US Death Rates Fall 60% in 75 Years, and 94% in Toddlers
By Jenni Laidman, from Medscape
In the last 75 years, the nation’s age-adjusted mortality rate fell 60%, dropping in every age group, but most dramatically among children aged 1 through 4 years, in whom mortality fell 94%, according to a National Center for Health Statistics Data Brief published online March 13.
Using data from the National Vital Statistics System, the report, written by Donna L. Hoyert, PhD, a health scientist at the Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Vital Statistics, Mortality Branch, Hyattsville, Maryland, brings to the fore the dramatic changes in survival that are unapparent in data from shorter time frames. The data range from 1935 to 2010; the 2010 statistics are preliminary.
“Although there were year to year exceptions, the last 75 years witnessed sustained declines in the risk of dying in the United States,” the author writes. The total number of deaths increased in those years, by 1.1 million to 2.5 million, but the unadjusted risk for death fell 27% in those 75 years, from 1094.5 deaths for every 100,000 people to 798.7 per 100,000. When the effect of increasing survival in an aging population was accounted for, the rate of death fell from 1860.1 per 100,000 in 1935 to 746.2 per 100,000 in 2010 — a 60% drop.
Death rates fell by more than half for all but the very oldest Americans, those aged 85 years and older. Even in that group, however, the death rate declined 38%. Among those aged 65 to 74 years, the death rate fell 62%, and for those aged 75 to 84 years, the rate declined 58%.
The largest overall decline seen was among children, especially those aged 1 to 4 years, in whom mortality fell 94%, from 440.9 deaths per 100,000 to 26.6 per 100,000.
The risk of dying fell in all racial groups from 1935 to 2010, but blacks continued to die at a higher rate than whites. The gap was widest between 1988 and 1996, when the ratio of black to white death rates was 1.4.
Until 1960, blacks were included in the category “all other races,” although blacks made up 96% of that group. Using age-adjusted figures, the ratio of deaths in the “all other races” category to deaths among whites was 1.3 between 1935 and 1942 and 1.2 from 1943 to 1959. In 1960, the first year data for blacks were kept separately, the ratio of black to white deaths was 1.2, rising to 1.4 between 1988 and 1996. The ratio has remained at 1.2 since 2008. By 2010, the age-adjusted death rate among blacks was 897.7 per 100,000; among whites, it was 741.0 per 100,000.
Leading Causes of Death
Heart disease, cancer, and stroke were among the 5 leading causes of death every year of the survey.
In 1946, accidents became 1 of the top 5 killers, and in 1979, chronic lower respiratory disease became a steady member of the top 5. Other causes have cycled in and out. Certain diseases of infancy (the report does not identify which) were among the top 5 causes of death from 1949 to 1962, and again in 1964. Kidney disease was a top 5 killer until 1948, and influenza and pneumonia were among the top 5 causes of death between 1935 and 1945, in 1963, and between 1965 and 1978.
Throughout the 75-year survey, males died at a higher rate than females.
At its peak, the ratio of male to female deaths reached 1.7 from 1975 to 1981, when age-adjusted male death rates were 65% higher than the rate for females. In 2010, the rate of male deaths was 40% higher, with a ratio of male to female deaths of 1.4. The death rate that year was 886.2 per 100,000 for males and 634.3 per 100,000 for females.
Data Shed Light on Cultural and Medical Trends
These 75 years of data also may tell the story of changes in culture and medical care, the authors state.
For instance, the emergence of antibiotics and other medications is probably behind the nearly 30% drop in age-adjusted mortality from 1935 to 1954.
In contrast, the 12-year-long slump in declining death rates from 1955 to 1968, in which death rates fell by only 2%, most likely reflects increased tobacco use and the accompanying increase in cancer and chronic lower respiratory diseases, the authors note.
In more recent years, the 41% drop in mortality from 1969 to 2010 may reflect improved prevention, diagnosis and treatment of cardiovascular disease, countering increasing rates of cancer from 1969 to 1990 and increasing lower respiratory disease rates from 1969 to 1998.
Dr. Pinna says:
There is no question people are living longer across the world.
Antibiotics, chemotherapy, radiation, early diagnosis–all play a role.
Most importantly, people are aware that they are vulnerable to dying and they seek advice, tests and cures.
In my mind, it is information and a strong self interest which are the predominant factors.
Health care plays a role but it is only a supportive role.
If a patient does not seek out a doctor, no doctor can help him.