County of Orange Health Care Agency. Orange County Mortality Data, 2002

Transcription

1 County of Orange Health Care Agency Orange County Mortality Data, 2002 October 2005 Prepared by: County of Orange Health Care Agency Disease Control & Epidemiology Division Epidemiology & Assessment

2 Juliette A. Poulson, RN, MN Agency Director Mark B. Horton, MD, MSPH Deputy Agency Director/Health Officer Public Health Services Prepared By: Elisabeth J. Gonzalez, PhD Senior Research Analyst Data Analysis by: Elisabeth J. Gonzalez, PhD Senior Research Analyst Acknowledgements: Stephen W. Klish, MPH Senior Epidemiologist Reviewed By: Holly R. Harris, MPH Epidemiologist Michael L. Carson, MS Program Manager II Hildy Meyers, MD, MPH Medical Director Prepared by: County of Orange Health Care Agency Disease Control & Epidemiology Division Epidemiology & Assessment

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 October 2005 To our colleagues in public health: We are pleased to announce the availability of our statistical report, Orange County Mortality Data, This information is compiled by the State of California from death certificates filed with the Birth and Death Registration Office of the County of Orange Health Care Agency and other jurisdictions. This document is one 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 report can be 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 & Assessment website, Thank you for your interest in this special report. We encourage you to make other interested colleagues aware of its publication. If you would like more information, please feel free to contact Epidemiology & 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 Orange County Mortality Data, 2002 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 with 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...10 Fifteen Leading Causes of Death, 5-9 years of age...11 Fifteen Leading Causes of Death, years of age...12 Fifteen Leading Causes of Death, years of age...13 Fifteen Leading Causes of Death, years of age...14 Fifteen Leading Causes of Death, years of age...15 Fifteen Leading Causes of Death, years of age...16 Fifteen Leading Causes of Death, years of age...17 Fifteen Leading Causes of Death, years of age...18 Fifteen Leading Causes of Death, years of age...19 Fifteen Leading Causes of Death, years of age...20 Fifteen Leading Causes of Death, 85 years of age and over...21 Section 2. Cause of Death by Gender Cause of Death by Rank and Gender...22 Cause of Death by Gender, Unranked, by ICD-10 Code...26 iv

5 Section 3. Deaths by Race/Ethnicity Number of Deaths by Race/Ethnicity with Crude and Age-Adjusted Rates...31 Fifteen Leading Causes of Death, Non-Hispanic White...32 Fifteen Leading Causes of Death, Hispanic...33 Fifteen Leading Causes of Death, Southeast Asian...34 Fifteen Leading Causes of Death, Other Asian...35 Fifteen Leading Causes of Death, African-American...36 Section 4. Additional Tables Fifteen Leading Causes of Death by Selected Race/Ethnicity with Crude and Age- Adjusted Rates...37 Deaths Due to Malignant Neoplasms with Race/Ethnicity and Gender Detail...38 Deaths Due to External Causes with Age and Gender Detail...39 Deaths Due to Transport Accidents with Age Detail...41 Deaths Due to Intentional Self-Harm (Suicide) by Method, Age, and Sex...42 Deaths Due to Assault (Homicide) by Method, Age, and Sex...44 Deaths Due to Firearm Discharge by Method, Age, and Sex...45 Appendices Appendix 1. Technical Notes...46 Appendix 2. Population Estimates...51 v

6 Orange County Mortality Data, 2002: Executive Summary Summary of 2002 mortality data Total deaths and crude death rate There were 16,792 deaths among Orange County residents in 2002, a slight increase (0.3%) from the 16,734 deaths that were registered in The crude death rate was per 100,000 in 2002, a 1.3% decrease from 2001 when the rate was Comparison to California and United States 2002 age-adjusted death rates The overall age-adjusted death rate for Orange County in 2002 was per 100,000. The corresponding California rate of was slightly higher and the United States rate of (a record historical low) was significantly higher than Orange County. Of the fifteen leading causes of death in Orange County, 10 of the Orange County age-adjusted rates were lower than the United States and 10 were lower than California (Figure 1). Figure 1. Age-Adjusted Death Rates per 100,000 Population, 2002 Diseases of the heart Malignant neoplasms Cerebrovascular diseases Chronic lower respiratory disease Influenza & pneumonia Accidents Diabetes mellitus Alzheimer's disease Chronic liver disease & cirrhosis Intentional self-harm (suicide) Essential (primary) hypertension & hypertensive renal disease Parkinson's disease Atherosclerosis Nephritis, nephrotic syndrome & nephrosis Aortic aneurysm Orange County California United States 1 Orange County Mortality Data, 2002 Epidemiology & Assessment

7 Fifteen leading causes of death The fifteen leading causes of death accounted for 87.5% of all deaths in Diseases of the heart remained the leading cause of death among Orange County residents, accounting for 5,087 deaths (30.3%). Malignant neoplasms ranked second with 4,057 deaths (24.2%). Cancers of the trachea, bronchus, and lung accounted for the largest share of Malignant neoplasms with 981 deaths (5.8%), followed by lymphomas, leukemias and related cancers with 440 deaths (2.6%). The third leading cause of death was Cerebrovascular diseases, with 1,373 deaths, accounting for 8.2% of deaths. Gender differences There were 8,809 female and 7,983 male deaths among Orange County residents in The ranking of the leading causes of death in year 2002 for males and females is shown in Table 1. Table 1. Fifteen Leading Causes of Death by Gender, Orange County, 2002 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 diseases 4 Accidents 4 Chronic lower respiratory diseases 5 Accidents 5 Chronic lower respiratory diseases 5 Influenza and pneumonia 6 Influenza and Pneumonia 6 Influenza and Pneumonia 6 Alzheimer s disease 7 Diabetes mellitus 7 Diabetes mellitus 7 Accidents 8 Alzheimer s disease 8 Intentional self-harm (suicide) 8 Diabetes mellitus 9 Intentional self-harm 9 Chronic liver disease and 9 Essential hypertension (suicide) cirrhosis and hypertensive renal disease 10 Chronic liver disease and 10 Alzheimer s disease 10 Atherosclerosis cirrhosis 11 Essential hypertension and 11 Parkinson s disease 11 Parkinson s disease hypertensive renal disease 12 Parkinson s disease 12 Essential hypertension and 12 Chronic liver disease hypertensive renal disease and cirrhosis 13 Atherosclerosis 12 Aortic aneurysm 13 In situ neoplasms, benign neoplasms, and neoplasms of unknown behavior 14 Nephritis, nephrotic 14 Assault (homicide) 14 Nephritis, nephrotic syndrome and nephrosis 15 Aortic aneurysm 15 Nephritis, nephrotic syndrome and nephrosis syndrome and nephrosis 15 Intentional self-harm (suicide) 2 Orange County Mortality Data, 2002 Epidemiology & Assessment

8 Deaths by age group The majority (60.6%) of all deaths among Orange County residents in 2002 were among those aged 75 years and older. Please see Figure Figure 2. Deaths by Age Group, Orange County, ,068 5, Number , , < Age Group (years) Among infants less than 1 year of age, the leading cause of death was Congenital malformation, deformations, and chromosomal abnormalities (57 deaths), followed by Disorders relating to short gestation and low birth weight (30 deaths), Respiratory distress (12 deaths), and Diseases of the Circulatory System and Accidents (10 deaths each). The leading cause of deaths for age groups 1-4, 5-9, 15-19, 20-24, and years was Accidents. For the age groups and through years, Malignant neoplasms were the leading cause of death. Diseases of the heart were the leading cause of death for those aged and 85 years and over. 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 and year age groups (for which Assault was the 2 nd leading cause and suicide was the 4 th and 3 rd leading cause, respectively). See Table 2 for ranking of suicide by age group. 3 Orange County Mortality Data, 2002 Epidemiology & Assessment

9 Table 2. Ranking of Intentional self-harm (suicide) by Age Group, Orange County, 2002 Age Group (years) Suicide rank within age group Number of suicides Assault (homicide) was a leading cause of death for age groups 1-4 through years of age. Homicide was the second leading cause of death for persons in the and year age groups. Human immunodeficiency virus (HIV) disease, the 21 st leading cause of death for all ages, was ranked highest among year olds and year-olds (ranked 6 th for both categories, 10 and 22 deaths, respectively). Additionally, HIV disease was a leading cause of death for year olds (ranked 8 th, 17 deaths), and year olds (ranked 14 th, 8 deaths). Leading causes by race/ethnicity Non-Hispanic Whites accounted for 80.3% of all Orange County deaths in the year 2002, while Hispanics accounted for 10.5%, Southeast Asians 2.9%, Other Asians 4.7%, African Americans 1.1%, and others less than 1%. Crude rates of death per 100,000 population were as follows: Non-Hispanic Whites 911.1; African Americans 415.6; Asians 306.7; and Hispanics Diseases of the heart was the leading cause of death for Whites and Hispanics. Malignant neoplasms were the leading cause of death for Asians. Diseases of the heart and Malignant neoplasms were equal for African Americans, with 46 deaths each. Age-adjusted rates by race/ethnicity Age-adjusted rates of death per 100,000 population were as follows: African Americans 845.5; Non- Hispanic Whites 735.4; Hispanics 537.3; and Asians Age-adjusted rates differed dramatically between race/ethnicity groups for many of the leading causes of death. Age-adjusted rates were higher for Whites than Hispanics for 11 of the 15 leading causes of death, and higher for Whites than Asians for 12 of the 15 leading causes of death. Due to a relatively small percentage of African Americans in the Orange County population, rates are available for only 8 of the 15 leading causes of death for this race/ethnicity category. Of those 8 leading causes, African Americans had higher rates than did Whites for 5 leading causes, and higher rates than did Asians or Hispanics for 7 leading causes. African Americans had the highest death rate due to Diseases of the heart (260.5 per 100,000), followed by Whites (228.2 per 100,000), Hispanics (161.7 per 100,000), and Asians (137.4 per 100,000). Non- Hispanic Whites had the highest death rate due to Malignant neoplasms (179.8 per 100,000), followed by African Americans (162.9 per 100,000), Asians (127.4 per 100,000), and Hispanics (111.9 per 100,000). Age-adjusted rates for these and other leading causes of death are depicted in Figure 3. 4 Orange County Mortality Data, 2002 Epidemiology & Assessment

10 Figure 3. Age-Adjusted Rates by Race/Ethnicity per 100,000 Population, Orange County, 2002 Diseases of the heart Malignant neoplasms Cerebrovascular diseases Chronic lower respiratory disease Accidents Influenza & pneumonia Diabetes mellitus Alzheimer's disease Intentional self-harm (suicide) Chronic liver disease & cirrhosis Essential (primary) hypertension & hypertensive renal disease Parkinson's disease Atherosclerosis Nephritis, nephrotic syndrome & nephrosis Aortic aneurysm White Hispanic Asian African-American Injury mortality (external causes of death) Intentional self-harm (suicide) was the leading external cause of death in Orange County in 2002, with 241 deaths. The second leading external cause of death was Motor vehicle accidents with 212 deaths. These were followed by Accidental poisoning (168 deaths), Falls (119 deaths), and Assault (homicide) (93 deaths). Among victims of Falls, 64.7% of deaths were among those aged 75 years and older. There were a total of 228 transport accident deaths, including 131 deaths to occupants of a car, pick-up truck, or van, 43 pedestrian deaths, 16 motorcyclist deaths, 10 pedal cyclist deaths, and 28 other transport accident deaths. A total of 30 deaths by Accidental drowning occurred; of these, 7 (23.3%) were among children aged 1-4 years of age. In 2002, there was one drowning death of an infant. Firearms were involved in 179 deaths: 110 suicides, 63 homicides, 3 deaths during legal intervention, 2 deaths due to undetermined intent, and 1 accidental death. Firearms were used in 45.6% of suicides and 67.7% of homicides. Figure 4 shows that in the last 20 years, the suicide rate has decreased 41.0% from 13.9 per 100,000 in 1983 to 8.2 in 2002 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 comparability ratios published by the National Center for Health Statistics. 5 Orange County Mortality Data, 2002 Epidemiology & Assessment

11 Figure 4. Intentional Self-Harm (Suicide) Mortality Rate, Orange County, ICD-9 ICD-10 Rate per 100,000 population Year Orange County Mortality Data, 2002 Epidemiology & Assessment

12 Section 1 Deaths by Age Group Age-Adjusted Death Rates for the 15 Leading Causes of Death Comparing Orange County with California and the United States, 2002 All ages Orange United Cause of Death County 1 California 2 States 3 All causes Diseases of the 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) Chronic liver disease & cirrhosis (K70, K73-K74) Intentional self-harm (suicide) (X60-X84, Y87.0) Essential (primary) hypertension & hypertensive renal disease (I10, I12) Parkinson's disease (G20-G21) Atherosclerosis (I70) Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) Aortic aneurysm (I71) Mortality rate is calculated per 100,000 Orange County population. 2 State of California, Department of Health Services ( 3 National Vital Statistics Reports, Vol. 53, No. 5, National Center for Health Statistics, October 12, Epidemiology Assessment 7 Orange County Mortality Data, 2002

13 Fifteen Leading Causes of Death All ages Rank Cause of Death & ICD-10 Codes Number Rate 1 1 Diseases of the heart (I00-I09, I11, I13, I20-I51) 5, Malignant neoplasms (C00-C97) 4, Cerebrovascular diseases (I60-I69) 1, Chronic lower respiratory diseases (J40-J47) 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 Influenza & pneumonia (J10-J18) Diabetes mellitus (E10-E14) Alzheimer's disease (G30) Intentional self-harm (suicide) (X60-X84, Y87.0) Chronic liver disease & cirrhosis (K70, K73-K74) Essential (primary) hypertension & hypertensive renal disease (I10, I12) Parkinson's disease (G20-G21) Atherosclerosis (I70) Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) Aortic aneurysm (I71) All other causes 2, Total 16, Mortality rate is calculated per 100,000 Orange County population. Population Source: State of California, Department of Finance, Race/Ethnic Population with Age and Sex Detail, Sacramento, CA, May, Epidemiology & Assessment 8 Orange County Mortality Data, 2002

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) Respiratory distress of newborn (P22) Diseases of the circulatory system (I00-I99) 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 Newborn affected by complications of placenta, cord & membranes (P02) Renal failure and other disorders of kidney (N17-N19, N25, N27) Bacterial sepsis of newborn (P36) Newborn affected by maternal complications of pregnancy (P01) Intrauterine hypoxia & birth asphyxia (P20-P21) Neonatal hemorrhage (P50-P52, P54) Malignant neoplasms (C00-C97) Birth trauma (P10-P15) Sudden infant death syndrome (R95) Neonatal aspiration syndrome (P24) Interstitial emphysema & related conditions (P25) Chronic respiratory disease originating in the perinatal period (P27) Atelectasis (P28.0, P28.1) 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. Epidemiology & Assessment 9 Orange County Mortality Data, 2002

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) Influenza & pneumonia (J10-J18) Diseases of the heart (I00-I09, I11, I13, I20-I51) Assault (homicide) (X85-Y09, Y87.1) All other causes 4 -- Total Rates not calculated for fewer than five deaths. 1 Mortality rate is calculated per 100,000 Orange County population in this age group. Epidemiology & Assessment 10 Orange County Mortality Data, 2002

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) Congenital malformations & chromosomal abnormalities (Q00-Q99) Assault (homicide) (X85-Y09, Y87.1) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) Anemias (D50-D64) Diseases of the heart (I00-I09, I11, I13, I20-I51) 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. Epidemiology & Assessment 11 Orange County Mortality Data, 2002

17 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 Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) Congenital malformations & chromosomal abnormalities (Q00-Q99) Diabetes mellitus (E10-E14) Assault (homicide) (X85-Y09, Y87.1) 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. Epidemiology & Assessment 12 Orange County Mortality Data, 2002

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 the heart (I00-I09, I11, I13, I20-I51) Congenital malformations & chromosomal abnormalities (Q00-Q99) Meningitis (G00, G03) Chronic lower respiratory diseases (J40-J47) Diseases of appendix (K35-K38) 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. Epidemiology & Assessment 13 Orange County Mortality Data, 2002

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 Assault (homicide) (X85-Y09, Y87.1) Malignant neoplasms (C00-C97) Intentional self-harm (suicide) (X60-X84, Y87.0) Diseases of the heart (I00-I09, I11, I13, I20-I51) Anemias (D50-D64) Cerebrovascular diseases (I60-I69) Diseases of appendix (K35-K38) Pregnancy, childbirth & the puerperium (O00-O99) 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. Epidemiology & Assessment 14 Orange County Mortality Data, 2002

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) Assault (homicide) (X85-Y09, Y87.1) Diseases of the heart (I00-I09, I11, I13, I20-I51) 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) Influenza & pneumonia (J10-J18) Congenital malformations & chromosomal abnormalities (Q00-Q99) Meningitis (G00, G03) Viral hepatitis (B15-B19) Anemias (D50-D64) Essential (primary) hypertension & hypertensive renal disease (I10, I12) Aortic aneurysm & dissection (I71) Hernia (K40-K46) 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. Epidemiology & Assessment 15 Orange County Mortality Data, 2002

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 the heart (I00-I09, I11, I13, I20-I51) Intentional self-harm (suicide) (X60-X84, Y87.0) Assault (homicide) (X85-Y09, Y87.1) Human immunodeficiency virus (HIV) disease (B20-B24) Chronic liver disease & cirrhosis (K70, K73-K74) Cerebrovascular diseases (I60-I69) Diabetes mellitus (E10-E14) Essential (primary) hypertension & hypertensive renal disease (I10, I12) Chronic lower respiratory diseases (J40-J47) Congenital malformations & chromosomal abnormalities (Q00-Q99) Viral hepatitis (B15-B19) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) Aortic aneurysm & dissection (I71) Peptic ulcer (K25-K28) 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. Epidemiology & Assessment 16 Orange County Mortality Data, 2002

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 the 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 Chronic liver disease & cirrhosis (K70, K73-K74) Intentional self-harm (suicide) (X60-X84, Y87.0) Cerebrovascular diseases (I60-I69) Diabetes mellitus (E10-E14) Human immunodeficiency virus (HIV) disease (B20-B24) Viral hepatitis (B15-B19) Influenza & pneumonia (J10-J18) Peptic ulcer (K25-K28) Congenital malformations & chromosomal abnormalities (Q00-Q99) Chronic lower respiratory diseases (J40-J47) Assault (homicide) (X85-Y09, Y87.1) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) Essential (primary) hypertension & hypertensive renal disease (I10, I12) Aortic aneurysm & dissection (I71) 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. Epidemiology & Assessment 17 Orange County Mortality Data, 2002

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 the heart (I00-I09, I11, I13, I20-I51) Cerebrovascular diseases (I60-I69) 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) Chronic lower respiratory diseases (J40-J47) Intentional self-harm (suicide) (X60-X84, Y87.0) Aortic aneurysm & dissection (I71) Essential (primary) hypertension & hypertensive renal disease (I10, I12) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) Influenza & pneumonia (J10-J18) Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) Human immunodeficiency virus (HIV) disease (B20-B24) Congenital malformations & chromosomal abnormalities (Q00-Q99) All other causes Total 1, Mortality rate is calculated per 100,000 Orange County population in this age group. Epidemiology & Assessment 18 Orange County Mortality Data, 2002

24 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 the 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 Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) Parkinson's disease (G20-G21) Essential (primary) hypertension & hypertensive renal disease (I10, I12) Aortic aneurysm & dissection (I71) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) Intentional self-harm (suicide) (X60-X84, Y87.0) Alzheimer's disease (G30) All other causes Total 2,709 1, Mortality rate is calculated per 100,000 Orange County population in this age group. Epidemiology & Assessment 19 Orange County Mortality Data, 2002

25 Fifteen Leading Causes of Death years of age Rank Cause of Death & ICD-10 Codes Number Rate 1 1 Diseases of the heart (I00-I09, I11, I13, I20-I51) 1,599 1, Malignant neoplasms (C00-C97) 1,235 1, Cerebrovascular diseases (I60-I69) Chronic lower respiratory diseases (J40-J47) Influenza & pneumonia (J10-J18) Alzheimer's disease (G30) 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 Parkinson's disease (G20-G21) Essential (primary) hypertension & hypertensive renal disease (I10, I12) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) Aortic aneurysm & dissection (I71) Atherosclerosis (I70) Chronic liver disease & cirrhosis (K70, K73-K74) All other causes Total 5,068 4, Mortality rate is calculated per 100,000 Orange County population in this age group. Epidemiology & Assessment 20 Orange County Mortality Data, 2002

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 the heart (I00-I09, I11, I13, I20-I51) 2,119 5, Malignant neoplasms (C00-C97) 621 1, Cerebrovascular diseases (I60-I69) 607 1, Influenza & pneumonia (J10-J18) Chronic lower respiratory diseases (J40-J47) Alzheimer's disease (G30) Atherosclerosis (I70) Diabetes mellitus (E10-E14) Essential (primary) hypertension & hypertensive renal disease (I10, I12) 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) Nephritis, nephrotic syndrome & nephrosis (N00-N07, N17-N19, N25-N27) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) Aortic aneurysm & dissection (I71) Peptic ulcer (K25-K28) All other causes 496 1,333.6 Total 5,116 13, Mortality rate is calculated per 100,000 Orange County population in this age group. Epidemiology & Assessment 21 Orange County Mortality Data, 2002

27 Section 2. Cause of Death by Gender Cause of Death by Rank and Gender Based on National Center for Health Statistics List of 113 selected Causes of Death Rank No. of Deaths Rate 1 Total Male Female Cause of Death (ICD-10 code) Total Male Female Total Male Female Diseases of the heart (I00-I09, I11, I13, I20-I51) 5,087 2,363 2, Acute rheumatic fever & chronic rheumatic heart diseases (I00-I09) Hypertensive heart disease (I11) Hypertensive heart & renal disease (I13) Ischemic heart diseases (I20-I25) 4,101 1,929 2, Acute myocardial infarction (I21-I22) 1, Other acute ischemic heart disease (I24) Other forms of chronic ischemic heart disease (I20, I25) 2,949 1,376 1, Atherosclerotic cardiovascular disease, so described (I25.0) All other forms of chronic ischemic heart disease (I20, I25.1-I25.9) 2,402 1,145 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) 4,057 2,039 2, 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). -- Rates not calculated for fewer than five deaths. 1 Rates per 100,000 Orange County population. Epidemiology & Assessment 22 Orange County Mortality Data, 2002

28 Rank No. of Deaths 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) 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 Water, air, space, other & unspecified transport accidents (V90-V99, Y85) Nontransport accidents (W00-X59, Y86) Falls (W00-W19) Accidental discharge of firearms (W32-W34) 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. Epidemiology & Assessment 23 Orange County Mortality Data, 2002

29 Rank No. of Deaths Rate 1 Total Male Female Cause of Death (ICD-10 code) Total Male Female Total Male Female 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) Influenza & pneumonia (J10-J18) Influenza (J10-J11) Pneumonia (J12-J18) 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) Essential (primary) hypertension & hypertensive renal disease (I10, I12) Parkinson's disease (G20-G21) Atherosclerosis (I70) 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) Aortic aneurysm & dissection (I71) In situ neopl., benign neopl., & neoplasms of unknown behavior (D00-D48) Certain conditions originating in the perinatal period (P00-P96) Congenital malformations & chromosomal abnormalities (Q00-Q99) 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. Epidemiology & Assessment 24 Orange County Mortality Data, 2002

30 Rank No. of Deaths 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 immunodeficiency virus (HIV) disease (B20-B24) Viral hepatitis (B15-B19) Cholelithiasis & other disorders of gallbladder (K80-K82) Hernia (K40-K46) Septicemia (A40-A41) Infections of kidney (N10-N12, N13.6, N15.1) Anemias (D50-D64) Pneumonitis due to solids and liquids (J69) Complications of medical & surgical care (Y40-Y84, Y88) Diseases of appendix (K35-K38) Tuberculosis (A16-A19) Respiratory tuberculosis (A16) Other tuberculosis (A17-A19) Meningococcal infection (A39) Hyperplasia of prostate (N40) Nutritional deficiencies (E40-E64) Malnutrition (E40-E46) Other nutritional deficiencies (E50-E64) Meningitis (G00, G03) Pneumoconioses & chemical effects (J60-J66, J68) Legal intervention (Y35, Y89.0) Acute bronchitis & bronchiolitis (J20-J21) Whooping cough (A37) Syphilis (A50-A53) Inflammatory diseases of female pelvic organs (N70-N76) Pregnancy, childbirth & the puerperium (O00-O99) Pregnancy with abortive outcome (O00-O07) Other complications of pregnancy, childbirth & puerperium (O10-O99) Not ranked (only the broader category, which includes this item, is ranked). -- Rates not calculated for fewer than five deaths. Rates per 100,000 Orange County population. Epidemiology & Assessment 25 Orange County Mortality Data, 2002

31 Cause of Death (ICD-10 code) Total Male Female Total Male Female All causes 16,792 7,983 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) 4,057 2,039 2, 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 for Health Statistics List of 113 Selected Causes of Death No. of Deaths Rate 1 Epidemiology & Assessment 26 Orange County Mortality Data, 2002

32 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. No. of Deaths Rate 1 Epidemiology & Assessment 27 Orange County Mortality Data, 2002

33 Cause of Death (ICD-10 code) Total Male Female Total Male Female Major cardiovascular diseases (I00-I78) 6,958 3,104 3, Diseases of the heart (I00-I09, I11, I13, I20-I51) 5,087 2,363 2, Acute rheumatic fever & chronic rheumatic heart diseases (I00-I09) Hypertensive heart disease (I11) Hypertensive heart & renal disease (I13) Ischemic heart diseases (I20-I25) 4,101 1,929 2, Acute myocardial infarction (I21-I22) 1, Other acute ischemic heart disease (I24) Other forms of chronic ischemic heart disease (I20, I25) 2,949 1,376 1, Atherosclerotic cardiovascular disease, so described (I25.0) All other forms of chronic ischemic heart disease (I20, I25.1-I25.9) 2,402 1,145 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) Essential (primary) hypertension & hypertensive renal disease (I10, I12) Cerebrovascular diseases (I60-I69) 1, Atherosclerosis (I70) Other diseases of circulatory system (I71-I78) Aortic aneurysm & dissection (I71) Other diseases of arteries, arterioles & capillaries (I72-I78) Other disorders of circulatory system (I80-I99) Influenza & pneumonia (J10-J18) Influenza (J10-J11) Pneumonia (J12-J18) Other acute lower respiratory infections (J20-J22) Acute bronchitis & bronchiolitis (J20-J21) Unspecified acute lower respiratory infection (J22) Rates not calculated for fewer than 5 deaths. 1 Rates per 100,000 Orange County population. No. of Deaths Rate 1 Epidemiology & Assessment 28 Orange County Mortality Data, 2002