County of Orange Health Care Agency. Orange County Mortality Data 2000

Transcription

1 County of Orange Health Care Agency Orange County Mortality Data 2000 November 2002

2 Prepared by: Public Health Services Epidemiology & Assessment Stephen Klish, MPH Epidemiologist Michael Carson, MS Senior Epidemiologist Hildy Meyers, MD, MPH Medical Director

3 COUNTY OF ORANGE HEALTH CARE AGENCY PUBLIC HEALTH SERVICES JULIETTE A. POULSON, RN, MN DIRECTOR MARK B. HORTON, MD, MSPH DEPUTY AGENCY DIRECTOR/HEALTH OFFICER MAILING ADDRESS: 405 W 5 th STREET,7 th Floor SANTA ANA, CA TELEPHONE: (714) FAX: (714) mhorton@hca.co.orange.ca.us November 2002 To our colleagues in public health, We are pleased to announce the availability of our statistical document, Orange County Mortality Data, This information is compiled by the State of California from death certificates filed with the Birth and Death Registration of the County of Orange Health Care Agency and other health jurisdictions. This document is the latest in an annual series and is one of the crucial elements in monitoring the health status of Orange County. It also provides data for the development of policies to improve the health of Orange County s diverse population. The information presented in this publication is considered to be the official data for Unless otherwise noted, reference is made to deaths to Orange County residents, regardless of where the event occurred. Similarly, deaths occurring within the county, but to residents of other jurisdictions, are not included in this report. The report is available and can be downloaded from the Epidemiology and Assessment website, Thank you for your interest in this document. We encourage you to make other interested colleagues aware of its publication. If you would like more information, please feel free to contact Epidemiology and Assessment at (714) Sincerely, Mark B. Horton, MD, MSPH Deputy Agency Director/Health Officer Public Health Services Juliette A. Poulson, RN, MN Agency Director

4 County of Orange Health Care Agency Table of Contents Executive Summary... 1 Section 1. Deaths by Age Group Age-adjusted Death Rates for the 15 Leading Causes of Death Comparing Orange County, California and the United States... 7 Fifteen Leading Causes of Death, All ages... 8 Fifteen Leading Causes of Death, Under one year of age... 9 Fifteen Leading Causes of Death, 1-4 years of age Fifteen Leading Causes of Death, 5-9 years of age Fifteen Leading Causes of Death, years of age Fifteen Leading Causes of Death, years of age Fifteen Leading Causes of Death, years of age Fifteen Leading Causes of Death, years of age Fifteen Leading Causes of Death, years of age Fifteen Leading Causes of Death, years of age Fifteen Leading Causes of Death, years of age Fifteen Leading Causes of Death, years of age Fifteen Leading Causes of Death, years of age Fifteen Leading Causes of Death, 85 years of age and over Section 2. Cause of Death by Gender Cause of Death by Rank and Gender Cause of Death by Gender, Unranked, by ICD-10 Code ii

5 Section 3. Deaths by Race/Ethnicity Number of Deaths by Race/Ethnicity Fifteen Leading Causes of Death, Non-Hispanic White Fifteen Leading Causes of Death, Hispanic Fifteen Leading Causes of Death, Southeast Asian Fifteen Leading Causes of Death, Other Asian Fifteen Leading Causes of Death, African-American Section 4. Additional Tables Fifteen Leading Causes of Death by Race/Ethnicity with Rates Deaths Due to Malignant Neoplasms with Race/Ethnicity and Gender Detail Deaths Due to External Causes with Age and Gender Detail Deaths Due to Transport Accidents Deaths Due to Intentional Self-Harm (Suicide) Deaths Due to Assault (Homicide) Deaths Due to Firearm Discharge Appendices Appendix 1. Technical Notes Appendix 2. Population Estimates iii

6 : Executive Summary Important note to readers of this report Significant changes in coding causes of death and in age adjustment were implemented with 1999 mortality data and have continued with the 2000 mortality data. It is important to keep in mind that these changes make direct comparisons with mortality data from years 1998 and prior of uncertain validity, with the exception of comparisons of deaths due to all causes. A brief explanation of the changes follows. International Classification of Diseases (ICD) 10 th Revision The International Classification of Diseases (ICD) 10 th Revision has significant differences from the 9 th revision: 1) changes in the actual codes, with a near doubling of the number of codes available; 2) changes in some of the methods for assigning the underlying cause of death; and 3) changes in the grouping of codes to determine leading causes of death. Therefore, there is not a one to one correspondence between codes used in the 9 th and 10 th revisions; similarly, there may not be a one to one correspondence between groups of causes (as in the leading causes of death). The federal government calculated comparability ratios for the change from ICD-9 to ICD-10 and uses them for trend analysis. However, the State of California has chosen not to use comparability ratios, and it is not clear how accurate these are at the county level. Among the most significant changes are a large decrease in deaths attributed to Influenza and pneumonia, estimated at 30%, and an increase in those due to Alzheimer s disease, approximately 55%. Age adjustment Age adjustment is a statistical procedure used to remove the affect of different age distributions when comparing populations with different age structures (see the Computation of Rates section). A standard population is chosen for this procedure. Prior to 1999, most reports of mortality data have used the 1940 United States standard population (1940 standard) for age adjustment. Beginning with the 1999 mortality report, the federal government began using the year 2000 United States standard population (2000 standard), which is also used in this report. Care must be exercised in comparing age-adjusted data from different reports to be sure that the same population standard was used. Since the age distribution of the 2000 standard is shifted to older age groups, reflecting the growth in this population segment since 1940, and because death rates increase with age, the age-adjusted death rates using the new standard are, in most instances, larger than those using the 1940 standard. Please see Age Standardization of death Rates: Implementation of the Year 2000 Standard published by the National Center for Health Statistics (available at: for more information about how the change in population standard affects trends and comparisons of racial/ethnic death rates. Use of State of California mortality data file Until 1999, Orange County used a locally generated file for analysis of mortality data. Beginning with 1999 data and continuing with the 2000 data, the file provided by the State of California is used. The use of the State data file as opposed to the Orange County data file ensures greater consistency between Orange County and California published reports. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

7 Summary of 2000 mortality data Total deaths and crude death rate There were 16,487 deaths among Orange County residents in 2000, a decrease of less than 1% from the 16,644 deaths that were registered in The crude death rate was per 100,000 in 2000, a decrease of 1.5% from 1999 (585.6 per 100,000). Fifteen leading causes of death The fifteen leading causes of death accounted for 87.6% of all deaths in Diseases of the heart remained the leading cause of death among Orange County residents, accounting for 5,181 (31.4%) deaths. Malignant neoplasms ranked second with 3,992 deaths (24.2%). Cancers of the trachea, bronchus, and lung accounted for the largest share of Malignant neoplasms with 981 deaths (24.6%), followed by lymphomas, leukemias and related cancers with 433 deaths (10.8%). The third leading cause of death was Cerebrovascular diseases, with 1,338 deaths, accounting for 8.1% of deaths. Comparison to California and United States 2000 age-adjusted death rates The overall age-adjusted death rate for Orange County in 2000 was per 100,000. The corresponding California rate of was slightly higher and the United States (U.S.) rate of was significantly higher than Orange County (Figure 1). Of the fifteen leading causes of death in Orange County, twelve of the Orange County age-adjusted rates were lower than the United States and twelve were lower than California. Figure 1. Comparison of 2000 Age -Adusted Rates Diseases of the heart Malingant neoplasms Cerebrovascular diseases Chronic lower respiratory disease Influenza & pneumonia Accidents Diabetes mellitus Alzheimer's disease Intentional self-harm (suicide) Chronic liver disease & cirrhosis Parkinson's Disease Essential (primary) hypertenion & hypertensive renal disease Nephritis, neprotic syndrome & neprosis Atherosclerosis Aortic aneurysm & disection Orange County California United States Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

8 Gender differences There were 8,604 female and 7,883 male deaths among Orange County residents in The ranking of the leading causes of death in year 2000 for males and females is shown in Table 1. Table 1. Fifteen Leading Causes of Death by Gender, Orange County, 2000 Orange County Males Females Rank Cause of death Rank Cause of death Rank Cause of death 1 Diseases of the heart 1 Diseases of the heart 1 Diseases of the heart 2 Malignant neoplasms 2 Malignant neoplasms 2 Malignant neoplasms 3 Cerebrovascular diseases 3 Cerebrovascular diseases 3 Cerebrovascular diseases 4 Chronic lower respiratory disease 4 Chronic lower respiratory disease 4 Chronic lower respiratory disease 5 Influenza and pneumonia 5 Accidents 5 Influenza and pneumonia 6 Accidents 6 Influenza and Pneumonia 6 Alzheimer s disease 7 Diabetes mellitus 7 Diabetes mellitus 7 Accidents (unintentional injuries) 8 Alzheimer s disease 8 Intentional self-harm 8 Diabetes mellitus 9 Intentional self-harm (suicide) (suicide) 9 Chronic liver disease and cirrhosis 9 Essential hypertension and hypertensive renal disease 10 Chronic liver disease and 10 Alzheimer s disease 10 Atherosclerosis cirrhosis 11 Parkinson s disease 11 Parkinson s disease 11 Chronic liver disease and cirrhosis 12 Essential hypertension and hypertensive renal disease 12 Aortic aneurysm and dissection 12 Intentional self-harm (suicide) 13 Nephritis, nephrotic syndrome and nephrosis 13 Nephritis, nephrotic syndrome and nephrosis 14 Atherosclerosis 14 Congenital malformations and chromosomal abnormalities 15 Aortic aneurysm and dissection 15 Certain conditions originating in the perinatal period 13 Parkinson s disease 14 Nephritis, nephrotic syndrome and nephrosis 15 Congenital malformations and chromosomal abnormalities Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

9 Deaths by age group The majority (59.6%) of all deaths among Orange County residents in 2000 were among those aged 75 years and older. Please see Figure 2. Figure 2. Orange County Deaths by Age Group Number < Age Group (years) Among infants less than 1 year of age, the leading cause of death was Congenital malformation, deformations, and chromosomal abnormalities (73 deaths), followed by Disorders relating to short gestation and low birth weight (21 deaths), Sudden infant death syndrome (12 deaths), and Diseases of the circulatory system (12). The leading cause of deaths for all age groups from 1-4 years to years was Accidents. For the age group years, Malignant neoplasms (130) was the leading cause of death and Accidents (93) was the second leading cause of death. Intentional self-harm (suicide) was among the 15 leading causes of death for all age groups from through the year age group. The number of suicides surpassed assault (homicide) in each of these age groups except for the year age group (for which assault was the 2 nd leading cause and suicide was the 4 th leading cause). See Table 2 for ranking of suicide by age group. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

10 Table 2. Ranking of Intentional self-harm (suicide) by Age Group Age Group (years) Suicide rank Number of suicides Assault (homicide) was a leading cause of death for age groups from persons 1-4 years of age through years, except for persons 5-9 years of age. Homicide was the second leading cause of death for persons in the year age group. Human immunodeficiency virus(hiv) infection, the 21 st leading cause of death for all ages, was ranked highest among year-olds (ranked 5 th, 23 deaths). Additionally, HIV infection was a leading cause of death for year olds (ranked 6 th, 1 death), year-olds (ranked 6 th, 11 deaths), year olds (ranked 10 th, 8 deaths), and year olds (ranked 13 th, 8 deaths). Leading causes by race/ethnicity Non-Hispanic Whites accounted for 82.0% of all Orange County deaths in the year 2000, while Hispanics accounted for 9.4%, Southeast Asians 2.5%, Other Asians 4.4%, African Americans 1.2%, and others less than 1%. Crude rates of death per 100,000 population were as follows: Non-Hispanics Whites 922.9, African Americans 479.2; Asians 295.9, and Hispanics Diseases of the heart was the leading cause of death for Whites, Hispanics and African Americans. Malignant neoplasms was the leading cause of death for Asians with 320 deaths; however, Diseases of the heart was a close second with 316 deaths. Age-adjusted rates by race/ethnicity Age-adjusted rates differed dramatically for many of the leading causes of death. African Americans had the highest death rate due to Diseases of the heart (365.8 per 100,000), followed by Whites (256.9 per 100,000), Asians (169.1 per 100,000), and Hispanics (168.0 per 100,000). African Americans also had the highest death rate due to Malignant neoplasms (260.7 per 100,000), followed by Non-Hispanic Whites (200.2 per 100,000), Asians (128.0 per 100,000), and Hispanics (116.9 per 100,000). Age-adjusted rates for Hispanics were lower than those for Non-Hispanic Whites for the majority of the 15 leading causes except Diabetes mellitus; Chronic liver disease & cirrhosis; Nephritis, nephrotic syndrome and nephrosis; and Essential (primary) hypertension & hypertensive renal disease. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

11 Injury mortality (external causes of death) Intentional self-harm (suicide) was the leading external cause of death in Orange County in 2000, with 236 deaths. The second leading external cause of death was Motor vehicle accidents with 198 deaths. These were followed by Accidental poisoning (135 deaths), Falls (107 deaths), and Assault (homicide) (60 deaths). Among victims of Falls, 68% of deaths were among those aged 75 years and older. There were 51 pedestrian deaths, 18 motorcyclist deaths, and 9 pedal cyclist deaths. A total of 22 deaths by Accidental drowning occurred; of these, 3 (13.6%) were among children aged 1-4 years of age (no drowning deaths in infants in 2000). Firearms were involved in 142 deaths: 104 suicides, 31 homicides, 4 accidental deaths, 2 during a legal intervention, and 1 death for which intent was undetermined. Firearms were used in 44.1% of suicides and 51.7% of homicides. Figure 3 shows that in the last 20 years, the suicide rate has decreased 32% from 12.2 per 100,000 in 1981 to 8.3 in 2000 with a high of 14.0 in 1987 and a low of 7.4 in In 1999, the underlying cause of death classification schemes change from ICD-9 to ICD-10; however, the classification of suicide is thought to be comparable between the two schemes based on compatibility ratios published by the National Center for Health Statistics. Figure 3. Intentional Self-Harm (Suicide) Mortality Rate, Orange County, ICD-9 ICD-10 Rate per 100,000 population Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November Year

12 Section 1 Deaths by Age Group Age-adjusted Death Rates for 15 Leading Causes of Death Comparing Orange County with California and the United States (2000) Orange United Cause of Death County California 1 States 2 All causes Diseases of heart (I00-I09, I11, I13, I20-I51) Malignant neoplasms (C00-C97) Cerebrovascular diseases (I60-I69) Chronic lower respiratory diseases (J40-J47) Influenza & pneumonia (J10-J18) Accidents (V01-X59, Y85-Y86) Diabetes mellitus (E10-E14) Alzheimer's disease (G30) Intentional self-harm (suicide) (X60-X84, Y87.0) Chronic liver disease & cirrhosis (K70, K73-K74) Parkinson's disease (G20-G21) Essential (primary) hypertension & hypertensive renal disease (I10, I12) Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) Atherosclerosis (I70) Aortic aneurysm & dissection (I71) State of California, Department of Finance, Population: Population projection by Age, Sex, and Race/Ethnic Detail, December ( 2 Minino AM, Arias E, Kochanek KD, Murphy SL, Smith BL. Deaths: Final Data for National vital statistics reports; vol 50 no 15 Hyattsville, Maryland: National Center for Health Statistics ( Note: Orange County rates are calculated from population data that are based on estimates from the 2000 Census (see appendix). California and United States rates are computed using postcensal estimates based on the 1990 Census, estimated as of July 1, Detailed populations from the 2000 Census were not available for California or the United States when this report was prepared. Differences between the 2000 enumerated population and the population estimates for 2000 used in this report for California and the United States could result in underestimation or overestimation of death rates. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

13 Fifteen Leading Causes of Death All ages Rank Cause of Death & ICD-10 Codes Number Rate 1 1 Diseases of heart (I00-I09, I11, I13, I20-I51) 5, Malignant neoplasms (C00-C97) 3, Cerebrovascular diseases (I60-I69) 1, Chronic lower respiratory diseases (J40-J47) Influenza & pneumonia (J10-J18) Accidents (V01-X59, Y85-Y86) Motor vehicle accid. (V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6,V20-V79, - V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2) All other accidents Diabetes mellitus (E10-E14) Alzheimer's disease (G30) Intentional self-harm (suicide) (X60-X84, Y87.0) Chronic liver disease & cirrhosis (K70, K73-K74) Parkinson's disease (G20-G21) Essential (primary) hypertension & hypertensive renal dis. (I10, I12) Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) Atherosclerosis (I70) Aortic aneurysm & dissection (I71) All other causes 2, Total 16, Mortality rate is calculated per 100,000 population in Orange County only. Population Source: State of California, Department of Finance, County Population Estimates and Components of Change, July 1, , with Historical Estimates, Sacramento, California, January Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

14 Fifteen Leading Causes of Death 1 Under one year of age Rank Cause of Death & ICD-10 Codes Number Rate 2 1 Congenital malformations & chromosomal abnormalities (Q00-Q99) Disorders relating to short gestation & low birth weight (P07) Diseases of the circulatory system (I00-I99) Sudden infant death syndrome (R95) Respiratory distress of newborn (P22) Newborn affected by complications of placenta, cord & membranes (P02) Bacterial sepsis of newborn (P36) Neonatal hemorrhage (P50-P52, P54) Newborn affected by maternal complications of pregnancy (P01) Atelectasis (P28.0, P28.1) Gastritis, duodenitis, and non-infective enteritis & colitis (K29, K50-K55) Accidents (V01-X59, Y85-Y86) Motor vehicle accid. (V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6,V20-V79, - V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2) All other accidents Hernia of abdominal cavity & intestinal obstuction - without hernia (K40-K46, K56) Meningococcal infections (A39) Malignant neoplasms (C00-C97) Diseases of the blood & blood-forming organs & certain disorders involving the immune mechanism (D50-D89) Influenza & pneumonia (J10-J18) Slow fetal growth & malnutrition (P05) Congenital pneumonia (P23) Hematological disorders (P60-P61) Necrotizing enterocolitis of newborn (P77) All other causes Total Rates not calculated for fewer than five deaths. 1 Infant deaths are based on the Federal list of 130 selected causes 2 These are infant death (not mortality) rates; rates are per 100,000 Orange County population in this age group Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

15 Fifteen Leading Causes of Death 1-4 years of age Rank Cause of Death & ICD-10 Codes Number Rate 1 1 Accidents (V01-X59, Y85-Y86) Motor vehicle accid. (V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6,V20-V79, - V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2) All other accidents Malignant neoplasms (C00-C97) Congenital malformations & chromosomal abnormalities (Q00-Q99) Diseases of heart (I00-I09, I11, I13, I20-I51) Assault (homicide) (X85-Y09, Y87.1) Chronic lower respiratory diseases (J40-J47) All other causes Total Rates not calculated for fewer than five deaths. 1 Mortality rate is calculated per 100,000 Orange County population in this age group. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

16 Fifteen Leading Causes of Death 5-9 years of age Rank Cause of Death & ICD-10 Codes Number Rate 1 1 Accidents (V01-X59, Y85-Y86) Motor vehicle accid. (V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6,V20-V79, - V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2) All other accidents Malignant neoplasms (C00-C97) Human immunodeficiency virus (HIV) disease (B20-B24) Diabetes mellitus (E10-E14) Diseases of heart (I00-I09, I11, I13, I20-I51) Epilepsy (G40) Other diseases of the stomach & duodenum (K31) Hanging, stangulation & suffocation, undetermined intent (Y20) Total Rates not calculated for fewer than five deaths. 1 Mortality rate is calculated per 100,000 Orange County population in this age group. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

17 Fifteen Leading Causes of Death years of age Rank Cause of Death & ICD-10 Codes Number Rate 1 1 Accidents (V01-X59, Y85-Y86) Motor vehicle accid. (V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6,V20-V79, - V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2) All other accidents Malignant neoplasms (C00-C97) Congenital malformations & chromosomal abnormalities (Q00-Q99) Diseases of heart (I00-I09, I11, I13, I20-I51) Chronic lower respiratory disease (J40-J47) Septicemia (A40-A41) Diabetes mellitus (E10-E14) Intentional self-harm (suicide) (X60-X84, Y87.0) Assault (homicide) (X85-Y09, Y87.1) All other causes Total Rates not calculated for five or fewer deaths 1 Mortality rate is calculated per 100,000 Orange County population in this age group. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

18 Fifteen Leading Causes of Death years of age Rank Cause of Death & ICD-10 Codes Number Rate 1 1 Accidents (V01-X59, Y85-Y86) Motor vehicle accid. (V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6,V20-V79, - V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2) All other accidents Assault (homicide) (X85-Y09, Y87.1) Malignant neoplasms (C00-C97) Intentional self-harm (suicide) (X60-X84, Y87.0) Diseases of heart (I00-I09, I11, I13, I20-I51) Diabetes mellitus (E10-E14) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) Hernia of abdominal cavity & intestinal obstruction - without hernia (K40-K46, K56) Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) Congenital malformations & chromosomal abnormalities (Q00-Q99) All other causes Total Rates not calculated for five or fewer deaths 1 Mortality rate is calculated per 100,000 Orange County population in this age group. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

19 Fifteen Leading Causes of Death years of age Rank Cause of Death & ICD-10 Codes Number Rate 1 1 Accidents (V01-X59, Y85-Y86) Motor vehicle accid. (V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6,V20-V79, - V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2) All other accidents Intentional self-harm (suicide) (X60-X84, Y87.0) Malignant neoplasms (C00-C97) Assault (homicide) (X85-Y09, Y87.1) Congenital malformations & chromosomal abnormalities (Q00-Q99) Human immunodeficiency virus (HIV) disease (B20-B24) Diseases of heart (I00-I09, I11, I13, I20-I51) Influenza & pneumonia (J10-J18) All other causes Total Rates not calculated for fewer than five deaths 1 Mortality rate is calculated per 100,000 Orange County population in this age group. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

20 Fifteen Leading Causes of Death years of age Rank Cause of Death & ICD-10 Codes Number Rate 1 1 Accidents (V01-X59, Y85-Y86) Motor vehicle accid. (V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6,V20-V79, - V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2) All other accidents Malignant neoplasms (C00-C97) Intentional self-harm (suicide) (X60-X84, Y87.0) Diseases of heart (I00-I09, I11, I13, I20-I51) Assault (homicide) (X85-Y09, Y87.1) Human immunodeficiency virus (HIV) disease (B20-B24) Cerebrovascular diseases (I60-I69) Viral hepatitis (B15-B19) Diabetes mellitus (E10-E14) Influenza & pneumonia (J10-J18) Pregnancy, childbirth & the puerperium (O00-O99) Congenital malformations & chromosomal abnormalities (Q00-Q99) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) Aortic aneurysm & dissection (I71) Chronic liver disease & cirrhosis (K70, K73-K74) Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) Legal intervention (Y35, Y89.0) All other causes Total Rates not calculated for fewer than five deaths 1 Mortality rate is calculated per 100,000 Orange County population in this age group. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

21 Fifteen Leading Causes of Death years of age Rank Cause of Death & ICD-10 Codes Number Rate 1 1 Malignant neoplasms (C00-C97) Accidents (V01-X59, Y85-Y86) Motor vehicle accid. (V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6,V20-V79, - V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2) All other accidents Diseases of heart (I00-I09, I11, I13, I20-I51) Intentional self-harm (suicide) (X60-X84, Y87.0) Human immunodeficiency virus (HIV) disease (B20-B24) Chronic liver disease & cirrhosis (K70, K73-K74) Cerebrovascular diseases (I60-I69) Diabetes mellitus (E10-E14) Chronic lower respiratory diseases (J40-J47) Congenital malformations & chromosomal abnormalities (Q00-Q99) Assault (homicide) (X85-Y09, Y87.1) Viral hepatitis (B15-B19) Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) Anemias (D50-D64) Aortic aneurysm & dissection (I71) Influenza & pneumonia (J10-J18) All other causes Total Rates not calculated for fewer than five deaths 1 Mortality rate is calculated per 100,000 Orange County population in this age group. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

22 Fifteen Leading Causes of Death years of age Rank Cause of Death & ICD-10 Codes Number Rate 1 1 Malignant neoplasms (C00-C97) Diseases of heart (I00-I09, I11, I13, I20-I51) Accidents (V01-X59, Y85-Y86) Motor vehicle accid. (V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6,V20-V79, - V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2) All other accidents Intentional self-harm (suicide) (X60-X84, Y87.0) Chronic liver disease & cirrhosis (K70, K73-K74) Cerebrovascular diseases (I60-I69) Diabetes mellitus (E10-E14) Chronic lower respiratory diseases (J40-J47) Viral hepatitis (B15-B19) Human immunodeficiency virus (HIV) disease (B20-B24) Aortic aneurysm & dissection (I71) Assault (homicide) (X85-Y09, Y87.1) Peptic ulcer (K25-K28) Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) Influenza & pneumonia (J10-J18) Complications of medical & surgical care (Y40-Y84, Y88) All other causes Total Rates not calculated for fewer than five deaths 1 Mortality rate is calculated per 100,000 Orange County population in this age group. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

23 Fifteen Leading Causes of Death years of age Rank Cause of Death & ICD-10 Codes Number Rate 1 1 Malignant neoplasms (C00-C97) Diseases of heart (I00-I09, I11, I13, I20-I51) Cerebrovascular diseases (I60-I69) Chronic lower respiratory diseases (J40-J47) Diabetes mellitus (E10-E14) Accidents (V01-X59, Y85-Y86) Motor vehicle accid. (V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6,V20-V79, - V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2) All other accidents Chronic liver disease & cirrhosis (K70, K73-K74) Intentional self-harm (suicide) (X60-X84, Y87.0) Influenza & pneumonia (J10-J18) Viral hepatitis (B15-B19) Aortic aneurysm & dissection (I71) Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) Human immunodeficiency virus (HIV) disease (B20-B24) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) Alzheimer's disease (G30) Essential (primary) hypertension & hypertensive renal disease (I10, I12) Assault (homicide) (X85-Y09, Y87.1) All other causes Total 1, Mortality rate is calculated per 100,000 Orange County population in this age group. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

24 Fifteen Leading Causes of Death years of age Rank Cause of Death & ICD-10 Codes Number Rate 1 1 Malignant neoplasms (C00-C97) 1, Diseases of heart (I00-I09, I11, I13, I20-I51) Chronic lower respiratory diseases (J40-J47) Cerebrovascular diseases (I60-I69) Diabetes mellitus (E10-E14) Influenza & pneumonia (J10-J18) Chronic liver disease & cirrhosis (K70, K73-K74) Accidents (V01-X59, Y85-Y86) Motor vehicle accid. (V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6,V20-V79, - V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2) All other accidents Parkinson's disease (G20-G21) Aortic aneurysm & dissection (I71) Alzheimer's disease (G30) Intentional self-harm (suicide) (X60-X84, Y87.0) Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) Essential (primary) hypertension & hypertensive renal disease (I10, I12) All other Total 2,855 1, Mortality rate is calculated per 100,000 Orange County population in this age group. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

25 Fifteen Leading Causes of Death years of age Rank Cause of Death & ICD-10 Codes Number Rate 1 1 Diseases of heart (I00-I09, I11, I13, I20-I51) 1,648 1, Malignant neoplasms (C00-C97) 1,167 1, Cerebrovascular diseases (I60-I69) Chronic lower respiratory diseases (J40-J47) Influenza & pneumonia (J10-J18) Diabetes mellitus (E10-E14) Alzheimer's disease (G30) Parkinson's disease (G20-G21) Accidents (V01-X59, Y85-Y86) Motor vehicle accid. (V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6,V20-V79, - V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2) All other accidents Aortic aneurysm & dissection (I71) Essential (primary) hypertension & hypertensive renal disease (I10, I12) Chronic liver disease & cirrhosis (K70, K73-K74) Atherosclerosis (I70) Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) All other Total 4,922 5, Mortality rate is calculated per 100,000 Orange County population in this age group. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

26 Fifteen Leading Causes of Death 85 years of age and over Rank Cause of Death & ICD-10 Codes Number Rate 1 1 Diseases of heart (I00-I09, I11, I13, I20-I51) 2,074 6, Cerebrovascular diseases (I60-I69) 568 1, Malignant neoplasms (C00-C97) 549 1, Influenza & pneumonia (J10-J18) Chronic lower respiratory diseases (J40-J47) Alzheimer's disease (G30) Atherosclerosis (I70) Essential (primary) hypertension & hypertensive renal disease (I10, I12) Diabetes mellitus (E10-E14) Accidents (V01-X59, Y85-Y86) Motor vehicle accid. (V02-V04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6,V20-V79, - V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2) All other accidents Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) Parkinson's disease (G20-G21) Aortic aneurysm & dissection (I71) Peptic ulcer (K25-K28) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) All other 519 1,516.8 Total 4,899 14, Mortality rate is calculated per 100,000 Orange County population in this age group. Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

27 Rank Number Rate 1 Total Male Female Cause of Death (ICD-10 code) Total Male Female Total Male Female Diseases of heart (I00-I09, I11, I13, I20-I51) 5,181 2,505 2, Acute rheumatic fever & chronic rheumatic heart diseases (I00-I09) Hypertensive heart disease (I11) Hypertensive heart & renal disease (I13) Ischemic heart diseases (I20-I25) 4,257 2,123 2, Acute myocardial infarction (I21-I22) 1, Other acute ischemic heart disease (I24) Other forms of chronic ischemic heart disease (I20, I25) 2,996 1,416 1, Atherosclerotic cardiovascular disease, so described (I25.0) All other forms of chronic ischemic heart disease (I20, I25.1-I25.9) 2,490 1,194 1, Other heart diseases (I26-I51) Acute & subacute endocarditis (I33) Diseases of pericardium & acute myocarditis (I30-I31, I40) Heart failure (I50) All other forms of heart disease (I26-I28, I34-I38, I42-I49, I51) Malignant neoplasms (C00-C97) 3,992 2,022 1, Malignant neoplasms of lip, oral cavity & pharynx (C00-C14) Malignant neoplasm of esophagus (C15) Malignant neoplasm of stomach (C16) Malignant neoplasms of colon, rectum and anus (C18-C21) Malignant neoplasms of liver & intrahepatic bile ducts (C22) Malignant neoplasm of pancreas (C25) Malignant neoplasm of larynx (C32) Malignant neoplasms of trachea, bronchus & lung (C33-C34) Malignant melanoma of skin (C43) Malignant neoplasm of breast (C50) Not ranked (only the broader category, which includes this item, is ranked) Section 2. Cause of Death by Gender Cause of Death by Rank and Gender Based on National Center of Health Statisitcs List of 113 selected Causes of Death -- Rates not calculated for fewer than five deaths 1 Rates per 100,000 Orange County population Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

28 Rank Number Rate 1 Total Male Female Cause of Death (ICD-10 code) Total Male Female Total Male Female Malignant neoplasm of cervix uteri (C53) Malignant neoplasms of corpus uteri & uterus, part unspecified (C54-C55) Malignant neoplasm of ovary (C56) Malignant neoplasm of prostate (C61) Malignant neoplasms of kidney & renal pelvis (C64-C65) Malignant neoplasm of bladder (C67) Malignant neoplasms of meninges, brain & other parts of CNS (C70-C72) Malig. neoplasms of lymphoid, hematopoietic & related tissues (C81-C96) Hodgkin's disease (C81) Non-Hodgkin's lymphoma (C82-C85) Leukemia (C91-C95) Multiple myeloma & immunoproliferative neoplasms (C88, C90) Oth. & unspec. malig. neoplasms of lymphoid & related tissues (C96) All other & unspecified malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44- C49, C51-C52, C57-C60, C62-C63, C66, C68-C69, C73-C80, C97) Cerebrovascular diseases (I60-I69) 1, Chronic lower respiratory diseases (J40-J47) Bronchitis, chronic & unspecified (J40-J42) Emphysema (J43) Asthma (J45-J46) Other chronic lower respiratory diseases (J44, J47) Influenza and pneumonia (J10-J18) Influenza (J10-J11) Pneumonia (J12-J18) Accidents (V01-X59, Y85-Y86) Transport accidents (V01-V99, Y85) Motor vehicle accid.(v02-v04, V09.0, V09.2, V12-V14, V19.0-V19.2, V19.4-V19.6,V20-V79, V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V83-V86, V87.0-V87.8, V88.0-V88.8, V89.0, V89.2) Oth. land transp. accid.(v01, V05-V06, V09.1, V09.3-V09.9, V10-V11, V15-V18, V19.3,V V19.9, V80.0-V80.2, V80.6-V80.9, V81.2-V81.9, V82.2-V82.9, V87.9, V88.9, V89.1, V89.3, V Not ranked (only the broader category, which includes this item, is ranked) -- Rates not calculated for fewer than five deaths 1 Rates per 100,000 Orange County population Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

29 Rank Number Rate 1 Total Male Female Cause of Death (ICD-10 code) Total Male Female Total Male Female Water, air, space, other & unspecified transport accidents (V90-V99, Y85) Nontransport accidents (W00-X59, Y86) Falls (W00-W19) Accidental discharge of firearms (W32-W34) Accidental drowning & submersion (W65-W74) Accidental exposure to smoke, fire & flames (X00-X09) Accidental poisoning & exposure to noxious substances (X40-X49) Other & unspecified nontransport accidents (W20-W31, W35-W64, W75-W99, X10-X39, X50-X59, Y86) Diabetes mellitus (E10-E14) Alzheimer's disease (G30) Intentional self-harm (suicide) (X60-X84, Y87.0) Intentional self-harm (suicide) by firearms (X72-X74) Intent'l self-harm (suicide) by oth. & unspec. means (X60-X71, X75-X84, Y87.0) Chronic liver disease & cirrhosis (K70, K73-K74) Alcoholic liver disease (K70) Other chronic liver disease & cirrhosis (K73-K74) Parkinson's disease (G20-G21) Essential (primary) hypertension & hypertensive renal disease (I10, I12) Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) Acute & rapidly progressive nephritic & nephrotic syndrome (N00-N01, N04) Chronic glomerulonephritis, nephritis, nephritis not specified as acute or chronic, & renal sclerosis unspecified (N02-N03, N05-N07, N26) Renal failure (N17-N19) Other disorders of kidney (N25, N27) Atherosclerosis (I70) Aortic aneurysm & dissection (I71) Congenital malformations & chromosomal abnormalities (Q00-Q99) Certain conditions originating in the perinatal period (P00-P96) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) Not ranked (only the broader category, which includes this item, is ranked) -- Rates not calculated for fewer than five deaths 1 Rates per 100,000 Orange County population Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

30 Rank Number Rate 1 Total Male Female Cause of Death (ICD-10 code) Total Male Female Total Male Female Assault (homicide) (X85-Y09, Y87.1) Assault (homicide) by firearms (X93-X95) Assault (homicide) by other & unspecified means (X85-X92, X96-Y09, Y87.1) Peptic ulcer (K25-K28) Human immunodefeciency virus (HIV) disease (B20-B24) Viral hepatitis (B15-B19) Septicemia (A40-A41) Cholelithiasis & other disorders of gallbladder (K80-K82) Anemias (D50-D64) Hernia (K40-K46) Complications of medical & surgical care (Y40-Y84, Y88) Tuberculosis (A16-A19) Respiratory tuberculosis (A16) Other tuberculosis (A17-A19) Infections of kidney (N10-N12, N13.6, N15.1) Hyperplasia of prostate (N40) Nutritional deficiencies (E40-E64) Malnutrition (E40-E46) Other nutritional deficiencies (E50-E64) Pneumonitis due to solids and liquids (J69) Meningitis (G00, G03) Pneumoconioses & chemical effects (J60-J66, J68) Diseases of appendix (K35-K38) Salmonella infections (A01-A02) Pregnancy, childbirth & the puerperium (O00-O99) Pregnancy with abortive outcome (O00-O07) Other complications of pregnancy, childbirth & puerperium (O10-O99) Meningococcal infection (A39) Legal intervention (Y35, Y89.0) Acute bronchitis & bronchiolitis (J20-J21) Not ranked (only the broader category, which includes this item, is ranked) -- Rates not calculated for fewer than five deaths 1 Rates per 100,000 Orange County population Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

31 Cause of Death (ICD-10 code) Total Male Female Total Male Female All causes 16,487 7,883 8, Certain infectious & parasitic diseases (A00-B99) Salmonella infections (A01-A02) Shigellosis and amebiasis (A03, A06) Certain other intestinal diseases (A04, A07-A09) Tuberculosis (A16-A19) Respiratory tuberculosis (A16) Other tuberculosis (A17-A19) Whooping cough (A37) Scarlet fever & erysipelas (A38, A46) Meningococcal infection (A39) Septicemia (A40-A41) Syphilis (A50-A53) Acute poliomyelitis (A80) Arthropod-borne viral encephalitis (A83-A84, A85.2) Measles (B05) Viral hepatitis (B15-B19) Human immunodeficiency virus (HIV) disease (B20-B24) Malaria (B50-B54) Other & unspecified infectious & parasitic diseases (A00, A05, A20-A36, A42- A44, A48-A49, A54-A79, A81-A82, A85.0-A85.1, A85.8, A86-B04, B06-B09, B25-B49, B55-B99) Malignant neoplasms (C00-C97) 3,992 2,022 1, Malignant neoplasms of lip, oral cavity & pharynx (C00-C14) Malignant neoplasm of esophagus (C15) Malignant neoplasm of stomach (C16) Malignant neoplasms of colon, rectum & anus (C18-C21) Rates not calculated for fewer than 5 deaths. 1 Rates per 100,000 Orange County population Cause of Death by Gender, Unranked, by ICD-10 Code National Center of Health Statistics List of 113 Selected Causes of Death No. of Deaths Rate 1 Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November

32 No. of Deaths Rate 1 Cause of Death (ICD-10 code) Total Male Female Total Male Female Malignant neoplasms of liver & intrahepatic bile ducts (C22) Malignant neoplasm of pancreas (C25) Malignant neoplasm of larynx (C32) Malignant neoplasms of trachea, bronchus & lung (C33-C34) Malignant melanoma of skin (C43) Malignant neoplasm of breast (C50) Malignant neoplasm of cervix uteri (C53) Malignant neoplasms of corpus uteri & uterus, part unspecified (C54-C55) Malignant neoplasm of ovary (C56) Malignant neoplasm of prostate (C61) Malignant neoplasms of kidney & renal pelvis (C64-C65) Malignant neoplasm of bladder (C67) Malignant neoplasms of meninges, brain & other parts of CNS (C70-C72) Malignant neoplasms of lymphoid, hematopoietic & related tissues (C81-C96) Hodgkin's disease (C81) Non-Hodgkin's lymphoma (C82-C85) Leukemia (C91-C95) Multiple myeloma & immunoproliferative neoplasms (C88, C90) Other & unspecified malignant neoplasms of lymphoid & related tissues (C96) All other & unspecified malignant neoplasms (C17, C23-C24, C26-C31, C37-C41, C44- C49, C51-C52, C57-C60, C62-C63, C66, C68-C69, C73-C80, C97) In situ neoplasms, benign neoplasms, & neoplasms of unknown behavior (D00-D48) Anemias (D50-D64) Diabetes mellitus (E10-E14) Nutritional deficiencies (E40-E64) Malnutrition (E40-E46) Other nutritional deficiencies (E50-E64) Meningitis (G00, G03) Parkinson's disease (G20-G21) Alzheimer's disease (G30) Rates not calculated for fewer than 5 deaths. 1 Rates per 100,000 Orange County population Prepared by: County of Orange, Health Care Agency, Epidemiology and Assessment, November