MORTALITY

Statistical Overview

There were 74,800 deaths of New Jersey residents in 2000 (Table M3).  This represents a 1.1 percent increase over 1999.  The crude death rate was 889.0 per 100,000 population and the age-adjusted rate was 852.4 (Table M1 and Figure M1).  Although the age-adjusted mortality rate remained nearly constant from 1999 to 2000, it had decreased 9.4 percent from the rate in 1990 (Table M1).  The age-adjusted death rate for males was 45.8 percent higher than the rate for females and the age-adjusted death rate for blacks was 33.2 percent higher than the rate for whites in 2000 (Table M2 and Figure M2).  Both figures represent a slight widening of the gaps that existed in 1999 (Baron Duffy, 2002).  For persons born in New Jersey in 2000, average life expectancy was 77.6 years.  For females, it was 80.1 years and for males it was 74.8 years.  Life expectancy for whites was 78.2 years and 71.8 years for blacks (Table M10 and Figure M4). 

Causes of Death

The ten leading causes of death remained unchanged from 1998 and 1999:  heart disease, cancer, stroke, chronic respiratory disease (CLRD), diabetes, unintentional injuries, influenza and pneumonia, septicemia, kidney disease, and Alzheimer's disease (Table M11).  These ten causes of death accounted for 80.8 percent of deaths in 2000 (Table M12).  The three leading causes of death among both sexes and all races (heart disease, cancer, and stroke) accounted for 61.6 percent of all deaths.  Chronic respiratory disease (CLRD) was the fourth leading cause of death for females and fifth for males.  Unintentional injury was the fourth leading cause of death among males, while it was ninth among females (Table M19).  HIV disease was the fourth leading cause of death among blacks and the nineteenth among whites (Table M20).  Unintentional injuries replaced cancer as the leading cause of death among residents 25-44 years old (Table M12).

There were 555,692 years of potential life lost (YPLL) before age 75 among New Jerseyans in 2000 (Table M21).  YPLL is the sum of all the years of life not lived by persons dying before reaching age 75 and is used as a measure of premature death.  For males, females, whites, and blacks, cancer was the leading cause of YPLL, followed by heart disease (Tables M21-M23 and Figures M8-M11).  Unintentional injury was the third leading cause of YPLL among all groups except blacks for whom HIV disease was ranked third (Tables M21-M23 and Figures M8-M11).

The age-adjusted death rate due to cancer was 8.8 percent lower in 2000 than it was in 1994.  Age-adjusted deaths rates for most cancer sites decreased over the time period (Table M24).  In 2000, 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).  Over 58 percent of cancer deaths occurred among those aged 65-84 (Table M25).  In 2000, the male age-adjusted death rate for cancer of the trachea, lung, and bronchus was 70.9 percent higher than the rate for females (Tables M26-M27). 

Firearms caused 341 deaths in 2000.  Of those, 172 were homicides, 154 were suicides, 12 were accidental, and 3 were of undetermined intent (Table M30).  The age-adjusted firearm death rate among males was 11 times the rate among females and the rate among blacks was 3.5 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 794 deaths, a 4.9 percent increase over the number in 1999 (Table M31).  Alcohol-related causes increased 9.6 percent since 1999 and 21.7 percent since 1998 to 500 deaths in 2000 (Table M32).  In 2000, the age-adjusted drug-related death rate among males was 2.9 times that of females and the age-adjusted alcohol-related death rate among males was 3.1 times the rate among females (Tables M31-M32).

Infant, Fetal, and Maternal Mortality

The number and rate of infant deaths decreased from 1999 (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).  Nearly 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 four 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 more than eight times as likely to die within the first year of life as those whose mothers received early prenatal care.  Infant mortality rates decreased with increasing maternal age until the 40-44 age group where rates rose again.  Infant mortality rates were about 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).  More than half of infant deaths had a medical risk factor reported on their birth certificate.  Previous preterm or small-for-gestational-age infant, incompetent cervix, and hydramnios/oligodramnios were the most commonly reported medical risk factors among infant death records.  Of newborns whose mothers had an incompetent cervix, 5.7 percent died within the first year of life (Table M45).  Congenital malformations, disorders related to short gestation and low birth weight, and sudden infant death syndrome (SIDS) were the three leading causes of infant deaths in 2000 (Table M46).

The fetal mortality rate and the number of fetal deaths decreased from 1999 (Table M40).  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).  Fetal deaths are more prevalent than infant deaths among older mothers and the negative correlation between mortality rates and maternal age reverses earlier - at the 35-39 year age group - than it does for infant mortality rates (Tables M44 and M47).  The fetal death rate among black non-Hispanics was three times the rate for white non-Hispanics and Hispanics (Table M48).  Cord and placenta complications remained the leading cause of fetal deaths in 2000 (Table M49).

Technical Changes

The data in this report may differ from comparable data presented in previous reports in this series because of six major changes in the reporting and analysis of mortality data.  Nationwide, the classification of causes of death (ICD) changed in 1999 and a policy that the standard population used for age-adjustment be changed from the US 1940 population to the US 2000 projected population was also adopted in 1999.  In New Jersey, the underlying cause of death from the multiple cause of death (MCD) file compiled by the National Center for Health Statistics (NCHS) was used to produce the tables in this report and the 1999 report.  In prior reports, the underlying cause from the single cause of death (SCD) file compiled internally was used.  Since the average life expectancy in New Jersey is over 75 years and to be comparable with federal reports, starting with this report, years of potential life lost (YPLL) are presented for persons under age 75 years of age.  Previous reports in this series presented YPLL before age 65.  Population figures used as denominators in the calculation of 2000 mortality rates are based on the 2000 Census.  1990-1999 mortality rates used population estimates based on the 1990 Census as denominators.  Consequently, there may be some breaks in mortality rate trends.   Because of these five changes, assessment of trends in death data should be undertaken with caution.  Also, 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.  For more detailed information on these changes, see New Jersey Health Statistics, 1999. 

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.