About Multiple Cause of Death, 1999-2020

The Multiple Cause of Death database contains mortality and population counts for all U.S. counties. Data are based on death certificates for U.S. residents. Each death certificate contains a single underlying cause of death, up to twenty additional multiple causes, and demographic data. The number of deaths, crude death rates, age-adjusted death rates and 95% confidence intervals for death rates can be obtained by cause of death (4 digit ICD-10 codes, 113 selected causes of death, 130 selected causes of infant death, drug and alcohol related causes of death, injury intent and injury mechanism categories), place of residence (national, region, division, state, and county), age (single-year-of age, 5-year age groups, 10-year age groups and infant age groups), race (American Indian or Alaskan Native, Asian/Pacific Islander, Black or African American, White), Hispanic ethnicity, sex and year. Data are also available by urbanization categories for county of residence, place of death, month and week day of death, and whether an autopsy was performed.

Data Use Restrictions:

The Public Health Service Act (42 U.S.C. 242m(d)) provides that the data collected by the National Center for Health Statistics (NCHS) may be used only for the purpose for which they were obtained; any effort to determine the identity of any reported cases, or to use the information for any purpose other than for health statistical reporting and analysis, is against the law. Therefore users will:

• Use these data for health statistical reporting and analysis only.
• Do not present or publish death counts of 9 or fewer or death rates based on counts of nine or fewer (in figures, graphs, maps, tables, etc.).
• Make no attempt to learn the identity of any person or establishment included in these data.
• Make no disclosure or other use of the identity of any person or establishment discovered inadvertently and advise the NCHS Confidentiality Officer of any such discovery.

Sanctions for Violating Rules:

Researchers who violate the terms of the data use restrictions will lose access to WONDER and their sponsors and institutions will be notified. Researchers who are suspected of violating the rules may be prevented from using WONDER until an investigation can be completed. Deliberately making a false statement in any matter within the jurisdiction of any department or agency of the Federal government violates 18 USC 1001 and is punishable by a fine of up to $10,000 or up to 5 years in prison, or both.