The distribution of the leading causes of death among the population over the age of one, by broad age group, can be found in Chart M2.

Mortality Among One Through Four Year Olds

There were 143 deaths of New Jersey children aged one through four years in 1997. The leading cause of death of children in this age group continued to be unintentional injuries which accounted for 37 deaths or 25.9 percent of the total (Table M19). Sixteen of the unintentional injury deaths were related to the use of motor vehicles and 21 were due to other unintentional injuries. The number of unintentional injury deaths in this age group was higher in 1997 than in the previous two years but still lower than in the late 1980s and early 1990s. The number of deaths in any year from unintentional injuries is small, so no long-term trend can be assumed.

The second leading cause of death of one through four year olds in 1997 was homicide, which accounted for 15 deaths or 10.5 percent of the total.

Deaths from congenital anomalies (14), cancer (10), and pneumonia/influenza (7) were the third through fifth leading causes of death among one through four year olds. There were seven deaths of males and three deaths of females from cancer in this age group (Table M4). Five of those deaths were due to leukemia and three to cancer of the nervous system.

Mortality Among Five Through 14 Year Olds

There were 194 deaths of New Jersey children aged five through 14 years in 1997. The leading cause of death in this age group was unintentional injuries (Table M20 and Figure M3), which accounted for 57 deaths or 29.4 percent of the total deaths. Of these deaths, 29 were related to the use of motor vehicles and 28 were due to other unintentional injuries. The general trend in unintentional injury deaths over the decade has been a decline, especially in motor vehicle-related deaths. After achieving a low point in 1996, the rate for other unintentional injury deaths increased in 1997.

The second leading cause of death in this age group over the decade was cancer, which caused 31 deaths. The cancer death rate has fluctuated over the past ten years and stood at 2.8 per 100,000 population in 1997. Of the deaths from cancer, twelve were due to leukemia and nine were cancer of the nervous system (Table M5). The overall cancer death rates were slightly higher for males than for females, but because of the small numbers, no conclusions can be drawn about the differences in death rates by site between males and females.

Congenital anomalies was the third leading cause of death of young people five through 14 in 1997, responsible for 15 deaths. Deaths due to HIV infection numbered 14 in 1997 and were the fourth leading cause of death in this age group, followed by homicide, which was responsible for nine deaths.

Mortality Among 15 Through 24 Year Olds

There were 666 deaths of New Jersey residents 15 through 24 years of age in 1997. Injuries continued to account for a large proportion of the deaths in this age group; there were 248 unintentional injury deaths, 125 homicides, and 59 deaths from suicide (Table M21 and Figure M4). These causes, plus 19 injury deaths of undetermined intentionality were responsible for two-thirds of deaths of 15 through 24 year olds (67.7%). There was no trend in numbers of deaths or death rates for unintentional injury or homicide over the previous ten years. The suicide death rate declined 15.5 percent from 1996 and 27.7 percent from 1995.

In 1997, the number of deaths (49) in this age group due to cancer increased again, after reaching a ten-year low in 1995 (Table M21). The cancer death rate in males was 27.3 percent higher than the female death rate (5.6 and 4.4 per 100,000 sex-specific population, respectively). The cancer type with the highest rate in females was leukemia (6 deaths or 1.3 per 100,000 females 15 through 24), while cancer of the bone, skin, and connective tissue caused the highest death rate in males (9 deaths or 1.8 per 100,000 males 15 through 24) (Table M6).

Mortality Among 25 Through 44 Year Olds

There were 4,168 deaths of New Jersey residents aged 25 through 44 in 1997. This figure is a decrease of 664 from the number of deaths reported ten years earlier in 1988. The death rate per 1,000 population for this age group decreased by 15.8 percent over the past ten years, from 1.9 in 1988 to 1.6 in 1997 (Table M16). Major factors in this decrease in the death rate are declines in the numbers of HIV infection, heart disease, cirrhosis, and homicide deaths.

Unintentional injuries ranked first as a cause of death in this age group. The majority of these deaths (436 deaths or 52.2%) were due to accidental poisonings by drugs, medicinal substances, and biologicals, a category which encompasses accidental drug overdoses (CHS, 2000b). An additional 250 deaths (29.9% of unintentional injury deaths) were due to motor vehicle fatalities.

HIV infection had been the leading cause of death in this age group since 1988, the first year in which it could be identified as a separate, distinct cause of death (Table M22). In 1997, HIV infection dropped to the second leading cause of death among 25 through 44 year olds and was responsible for 663 deaths. For the first time, the number of deaths from HIV infection in this age group was below the number in 1988. The age-specific death rate had risen from 36.7 to 69.5 per 100,000 population by 1995. In 1997, the rate was 26.0 (Figure M4).
Cancer was the third leading cause of death of New Jerseyans 25 through 44, causing 645 deaths in 1997. More cancer deaths in this age group were caused by female breast cancer (117 deaths) than any other type, followed by lung and bronchus cancer (93 deaths) (Table M7). Other high frequency types of cancer deaths in this age group were cancer of the digestive organs other than the colon and rectum (70); cancer of the bone, skin, and connective tissue (51); nervous system cancer (45); and cancer of hematopoietic tissue other than leukemia (57 deaths). This is the youngest age group in which there were deaths from female breast cancer.

Diseases of the heart, suicide, homicide and legal intervention, and chronic liver disease and cirrhosis were the fourth through seventh ranking causes of death in this age group. Injury deaths including unintentional injuries, suicide, homicide and legal intervention, and other external causes accounted for 30.3 percent of the deaths of persons in this age group.

Mortality Among 45 Through 64 Year Olds

There were 11,223 deaths of New Jersey residents aged 45 through 64 years in 1997. For more a decade, malignant neoplasms have been the leading cause of deaths in this age group and diseases of the heart has ranked second (Table M23 and Figure M6). Together, these two causes accounted for 6,794 deaths (60.5% of the total) in this age group in 1997. Deaths from both of these causes have been declining; however, deaths from heart disease have been declining at a faster rate than cancer deaths.

There were 4,100 deaths from cancer in this age group in 1997. Lung and bronchus cancer caused more deaths overall in this age group and in both males and females than any other cancer type, accounting for 1,193 deaths (Table M8). Although the death rate from lung and bronchus cancer was high in both males and females, the death rate in males was 36.3 percent higher than the female rate. Among males, the next most frequent causes of malignant neoplasm deaths were cancer of the digestive organs other than the colon and rectum (346), colon and rectum cancer (219), hematopoietic tissue cancer other than leukemia (139), and cancer of the urinary organs (106 deaths). Other than lung and bronchus cancer, female cancer death rates were highest from female breast cancer (505), cancer of the digestive organs other than the colon and rectum (200), cancer of the female genital organs other than the cervix uteri (199), and cancer of the colon and rectum (154 deaths). For each of the cancer sites with the exception of those that are sex-specific, the male death rates were higher than the comparable female rates.

Diabetes mellitus was the third leading cause of death among residents 45 through 64 years old in 1997, responsible for 478 deaths. The death rate from diabetes mellitus increased sharply in 1989, which was the year of implementation of a revised death certificate which was designed to clarify the certification of the cause of death. Since 1989, the death rate has been higher than in previous years, but relatively stable until 1995. The number of deaths and the death rates in 1997, however, were near the levels recorded between 1989 and 1993 (Table M23). Stroke was the fourth leading cause of death in this age group though its rate was at a ten-year low in 1997. The fifth leading cause of death among 45 through 64 year olds was unintentional injuries. This cause was responsible for 421 deaths in 1997. This was the highest number of deaths from unintentional injuries in the previous ten years. The number of deaths and death rate for chronic liver disease and cirrhosis, the sixth leading cause of death, were at a ten-year low in 1997. For the first time since 1991, HIV infection was not among the six leading causes of death among 45 through 64 year olds.

Mortality Among The Population Aged 65 And Over

There were 54,825 deaths of New Jersey residents aged 65 and over in 1997, a decrease of 0.4 percent from the 1996 number. Over three-fourths of all deaths of New Jerseyans in 1997 (76.1%) occurred among the elderly. The number of deaths of elderly New Jerseyans has increased in recent years, but because of growth in the population over 65, the age-specific death rate has generally been declining.

Heart disease and cancer continued to rank first and second as the leading causes of death of the elderly, together accounting for 60.2 percent of the deaths in this age group in 1997. While deaths from heart disease have declined during the past ten years, the number of cancer deaths and the cancer death rate had been increasing until 1995 after which they began to decline (Table M24 and Figure M7).

There were 13,067 deaths from cancer in New Jerseyans 65 and over in 1997, 10,656 of persons 65 through 84 and 2,411 of those 85 and over. Among the "younger elderly," those 65 through 84 years, cancer of the lung and bronchus was the leading cause of death from cancer, overall and in both males and females (Table M9). Lung and bronchus cancer was the underlying cause in 3,076 deaths of New Jerseyans 65 through 84 years of age. The death rate from lung and bronchus cancer in this age group was nearly twice as high in males as in females. The second highest cancer death rate among males 65 through 84 was from cancer of the digestive organs other than the colon and rectum, while breast cancer was the second most frequent cause of death from cancer among females in the age group.

The overall cancer death rate among the "older elderly," persons 85 and over, was almost twice that of the 65 through 84 year olds (Tables M9 and M10). The death rates by site were higher among the older elderly in every case with the exception of male genital organs other than the prostate and unspecified male genital organs, which caused no deaths of the older elderly in 1997. Among males 85 and over, the leading causes of death from malignant neoplasms were cancer of the prostate, followed by lung and bronchus cancer, and cancer of the colon and rectum and other digestive organs (Table M10). Female death rates in the older elderly population were highest from cancer of the colon and rectum, other digestive organs, and the breast.

Stroke, the third leading cause of death among persons 65 and over, had decreased in number from 1988 to 1990 and then began increasing through 1996 (Table M24). The death rate from stroke has generally steady since 1990. At the same time, COPD and pneumonia/ influenza, the fourth and fifth leading causes of death in the elderly population, have increased over the past decade. Diabetes mellitus was the sixth leading cause of death among the elderly in 1997. A revision in the death certificate in 1989 resulted in larger numbers of death assigned diabetes mellitus as an underlying cause. This effect was particularly pronounced in deaths of the elderly. Since 1989, the death rate from diabetes has been steadily increasing in this age group.

The population 65 and over experiences rising cause-specific death rates with increasing age. For each of the ten leading causes of death in the elderly, the death rate among the older elderly is greater than among the younger elderly, with the exception of chronic liver disease and cirrhosis which was 19.6 percent lower among the older elderly than in the younger elderly (Table M11). However, the amount of discrepancy in cause-specific death rates between the older and younger elderly varies by specific cause. The susceptibility to death from certain causes, especially those caused by or related to infectious organisms, rises at an accelerated rate with increasing age. The leading causes of death were similar in the older and younger elderly, but the rankings for pneumonia/influenza, septicemia, and atherosclerosis were higher among the older elderly than among the younger elderly. The death rate from atherosclerosis was more than ten times as high in the older elderly as in the younger elderly, although the age-specific total death rate is only about four times as high. The death rate for pneumonia/influenza among the older segment of the population was 8.7 times the rate among the younger elderly; the death rates for septicemia and stroke were each 5.7 times as high; and the heart disease death rate was 5.5 times as high. However, the death rate from diabetes among those 85 and over was only 2.4 times the comparable rate in the younger elderly and the cancer death rate was 1.8 times the rate in 65 through 84 year olds.