Annual Summary of Vital Statistics—1989

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 835-847
Author(s):  
Myron E. Wegman

US infant mortality continued to decline slowly and the provisional 1989 rate, 9.7 per 1000 live births, was the lowest ever recorded. Final 1988 data showed no change in cause of death distribution or in the wide discrepancy between white and black infant mortality. State rates varied from 6.8 in Vermont to 12.6 in Georgia. Worldwide, the US rate of 10.0 was bettered by 21 other countries, with Japan lowest at 4.8. Births increased in number and rate, because of a higher fertility rate and more women in the childbearing years. The birth rate to mothers 17 years of age and younger increased again. The proportion of women who had no or inadequate prenatal care was essentially unchanged. Deaths, crude death rate, and age-adjusted death rate decreased. The excess of births over deaths added almost 1.9 million persons to the US population, the highest rate of natural increase since 1971. The marriage rate was essentially unchanged, whereas the divorce rate decreased slightly, to the lowest level since 1973. With the exception of human immunodeficiency virus infection, homicide, and pulmonary malignancies, rates for most causes of death declined from 1988 to 1989. In comparison with 1940, most declines were substantial, led by pneumonia, down about 80%, and perinatal conditions, down about 75%. The only large-scale increases among major causes in the half century were in two diseases related to cigarette smoking: chronic obstructive pulmonary disease, up eightfold, and respiratory cancer, up almost sixfold. Death rates from all other cancers, as a group, decreased by some 20% and from cardiovascular diseases by some 60%.

PEDIATRICS ◽  
1993 ◽  
Vol 92 (6) ◽  
pp. 743-754
Author(s):  
Myron E. Wegman

A new low in the infant mortality rate was reached in 1992, at 848.7 deaths per 100 000 live births, a decline of 5% from 894.4 in 1991. Birth, death, and marriage rates were also lower, but the divorce rate inched up to 4.8 per 1000 population, the same level as in 1988. The age-adjusted death rate was 504.9 per 100 000 population, the lowest in US history. Natural increase in the population, excess of births over deaths, decreased from 1 941 389 to 1 907 000, from 7.7 to 7.5 per 1000 population. Births outside hospital were fewer, both in numbers and in proportion to all births. Birth rates increased at both ends of the age range but declined in the principal childbearing years. Births to unmarried mothers increased again, comprising more than one fifth of white births and two thirds of black births. A higher proportion of newborns weighed less than 2500 g than in 1989. Life expectancy at birth increased again, to 75.7 years overall, paralleled in both sexes and white and black races. The age-adjusted death rate for cardiovascular diseases declined, but malignancies of the respiratory system increased again, to almost six times what it was in 1940. Chronic obstructive pulmonary diseases, despite slight improvement since 1991, caused death more than eight times as often as in 1940. Black and white infant mortality rates both showed a decline, greater in the white neonatal component; the black/white discrepancy widened slightly. Infant mortality in those of Hispanic origin was slightly higher than non-Hispanic whites, but the National Center for Health Statistics warns that Hispanic rates may be understated. There was little change in causes of infant mortality, or in black to white ratios for the several causes. On the world scene, most industrialized countries showed declines in infant mortality matching the US. In 1991, 21 countries, 15 in Europe, 3 in Asia, 2 in Oceania, and 1 in North America, had infant mortality rates less than the US. The decline in most other countries has been more rapid than in the US.


PEDIATRICS ◽  
1979 ◽  
Vol 64 (6) ◽  
pp. 835-842
Author(s):  
Myron E. Wegman

Continued decrease in infant mortality and relative stability in the other major indices highlight 1978 vital data (Table 1)2. The provisional infant mortality rate of 13.6 deaths in the first year of life per 1,000 live births set a new record, 3.5% below the final rate of 14.1 in 1977. Births in 1978 were slightly higher in number but, with the natural increase in the population, the birth rate was slightly lower than in 1977. The crude death rate, marriage rate, and divorce rate were all up slightly. BIRTHS Estimated live births in 1978 totaled 3,329,000,2 fractionally higher than the final figure for 1977.


PEDIATRICS ◽  
1992 ◽  
Vol 90 (6) ◽  
pp. 835-845
Author(s):  
Myron E. Wegman

Between 1990 and 1991, provisional data show that the infant mortality rate decreased again, from 9.1 to 8.9, a decline of 2% in contrast to the 7% decline from 1989 to 1990. Birth, death, and marriage rates were also lower, but the divorce rate stayed at about the same level as in 1990. Natural increase in the population, excess of births over deaths, was less than 2 million, 4% less than the increase in 1990. Detailed analysis of changes and of the influence of factors like age and race requires final data; at the time of preparation of this report final birth and death data were available only through 1989. For a variety of reasons, including staff shortages and delays in receipt of state data by the National Center for Health Statistics (NCHS), final data for 1990, which would usually have been available in late August 1992, are not expected before early 1993. Unlike recent years, the decline in the infant mortality rate was only in the neonatal component, which decreased 3.6%. Postneonatal mortality increased, for the first time in many years, by 1.6%, suggesting that the decline in the total is related more to therapeutic advances in neonatology than to improved prevention. Internationally, newly independent Latvia was added to the list of countries with rates less than 15, but Costa Rica was deleted. With the reunification of Germany the list shrank to 28 and, by default, the United States moved up from 21st to 20th. Some 12.5 million births, less than 9% of the world total, took place in countries with under-5 mortality rates of less than 20 per 1000. At the other end of the scale, 42% of the world's births occurred in countries with under-5 mortality rates of more than 140 per 1000. The median under-5 mortality rate for those countries in 1990 was 189 per 1000, meaning that almost 20% of the infants born alive in these countries died before their fifth birthday.


PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 792-803 ◽  
Author(s):  
Myron E. Wegman

A new low in the infant mortality rate was reached again in 1993, at 828.8 deaths per 100 000 live births, a decline of 2% from 848.7 in 1992. Births, marriages, and divorces were all lower, both in number and rate. Deaths and the death rate, however, both increased and, more significantly, the age-adjusted death rate increased. A likely explanation is the occurrence of influenza epidemics in early and late 1993. The rate of natural increase declined 8%, to a level of 6.9 per 1000 population. Final figures on births for 1992 indicate that, for the first time in many years, birth rates to teen-agers declined, more among black mothers than white. Increase in birth rate among older mothers continued at a somewhat slower rate than recently; older mothers tended to be better educated than the general population in their age groups. Total fertility rates were higher among mothers of Hispanic origin than among non-Hispanic blacks who, in turn, had higher rates than non-Hispanic whites. Among Hispanics the highest rates were in those of Mexican origin. Unlike recent years, birth rates to unmarried mothers did not increase in 1992. Prenatal care coverage improved, with more mothers seeking care early and fewer receiving late or no care. Electronic and fetal monitoring was performed on more than three-quarters of all births and ultrasound on more than half. Life expectancy decreased slightly, in contrast to recent years. Among major causes of death, increases were recorded in 1993 for chronic obstructive pulmonary diseases, pneumonia and influenza, and HIV infection, the latter having the largest percentage increase. Internationally, infant mortality rates in most other industrialized countries declined further in 1992. Comparatively, as in 1991, 21 other countries had infant mortality rates lower than the United States.


2008 ◽  
Vol 53 (No. 1) ◽  
pp. 1-8
Author(s):  
J. Dufek

The article aims to analyze the development of the basic characteristics of the demographic dynamics in the CR in urban areas divided according to size in 1993−2004 and to express the changes in the development of the natural increase. Urban areas in the CR were divided into 3 groups according to their size (size-related groups): urban areas of up to 2 000 inhabitants − a country type, urban areas with 2 000 to 10 000 inhabitants − a transition type, urban areas with more than 10 000 inhabitants − towns. In 2004, there were 26% of inhabitants living in the country group, 20% in the transition group and 54% in towns. There was a decline in marriage rate in all the groups; in the country, with its higher level, the decline was more moderate. The divorce rate shows a moderate increase except 1999, when it dramatically fell thanks to the legislation. The divorce rate was the highest in towns and the lowest in the country. The birth rate continued its sharp decline in urban areas of all sizes during the first four years of the researched period, then it levelled off, and it has even been slightly rising in the last years. It was considerably lower in bigger towns than in the other two groups, which had practically an identical development. There was a kind of balance at the end of the period. The death rate was generally going down; it was the highest in the country areas, however, it was approximating the values in the other two groups. The dramatic fall of the natural increase levelled off and it also showed a moderate rise. Trends are expressed with polynomial functions. The article presents the characteristics development in graphs and the reasons for changes are being commented upon.


2021 ◽  
Vol 12 ◽  
pp. 204062232098245
Author(s):  
Hye Yun Park ◽  
Hyun Lee ◽  
Danbee Kang ◽  
Hye Sook Choi ◽  
Yeong Ha Ryu ◽  
...  

Background: There are limited data about the racial difference in the characteristics of chronic obstructive pulmonary disease (COPD) patients who are treated at clinics. We aimed to compare sociodemographic and clinical characteristics between US and Korean COPD patients using large-scale nationwide COPD cohorts. Methods: We used the baseline demographic and clinical data of COPD patients aged 45 years or older with at least a 10 pack-per year smoking history from the Korean COPD Subtype Study (KOCOSS, n = 1686) cohort (2012–2018) and phase I (2008–2011) of the US Genetic Epidemiology of COPD (COPDGene) study ( n = 4477, 3461 were non-Hispanic whites [NHW], and 1016 were African Americans [AA]). Results: Compared to NHW, AA had a significantly lower adjusted prevalence ratio (aPR) of cough >3 months (aPR: 0.67; 95% CI [confidence interval]: 0.60–0.75) and phlegm >3 months (aPR: 0.78, 95% CI: 0.70–0.86), but higher aPR of dyspnea (modified Medical Round Council scale ⩾2) (aPR: 1.22; 95% CI: 1.15–1.29), short six-minute walk distance (<350 m) (aPR: 1.98; 95% CI: 1.81–2.14), and poor quality of life (aPR: 1.10; 95% CI: 1.05–1.15). Compared to NHW, Koreans had a significantly lower aPR of cough >3 months (aPR: 0.53; 95% CI: 0.47–0.59), phlegm >3 months (aPR: 0.75; 95% CI: 0.67–0.82), dyspnea (aPR: 0.72; 95% CI: 0.66–0.79), and moderate-to-severe acute exacerbation in the previous year (aPR: 0.73; 95% CI: 0.65–0.82). NHW had the highest burden related to chronic bronchitis symptoms and cardiovascular diseases related to comorbidities. Conclusion: There are substantial differences in sociodemographic characteristics, clinical presentation, and comorbidities between COPD patients from the KOCOSS and COPDGene, which might be caused by interactions between various intrapersonal, interpersonal, and environmental factors of the ecological model. Thus, a broader and more comprehensive approach would be necessary to understand the racial differences of COPD patients.


1982 ◽  
Vol 12 (2) ◽  
pp. 215-229 ◽  
Author(s):  
Charles H. Wood

After the military took power in Brazil in 1964, the government adopted a wide range of policies designed to stimulate economic growth. A central aspect of the Brazilian model of development was the control of wages. From 1964 to 1975 this strategy caused the purchasing power of the minimum wage in the city of São Paulo to fall. The decline in the real wage index was associated with a rise in infant mortality during the period. When real wages rose after 1974, the death rate dropped off. The infant mortality trend cannot be explained by other factors that affect the actual or the reported death rate, such as changes in cityward migration, shifts in the distribution of income, and improvements in the quality of vital statistics. The findings of this study indicate a causal relationship between the infant mortality trend and changes in the purchasing power of the urban poor. Additional data on nutrition, changes in household behavior, and shifts in the cause structure of mortality support this conclusion.


PEDIATRICS ◽  
1969 ◽  
Vol 44 (6) ◽  
pp. 1031-1034
Author(s):  
Myron E. Wegman

Infant mortality declined again in 1968, for the third successive year, and there is some evidence of a more rapidly downward trend in the unacceptably higher infant death rates which have existed among some population groups. The birth rate also declined again, but the marriage rate showed rather a sharp rise ( Table I ). With an excess of births over deaths of 1.55 million persons, the rate of natural increase was 7.8 per 1,000 population. Births Once more there was a decline in annual number of births, although a smaller one than last year. Nevertheless, with a rising population the birth rate fell to 17.4, the lowest ever recorded in the United States.


PEDIATRICS ◽  
1996 ◽  
Vol 98 (6) ◽  
pp. 1007-1019 ◽  
Author(s):  
Bernard Guyer ◽  
Donna M. Strobino ◽  
Stephanie J. Ventura ◽  
Marian MacDorman ◽  
Joyce A. Martin

Recent trends in the vital statistics of the United States continued in 1995, including decreases in the number of births, the birth rate, the age-adjusted death rate, and the infant mortality rate; life expectancy at birth increased to a level equal to the record high of 75.8 years in 1992. Marriages and divorces both decreased. An estimated 3 900 089 infants were born during 1995, a decline of 1% from 1994. The preliminary birth rate for 1995 was 14.8 live births per 1000 total population, a 3% decline, and the lowest recorded in nearly two decades. The fertility rate, which relates births to women in the childbearing ages, declined to 65.6 live births per 1000 women 15 to 44 years old, the lowest rate since 1986. According to preliminary data for 1995, fertility rates declined for all racial groups with the gap narrowing between black and white rates. The fertility rate for black women declined 7% to a historic low level (71.7); the preliminary rate for white women (64.5) dropped just 1%. Fertility rates continue to be highest for Hispanic, especially Mexican-American, women. Preliminary data for 1995 suggest a 2% decline in the rate for Hispanic women to 103.7. The birth rate for teenagers has now decreased for four consecutive years, from a high of 62.1 per 1000 women 15 to 19 years old in 1991 to 56.9 in 1995, an overall decline of 8%. The rate of childbearing by unmarried mothers dropped 4% from 1994 to 1995, from 46.9 births per 1000 unmarried women 15 to 44 years old to 44.9, the first decline in the rate in nearly two decades. The proportion of all births occurring to unmarried women dropped as well in 1995, to 32.0% from 32.6% in 1994. Smoking during pregnancy dropped steadily from 1989 (19.5%) to 1994 (14.6%), a decline of about 25%. Prenatal care utilization continued to improve in 1995 with 81.2% of all mothers receiving care in the first trimester compared with 78.9% in 1993. Preliminary data for 1995 suggests continued improvement to 81.2%. The percent of infants delivered by cesarean delivery declined slightly to 20.8% in 1995. The percent of low birth weight (LBW) infants continued to climb in 1994 rising to 7.3%, from 7.2% in 1993. The proportion of LBW improved slightly among black infants, declining from 13.3% to 13.2% between 1993 and 1994. Preliminary figures for 1995 suggest continued decline in LBW for black infants (13.0%). The multiple birth ratio rose to 25.7 per 1000 births for 1994, an increase of 2% over 1993 and 33% since 1980. Age-adjusted death rates in 1995 were lower for heart disease, malignant neoplasms, accidents, and homicide. Although the total number of human immunodeficiency virus (HIV) infection deaths increased slightly from 42 114 in 1994 to an estimated 42 506 in 1995, the age-adjusted death rate for HIV infection did not increase, which may indicate a leveling off of the steep upward trend in mortality from HIV infection since 1987. Nearly 15 000 children between the ages of 1-14 years died in the United States (US) in 1995. The death rate for children 1 to 4 years old in 1995 was 40.4 per 100 000 population aged 1 to 4 years, 6% lower than the rate of 42.9 in 1994. The 1995 death rate for 5-to 14-year-olds was 22.1,2% lower than the rate of 22.5 in 1994. Since 1979, death rates have declined by 37% for children 1 to 4 years old, and by 30% for children 5 to 14 years old. For children 1 to 4 years old, the leading cause of death was injuries, which accounted for an estimated 2277 deaths in 1995, 36% of all deaths in this age group. Injuries were the leading cause of death for 5-to 14-year-olds as well, accounting for an even higher percentage (41%) of all deaths. In 1995, the preliminary infant mortality rate was 7.5 per 1000 live births, 6% lower than 1994, and the lowest ever recorded in the US. The decline occurred for neonatal as well as postneonatal mortality rates, and among white and black infants alike. Sudden infant death syndrome (SIDS) rates have dropped precipitously since 1992, when the American Academy of Pediatrics issued recommendations that infants be placed on their backs or sides to sleep to reduce the risk of SIDS. SIDS dropped to the third leading cause of infant death in 1994, after being the second leading cause of death since 1980. Infant mortality rates (IMRs) have also declined rapidly for respiratory distress syndrome since 1989, concurrent with the widespread availability of new treatments for this condition.


PEDIATRICS ◽  
1954 ◽  
Vol 13 (6) ◽  
pp. 588-589
Author(s):  
MYRON E. WEGMAN

THROUGH the sampling procedure developed by the National Office of Vital Statistics, preliminary estimates were made early in 1954 of the most important statistical indices for 1953. These estimates have been shown to be quite accurate and when the final actual figures are available there is only slight variation. Presented below are the graphs and figures illustrating the data for 1953 and 1952 on Birth Rate, Marriage License Rate, Death Rate, and Infant Mortality Rate, as shown in Monthly Vital Statistics Report, Volume 2, No. 12, Feb. 17, 1954. Little change is to be seen between the two years, although it is gratifying to note continuation, even though slight, of the decline in Infant Mortality Rate. Births continue at a supnisingly high level with the rate showing no signs of the long predicted fall. The figure of over 3.9 million births refers to registered births and is the highest ever recorded. Furthermore, if we take into account those which occurred but for which birth certificates were not filed, the total number of births in the U.S.A. in 1953 probably exceeded 3,970,000. [SEE GRAPH 1 IN SOURCE PDF.] Marriages also continued at a high rate, but in the last two months of the year there was a suggestion of a slight turndown, with the December 1953 rate being 7.5% under the December 1952 rate. Reports in 1954 will determine whether this trend remains in evidence. Seasonal variations, both in marriages and births, show the same pattern as in previous years. While the total Death Rate shows no change, this is due to a rather sharp increase in the first two months of the year with 1953 showing better rates than 1952 for most of the year.


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