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New Jersey Health Statistics
1999

Data files have been updated since this report was published. Updated data are available on NJSHAD.

MORTALITY

Statistical Overview
There were 73,981 deaths of New Jersey residents in 1999 (Table M3). This represents a 4.0 percent increase over 1998. The crude death rate was 908.5 per 100,000 population and the age-adjusted rate was 857.7 (Table M1 and Figure M1). The age-adjusted mortality rate decreased 10.9 percent from 1989 to 1999 despite a 2.5 percent increase between 1998 and 1999 (Table M1). The number of deaths, crude death rate, and age-adjusted death rate all increased nationally, also, though not as steeply as in New Jersey (Hoyert, et al, 2001). The age-adjusted death rate for New Jersey males was 40.4 percent higher than the rate for females and the age-adjusted death rate for blacks was 31.0 percent higher than the rate for whites in 1999 (Table M2 and Figure M2). The ten leading causes of death remained unchanged from 1998: heart disease, cancer, stroke, chronic respiratory disease, diabetes, unintentional injuries, influenza and pneumonia, septicemia, kidney disease, and Alzheimer's disease (Table M11).

For persons born in New Jersey in 1999, average life expectancy was 77.3 years. For females, it was 79.6 years and for males it was 74.7 years. Life expectancy for whites was 77.8 years and 72.0 years for blacks (Table M10 and Figure M4).

Technical Changes
The data in this report may differ from comparable data presented in previous reports in this series because of four major changes in the reporting and analysis of mortality data. Because of these changes, assessment of trends in death data should be undertaken with caution.

First, the classification of causes of death changed in 1999. The International Classification of Diseases (ICD) is a product of the World Health Organization and is used worldwide. The United States adopted the Tenth Revision of the ICD (ICD-10) in 1999. The revision not only effects the codes and names assigned to causes of death, it also effects the rules for selecting the underlying cause of death and the grouping of causes for tabulation and selection of leading causes of death. Because of this, there were dramatic increases or decreases in the numbers of deaths due to certain causes between 1998 and 1999. To make deaths coded under the ninth revision (ICD-9) comparable to current data, the National Center for Health Statistics (NCHS) computed preliminary comparability ratios for 113 selected causes of death and 130 selected causes of infant death. When applied to deaths coded in accordance with ICD-9, the comparability ratios allow for trend analysis by eliminating differences due solely to the change in ICD. Tables of comparability ratios used in this chapter are given in Tables A-B.

Second, the federal Department of Health and Human Services adopted a policy that the standard population used for age-adjustment be changed from the US 1940 population to the US 2000 projected population. Therefore age-adjusted rates are now higher because the 2000 population has an older age distribution than in 1940 and are closer to corresponding crude rates because we are close to the standard population year. Rates for 1989-1998 have been recalculated using the new standard (Table M1 and Figure M1). The change in standard does not affect trends once rates are recalculated, but differentials in rates between race and sex groups are affected (Hoyert, et al, 2001).

Third, the underlying cause of death from the multiple cause of death (MCD) file compiled by NCHS was used to produce the tables in this report. In past reports, the underlying cause from the single cause of death (SCD) file compiled internally was used. There are several differences between the two files. Cause of death information on MCD files is coded automatically through use of a specialized computer software package, while the SCD files are coded manually by nosologists (persons trained to classify diseases in accordance with an organized list of diseases and injuries). This may lead to differences in the selection of the underlying cause of death. The MCD file yields full information on resident deaths occurring out of state, while the SCD file contains full information from some states but limited information from other states and New York City. Missing race, sex, and county of residence are imputed on the MCD file (missing data are assigned a value based on an algorithm), while the SCD file leaves them blank. The use of the MCD file will lead to increases in both the number of deaths and death rates by race and, to a lesser extent, by county and sex, since race is not stated more frequently than county and sex. NCHS's cut-off date for the receipt of 1999 death records was June 30, 2000. So, any records sent to the state registrar after that date will not be in the MCD file. However, this number is negligible. The MCD file does not separately code residence information for municipalities with populations less than 10,000.

Fourth, since Asian and Pacific Islander and Hispanic ethnicity reporting on death certificates in New Jersey and the rest of the country is known to be undermeasured, mortality data are presented separately for Asians and Pacific Islanders (Tables MA1-MA9) and for Hispanics (Tables MH1-MH9) in a supplemental section near the end of this chapter. In Tables M1-M39, Asians and Pacific Islanders are included in the Other race group. Since Hispanics can be of any race, Hispanic decedents are included in the race group indicated on their death certificates in Tables M1-M39.

Causes of Death
The top ten causes of death remained unchanged from 1998 after ICD-10 comparability modifications were made to the 1998 data (Table M11). Comparability modifications caused influenza and pneumonia to drop from the fifth leading cause of death to seventh in 1998, thereby causing diabetes and unintentional injuries to increase to fifth and sixth, respectively (Table M11). Alzheimer's disease became the tenth leading cause of death in 1998, after comparability modification, and remained tenth in 1999 (Table M11). The ten leading causes of death accounted for 80.9 percent of deaths in 1999 (Table M12). The two leading causes of death among both sexes and all races (heart disease and cancer) accounted for 56.3 percent of all deaths. Stroke and chronic respiratory disease were the third and fourth leading cause of death, respectively, for both sexes. Unintentional injury was the fifth leading cause of death among males, while it was eighth among females (Table M19). HIV disease was the third leading cause of death among blacks and the eighteenth among whites (Table M20). Cancer returned as the leading cause of death among residents 25-44 years old for the first time since the early 1990s when it was overtaken by unintentional injuries (Tables M12).

There were 301,830 years of potential life lost (YPLL) before age 65 among New Jerseyans in 1999 (Table M21). YPLL is the sum of all the years of life not lived by persons dying before reaching age 65 and is used as a measure of premature death. For the total population, for males, and for whites, cancer was the leading cause of YPLL, followed by unintentional injuries and heart disease (Tables M21-M23 and Figures M8, M10, M12). Cancer and perinatal conditions were the leading causes of YPLL among females (Table M22 and Figure M10). Among blacks, HIV disease was the leading cause of YPLL, followed by perinatal conditions (Table M23 and Figure M12).

The age-adjusted death rate due to cancer was 8.8 percent lower in 1999 than it was in 1994. Age-adjusted deaths rates for most cancer sites decreased over the time period (Table M24). In 1999, trachea, lung, and bronchus remained the most common cancer mortality site, followed by cancer of the colon, rectum, and anus and cancer of the breast (Table M24). Nearly 58 percent of cancer deaths occurred among those aged 65-84 (Table M25). In 1999, the male age-adjusted death rate for cancer of the trachea, lung, and bronchus was 77.2 percent higher than the rate for females (Tables M26-M27).

Firearms caused 366 deaths in 1999. Of those, 195 were suicides, 153 were homicides, 8 were accidental, 5 were legal intervention, and 5 were of undetermined intent (Tables M30 and M37). The firearm death rate among males was 7.4 times the rate among females and the rate among blacks was 2.9 times the white rate (Table M30A). Drug-related causes such as mental and behavioral disorders due to psychoactive substance use, accidental overdoses, and intentional poisonings resulted in 757 deaths, a 10.0 percent decrease from the comparability-modified 1998 number of deaths (841) (Table M31). Meanwhile, alcohol-related causes such as mental and behavioral disorders due to alcohol use; degeneration of nervous system due to alcohol; alcoholic polyneuropathy, cardiomyopathy, gastritis, and liver disease; finding of alcohol in blood; and accidental and intentional alcohol poisoning increased 10.9 percent from the comparability-modified 1998 number (411) to 456 deaths in 1999 (Table M32). In 1999, the drug-related death rate among males was 3.1 times that of females and the alcohol-related death rate among males was 3.4 times the rate among females (Tables M31-M32).

Infant, Fetal, and Maternal Mortality

The number and rate of infant deaths increased slightly from 1998 (Table M40). The infant mortality rate among black non-Hispanics remained more than three times as high as the rate among white non-Hispanics (Table M41). Over seventy percent of infant deaths occurred in the neonatal period (within the first 27 days of life). Infants who were part of a multiple birth were six times as likely to die within the first year of life as singletons. Mortality was negatively related to birth weight and gestational age. Infants whose mothers received no prenatal care were ten times as likely to die within the first year of life as those whose mothers received early prenatal care. Infant mortality rates were twice as high for infants of unmarried mothers versus married mothers and for mothers who smoked during pregnancy versus mothers who did not smoke during pregnancy (Table M44). Sixty percent of infant deaths had a medical risk factor reported on their birth certificate. Previous preterm or small-for-gestational-age infant, incompetent cervix, hydramnios/oligodramnios, and lung disease were the most commonly reported medical risk factors among infant deaths. Of newborns whose mothers had an incompetent cervix, 8.2 percent died within the first year of life (Table M45). Disorders related to short gestation and low birth weight, congenital malformations, and respiratory distress syndrome remained the three leading causes of infant deaths (Table M46).

The fetal mortality rate was 10 percent higher than it was in 1998 (Table M40). Additional years of data are needed to determine if this is a true increase in the rate or merely a one-time anomaly. As with infant deaths, plurality, low birth weight, short gestation, lack of prenatal care, unmarried mothers, and maternal smoking are each correlated with higher rates of fetal mortality (Table M47). The fetal death rate among black non-Hispanics was approximately twice as high as the rate for white non-Hispanics and Hispanics (Table M48). Cord and placenta complications were the leading cause of fetal deaths in 1999 (Table M49).

The Technical Notes section contains information on sources of data, allocation of data by residence or occurrence, quality of data, racial and ethnic classification, definitions, rates and ratios, and cause of death rankings.

For additional information on age standardization of death rates, see the New Jersey Center for Health Statistics publication Age Standardization of Death Rates in New Jersey: Implications of a Change in the Standard Population and the National Center for Health Statistics publication Age Standardization of Death Rates: Implementation of the Year 2000 Standard.

For additional information on the Tenth Revision of the International Classification of Diseases (ICD-10), see the National Center for Health Statistics publications Comparability of Cause of Death Between ICD-9 and ICD-10: Preliminary Estimates and Deaths: Final Data for 1999.

MORTALITY DATA TABLES
Table M1 Age-Adjusted Death Rate and Crude Death Rates by Age, Race, and Sex, 1989-1999
Table M2 Age-Adjusted Death Rates by Race and Sex
Table M3 Mortality by Detailed Race Groups
Table M4 Mortality by County of Residence
Table M4A Mortality by Race and County
Table M4B Mortality by Age and County
Table M5 Mortality in Selected Municipalities
Table M6 Mortality by Month and Day of the Week
Table M7 Place of Death, 1989-1999
Table M8 Place of Death for Leading Causes of Death
Table M9 Disposition of Decedents, 1989-1999
Table M10 Life Expectancy at Birth by Race and Sex
Table M11 Leading Causes of Death, 1994-1999
Table M12 Leading Causes of Death by Age Group
Table M13 Leading Causes of Death in 1999 Among Residents 1-4 Years Old, 1994-1999
Table M14 Leading Causes of Death in 1999 Among Residents 5-14 Years Old, 1994-1999
Table M15 Leading Causes of Death in 1999 Among Residents 15-24 Years Old, 1994-1999
Table M16 Leading Causes of Death in 1999 Among Residents 25-44 Years Old, 1994-1999
Table M17 Leading Causes of Death in 1999 Among Residents 45-64 Years Old, 1994-1999
Table M18 Leading Causes of Death in 1999 Among Residents 65 and Over, 1994-1999
Table M19 Leading Causes of Death by Sex
Table M20 Leading Causes of Death by Race
Table M20A Age-Adjusted Rates for Leading Causes of Death by County
Table M21 Leading Causes of YPLL, New Jersey and United States
Table M22 Leading Causes of YPLL by Sex
Table M23 Leading Causes of YPLL by Race
Table M24 Cancer Mortality by Site, 1994 and 1999
Table M25 Cancer Mortality by Age and Site
Table M26 Cancer Mortality Among Males by Age and Site
Table M27 Cancer Mortality Among Females by Age and Site
Table M28 YPLL due to Cancer by Sex
Table M29 YPLL due to Cancer by Race
Table M30 Firearm Mortality by Age, Race, Sex, and Intention
Table M31 Drug-Related Mortality by Age, Race, and Sex
Table M32 Alcohol-Related Mortality by Age, Race, and Sex
Table M33 Fatal Injuries at Work by Age and Sex
Table M34 YPLL due to Unintentional Injury by Race
Table M35 Alcohol-Related, Drug-Related, and Injury Deaths by County
Table M36 Mortality by Cause and Age Group
Table M36A White Male Mortality by Cause and Age Group
Table M36B White Female Mortality by Cause and Age Group
Table M36C Black Male Mortality by Cause and Age Group
Table M36D Black Female Mortality by Cause and Age Group
Table M36E Other Race Male Mortality by Cause and Age Group
Table M36F Other Race Female Mortality by Cause and Age Group
Table M37 Mortality by Detailed Cause of Death and Age Group
Table M38 Mortality by Cause Group and County
Table M39 Mortality by Detailed Cause of Death and County
Table M40 Infant, Neonatal, Postneonatal, Fetal, and Maternal Mortality, 1989-1999
Table M41 Infant Mortality by Race/Ethnicity of Mother, 1989-1999
Table M42 Infant, Neonatal, Postneonatal, Fetal, and Maternal Mortality by County
Table M43 Infant, Neonatal, Postneonatal, Fetal Mortality To Residents of Selected Municipalities
Table M44 Infant Mortality by Selected Characteristics and Race/Ethnicity of Mother
Table M45 Infant Mortality by Medical Risk Factors and Race/Ethnicity of Mother
Table M46 Leading Causes of Infant Mortality
Table M47 Fetal Mortality by Selected Characteristics and Race/Ethnicity of Mother
Table M48 Fetal Mortality by Race/Ethnicity of Mother
Table M49 Leading Causes of Fetal Mortality
Table M-H1 Crude and Age-Adjusted Hispanic Death Rates by Sex
Table M-H2 Reported Hispanic Mortality by Age Group and County
Table M-H3 Reported Hispanic Mortality by Country of Origin and Sex
Table M-H4 Reported Hispanic Unintentional Injury Mortality by Type and Sex
Table M-H5 Reported Hispanic Firearm, Drug, and Alcohol Mortality by Sex
Table M-H6 Reported Hispanic Male Mortality by Cause and Age Group
Table M-H7 Reported Hispanic Female Mortality by Cause and Age Group
Table M-H8 Reported Hispanic Male Cancer Mortality by Site and Age Group
Table M-H9 Reported Hispanic Female Cancer Mortality by Site and Age Group
Table M-A1 Crude and Age-Adjusted Asian/Pacific Islander Death Rates by Sex
Table M-A2 Reported Asian/Pacific Islander Mortality by Age Group and County
Table M-A3 Reported Asian/Pacific Islander Mortality by Country of Origin and Sex
Table M-A4 Reported Asian/Pacific Islander Unintentional Injury Mortality by Type and Sex
Table M-A5 Reported Asian/Pacific Islander Firearm, Drug, and Alcohol Mortality by Sex
Table M-A6 Reported Asian/Pacific Islander Male Mortality by Cause and Age Group
Table M-A7 Reported Asian/Pacific Islander Female Mortality by Cause and Age Group
Table M-A8 Reported Asian/Pacific Islander Male Cancer Mortality by Site and Age Group
Table M-A9 Reported Asian/Pacific Islander Female Cancer Mortality by Site and Age Group
Table A ICD Codes and Comparability Ratios for Major Cause of Death Groups
Table B ICD Codes and Comparability Ratios for 113 Selected Causes of Death
Table C ICD Codes and Comparability Ratios for 130 Selected Causes of Infant Death
MORTALITY ILLUSTRATIONS
Figure M1 Crude and Age-Adjusted Death Rates, 1989-1999
Figure M2 Age-Adjusted Death Rates by Race and Sex
Figure M3 Age-Adjusted Death Rates from All Causes by County
Figure M3A Age-Specific Mortality Rates by County, Ages 25-44
Figure M3B Age-Specific Mortality Rates by County, Ages 45-64
Figure M3C Age-Specific Mortality Rates by County, Ages 65-84
Figure M3D Age-Specific Mortality Rates by County, Ages 85+
Figure M4 Life Expectancy by Race and Sex
Figure M5 Leading Causes of Death
Figure M6 Average Number of Deaths per Day by Cause
Figure M7 Age-Adjusted Death Rates for Leading Causes of Death, 1994 and 1999
Figure M7A Age-Adjusted Heart Disease Mortality Rates by County
Figure M7B Age-Adjusted Cancer Mortality Rates by County
Figure M7C Age-Adjusted Stroke Mortality Rates by County
Figure M7D Age-Adjusted Chronic Respiratory Disease Mortality Rates by County
Figure M8 Leading Causes of YPLL
Figure M9 YPLL Rates for Leading Causes, New Jersey and the United States
Figure M10 Leading Causes of YPLL by Sex
Figure M11 YPLL Rates for Leading Causes by Sex
Figure M12 Leading Causes of YPLL by Race
Figure M13 YPLL Rates for Leading Causes by Race
Figure M14 Cancer YPLL by Site
Figure M15 Drug, Alcohol, and Firearm Death Rates by Race and Sex
Figure M16 Unintentional Injury Death Rates by County

Mortality chapter in PDF format

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