 40.4 29.8 GESTATION BIRTH WEIGHT AND RACE < 28 28-31 32-35 36 OF CHILD TOTAL WEEKS WEEKS WEEKS WEEKS BLACK CONTINUED 2,000-2,499 GRAMS LIVE BIRTHS 43,878 594 1,678 10,902 4,825 INFANT DEATHS 790 24 44 205 74 INF. MORT. RATE 18.0 40.4 26.2 18.8 15.3 2,500-2,999 GRAMS LIVE BIRTHS 140,269 859 2,016 12,270 9,079 INFANT DEATHS 1,203 23 40 150 84 INF. MORT. RATE 8.6 26.8 19.8 12.2 9.3 3,000-3,499 GRAMS LIVE BIRTHS 227,559 944 1,934 10,511 7,753 INFANT DEATHS 1,277 26 15 94 36 INF. MORT. RATE 5.6 27.5 7.8 8.9 4.6 3,500-3,999 GRAMS LIVE BIRTHS 119,608 364 724 3,856 2,708 INFANT DEATHS 538 18 13 22 11 INF. MORT. RATE 4.5 49.5 18.0 5.7 4.1 4,000-4,499 GRAMS LIVE BIRTHS 26,274 82 112 624 551 INFANT DEATHS 115 4 2 2 2 INF. MORT. RATE 4.4 48.8 17.9 3.2 3.6 4,500-4,999 GRAMS LIVE BIRTHS 4,229 21 19 97 88 INFANT DEATHS 38 10 1 1 - INF. MORT. RATE 9.0 476.2 52.6 10.3 - 5,000 GRAMS OR MORE LIVE BIRTHS 753 27 11 25 6 INFANT DEATHS 41 19 3 2 - INF. MORT. RATE 54.4 703.7 272.7 80.0 - NOT STATED LIVE BIRTHS 912 246 66 64 12 INFANT DEATHS 378 193 29 15 7 INF. MORT. RATE 414.5 784.6 439.4 234.4 583.3 GESTATION BIRTH WEIGHT AND RACE 37-39 40 41 42 WEEKS NOT OF CHILD WEEKS WEEKS WEEKS OR MORE STATED BLACK CONTINUED TOTAL LIVE BIRTHS 230,912 103,751 64,059 73,656 24,755 INFANT DEATHS 1,607 662 436 582 1,090 INF. MORT. RATE 7.0 6.4 6.8 7.9 44.0 LESS THAN 2,500 GRAMS LIVE BIRTHS 18,072 3,995 2,244 3,481 4,806 INFANT DEATHS 426 120 98 145 820 INF. MORT. RATE 23.6 30.0 43.7 41.7 170.6 LESS THAN 500 GRAMS LIVE BIRTHS 24 12 23 14 282 INFANT DEATHS 11 6 20 7 255 INF. MORT. RATE 458.3 500.0 869.6 500.0 904.3 500-749 GRAMS LIVE BIRTHS 52 35 22 35 353 INFANT DEATHS 23 16 15 23 256 INF. MORT. RATE 442.3 457.1 681.8 657.1 725.2 750-999 GRAMS LIVE BIRTHS 67 40 31 39 316 INFANT DEATHS 24 9 11 12 129 INF. MORT. RATE 358.2 225.0 354.8 307.7 408.2 1,000-1,249 GRAMS LIVE BIRTHS 111 43 24 57 287 INFANT DEATHS 10 8 2 7 48 INF. MORT. RATE 90.1 186.0 83.3 122.8 167.2 1,250-1,499 GRAMS LIVE BIRTHS 265 43 23 66 297 INFANT DEATHS 30 3 1 5 33 INF. MORT. RATE 113.2 69.8 43.5 75.8 111.1 1,500-1,999 GRAMS LIVE BIRTHS 2,151 391 272 406 938 INFANT DEATHS 92 23 10 28 49 INF. MORT. RATE 42.8 58.8 36.8 69.0 52.2 GESTATION BIRTH WEIGHT AND RACE 37-39 40 41 42 WEEKS NOT OF CHILD WEEKS WEEKS WEEKS OR MORE STATED BLACK CONTINUED 2,000-2,499 GRAMS LIVE BIRTHS 15,402 3,431 1,849 2,864 2,333 INFANT DEATHS 236 55 39 63 50 INF. MORT. RATE 15.3 16.0 21.1 22.0 21.4 2,500-2,999 GRAMS LIVE BIRTHS 64,690 19,908 11,146 14,270 6,031 INFANT DEATHS 485 148 82 126 65 INF. MORT. RATE 7.5 7.4 7.4 8.8 10.8 3,000-3,499 GRAMS LIVE BIRTHS 96,968 44,805 26,004 30,091 8,549 INFANT DEATHS 476 235 148 174 73 INF. MORT. RATE 4.9 5.2 5.7 5.8 8.5 3,500-3,999 GRAMS LIVE BIRTHS 42,456 27,479 18,551 19,363 4,107 INFANT DEATHS 165 118 70 91 30 INF. MORT. RATE 3.9 4.3 3.8 4.7 7.3 4,000-4,499 GRAMS LIVE BIRTHS 7,341 6,300 5,027 5,373 864 INFANT DEATHS 31 24 22 25 3 INF. MORT. RATE 4.2 3.8 4.4 4.7 3.5 4,500-4,999 GRAMS LIVE BIRTHS 1,039 1,018 925 883 139 INFANT DEATHS 5 4 7 5 5 INF. MORT. RATE 4.8 3.9 7.6 5.7 36.0 5,000 GRAMS OR MORE LIVE BIRTHS 198 178 129 151 28 INFANT DEATHS 1 2 2 4 8 INF. MORT. RATE 5.1 11.2 15.5 26.5 285.7 NOT STATED LIVE BIRTHS 148 68 33 44 231 INFANT DEATHS 18 11 7 12 86 INF. MORT. RATE 121.6 161.8 212.1 272.7 372.3 1 INCLUDES RACES OTHER THAN WHITE AND BLACK. 4. Live Birth/Infant Death/Mort Rate by Birth Wt,Race,Age at Dea 1984 DOCUMENTATION TABLE 4 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND AGE AT DEATH: UNITED STATES 1984 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 1000 LIVE BIRTHS) BIRTH WEIGHT AND RACE LIVE INFANT TOTAL OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 TOTAL (ALL BIRTH WEIGHTS)...NUMBER.. 3,669,268 38,292 24,995 RATE.. 10.4 6.8 LESS THAN 2,500 GRAMS.......NUMBER.. 246,170 22,556 18,327 RATE.. 91.6 74.4 LESS THAN 500 GRAMS.......NUMBER.. 4,471 3,936 3,902 RATE.. 880.3 872.7 500-749 GRAMS.............NUMBER.. 7,888 5,899 5,472 RATE.. 747.8 693.7 750-999 GRAMS.............NUMBER.. 8,927 3,578 2,925 RATE.. 400.8 327.7 1,000-1,249 GRAMS.........NUMBER.. 10,307 1,987 1,497 RATE.. 192.8 145.2 1,250-1,499 GRAMS.........NUMBER.. 11,961 1,301 956 RATE.. 108.8 79.9 1,500-1,999 GRAMS.........NUMBER.. 47,064 2,627 1,769 RATE.. 55.8 37.6 2,000-2,499 GRAMS.........NUMBER.. 155,552 3,228 1,806 RATE.. 20.8 11.6 2,500-2,999 GRAMS...........NUMBER.. 583,512 4,547 1,837 RATE.. 7.8 3.1 3,000-3,499 GRAMS...........NUMBER.. 1,345,139 5,548 1,963 RATE.. 4.1 1.5 BIRTH WEIGHT AND RACE LIVE INFANT TOTAL OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 CONTINUED 3,500-3,999 GRAMS...........NUMBER.. 1,083,116 3,150 1,152 RATE.. 2.9 1.1 4,000-4,499 GRAMS...........NUMBER.. 335,176 961 400 RATE.. 2.9 1.2 4,500-4,999 GRAMS...........NUMBER.. 62,629 215 113 RATE.. 3.4 1.8 5,000 GRAMS OR MORE.........NUMBER.. 8,450 156 120 RATE.. 18.5 14.2 NOT STATED..................NUMBER.. 5,076 1,159 1,083 RATE.. 228.3 213.4 BIRTH WEIGHT AND RACE EARLY LATE POST OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 CONTINUED TOTAL (ALL BIRTH WEIGHTS)...NUMBER.. 20,977 4,018 13,297 RATE.. 5.7 1.1 3.6 LESS THAN 2,500 GRAMS.......NUMBER.. 16,035 2,292 4,229 RATE.. 65.1 9.3 17.2 LESS THAN 500 GRAMS.......NUMBER.. 3,876 26 34 RATE.. 866.9 5.8 7.6 500-749 GRAMS.............NUMBER.. 5,055 417 427 RATE.. 640.8 52.9 54.1 750-999 GRAMS.............NUMBER.. 2,387 538 653 RATE.. 267.4 60.3 73.1 1,000-1,249 GRAMS.........NUMBER.. 1,144 353 490 RATE.. 111.0 34.2 47.5 1,250-1,499 GRAMS.........NUMBER.. 742 214 345 RATE.. 62.0 17.9 28.8 1,500-1,999 GRAMS.........NUMBER.. 1,443 326 858 RATE.. 30.7 6.9 18.2 2,000-2,499 GRAMS.........NUMBER.. 1,388 418 1,422 RATE.. 8.9 2.7 9.1 2,500-2,999 GRAMS...........NUMBER.. 1,283 554 2,710 RATE.. 2.2 .9 4.6 3,000-3,499 GRAMS...........NUMBER.. 1,346 617 3,585 RATE.. 1.0 .5 2.7 3,500-3,999 GRAMS...........NUMBER.. 794 358 1,998 RATE.. .7 .3 1.8 BIRTH WEIGHT AND RACE EARLY LATE POST OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 CONTINUED 4,000-4,499 GRAMS...........NUMBER.. 299 101 561 RATE.. .9 .3 1.7 4,500-4,999 GRAMS...........NUMBER.. 90 23 102 RATE.. 1.4 .4 1.6 5,000 GRAMS OR MORE.........NUMBER.. 103 17 36 RATE.. 12.2 2.0 4.3 NOT STATED..................NUMBER.. 1,027 56 76 RATE.. 202.3 11.0 15.0 BIRTH WEIGHT AND RACE LIVE INFANT TOTAL OF CHILD BIRTHS DEATHS NEONATAL WHITE TOTAL (ALL BIRTH WEIGHTS)...NUMBER.. 2,923,627 26,158 17,178 RATE.. 8.9 5.9 LESS THAN 2,500 GRAMS.......NUMBER.. 163,217 14,759 12,233 RATE.. 90.4 74.9 LESS THAN 500 GRAMS.......NUMBER.. 2,559 2,252 2,235 RATE.. 880.0 873.4 500-749 GRAMS.............NUMBER.. 4,663 3,595 3,371 RATE.. 771.0 722.9 750-999 GRAMS.............NUMBER.. 5,469 2,373 2,035 RATE.. 433.9 372.1 1,000-1,249 GRAMS.........NUMBER.. 6,632 1,413 1,118 RATE.. 213.1 168.6 1,250-1,499 GRAMS.........NUMBER.. 7,674 930 711 RATE.. 121.2 92.7 1,500-1,999 GRAMS.........NUMBER.. 31,192 1,908 1,371 RATE.. 61.2 44.0 2,000-2,499 GRAMS.........NUMBER.. 105,028 2,288 1,392 RATE.. 21.8 13.3 2,500-2,999 GRAMS...........NUMBER.. 413,512 3,120 1,350 RATE.. 7.5 3.3 3,000-3,499 GRAMS...........NUMBER.. 1,055,523 3,993 1,505 RATE.. 3.8 1.4 3,500-3,999 GRAMS...........NUMBER.. 924,435 2,474 908 RATE.. 2.7 1.0 BIRTH WEIGHT AND RACE LIVE INFANT TOTAL OF CHILD BIRTHS DEATHS NEONATAL WHITE CONTINUED 4,000-4,499 GRAMS...........NUMBER.. 299,072 806 336 RATE.. 2.7 1.1 4,500-4,999 GRAMS...........NUMBER.. 56,538 165 81 RATE.. 2.9 1.4 5,000 GRAMS OR MORE.........NUMBER.. 7,405 113 86 RATE.. 15.3 11.6 NOT STATED..................NUMBER.. 3,925 728 679 RATE.. 185.5 173.0 BIRTH WEIGHT AND RACE EARLY LATE POST OF CHILD NEONATAL NEONATAL NEONATAL WHITE CONTINUED TOTAL (ALL BIRTH WEIGHTS)...NUMBER.. 14,304 2,874 8,980 RATE.. 4.9 1.0 3.1 LESS THAN 2,500 GRAMS.......NUMBER.. 10,681 1,552 2,526 RATE.. 65.4 9.5 15.5 LESS THAN 500 GRAMS.......NUMBER.. 2,217 18 17 RATE.. 866.4 7.0 6.6 500-749 GRAMS.............NUMBER.. 3,130 241 224 RATE.. 671.2 51.7 48.0 750-999 GRAMS.............NUMBER.. 1,667 368 338 RATE.. 304.8 67.3 61.8 1,000-1,249 GRAMS.........NUMBER.. 876 242 295 RATE.. 132.1 36.5 44.5 1,250-1,499 GRAMS.........NUMBER.. 563 148 219 RATE.. 73.4 19.3 28.5 1,500-1,999 GRAMS.........NUMBER.. 1,138 233 537 RATE.. 36.5 7.5 17.2 2,000-2,499 GRAMS.........NUMBER.. 1,090 302 896 RATE.. 10.4 2.9 8.5 2,500-2,999 GRAMS...........NUMBER.. 953 397 1,770 RATE.. 2.3 1.0 4.3 3,000-3,499 GRAMS...........NUMBER.. 1,032 473 2,488 RATE.. 1.0 .4 2.4 3,500-3,999 GRAMS...........NUMBER.. 622 286 1,566 RATE.. .7 .3 1.7 BIRTH WEIGHT AND RACE EARLY LATE POST OF CHILD NEONATAL NEONATAL NEONATAL WHITE CONTINUED 4,000-4,499 GRAMS...........NUMBER.. 248 88 470 RATE.. .8 .3 1.6 4,500-4,999 GRAMS...........NUMBER.. 62 19 84 RATE.. 1.1 .3 1.5 5,000 GRAMS OR MORE.........NUMBER.. 71 15 27 RATE.. 9.6 2.0 3.6 NOT STATED..................NUMBER.. 635 44 49 RATE.. 161.8 11.2 12.5 BIRTH WEIGHT AND RACE LIVE INFANT TOTAL OF CHILD BIRTHS DEATHS NEONATAL BLACK TOTAL (ALL BIRTH WEIGHTS)...NUMBER.. 592,760 10,630 6,927 RATE.. 17.9 11.7 LESS THAN 2,500 GRAMS.......NUMBER.. 73,156 7,040 5,490 RATE.. 96.2 75.0 LESS THAN 500 GRAMS.......NUMBER.. 1,786 1,573 1,557 RATE.. 880.7 871.8 500-749 GRAMS.............NUMBER.. 2,949 2,110 1,922 RATE.. 715.5 651.7 750-999 GRAMS.............NUMBER.. 3,198 1,105 809 RATE.. 345.5 253.0 1,000-1,249 GRAMS.........NUMBER.. 3,339 509 328 RATE.. 152.4 98.2 1,250-1,499 GRAMS.........NUMBER.. 3,843 322 207 RATE.. 83.8 53.9 1,500-1,999 GRAMS.........NUMBER.. 14,163 631 339 RATE.. 44.6 23.9 2,000-2,499 GRAMS.........NUMBER.. 43,878 790 328 RATE.. 18.0 7.5 2,500-2,999 GRAMS...........NUMBER.. 140,269 1,203 400 RATE.. 8.6 2.9 3,000-3,499 GRAMS...........NUMBER.. 227,559 1,277 371 RATE.. 5.6 1.6 3,500-3,999 GRAMS...........NUMBER.. 119,608 538 203 RATE.. 4.5 1.7 BIRTH WEIGHT AND RACE LIVE INFANT TOTAL OF CHILD BIRTHS DEATHS NEONATAL BLACK CONTINUED 4,000-4,499 GRAMS...........NUMBER.. 26,274 115 49 RATE.. 4.4 1.9 4,500-4,999 GRAMS...........NUMBER.. 4,229 38 26 RATE.. 9.0 6.1 5,000 GRAMS OR MORE.........NUMBER.. 753 41 34 RATE.. 54.4 45.2 NOT STATED..................NUMBER.. 912 378 354 RATE.. 414.5 388.2 BIRTH WEIGHT AND RACE EARLY LATE POST OF CHILD NEONATAL NEONATAL NEONATAL BLACK CONTINUED TOTAL (ALL BIRTH WEIGHTS)...NUMBER.. 5,946 981 3,703 RATE.. 10.0 1.7 6.2 LESS THAN 2,500 GRAMS.......NUMBER.. 4,840 650 1,550 RATE.. 66.2 8.9 21.2 LESS THAN 500 GRAMS.......NUMBER.. 1,551 6 16 RATE.. 868.4 3.4 9.0 500-749 GRAMS.............NUMBER.. 1,759 163 188 RATE.. 596.5 55.3 63.8 750-999 GRAMS.............NUMBER.. 658 151 296 RATE.. 205.8 47.2 92.6 1,000-1,249 GRAMS.........NUMBER.. 230 98 181 RATE.. 68.9 29.4 54.2 1,250-1,499 GRAMS.........NUMBER.. 150 57 115 RATE.. 39.0 14.8 29.9 1,500-1,999 GRAMS.........NUMBER.. 259 80 292 RATE.. 18.3 5.6 20.6 2,000-2,499 GRAMS.........NUMBER.. 233 95 462 RATE.. 5.3 2.2 10.5 2,500-2,999 GRAMS...........NUMBER.. 272 128 803 RATE.. 1.9 .9 5.7 3,000-3,499 GRAMS...........NUMBER.. 251 120 906 RATE.. 1.1 .5 4.0 3,500-3,999 GRAMS...........NUMBER.. 144 59 335 RATE.. 1.2 .5 2.8 BIRTH WEIGHT AND RACE EARLY LATE POST OF CHILD NEONATAL NEONATAL NEONATAL BLACK CONTINUED 4,000-4,499 GRAMS...........NUMBER.. 39 10 66 RATE.. 1.5 .4 2.5 4,500-4,999 GRAMS...........NUMBER.. 23 3 12 RATE.. 5.4 .7 2.8 5,000 GRAMS OR MORE.........NUMBER.. 32 2 7 RATE.. 42.5 2.7 9.3 NOT STATED..................NUMBER.. 345 9 24 RATE.. 378.3 9.9 26.3 1 INCLUDES RACES OTHER THAN WHITE AND BLACK. 5. Live Birth/Infant Mort Rate for 10 Leading Causes Infant Deat 1984 DOCUMENTATION TABLE 5 LIVE BIRTHS BY BIRTH WEIGHT AND RACE OF CHILD AND INFANT DEATHS AND INFANT MORTALITY RATES BY AGE AT DEATH, BIRTH WEIGHT, AND RACE OF CHILD FOR 10 LEADING CAUSES OF INFANT DEATH: UNITED STATES, 1984 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 100,000 LIVE BIRTHS) CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 ALL BIRTH WEIGHTS ... ALL CAUSES...................NUMBER.. 3,669,268 38,292 24,995 RATE.. 1,043.6 681.2 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 8,267 6,134 RATE.. 225.3 167.2 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 5,007 331 RATE.. 136.5 9.0 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 3,519 3,252 RATE.. 95.9 88.6 4 PREMATURITY (765)............NUMBER.. 3,174 3,142 RATE.. 86.5 85.6 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 1,373 1,354 RATE.. 37.4 36.9 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 1,144 1,073 RATE.. 31.2 29.2 7 ACCIDENTS (E800-E949)........NUMBER.. 806 63 RATE.. 22.0 1.7 8 INFECTIONS (771).............NUMBER.. 892 852 RATE.. 24.3 23.2 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 857 847 RATE.. 23.4 23.1 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 ALL BIRTH WEIGHTS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 640 141 RATE.. 17.4 3.8 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 1,832 614 RATE.. 49.9 16.7 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 ALL BIRTH WEIGHTS (CONTINUED) ... ALL CAUSES...................NUMBER.. 20,977 4,018 13,297 RATE.. 571.7 109.5 362.4 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 4,994 1,140 2,133 RATE.. 136.1 31.1 58.1 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 37 294 4,676 RATE.. 1.0 8.0 127.4 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 2,735 517 267 RATE.. 74.5 14.1 7.3 4 PREMATURITY (765)............NUMBER.. 3,116 26 32 RATE.. 84.9 .7 .9 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 1,342 12 19 RATE.. 36.6 .3 .5 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 937 136 71 RATE.. 25.5 3.7 1.9 7 ACCIDENTS (E800-E949)........NUMBER.. 20 43 743 RATE.. .5 1.2 20.2 8 INFECTIONS (771).............NUMBER.. 562 290 40 RATE.. 15.3 7.9 1.1 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 825 22 10 RATE.. 22.5 .6 .3 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 ALL BIRTH WEIGHTS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 72 69 499 RATE.. 2.0 1.9 13.6 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 378 236 1,218 RATE.. 10.3 6.4 33.2 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 LESS THAN 2,500 GRAMS ... ALL CAUSES...................NUMBER.. 246,170 22,556 18,327 RATE.. 9,162.8 7,444.9 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 3,738 3,042 RATE.. 1,518.5 1,235.7 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 941 46 RATE.. 382.3 18.7 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 3,319 3,077 RATE.. 1,348.3 1,249.9 4 PREMATURITY (765)............NUMBER.. 2,865 2,839 RATE.. 1,163.8 1,153.3 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 1,221 1,208 RATE.. 496.0 490.7 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 633 608 RATE.. 257.1 247.0 7 ACCIDENTS (E800-E949)........NUMBER.. 133 17 RATE.. 54.0 6.9 8 INFECTIONS (771).............NUMBER.. 642 611 RATE.. 260.8 248.2 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 681 680 RATE.. 276.6 276.2 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 LESS THAN 2,500 GRAMS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 242 63 RATE.. 98.3 25.6 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 821 361 RATE.. 333.5 146.6 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 LESS THAN 2,500 GRAMS (CONTINUED) ... ALL CAUSES...................NUMBER.. 16,035 2,292 4,229 RATE.. 6,513.8 931.1 1,717.9 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 2,643 399 696 RATE.. 1,073.6 162.1 282.7 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 5 41 895 RATE.. 2.0 16.7 363.6 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 2,584 493 242 RATE.. 1,049.7 200.3 98.3 4 PREMATURITY (765)............NUMBER.. 2,816 23 26 RATE.. 1,143.9 9.3 10.6 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 1,198 10 13 RATE.. 486.7 4.1 5.3 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 551 57 25 RATE.. 223.8 23.2 10.2 7 ACCIDENTS (E800-E949)........NUMBER.. 10 7 116 RATE.. 4.1 2.8 47.1 8 INFECTIONS (771).............NUMBER.. 405 206 31 RATE.. 164.5 83.7 12.6 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 668 12 1 RATE.. 271.4 4.9 .4 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 LESS THAN 2,500 GRAMS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 38 25 179 RATE.. 15.4 10.2 72.7 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 226 135 460 RATE.. 91.8 54.8 186.9 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 2,500 GRAMS OR MORE ... ALL CAUSES...................NUMBER.. 3,418,022 14,577 5,585 RATE.. 426.5 163.4 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 4,318 2,896 RATE.. 126.3 84.7 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 4,056 285 RATE.. 118.7 8.3 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 117 96 RATE.. 3.4 2.8 4 PREMATURITY (765)............NUMBER.. 79 73 RATE.. 2.3 2.1 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 40 34 RATE.. 1.2 1.0 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 442 400 RATE.. 12.9 11.7 7 ACCIDENTS (E800-E949)........NUMBER.. 668 44 RATE.. 19.5 1.3 8 INFECTIONS (771).............NUMBER.. 241 232 RATE.. 7.1 6.8 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 129 121 RATE.. 3.8 3.5 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 2,500 GRAMS OR MORE (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 389 76 RATE.. 11.4 2.2 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 985 240 RATE.. 28.8 7.0 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 2,500 GRAMS OR MORE (CONTINUED) ... ALL CAUSES...................NUMBER.. 3,915 1,670 8,992 RATE.. 114.5 48.9 263.1 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 2,171 725 1,422 RATE.. 63.5 21.2 41.6 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 32 253 3,771 RATE.. .9 7.4 110.3 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 83 13 21 RATE.. 2.4 .4 .6 4 PREMATURITY (765)............NUMBER.. 70 3 6 RATE.. 2.0 .1 .2 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 32 2 6 RATE.. .9 .1 .2 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 326 74 42 RATE.. 9.5 2.2 1.2 7 ACCIDENTS (E800-E949)........NUMBER.. 8 36 624 RATE.. .2 1.1 18.3 8 INFECTIONS (771).............NUMBER.. 149 83 9 RATE.. 4.4 2.4 .3 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 112 9 8 RATE.. 3.3 .3 .2 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 2,500 GRAMS OR MORE (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 33 43 313 RATE.. 1.0 1.3 9.2 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 143 097 745 RATE.. 4.2 2.8 21.8 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 NOT STATED BIRTH WEIGHT ... ALL CAUSES...................NUMBER.. 5,076 1,159 1,083 RATE.. 22,832.9 21,335.7 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 211 196 RATE.. 4,156.8 3,861.3 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 10 - RATE.. 197.0 - 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 83 79 RATE.. 1,635.1 1,556.3 4 PREMATURITY (765)............NUMBER.. 230 230 RATE.. 4,531.1 4,531.1 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 112 112 RATE.. 2,206.5 2,206.5 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 69 65 RATE.. 1,359.3 1,280.5 7 ACCIDENTS (E800-E949)........NUMBER.. 5 2 RATE.. 98.5 39.4 8 INFECTIONS (771).............NUMBER.. 9 9 RATE.. 177.3 177.3 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 47 46 RATE.. 925.9 906.2 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL ALL RACES1 NOT STATED BIRTH WEIGHT 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 9 2 RATE.. 177.3 39.4 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 26 13 RATE.. 512.2 256.1 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 NOT STATED BIRTH WEIGHT (CONTINUED) ... ALL CAUSES...................NUMBER.. 1,027 56 76 RATE.. 20,232.5 1,103.2 1,497.2 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 180 16 15 RATE.. 3,546.1 315.2 295.5 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. - - 10 RATE.. - - 197.0 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 68 11 4 RATE.. 1,339.6 216.7 78.8 4 PREMATURITY (765)............NUMBER.. 230 - - RATE.. 4,531.1 - - 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 112 - - RATE.. 2,206.5 - - 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 60 5 4 RATE.. 1,182.0 98.5 78.8 7 ACCIDENTS (E800-E949)........NUMBER.. 2 - 3 RATE.. 39.4 - 59.1 8 INFECTIONS (771).............NUMBER.. 8 1 - RATE.. 157.6 19.7 - 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 45 1 1 RATE.. 886.5 19.7 19.7 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL ALL RACES1 NOT STATED BIRTH WEIGHT (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 1 1 7 RATE.. 19.7 19.7 137.9 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 9 4 13 RATE.. 177.3 78.8 256.1 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE ALL BIRTH WEIGHTS ... ALL CAUSES...................NUMBER.. 2,923,627 26,158 17,178 RATE.. 894.7 587.6 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 6,546 4,910 RATE.. 223.9 167.9 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 3,420 215 RATE.. 117.0 7.4 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 2,508 2,338 RATE.. 85.8 80.0 4 PREMATURITY (765)............NUMBER.. 1,815 1,797 RATE.. 62.1 61.5 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 941 932 RATE.. 32.2 31.9 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 744 697 RATE.. 25.4 23.8 7 ACCIDENTS (E800-E949)........NUMBER.. 560 48 RATE.. 19.2 1.6 8 INFECTIONS (771).............NUMBER.. 625 601 RATE.. 21.4 20.6 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 616 610 RATE.. 21.1 20.9 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE ALL BIRTH WEIGHTS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 394 91 RATE.. 13.5 3.1 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 1,201 427 RATE.. 41.1 14.6 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE ALL BIRTH WEIGHTS (CONTINUED) ... ALL CAUSES...................NUMBER.. 14,304 2,874 8,980 RATE.. 489.3 98.3 307.2 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 4,020 890 1,636 RATE.. 137.5 30.4 56.0 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 25 190 3,205 RATE.. .9 6.5 109.6 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 1,944 394 170 RATE.. 66.5 13.5 5.8 4 PREMATURITY (765)............NUMBER.. 1,782 15 18 RATE.. 61.0 .5 .6 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 924 8 9 RATE.. 31.6 .3 .3 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 605 92 47 RATE.. 20.7 3.1 1.6 7 ACCIDENTS (E800-E949)........NUMBER.. 13 35 512 RATE.. .4 1.2 17.5 8 INFECTIONS (771).............NUMBER.. 405 196 24 RATE.. 13.9 6.7 .8 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 595 15 6 RATE.. 20.4 .5 .2 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE ALL BIRTH WEIGHTS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 51 40 303 RATE.. 1.7 1.4 10.4 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 255 172 774 RATE.. 8.7 5.9 26.5 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE LESS THAN 2,500 GRAMS ... ALL CAUSES...................NUMBER.. 163,217 14,759 12,233 RATE.. 9,042.6 7,494.9 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 2,916 2,415 RATE.. 1,786.6 1,479.6 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 545 28 RATE.. 333.9 17.2 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 2,359 2,207 RATE.. 1,445.3 1,352.2 4 PREMATURITY (765)............NUMBER.. 1,654 1,638 RATE.. 1,013.4 1,003.6 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 845 839 RATE.. 517.7 514.0 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 381 363 RATE.. 233.4 222.4 7 ACCIDENTS (E800-E949)........NUMBER.. 78 10 RATE.. 47.8 6.1 8 INFECTIONS (771).............NUMBER.. 436 418 RATE.. 267.1 256.1 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 486 486 RATE.. 297.8 297.8 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE LESS THAN 2,500 GRAMS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 132 37 RATE.. 80.9 22.7 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 496 247 RATE.. 303.9 151.3 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE LESS THAN 2,500 GRAMS (CONTINUED) ... ALL CAUSES...................NUMBER.. 10,681 1,552 2,526 RATE.. 6,544.0 950.9 1,547.6 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 2,125 290 501 RATE.. 1,301.9 177.7 307.0 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 4 24 517 RATE.. 2.5 14.7 316.8 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 1,832 375 152 RATE.. 1,122.4 229.8 93.1 4 PREMATURITY (765)............NUMBER.. 1,625 13 16 RATE.. 995.6 8.0 9.8 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 833 6 6 RATE.. 510.4 3.7 3.7 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 330 33 18 RATE.. 202.2 20.2 11.0 7 ACCIDENTS (E800-E949)........NUMBER.. 5 5 68 RATE.. 3.1 3.1 41.7 8 INFECTIONS (771).............NUMBER.. 290 128 18 RATE.. 177.7 78.4 11.0 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 478 8 - RATE.. 292.9 4.9 - CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE LESS THAN 2,500 GRAMS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 26 11 95 RATE.. 15.9 6.7 58.2 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 148 99 249 RATE.. 90.7 60.7 152.6 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE 2,500 GRAMS OR MORE ... ALL CAUSES...................NUMBER.. 2,756,485 10,671 4,266 RATE.. 387.1 154.8 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 3,459 2,335 RATE.. 125.5 84.7 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 2,867 187 RATE.. 104.0 6.8 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 92 77 RATE.. 3.3 2.8 4 PREMATURITY (765)............NUMBER.. 45 43 RATE.. 1.6 1.6 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 29 26 RATE.. 1.1 .9 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 326 299 RATE.. 11.8 10.8 7 ACCIDENTS (E800-E949)........NUMBER.. 479 36 RATE.. 17.4 1.3 8 INFECTIONS (771).............NUMBER.. 182 176 RATE.. 6.6 6.4 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 94 88 RATE.. 3.4 3.2 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE 2,500 GRAMS OR MORE (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 258 53 RATE.. 9.4 1.9 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 689 173 RATE.. 25.0 6.3 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE 2,500 GRAMS OR MORE (CONTINUED) ... ALL CAUSES...................NUMBER.. 2,988 1,278 6,405 RATE.. 108.4 46.4 232.4 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 1,750 585 1,124 RATE.. 63.5 21.2 40.8 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 21 166 2,680 RATE.. .8 6.0 97.2 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 66 11 15 RATE.. 2.4 .4 .5 4 PREMATURITY (765)............NUMBER.. 41 2 2 RATE.. 1.5 .1 .1 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 24 2 3 RATE.. .9 .1 .1 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 243 56 27 RATE.. 8.8 2.0 1.0 7 ACCIDENTS (E800-E949)........NUMBER.. 6 30 443 RATE.. .2 1.1 16.1 8 INFECTIONS (771).............NUMBER.. 109 67 6 RATE.. 4.0 2.4 .2 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 82 6 6 RATE.. 3.0 .2 .2 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE 2,500 GRAMS OR MORE (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 25 28 205 RATE.. .9 1.0 7.4 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 102 71 516 RATE.. 3.7 2.6 18.7 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE NOT STATED BIRTH WEIGHT ... ALL CAUSES...................NUMBER.. 3,925 728 679 RATE.. 18,547.8 17,299.4 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 171 160 RATE.. 4,356.7 4,076.4 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 8 - RATE.. 203.8 - 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 57 54 RATE.. 1,452.2 1,375.8 4 PREMATURITY (765)............NUMBER.. 116 116 RATE.. 2,955.4 2,955.4 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 67 67 RATE.. 1,707.0 1,707.0 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 37 35 RATE.. 942.7 891.7 7 ACCIDENTS (E800-E949)........NUMBER.. 3 2 RATE.. 76.4 51.0 8 INFECTIONS (771).............NUMBER.. 7 7 RATE.. 178.3 178.3 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 36 36 RATE.. 917.2 917.2 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL WHITE NOT STATED BIRTH WEIGHT 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 4 1 RATE.. 101.9 25.5 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 16 7 RATE.. 407.6 178.3 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE NOT STATED BIRTH WEIGHT (CONTINUED) ... ALL CAUSES...................NUMBER.. 635 44 49 RATE.. 16,178.3 1,121.0 1,248.4 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 145 15 11 RATE.. 3,694.3 382.2 280.3 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. - - 8 RATE.. - - 203.8 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 46 8 3 RATE.. 1,172.0 203.8 76.4 4 PREMATURITY (765)............NUMBER.. 116 - - RATE.. 2,955.4 - - 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 67 - - RATE.. 1,707.0 - - 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 32 3 2 RATE.. 815.3 76.4 51.0 7 ACCIDENTS (E800-E949)........NUMBER.. 2 - 1 RATE.. 51.0 - 25.5 8 INFECTIONS (771).............NUMBER.. 6 1 - RATE.. 152.9 25.5 - 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 35 1 - RATE.. 891.7 25.5 - CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL WHITE NOT STATED BIRTH WEIGHT (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. - 1 3 RATE.. - 25.5 76.4 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 5 2 9 RATE.. 127.4 51.0 229.3 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK ALL BIRTH WEIGHTS ... ALL CAUSES...................NUMBER.. 592,760 10,630 6,927 RATE.. 1,793.3 1,168.6 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 1,354 964 RATE.. 228.4 162.6 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 1,349 101 RATE.. 227.6 17.0 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 892 805 RATE.. 150.5 135.8 4 PREMATURITY (765)............NUMBER.. 1,264 1,253 RATE.. 213.2 211.4 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 388 381 RATE.. 65.5 64.3 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 349 328 RATE.. 58.9 55.3 7 ACCIDENTS (E800-E949)........NUMBER.. 200 14 RATE.. 33.7 2.4 8 INFECTIONS (771).............NUMBER.. 232 216 RATE.. 39.1 36.4 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 208 204 RATE.. 35.1 34.4 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK ALL BIRTH WEIGHTS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 218 42 RATE.. 36.8 7.1 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 560 163 RATE.. 94.5 27.5 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK ALL BIRTH WEIGHTS (CONTINUED) ... ALL CAUSES...................NUMBER.. 5,946 981 3,703 RATE.. 1,003.1 165.5 624.7 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 761 203 390 RATE.. 128.4 34.2 65.8 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 9 92 1,248 RATE.. 1.5 15.5 210.5 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 704 101 87 RATE.. 118.8 17.0 14.7 4 PREMATURITY (765)............NUMBER.. 1,243 10 11 RATE.. 209.7 1.7 1.9 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 377 4 7 RATE.. 63.6 .7 1.2 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 292 36 21 RATE.. 49.3 6.1 3.5 7 ACCIDENTS (E800-E949)........NUMBER.. 7 7 186 RATE.. 1.2 1.2 31.4 8 INFECTIONS (771).............NUMBER.. 133 83 16 RATE.. 22.4 14.0 2.7 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 198 6 4 RATE.. 33.4 1.0 .7 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK ALL BIRTH WEIGHTS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 19 23 176 RATE.. 3.2 3.9 29.7 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 113 50 397 RATE.. 19.1 8.4 67.0 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK LESS THAN 2,500 GRAMS ... ALL CAUSES...................NUMBER.. 73,156 7,040 5,490 RATE.. 9,623.3 7,504.5 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 655 493 RATE.. 895.3 673.9 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 364 16 RATE.. 497.6 21.9 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 850 768 RATE.. 1,161.9 1,049.8 4 PREMATURITY (765)............NUMBER.. 1,126 1,117 RATE.. 1,539.2 1,526.9 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 340 335 RATE.. 464.8 457.9 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 234 227 RATE.. 319.9 310.3 7 ACCIDENTS (E800-E949)........NUMBER.. 48 6 RATE.. 65.6 8.2 8 INFECTIONS (771).............NUMBER.. 185 172 RATE.. 252.9 235.1 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 171 170 RATE.. 233.7 232.4 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK LESS THAN 2,500 GRAMS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 103 24 RATE.. 140.8 32.8 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 295 100 RATE.. 403.2 136.7 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK LESS THAN 2,500 GRAMS (CONTINUED) ... ALL CAUSES...................NUMBER.. 4,840 650 1,550 RATE.. 6,616.0 888.5 2,118.8 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 400 93 162 RATE.. 546.8 127.1 221.4 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 1 15 348 RATE.. 1.4 20.5 475.7 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 670 98 82 RATE.. 915.9 134.0 112.1 4 PREMATURITY (765)............NUMBER.. 1,108 9 9 RATE.. 1,514.6 12.3 12.3 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 331 4 5 RATE.. 452.5 5.5 6.8 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 206 21 7 RATE.. 281.6 28.7 9.6 7 ACCIDENTS (E800-E949)........NUMBER.. 5 1 42 RATE.. 6.8 1.4 57.4 8 INFECTIONS (771).............NUMBER.. 101 71 13 RATE.. 138.1 97.1 17.8 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 166 4 1 RATE.. 226.9 5.5 1.4 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK LESS THAN 2,500 GRAMS (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 12 12 79 RATE.. 16.4 16.4 108.0 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 72 28 195 RATE.. 98.4 38.3 266.6 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK 2,500 GRAMS OR MORE ... ALL CAUSES...................NUMBER.. 518,692 3,212 1,083 RATE.. 619.2 208.8 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 671 445 RATE.. 129.4 85.8 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 983 85 RATE.. 189.5 16.4 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 18 14 RATE.. 3.5 2.7 4 PREMATURITY (765)............NUMBER.. 31 29 RATE.. 6.0 5.6 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 10 8 RATE.. 1.9 1.5 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 92 80 RATE.. 17.7 15.4 7 ACCIDENTS (E800-E949)........NUMBER.. 150 8 RATE.. 28.9 1.5 8 INFECTIONS (771).............NUMBER.. 45 42 RATE.. 8.7 8.1 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 27 25 RATE.. 5.2 4.8 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK 2,500 GRAMS OR MORE (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 110 17 RATE.. 21.2 3.3 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 256 57 RATE.. 49.4 11.0 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK 2,500 GRAMS OR MORE (CONTINUED) ... ALL CAUSES...................NUMBER.. 761 322 2,129 RATE.. 146.7 62.1 410.5 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 336 109 226 RATE.. 64.8 21.0 43.6 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 8 77 898 RATE.. 1.5 14.8 173.1 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 13 1 4 RATE.. 2.5 .2 .8 4 PREMATURITY (765)............NUMBER.. 28 1 2 RATE.. 5.4 .2 .4 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 8 - 2 RATE.. 1.5 - .4 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 66 14 12 RATE.. 12.7 2.7 2.3 7 ACCIDENTS (E800-E949)........NUMBER.. 2 6 142 RATE.. .4 1.2 27.4 8 INFECTIONS (771).............NUMBER.. 30 12 3 RATE.. 5.8 2.3 .6 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 23 2 2 RATE.. 4.4 .4 .4 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK 2,500 GRAMS OR MORE (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 6 11 93 RATE.. 1.2 2.1 17.9 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 37 20 199 RATE.. 7.1 3.9 38.4 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK NOT STATED BIRTH WEIGHT ... ALL CAUSES...................NUMBER.. 912 378 354 RATE.. 41,447.4 38,815.8 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 28 26 RATE.. 3,070.2 2,850.9 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. 2 - RATE.. 219.3 - 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 24 23 RATE.. 2,631.6 2,521.9 4 PREMATURITY (765)............NUMBER.. 107 107 RATE.. 11,732.5 11,732.5 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 38 38 RATE.. 4,166.7 4,166.7 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 23 21 RATE.. 2,521.9 2,302.6 7 ACCIDENTS (E800-E949)........NUMBER.. 2 - RATE.. 219.3 - 8 INFECTIONS (771).............NUMBER.. 2 2 RATE.. 219.3 219.3 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 10 9 RATE.. 1,096.5 986.8 CAUSE OF DEATH, BIRTH WEIGHT, LIVE INFANT TOTAL AND RACE OF CHILD BIRTHS DEATHS NEONATAL BLACK NOT STATED BIRTH WEIGHT 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 5 1 RATE.. 548.2 109.6 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 9 6 RATE.. 986.8 657.9 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK NOT STATED BIRTH WEIGHT (CONTINUED) ... ALL CAUSES...................NUMBER.. 345 9 24 RATE.. 37,828.9 986.8 2,631.6 1 CONGENITAL ANOMALIES (740-759)....................NUMBER.. 25 1 2 RATE.. 2,741.2 109.6 219.3 2 SUDDEN INFANT DEATH SYNDROME (798.0).............NUMBER.. - - 2 RATE.. - - 219.3 3 RESPIRATORY DISTRESS SYNDROME (769)...............NUMBER.. 21 2 1 RATE.. 2,302.6 219.3 109.6 4 PREMATURITY (765)............NUMBER.. 107 - - RATE.. 11,732.5 - - 5 MATERNAL COMPLICATIONS (761)........................NUMBER.. 38 - - RATE.. 4,166.7 - - 6 HYPOXIA AND ASPHYXIA (768)...NUMBER.. 20 1 2 RATE.. 2,193.0 109.6 219.3 7 ACCIDENTS (E800-E949)........NUMBER.. - - 2 RATE.. - - 219.3 8 INFECTIONS (771).............NUMBER.. 2 - - RATE.. 219.3 - - 9 COMPLICATIONS OF PLACENTA, ETC. (762).........NUMBER.. 9 - 1 RATE.. 986.8 - 109.6 CAUSE OF DEATH, BIRTH WEIGHT, EARLY LATE POST- AND RACE OF CHILD NEONATAL NEONATAL NEONATAL BLACK NOT STATED BIRTH WEIGHT (CONTINUED) 10 PNEUMONIA AND INFLUENZA (480-487)....................NUMBER.. 1 - 4 RATE.. 109.6 - 438.6 ... ALL OTHER CAUSES (RESIDUAL)..NUMBER.. 4 2 3 RATE.. 438.6 219.3 328.9 1 INCLUDES RACES OTHER THAN WHITE AND BLACK. TECHNICAL APPENDIX, 1983-84 NATALITY FILES Definition of Live Birth Every product of conception that gives a sign of life after birth, regardless of the length of the pregnancy, is considered a live birth. This concept is included in the definition set forth by the World Health Organization1 as follows: Live birth is the complete expulsion of extraction from its mother of a product of conception, irrespective of the duration of pregnancy, which, after such separation, breathes or shows any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached; each product of such a birth is considered liveborn. This definition distinguishes in precise terms a live birth from a fetal death (see section on fetal deaths in the Technical Appendix of volume II of this report). In the interest of comparable natality statistics, both the Statistical Commission of the United Nations and the National Center for Health Statistics have adopted this definition.2,3 History of Birth-Registration Area The national birth-registration area was proposed in 1850 and established in 1915. By 1933 all 48 States and the District of Columbia were participating in the registration system. The organized territories of Hawaii and Alaska were admitted in 1929 and 1950, respectively; data from these areas were prepared separately until they became States--Alaska in 1959 and Hawaii in 1960. At present the birth-registration system of the United States covers the 50 States, the District of Columbia, the independent registration area of New York City, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Trust Territory of the Pacific Islands. However, in the statistical tabulations, "United States" refers only to the aggregate of the 50 States (including New York City) and the District of Columbia. Tabulations for Puerto Rico, the Virgin Islands, and Guam are shown separately in section 3 of this volume. The original birth-registration area of 1915 consisted of 10 States and the District of Columbia. The growth of this area is indicated in table 4-1. This table also presents for each year through 1932 the estimated midyear population of the United States and of those States included in the registration system. Because of the growth of the area for which data have been collected and tabulated, a national series of geographically comparable data before 1933 can be obtained only by estimation. Annual estimates of births have been prepared by P. K. Whelpton for the period 1909-344 (table 1-1). These estimates include adjustments both for underregistration and for States that were not part of the birth-registration area before 1933. Sources of Data Natality Statistics Natality statistics for 19-3/4 are based on information from two sources. Statistics for 46 States are based on the total file of records received on computer data tapes coded by the States and provided to the National Center for Health Statistics (NCHS) through the Vital Statistics Cooperative Program. Statistics for the remaining States (Arizona, California, Delaware, and Georgia) and the District of Columbia are based on information obtained from a 50-percent sample of microfilm copies of all live-birth certificates filed in these States. NCHS receives these tapes and microfilm copies from the registration offices of each State, the District of Columbia, and New York City. Records from the Virgin Islands are received in the form of microfilm copies of birth certificates; those from Guam are received as photocopies of original birth certificates; and those from Puerto Rico are received as computer tapes through the Vital Statistics Cooperative Program. Natality data for 1983/4 for these areas are based on the total file of records. Before 1977 Puerto Rican records were sampled on a 50-percent basis. Information for previous years for these three areas is published in the annual vital statistics reports of the Department of Health of the Commonwealth of Puerto Rico, the Department of Public Health of the virgin Islands, the Department of Public Health and Social Services of the Government of Guam, and in selected Vital Statistics of the United States annual reports. When the microfilmed data are received from the various registration offices, the information on the sampled microfilm records is coded onto magnetic tape for the computer, which then edits all the taped records and produces tabulations of natality statistics adjusted for sampling factors. U.S. natality data are limited to births occurring within the United States, including those occurring to U.S. residents and nonresidents. Births to nonresidents of the United States are excluded from all tabulations by place of residence beginning in 1970. (See "Classification by occurrence and residence" for further discussion.) Births occurring to U.S. citizens outside the United States are not included in any tabulations in this report. Similarly the data for Puerto Rico, the Virgin Islands, and Guam are limited to births registered in these areas. Standard Certificate of Live Birth The U.S. Standard Certificate of Live Birth, issued by the Public Health Service, has served for many years as the principal means of attaining uniformity in the content of the documents used to collect information on births in the United States. It has been modified in each State to the extent required by the particular State's needs or by special provisions of the State's vital statistics law. However, most State certificates conform closely in content to the standard certificate. The first standard certificate of birth was developed 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 other working in the fields of public health, social welfare, demography, and insurance. This procedure has assured careful evaluation of each item for its current and future usefulness for legal, medical, 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, dropped when their usefulness appeared to be limited. 1978 revision -- Effective January 1, 1978, a revised U.S. Standard Certificate of Live Birth replaced the 1968 revision. Changes on the 1978 standard certificate include a new item on 1- and 5-minute Apgar scores, the deletion of the item on birth injuries, and revisions of the items on legitimacy status and previous pregnancies. The item on legitimacy status was changed to read "Is mother married?" This is now a factual piece of information about the mother rather than an attribute ascribed to the child, and the person completing the record does not have the responsibility for making what may be a legal determination. The item on previous deliveries was changed to pregnancy history and expanded to include two categories of fetal loss, before and after 20 completed weeks of gestation. This change provides information on two groups that are of interest in medical research and emphasizes the fact that all previous fetal losses should be included, both spontaneous and induced, regardless of length of gestation. For further discussion see individual sections for each item. Classification of Data General Information One of the principal values of vital statistics data is realized through the presentation of rates that are computed by relating the vital events of a class to the population of a similarly defined class. Vital statistics and population statistics must therefore be classified according to similarly defined systems and tabulated in comparable groups. Even when the variables common to both, such as geographic area, age, race, and sex, have been similarly classified and tabulated, differences between the enumeration method of obtaining population data and the registration method of obtaining vital statistics data may result in significant discrepancies. The general rules used to classify geographic and personal items for live births are set forth in "Vital Statistics Classification and Coding Instructions for Live Birth Records, 1983," NCHS Instruction Manual, Part 3a. The classification of certain important items is discussed in the following pages. Classification by Occurrence and Residence All but three tabulations for States and other areas within the United States are by place of mother's residence. These three tabulations (1-49, 1-50, and 2-1) show births by place of occurrence. Births to U.S. residents occurring outside this country are not reallocated to the United States. In tabulations by place of residence, births occurring within the United States to U.S. citizens and to resident aliens are allocated to the usual place of residence of the mother in the United States as reported on the birth certificate. Beginning in 1970, births to nonresidents of the United States occurring in the United States are excluded from these tabulations. From 1966 to 1969, births occurring in the United States to mothers who were nonresidents of the United States were considered as births to residents of the exact place of occurrence; in 1964 and 1965 all such births were allocated to "balance of county" of occurrence even if the birth had occurred in a city. The change in coding beginning in 1970 to exclude births to nonresidents of the United States from residence data significantly affects the comparability of data with years before 1970 only for Texas. In 1983 births to residents of Mexico constituted 84.7 percent of the 3,888 nonresident births in the United States. No evaluation of the effect of the change in procedure between 1965 and 1966 has been made. For the total United States the tabulations by place of residence and by place of occurrence are not identical. Births to nonresidents of the United States are included in data by place of occurrence but excluded from data by place of residence, as previously indicated. Residence error--A nationwide test of birth-registration completeness in 1950 provided measures of residence error for natality statistics. According to this test, errors in residence reporting for the country as a whole tend to overstate the number of births to residents of urban areas and to understate the number of births to residents of other areas. This tendency has assumed special importance because of a concomitant development--the increased utilization of hospitals in cities by residents of nearby places--with the result that a number of births are erroneously reported as having occurred to residents of urban areas. Another factor that contributes to this overstatement of urban births is the customary procedure of using "city" addresses for persons living outside the city limits. Incomplete residence--Beginning in 1973 where only the State of residence is reported with no city or county specified, and the State named is different from the State of occurrence, the birth is allocated to the largest city of the State of residence. Before 1973 such births were allocated to the exact place of occurrence. Geographic Classification The rules followed in the classification of geographic areas for live births are contained in the instruction manual mentioned previously. The geographic code structure for 1983 is given in another manual, "Vital Records Geographic Classification, 1982." United States--In the statistical tabulations, "United States" refers only to the aggregate of the 50 States and the District of Columbia. Alaska has been included in the U.S. tabulations since 1959 and Hawaii since 1960. Standard metropolitan statistical areas--The standard metropolitan statistical areas (SMSA's) used in this report are those established by the U.S. Office of Management and Budget from final 1980 census population counts5 and used by the U.S. Bureau of the Census except in the New England States. Except in the New England States, an SMSA is a county or a group of contiguous counties containing either a city of 50,000 inhabitants or more or an urbanized area of 50,000 with a total metropolitan population of at least 100,000. In addition to the county or counties containing such a city or urbanized area, contiguous counties are included in an SMSA if, according to specified criteria, they are essentially metropolitan in character and are socially and economically integrated with the central city or urbanized area.6 In the New England States the U.S. Office of Management and Budget uses towns and cities rather than counties as geographic components of SMSA's. The National Center for Health Statistics cannot, however, use the SMSA classification for these States because its data are not coded to identify all towns. Instead, the New England County Metropolitan Areas (NECMA's) are used. These areas are established by the U.S. Office of Management and Budget and are made up of county units.6,7 Metropolitan and nonmetropolitan counties--Independent cities and counties included in SMSA's or NECMA's are included in data for metropolitan counties; all other counties are classified as nonmetropolitan. Population-size groups--Beginning in 1982 vital statistics data for cities and certain other urban places are classified according to the population enumerated in the 1980 Census of Population. Data are available for individual cities and other urban places of 10,000 or more population. Data for the remaining areas not separately identified are shown in the tables under the heading "Balance of area" or "Balance of county." Classification of areas for the years 1970-81 was determined by the population enumerated in the 1970 Census of Population. As a result of changes in the enumerated population between 1970 and 1980, some urban places identified in previous reports are no longer included, and a number of other urban places have been added. Urban places other than incorporated cities for which vital statistics data are shown in this report 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 10,000 or more population, as there are no incorporated cities in the State. Race or National Origin The race or national origin shown in a tabulation is that of the newborn child. Classification of the Child's race or national origin for statistical purposes is based on the race or national origin of the parents. The categories are "White," "Black," "American Indian," "Chinese," "Japanese," "Hawaiian," "Filipino," "Other Asian or Pacific Islander," and "Other." Before 1978 the category "Other Asian or Pacific Islander" was not identified separately but included with "Other" races. The separation of this category allows identification of the category "Asian or Pacific Islander" with Chinese, Japanese, Hawaiian, and Filipino. If the parents are of different races or national origins, the following rules are used to assign race or national origin to the newborn child. When only one parent is white, the child is assigned the other parent's race or national origin. When neither parent is white, the child is assigned the father's race or national origin with one exception; if the mother is Hawaiian or part-Hawaiian, the child is assigned to Hawaiian. If race is missing for one parent, the child is assigned the race of the parent for whom race is given. When information on race is missing for both parents, the race of the child is considered not stated and the birth is allocated according to rules discussed in the section "Race or national origin not stated." White--The category "White" comprises births reported as white, and births where race is reported as Hispanic. Before 1964, all births for which race or national origin was not stated were classified as white. Beginning in 1964 changes in the procedures for allocating race when race or national origin is not stated have changed the composition of this category. (See discussion on "Race or national origin not stated.") All other--The category "All Other" comprises black, American Indian, Chinese, Japanese, Hawaiian and part-Hawaiian, Filipino, other Asian or Pacific Islander including Asian Indian, and "Other." Aleuts and Eskimos are included in "American Indian." If the race or naional origin of an Asian parent is ill-defined or not clearly identifiable with one of the categories used in the classification (for example, if "Oriental" is entered), an attempt is made to determine the specific race from the entry for place of birth. If the birthplace is China, Japan, or the Philippines, the parent's race is assigned to that category. When race cannot be determined from birthplace, it is assigned to the category "Other Asian or Pacific Islander." Race or national origin not stated--The race of a child is considered not stated in those cases in which information for both parents is missing. Before 1964 all such cases were tabulated as white. From 1964 through 1968 the race of the child was allocated by the computer as follows. If the race on the preceding record were white the assignment was to white; otherwise the assignment was to black. Beginning in 1969 the race of the child has been allocated electronically according to the specific race of the child on the preceding record. Consequently, some of the not-stated frequencies that had previously been assigned to the black category may now be assigned to one of the other race or national origin categories. Nearly all statistics by race or national origin for the United States as a whole in 1962 and 1963 are affected by a lack of information for New Jersey, which did not report parents' race in those years. Birth rates by race for those years are computed on a population base that excludes New Jersey. (For the method of estimating the U.S. population by age, sex, and race excluding New Jersey in 1962 and 1963, see Vital Statistics of the United States, 1963, Volume I, page 4-8). Estimates of births to unmarried mothers by race for the United States, which include special estimates for New Jersey for 1962 and 1963, have been prepared and are shown in table 1-31.) Interracial parentage--The number of births for each racial or national origin group classified according to the child's race by the preceding rules differs from the number of births if classification were by the mother's race because of interracial parentage. For white and black births, the differences are relatively small. In 1983 there were 1.4 percent more white mothers than there were births classified as white and 4.0 percent fewer black mothers than births classified as black. The number of mothers of other racial and national origin groups was considerably lower than the number of births classified according to the child's race; American Indian, 20.6 percent; Chinese, 8.4 percent; Japanese, 17.3 percent; Hawaiian, 31.0 percent; Filipino, 6.9 percent; Other Asian and Pacific Islander, 6.4 percent; and Other, 24.3 percent. Age of Mother The birth certificate asks for "Age (at time of this birth)." The age of the mother is edited for upper and lower limits. When mothers are reported to be under 10 years of age or 50 years and over, the age of the mother is considered not stated and is assigned as described below. Age-specific birth rates shown in this report are based on populations of women by age, which are prepared by the U.S. Bureau of the Census. In census years the decennial census counts are used. In intercensal years, estimates of the population by women by age are published by the U.S. Bureau of the Census in Current Population Reports. The 1980 Census of Population derived age in completed years as of April 1, 1980, from the responses to questions on age at last birthday and month and year of birth, with the latter given preference. In the 1960 and the 1970 Census of Population, age was also derived from month and year of birth. "Age in completed years" was asked in censuses before 1960. This was nearly the equivalent of the birth certificate question, which the 1950 test of matched birth and census records confirms by showing a high degree of consistency in the reporting of age in these two sources.8 Median age of mother--Median age is the value that divides an age distribution into two equal parts, one-half of the values being less and one-half being greater. Median ages of mothers for 1960 to the present have been computed from birth rates for 5-year age groups rather than from birth frequencies. This method eliminates the effects of changes in the age composition of the childbearing population over time. Changes in the median ages from year to year can thus be attributed solely to changes in the age-specific birth rates. Not stated age of mother--Beginning in 1964 birth records with age of mother not stated have been allocated according to the age appearing on the record previously processed for a mother of identical race and having the same total-birth order (total of fetal deaths and live births). In 1963 birth records with age not stated were allocated according to the age appearing on the record previously processed for a mother of identical race and parity (number of live births). For 1960-62, not stated and unknown ages were distributed in proportion to the known ages for each racial group. Before 1960 this was done for age-specific birth rates but not for the birth frequency tables, which showed a separate category for age not stated. Age of Father Age of father is coded as stated on the birth certificate. If the age is under 10 years, it is considered not stated and grouped with those cases for which age is not stated on the certificate. Information on father's age is often missing on birth certificates of children born to unwed mothers, greatly inflating the number of "not stated" in all tabulations by age of father. In computing birth rates by age of father, births tabulated as age of father not stated are distributed in the same proportions as births with known age within each 5-year age classification of the mother. This procedure is done separately by race. The resulting distributions are summed to form a composite frequency distribution which is the basis for computing birth rates by age of father. This procedure avoids the distortion in rates that would result if the relationship between age of mother and age of father were disregarded. Live-Birth Order and Parity Birth order and parity classifications shown in this volume refer to the total number of live births the mother has had including the 1983 birth. Fetal deaths are excluded. Birth order indicates what number the present birth represents; for example, a baby born to a mother who has had two previous live births (even if one or both are not now living) has a birth order of three. Parity indicates how many live births a mother has had. Before delivery a mother having her first baby has a parity of zero and a mother having her third baby has a parity of two. After delivery the mother of a baby who is a first live birth has a parity of one and the mother of a baby who is a third live birth has a parity of three. Birth order and parity are determined from two items on the birth certificate, "Live births--now living" and "Live Births--now dead." Not stated birth order--Before 1969 if both of these items were blank, the birth was considered a first birth. Beginning in 1969, births for which the pregnancy history items were not completed have been tabulated as birth order not stated. As a result of this revised procedure, 22,686 births in 1969 that would have been assigned to the "First birth order" category under the old rules were assigned to the "Not Stated" category. All births tabulated in the "Not stated birth order" category are excluded from the computation of percents. In computing birth rates by live-birth order, births tabulated as birth order not stated are distributed in the same proportion as births of known live-birth order. Dates of Last Live Birth and Last Fetal Death Date of last live birth and date of last fetal death were added to the U.S. Standard Certificate of Live Birth in 1968 for the purpose of providing information on child spacing and pregnancy intervals. Tabulations of these items were presented for the first time in 1969. In 1978 the item "Date of last fetal death" was reworded to "Date of last other termination" to ensure inclusion of both spontaneous fetal deaths and induced terminations of pregnancy. In 1983 this information was obtained from all States except Texas. Intervals since last live birth and last other termination--These data are computed from the date of birth, date of last live birth, and date of last other termination. The interval since last live birth is the difference between the date of last live birth and the date of present birth; the interval since last other termination is the difference between the date of last other termination and the date of present birth. For an interval to be computed, both the month and year of the last live birth or the last other termination must be valid. These intervals are computed only for events to mothers who have had at least one previous delivery. Births for which the interval since last birth or last other termination is not stated are excluded from the computation of percents and means. Interval since last pregnancy and outcome of last pregnancy--These data are derived from the computed intervals since the last live birth and the last other termination. Before 1982, the outcome of the last pregnancy was considered not stated if the interval since either the last live birth or the last fetal death was not computed because only the year of the event was recorded. Beginning in 1982, the outcome of the last pregnancy was derived for such records if the year of the last live birth and the year of the last fetal death were not the same. The effect of this revised procedure is to reduce substantially the number of records with outcome of last pregnancy not stated. In addition, for such records, the interval since the termination of the last pregnancy was determined if both the month and year were reported for the event immediately preceding the current live birth. Before 1982, the interval since the termination of the last pregnancy was considered not stated for such births. Births for which the interval since last pregnancy is not stated are excluded from the computation of percents and means. Zero interval--An interval of zero months since the last live birth or fetal death indicates the second born of a set of twins, the second or third born of a set of twins, the second or third born of a set of triplets, and so forth. Births with an interval of zero months are excluded from the computation of mean intervals. Educational Attainment Data on the educational attainment of both parents were collected beginning in 1968 and tabulated for publication in 1969 for the first time. In 1983, data on education were obtained from 47 States and the District of Columbia, as indicated in table A. The educational attainment of either parent is defined as "the number of years of school completed." Only those years completed in "regular" schools, that is, a formal educational system of public schools or the equivalent in accredited private or parochial schools, are counted. Business or trade schools, such as beauty and barber schools, are not considered "regular" schools for the purposes of this item. No attempt has been made to convert years of school completed in foreign school systems, ungraded school systems, and so forth, to equivalent grades in the American school system. Such entries are included in the category "Not stated." Persons who have completed only a partial year in high school or college are tabulated as having completed the highest preceding grade. For those certificates on which a specific degree is stated, years of school completed is coded to the level at which the degree is most commonly attained; for example, persons reporting B.A., A.B., or B.S. degrees are considered to have completed 16 years of school. Education not stated--The category "Not stated" includes all records in reporting areas for which there is no information on years of school completed as well as all records for which the information provided is not compatible with coding specifications. Births tabulated as education not stated are excluded from the computations of percents. Marital Status Beginning with 1980 data, national estimates of births to unmarried women are derived from two sources. For 41 States and the District of Columbia marital status of the mother was reported directly on the birth certificate in 1983 (see table A); for the remaining 9 States that lack this item, marital status was inferred from a comparison of the child's and parents' surnames. This procedure represents a substantial departure from the previous method used to prepare national estimates, which assumed that the incidence of births to unmarried women in States with no direct question on marital status was the same as the incidence in reporting States in the same geographic division. Ratios of births to unmarried women were computed by race for the reporting States in each geographic division, applied to all births in the division, and then summed to obtain national estimates by race. The figures by race were summed to yield the totals for the United States. The new method attempts to use related information on the birth certificate to improve the quality of national data on this topic, as well as to provide data for the individual nonreporting States. Beginning in 1980, a birth in a nonreporting State is classified as occurring to a married woman if the parents' surnames are the same or if the child's and father's surnames are the same and the mother's current surname cannot be obtained from the informant item of the birth certificate. A birth is classified as occurring to an unmarried woman if the father's name is missing, if the parents' surnames are different, or if the father's and child's surnames are different and the mother's current surname is missing. No adjustments are made during the data processing for errors in the reporting of marital status on the birth records of the 41 reporting States and the District of Columbia because the extent of this reporting problem is unknown. When marital status is not stated on the birth certificate of a reporting area, the mother is considered married. When out-of-wedlock births are reported as second or higher order births, it is not known whether the mother's previous deliveries occurred out of wedlock, because her marital status at the time of these earlier births is not available from the birth record. Rates for 1940 and 1950 are based on decennial cnsus counts. In this volume, rates for 1955-83 are based on a smoothed series of population estimates.9 Because of sampling error, the original Bureau of the Census population estimates fluctuate erratically from year to year; therefore, they have been smoothed so that the rates do not show similar variations. The rates shown in this volume differ from those published in issues of Vital Statistics of the United States before 1969, which were based on the original estimates provided annually by the Bureau of the Census. Birth rates by marital status for 1971-79 have been revised and differ from rates published before 1980 in issues of Vital Statistics of the United States (see "Computation of Rates and Other Measures"). Table A. Areas reporting selected items on the live-birth certificate: Each State, 1982 Date last normal Dates of menstrual Number Educational last live period of attainment birth and began prenatal of parents fetal death (LMP) visits Alabama X X X X Alaska X X X X Arizona X X X X Arkansas X X X X California X X Colorado X X X X Connecticut X X X X Delaware X X X X District of Columbia X X X X Florida X X X X Georgia X X X X Hawaii X X X X Idaho X X X X Illinois X X X X Indiana X X X X Iowa X X X X Kansas X X X X Kentucky X X X X Louisiana X X X X Maine X X X X Maryland X X X X Massachusetts X X X X Michigan X X X X Minnesota X X X X Mississippi X X X X Missouri X X X X Montana X X X X Nebraska X X X X Nevada X X X X New Hampshire X X X X New Jersey X X X X New Mexico X X X New York X X X X North Carolina X X X X North Dakota X X X X Ohio X X X X Oklahoma X X X X Oregon X X X X Pennsylvania X X X X Rhode Island X X X X South Carolina X X X X South Dakota X X X X Tennessee X X X X Texas X X Utah X X X X Vermont X X X X Virginia X X X X Washington X X X West Virginia X X X X Wisconsin X X X X Wyoming X X X X Marital status 1-Minute 5-Minute of Apgar Apgar Ethnic Hispanic mother score score origin origin Alabama X X X Alaska X X X Arizona X X X X Arkansas X X X X California X Colorado X X X X Connecticut X X Delaware X District of Columbia X X X X Florida X X X X Georgia X X X X Hawaii X X X X Idaho X X X Illinois X X X X Indiana X X X X Iowa X X X Kansas X X X X Kentucky X X X Louisiana X X X Maine X X X X Maryland X X Massachusetts X X X Michigan X X Minnesota X X X Mississippi X X X X Missouri X X X Montana X X Nebraska X X X X Nevada X X X New Hampshire X X X New Jersey X X X X New Mexico X X X X New York X X X1 X2 North Carolina X X X North Dakota X X X X Ohio X X X Oklahoma X Oregon X X X Pennsylvania X X X Rhode Island X X X South Carolina X X X South Dakota X X X Tennessee X X X X Texas X Utah X X X X Vermont X X X Virginia X X X Washington X X X West Virginia X X X Wisconsin X X X Wyoming X X X X 1New York City only. 2Excludes New York City. Date last normal Dates of menstrual Number Educational last live period of attainment birth and began prenatal of parents fetal death (LMP) visits Alabama X X X X Alaska X X X X Arizona X X X X Arkansas X X X X California X X Colorado X X X X Connecticut X X X X Delaware X X X X District of Columbia X X X X Florida X X X X Georgia X X X X Hawaii X X X X Idaho X X X X Illinois X X X X Indiana X X X X Iowa X X X X Kansas X X X X Kentucky X X X X Louisiana X X X X Maine X X X X Maryland X X X X Massachusetts X X X X Michigan X X X X Minnesota X X X X Mississippi X X X X Missouri X X X X Montana X X X X Nebraska X X X X Nevada X X X X New Hampshire X X X X New Jersey X X X X New Mexico X X X New York X X X X North Carolina X X X X North Dakota X X X X Ohio X X X X Oklahoma X X X X Oregon X X X X Pennsylvania X X X X Rhode Island X X X X South Carolina X X X X South Dakota X X X X Tennessee X X X X Texas X X Utah X X X X Vermont X X X X Virginia X X X X Washington X X X West Virginia X X X X Wisconsin X X X X Wyoming X X X X Marital status 1-Minute 5-Minute of Apgar Apgar Ethnic Hispanic mother score score origin origin Alabama X X X Alaska X X X Arizona X X X X Arkansas X X X X California X Colorado X X X X Connecticut X X Delaware X District of Columbia X X X X Florida X X X X Georgia X X X X Hawaii X X X X Idaho X X X Illinois X X X X Indiana X X X X Iowa X X X Kansas X X X X Kentucky X X X Louisiana X X X Maine X X X X Maryland X X Massachusetts X X X Michigan X X Minnesota X X X Mississippi X X X X Missouri X X X Montana X X Nebraska X X X X Nevada X X X New Hampshire X X X New Jersey X X X X New Mexico X X X X New York X X X1 X2 North Carolina X X X North Dakota X X X X Ohio X X X Oklahoma X Oregon X X X Pennsylvania X X X Rhode Island X X X South Carolina X X X South Dakota X X X Tennessee X X X X Texas X Utah X X X X Vermont X X X Virginia X X X Washington X X X West Virginia X X X Wisconsin X X X Wyoming X X X X 1 New York City only. 2 Excludes New York City. Place of Delivery and Attendant at Birth Births occurring in hospitals, institutions, clinics, centers, or homes are included in the category "In hospital." In this context the word "homes" does not refer to the mother's residence but to an institution such as a home for unwed mothers. Beginning in 1975, the attendant at birth and place of delivery items were coded independently, primarily to permit the identification of the person in attendance at hospital deliveries. Tables 1-37 and 1-38 of this report present this more detailed information for the years 1975-83. Data shown in this volume for the "In hospital" category for the years 1975-83 include all births in clinics or maternity centers, regardless of the attendant. Data for 1975-77 published before 1980 included clinic and center births in the category "In hospital" only when the attendant was a physician. Data shown for 1975-77 in tables 1-37 and 1-38 therefore differ from data published before 1980. As a result of this change, for 1975 an additional 12,352 births are now classified as occurring in hospitals, raising the percent of births occurring in hospitals from 98.7 to 99.1. Similarly, for 1976 the number of births occurring in hospitals is increased by 14,133 and the percent in hospitals raised from 98.6 to 99.1; for 1977, the increase is 15,937 and the percent in hospitals raised from 98.5 to 99.0. For 1974 and earlier, the "In hospital" category includes all births in hospitals or institutions and births in clinics, centers, or maternity homes only when attended by physicians. For births occurring outside of hospitals, separate classifications are shown for physicians, midwives, and "Other" attendants. The "Out-of-hospital" category also includes births for which no information is reported on place of birth. Before 1975, the category "In hospital" included births for which the stated place of birth was a doctor's office" and delivery was by a physician. Beginning in 1975, births that were delivered by physicians in a "doctor's office" were tabulated as "Not in hospital" and included with births delivered by physicians in this category. Although the actual number of such births is unknown, the effect of the change is minimal. In 1974, 0.3 percent of all births were delivered by physicians outside of hospitals; in 1975 this proportion was 0.4 percent. Babies born on the way to or on arrival at the hospital was classified as having been born in the hospital. This may account for some of the hospital births not delivered by physicians or midwives. The percent distributions by attendant at birth for 1975-81 shown in table 1-38 have been revised to exclude births for which the attendant was unspecified. In recent years, the number of births with unspecified attendant has fluctuated substantially. Excluding these births from the percent distributions allows for a more meaningful year-to-year comparison in the proportion of births for each specified attendant. Birth Weight Birth weight is reported in some areas in pounds and ounces rather than in grams. However, the metric system has been used in tabulating and presenting the statistics to facilitate comparison with data published by other groups. The categories for birth weight were changed in 1979 to be consistent with the recommendations in the Ninth Revision of the International Classification of Diseases (ICD-9). The revised categories in gram intervals and their equivalents in pounds and ounces are as follows: Less than 500 grams = 1 lb 1 oz or less 500- 999 grams = 1 lb 2 oz- 2 lb 3 oz 1,000-1,499 grams = 2 lb 4 oz- 3 lb 4 oz 1,500-1,999 grams = 3 lb 5 oz- 4 lb 6 oz 2,000-2,499 grams = 4 lb 7 oz- 5 lb 8 oz 2,500-2,999 grams = 5 lb 9 oz- 6 lb 9 oz 3,000-3,499 grams = 6 lb 10 oz- 7 lb 11 oz 3,500-3,999 grams = 7 lb 12 oz- 8 lb 13 oz 4,000-4,499 grams = 8 lb 14 oz- 9 lb 14 oz 4,500-4,999 grams = 9 lb 15 oz- 11 lb 0 oz 5,000 grams or more = 11 lb 1 oz or more The ICD-9 defines low birth weight as less than 2,500 grams. This is a shift of 1 gram from the previous criterion of 2,500 grams or less, which was recommended by the American Academy of Pediatrics in 1935 and adopted by the World Health Organization in the Sixth Revision of the International Lists of Diseases and Causes of Death (1948). After data classified by pounds and ounces are converted to grams, median weights are computed and rounded before publication. To establish the continuity of class intervals needed to convert pounds and ounces to grams, the end points of these intervals are assumed to be half an ounce less at the lower end and half an ounce more at the upper end. For example, 2 lb 4 oz-3 lb 4 oz is interpreted as 2 lb 3 1/2 oz-3 lb 4 1/2 oz. Births for which birth weight is not reported are excluded from the computation of percents and medians. Period of Gestation The period of gestation is defined as beginning with the first day of the last normal menstrual period (LMP) and ending with the day of the birth. The LMP is used as the initial date as it can be more accurately determined than the date of conception, which usually occurs 2 weeks after the LMP. For 1983 the computation of period of gestation is based entirely on LMP data from the 49 States and the District of Columbia reporting LMP; gestation data for New Mexico, which reports period of gestation in terms of weeks or months, are excluded from the tabulations in this report. Births occurring before 37 weeks of gestation are considered to be "preterm" or "premature" for purposes of classification. At 37-41 weeks gestation, births are considered to be "term," and at 42 weeks and over, "post term." These distinctions are according to the ICD-9 definitions. Before 1981, the period of gestation was computed only when there was a valid month, day, and year of LMP. However, length of gestation could not be determined from a substantial number of live birth certificates each year because the day of LMP was missing. Beginning in 1981 weeks of gestation have been imputed for records with missing day of LMP when there is a valid month and year. Each such record is assigned the gestational period in weeks of the preceding record that has a complete LMP date with the same computed months of gestation and the same 500-gram birth weight interval. The effect of the imputation procedure is to increase slightly the proportion of premature births and to lower the proportion of births at 39, 40, 41, and 42 weeks of gestation. A more complete discussion of this procedure and its implications is presented in a previous report.10 The calculated period of gestation in completed weeks is edited for upper and lower limits. If the interval between date of last normal menstrual period and date of birth is 16 weeks or less, or 53 weeks or more, the period of gestation is considered not stated. Because of post-conception bleeding or menstrual irregularities, the presumed date of LMP may be in error. In these instances the computed gestational period may be longer or shorter than the true gestational period, but the extent of such errors is unknown. Month of Pregnancy Prenatal Care Began For those records in which the name of the month is entered for this item, instead of first, second, third, and so forth, the month of pregnancy in which prenatal care began is determined from the month named and the month last normal menses began. For these births, if the item "Date last normal menses began" is not on the certificate or is not stated, the month of pregnancy in which prenatal care began is tabulated as not stated. Number of Prenatal Visits Tabulations of the number of prenatal visits were presented for the first time in 1972. In 1983 these data were collected from the birth certificate of 49 States and the District of Columbia (see table A). Apgar Score One-and 5-minute Apgar scores were added to the U.S. Standard Certificate of Live Birth in 1978 to evaluate the condition of the newborn infant at 1 and 5 minutes after birth. The Apgar score is a useful measure of the need for resuscitation and a predictor of the infant's chances of surviving the first year of life. It is a summary measure of the infant's condition based on heart rate, respiratory effort, muscle tone, reflex irritability, and color. Each of these factors is given a score of 0, 1, or 2; the sum of these 5 values is the Apgar score, which ranges from 0 to 10. A score of 10 is optimum, and a low score raises some doubts about the survival and subsequent health of the infant. In 1983 the 1- and 5-minute Apgar scores were included on the birth certificates of 46 States and the District of Columbia. See table A for a listing of reporting areas. Hispanic Parentage Concurrent with the 1978 revision of the U.S. Standard Certificate of Live Birth, NCHS recommended that States add items to identify the Hispanic or ethnic origin of the newborn's parents. Two formats were used: An open-ended item to obtain the specific origin or descent of each parent, for example, Italian, Mexican, or English; and an item directed toward the Hispanic population, requesting only the specific Hispanic origin (Mexican, Puerto Rican, Cuban, and so forth). In 1983 items requesting Hispanic or ethnic origin were included on the birth certificates of 23 States and the District of Columbia (see table A). Quality of Data General Information Although vital statistics data are useful for a variety of administrative and scientific purposes, they cannot be correctly interpreted unless various qualifying factors and methods of classification are taken into account. The factors to be considered depend on the specific purposes for which the data are to be used. It is not feasible to discuss all the pertinent factors in the use of vital statistics tabulations, but some of the more important ones should be mentioned. Most of the factors limiting the use of data arise from imperfections in the original records or from the impracticability of tabulating these data in very detailed categories. These limitations should not be ignored, but their existence does not vitiate the value of the data for most general purposes. Completeness of Registration An estimated 99.3 percent of all births occurring in the United States in 1983 were registered; for white births registration was 99.4 percent complete and for all other births, 98.6 percent complete. These estimates are based on the results of the 1964-68 test of birth registration completeness according to place of delivery (in or out of hospital) and race and on the 1983 proportions of births in these categories. The primary purpose of the test was to obtain current measures of registration completeness for births in and out of hospital by race on a national basis. Data for States were not available as they had been from the previous birth-registration tests in 1940 and 1950. A detailed discussion of the method and results of the 1964-68 birth registration test is available.11 The 1964-68 test has provided an opportunity to revise the estimates of birth-registration completeness for the years since the previous test in 1950 to reflect the improvement in registration. This has been done using registration completeness figures from the two tests by place of delivery and race. Estimates of registration completeness for four groups (based on place of delivery and race) for 1951-65 were computed by interpolation between the test results. (It was assumed that the data from the more recent test are for 1966, the midpoint of the test period.) The results of the 1964-68 test are assumed to prevail for 1966 and later years. These estimates were used with the proportions of births registered in these categories to obtain revised numbers of births adjusted for underregistration for each year. The overall percent of birth-registration completeness by race was then computed. The figures for 1951-68 shown in table 1-21 differ slightly from those shown in annual reports for years prior to 1969. Dated adjusted for underregistration for 1951-59 shown in tables 1-1, 1-3, 1-4, 1-6, and 1-8 have been revised to be consistent with the 1964-68 test results and differ slightly from data shown in annual reports for years before 1969. For these years the published number of births and birth rates for both racial groups have been revised slightly downward because the 1964-68 test indicated that previous adjustments to registered births were slightly inflated. Because registration completeness figures by age of mother and by live-birth order are not available from the 1964-68 test, it must be assumed that the relationships among these variables have not changed since 1950. Discontinuation of adjustment for underregistration, 1960--Adjustment for underregistration of births was discontinued in 1960, when birth registration for the United States was estimated to be 99.1 percent complete. This removed a bias introduced into age-specific rates when adjusted births classified by age were used. Age-specific rates are calculated by dividing the number of births to an age group of mothers by the population of women in that age group. Tests have shown that population figures are likely to be understated through census undercounts; these errors compensate for underregistration of births. Adjustment for underregistration of births, therefore, reoved the compensating effect of underenumeration, biasing the age-specific rates more than when uncorrected birth and population data are used. (For further details see Vital Statistics of the United States, 1963, Volume I, page 4-11.) The age-specific rates used in the cohort fertility tables (tables 1-12 through 1-19) are an exception to the above statement. These rates are computed from births corrected for underregistration and population estimates adjusted for underenumeration and misstatement of age. Adjusted births and population estimates are used for the cohort rates because they are an integral part of a series of rates, estimated with a consistent methodology. It was considered desirable to maintain consistency with respect to the cohort rates, even though it means that they will not be precisely comparable with other rates shown for 5-year age groups. Quality Control Procedures Natality data coded by NCHS are simultaneously coded and entered onto magnetic tape for input to the computer. Errors are controlled by an independent replication of the original coding by verification clerks and by resolution of any discrepancies. Original coding entries are subject to total verification except for work by coders who maintain an error rate of 2.5 percent or less. For these qualified coders the original coding is verified on the basis of a 10-percent sample of the coded natality records until the allowable rate is exceeded. Then their coding is verified on a 100-percent basis until it requalifies for sample verification. Errors detected by any method of verification are reviewed to determine coding bias. States in the Vital Statistics Cooperative Program are required to have an error rate of less than 2.0 percent fo each item for 3 consecutive data months during the initial qualifying period. Once a State is qualified, NCHS monitors the quality of data received through independent verification of a sample of records to ensure that the item error rate is not more than approximately 4 percent. In addition, there is verification at the State level before NCHS is sent the data. After completion of coding, counts of the taped records are balanced against control totals for each shipment of records from a registration area. Impossible codes are eliminated during the editing processes on the computer and corrected on the basis of reference to the source record or adjusted by arbitrary code assignment. All subsequent operations involved in tabulation and table preparation are verified during the computer processing or by statistical clerks. Small Frequencies The numbers of births reported for an area represent complete counts except for those States where data are based on a 50-percent sample. As such, they are not subject to sampling error, although they are subject to errors in the registration process. However, when the figures are used for analytical purposes, such as the comparison of rates over a time period 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. The probable range of values may be estimated from the actual figures according to certain statistical assumptions. In general, distributions of vital evnts may be assumed to follow the binomial distribution. Estimates of standard errors and tests of significance under this assumption are described in most standard statistic tests. When the number of events is large, the standard error, expressed as a percent of the number or rate, 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 conditions described by the figures. Events of rare nature may be assumed to follow a Poisson probability distribution. For this distribution, a simple approximation may be used to estimate the error as follows: If N is the number of birthsa and R is the corresponding rate, the changes are 19 in 20 that: aFor States for which birth data are based on a 50-percent sample of births, N should be taken as one-half of the number of births given in the tables. 1. The "true" number of events lies between N - 2 N and N + 2 N 2. The "true" rate lies between R R R - 2 and R + 2 N N If the rate R corresponding to N events is compared with the rate S corresponding to M events, the difference between the two rates may be regarded as statistically significant if it exceeds R2 S2 2 + N M For example, suppose that the observed birth rate for area A was 15.0 per 1,000 population and that this rate was based on 50 recorded births. Given prevailing conditions, the chances are 19 in 20 that the "true" or underlying birth rate for that area lies between 10.8 and 19.2 per 1,000 population. Let it be further supposed that the birth rate for area A of 15.0 per 1,000 population is being compared with a rate of 20.0 per 1,000 population for area B, which is based on 40 recorded births. Although the difference between the rates for the two areas is 5.0, this difference is less than twice the standard error of the difference (15.0)2 (20.0)2 2 + 50 40 of the two rates that is computed to be 7.6. From this, it is concluded that the difference between the rates for the two areas is not statistically significant. Sampling of Birth Records Birth statistics presented in this report for years before 1951 and for 1955 are based on the total file of birth records. Statistics for 1951-54, 1956-66, and 1968-71 are based on 50-percent samples with the exception of data for Guam and the Virgin Islands, which are based on all the records filed. During the course of processing the 1967 data, the sampling rate was reduced from 50 percent to 20 percent. For details of this procedure and its consequences for the 1967 data, see Vital Statistics of the United States, 1967, Volume I, pages 3-9 to 3-11. Beginning in 1972 statistics are based on all records filed in the States submitting computer tapes and on a 50-percent sample of records in all other States. In 1983 the total file of birth records was used for 46 States (see "Sources of Data"), which accounted for 84 percent of all births in the country. The total file of records was also used for Puerto Rico, the Virgin Islands, and Guam. In the four States (Arizona, California, Delaware, and Georgia) and the District of Columbia where a sample was used, the sampling design is essentially a stratified random sample. The sampling frame consists of births that occur in the State during a calendar year and that are rerecorded by State registrars of vital statistics. Each month the birth certificates that have been filed during the month are sent by local registrars to the State registrars, where the records are numbered sequentially as they are received. Therefore, the records for each local registration area, usually a county, are numbered sequentially, and births in the total file for each State are grouped by month of filing and county of occurrence. Microfilm copies of the birth records filed in the State are forwarded to the National Center for Health Statistics, where even-numbered records are selected for the 50-percent sampling rate. Reliability of Estimates There is no sampling error in the total number of births occurring in a State, whether the total file or a 50-percent sample is used. Characteristics such as race and month of birth when shown by place of occurrence are subject to sampling error only for the sampled States. All data by place of residence, for all States, are subject to sampling error. Sampling error is the difference between an estimate based on a sample and the true value (assuming there is no measurement error). As calculated for this report the standard error reflects this error as well as random measurement errors that may have been made in data collection and processing. However, it does not include any systematic biases in the data. The chances are about 2 out of 3 that the difference between the estimate and the value that would have been obtained from all births is less than 1 standard error. The chances are about 19 out of 20 that the difference is less than twice the standard error and about 99 out of 100 that it is less than 2 1/2 times as large. The approximate standard errors for 1983 for total births in an area and for numbers of births with a specific characteristic can be obtained using table B in conjunction with table C. To use table B, both the total number of births in the area and the estimated number of births with a specific characteristic must be known. For estimated births with a specified characteristic other than geographic area, the appropriate "Total births in the area" in table B is the number in the relevant area--for example, city, county, State, or United States. When the specified characteristic is a substate geographic area, the number of births in the State is used as the "Total births in the area." Linear interpolation may be used to obtain standard errors for estimated numbers of births not shown in table B. After the standard error is determined from table B, it is multiplied by the appropriate factor from table C. If the multiplier is zero ("-"), then there is no standard error. For substate geographic areas, the multiplier shown for the State should be used. For example, consider an estimate of 10,000 births to women with a particular characteristic residing in Oregon, which has a total of 39,977 births to residents. Table B shows that the standard error for an estimate of 10,000 births is 70.7 for an area having 20,000 total births and 89.4 for an area having 50,000 total births. Linear interpolation yields a value of 83.2 for the appropriate standard error for an area having 39,977 births. According to table C, the multiplier for resident births for Oregon is 0.28. Hence, the standard error for the estimate of 10,000 births to women with a particular characteristic residing in Oregon is approximately 23.3 = (83.2)(0.28). The multiplier in table C for a nonsampled State is based on the estimated proportion of births to that State's residents occurring in adjacent sampled States. When the multiplier is zero ("-"), there are no adjacent sampled States. The proportion of births to that State's residents occurring in nonadjacent sampled States is small, with only a negligible effect on the standard error. Table B. Standard errors of estimated births for specified size of estimate and total births in the area (Standard errors shown must be used in conjunction with multipliers in table C. See text.) Number of Births With a Total Births in the Area (B) Specified Characteristic(X)1 250 500 1,000 2,000 5,000 10 ------------------------------ 3.1 3.1 3.1 3.2 3.2 20 ------------------------------ 4.3 4.4 4.4 4.5 4.5 30 ------------------------------ 5.2 5.3 5.4 5.4 5.5 50 ------------------------------ 6.4 6.7 6.9 7.0 7.0 125 ----------------------------- 7.9 9.7 10.5 10.8 11.0 250 ----------------------------- 0.0 11.2 13.7 14.8 15.4 500 ----------------------------- - 0.0 15.8 19.4 21.2 1,000 --------------------------- - - 0.0 22.4 28.3 2,500 --------------------------- - - - 0.0 35.4 5,000 --------------------------- - - - - 0.0 10,000 -------------------------- - - - - - 25,000 -------------------------- - - - - - 50,000 -------------------------- - - - - - 100,000 ------------------------- - - - - - 250,000 ------------------------- - - - - - 500,000 ------------------------- - - - - - 1,000,000 ----------------------- - - - - - 2,000,000 ----------------------- - - - - - 3,000,000 ----------------------- - - - - - (Standard errors shown must be used in conjunction with multipliers in table C. See text.) Number of Births With a Specified Total Births in the Area (B) Characteristic(X)1 10,000 20,000 50,000 500,000 3,600,000 10 ----------------------------- 3.2 3.2 3.2 3.2 3.2 20 ----------------------------- 4.5 4.5 4.5 4.5 4.5 30 ----------------------------- 5.5 5.5 5.5 5.5 5.5 50 ----------------------------- 7.1 7.1 7.1 7.1 7.1 125 ---------------------------- 11.1 11.1 11.2 11.2 11.2 250 ---------------------------- 15.6 15.7 15.8 15.8 15.8 500 ---------------------------- 21.8 22.1 22.2 22.3 22.4 1,000 -------------------------- 30.0 30.8 31.3 31.6 31.6 2,500 -------------------------- 43.3 46.8 48.7 49.9 50.0 5,000 -------------------------- 50.0 81.2 67.1 70.4 70.7 10,000 ------------------------- 0.0 70.7 89.4 99.0 99.9 25,000 ------------------------- - 0.0 111.8 154.1 157.6 50,000 ------------------------- - - 0.0 212.1 222.0 100,000 ------------------------ - - - 282.8 311.8 250,000 ------------------------ - - - 353.6 482.3 500,000 ------------------------ - - - 0.0 656.2 1,000,000 ---------------------- - - - - 849.8 2,000,000 ---------------------- - - - - 942.8 3,000,000 ---------------------- - - - - 707.1 1Standard errors for B minus X are the same as those shown for X. Table C. Multipliers for approximating maximum standard errors, by place of occurrence and place of residence: United States, each division and State, 1983 Place of Place of Division and State Occurrence Residence United States ------------------------ 0.41 0.41 Geographic divisions: New England ------------------------ - - Middle Atlantic -------------------- - 0.08 East North Central ----------------- - - West North Central ----------------- - - South Atlantic --------------------- 0.46 0.48 East South Central ----------------- - 0.24 West South Central ----------------- - - Mountain --------------------------- 0.48 0.49 Pacific ---------------------------- 0.87 0.87 New England: Maine ------------------------------ - - New Hampshire ---------------------- - - Vermont ---------------------------- - - Massachusetts ---------------------- - - Rhode Island ----------------------- - - Connecticut ------------------------ - - Middle Atlantic: New York --------------------------- - - New Jersey-------------------------- - 0.18 Pennsylvania------------------------ - 0.14 East North Central: Ohio ------------------------------- - - Indiana ---------------------------- - - Illinois --------------------------- - - Michigan --------------------------- - - Wisconsin -------------------------- - - West North Central: Minnesota -------------------------- - - Iowa ------------------------------- - - Missouri --------------------------- - - North Dakota ----------------------- - - South Dakota ----------------------- - - Nebraska --------------------------- - - Kansas ----------------------------- - - South Atlantic: Delaware -------------------------- 1.00 1.00 Maryland -------------------------- - 0.62 District of Columbia -------------- 1.00 1.00 Virginia -------------------------- - 0.50 West Virginia --------------------- - - North Carolina -------------------- - 0.39 South Carolina -------------------- - 0.51 Georgia --------------------------- 1.00 1.00 Florida --------------------------- - 0.29 East South Central: Kentucky -------------------------- - - Tennessee ------------------------- - 0.42 Alabama --------------------------- - 0.47 Mississippi ----------------------- - - West South Central: Arkansas -------------------------- - - Louisiana ------------------------- - - Oklahoma -------------------------- - - Texas ----------------------------- - - Mountain: Montana --------------------------- - - Idaho ----------------------------- - - Wyoming --------------------------- - - Colorado -------------------------- - 0.20 New Mexico ------------------------ - 0.29 Arizona --------------------------- 1.00 1.00 Utah ------------------------------ - 0.24 Nevada ---------------------------- - 0.63 Pacific: Washington ------------------------ - - Oregon ---------------------------- - 0.28 California ------------------------ 1.00 1.00 Alaska ---------------------------- - - Hawaii ---------------------------- - - Table C. Multipliers for approximating maximum standard errors, by place of occurrence and place of residence: United States, each division and State, 1984 Place of Place of Division and State Occurrence Residence United States ------------------------ 0.40 0.41 Geographic divisions: New England ------------------------ - - Middle Atlantic -------------------- - 0.08 East North Central ----------------- - - West North Central ----------------- - - South Atlantic --------------------- 0.46 0.46 East South Central ----------------- - 0.24 West South Central ----------------- - - Mountain --------------------------- 0.49 0.50 Pacific ---------------------------- 0.87 0.87 New England: Maine ------------------------------ - - New Hampshire ---------------------- - - Vermont ---------------------------- - - Massachusetts ---------------------- - - Rhode Island ----------------------- - - Connecticut ------------------------ - - Middle Atlantic: New York --------------------------- - - New Jersey-------------------------- - 0.18 Pennsylvania------------------------ - 0.14 East North Central: Ohio ------------------------------- - - Indiana ---------------------------- - - Illinois --------------------------- - - Michigan --------------------------- - - Wisconsin -------------------------- - - West North Central: Minnesota -------------------------- - - Iowa ------------------------------- - - Missouri --------------------------- - - North Dakota ----------------------- - - South Dakota ----------------------- - - Nebraska --------------------------- - - Kansas ----------------------------- - - South Atlantic: Delaware -------------------------- 1.00 1.00 Maryland -------------------------- - 0.62 District of Columbia -------------- 1.00 1.00 Virginia -------------------------- - 0.50 West Virginia --------------------- - - North Carolina -------------------- - 0.39 South Carolina -------------------- - 0.52 Georgia --------------------------- 1.00 1.00 Florida --------------------------- - 0.29 East South Central: Kentucky -------------------------- - - Tennessee ------------------------- - 0.44 Alabama --------------------------- - 0.48 Mississippi ----------------------- - - West South Central: Arkansas -------------------------- - - Louisiana ------------------------- - - Oklahoma -------------------------- - - Texas ----------------------------- - - Mountain: Montana --------------------------- - - Idaho ----------------------------- - - Wyoming --------------------------- - - Colorado -------------------------- - 0.20 New Mexico ------------------------ - 0.28 Arizona --------------------------- 1.00 1.00 Utah ------------------------------ - 0.23 Nevada ---------------------------- - 0.58 Pacific: Washington ------------------------ - - Oregon ---------------------------- - 0.26 California ------------------------ 1.00 1.00 Alaska ---------------------------- - - Hawaii ---------------------------- - - The appropriate relative standard error for rates is equivalent to the relative standard error of the numerator obtained using tables B and C. This is because the denominators are estimates that are considered to be without sampling errors (for example, populations by age, race, and sex or by month for the United States; or populations for States or for SMSA's). The standard error for estimates of the difference between two estimates X1 and X2 may be calculated using SE(d) = SE2(X1) + SE2(X2) This formula represents the standard error quite accurately for the difference between separate and uncorrelated characteristics. When the characteristics are correlated, however, this formula overstates the standard error. The standard error for an estimate of the ratio R = X/Y may be approximated if the sample sizes are large enough for the ratio's variance to be valid. As a working rule, the variance formula may be used if Y exceeds 60 and is also large enough that the relative standard errors (RSE's) for both X and Y are less than 0.1012 or if RSE(Y) is less than 0.05.13 The RSE of an estimate (X or Y) is approximated by dividing the standard error by the estimate itself. In the following it is assumed that Y exceeds 60 and that at least on of the two conditions of the RSE's is satisfied. The standard error for percent estimates where X is a subclass of the denominator Y may be calculated using SE(R) = R RSE2(X) - RSE2(Y) The standard error for estimates of means and other ratios where the numerator X is not a subclass of the denominator Y may be calculated using SE(R) = R RSE2(X) + RSE2(Y) COMPUTATION OF RATES AND OTHER MEASURES Population Bases The rates shown in this report were computed on the basis of population statistics prepared by the U.S. Bureau of the Census. Rates for 1940, 1950, 1960, 1970, and 1980 are based on the population enumerated as of April 1 in the censuses of those years. Rates for all other years are based on the estimated midyear (July 1) population for the respective years. Birth rates for the United States, individual States, and SMSA's 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 population of the birth- and death-registration States for 1900-1932 and for the United States for 1900-1983 is shown in table 4-1. In addition, the population including Armed Forces abroad is shown for the United States. Table D shows the sources for these populations. Population estimates for 1981-83--The population of the United States by age, race, and sex for 1983 is shown in table 4-2. The population for each State is shown in table 4-3 and the monthly population figures were published in Current Population Reports, Series P-25, Number 961. Comparable data for 1981 and 1982 were shown in tables 4-2 and 4-3 of Vital Statistics of the United States, Volume I, for those years and in Current Population Reports, Series P-25, Numbers 931 and 949. Population data by race are consistent with the modified 1980 populations by race. Populations for 1980--The population of the United States by age, race, and sex, and the population for each State are shown in tables 4-2 and 4-3 of Vital Statistics of the United States, 1980, Volume I. The figures by race have been modified as described below. Monthly population figures were published in Current Population Reports, Series P-25, Nuber 899. The racial counts in the 1980 census are affected by changes in racial reporting practices, particularly by the Hispanic population, and in coding and classifying racial groups in the 1980 census. One particular change has created a major inconsistency between the 1980 census data and historical data series, including censuses and vital statistics. About 40 percent of the Hispanic population counted in 1980, over 5.8 million persons, did not mark one of the specified races listed on the census questionnaire but instead marked the "Other" category. In the 1980 census, coding procedures were modified for persons who marked "Other" race and wrote in a national origin designation of a Latin American country or a specific Hispanic origin group in response to the racial question. These persons remained in the "Other" racial category in 1980 census data; in previous censuses and in vital statistics such responses were almost always coded into the "White" category. In order to maintain comparability, the "Other" racial category in the 1980 census was reallocated to be consistent with previous procedures. Persons who marked the "Other" racial category and reported any Spanish origin on the Spanish origin question (5,840,648 persons) were distributed to white and black races in proportion to the distribution of persons of Hispanic origin who reported their race to be white or black. This was done for each age-sex group. As a result of this procedure, 5,705,155 persons were added to the white population and 135,493 persons to the black population. Persons who marked the "Other" racial category and reported that they were not of Spanish origin (916,338 persons) were distributed as follows: 20 percent in each age-sex group were added to the "Asian and Pacific Islander" category (183,268 persons), and 80 percent were added to the "White" category (733,070 persons). The count of American Indians, Eskimos, and Aleuts was not affected by these procedures. Unpublished tabulations of these modified census counts were obtained from the Bureau of the Census and used to compute the 1980 rates for this report, except for tables 1-12 through 1-19. Population estimates for 1971-79--Birth rates for 1971-79 (except those for cohorts of women in tables 1-12 through 1-19) have been revised, based on revised population estimates that are consistent with the 1980 census levels. The 1980 census counted approximately 5.5 million more persons than had earlier been estimated for April 1, 1980.14 The revised estimates for the United States by age, race, and sex were published by the Bureau of the Census in the Current Population Reports, Series P-25, Number 917. Population estimates by month are based on data published in Current Population Reports, Series P-25, Number 899. Unpublished revised estimates for States were obtained from the Bureau of the Census. Population estimates for 1961-69--Birth Rates in this volume for 1961-69 (except for those shown in tables 1-4 and 1-5) are based on revised estimates of the population and thus may differ slightly from rates published before 1976. The revised estimates used in computing these rates were published in Current Population Reports, Series P-25, Number 519. The rates shown in tables 1-4 and 1-5 for 1961-64 are based on revised estimates of the population published in Current Population Reports, Series P-25, Numbers 321 and 324, and may differ slightly from rates published in those years. Population estimates for 1951-59--Final intercensal estimates of the population by age, race, and sex and total population by State for 1951-59 are shown in tables 4-4 and 4-5 of Vital Statistics of the United States, 1966, Volume I. Beginning with 1963 these final estimates have been used to compute birth rates for 1951-59 in all issues of Vital Statistics of the United States. Net Census Undercounts and Overcounts The Bureau of the Census has conducted extensive research to evaluate the coverage of the United States population (including undercount and overcount and misstatement of age, race, and sex) in the last four decennial censuses--1950, 1960, 1970, and 1980. These studies provide estimates of the national population that was not enumerated or overenumerated in the respective censuses, by age, race, and sex.15-17 The report for 198017 includes 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 Populations for 1980. Table D. Sources for resident population and population including Armed Forces abroad: Birth- and death-registration States, 1900-1932, and United States, 1900-1984 Year Source 1984-------------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 985, April 1986. 1983-------------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 965, Dec. 1984. 1982-------------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 949, May 1984. 1981-------------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 929, May 1983. 1980-------------- U.S. Bureau of the Census, U.S. Census of Population: 1980, Number of Inhabitants, PC80-1-A1, United States Summary, 1983. 1971-79----------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 917, July 1982. 1970-------------- U.S. Bureau of the Census, U.S. Census of Population: 1970, Number of Inhabitants, Final Report PC(1)-A1, United States Summary, 1971. 1961-69----------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 519, April 1974. 1960-------------- U.S. Bureau of the Census, U.S. Census of Population: 1960, Number of Inhabitants, Final Report PC(1)-A1, United States Summary, 1964. 1951-59----------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 310, June 30, 1965. 1940-50----------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 499, May 1973. 1930-39----------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 499, May 1973, and National Office of Vital Statistics, Vital Statistics Raters in the United States, 1900-1940, 1947. 1920-29----------- National Office of Vital Statistics, Vital Statistics Rates in the United States, 1900-1940, 1947. 1917-19----------- Same as for 1930-39. 1900-1916--------- Same as for 1920-29. These studies indicate that there is differential coverage in the censuses among the population subgroups; that is, some age, race, and sex groups are more completely enumerated than others. To the extent that these estimates of over- or undercounts are valid, that they are substantial, and that they vary among subgroups and geographic areas, census miscounts can have consequences for vital statistics measures.16 However, the effects of undercounts in the census are reduced to the extent that there is underregistration of births. If these two factors are of equal magnitude, rates based on the unadjusted populations are more accurate than those based on adjusted populations since the births have not been adjusted for underregistration. The impact of net census miscounts on vital statistics measures includes the effects on levels of the rates and effects on differentials among groups. If adjustments were made for persons who were not counted in the census population, the size of the denominators would generally increase and the rates would be smaller than without an adjustment. Adjusted rates for 1980 can be computed by multiplying the reported rates by ratios of the 1980 census-level population adjusted for the estimated net census miscounts, which are shown in table E. A ratio of less than 1.0 indicates a net census undercount and would result in a corresponding decrease in the rate. A ratio in excess of 1.0 indicates a net census overcount and would result in a corresponding increase in the rate. Enumeration of females in the childbearing ages was at least 99 percent complete for all ages; the underenumerated age groups were 25-29 years, 35-39 years, and 45-49 years. Only one white female age group was underenumerated (35-39 years). Among women of races other than white, all age groups but one (15-19 years) were underenumerated, with undercounts ranging up to 4 percent. Generally, females in the childbearing ages were more completely enumerated than males for similar race-age groups. If vital statistics measures were calculated with adjustments for net census miscounts for each of these subgroups, the resulting rates would have been differentially changed from their original levels; that is, rates for those groups with the greatest estimated overcounts or undercounts would show the greatest relative changes due to these adjustments. Thus the racial differential in fertility between the white and the all other population can be affected by such adjustments. Table E. provided for 1983 Birth Cohort Table E. Ratio of census-level population to population adjusted for estimated net census undercount, by age, sex, and race: April 1, 1980 All Races White Age Both Both Sexes Male Female Sexes Male Female All ages --------------- 0.9912 0.9822 0.9999 0.9960 0.9888 1.0029 10-14 years ------------ 1.0047 1.0052 1.0042 1.0071 1.0077 1.0066 15-19 years ------------ 1.0082 1.0070 1.0094 1.0068 1.0052 1.0084 20-24 years ------------ 0.9970 0.9876 1.0067 1.0004 0.9924 1.0088 25-29 years ------------ 0.9840 0.9694 0.9989 0.9885 0.9767 1.0007 30-34 years ------------ 0.9908 0.9739 1.0079 0.9964 0.9828 1.0104 35-39 years ------------ 0.9722 0.9535 0.9910 0.9815 0.9673 0.9961 40-44 years ------------ 0.9843 0.9646 1.0041 0.9933 0.9784 1.0083 45-49 years ------------ 0.9788 0.9600 0.9974 0.9891 0.9751 1.0029 50-54 years ------------ ... 0.9678 ... ... 0.9778 ... 55 years and older------ ... 0.9896 ... ... 0.9892 ... 15-44 years ------------ ... ... 1.0035 ... ... 1.0057 15-54 years ------------ ... 0.9761 ... ... 0.9838 ... All Other Total Black Age Both Both Sexes Male Female Sexes Male Female All ages --------------- 0.9628 0.9425 0.9821 0.9458 0.9189 0.9716 10-14 years ------------ 0.9931 0.9932 0.9930 0.9858 0.9855 0.9861 15-19 years ------------ 1.0153 1.0183 1.0143 1.0042 1.0028 1.0056 20-24 years ------------ 0.9786 0.9614 0.9957 0.9504 0.9233 0.9775 25-29 years ------------ 0.9588 0.9269 0.9894 0.9264 0.8816 0.9705 30-34 years ------------ 0.9568 0.9179 0.9935 0.9214 0.8668 0.9746 35-39 years ------------ 0.9149 0.8666 0.9608 0.8828 0.8190 0.9448 40-44 years ------------ 0.9299 0.8783 0.9791 0.8992 0.8334 0.9623 45-49 years ------------ 0.9132 0.8597 0.9629 0.8930 0.8280 0.9548 50-54 years ------------ ... 0.8920 ... ... 0.8620 ... 55 years and older------ ... 0.9935 ... ... 0.9771 ... 15-44 years ------------ ... ... 0.9919 ... ... 0.9763 15-54 years ------------ ... 0.9302 ... ... 0.8939 ... SOURCE: U.S. Bureau of the Census: Estimates of the population of the United States, by age, sex, and race: 1980 to 1984. Current Population Reports. Series P-25, No. 965. Washington. U.S. Government Printing Office, March 1985. Table E. provided for 1984 Birth Cohort Table E. Ratio of census-level resident population to resident population adjusted for estimated net census undercount, by age, race, and sex: United States, April 1, 1980 All Races White Age Both Both Sexes Male Female Sexes Male Female All ages --------------- 0.9862 0.9763 0.9958 0.9916 0.9839 0.9990 10-14 years ------------ 0.9978 0.9982 0.9974 1.0003 1.0008 0.9998 15-19 years ------------ 1.0011 0.9988 1.0034 1.0003 0.9976 1.0030 20-24 years ------------ 0.9834 0.9706 0.9965 0.9879 0.9769 0.9993 25-29 years ------------ 0.9742 0.9581 0.9908 0.9799 0.9673 0.9929 30-34 years ------------ 0.9850 0.9683 1.0020 0.9905 0.9778 1.0036 35-39 years ------------ 0.9776 0.9597 0.9955 0.9860 0.9730 0.9991 40-44 years ------------ 0.9743 0.9549 0.9937 0.9849 0.9706 0.9992 45-49 years ------------ 0.9734 0.9538 0.9926 0.9828 0.9690 0.9967 50-54 years ------------ ... 0.9638 ... ... 0.9755 ... 55 years and older------ ... 0.9865 ... ... 0.9875 ... 15-44 years ------------ ... ... 0.9973 ... ... 0.9995 15-54 years ------------ ... 0.9683 ... ... 0.9770 ... All Other Total Black Age Both Both Sexes Male Female Sexes Male Female All ages --------------- 0.9543 0.9309 0.9765 0.9392 0.9103 0.9669 10-14 years ------------ 0.9858 0.9858 0.9859 0.9808 0.9807 0.9816 15-19 years ------------ 1.0051 1.0052 1.0055 0.9980 0.9958 1.0001 20-24 years ------------ 0.9590 0.9354 0.9819 0.9390 0.9076 0.9696 25-29 years ------------ 0.9422 0.9040 0.9786 0.9168 0.8695 0.9628 30-34 years ------------ 0.9519 0.9081 0.9931 0.9197 0.8638 0.9735 35-39 years ------------ 0.9248 0.8743 0.9736 0.8968 0.8322 0.9588 40-44 years ------------ 0.9107 0.8576 0.9614 0.8782 0.8135 0.9401 45-49 years ------------ 0.9124 0.8544 0.9669 0.8833 0.8139 0.9497 50-54 years ------------ ... 0.8759 ... ... 0.8413 ... 55 years and older------ ... 0.9779 ... ... 0.9578 ... 15-44 years ------------ ... ... 0.9848 ... ... 0.9712 15-54 years ------------ ... 0.9157 ... ... 0.8843 ... SOURCE: U.S. Bureau of the Census: Estimates of the population of the United States, by age, sex, and race: 1980 to 1985. Current Population Reports. Series P-25, No. 985. Washington. U.S. Government Printing Office, April 1986. Cohort Fertility Tables The various fertility measures shown for cohorts of women in tables 1-12 through 1-19 are computed from births adjusted for underregistration and population estimates corrected for underenumeration and misstatement of age. The data shown in this volume are not consistent with data published in annual reports before 1974. These data use revised population estimates prepared by the Bureau of the Census and have been expanded to include data for the two major racial groups. A detailed description of the methods used in deriving these measures as well as more detailed data for earlier years were published in a separate report.18 Age-Sex-Adjusted Birth Rates The age-sex-adjusted birth rates shown in table 1-3 are computed by the direct method. The age distribution of women aged 10-49 years as enumerated in 1940 and the total population of the United States for that year are used as the standard populations. The birth rates by age of mother and race that are used to compute these adjusted rates are shown in table 1-6. The age-sex-adjusted birth rates show differences in the level of fertility independent of differences in the age and sex composition of the population. It is important not to confuse these adjusted rates with the crude rates shown in other tables. Total Fertility Rate The total fertility rate is the sum of the birth rates by age of mother (in 5-year age groups) multiplied by 5. It is an age-adjusted rate because it is based on the assumption that there are the same number of women in each age group. In table 1-6 the rate of 1,803 in 1983, for example, means that if a hypothetical group of 1,000 women were to have the same birth rates in each group that were observed in the actual childbearing population in 1983, they would have a total of 1,803 children by the time they reached the end of the reproductive period (taken here as age 50), assuming that all of the women survived to that age. Intrinsic Vital Rates The intrinsic vital rates shown in table 1-5 are calculated from a stable population. A stable population is that hypothetical population, closed to external migration, which would become fixed in age-sex structure after repeated applications of a constant set of age-sex specific birth and death rates. For the mathematical derivation of intrinsic vital rates, see Vital Statistics of the United States, 1962, Volume I, pages 4-13 and 4-14. The technique of calculating intrinsic vital rates is described elsewhere.19 Parity Distribution The percent distribution of women by parity (number of children ever born alive to mother) shown in tables 1-13 and 1-17 is derived from cumulative birth rates by order of birth, which are shown in tables 1-15 and 1-19. The percent of zero-parity women is found by subtracting the cumulative first birth rate from 1,000 and dividing by 10. The proportions of women at parities one through six are found from the following formula: Percent at N parity = (cum. rate, order N) - (cum. rate, order N + 1) 10 The percent of women at seventh and higher parities is found by dividing the cumulative rate for seventh-order births by 10. Seasonal Adjustment of Rates The seasonally adjusted birth and fertility rates shown in table 1-23 are computed from the X-11 variant of Census Method II.20 This method of seasonal adjustment used since 1964 differs slightly from the U.S. Bureau of Labor Statistics Seasonal Factor Method, which was used for Vital Statistics of the United States, 1964. The fundamental technique is the same in that it is an adaptation of the ratio-to-moving-average method. Before 1964 the method of seasonal adjustment was based on the X-9 variant and other variants of Census Method II. A comparison of the Census Method II with the BLS Seasonal Factor Method shows the differences in the seasonal patterns of births to be negligible. Computation of Percents, Medians, and Means Percent distributions, medians, and means are computed using only events for which the characteristic is reported. The "Not stated" category is subtracted from the total before computation of these measures. Symbols Used in Tables SYMBOLS USED IN TABLES Data not available--------------------------- --- Category not applicable---------------------- ... Quantity zero-------------------------------- - Quantity more than 0 but less than 0.05------ 0.0 Figure does not meet standards of reliability or precision------------------- References REFERENCES 1. Third World Health Assembly: Official Records, No. 28 (WHO 3.6). Geneva. World Health Organization. May 1950, pp. 16-17. 2. Statistical Office of the United Nations: Principles for a Vital Statistics System, Recommendations for the Improvement and Standardization of Vital Statistics, Doc. ST/STAT/SERM/19. New York. United Nations, Aug. 1953, p. 6. 3. National Office of Vital Statistics: International Recommendations on Definitions of Live Birth and Fetal Deaths. PHS Pub. No. 39. Public Health Service. Washington. U.S. Government Printing Office, Oct. 1950, p. 6. 4. National Office of Vital Statistics: Births and birth rates in the entire United States, 1909 to 1948. Vital Statistics--Special Reports, Vol. 33, No. 8, 1950. Public Health Service. Washington. U.S. Government Printing Office, 1954. 5. U.S. Office of Management and Budget: Standard metropolitan statistical areas and standard consolidated areas. Statistical Reporter. Washington. U.S. Government Printing Office, Oct. 1981, pp. 1-20. 6. U.S. Office of Management and Budget: 36 new standard metropolitan statistical areas. Statistical Reporter. Washington. U.S. Government Printing Office, July 1981, p. 420. 7. U.S. Office of Management and Budget: Standard metropolitan statistical areas, rev. ed. Washington. U.S. Government Printing Office, 1975, pp. 89-90. 8. National Vital Statistics Division, J. Schachter: Matched record comparison of birth certificate and census information in the United States 1950. Vital Statistics--Special Reports, Vol. 47, No. 12. Public Health Service. Washington, D.C., Mar. 1962. 9. National Center for Health Statistics, S. J. Ventura: Trends and differentials in births to unmarried women. United States, 1970-76. Vital and Health Statistics, Series 21, No. 36. DHHS Pub. No. (PHS) 80-1914. Public Health Service. Washington. U.S. Government Printing Office, May 1980. 10. National Center for Health Statistics, S. Taffel, D. Johnson, and R. Heuser: A method of imputing length of gestation on birth certificates. Vital and Health Statistics, Series 2, No. 93. DHHS Pub. No. (PHS) 82-1367. Public Health Service. Washington. U.S. Government Printing Office, May 1982. 11. U.S. Bureau of the Census: Test of birth registration completeness 1964 to 1968. 1970 Census of Population and Housing. Evaluation and Research Program. PHC (E)-2. Washington. U.S. Government Printing Office, 1973. 12. W. G. Cochran: Sampling Techniques. New York. John Wiley & Sons, Inc. 1963. 13. H. Hansen, N. Hurwitz, and G. Madow: Sample Survey Methods and Theory, Vol. 1, New York. John Wiley & Sons, Inc., 1953, 14. 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. Government Printing Office, Feb. 1982. 15. 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. Government Printing Office, Dec. 1977. 16. U.S. Bureau of the Census: 1970 Census of Population and Housing Estimates of coverage of the population by sex, race, and age--demographic analysis. Evaluation and Research Program. PHC (E)-4. Washington. U.S. Government Printing Office, 1974. 17. U.S. Bureau of the Census: Estimates of the population of the United States, by age, sex, and race: 1960 to 1984. Current Population Reports. Series P-25, No. 965. Washington. U.S. Government Printing Office, March 1985. 18. National Center for Health Statistics, R. Heuser: Fertility Tables for Birth Cohorts by Color: United States, 1917-73. DHEW Pub. No. (HRA) 76-1152. Health Resources Administration. Washington. U.S. Government Printing Office, 1976. 19. G. W. Barclay: Techniques of Population Analysis. New York, John Wiley and Sons, Inc., 1958, pp. 216-222. 20. U.S. Bureau of the Census: The X-11 Variant of the Census Method II Seasonal Adjustment Program. Technical Paper No. 13. Washington. U.S. Government Printing Office, 1963. TECHNICAL APPENDIX, 1983 MORTALITY FILE Sources of Data Death and Fetal-Death Statistics Mortality statistics for 1983 are, as for all previous years except 1972, based on information from records of all deaths occurring in the United States. Fetal-death statistics for every year are based on all reports of fetal death received by the National Center for Health Statistics (NCHS). The death-registration system and the fetal-death reporting system of the United States encompass 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 Trust Territory of the Pacific Islands. In the statistical tabulations of this publication, United States refers only to the aggregate of the 50 States (including New York City) and the District of Columbia. Tabulations for Guam, Puerto Rico, and the Virgin Islands are shown separately in this volume. No data have ever been included for American Samoa or the Trust Territory of the Pacific Islands. 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 the annual volumes of Vital Statistics of the United States from the year of their admission through 1971 except for the years 1967 through 1969, and tabulations for Guam were included for 1970 and 1971. Death statistics for Puerto Rico, the Virgin Islands, and Guam were not included in the 1972 volume but have been included in section 8 of the volumes for each of the years 1973-78 and in section 9 beginning with 1979. 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 and fetal 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 with computer tapes of data coded according to NCHS specifications and provided to NCHS through the Vital Statistics Cooperative Program. The year in which State-coded demographic data were first transmitted to NCHS is shown below for New York City, Puerto Rico, and each of the 46 States now furnishing demographic data. 1971 1976--Con. Florida Minnesota Nevada 1972 Texas West Virginia Maine Missouri 1977 New Hampshire Rhode Island Alaska Vermont Idaho Massachusetts 1973 New York City Ohio Colorado Puerto Rico Michigan New York (except New York City) 1978 1974 Indiana Utah Illinois Washington Iowa Kansas 1979 Montana Nebraska Connecticut Oregon Hawaii South Carolina Mississippi New Jersey 1975 Pennsylvania Wyoming Louisiana Maryland 1980 North Carolina Oklahoma Arkansas Tennessee New Mexico Virginia South Dakota Wisconsin 1982 1976 North Dakota Alabama Kentucky For the remaining four States, the District of Columbia, the Virginia Islands, and Guam, mortality statistics for 1983 are based on information obtained directly by NCHS from copies of the original certificates received from the registration offices. In 1974, States began coding medical (cause-of-death) data on computer tapes according to NCHS specifications. The year in which State-coded medical data were first transmitted to NCHS is shown below for the 16 States now furnishing such data. 1974 1980--Con. Iowa Massachusetts Michigan Mississippi New Hampshire 1975 Pennsylvania South Carolina Louisiana Nebraska 1981 North Carolina Virginia Maine Wisconsin 1983 1980 Minnesota Colorado Kansas For 1983 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, it was necessary to change these procedures because of a backlog in coding and processing that resulted from personnel and budgetary restrictions. To produce the mortality files on a timely basis with reduced resources, NCHS used State-coded underlying cause-of-death 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 below in the section "Estimates of errors arising from 50-percent sample for 1972." Fetal-death data are obtained directly from copies of original reports of fetal deaths received by NCHS, except New York State (excluding New York City), which began submitting State-coded data in 1980. Fetal-death data are not published by NCHS for the Virgin Islands and Guam. Standard Certificates and Reports The U.S. Standard Certificate of Death and the U.S. Standard Report of Fetal Death, issued by the Public Health Service, have served for many years as the principal means of attaining uniformity in the content of documents used to collect information on these events. They have been modified in 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 or reports 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 assured 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 have been dropped when their usefulness appeared to be limited. New revisions of the U.S. Standard Certificate of Death and the U.S. Standard Report of Fetal Death were recommended for State use beginning January 1, 1978. The certificate of death is for use by a physician, a medical examiner, or a coroner. Two other forms of the U.S. Standard Certificate of Death are available, they are similar except that the section on certification is designed for the physician's signature on one, and for the medical examiner's or coroner's signature on the other. Among the changes in the new revision were the addition of (1) an item asking "If Hosp. or Inst., Indicate DOA, OP/Emer. Rm., Inpatient" and (2) an item "Was Decedent Ever in U.S. Armed Forces?" The latter item was previously on the certificate but was deleted during 1968 through 1977. An item on whether autopsy findings were considered for determining cause of death was dropped. 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 consisting of two States (Massachusetts and New Jersey), the District of Columbia, and several large cities having efficient systems for death registrations, the death-registration area continued to expand until 1933, when it included the entire United States for the first time. Tables that show 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 the technical Appendix in Vital Statistics of the United States, 1979, Volume II, Mortality, Part A, Section 7, pages 3-4, and the section "History and Organization of the Vital Statistics System," chapter 1, Vital Statistics of the United States, 1950, Volume I, pages 2-19. Statistics on fetal deaths were first published for the birth-registration area in 1918, and then every year beginning with 1922. Classification of Data Introduction The principal value of vital statistics data is realized through the presentation of rates, which are computed by relating the vital events of a class to the population of a similarly defined class. Vital statistics and population statistics must therefore be classified according to similarly defined systems and tabulated in comparable groups. Even when the variables common to both, such as geographic area, age, sex and race, have been similarly classified and tabulated, differences between the enumeration method of obtaining population data and the registration method of obtaining vital statistics data may result in significant discrepancies. The general rules used in the classification of geographic and personal items for deaths and fetal deaths are set forth in two NCHS instruction manuals.1,2 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 in this report are 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 United States, with deaths of "nonresidents of the United States" assigned to place of death. Deaths of nonresidents of the United States" refers to deaths that occur in the United States of nonresident aliens, nationals residing abroad, and residents of Puerto Rico, the Virgin Islands, Guam, and other territories of the United States. Beginning with 1970, deaths of nonresidents of the United States are not included in tables by place of residence. Tables 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 1984 this difference amounted to 2,935 deaths. Mortality statistics by place of occurrence are shown in tables 1-10, 1-18, 1-19, 1-28, 1-29, 3-1, 3-8, 8-1, and 8-7. 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.3 A comparison of the results of this study of deaths with those for a previous matched record study of births4 showed that the quality of residence data had considerably improved between 1950 and 1960. Both studies found that events in urban areas were overstated by the NCHS classification in comparison with the U.S. Bureau of the Census classification. The magnitude of the difference was substantially less for deaths in 1960 than it was for births in 1950. The improvement is attributed to an item added in 1956 to the U.S. Standard Certificates of Birth and of Death, asking if residence was inside or outside city limits. This new item aided in properly allocating the residence of persons living near cities but outside the corporate limits. Geographic Classification The rules followed in the classification of geographic areas for deaths and fetal deaths are contained in the two instruction manuals referred to previously.1,2 The geographic codes assigned by the National Center for Health Statistics during data reduction of source information on birth, death, and fetal-death records are given in another instruction manual.5 Beginning with 1982 data, the geographic codes were modified to reflect results of the 1980 census. For 1980-81, codes are based on results of the 1970 census. Standard metropolitan statistical areas--The standard metropolitan statistical areas (SMSA's) used in this report are those established by the U.S. Office of Management and Budget from final 1980 census population counts6 and used by the U.S. Bureau of the Census, except in the New England States. Except in the New England States, an SMSA is a county or a group of contiguous counties containing a city of 50,000 inhabitants or more or an urbanized area of 50,000 with a total metropolitan population of at least 100,000. In addition to the county or counties containing such a city or urbanized area, contiguous counties are included in an SMSA if, according to specified criteria, they are essentially metropolitan in character and are socially and economically integrated with the central city or urbanized area.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 SMSA's. The National Center for Health Statistics cannot, however, use the SMSA classification for these States because its data are not coded to identify all towns. Instead, NCHS uses New England County Metropolitan Areas (NECMA's). These areas, established by the U.S. Office of Management and Budget, are made up of county units.7,8 Metropolitan and nonmetropolitan counties--Independent cities and counties included in SMSA's or NECMA's are included in data for metropolitan counties; all other counties are classified as nonmetropolitan. Population-size groups--Vital statistics data for cities and certain other urban places in 1984 are classified according to the population enumerated in the 1980 Census of Population. Data are available for individual cities and other urban places of 10,000 or more population. Data for the remaining areas not separately identified are shown in the tables under the heading "Balance of area" or "Balance of county." For the years 1970-81, classification of areas was determined by the population enumerated in the 1970 Census of Population. Beginning in 1982, as a result of changes in the enumerated population between 1970 and 1980, some urban places identified in previous reports are no longer included, and a number of other urban places have been added. Urban places other than incorporated cities for which vital statistics data are shown in this report 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 10,000 or more population, as there are no incorporated cities in the State. Before 1964, places were classified as "urban" or "rural." The Technical Appendixes for earlier years discuss the previous classification system. State or Country of Birth Mortality statistics by State or country of birth (table 1-32) 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 1984, about 0.5 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. With respect to the computation of death rates, the age classification used by the U.S. Bureau of the Census is also based on the age of the person in completed years. 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. Race For vital statistics in the United States in 1984, deaths are classified by race--white, black, Indian, Chinese, Japanese, Filipino, Other Asian or Pacific Islander, and 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 as Mexican, Puerto Rican, Cuban, and all other Caucasians. The Indian category includes American, Alaskan, Canadian, 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 other 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 in use 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. Most of the tables in this report, however, do not show data for this detailed classification by race. In about half of all the tables the divisions are white, all other (including black), and black separately. In other tables by race, where the main purpose is to isolate the major groups, the classifications are simply white and all other. Race not stated--For 1984 the number of death records for which race was unknown, not stated, or not classifiable was 3,172, or less than 0.2 percent of the total deaths. Death records with race entry not stated are assigned to a racial designation as follows: If the preceding record is coded white, the code assignment is made to white; if the code is other than white, the assignment is 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, death, and fetal death in use 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 in use for residents of New Jersey did not contain the race item. Adjustments made in vital statistics to take into account the omission of the race item in New Jersey for part of the certificates filed during 1962 through 1964 are described in the Technical Appendix of Vital Statistics of the United States for each of those data years. Hispanic Origin Mortality statistics for the Hispanic-origin population are published in this report for the first time. They 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 were obtained from the District of Columbia and the following 22 States: Arizona, Arkansas, California, Colorado, Georgia, Hawaii, Illinois, Indiana, Kansas, Maine, Mississippi, Nebraska, Nevada, New Jersey, New Mexico, New York (including New York City), North Dakota, Ohio, Tennessee, Texas, Utah, and Wyoming. Generally, the reporting States used items similar to one of two basic formats recommended by NCHS: the first format is open-ended to obtain the specific origin or descent of the decedent (for example, Italian, Mexican, Puerto Rican, English, and Cuban). The second format is directed specifically toward the Hispanic population and asks whether the decedent is of Spanish origin. If so, the specific origin--Mexican, Puerto Rican, and Cuban--is to be indicated. For 1984, mortality data in tables 1-33 and 2-18 are based on deaths to residents of all 22 reporting States and the District of Columbia. In tables 1-34, 2-19, 2-20, and 2-21 mortality data for the Hispanic-origin population are based on deaths to residents of 15 reporting States whose data were at least 90 percent complete and considered to be sufficiently comparable to be used for analysis. The 15 States are as follows: Arizona, Colorado, Georgia, Hawaii, Illinois, Indiana, Kansas, Mississippi, Nebraska, New York (including New York City), North Dakota, Ohio, Texas, Utah, and Wyoming. Excluded from these tables are data for New Mexico because the format for the Hispanic item on the New Mexico death certificate departs sufficiently from that of other areas to result in non-comparable data. In addition, in tables 1-33 and 1-34 for New Mexico, no deaths are shown for the category "not stated" origin. Because of the way in which the item on the death certificate for New Mexico is worded, it was not possible to determine if a blank entry represented a response of "non-Hispanic origin" or of "unknown origin." Accordingly, blank entries were coded to "non-Hispanic." Also excluded from the tables are data for California because, according to information from registration officials in California, coding procedures resulted in undercounts of deaths for the categories total "Hispanic origin" and "Mexican origin" as well as overcounts of deaths for the categories "Hispanic origins other than Mexican origin" and "not stated origin." The data for five other States--Arkansas, Maine, Nevada, New Jersey, and Tennessee--and the District of Columbia are excluded from these tables because of the large proportion of deaths (in excess of 10 percent) occurring in these States for which Hispanic origin was not stated or unknown. In 1980 the 15 reporting States accounted for about 45 percent of the Hispanic population in the United States, including about 47 percent of the Mexican population, 61 percent of the Puerto Rican population, 16 percent of the Cuban population, and 38 percent of the "Other Hispanic" population.9 Accordingly, caution should be exercised in generalizing mortality patterns from the reporting area to the Hispanic-origin population (especially Cubans) of the entire U.S. For qualifications regarding infant mortality of the Hispanic-origin population, see section Infant Deaths. Marital Status Mortality statistics by marital status (table 1-31) were published in 1979 for the first time since 1961. (Previously they had been published only in the annual reports for the years 1949-51 and 1959-61.) Several reports analyzing mortality by marital status have been published, including the special study based on 1959-61 data.10 Reference to earlier reports may be found 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. Certificates in which the marriage is specified as being annulled are classified as never married. Where marital status is specified as separated or common-law marriage, it is classified as married. Of the 1,982,817 resident deaths 15 years of age and over in 1984, 8,580 certificates (0.4 percent) had marital status not stated. Place of Death and Status of Decedent Mortality statistics by place of death were published in 1979 for the first time since 1958 (tables 1-28 and 1-29). In addition, mortality data were also available for the first time in 1979 for the status of decedent when death occurred in a hospital or medical center (table 1-28). These data were obtained from the following two items that appeared on the U.S. Standard Certificate of Death: * Item 7c, Hospital or Other Institution--Name (If not in either, give street and number) * Item 7d, If Hosp. or Inst. Indicate DOA, OP/Emer. Rm., Inpatient (Specify) All of the States and the District of Columbia have item 7c (or its equivalent) on the death certificate. For 46 States in the Vital Statistics Cooperative Program, NCHS accepts the State definition, classification, or codes for hospitals, medical centers, or other institutions. For the remaining four States not in the Program, and the District of Columbia, NCHS classifies and codes to a hospital or medical center according to whether the terms "hospital" or "medical center" are entered as part of the name in item 7c or its equivalent. If the terms "hospital" or "medical center" are not entered as part of the name, the entry is coded to one of the following according to the information entered in item 7c on the certificate: (1) other institutions, (2) all other reported entries, or (3) unknown, not stated. Table 1-28 shows mortality data for the total of the following 42 States (including New York City) that have item 7d or its equivalent on their death certificates: Alaska Nevada Arizona New Hampshire Arkansas New Jersey Colorado New Mexico Connecticut New York Florida North Carolina Georgia North Dakota Hawaii Ohio Idaho Oregon Illinois Pennsylvania Indiana Rhode Island Iowa South Carolina Kansas South Dakota Kentucky Tennessee Louisiana Utah Maine Vermont Michigan Virginia Mississippi Washington Missouri West Virginia Montana Wisconsin Nebraska Wyoming Effective with data for 1980, the coding of place of death and status of decedent was changed. A new coding category was added: "Dead on arrival--hospital, clinic, medical center name not given." Deaths coded to this category are tabulated in table 1-28 as "Dead on arrival" and in table 1-29 as "Not in hospital or medical center." Had the 1979 coding categories been used, these deaths would have been tabulated as "Place unknown." Mortality by Month and Date of Birth Deaths by month have been regularly tabulated and published in the annual report for each year beginning with data year 1900. For 1984, deaths by month are shown in tables 1-19, 1-20, 1-23, 1-30, 2-12, 2-13, 2-14, and 3-9. Date of death was first published for data year 1972. In addition, unpublished data for selected causes by date of death for 1962 are available from NCHS. Number of deaths by date of death in this report are shown in table 1-30 for the total number of deaths and for the number 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 the 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 Before 1972, the last year for which autopsy data were tabulated was 1958. Beginning in 1972, all registration areas requested information on the death certificate as to whether autopsies were performed. For 1984, autopsies were reported on 259,187 death certificates, 12.7 percent of the total (table 1-27). Information as to whether the autopsy findings were used in determining the causes of death were tabulated for 1972-73 for all but nine registration areas and from 1974-77 for all but eight registration areas. The item "autopsy findings used" was deleted from the 1978 U.S. Standard Certificate of Death. For five of the cause-of-death categories shown in table 1-27, autopsies were reported as performed for 50 percent or more of all deaths (Meningococcal infection; Pregnancy with abortive outcome; Other complications of pregnancy, childbirth, and the puerperium; Homicide and legal intervention; and All other external causes). There were five other categories for which 40 percent or more of the death certificates reported autopsies. Autopsies were reported for only 8.0 percent of the Major cardiovascular diseases. Among all causes other than major cardiovascular diseases, autopsies were reported for 17.0 percent of all deaths. 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."11 For a given death the underlying cause is selected from an array of conditions given in the cause-of-death section on the death certificate. These conditions are translated into medical codes through use of the classification structure and 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 in terms of the format of reported conditions and their causal relationship. 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 or more conditions on the certificate into a single classification category. As a statistical datum, the 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 start of the chain of events leading to death. The rules for coding underlying causes of death are included with the ICD as a means of standardizing classification, which contributes toward uniformity in mortality medical statistics among countries. Beginning with data year 1979 the cause-of-death statistics published by the National Center for Health Statistics have been classified according to the Ninth Revision of the International Classification of Diseases (ICD-9).11 In addition to specifying that the Classification be used, WHO also recommends how the data should be tabulated in order to promote international comparability. The recommended system for tabulating data in the Ninth Revision allows countries to construct their own mortality and morbidity tabulation lists from the rubrics of the WHO Basic Tabulation List as long as rubrics from the WHO mortality and morbidity lists, respectively, are included. This tabulation system for the Ninth Revision is more flexible than that of the Eighth Revision in which specific lists were recommended for tabulating mortality and morbidity data. The Basic Tabulation List (BTL) recommended under the Ninth Revision consists of 57 two-digit rubrics that add to the "all causes" total. Within each two-digit rubric, up to 9 three-digit rubrics numbered from 0 to 8 are identified, but these do not add to the total of the two-digit rubric. The two-digit rubrics of the BTL 01 through 46 provide for the tabulation of nonviolent deaths to ICD categories 001-799. Rubrics relating to chapter 17 (nature-of-injury causes 47 through 56) are not used by NCHS for selecting underlying cause of death; rather, preference is given to rubrics E47 through E56. The 57th two-digit rubric V0 is the Supplementary Classification of Factors Influencing Health Status and Contact with Health Services and is not appropriate for the tabulation of mortality data. The WHO Mortality List, a subset of the title contained in the BTL, consists of 50 rubrics which are a minimum for the national display of mortality data. Five lists of causes have been developed for tabulation and publication of mortality data in this volume. The Each-Cause List, List of 282 Selected Causes, List of 72 Selected Causes, 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 more recently in use 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 and each four-digit subcategory to which deaths may be validly assigned and most four-digit subcategories. The list is used for tabulation for the entire United States. The published Each-Cause table does not show the four-digit subcategories provided for Motor vehicle accidents (E810-E825); however, these subcategories, which identify persons injured, are shown in the accident tables of this report (section 5). Special fifth-digit subcategories are also used in the accident tables to identify place of accident when deaths from nontransport accidents are shown. These are not shown in the Each-Cause table. The List of 282 Selected Causes of Death is constructed from BTL rubrics 01-46 and E47-E56. Each of the 56 BTL two-digit titles can be obtained either directly or by combining titles in the List. The three-digit level of the BTL is modified more extensively. Where more detail was desired, categories not shown in the three-digit rubrics were added to the List of 282 Selected Causes of Death. Where less detail was needed, the three-digit rubrics were combined. Moreover, each of the 50 rubrics of the WHO Mortality List can be obtained from the List of 282 Selected Causes of Death. The List of 72 Selected Causes of Death was constructed by combining titles in the List of 282 Selected Causes of Death. It is used in tables published for the United States and each State, and for standard metropolitan statistical areas. 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. The List of 34 Selected Causes of Death was created by combining titles in the List of 72 Selected Causes. A table using this list is published to show detailed geographic areas. Effect of list revisions--The International Lists, in use in this country since 1900, have been revised approximately every 10 years so that the disease classification may be consistent with advances in medical science and with advances in diagnostic practice. Each revision of the International Lists has produced some break in comparability of cause-of-death statistics. Cause-of-death statistics beginning with 1979 are classified by NCHS according to the ICD-9.11 For a discussion of each of the classifications used with death statistics since 1900, see the Technical Appendix in Vital Statistics of the United States, 1979, Volume II, Mortality, Part A, section 7, pages 9-14. A dual coding study was undertaken between the Ninth and Eighth Revisions to measure the extent of discontinuity in cause-of-death statistics resulting from introducing the new Revision. An initial study for the List of 72 Selected Causes of Death and the List of 10 Selected Causes of Infant Death has been published in the Monthly Vital Statistics Report (MVSR)12 The List of 10 Selected Causes of Infant Death is a basic NCHS tabulation list but is not used in this volume. Comparability studies were also undertaken between the Eighth and Seventh, Seventh and Sixth, and Sixth and Fifth Revisions. For additional information about these studies, again see the 1979 Technical Appendix. Significant coding changes during 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. The more important changes will be discussed below. In early 1983, a change was made in the coding of Acquired Immunodeficiency Syndrome (AIDS), which affected data from 1981 onward. Also effective with data year 1981 was a coding change for poliomyelitis. For data year 1982, a change was made in the definition of child (which affects the classification of deaths to a number of categories, including child battering and other maltreatment); and in guidelines for coding deaths to the category Child battering and other maltreatment (ICD No. E967). Detailed discussion of these changes may be found in the technical appendix for previous volumes. Coding in 1984--The rules for coding the 1984 mortality data remained essentially the same as the previous year manuals that contain decisions and interpretations that apply each year. Medical certification--The use of a standard classification list, although essential for State, regional, and international comparison, does not assure strict comparability of the tabulated figures. A high degree of comparability between 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, 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 completes 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, covering 128 references over a period of 23 years indicates that no definitive conclusions have been reached about the quality of medical certification on the death certificate.13 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). While there are cases for which it is not possible to determine the causes of death, this proportion indicates the care and consideration given to the certification by the medical certifier. It may also be used as a rough measure of the specificity of the medical diagnoses made by the certifier in various areas. In 1984, 1.5 percent of all reported deaths in the United States were assigned to ill-defined or unknown causes. However, this percentage varied among the States, from 0.4 percent to 6.0 percent. Automated selection of underlying cause of death--Beginning with data year 1968, NCHS began using a computer system for assigning the underlying cause of death. It has been used every year since to select the underlying cause of death. The system is called "Automated Classification of Medical Entities" (ACME). The ACME system applies the same rules for selecting the underlying cause as applied 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 international rules. The decision tables provide not only a comprehensive relationship between 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 are periodically updated to reflect additional new information on the relationship among medical conditions. For 1984, the content of these tables was identical to that in the 1983 tables.14 Cause-of-death ranking--Cause-of-death ranking (except for infants) is based on the List of 72 Selected Causes of Death. Cause-of-death ranking for infants is based on the List of 61 Selected Causes of Infant Death. The group titles Major cardiovascular diseases and Symptoms, signs, and ill-defined conditions are not ranked from the List of 72 Selected Causes, and Certain conditions originating in the perinatal period and Symptoms, signs, and ill-defined conditions are not ranked from the List of 61 Selected Causes of Infant Death. In addition, category titles that begin with the words "Other" or "All other" are not ranked to determine the leading causes of death. When one of the titles that represents 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.11 Under the Eighth Revision, maternal deaths were assigned to category title "Complications of pregnancy, childbirth, and the puerperium" (ICDA-8 Nos. 630-678). Although WHO did not define maternal mortality, there was an NCHS classification rule that limited a maternal death to a death 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 applied only if a duration of time for the condition was given. If no duration was specified and the underlying cause of death was a maternal condition, then 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 on duration used in the Eighth Revision to an under-42-days limitation used in the Ninth Revision is not expected to have much effect on the comparability of maternal mortality statistics. However, comparability is affected by the following classification change. Under the Ninth Revision, maternal causes have been expanded to include indirect obstetric causes (ICD-9 Nos. 647-648). These causes include Infective and parasitic conditions and other current conditions in the mother that are classifiable elsewhere but which 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 that a pregnant woman will die from 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. Infant Deaths Age--An infant death is defined as a death under 1 year of age. The term excludes fetal deaths. Infant deaths are usually divided into two categories according to age, neonatal and postneonatal. Neonatal deaths are those that occur during the first 27 days of life, and postneonatal deaths are those that occur between 28 days and 1 year of age. It has generally 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; and 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 shown in section 2 and section 8 are the most commonly used index 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 of the risk of dying in infancy because some of the live births will not have been exposed to a full year's risk of dying and some of the infants that 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.15,16 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.17,18 In contrast to infant mortality rates based on live births, infant death rates shown in section 1 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 period. 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 through June, the denominator for the infant mortality rate is a count of births occurring during the 12 months of January through December. The difference in the time reference period can result in different trends between the two indices during periods when birth rates are moving up or down markedly. In addition, the infant death rate is also subject to greater imprecision than is the infant mortality rate because of problems of enumerating and estimating the population under 1 year of age.17 Race--Infant mortality rates for specified races other than white or black may be underestimated, based on result of studies in which race on the birth and death certificates for the same infant were compared.19 The figures should be interpreted with caution because of possible inconsistencies in reporting of race between the numerator and denominator of the rates. This reflects differences in the nature of reporting and processing race on these two vital records. On the birth certificate, race of parents is reported by the mother at the time of delivery. On the death certificate, race of the deceased infant is reported by the funeral director based on observation or on information supplied by an informant, such as a parent. With respect to processing, race of infant at birth is coded using coding rules that take account of the race of each parent (see the Technical Appendix in Vital Statistics of the United States, 1984, Volume I, Natality, section entitled Race or national origin). For infant deaths, the race of child is coded directly from the race reported on the death certificate. Hispanic origin--Infant mortality rates for the Hispanic-origin population are based on numbers of resident infant deaths reported as of Hispanic origin (See section Hispanic origin) and numbers of resident live births by Hispanic origin of mother for the 15 reporting States. In computing infant mortality rates, deaths and live births of unknown origin are not distributed among the specified Hispanic and non-Hispanic groups. Because for 1984 the percent of deaths of unknown origin was 7.0 percent and the percent of live births of unknown origin was 3.1 percent, infant mortality rates by Hispanic origin may be somewhat underestimated. Small numbers of infant deaths to specific Hispanic-origin groups can result in imfant mortality rates subject to relatively large random variation (See section on Random variation in numbers of deaths, death rates, and mortality rates and ratios). 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 section "Cause-of-death classification.") Infant and neonatal mortality for Wyoming, 1981--The 1981 data on infant and neonatal mortality shown in tables 2-8 and 2-9 for Wyoming are incorrect because of NCHS processing errors. The correct numbers for Wyoming are 124 infant deaths and 76 neonatal deaths; the corresponding infant mortality rates are 11.2 and 7.0 deaths under 1 year of age per 1,000 live births. Fetal Deaths In May 1950 the World Health Organization recommended the following definition of fetal death be adopted for international use: Death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy; the death is indicated by the fact that after such separation, the fetus does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles.20 The term "fetal death" was defined on an all-inclusive basis to end confusion arising from use of such terms as stillbirth, abortion, and miscarriage. Shortly thereafter, this definition of fetal death was adopted by the National Center for Health Statistics as the nationally recommended standard. Currently all registration areas except Puerto Rico have definitions similar to the standard definition.21 Puerto Rico has no formal definition. As another step toward increasing the comparability of data on fetal deaths for different countries, the World Health Organization recommended that for statistical purposes fetal deaths be classified as early, intermediate, and late. These groups are defined as follows: Less than 20 completed weeks of gestation (early fetal deaths) ............................ Group I 20 completed weeks of gestation but less than 28 (intermediate fetal deaths) ............. Group II 28 completed weeks of gestation and over (late fetal deaths) ............................. Group III Gestation period not classifiable in groups I, II and III ............................ Group IV Note that in table 3-13, group IV consists of fetal deaths with gestation not stated but presumed to be 20 weeks or more gestation. Until 1939 the nationally recommended procedures for registration of a fetal death required the filing of both a live-birth and a death certificate. In 1939 a separate Standard Certificate of Stillbirth (fetal death) was created to replace the former procedure. This was revised in 1949, 1955, 1956, and 1968. In 1976 the Standard Certificate of Fetal Death was replaced by the Standard Report of Fetal Death (figure 7-B). The 1977 revision of the Model State Vital Statistics Act and Model State Vital Statistics Regulations22 recommended that spontaneous fetal deaths of 20 weeks or more gestation, or a weight of 350 grams or more, and all induced terminations of pregnancy regardless of gestational age be reported and further that they be reported on separate forms. These forms are to be considered legally required statistical reports rather than legal documents. Beginning with 1970 fetal deaths, procedures were implemented that attempted to separate reports of spontaneous fetal deaths from those of induced terminations of pregnancy. These procedures were implemented because the health implications are different for spontaneous fetal deaths and induced terminations of pregnancy. These procedures are still in use. Comparability and completeness of data--Registration area requirements for reporting fetal deaths vary. Most of these areas require reporting fetal deaths of gestations of 20 weeks or more. Table 3-1 shows the minimum period of gestation required by each State for fetal-death reporting. There is substantial evidence that not all fetal deaths for which reporting is required are reported.23 For registration areas not requiring the reporting of fetal deaths of all periods of gestation, underreporting is more likely to occur in the earlier gestational periods. This is illustrated by the fact that for most areas requiring reporting of fetal deaths of 20 weeks or more, the total number reported for 20-23 weeks is lower than the numbers reported for 24-27 and 28-31 weeks. For areas requiring the reporting of all fetal deaths, however, the opposite is generally true. Another type of reporting problems arises from the inconsistent application of the definition of fetal death by individual registration areas. For example, some live-born infants who die shortly after birth, particularly those born prematurely who die before the umbilical cord is severed or while the placenta is still attached, may be erroneously reported as fetal deaths. To maximize the comparability of data by year and by State, most of the tables in section 3 are based on fetal deaths occurring at gestations of 20 weeks or more. These tables also include fetal deaths of not stated gestation for those States requiring reporting at 20 weeks or more only. Beginning with 1969, fetal deaths of not stated gestation were excluded for States requiring reporting of all products of conception except for those with a stated birth weight of 500 grams or more. In 1984 this rule was applied to the following States: Colorado, Georgia, Hawaii, New York (including New York City), Rhode Island, and Virginia. Each year there are some exceptions to this procedure. The data in table 3-3 include only fetal deaths to residents of those areas in the United States that report all periods of gestation. The areas are Colorado, Georgia, Hawaii, New York (including New York City), Rhode Island, and Virginia. Arkansas--Arkansas has been using two reporting forms for fetal deaths. A confidential Spontaneous Abortion form and a Fetal Death Certificate. From 1981 through 1983 Arkansas specified that fetal deaths of less than 28 weeks gestation or weighing less than 1,000 grams could be reported on the Spontaneous Abortion form rather than on their report of fetal death; for 1984 Arkansas specified that fetal deaths of 20 weeks gestation or weighing 500 grams be reported on its certificate of fetal death. The National Center for Health Statistics receives the Arkansas certificates of fetal death, but not the confidential abortion reports. Accordingly, counts of fetal deaths of gestational age 20 to 27 weeks were not comparable between Arkansas and other reporting areas for 1981 to 1983. District of Columbia--Beginning in 1981, the District of Columbia changed its reporting requirements for spontaneous fetal deaths from "passed the fifth month of uterogestation" to "20 completed weeks or more or a weight of 500 grams or more." Idaho--Beginning in 1983, Idaho changed its reporting requirements for spontaneous fetal deaths from "after 20 weeks" to "after 20 weeks or a weight of 350 grams or more." Kentucky--Beginning in 1981, Kentucky changed its reporting requirements for spontaneous fetal deaths from "20 weeks gestation or more" to "a weight of 350 grams or more or a gestational age of 20 weeks or more." Massachusetts-Beginning in 1981, Massachusetts changed its reporting requirements for spontaneous fetal deaths from "20 weeks or more" to "20 weeks or more or a weight of 350 grams or more." Michigan--Beginning in 1981, Michigan changed its reporting requirements for spontaneous fetal deaths from "advanced through 20th week" to "completed 20 weeks gestation or weighs at least 400 grams." Missouri--Beginning in 1984, Missouri changed its reporting requirements for spontaneous fetal deaths from "after 20 weeks" to "after 20 weeks or a weight of 350 grams or more." New Hampshire--Beginning in 1981, New Hampshire changed its reporting requirements for spontaneous fetal deaths from "advanced to 20 weeks" to "completed 20 weeks or weighing at least 350 grams." New Mexico--Beginning in 1982, New Mexico changed its reporting requirements for spontaneous fetal deaths from "20 completed weks" to "500 grams or more." Tennessee--Beginning in 1981, Tennessee changed its reporting requirements for spontaneous fetal deaths from "22 weeks or more (500 grams weight)" to "a weight of 500 grams or more or if weight is unknown but fetus is of 22 completed weeks or more." Period of gestation--The period of gestation is the number of completed weeks elapsed between the first day of the last normal menstrual period and the date of delivery. The first day of the last normal menstrual period (LMP) is used as the initial date because it can be more accurately determined than the date of conception, which usually occurs 2 weeks after LMP. Data on period of gestation are computed from information on "date of delivery" and "date last normal menses began." If "date last normal menses began" is not on the record or the calculated gestation falls beyond a duration considered biologically plausible, "gestation in weeks" or "Physician's estimate of gestation" is used. When the period of gestation is reported in months on the report, it is allocated to gestational intervals in weeks as follows: 1-3 months to under 16 weeks 4 months to 16-19 weeks 5 months to 20-23 weeks 6 months to 24-27 weeks 7 months to 28-31 weeks 8 months to 32-35 weeks 9 months to 40 weeks 10 months and over to 43 weeks and over All areas reported LMP in 1984 except Delaware, New Mexico, Puerto Rico, and South Dakota. Birth weight--Of the 55 registration areas (including the 50 States, the District of Columbia New York City, Puerto Rico, the Virgin Islands, and Guam), 27 do not specify how weight should be given; 16 specify that weight should be given in pounds and ounces; 5 specify grams; and the remaining 7 areas indicate weight can be given either in pounds and ounces or in grams. Data on fetal deaths for the Virgin Islands and Guam are not published by NCHS. In the tabulation and presentation of these data, the metric system (grams) has been used to facilitate comparison with other data published in the United States and internationally. The equivalents of the gram intervals in pounds and ounces are as follows: Less than 350 grams = 0 lb 12 oz or less 350- 499 grams = 0 lb 13 oz- 1 lb 1 oz 500- 999 grams = 1 lb 2 oz- 2 lb 3 oz 1,000-1,499 grams = 2 lb 4 oz- 3 lb 4 oz 1,500-1,999 grams = 3 lb 5 oz- 4 lb 6 oz 2,000-2,499 grams = 4 lb 7 oz- 5 lb 8 oz 2,500-2,999 grams = 5 lb 9 oz- 6 lb 9 oz 3,000-3,499 grams = 6 lb 10 oz- 7 lb 11 oz 3,500-3,999 grams = 7 lb 12 oz- 8 lb 13 oz 4,000-4,499 grams = 8 lb 14 oz- 9 lb 14 oz 4,500-4,999 grams = 9 lb 15 oz- 11 lb 0 oz 5,000 grams or more = 11 lb 1 oz or more With the introduction of the Ninth Revision, International Classification of Diseases, the birth-weight classification intervals for perinatal mortality statistics were shifted downward by 1 gram, as shown above. Previously, the intervals were, for example, 1,001-1,500; 1,501-2,000; etc. Race--The race of the fetus is ordinarily classified based on the race of the parents. If the parents are of different races, the following rules apply. (1) When only one parent is white, the fetus is assigned the other parent's race. (2) When neither parent is white, the fetus is assigned the father's race with one exception: If the mother is Hawaiian or Part-Hawaiian, the fetus is classified as Hawaiian. When the race of one parent is missing or ill defined, the race of the other determines that of the fetus. When race of both parents is missing, the race of the fetus is allocated to the specific race of the fetus on the preceding record. Total-birth order--Total-birth order refers to the sum of the live births and other terminations (including both spontaneous fetal deaths and induced terminations of pregnancy) that a woman has had including the fetal death being recorded. For example, if a woman has previously given birth to two live babies and to one born dead, the next fetal death to occur is counted as number four in total-birth order. In the 1978 revision of the Standard Report of Fetal Death, total-birth order is calculated from four items on pregnancy history: Number of previous live births, now living; number of previous live births, now dead; number of other terminations before 20 weeks; and number of other terminations after 20 weeks. All registration areas use the two standard items pertaining to the number of previous live births. Thirty areas use the two standard items pertaining to the number of "other terminations" before and after 20 weeks gestation; 4 report "other terminations" of 20 weeks or more; 14 do not differentiate "other terminations" by gestational age; 6 areas use other criteria for differentiating spontaneous and induced terminations; and 1 area reports "other terminations" before and after 16 weeks gestation. Total-birth order for all areas is calculated from the sum of available information. Thus, information on total-birth order may not be completely comparable among the registration areas. Marital status--Table 3-4 shows fetal deaths and fetal-death ratios by mother's marital status. States excluded from this table are as follows: California, Connecticut, Maryland, Michigan, Montana, New York (including New York City), Ohio, Texas, and Vermont. Because live births comprise the denominator of the ratio, marital status must also be reported for mothers of live births. Starting in 1980, marital status of the mother of the live birth was inferred for States that did not report it on the birth certificate. There are no quantitative data on the characteristics of unmarried women who may misreport their marital status or who fail to register fetal deaths. Underreporting may be greater for the unmarried group than for the married group. Age of mother--The fetal-death report asks for the mother's "age (at time of delivery)," and the ages are edited in NCHS for upper and lower limits. When mothers are reported to be under 10 years of age or 50 years and over, the age of the mother is considered and not stated and is assigned as follows: Age on all fetal-death records with age of mother not stated is allocated according to the age appearing on the record previously processed for a mother of identical race and having the same total-birth order (total of live births and other terminations). Perinatal Mortality Perinatal definitions--Beginning with data year 1979, perinatal mortality data for the United States and each State have been published in section 4. The World Health Organization in the Ninth Revision of the International Classification of Diseases (ICD-9) recommended that "national perinatal statistics should include all fetuses and infants delivered weighing at least 500 grams (or when birth weight is unavailable, the corresponding gestational age (22 weeks) or body length (25 cm crown-heel)), whether alive or dead...." It was further recommended that countries should present, solely for international comparisons 'standard perinatal statistics' in which both the numerator and denominator of all rates are restricted to fetuses and infants weighing 1,000 grams or more (or, where birth weight is unavailable, the corresponding gestational age (28 weeks) or body length (35 cm crown-heel))." Because birth weight and gestational age are not reported on the death certificate in the United States, NCHS was unable to recommend adopting these definitions. Three definitions of perinatal mortality are currently used by NCHS. Perinatal Definition I, generally used for international comparisons, which includes fetal deaths of 28 weeks or more gestation and infant deaths of less than 7 days, Perinatal Definition II, which includes fetal deaths of 20 weeks or more gestation and infant deaths of less than 28 days; and Perinatal Definition III, which includes fetal deaths of 20 weeks or more gestation and infant deaths of less than 7 days. Variations in fetal death reporting requirements and practices have implications for comparing perinatal rates among States. Since reporting is generally poorer near the lower limit of the reporting requirement, States that require reporting of all products of pregnancy regardless of gestation are likely to have more complete reporting of fetal deaths of 20 weeks or more than are other States. The larger number of fetal deaths reported by these "all periods" States may result in higher perinatal rates compared with States whose reporting is less complete. Accordingly, reporting completeness may account, in part, for differences among the State perinatal rates, particularly differences for Definitions II and III, which use data for fetal deaths of 20-27 weeks. Not stated--Fetal deaths with gestational age not stated are presumed to be of 20 weeks gestation or more if (1) the State requires reporting of all fetal deaths of gestational age 20 weeks or more or (2) the fetus weighed 500 grams or more, in those States requiring reporting of all fetal deaths regardless of gestational age. For Definition I, fetal deaths with gestation not stated but presumed to be 20 weeks or more are allocated to the category 28 weeks or more, according to the proportion of fetal deaths with stated gestational age that falls into that category. For Definitions II and III, fetal deaths with presumed gestation of 20 weeks or more are included with those of stated gestation of 20 weeks or more. For all three definitions, following the distribution of gestation not- stated described above, fetal deaths with nonstated sex are allocated within gestational age groups on the basis of the distribution of stated cases. The allocation of not-stated gestational age and sex for fetal deaths is made individually for each State, for metropolitan and nonmetropolitan areas, and separately for the United States as a whole. Accordingly, the sum of perinatal deaths for the areas according to Definition I may not equal the total number of perinatal deaths for the United States. Completeness of Registration All States have adopted laws that require the registration of births and deaths, and the reporting of fetal deaths. It is believed that over 99 percent of the births and deaths occurring in this country are registered. Reporting requirements for fetal deaths vary somewhat from State to State (see "Comparability and completeness of data"). Overall reporting completeness is not as good for fetal deaths as for births and deaths, but it is believed to be relatively complete for fetal deaths of 28 weeks gestation or more. National statistical data on fetal deaths include only those fetal deaths with stated or presumed gestation of 20 weeks or more. Massachusetts Data The 1964 data statistics for deaths exclude approximately 6,000 events 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 also somewhat affected. Quality Control Procedures Demographic items on the death certificate--As previously indicated, for 1984 the mortality data for these items were obtained from two sources: (1) Microfilm images of the original certificates furnished by 4 States, the District of Columbia, and the Virgin Islands, and photocopies from Guam; and (2) records on data tape furnished by the remaining 46 States, New York City, and Puerto Rico. For the four States, the District of Columbia, the Virgin Islands, and Guam that sent only copies of the original certificates, the demographic items were coded for 100 percent of the death certificates. The demographic coding for a 10-percent sample of the certificates was independently verified. As part of the quality control procedures for mortality data, each registration area has to go through a calibration period during which it must achieve the specified error tolerance level of 2 percent per item for 3 consecutive months, based on NCHS independent verification of a 50-percent sample of that area's records. Once the area has achieved the required error tolerance level, a sample of 70-80 records per month is used to monitor quality of coding. All of the areas had achieved the specified error tolerance before 1984; accordingly, for these areas the demographic items on about 70-80 records per area per month were independently verified by NCHS. These areas include New York City, Puerto Rico, and the 46 States that furnished data on computer tape to NCHS. The estimated average error rate for all demographic items in the entire 1984 mortality file was 0.25 percent. These verification procedures involve controlling two types of error (coding and entering into the data record tape) at the same time and the error rates are a combined measure of both types. While it may be assumed that the entering errors are randomly distributed across all items on the record, this assumption cannot be made as readily for coding errors. Although systematic errors in coding infrequent events may escape detection during sample verification, it is probable that some of these errors were detected during the initial period when 50 percent of the file was being verified, thus providing an opportunity to retrain the coders. Medical items on the death certificate--As for demographic data, mortality medical data are also subject to quality control procedures which control for errors of both coding and data entry. Each of the 19 registration areas that furnished NCHS with coded medical information according to NCHS specifications first had to qualify for sample verification. During an initial calibration period, the area had to achieve a specified error tolerance level of less than 5 percent for coding all medical items. After the area has achieved the required error tolerance level, a sample of 70-80 records per month is used to monitor quality of medical coding. For these 19 States, the average coding error rate in 1984 was estimated at just over 4 percent. For the remaining 39 registration areas--31 States, the District of Columbia, New York City, Puerto Rico, the Virgin Islands, and Guam--NCHS coded the medical items for 100 percent of the death records. A 1-percent sample of the records was independently coded for quality control purposes. The estimated average error rate for these areas was about 3 percent. The ACME system for selecting the underlying cause of death through computer application contributes to the quality control of medical items on the death certificate (see the section on Automated selection of underlying cause of death). Demographic items on the report of fetal death--For 1984, all data on fetal deaths, except for New York State (excluding New York City), were coded under contract by the U.S. Bureau of the Census. For Oklahoma, portions of the data were coded under contract by the U.S. Bureau of the Census, and other portions were coded by the State. The combination coding was necessary because the medical and confidential portion of the fetal death report, which contain some of the essential statistical information, became detached from the other part of the fetal death report prior to receipt by NCHS. Coding and entering information "on data tapes were verified on a 100-percent basis because of the relatively small number of records involved. Other control procedures--After coding and entering on data tape 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, where there is 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.24 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 in this report (excluding fetal-death statistics) 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 number of deaths by size of estimate and total deaths in the area are shown in the Technical Appendix of Vital Statistics of the United States, 1972, Volume II, Mortality, Part A. Population Bases The population bases from which death rates shown in this report are computed are prepared by the U.S. Bureau of the Census. Rates for 1940, 1950, 1960, 1970, and 1980, are based on the population enumerated as of April 1 in the censuses of those years. Rates for all other years use the estimated midyear (July 1) population for the respective years. Death rates for the United States, individual States, and SMSA's 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 1900-84 are shown in table 7-1. In addition, the population including Armed Forces abroad is shown for the United States. Table A lists the sources for these populations. Table A. Sources for resident population and population including Armed Forces abroad: Birth- and death-registration States, 1900-1932, and United States, 1900-1984 Year Source 1984-------------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 985, Apr. 1986. 1983-------------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 965, Mar. 1985. 1982-------------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 949, May 1984. 1981-------------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 929, May 1983. 1980-------------- U.S. Bureau of the Census, U.S. Census of Population: 1980, Number of Inhabitants, PC80-1-A1, United States Summary, 1983. 1971-79----------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 917, July 1982. 1970-------------- U.S. Bureau of the Census, U.S. Census of Population: 1970, Number of Inhabitants, Final Report PC(1)-A1, United States Summary, 1971. 1961-69----------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 519, April 1974. 1960-------------- U.S. Bureau of the Census, U.S. Census of Population: 1960, Number of Inhabitants, Final Report PC(1)-A1, United States Summary, 1964. 1951-59----------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 310, June 30, 1965. 1940-50----------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 499, May 1973. 1930-39----------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 499, May 1973, and National Office of Vital Statistics, Vital Statistics Raters in the United States, 1900-1940, 1947. 1920-29----------- National Office of Vital Statistics, Vital Statistics Rates in the United States, 1900-1940, 1947. 1917-19----------- Same as for 1930-39. 1900-1916--------- Same as for 1920-29. Population estimates for 1984--The population of the United States estimated by age, race, and sex for 1984 is shown in table 7-2, and the population for each State by broad age groups follows in table 7-3. Population estimates for 1984 incorporate new estimates for net migration and net undocumented immigration; and, thus, are not comparable with the postcensal estimates for 1981-83 shown in tables 7-2 and 7-3 of Vital Statistics of the United States, Volume II, for those years. A comparison of population estimates based on the new migration assumptions with estimates based on the old assumption, by 5- and 10-year age-race-sex groups, produced differences of less than 2 percent in all age groups except 40-44 years and 85 years and over for the black population. The 1984 population estimates for the black populations based on the new assumptions were about 4 percent smaller for ages 40-44 years and about 3 percent smaller for ages 85 years and over. Death rates and estimates of life expectancy for 1984, therefore, are not strictly comparable with those for previous years, although trends for the total population and most age-race-sex groups are not substantially affected. Additional information has been published by the U.S. Bureau of the Census.25 Population data by race are consistent with the modified (see below) 1980 population by race. Population for 1980--The population of the United States by age, race, and sex and the population for each State by age are shown in tables 7-2 and 7-3, respectively, of Vital Statistics of the United States, 1980, Volume II. The figures by race have been modified as described below. The racial counts in the 1980 census are affected by changes in reporting practices, particularly of the Hispanic population, and in coding and classifying. One particular change created a major inconsistency between the 1980 census data and historical data series, including censuses and vital statistics. About 40 percent of the Hispanic population counted in 1980, over 5.8 million persons, did not mark one of the specified races listed on the census questionnaire but instead marked the "Other" category. In the 1980 census, coding procedures were modified for persons who marked "Other" race and wrote in a national origin designation of a Latin American country or a specific Hispanic origin group in response to the racial question. These persons remained in the "Other" racial category in 1980 census data; in previous censuses and in vital statistics, such responses had almost always been coded into the "White" category. In order to maintain comparability, the "Other" racial category in the 1980 census was reallocated to be consistent with previous procedures. Persons who marked the "Other" racial category and reported any Spanish origin on the Spanish origin question (5,840,648 persons) were distributed to white and black races in proportion to the distribution of persons of Hispanic origin who actually reported their race as "White" or "Black." This was done for each age-sex group. As a result of this procedure, 5,705,155 persons (98 percent) were added to the white population and 135,493 persons (2 percent) to the black population. Persons who marked the "Other" racial category and reported that they were not of Spanish origin (916,338 persons) were distributed as follows: 20 percent in each age-sex group were added to the "Asian and Pacific Islander" category (183,268 persons), and 80 percent were added to the "White" category (733,070 persons). The count of American Indians, Eskimos, and Aleuts was not affected by these procedures. Unpublished tabulations of these modified census counts were obtained from the U.S. Bureau of the Census and used to compute the rates for this report. Population estimates for 1971-79--Death rates in this volume 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 previously been estimated for April 1, 1980.26 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 in this volume for 1961-69 are based on revised estimates of the population and thus may differ slightly from rates published before 1976. The rates shown in tables 1-1 and 1-2, the life table values in table 6-5, and the population estimates in table 7-1 for each year in the period 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-25, Number 519. The data shown in table 1-10 for 1961-69 have not been revised. Rates and ratios based on live births--Infant and maternal mortality rates, and fetal death and perinatal mortality ratios, are computed on the basis of the number of live births. Fetal death and perinatal mortality rates are computed on the basis of the number of live births and fetal deaths. Counts of live births are published annually in Vital Statistics of the United States, Volume I, Natality. New Jersey--As previously indicated, data by race are not available for New Jersey for 1962 and 1963. Therefore for 1962 and 1963 the National Center for Health Statistics estimated a population by age, race, and sex excluding 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 reports. Net Census Undercount Just as the underenumeration of deaths and the misreporting of demographic characteristics on the death certificate can introduce error into the annual rates, errors in the latest decennial census such as undercount or overcount can also adversely affect mortality statistics. 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.25 Net census undercount is determined by miscounting and misreporting of demographic characteristics such as age. Age-specific death rates are affected by both the net census undercount and the misreporting of age on the death certificate.27 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. Although death rates based on a population adjusted for net census undercount may be more accurate than rates based on an unadjusted population, rates in this volume are not adjusted; rather, they are computed using population estimates that preserve the age pattern of the net census undercount across the postcensal interval. Thus, it is important to consider the possible impact of net census undercount on death rates. The U.S. Bureau of the Census has conducted extensive research on completeness of coverage of the U.S. population (including underenumeration and misstatement of age, race, and sex) in the last four decennial censuses--1950, 1960, 1970, and 1980. From this work have come estimates of the national population that was not counted by age, race, and sex.22,28,29 The reports for 1980 include estimates of net census undercount using alternative methodological assumptions for age, race, and sex subgroups of the national population.22,30 These studies indicate that, although coverage was improved over previous censuses, there was differential coverage in the 1980 census among the population subgroups; that is, some age, race, and sex groups were more completely counted than others. Net census undercounts can affect (1) levels of the observed vital rates, (2) differences among groups, and (3) levels and group differences shown by summary measures such as age-adjusted death rates and life expectancy. Levels and differentials--If adjustments are made for net census were m undercount, the size of denominators of the death rates generally would increase and the rates, therefore, would decrease. Assuming net census undercounts remained consistent by age after the 1980 census, the estimated rates for 1984 can be computed by multiplying the reported rates by ratios of the census-level population to the population adjusted for the estimated net census undercount (table 7-4). 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--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 than the population of all other races. The black population was counted less completely than the total population of all other races. For the total population, underenumeration varied by age group, with the greatest undercount found for persons aged 80-84, and 85 years and over. All other age groups were overcounted or undercounted by less than 3 percent. Among the age-sex-race groups, coverage was lowest for black males aged 35-39, 40-44, and 45-49 years. Underenumeration for these groups was 19 percent. In contrast, white females in these age groups were essentially completely enumerated. For black females and white males in these same age groups, the undercount ranged from 3 to 6 percent. For the under-1-year age group the white population was overenumerated by 2 percent, whereas infants of other races were underenumerated by 9 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. As a consequence, the ratio of mortality between the rates for males and females, and between the rates for the white population and the population of other races, or 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, for the age group 35-39 years in 1984, the ratio of the death rate for Homicide and legal intervention for black males to that for white males is 6.9, whereas the ratio of the death rates adjusted for net census undercount in 1984 is 5.4, a reduction of 22 percent. For Ischemic heart disease for males aged 40-44 years, the ratio of the death rate for the population of all other races to that for the white population is 1.3 using the unadjusted rates, but it is 1.1 when adjusted for estimated underenumeration. Summary measures--The effect of net census undercount on age-adjusted death rates depends on the underenumeration of each age group and on the distribution of deaths by age. In 1984, the age-adjusted death rate for All causes would decrease from 545.9 to 538.4 per 100,000 population if the age-specific death rates were corrected for net census undercount. For Diseases of the heart, the age-adjusted death rate for white males would decrease from 249.5 to 245.5 per 100,000 population, a decline of 1.6 percent. For black males the change, from an unadjusted rate of 300.1 to an adjusted rate of 273.2, would amount to 9.0 percent. If death rates by age were adjusted, then the corresponding life expectancy at birth computed from these rates would change. The importance of adjustments varies by age, that is, when calculating life expectancy, the impact of an undercount (or overcount) is greatest at the younger ages. In general, the effect of correcting the death rates is to increase the estimate of life expectancy at birth. Differential underenumeration among race-sex groups would lead to greater changes in life expectancy at birth. Differential underenumeration among race-sex groups would lead to greater changes in life expectancy for some groups than for others. For white females who were completely enumerated in 1980, revised estimates of life expectancy would remain roughly constant; those for black males would show the greatest increase. Age-Adjusted Death Rates Age-adjusted death rates shown in this report are computed by using the distribution in 10-year age intervals of the enumerated population of the United States in 1940 as the standard population. Each figure represents the rate that would have existed if the age-specific rates of the particular year prevailed in a population whose age distribution was the same as that of the United States in 1940. The rates for the total population and for each race-sex group were adjusted using the same standard population. It is important not to compare age-adjusted death rates with crude rates. The standard 1940 population, on the basis of one million total population, is as follows: Age Number All ages ............................................... 1,000,000 Under 1 year................................................. 15,343 1-4 years.................................................... 64,718 5-14 years................................................... 170,355 15-24 years.................................................. 181,677 25-34 years.................................................. 162,066 35-44 years.................................................. 139,237 45-54 years.................................................. 117,811 55-64 years.................................................. 80,294 65-74 years.................................................. 48,426 75-84 years.................................................. 17,303 85 years and over............................................ 2,770 Life Tables U.S. abridged life tables are constructed by reference to a standard table.31 Life tables for the decennial period 1979-81 are used as the standard life tables in constructing the 1980-84 abridged life tables. With the availability of the 1979-81 standard life tables, revised life table values were computed for 1980-82; these appear for the first time in this volume. Life table values appearing in Vital Statistics of the United States, 1983. 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 tables values for 1951-59, 1961-69, and 1971-79 appearing in this publication are based on revised intercensal estimates of the populations for those years. As such, these life table values may differ from the life table values for those years published in previous volumes. There has been an increasing interest in data on average length of life ( 0) for single calendar years before the initiation of the annual abridged life table series for selected race-sex groups in 1945. The figures in table 6-5 for the race and sex groups for the following years were estimated to meet these needs.32 Race and Years 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 1900-1902 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 counterminous United States. Decennial life table values for the 3-year period 1959-61 were derived from data that include both Alaska and Hawaii for each year (table 6-4). Data for each year shown in table 6-5 include Alaska beginning in 1959 and Hawaii beginning in 1960. It is not believed that the inclusion of these two States materially affects life table values. Random Variation in No. Deaths, Death Rates, Mort. Rates & Ratio Deaths and population-based rates--Except for 1972, the numbers of deaths reported for a community represent complete counts of such events. As such, they are not subject to sampling error, although they are subject to errors in the registration process. However, when the figures are used for analytical purposes, such as the comparison of rates over a time period 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.33 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. Estimates of standard error and tests of significance under this assumption are described in most standard statistics texts. When the number of events is large, the standard error, expressed as a percent of the number or rate, 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 conditions described by the figures. This is particularly true for infant mortality rates, cause-specific death rates, and death rates for counties. Events of a rare nature may be assumed to follow a Poisson probability distribution. For this distribution, a simple approximation may be used to estimate a confidence interval, as follows. If N is the number of registered deaths in the population and R is the corresponding rate, the chances are 19 in 20 that 1. N - 2 / N and N + 2 / N covers the "true" number of events. 2. R - 2 R and R + 2 R /N /N covers the "true" rate. If the rate R corresponding to N events is compared with the rate S corresponding to M events, the difference between the two rates may be regarded as statistically significant if it exceeds R2 S2 2 + N M For example, if the observed death rate for Community A were 10.0 per 1,000 population and if this rate were based on 20 recorded deaths, then the chances are 19 in 20 that the "true" death rate for that community lies between 5.5 and 14.5 per 1,000 population. If the death rate for Community A of 10.0 per 1,000 population were being compared with a rate of 20.0 per 1,000 population for Community B, which is based on 10 recorded deaths, then the difference between the rates for the two communities is 10.0. This difference is less than twice the standard error of the difference (10.0)2 (20.0)2 2 + 20 10 of the two rates, which is computed to be 13.4. From this, it is concluded that the difference between the rates for the two communities is not statistically significant. Symbols Used in Tables SYMBOLS USED IN TABLES Data not available------------------------------------------ --- Category not applicable------------------------------------- ... Quantity zero----------------------------------------------- - Quantity more than 0 but less than 0.05--------------------- 0.0 Quantity more than zero but less than 500 where numbers are rounded to thousands-------------------------------------- Z Figure does not meet standards of reliability or precision-- * REFERENCES 1. National Center for Health Statistics: Vital statistics, classification and coding instructions for fetal death records. NCHS Instruction Manual, Part 3b. Public Health Service, Hyattsville, Md. Published annually. 2. National Center for Health Statistics: Vital statistics, demographic classification and coding instructions for death records. NCHS Instruction Manual, Part 4. Public Health Service, Hyattsville, Md. Published annually. 3. National Center for Health Statistics, M.A. McCarthy: Comparison of the classification of place of residence on death certificates and matching census records, United States, May-August 1960. Vital and Health Statistics, Series 2, No. 30. PHS Pub. No. 1000. Public Health Service. Washington. U.S. Government Printing Office, Jan. 1969. 4. National Vital Statistics Division: Matched record comparison of birth certificate and census information, United States, 1950. Vital Statistics--Special Reports. Vol. 47, No. 12. Public Health Service. Washington, D.C., Mar. 1962. 5. National Center for Health Statistics: Vital statistics, vital records geographic classification, 1982. NCHS Instruction Manual, Part 8. Public Health Service, Hyattsville, Md., June 1985. 6. U.S. Office of Management and Budget: Standard metropolitan statistical areas and standard consolidated areas. Statistical Reporter. Washington. U.S. Government Printing Office, Oct. 1981, pp. 1-20. 7. U.S. Office of Management and Budget: 36 new standard metropolitan statistical areas and standard consolidated areas. Statistical Reporter. Washington. U.S. Government Printing Office, July 1981, p. 420. 8. U.S. Office of Management and Budget: Standard Metropolitan Statistical Areas, rev. ed. Statistical Reporter. Washington. U.S. Government Printing Office, 1975, pp. 89-90. 9. U.S. Bureau of the Census: 1980 Census of Population, Persons of Spanish Origin by State, 1980. Supplementary Report, PC80-S1-7. Washington. Aug. 1982. 10. National Center for Health Statistics, A. J. Klebba: Mortality from selected causes by marital status, United States, Parts A & B. Vital and Health Statistics, Series 20, No. 8a, Series 20, No. 8b. PHS Pub. No. 1000. Public Health Service. Washington. U.S. Government Printing Office, Dec. 1970. 11. 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. 12. 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 Supp. DHEW Pub. No. (PHS) 80-1120. Public Health Service, Hyattsville, Md., Feb. 29, 1980. 13. National Center for Health Statistics, A. Gittelsohn and P. N. Royston: Annotated bibliography of cause-of-death validation studies, 1958-80, Vital and Health Statistics, Series 2, No. 89. DHHS Pub. No. (PHS) 82-1363. Public Health Service. Washington. U.S. Government Printing Office, Sept. 1982. 14. National Center for Health Statistics: Vital statistics, ICD-9 ACME decision tables for classifying the underlying causs of death, 1984. NCHS Instruction Manual, Part 2c. Public Health Service, Hyattsville, Md., Sept. 1982. 15. L. Guralnick and E. D. Winter. A note on cohort infant mortality rates. Pub. Health Rep. 80:692-694, 1965. 16. National Center for Health Statistics, R. D. Grove and A. M. Hetzel. Vital Statistics Rates in the United States, 1940-1960. Public Health Service. Washington. U.S. Government Printing Office, 1968. 17. National Office of Vital Statistics, F. E. Linder and R. D. Grove. Vital Statistics Rates in the United States, 1900-1940. U.S. Public Health Service. Washington. U.S. Government Printing Office, 1947. 18. B.J. McCarthy et al. The underregistration of neonatal deaths: Georgia 1974-77. Am. J. Pub. Health 70:977-982, 1980. 19. F. Frost and Kirkwood K. Shy: Racial differences between linked birth and infant death records in Washington State. American Journal of Public Health, 70:974-976, Sept. 1980. 20. National Office of Vital Statistics: International Recommendations on Definitions of Live Birth and Fetal Death, PHS Pub. No. 39. Public Health Service. Washington. U.S. Government Printing Office, Oct. 1950. 21. For definitions used by the States and registration areas, see National Center for Health Statistics, State Definitions and Reporting Requirements for Live Births, Fetal Deaths, and Induced Terminations of Pregnancy. DHHS Pub. No. (PHS) 81-1119. Public Health Service. Washington. U.S. Government Printing Office, May 1981. 22. National Center for Health Statistics: Model State Vital Statistics Act and Model State Vital Statistics Regulations. DHEW Pub. No. (PHS) 78-1115. Public Health Service. Washington. U.S. Government Printing Office, May 1978. 23. Unpublished fetal mortality data contained in a thesis for Harvard: School of Public Health, Apr. 1962, by Carl L. Erhardt, Sc.D., Director, Bureau of Records and Statistics, Department of Health, New York, N.Y. 24. National Center for Health Statistics: Vital Statistics, computer edits for mortality data, effective 1979. NCHS Instruction Manual, Part 11. Public Health Service, Hyattsville, Md., Nov. 1979. 25. U.S. Bureau of the Census: Estimates of the Population of the United States, by age, sex, and race: 1980 to 1985. Current Population Reports. Series P-25, No. 985. Washington. U.S. Government Printing Office, April 1986. 26. 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. Government Printing Office, Feb. 1982. 27. National Center for Health Statistics, T. Z. Hambright: Comparability of age on the death certificate and matching census records. United States, May-August 1960. Vital and Health Statistics. Series 2, No. 29. PHS Pub. No. 1000. Public Health Service. Washington. U.S. Government Printing Office, June 1968. 28. 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. Government Printing Office, Dec. 1977. 29. 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. Government Printing Office, 1974. 30. J. S. Passel and J. G. Robinson. 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, D.C., Apr. 8, 1985. 31. National Center for Health Statistics, M. G. Sirken: Comparison of two methods of constructing abridged life tables by reference to a "standard" table. Vital and Health Statistics. Series 2, No. 4. PHS Pub. No. 1000. Public Health Service. Washington. U.S. Government Printing Office, Mar. 1966. 32. For estimating procedure see National Office of Vital Statistics, T. N. E. Greville and G. A. Carlson: Estimated average length of life in the death-registration States. Vital Statistics--Special Reports, Vol. 33, No. 9. Public Health Service. Washington, D.C., 1951. 33. National Office of Vital Statistics, C. L. Chiang: Standard error of the age-adjusted death rate. Vital Statistics--Special Reports, Vol. 47, No. 9. U.S. Public Health Service. Washington, D.C., Aug. 1961. TECHNICAL APPENDIX, 1984,1985 MORTALITY FILE Sources of Data Death and Fetal-Death Statistics Mortality statistics for 1984-85 are, as for all previous years except 1972, based on information from records of all deaths occurring in the United States. Fetal-death statistics for every year are based on all reports of fetal death received by the National Center for Health Statistics (NCHS). The death-registration system and the fetal-death reporting system of the United States encompass 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 Trust Territory of the Pacific Islands. In the statistical tabulations of this publication, United States refers only to the aggregate of the 50 States (including New York City) and the District of Columbia. Tabulations for Guam, Puerto Rico, and the Virgin Islands are shown separately in this volume. No data have ever been included for American Samoa or the Trust Territory of the Pacific Islands. 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 the annual volumes of Vital Statistics of the United States from the year of their admission through 1971 except for the years 1967 through 1969, and tabulations for Guam were included for 1970 and 1971. Death statistics for Puerto Rico, the Virgin Islands, and Guam were not included in the 1972 volume but have been included in section 8 of the volumes for each of the years 1973-78 and in section 9 beginning with 1979. 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 and fetal 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 with computer tapes of data coded according to NCHS specifications and provided to NCHS through the Vital Statistics Cooperative Program. The year in which State-coded demographic data were first transmitted to NCHS is shown below for New York City, Puerto Rico, and each of the 46 States now furnishing demographic data. 1971 1976--Con. Florida Minnesota Nevada 1972 Texas West Virginia Maine Missouri 1977 New Hampshire Rhode Island Alaska Vermont Idaho Massachusetts 1973 New York City Ohio Colorado Puerto Rico Michigan New York (except New York City) 1978 1974 Indiana Utah Illinois Washington Iowa Kansas 1979 Montana Nebraska Connecticut Oregon Hawaii South Carolina Mississippi New Jersey 1975 Pennsylvania Wyoming Louisiana Maryland 1980 North Carolina Oklahoma Arkansas Tennessee New Mexico Virginia South Dakota Wisconsin 1982 1976 North Dakota Alabama Kentucky 1985 Arizona California Delaware Georgia District of Columbia For the remaining four States, the District of Columbia, the Virginia Islands, and Guam, mortality statistics for 1984 are based on information obtained directly by NCHS from copies of the original certificates received from the registration offices. In 1974, States began coding medical (cause-of-death) data on computer tapes according to NCHS specifications. The year in which State-coded medical data were first transmitted to NCHS is shown below for the 19 States now furnishing such data. 1974 1980--Con. Iowa Pennsylvania Michigan South Carolina 1975 1981 Louisiana Maine Nebraska North Carolina 1983 Virginia Wisconsin Minnesota 1980 1984 Colorado Maryland Kansas New York State Massachusetts (except New Mississippi York City) New Hampshire Vermont For 1985 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, it was necessary to change these procedures because of a backlog in coding and processing that resulted from personnel and budgetary restrictions. To produce the mortality files on a timely basis with reduced resources, NCHS used State-coded underlying cause-of-death 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 vaiation associated with the 50-percent sample is described below in the section "Estimates of errors arising from 50-percent sample for 1972." Fetal-death data are obtained directly from copies of original reports of fetal deaths received by NCHS, except New York State (excluding New York City), which submitted State-coded data in 1984. For Oklahoma in 1984, fetal-death data were obtained partly from copies of original reports of fetal deaths received by NCHS, and partly from State-coded data (See section Quality control procedures). Fetal-death data are not published by NCHS for the Virgin Islands and Guam. Standard Certificates and Reports The U.S. Standard Certificate of Death and the U.S. Standard Report of Fetal Death, issued by the Public Health Service, have served for many years as the principal means of attaining uniformity in the content of documents used to collect information on these events. They have been modified in 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 or reports 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 assured 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 have been dropped when their usefulness appeared to be limited. New revisions of the U.S. Standard Certificate of Death and the U.S. Standard Report of Fetal Death were recommended for State use beginning January 1, 1978. The certificate of death is for use by a physician, a medical examiner, or a coroner. Two other forms of the U.S. Standard Certificate of Death are available, they are similar except that the section on certification is designed for the physician's signature on one, and for the medical examiner's or coroner's signature on the other. Among the changes in the new revision were the addition of (1) an item asking "If Hosp. or Inst., Indicate DOA, OP/Emer. Rm., Inpatient" and (2) an item "Was Decedent Ever in U.S. Armed Forces?" The latter item was previously on the certificate but was deleted during 1968 through 1977. An item on whether autopsy findings were considered for determining cause of death was dropped. 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 consisting of two States (Massachusetts and New Jersey), the District of Columbia, and several large cities having efficient systems for death registrations, the death-registration area continued to expand until 1933, when it included the entire United States for the first time. Tables that show 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 the technical Appendix in Vital Statistics of the United States, 1979, Volume II, Mortality, Part A, Section 7, pages 3-4, and the section "History and Organization of the Vital Statistics System," chapter 1, Vital Statistics of the United States, 1950, Volume I, pages 2-19. Statistics on fetal deaths were first published for the birth-registration area in 1918, and then every year beginning with 1922. Classification of Data Introduction The principal value of vital statistics data is realized through the presentation of rates, which are computed by relating the vital events of a class to the population of a similarly defined class. Vital statistics and population statistics must therefore be classified according to similarly defined systems and tabulated in comparable groups. Even when the variables common to both, such as geographic area, age, sex and race, have been similarly classified and tabulated, differences between the enumeration method of obtaining population data and the registration method of obtaining vital statistics data may result in significant discrepancies. The general rules used in the classification of geographic and personal items for deaths and fetal deaths are set forth in two NCHS instruction manuals.1,2 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 in this report are 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 United States, with deaths of "nonresidents of the United States" assigned to place of death. Deaths of nonresidents of the United States" refers to deaths that occur in the United States of nonresident aliens, nationals residing abroad, and residents of Puerto Rico, the Virgin Islands, Guam, and other territories of the United States. Beginning with 1970, deaths of nonresidents of the United States are not included in tables by place of residence. Tables 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 1985 this difference amounted to 2,938 deaths. Mortality statistics by place of occurrence are shown in tables 1-10, 1-18, 1-19, 1-28, 1-29, 3-1, 3-8, 8-1, and 8-7. 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.3 A comparison of the results of this study of deaths with those for a previous matched record study of births4 showed that the quality of residence data had considerably improved between 1950 and 1960. Both studies found that events in urban areas were overstated by the NCHS classification in comparison with the U.S. bureau of the Census classification. The magnitude of the difference was substantially less for deaths in 1960 than it was for births in 1950. The improvement is attributed to an item added in 1956 to the U.S. Standard Certificates of Birth and of Death, asking if residence was inside or outside city limits. This new item aided in properly allocating the residence of persons living near cities but outside the corporate limits. Geographic Classification The rules followed in the classification of geographic areas for deaths and fetal deaths are contained in the two instruction manuals referred to previously.1,2 The geographic codes assigned by the National Center for Health Statistics during data reduction of source information on birth, death, and fetal-death records are given in another instruction manual.5 For 1982-83, geographic codes were modified to reflect results of the 1980 census. For 1980-81, codes are based on results of the 1970 census. Standard metropolitan statistical areas--The standard metropolitan statistical areas (SMSA's) used in this report are those established by the U.S. Office of Management and Budget from final 1980 census population counts6 and used by the U.S. Bureau of the Census, except in the New England States. Except in the New England States, an SMSA is a county or a group of contiguous counties containing a city of 50,000 inhabitants or more or an urbanized area of 50,000 with a total metropolitan population of at least 100,000. In addition to the county or counties containing such a city or urbanized area, contiguous counties are included in an SMSA if, according to specified criteria, they are essentially metropolitan in character and are socially and economically integrated with the central city or urbanized area.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 SMSA's. The National Center for Health Statistics cannot, however, use the SMSA classification for these States because its data are not coded to identify all towns. Instead, NCHS uses New England County Metropolitan Areas (NECMA's). These areas, established by the U.S. Office of Management and Budget, are made up of county units.7,8 Metropolitan and nonmetropolitan counties--Independent cities and counties included in SMSA's or NECMA's are included in data for metropolitan counties; all other counties are classified as nonmetropolitan. Population-size groups--Vital statistics data for cities and certain other urban places in 1983 are classified according to the population enumerated in the 1980 Census of Population. Data are available for individual cities and other urban places of 10,000 or more population. Data for the remaining areas not separately identified are shown in the tables under the heading "Balance of area" or "Balance of county." For the years 1970-81, classification of areas was determined by the population enumerated in the 1970 Census of Population. Beginning in 1982, as a result of changes in the enumerated population between 1970 and 1980, some urban places identified in previous reports are no longer included, and a number of other urban places have been added. Urban places other than incorporated cities for which vital statistics data are shown in this report 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 10,000 or more population, as there are no incorporated cities in the State. Before 1964, places were classified as "urban" or "rural." The Technical Appendixes for earlier years discuss the previous classification system. State or Country of Birth Mortality statistics by State or country of birth (table 1-32) 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 1983, about 0.5 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. With respect to the computation of death rates, the age classification used by the U.S. Bureau of the Census is also based on the age of the person in completed years. 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. Race For vital statistics in the United States in 1983, deaths are classified by race--white, black, Indian, Chinese, Japanese, Filipino, Other Asian or Pacific Islander, and 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 as Mexican, Puerto Rican, Cuban, and all other Caucasians. The Indian category includes American, Alaskan, Canadian, 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 other 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 in use 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. Most of the tables in this report, however, do not show data for this detailed classification by race. In about half of all the tables the divisions are white, all other (including black), and black separately. In other tables by race, where the main purpose is to isolate the major groups, the classifications are simply white and all other. Race not stated--For 1985 the number of death records for which race was unknown, not stated, or not classifiable was 3,488, or less than 0.2 percent of the total deaths. Death records with race entry not stated are assigned to a racial designation as follows: If the preceding record is coded white, the code assignment is made to white; if the code is other than white, the assignment is 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, death, and fetal death in use 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, 6.3 percent of the death records in use for residents of New Jersey did not contain the race item. Adjustments made in vital statistics to take into account the omission of the race item in New Jersey for part of the certificates filed during 1962 through 1964 are described in the Technical Appendix of Vital Statistics of the United States for each of those data years. Hispanic Origin Mortality statistics for the Hispanic-origin population were published in 1984 for the first time. They 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 were obtained from D.C. and the following 22 states: Arizona, Arkansas, California, Colorado, Georgia, Hawaii, Illinois, Indiana, Kansas, Maine, Mississippi, Nebraska, Nevada, New Jersey, New Mexico, New York (including New York City), North Dakota, Ohio, Tennessee, Texas, Utah, and Wyoming. Generally, the reporting states used items similar to one of two basic formats recommended by NCHS. The first format is open-ended to obtain the specific origin or descent of the decedent (for example, Italian, Mexican, Puerto Rican, English, and Cuban). The second format is directed specifically toward the Hispanic population and asks whether the decedent is of Spanish origin. If so, the specific origin - for example, Mexican, Puerto Rican, or Cuban - is to be indicated. For 1985, mortality data in tables 1-33 and 2-18 are based on deaths to residents of all 22 reporting States and D.C. In tables 1-34, 2-19, 2-20, 2-21 mortality data for the Hispanic-origin population are based on deaths to residents of 17 reporting states and D.C. whose data were at least 90 percent complete and considered to be sufficiently comparable to be used for analysis. The 17 states are as follows: Arizona, Arkansas, California, Colorado, Georgia, Hawaii, Illinois, Indiana, Kansas, Mississippi, Nebraska, New York (including New York City), North Dakota, Ohio, Texas, Utah, and Wyoming. Excluded from these tables are data for New Mexico because the format for the Hispanic item on the N.M. death certificate departs sufficiently from that of other areas to result in noncomparable data. In addition, in tables 1-33 and 1-34 for New Mexico, no deaths are shown for the category "not stated" origin. Because of the way in which the item on the death certificate for N.M. is worded, it was not possible to determine whether a blank entry represented a response of "non-Hispanic origin" or of "unknown origin." Accordingly, blank entries were coded to "non-Hispanic." The data for four other states - Maine, Nevada, New Jersey, and Tennesse - are excluded from tables 1-34, 2-19, 2-20, and 2-21 because of the large proportion of deaths (in excess of 10%) occurring in these states for which Hispanic origin was not stated or was unknown. In 1980, the 17 reporting states and D.C. accounted for about 77 percent of the Hispanic population in the U.S., including about 89 percent of the Mexican population, 66 percent of the Puerto Rican population, 24 percent of the Cuban population, and 63 percent of the "other Hispanic" population (U.S. Bureau of the Census, 1982b). Accordingly, caution should be exercised in generalizing mortality patterns from the reporting area to the Hispanic-origin population (especially Cubans) of the entire U.S. For qualifications regarding infant mortality of the Hispanic-origin population, see "Infant deaths." Marital Status Mortality statistics by marital status (table 1-31) were published in 1979 for the first time since 1961. (Previously they had been published only in the annual reports for the years 1949-51 and 1959-61.) Several reports analyzing mortality by marital status have been published, including the special study based on 1959-61 data.9 Reference to earlier reports may be found 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. Certificates in which the marriage is specified as being annulled are classified as never married. Where marital status is specified as separated or common-law marriage, it is classified as married. Of the 2,029,261 resident deaths 15 years of age and over in 1985, 9,692 certificates (0.5%) had marital status not stated. Mortality statistics by marital status are tabulated separately for never married, married, widowed, and divorced. Certificates in which the marriage is specified as being annulled are classified as never married. Where marital status is specified as separated or common-law marriage, it is classified as married. Of the 1,961,007 resident deaths 15 years of age and over in 1983, 8,442 certificates (0.4 percent) had marital status not stated. Place of Death and Status of Decedent Mortality statistics by place of death were published in 1979 for the first time since 1958 (tables 1-28 and 1-29). In addition, mortality data were also available for the first time in 1979 for the status of decedent when death occurred in a hospital or medical center (table 1-28). These data were obtained from the following two items that appeared on the U.S. Standard Certificate of Death: * Item 7c, Hospital or Other Institution--Name (If not in either, give street and number) * Item 7d, If Hosp. or Inst. Indicate DOA, OP/Emer. Rm., Inpatient (Specify) All of the States and the District of Columbia have item 7c (or its equivalent) on the death certificate. For 46 States in the Vital Statistics Cooperative Program, NCHS accepts the State definition, classification, or codes for hospitals, medical centers, or other institutions. For the remaining four States not in the Program, and the District of Columbia, NCHS classifies and codes to a hospital or medical center according to whether the terms "hospital" or "medical center" are entered as part of the name in item 7c or its equivalent. If the terms "hospital" or "medical center" are not entered as part of the name, the entry is coded to one of the following according to the information entered in item 7c on the certificate: (1) other institutions, (2) all other reported entries, or (3) unknown, not stated. Table 1-28 shows mortality data for the total of the following 42 States (including New York City) that have item 7d or its equivalent on their death certificates: Alaska Louisiana Ohio Arizona Maine Oregon Arkansas Michigan Pennsylvania Colorado Mississippi Rhode Island Connecticut Missouri South Carolina Florida Montana South Dakota Georgia Nebraska Tennessee Hawaii Nevada Utah Idaho New Hampshire Vermont Illinois New Jersey Virginia Indiana New Mexico Washington Iowa New York West Virginia Kansas North Carolina Wisconsin Kentucky North Dakota Wyoming Effective with data for 1980, the coding of place of death and status of decedent was changed. A new coding category was added: "Dead on arrival--hospital, clinic, medical center name not given." Deaths coded to this category are tabulated in table 1-28 as "Dead on arrival" and in table 1-29 as "Not in hospital or medical center." Had the 1979 coding categories been used, these deaths would have been tabulated as "Place unknown." Mortality by Month and Date of Birth Deaths by month have been regularly tabulated and published in the annual report for each year beginning with data year 1900. For 1983, deaths by month are shown in tables 1-19, 1-20, 1-23, 1-30, 2-12, 2-13, 2-14, and 3-9. Date of death was first published for data year 1972. In addition, unpublished data for selected causes by date of death for 1962 are available from NCHS. Number of deaths by date of death in this report are shown in table 1-30 for the total number of deaths and for the number 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 the 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 Before 1972, the last year for which autopsy data were tabulated was 1958. For 1972-83, all registration areas requested information on the death certificate as to whether autopsies were performed. For 1985, autopsies were reported on 258,596 death certificates, 12.4 percent of the total (table 1-27). Information as to whether the autopsy findings were used in determining the causes of death were tabulated for 1972-73 for all but nine registration areas and from 1974-77 for all but eight registration areas. The item "autopsy findings used" was deleted from the 1978 U.S. Standard Certificate of Death. For 8 of the cause of death categories shown in table 1-27, autopsies were reported as performed for 50 percent or more of all deaths (meningococcal infection; measles; pregnancy with abortive outcome; other complications of pregnancy, childbirth, and the puerperium; motor vehicle accidents; suicide; homicide and legal intervention; and all other external causes). There were four other categories for which 40% or more of the death certificates reported autopsies. Autopsies were reported for only 7.9% of the major cardiovascular diseases. For six of the cause-of-death categories shown in table 1-27, autopsies were reported as performed for 50 percent or more of all deaths (Whooping cough; Meningoccocal infection; Pregnancy with abortive outcome; Other complications of pregnancy, childbirth, and the puerperium; Homicide and legal intervention; and All other external causes). There were five other categories for which 40 percent or more of the death certificates reported autopsies. Autopsies were reported for only 8.3 percent of the Major cardiovascular diseases. Among all causes other than major cardiovascular diseases, autopsies were reported for 17.8 percent of all deaths. 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."10 For a given death the underlying cause is selected from an array of conditions given in the cause-of-death section on the death certificate. These conditions are translated into medical codes through use of the classification structure and 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 in terms of the format of reported conditions and their causal relationship. 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 or more conditions on the certificate into a single classification category. As a statistical datum, the 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 start of the chain of events leading to death. The rules for coding underlying causes of death are included with the ICD as a means of standardizing classification, which contributes toward uniformity in mortality medical statistics among countries. Beginning with data year 1979 the cause-of-death statistics published by the National Center for Health Statistics have been classified according to the Ninth Revision of the International Classification of Diseases (ICD-9).10 In addition to specifying that the Classification be used, WHO also recommends how the data should be tabulated in order to promote international comparability. The recommended system for tabulating data in the Ninth Revision allows countries to construct their own mortality and morbidity tabulation lists from the rubrics of the WHO Basic Tabulation List as long as rubrics from the WHO mortality and morbidity lists, respectively, are included. This tabulation system for the Ninth Revision is more flexible than that of the Eighth Revision in which specific lists were recommended for tabulating mortality and morbidity data. The Basic Tabulation List (BTL) recommended under the Ninth Revision consists of 57 two-digit rubrics that add to the "all causes" total. Within each two-digit rubric, up to 9 three-digit rubrics numbered from 0 to 8 are identified, but these do not add to the total of the two-digit rubric. The residual of each two-digit rubric, the difference between the two-digit total and the sum of its three-digit rubrics, is given the number 9. The WHO Mortality List, a subset of the titles contained in the BTL, consists of 50 rubrics, which are a minimum for the national display of mortality data. The two-digit rubrics of the BTL 01 through 46 provide for the tabulation of nonviolent deaths to ICD categories 001-799. Rubrics relating to chapter 17 (nature-of-injury causes 47 through 56) are not used by NCHS for selecting underlying cause of death, rather, preference is given to rubrics E47 through E56. The 57th two-digit rubric VO is the Supplementary Classification of Factors Influencing Health Status and Contact with Health Services and is not appropriate for the tabulation of mortality data. Five lists of causes have been developed for tabulation and publication of mortality data in this volume. The Each-Cause List, List of 282 Selected Causes, List of 72 Selected Causes, 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 more recently in use 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 and each four-digit subcategory to which deaths may be validly assigned. The list is used for tabulation for the entire United States. The published Each-Cause table does not show the four-digit subcategories provided for Motor vehicle accidents (E810-E825); however, these subcategories, which identify persons injured, are shown in the accident tables of this report (section 5). Special fifth-digit subcategories are also used in the accident tables to identify place of accident when deaths from nontransport accidents are shown. These are not shown in the Each-Cause table. The List of 282 Selected Causes of Death is constructed from BTL rubrics 01-46 and E47-E56. Each of the 56 BTL two-digit titles can be obtained either directly or by combining titles in the List. The three-digit level of the BTL is modified more extensively. Where more detail was desired, categories not shown in the three-digit rubrics were added to the List of 282 Selected Causes of Death. Where less detail was needed, the three-digit rubrics were combined. Moreover, each of the 50 rubrics of the WHO Mortality List can be obtained from the List of 282 Selected Causes of Death. The List is used in tables published for the United States and each State. The List of 72 Selected Causes of Death was constructed by combining titles in the List of 282 Selected Causes of Death. It is used in tables published for the United States and each State, and for standard metropolitan statistical areas. 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. The List of 34 Selected Causes of Death was created by combining titles in the List of 72 Selected Causes. A table using this list is published to show detailed geographic areas. Effect of list revisions--The International Lists, in use in this country since 1900, have been revised approximately every 10 years so that the disease classification may be consistent with advances in medical science and with advances in diagnostic practice. Each revision of the International Lists has produced some break in comparability of cause-of-death statistics. Cause-of-death statistics beginning with 1979 are classified by NCHS according to the ICD-9.10 For a discussion of each of the classifications used with death statistics since 1900, see the Technical Appendix in Vital Statistics of the United States, 1979, Volume II, Mortality, Part A, section 7, pages 9-14. A dual coding study was undertaken between the Ninth and Eighth Revisions to measure the extent of discontinuity in cause-of-death statistics resulting from introducing the new Revision. An initial study has been published for the list of 72 causes and the list of 10 infant causes, both of which appear in the Monthly Vital Statistics Report.11 The 72-cause list is also a basic list used in this volume. Comparability studies were also undertaken between the Eighth and Seventh, Seventh and Sixth, and Sixth and Fifth Revisions. For additional information about these studies, again see the 1979 Technical Appendix. Significant coding changes during the Ninth Revision--Coding changes have been introduced since the implementation of ICD-9 in the United States, effective with mortality data for 1979. Among the more important changes are the following. For 1981, a change was made in the coding of Acquired Immunity Deficiency Syndrome (AIDS), described below. For 1982, a change was made in the procedures for coding poliomyelitis; in the definition of child (which affects the classification of deaths to a number of categories, including child battering and other maltreatment); and in guidelines for coding deaths to the category Child battering and other maltreatment (ICD No. E967). Detailed discussion of these changes may be found in the technical appendixes of the respective volumes. Coding in 1983--The National Center for Health Statistics prepares for its cause-of-death coding clerks instruction manuals that contain decisions and interpretations that apply each year.12-16 These manuals are revised annually, chiefly to bring coding procedures into alignment with new developments in reporting practices and in medical opinions as to the etiology and causal relationship of diseases and to eliminate inconsistencies in coding procedures. Part 2e, Non-Indexed Terms, Standard Abbreviations, and State Geographic Codes Used in Mortality Data Classification, 1983 (including WHO Amendments to ICD-9)16 was added to the vital statistics instruction manual series in 1983. The major reason for development of Part 2e was to provide a published source of code assignments for terms not indexed in Volume 2 of ICD-9. The rules for coding the 1983 mortality data essentially remained the same as the previous year except for the coding of Acquired Immunity Deficiency Syndrome (AIDS). Coding in 1985 -- The rules for coding the 1985 medical data remained essentially the same as in the previous year. However, during the calendar year 1985, detailed instructions for coding motor vehicle accidents involving all-terrain vehicles (ATV's) were implemented by NCHS and state medical coders in order to ensure consistency in coding these accidents. The instructions specify that accidents involving ATV's are to be coded to nontraffic accidents involving other off-road motor vehicle (ICD-9 No. E821) unless "on road use" is clearly specified. If "on road use" is specified, then ATV's are to be coded to the appropriate category for traffic accidents (ICD-9 Nos. E810- E819). Previously, there were no specific instructions for coding these accidents. AIDS--In early 1983, during the processing of the 1981, 1982, and 1983 mortality files, the code assignment for the Acquired Immunity Deficiency Syndrome (AIDS) was changed from ICD No. 279.3 to ICD No. 279.1, both subcategories of Disorders involving the immune mechanism (ICD No. 279). This change was made in accordance with the World Health Organization's recommendations. Prior to early 1983, AIDS had been assigned to Unspecified immunity deficiency (ICD No. 279.3). (It was not included as an entry in the index to ICD-9). As a result of the change, all AIDS deaths from the 1983 mortality file were assigned to ICD No. 279.1. For 1982, approximately 25 percent were assigned to ICD No. 279.1 and 75 percent to ICD No. 279.3. For 1981, approximately 10 percent were assigned to ICD No. 279.1 and 90 percent to ICD No. 279.3. Medical certification--The use of a standard classification list, although essential for State, regional, and international comparison, does not assure strict comparability of the tabulated figures. A high degree of comparability between 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, 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 completes 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, covering 128 references over a period of 23 years indicates that no definitive conclusions have been reached about the quality of medical certification on the death certificate.17 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 rubrics for Symptoms, signs, and ill-defined conditions (ICD-9 Nos. 780-799). While there are cases for which it is not possible to determine the causes of death, this proportion indicates the care and consideration given to the certification by the medical certifier. It may also be used as a rough measure of the specificity of the medical diagnoses made by the certifier in various areas. In 1985, 1.5 percent of all reported deaths in the United States were assigned to ill-defined or unknown causes. However, this percentage varied among the States, from 0.3 percent to 6.1 percent. Automated selection of underlying cause of death--Beginning with data year 1968, NCHS began using a computer system for assigning the underlying cause of death. It has been used every year since to select the underlying cause of death. The system is called "Automated Classification of Medical Entities" (ACME). The ACME system applies the same rules for selecting the underlying cause as applied 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 international rules. The decision tables provide not only a comprehensive relationship between the conditions classifiable by ICD when applying the rules of selection and modification, but also decisions used when the underlying cause of death is assigned by ACME. 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 are periodically updated to reflect additional new information on the relationship among medical conditions. For 1983, the content of these tables was identical to that in the 1982 tables.14 Cause-of-death ranking--Cause-of-death ranking (except for infants) is based on the List of 72 Selected Causes of Death. Cause-of-death ranking for infants is based on the List of 61 Selected Causes of Infant Death. The group titled Major cardiovascular diseases and Symptoms, signs, and ill-defined conditions are not ranked from the List of 72 Selected Causes, and Certain conditions originating in the perinatal period and Symptoms, signs, and ill-defined conditions are not ranked from the List of 61 Selected Causes of Infant Death. In addition, category titles that begin with the words "Other" or "All other" are not ranked to determine the leading causes of death. When one of the titles that represents 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.10 Under the Eighth Revision, maternal deaths were assigned to category title "Complications of pregnancy, childbirth, and the puerperium" (ICDA-8 Nos. 630-678). Although WHO did not define maternal mortality, there was an NCHS classification rule that limited a maternal death to a death 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 applied only if a duration of time for the condition was given. If no duration was specified and the underlying cause of death was a maternal condition, then 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 on duration used in the Eighth Revision to an under-42-days limitation used in the Ninth Revision is not expected to have much effect on the comparability of maternal mortality statistics. However, comparability is affected by the following classification change. Under the Ninth Revision, maternal causes have been expanded to include indirect obstetric causes (ICD-9 Nos. 647-648). These causes include Infective and parasitic conditions and other current conditions in the mother that are classifiable elsewhere but which 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 that a pregnant woman will die from 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. Infant Deaths An infant death is defined as a death under 1 year of age. The term excludes fetal deaths. Infant deaths are usually divided into two categories according to age, neonatal and postneonatal. Neonatal deaths are those that occur during the first 27 days of life, and postneonatal deaths are those that occur between 28 days and 1 year of age. It has generally 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; and 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. Infant mortality rates shown in section 2 and section 8 are the most commonly used index 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 of the risk of dying in infancy because some of the live births will not have been exposed to a full year's risk of dying and some of the infants that 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.18,19 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.20,21 In contrast to infant mortality rates based on live births, infant death rates shown in section 1 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 period. 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 through June, the denominator for the infant mortality rate is a count of births occurring during the 12 months of January through December. The difference in the time reference period can result in different trends between the two indices during periods when birth rates are moving up or down markedly. In addition, the infant death rate is also subject to greater imprecision than is the infant mortality rate because of problems of enumerating and estimating the population under 1 year of age.20 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 section "Effect of list revisions.") Infant and neonatal mortality for Wyoming, 1981--The 1981 data on infant and neonatal mortality shown in tables 2-8 and 2-9 for Wyoming are incorrect because of NCHS processing errors. The correct numbers for Wyoming are 124 infant deaths and 76 neonatal deaths; the corresponding infant mortality rates are 11.2 and 7.0 deaths under 1 year of age per 1,000 live births. Race - Infant mortality rates for specified races other than white or black may be underestimated, based on results of studies in which race on the birth and death certificates for the same infant were compared (Frost and Shy, 1980). The figures should be interpreted with caution because of possible inconsistencies in reporting of race between the numerator and denominator of the rates. This reflects differences in the nature of reporting and processing of race on these two vital records. On the birth certificate, race of parents is reported by the mother at the time of delivery. On the death certificate, race of the deceased infant is reported by the funeral director based on observation or on information supplied by an informant, such as a parent. With respect to processing, race of infant at birth is coded using coding rules that take account of the race of each parent (see the technical appendix in Vital Statistics of the U.S., 1984 and 1985, Volume I, Natality, section entitled Race or national origin). For infant deaths, the race of child is coded directly from the race reported on the death certificate. 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 section "Hispanic origin") and numbers of resident live births by Hispanic origin of mother for the 17 reporting states and D.C. In computing infant mortality rates, deaths and live births of unknown origin are not distributed among the specified Hispanic and non-Hispanic groups. Because for 1985 the percent of deaths of unknown origin was 7.5 percent and the percent of live births of unknown origin was 2.7 percent, infant mortality rates by Hispanic origin may be somewhat underestimated. Small numbers of infant deaths for Hispanic-origin groups can result in infant mortality rates subject to relatively large random variation (see section "Random variation in numbers of deaths, death rates, and mortality rates and ratios"). Fetal Deaths In May 1950 the World Health Organization recommended the following definition of fetal death be adopted for international use: Death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy; the death is indicated by the fact that after such separation, the fetus does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles.22 The term "fetal death" was defined on an all-inclusive basis to end confusion arising from use of such terms as stillbirth, abortion, and miscarriage. Shortly thereafter, this definition of fetal death was adopted by the National Center for Health Statistics as the nationally recommended standard. Currently all registration areas except Puerto Rico have definitions similar to the standard definition.23 Puerto Rico has no formal definition. As another step toward increasing the comparability of data on fetal deaths for different countries, the World Health Organization recommended that for statistical purposes fetal deaths be classified as early, intermediate, and late. These groups are defined as follows: Less than 20 completed weeks of gestation (early fetal deaths) ............................ Group I 20 completed weeks of gestation but less than 28 (intermediate fetal deaths) ............. Group II 28 completed weeks of gestation and over (late fetal deaths) ............................. Group III Gestation period not classifiable in groups I, II and III ............................ Group IV Note that in table 3-13, group IV consists of fetal deaths with gestation not stated but presumed to be 20 weeks or more gestation. Until 1939 the nationally recommended procedures for registration of a fetal death required the filing of both a live-birth and a death certificate. In 1939 a separate Standard Certificate of Stillbirth (fetal death) was created to replace the former procedure. This was revised in 1949, 1955, 1956, and 1965. In 1976 the Standard Certificate of Fetal Death was replaced by the Standard Report of Fetal Death (figure 7-B). The 1977 revision of the Model State Vital Statistics Act and Model State Vital Statistics Regulations24 recommended that spontaneous fetal deaths of 20 weeks or more gestation, or a weight of 350 grams or more, and all induced terminations of pregnancy regardless of gestational age be reported and further that they be reported on separate forms. These forms are to be considered legally required statistical reports rather than legal documents. Beginning with 1970 fetal deaths, procedures were implemented that attempted to separate reports of spontaneous fetal deaths from those of induced terminations of pregnancy. These procedures were implemented because the health implications are different for spontaneous fetal deaths and induced terminations of pregnancy. These procedures are still in use. Comparability and completeness of data--Registration area requirements for reporting fetal deaths vary. Most of these areas require reporting fetal deaths of gestations of 20 weeks or more. Table 3-1 shows the minimum period of gestation required by each State for fetal-death reporting. There is substantial evidence that not all fetal deaths for which reporting is required are reported.25 For registration areas not requiring the reporting of fetal deaths of all periods of gestation, underreporting is more likely to occur in the earlier gestational periods. This is illustrated by the fact that for most areas requiring reporting of fetal deaths of 20 weeks or more, the total number reported for 20-23 weeks is lower than the numbers reported for 24-27 and 28-31 weeks. For areas requiring the reporting of all fetal deaths, however, the opposite is generally true. Another type of reporting problems arises from the inconsistent application of the definition of fetal death by individual registration areas. For example, some live-born infants who die shortly after birth, particularly those born prematurely who die before the umbilical cord is severed or while the placenta is still attached, may be erroneously reported as fetal deaths. To maximize the comparability of data by year and by State, most of the tables in section 3 are based on fetal deaths occurring at gestations of 20 weeks or more. These tables also include fetal deaths of not stated gestation for those States requiring reporting at 20 weeks or more only. Beginning with 1969, fetal deaths of not stated gestation were excluded for States requiring reporting of all products of conception except for those with a stated birth weight of 500 grams or more. In 1983 this rule was applied to the following States: Colorado, Georgia, Hawaii, New York (including New York City), Rhode Island, and Virginia. Each year there are some exceptions to this procedure. Arkansas was one such exception in 1983, requiring the reporting of fetal deaths of all periods of gestation; however, all fetal deaths of not stated gestation were assumed to be of 20 weeks or more gestation. The data in table 3-3 include only fetal deaths to residents of those areas in the United States that report all periods of gestation. The areas are Colorado, Georgia, Hawaii, New York (including New York City), Rhode Island, and Virginia. Although Arkansas reports all periods of gestation, it is excluded from this table because of a noncomparable reporting practice explained below. This reporting practice results in undercounts of fetal deaths of less than 28 weeks gestation. Arkansas--Arkansas has been using two reporting forms for fetal deaths. A confidential Spontaneous Abortion form and a Fetal Death Certificate. Beginning with data year 1981, Arkansas specified that fetal deaths of less than 28 weeks gestation or weighing less than 1,000 grams could be reported on the Spontaneous Abortion form rather than on their report of fetal death. Although the National Center for Health Statistics receives their certificates of fetal death, it does not receive their confidential abortion reports. Accordingly, counts of fetal deaths of gestational age 20 to 27 weeks declined sharply from 100 in 1980 to 39 in 1981 to 7 in 1982 and increased to 24 in 1983. Beginning with 1984 data, the State specified that fetal deaths of 20 weeks gestation or weighing 500 grams be reported on the fetal death certificate. Because of these changes, the comparability of counts of early fetal deaths may be affected. In particular, counts of fetal deaths aged 20-27 weeks during 1981-83 were not comparable between Arkansas and other reporting areas nor with data for 1984 and 1985. This reporting practice results in noncomparability of fetal death data for fetal deaths under 28 weeks of gestation between Arkansas and other reporting areas. District of Columbia--Beginning in 1981, the District of Columbia changed its reporting requirements for spontaneous fetal deaths from "passed the fifth month of uterogestation" to "20 completed weeks or more or a weight of 500 grams or more." Kentucky--Beginning in 1981, Kentucky changed its reporting requirements for spontaneous fetal deaths from "20 weeks gestation or more" to "a weight of 350 grams or more or a gestational age of 20 weeks or more." Maine--Beginning with data year 1978, Maine changed its reporting requirements for spontaneous fetal deaths from "all periods of gestation" to "20 weeks or more." This change affects the tabulation of fetal deaths with no stated gestational age. Data for 1978-83 include all fetal deaths of not stated gestational age. New Mexico--Beginning in 1980, New Mexico changed its reporting requirements for spontaneous fetal deaths from "20 completed weeks" to "500 grams or more." South Dakota--Beginning in 1979, South Dakota changed its reporting requirements for spontaneous fetal deaths from "20 weeks or more gestation" to a weight of more than 500 grams." Tennessee--Beginning in 1979, Tennessee changed its reporting requirements for spontaneous fetal deaths from "20 weeks or more gestation" to "500 grams or more, or in the absence of weight, of 22 completed weeks' gestation or more." Period of gestation--The period of gestation is the number of completed weeks elapsed between the first day of the last normal menstrual period and the date of delivery. The first day of the last normal menestrual period (LMP) is used as the initial date because it can be more accurately determined than the date of conception, which usually occurs 2 weeks after LMP. Data on period of gestation are computed from information on "date of delivery" and "date last normal menses began." If "date last normal menses began" is not on the record or the calculated gestation falls beyond a duration considered biologically plausible, "gestation in weeks" or "Physician's estimate of gestation" is used. When the period of gestation is reported in months on the report, it is allocated to gestational intervals in weeks as follows: 1-3 months to under 16 weeks 4 months to 16-19 weeks 5 months to 20-23 weeks 6 months to 24-27 weeks 7 months to 28-31 weeks 8 months to 32-35 weeks 9 months to 40 weeks 10 months and over to 43 weeks and over All areas reported LMP in 1983 except Delaware, New Mexico, Puerto Rico, and South Dakota. Table A-1. Period of gestation at which fetal-death reporting is required: Each reporting area, 1985 / All periods / / / / of / / / 20 wks or Area / gestation / 16 weeks / 20 weeks / 350 grams Alabama / / / X / Alaska / / / X / Arizona / / / X / Arkansas / X / / / California / / / X / Colorado / X / / / Connecticut / / / X / Delaware / / / X / District of Columbia / / / / Florida / / / X / Georgia / X / / / Hawaii / X / / / Idaho / / / / X Illinois / / / X / Indiana / / / X / Iowa / / / X / Kansas / / / / Kentucky / / / / X Louisiana / / / / X Maine / / / X / Maryland / / / X* / Massachusetts / / / / X Michigan / / / / Minnesota / / / X / Mississippi / / / / X Missouri / / / / X Montana / / / X / Nebraska / / / X / Nevada / / / X / New Hampshire / / / / X New Jersey / / / X / New Mexico / / / / New York / / / / NY excluding NYC / X / / / New York City / X / / / North Carolina / / / X / North Dakota / / / X / Ohio / / / X / Oklahoma / / / X / Oregon / / / X** / Pennsylvania / / X / / Rhode Island / X / / / South Carolina / / / / X South Dakota / / / / Tennessee / / / / Texas / / / X / Utah / / / X / Vermont / / / X**** / Virginia / X / / / Washington / / / X / West Virginia / / / X / Wisconsin / / / X / Wyoming / / / X / Table A-1. Period of gestation at which fetal-death reporting is required: Each reporting area, 1985 / 20 weeks / 20 weeks / / / / or / or / / 350 / 500 Area / 400 grams / 500 grams / 5 months / grams /grams Alabama / / / / / Alaska / / / / / Arizona / / / / / Arkansas / / / / / California / / / / / Colorado / / / / / Connecticut / / / / / Delaware / / / / / District of Columbia / / X / / / Florida / / / / / Georgia / / / / / Hawaii / / / / / Idaho / / / / / Illinois / / / / / Indiana / / / / / Iowa / / / / / Kansas / / / / X / Kentucky / / / / / Louisiana / / / / / Maine / / / / / Maryland / / / / / Massachusetts / / / / / Michigan / X / / / / Minnesota / / / / / Mississippi / / / / / Missouri / / / / / Montana / / / / / Nebraska / / / / / Nevada / / / / / New Hampshire / / / / / New Jersey / / / / / New Mexico / / / / / X New York / / / / / New York excluding NYC/ / / / / New York City / / / / / North Carolina / / / / / North Dakota / / / / / Ohio / / / / / Oklahoma / / / / / Oregon / / / / / Pennsylvania / / / / / Rhode Island / / / / / South Carolina / / / / / South Dakota / / / / / X Tennessee / / / / / X Texas / / / / / Utah / / / / / Vermont / / / / / Virginia / / / / / Washington / / / / / West Virginia / / / / / Wisconsin / / / / / Wyoming / / / / / * If gestational age is unknown, weight of 500 grams or more. ** If gestational age is unknown, weight of 400 grams or more, or crown-heel length of 28 centimeters or more *** If weight is unknown, 22 completed weeks' gestation or more. **** If gestational age is unknown, weight of 400 or more grams, 15 or more ounces. Birth weight--Of the 55 registration areas (including the 50 States, the District of Columbia New York City, Puerto Rico, the Virgin Islands, and Guam), 27 do not specify how weight should be given; 16 specify that weight should be given in pounds and ounces; 5 specify grams; and the remaining 7 areas indicate weight can be given either in pounds and ounces or in grams. Data on fetal deaths for the Virgin Islands and Guam are not published by NCHS. In the tabulation and presentation of these data, the metric system (grams) has been used to facilitate comparison with other data published in the United States and internationally. The equivalents of the gram intervals in pounds and ounces are as follows: Less than 350 grams = 0 lb 12 oz or less 350- 499 grams = 0 lb 13 oz- 1 lb 1 oz 500- 999 grams = 1 lb 4 oz- 2 lb 3 oz 1,000-1,499 grams = 2 lb 5 oz- 3 lb 4 oz 1,500-1,999 grams = 3 lb 7 oz- 4 lb 6 oz 2,000-2,499 grams = 4 lb 9 oz- 5 lb 8 oz 2,500-2,999 grams = 5 lb 10 oz- 6 lb 9 oz 3,000-3,499 grams = 6 lb 12 oz- 7 lb 11 oz 3,500-3,999 grams = 7 lb 14 oz- 8 lb 13 oz 4,000-4,499 grams = 8 lb 15 oz- 9 lb 14 oz 4,500-4,999 grams = 9 lb 15 oz- 11 lb 0 oz 5,000 grams or more = 11 lb 1 oz or more With the introduction of the Ninth Revision, International Classification of Diseases, the birth-weight classification intervals for perinatal mortality statistics were shifted downward by 1 gram, as shown above. Previously, the intervals were, for example, 1,001-1,500; 1,501-2,000; etc. Race--The race of the fetus is ordinarily classified based on the race of the parents. If the parents are of different races, the following rules apply. (1) When only one parent is white, the fetus is assigned the other parent's race. (2) When neither parent is white, the fetus is assigned the father's race with one exception: If the mother is Hawaiian or Part-Hawaiian, the fetus is classified as Hawaiian. When the race of one parent is missing or ill defined, the race of the other determines that of the fetus. When race of both parents is missing, the race of the fetus is allocated to the specific race of the fetus on the preceding record. Total-birth order--Total-birth order refers to the sum of the live births and other terminations (including both spontaneous fetal deaths and induced terminations of pregnancy) that a woman has had including the fetal death being recorded. For example, if a woman has previously given birth to two live babies and to one born dead, the next fetal death to occur is counted as number four in total-birth order. In the 1976 revision of the Standard Report of Fetal Death, total-birth order is calculated from four items on pregnancy history: Number of previous live births, now living; number of previous live births, now dead; number of other terminations before 20 weeks; and number of other terminations after 20 weeks. All registration areas use the two standard items pertaining to the number of previous live births. Thirty areas use the two standard items pertaining to the number of "other terminations" before and after 20 weeks gestation; 4 report "other terminations" of 20 weeks or more; 14 do not differentiate "other terminations" by gestational age; 6 areas use other criteria for differentiating spontaneous and induced terminations; and 1 area reports "other terminations" before and after 16 weeks gestation. Total-birth order for all areas is calculated from the sum of available information. Thus, information on total-birth order may not be completely comparable among the registration areas. Marital status--Table 3-4 shows fetal deaths and fetal-death ratios by mother's marital status. States excluded from this table are as follows: California, Connecticut, Maryland, Michigan, Montana, New York (including New York City), Ohio, Texas, and Vermont. Because live births comprise the denominator of the ratio, marital status must also be reported for mothers of live births. Starting in 1980, marital status of the mother of the live birth was inferred for States that did not report it on the birth certificate. There are no quantitative data on the characteristics of unmarried women who may misreport their marital status or who fail to register fetal deaths. Underreporting may be greater for the unmarried group than for the married group. Age of mother--The fetal-death report asks for the mother's "age (at time of delivery)," and the ages are edited in NCHS for upper and lower limits. When mothers are reported to be under 10 years of age or 50 years and over, the age of the mother is considered and not stated and is assigned as follows: Age on all fetal-death records with age of mother not stated is allocated according to the age appearing on the record previously processed for a mother of identical race and having the same total-birth order (total of live births and other terminations). Perinatal Mortality Perinatal definitions--Beginning with data year 1979, perinatal mortality data for the United States and each State have been published in section 4. The World Health Organization in the Ninth Revision of the International Classification of Diseases (ICD-9) recommended that "national perinatal statistics should include all fetuses and infants delivered weighing at least 500 grams (or when birth weight is unavailable, the corresponding gestational age (22 weeks) or body length (25 cm crown-heel)), whether alive or dead...." It was further recommended that countries should present, solely for international comparisons 'standard perinatal statistics' in which both the numerator and denominator of all rates are restricted to fetuses and infants weighing 1,000 grams or more (or, where birth weight is unavailable, the corresponding gestational age (28 weeks) or body length (35 cm crown-heel))." Because birth weight and gestational age are not reported on the death certificate in the United States, NCHS was unable to recommend adopting these definitions. Three definitions of perinatal mortality are currently used by NCHS. Perinatal Definition I, generally used for international comparisons, which includes fetal deaths of 28 weeks or more gestation and infant deaths of less than 7 days, Perinatal Definition II, which includes fetal deaths of 20 weeks or more gestation and infant deaths of less than 28 days; and Perinatal Definition III, which includes fetal deaths of 20 weeks or more gestation and infant deaths of less than 7 days. Variations in fetal death reporting requirements and practices have implications for comparing perinatal rates among States. Since reporting is generally poorer near the lower limit of the reporting requirement, States that require reporting of all products of pregnancy regardless of gestation are likely to have more completereporting of fetal deaths of 20 weeks or more than are other States. The larger number of fetal deaths reported by these "all periods" States may result in higher perinatal rates compared with States whose reporting is less complete. Accordingly, reporting completeness may account, in part, for differences among the State perinatal rates, particularly differences for Definitions II and III, which use data for fetal deaths of 20-27 weeks. Not stated--Fetal deaths with gestational age not stated are presumed to be of 20 weeks gestation or more if (1) the State requires reporting of all fetal deaths of gestational age 20 weeks or more or (2) the fetus weighed 500 grams or more, in those States requiring reporting of all fetal deaths regardless of gestational age. For Definition I, fetal deaths with gestation not stated but presumed to be 20 weeks or more are allocated to the category 28 weeks or more, according to the proportion of fetal deaths with stated gestational age that falls into that category. For Definitions II and III, fetal deaths with presumed gestation of 20 weeks or more are included with those of stated gestation of 20 weeks or more. For all three definitions, following the distribution of gestation not- stated described above, fetal deaths with nonstated sex are allocated within gestational age groups on the basis of the distribution of stated cases. The allocation of not-stated gestational age and sex for fetal deaths is made individually for each State, for metropolitan and nonmetropolitan areas, and separately for the United States as a whole. Accordingly, the sum of perinatal deaths for the areas according to Definition I may not equal the total number of perinatal deaths for the United States. Quality of Data Completeness of Registration All States have adopted laws that require the registration of births and deaths, and the reporting of fetal deaths. It is believed that over 99 percent of the births and deaths occurring in this country are registered. Reporting requirements for fetal deaths vary somewhat from State to State (see "Comparability and completeness of data"). Overall reporting completeness is not as good for fetal deaths as for births and deaths, but it is believed to be relatively complete for fetal deaths of 28 weeks gestation or more. National statistical data on fetal deaths include only those fetal deaths with stated or presumed gestation of 20 weeks or more. Massachusetts Data The 1964 data statistics for deaths exclude approximately 6,000 events 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 also somewhat affected. Quality Control Procedures Demographic items on the death certificate--As previously indicated, for 1985 the mortality data for these items were obtained from two sources: (1) Microfilm images of the original certificates furnished by the Virgin Islands and photocopies from Guam, and (2) records on data tape furnished by the 50 States, D.C., New York City, City, and Puerto Rico. For the Virgin Islands and Guam which sent only only copies of the original certificates, the demographic items were coded for 100 percent of the death certificates. The demographic coding for a 10-percent sample of the certificates was independently verified. As part of the quality control procedures for mortality data, each registration area has to go through a calibration period during which it must achieve the specified error tolerance level of 2 percent per item for 3 consecutive months, based on NCHS independent verification of a 50-percent sample of that area's records. Once the area has achieved the required error tolerance level, a sample of 70-80 records per month is used to monitor quality of coding. All of the areas had achieved the specified tolerance error before 1983; accordingly, for these areas the demographic items on about 70-80 records per area per month were independently verified by NCHS. These areas include New York City, Puerto Rico, and the 46 States that furnished data on computer tape to NCHS. The estimated average error rate for all demographic items in the entire 1985 mortality file was 0.25 percent. These verification procedures involve controlling two types of error (coding and entering into the data record tape) at the same time and the error rates are a combined measure of both types. While it may be assumed that the entering errors are randomly distributed across all items on the record, this assumption cannot be made as readily for coding errors. Although systematic errors in coding infrequent events may escape detection during sample verification, it is probable that some of these errors were detected during the initial period when 50 percent of the file was being verified, thus providing an opportunity to retrain the coders. Medical items on the death certificate--As for demographic data, mortality medical data are also subject to quality control procedures which control for errors of both coding and data entry. Each of the 16 registration areas that furnished NCHS with coded medical information according to NCHS specifications first had to qualify for sample verification. During an initial calibration period, the area had to achieve a specified error tolerance level of less than 5 percent for coding all medical items for 3 consecutive months, based on independent verification by NCHS, for all records. After the area has achieved the required error tolerance level, a sample of 70-80 records per month is used to monitor quality of medical coding. For these 16 States, the average coding error rate in 1983 was just over 3 percent. For the remaining 39 registration areas--34 States, the District of Columbia, New York City, Puerto Rico, the Virgin Islands, and Guam--NCHS coded the medical items for 100 percent of the death records. A 1-percent sample of the records was independently coded for quality control purposes. The estimated average error rate for these areas was about 3 percent. The ACME system for selecting the underlying cause of death through computer application contributes to the quality control of medical items on the death certificate (see the section "Automated selection of underlying cause of death"). Demographic items on the report of fetal death--For 1985, all data on fetal deaths were coded under contract by the U.S. Bureau of the Census except New York State (excluding New York City), which submitted State-coded data. Coding and entering information on data tapes were verified on a 100-percent basis because of the relatively small number of records involved. Other control procedures--After coding and entering on data tape 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, where there is 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.26 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 in this report (excluding fetal-death statistics) 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 number of deaths by size of estimate and total deaths in the area are shown in the Technical Appendix of Vital Statistics of the United States, 1972, Volume II, Mortality, Part A. Computation of Rates and Other Measures Population Bases The population bases from which death rates shown in this report are computed are prepared by the U.S. Bureau of the Census. Rates for 1940, 1950, 1960, 1970, and 1980, are based on the population enumerated as of April 1 in the censuses of those years. Rates for all other years use the estimated midyear (July 1) population for the respective years. Death rates for the United States, individual States, and SMSA's 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 1900-83 are shown in table 7-1. In addition, the population including Armed Forces abroad is shown for the United States. Table A shows the sources for these populations. Population estimates for 1984-85--The population of the United States estimated by age, race, and sex for 1985 is shown in table 7-2, and the population for each State by broad age groups follows in table 7-3. Comparable data for 1981 and 1982 were shown in tables 7-2 and 7-3 of Vital Statistics of the United States, Volume II, for those years. Population estimates for 1984 and 1985 incorporate new estimation procedures for net migration and net undocumented immigration. The 1985 estimates are comparable with those of 1984 but are not strictly comparable with the postcensal estimates for 1981-83 shown in tables 7-2 and 7-3 of Vital Statistics of the U.S., Volume II, for those years. Although the death rates and estimates of life expectancy for 1984 and 1985 are not strictly comparable with those for previous years, the trends for the total population and most age-race-sex groups are not substantially affected. For additional details, see the technical appendix in Vital Statistics of the U.S., 1984, Volume II, and the report of the U.S. Bureau of the Census (1986). Population data by race are consistent with the modified (see below) 1980 population by race. Population for 1980--The population of the United States by age, race, and sex and the population for each State by age are shown in tables 7-2 and 7-3, respectively, of Vital Statistics of the United States, 1980, Volume II. The figures by race have been modified as described below. The racial counts in the 1980 census are affected by changes in reporting practices, particularly of the Hispanic population, and in coding and classifying. One particular change created a major inconsistency between the 1980 census data and historical data series, including censuses and vital statistics. About 40 percent of the Hispanic population counted in 1980, over 5.8 million persons, did not mark one of the specified races listed on the census questionnaire but instead marked the "Other" category. Table A. Sources for resident population and population including Armed Forces abroad: Birth- and death-registration States, 1900-1932, and United States, 1900-1983 Year Source 1985-------------- U.S. Bureau of the Census, Current Population Reprts, Series P-25, No. 1000, Feb. 1987. 1984-------------- U.S. Bureau of the Census, Current Population Reprts, Series P-25, No. 985, April 1986. 1983-------------- U.S. Bureau of the Census, Current Population Reprts, Series P-25, No. 965, Dec. 1984. 1982-------------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 949, May 1984. 1981-------------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 929, May 1983. 1980-------------- U.S. Bureau of the Census, U.S. Census of Population: 1980, Number of Inhabitants, PC80-1-A1, United States Summary, 1983. 1971-79----------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 917, July 1982. 1970-------------- U.S. Bureau of the Census, U.S. Census of Population: 1970, Number of Inhabitants, Final Report PC(1)-A1, United States Summary, 1971. 1961-69----------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 519, April 1974. 1960-------------- U.S. Bureau of the Census, U.S. Census of Population: 1960, Number of Inhabitants, Final Report PC(1)-A1, United States Summary, 1964. 1951-59----------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 310, June 30, 1965. 1940-50----------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 499, May 1973. 1930-39----------- U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 499, May 1973, and National Office of Vital Statistics, Vital Statistics Raters in the United States, 1900-1940, 1947. 1920-29----------- National Office of Vital Statistics, Vital Statistics Rates in the United States, 1900-1940, 1947. 1917-19----------- Same as for 1930-39. 1900-1916--------- Same as for 1920-29. In the 1980 census, coding procedures were modified for persons who marked "Other" race and wrote in a national origin designation of a Latin American country or a specific Hispanic origin group in response to the racial question. These persons remained in the "Other" racial category in 1980 census data; in previous censuses and in vital statistics, such responses had almost always been coded into the "White" category. In order to maintain comparability, the "Other" racial category in the 1980 census was reallocated to be consistent with previous procedures. Persons who marked the "Other" racial category and reported any Spanish origin on the Spanish origin question (5,840,648 persons) were distributed to white and black races in proportion to the distribution of persons of Hispanic origin; who actually reported their race as "White" or "Black." This was done for each age-sex group. As a result of this procedure, 5,705,155 persons (98 percent) were added to the white population and 135,493 persons (2 percent) to the black population. Persons who marked the "Other" racial category and reported that they were not of Spanish origin (916,338 persons) were distributed as follows: 20 percent in each age-sex group were added to the "Asian and Pacific Islander" category (183,268 persons), and 80 percent were added to the "White" category (733,070 persons). The count of American Indians, Eskimos, and Aleuts was not affected by these procedures. Unpublished tabulations of these modified census counts were obtained from the U.S. Bureau of the Census and used to compute the rates for this report. Population estimates for 1971-79--Death rates in this volume 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 previously been estimated for April 1, 1980.27 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 in this volume for 1961-69 are based on revised estimates of the population and thus may differ slightly from rates published before 1976. The rates shown in tables 1-1 and 1-2, the life table values in table 6-5, and the population estimates in table 7-1 for each year in the period 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-25, Number 519. The data shown in table 1-10 for 1961-69 have not been revised. Rates and ratios based on live births--Infant and maternal mortality rates, and fetal death and perinatal mortality ratios, are computed on the basis of the number of live births. Fetal death and perinatal mortality rates are computed on the basis of the number of live births and fetal deaths. Counts of live births are published annually in Vital Statistics of the United States, Volume I, Natality. New Jersey--As previously indicated, data by race are not available for New Jersey for 1962 and 1963. Therefore for 1962 and 1963 the National Center for Health Statistics estimated a population by age, race, and sex excluding 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 reports. Net Census Undercount Just as the underenumeration of deaths and the misreporting of demographic characteristics on the death certificate can introduce error into the annual rates, errors in the latest decennial census such as undercount or overcount can also adversely affect mortality statistics. 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.28 Net census undercount is determined by miscounting and misreporting of demographic characteristics such as age. Age-specific death rates are affected by both the net census undercount and the misreporting of age on the death certificate.29 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. Although death rates based on a population adjusted for net census undercount may be more accurate than rates based on an unadjusted population, rates in this volume are not adjusted; rather, they are computed using population estimates that preserve the age pattern of the net census undercount across the postcensal interval. Thus, it is important to consider the possible impact of net census undercount on death rates. The U.S. Bureau of the Census has conducted extensive research on completeness of coverage of the U.S. population (including underenumeration and misstatement of age, race, and sex) in the last four decennial censuses--1950, 1960, 1970, and 1980. From this work have come estimates of the national population that was not counted by age, race, and sex.25,30,31 The reports for 1980 include estimates of net census undercount using alternative methodological assumptions for age, race, and sex subgroups of the national population.25,32 These studies indicate that, although coverage was improved over previous censuses, there was differential coverage in the 1980 census among the population subgroups; that is, some age, race, and sex groups were more completely counted than others. Net census undercounts can affect (1) levels of the observed vital rates, (2) differences among groups, and (3) levels and group differences shown by summary measures such as age-adjusted death rates and life expectancy. Levels and differentials--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. Assuming net census undercounts remained consistent by age after the 1980 census, the estimated rates for 1985 can be computed by multiplying the reported rates by ratios of the census-level population to the population adjusted for the estimated net census undercount (table 7-4). 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--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 than the population of all other races. The black population was counted less completely than the total population of all other races. For the total population, underenumeration varied by age group, with the greatest undercount found for persons aged 80-84, and 85 years and over. All other age groups were overcounted or undercounted by less than three percent. Among the age-sex-race groups, coverage was lowest for black males aged 35-39, 40-44, and 45-49 years. Underenumeration for these groups averaged 17.3 percent. In contrast, white females in these age groups were essentially completely enumerated. For black females and white males in these same age groups, the undercount ranged from 2 to 6 percent. For the under-1-year age group the white population was overenumerated by about 2 percent, whereas infants of other races were underenumerated by about 8 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. As a consequence, the ratio of mortality between the rates for males and females, and between the rates for the white population and the population of other races, or 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, for the age group 35-39 years in 1985, the ratio of the death rate for Homicide and legal intervention for black males to that for white males is 6.9, whereas the ratio of the death rates adjusted for net census undercount in 1985 is 5.9, a reduction of about 16 percent. For Ischemic heart disease for males aged 40-44 years, the ratio of the death rate for the population of all other races to that for the white population is 1.3 using the unadjusted rates, but it is 1.1 when adjusted for estimated underenumeration. Summary measures--The effect of net census undercount on age-adjusted death rates depends on the underenumeration of each age group and on the distribution of deaths by age. In 1985, the age-adjusted death rate for All causes would decrease from 546.1 to 540.1 per 100,000 population if the age-specific death rates were corrected for net census undercount. For Diseases of the heart, the age-adjusted death rate for white males would decrease from 244.5 to 241.4 per 100,000 population, a decline of 1.3 percent. For black males the change, from an unadjusted rate of 301 to an adjusted rate of 284.4, would amount to 5.5 percent. If death rates by age were adjusted, then the corresponding life expectancy at birth computed from these rates would change. The importance of adjustments varies by age, that is, when calculating life expectancy, the impact of an undercount (or overcount) is greatest at the younger ages. In general, the effect of correcting the death rates is to increase the estimate of life expectancy at birth. Differential underenumeration among race-sex groups would lead to greater changes in life expectancy at birth. Differential underenumeration among race-sex groups would lead to greater changes in life expectancy for some groups than for others. For white females who were completely enumerated in 1980, revised estimates of life expectancy would remain roughly constant; those for black males would show the greatest increase. Age-Adjusted Death Rates Age-adjusted death rates shown in this report are computed by using the distribution in 10-year age intervals of the enumerated population of the United States in 1940 as the standard population. Each figure represents the rate that would have existed if the age-specific rates of the particular year prevailed in a population whose age distribution was the same as that of the United States in 1940. The rates for the total population and for each race-sex group were adjusted using the same standard population. It is important not to compare age-adjusted death rates with crude rates. The standard 1940 population, on the basis of one million total population, is as follows: Age Number All ages ............................................... 1,000,000 Under 1 year................................................. 15,343 1-4 years.................................................... 64,718 5-14 years................................................... 170,355 15-24 years.................................................. 181,677 25-34 years.................................................. 162,066 35-44 years.................................................. 139,237 45-54 years.................................................. 117,811 55-64 years.................................................. 80,294 65-74 years.................................................. 48,426 75-84 years.................................................. 17,303 85 years and over............................................ 2,770 Life Tables U.S. abridged life tables are constructed by reference to a standard table.33 Life tables for the decennial period 1979-81 are used as the standard life tables in constructing the 1980-83 abridged life tables. With the availability of the 1979-81 standard life tables, revised life table values were computed for 1980-82, these appear for the first time in this volume. Life table values appearing in Vital Statistics of the United States for 1980-82 were constructed using the 1969-71 decennial life tables. 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 tables values for 1951-59, 1961-69, and 1971-79 appearing in this publication are based on revised intercensal estimates of the populations for those years. As such, these life table values may differ from the life table values for those years published in previous volumes. There has been an increasing interest in data on average length of life (e0) for single calendar years before the initiation of the annual abridged life table series for selected race-sex groups in 1945. The figures in table 6-5 for the race and sex groups for the following years were estimated to meet these needs.34 Race and Years 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 1900-1902 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 counterminous United States. Decennial life table values for the 3-year period 1959-61 were derived from data that include both Alaska and Hawaii for each year (table 6-4). Data for each year shown in table 6-5 include Alaska beginning in 1959 and Hawaii beginning in 1960. It is not believed that the inclusion of these two States materially affects life table values. Random Variation in No. Deaths, Death Rates, Mort. Rates & Ratios Deaths and population-based rates--Except for 1972, the numbers of deaths reported for a community represent complete counts of such events. As such, they are not subject to sampling error, although they are subject to errors in the registration process. However, when the figures are used for analytical purposes, such as the comparison of rates over a time period 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.35 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. Estimates of standard error and tests of significance under this assumption are described in most standard statistics texts. When the number of events is large, the standard error, expressed as a percent of the number or rate, 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 conditions described by the figures. This is particularly true for infant mortality rates, cause-specific death rates, and death rates for counties. Events of a rare nature may be assumed to follow a Poisson probability distribution. For this distribution, a simple approximation may be used to estimate a confidence interval, as follows. If N is the number of registered deaths in the population and R is the corresponding rate, the chances are 19 in 20 that 1. N - 2 / N and N + 2 / N covers the "true" number of events. 2. R - 2 R and R + 2 R /N /N covers the "true" rate. If the rate R corresponding to N events is compared with the rate S corresponding to M events, the difference between the two rates may be regarded as statistically significant if it exceeds R2 S2 2 + N M For example, if the observed death rate for Community A were 10.0 per 1,000 population and if this rate were based on 20 recorded deaths, then the chances are 19 in 20 that the "true" death rate for that community lies between 5.3 and 14.5 per 1,000 population. If the death rate for Community A of 10.0 per 1,000 population were being compared with a rate of 20.0 per 1,000 population for Community B, which is based on 10 recorded deaths, then the difference between the rates for the two communities is 10.0. This difference is less than twice the standard error of the difference (10.0)2 (20.0)2 2 + 20 10 of the two rates, which is computed to be 13.4. From this, it is concluded that the difference between the rates for the two communities is not statistically significant. Symbols Used in Tables SYMBOLS USED IN TABLES Data not available--------------------------- --- Category not applicable---------------------- ... Quantity zero-------------------------------- - Quantity more than 0 but less than 0.05------ 0.0 Quantity more than zero but less than 500 where numbers are rounded to thousands---------------------------------- Z Figure does not meet standards of reliability or precision------------------- * REFERENCES 1. National Center for Health Statistics: Vital statistics, classification and coding instructions for fetal death records. NCHS Instruction Manual, Part 3b. Public Health Service, Hyattsville, Md. Published annually. 2. National Center for Health Statistics: Vital statistics, demographic classification and coding instructions for death records. NCHS Instruction Manual, Part 4. Public Health Service, Hyattsville, Md. Published annually. 3. 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Passel and J. G. Robinson. 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, D.C., Apr. 8, 1985. 33. National Center for Health Statistics, M. G. Sirken: Comparison of two methods of constructing abridged life tables by reference to a "standard" table. Vital and Health Statistics. Series 2, No. 4. PHS Pub. No. 1000. Public Health Service. Washington. U.S. Government Printing Office, Mar. 1966. 34. For estimating procedure see National Office of Vital Statistics, T. N. E. Greville and G. A. Carlson: Estimated average length of life in the death-registration States. Vital Statistics--Special Reports, Vol. 33, No. 9. Public Health Service. Washington, D.C., 1951. 35. National Office of Vital Statistcs, C. L. Chiang: Standard error of the age-adjusted death rate. Vital Statistics--Special Reports, Vol. 47, No. 9. U.S. Public Health Service. Washington, D.C., Aug. 1961. 36. Frost, F. and K.K. Shy. 1980. Racial differences between linked birth and infant death records in Washington State. Am.J.Public Health 70:974-6.
