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THE LIBRARY OF THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL THE COLLECTION OF NORTH CAROLINIANA C614.1 N87v5 1984 UNIVERSITY OF N.C AT CHAPEL HILI llllllilillill 00034018731 FOR USE ONLY IN THE NORTH CAROLINA COLLECTION Digitized by tine Internet Archive in 2009 with funding from Ensuring Democracy through Digital Access (NC-LSTA) http://www.archive.org/details/northcarolinavit198402nort LEADING CAUSES OF MORTALITY North Carolina Vital Statistics 1984—Volume 2 > LEADING CAUSES OF MORTALITY North Carolina Vital Statistics 1984—Volume 2 State Center For Health Statistics EC Departmentd Hnnuui Resooreaf Diviskm of Health SerfiMt STATE OF NORTH CAROLINA James G. Martin, Governor DEPARTMENT OF HUMAN RESOURCES Phillip J. Kirk, Jr., Secretary DIVISION OF HEALTH SERVICES Ronald H. Levine, M.D., M.P.H., State Health Director OFHCE OF MANAGEMENT SERVICES Margaret Woodcock, M.A., M.P.A, Assistant Director STATE CENTER FOR HEALTH STATISTICS Charles J. Rothwell, M.B.A., M.S., Director October 1985 750 copies of this public document were printed at a cost of $1,283.00 or $1.71 per copy. TABLE OF CONTENTS Page FIGURE l.A—Department of Human Resources Regions v FIGURE 1 .B—Health Service Areas . . . . vi PREFACE vii I. COMPUTATION OF MORTALITY RATES 1- i II. INTERPRETATION OF MORTALITY RATES 2- 1 III. FLAGGING BIASED RATES 3. 1 IV. NORTH CAROLINA MORTALITY HIGHLIGHTS 4. l V. TABLES AND RGURES: MORTALITY STATISTICS FOR 1980-84 Total Deaths 5, 3 Heart Disease 5, 9 Acute Myocardial Infarction 5, 15 Other Forms of Ischemic Heart Disease 5, 21 Hypertension with or without Renal Disease 5. 27 Cerebrovascular Disease 5, 29 Atherosclerosis 5, 35 Cancer 5-37 Cancer of Stomach 5, 43 Cancer of Colon, Rectum, and Anus 5- 49 Cancer of Pancreas 5- 55 Cancer of Trachea, Bronchus, and Lung 5- 61 Cancer of Female Breast 5. 67 Cancer of Cervix Uteri 5. 73 Cancer of Ovary and Other Uterine Adnexa 5- 79 Cancer of Prostate 5-85 Leukemia 5-91 Diabetes Mellitus 5- 97 Pneumonia and Influenza 5, 99 Chronic Obstructive Pulmonary Disease 5-105 Chronic Liver Disease and Cirrhosis 5-111 Nephritis, Nephrotic Syndrome, and Nephrosis 5-117 Motor Vehicle Accidents 5-123 All Other Accidents and Adverse Effects 5-129 Suicide 5-135 Homicide 5-141 Infant Mortahty 5-147 VI. TABLES AND HGURES: MULTIPLE CONDITIONS PRESENT AT DEATH, 1980-84 REFERENCES O en o o LU Q cr o (X o Of o CE LU (_J o o cr vi PREFACE The State Center for Health Statistics has produced periodically a major publication describing North Carolina's mortality experience for a five-year period. The 1981 Leading Causes of Mortality, the third major publication of this type, included statistical tables, maps, and graphs as well as an analysis for each leading cause of death in North Carolina. In the interim years, the State Center publishes supportive reports of mapped and tabular data only. This edition o( Leading Causes of Mortality is a supportive report which should be used in conjunction with the 1981 edition for purposes of health planning and analysis. Another report that can be used is Detailed Mortality Statistics which provides annual counts of deaths classified according to detailed underlying causes of death and the age, race, and sex of decedents. The tables and maps in this report show selected mortality statistics for counties. Department of Human Resources regions. Health Services Areas, and the state (see maps on preceding pages). More than a dozen of North Carolina's leading causes of mortality are depicted in these tables and maps. In addition, the site-specific cancers and total infant mortality are also tabled and mapped. Table 1 on page 4-3 describes the selected cause-of-death categories in terms of codes from International Classification of Diseases (Ninth Revision). Altogether, the causes included in this report accounted for 86.1 percent of all North Carolina deaths during 1984. As with previous editions, multiple conditions present at death are included in this volume. Three diseases in particular—hypertension, atherosclerosis, and diabetes—are considered associated conditions far more often than they are considered an underlying cause. Hence, Figures 29.A through 3 1 .B display 1980-84 county rates for deaths associated with a mention of each of these diseases. IN USING THIS VOLUME PARTICULAR ATTENTION IS CALLED TO THE SECTIONS ON INTERPRE-TATION OF MORTALITY RATES AND FLAGGING BIASED RATES. I. COMPUTATION OF MORTALITY RATES In this report, total death rates are expressed as resident deaths per 1,000 population while all cause-specific mortality rates are expressed as resident deaths per 1 00,000 population . All rates in Tables 1-27 use total population in the denominator, except rates for the sex-specific cancer sites, which use male or female population in the denominator. The infant mortality rates of Table 28 and Figure 28 are computed as the number of resident deaths under one year of age per 1 ,000 resident live births. Population bases for the rates of this report were provided by the Office of State Budget and Management in the Governor's Office. Vital events in this report are allocated to place of residence. For deaths of inmates of long-term institutions (mental, penal, old age, orphan, nursing home, rest home, etc.), the institution is considered the usual residence provided the decedent had resided in the institution at least one year. College students and military personnel are considered residents of the college or military community. The following definitions apply to the rates of Tables 1-27. Unadjusted Annual Death Rate: the annual death rate computed as resident deaths per 1,000 or 100,000 population. These rates permit the user knowledge of an area's status with respect to the observed incidence of mortality during the given year. Unadjusted 5-Year Death Rate: the average annual death rate computed as average resident deaths per 1 ,000 or 1 00,000 average population. These rates permit the user knowledge of an area's status with respect to the observed incidence of mortality during the 5-year period. These rates are depicted in the Series A maps (e.g.. Figures 2. A, 3. A, etc.) printed in blue. Adjusted 5-Year Death Rate: the average annual age-race-sex-adjusted rates computed by the direct method. Also expressed as deaths per 1 ,000 or 100,000 population, these rates are those which would be expected if the average annual age, race, and sex composition of each county's population were the same as that estimated for the state. These rates are free of differing effects of age, race, and sex and thus permit the user knowledge of an area's status with respect to other determinants of mortality during the 5-year period. However, the user should not compare an adjusted death rate with an unadjusted death rate. Also, adjusted rates for different time periods cannot be directly compared unless they were adjusted by the same standard population. The adjusted rates are depicted in the Series B maps (e.g., Figures 2.B., 3.B., etc.) printed in red. For the maps, a clustering routine* from the Statistical Analysis System (SAS) was used to group counties that are "most like each other" with respect to their unadjusted rate and then their adjusted rate ( 1 ). These maps show six levels of death rates, where level one is the lowest rate interval and level six the highest. *In 1 983 the State Center for Health Statistics conducted an evaluation of several clustering methods. It was found that one method, called "Average Linkage Method," produced tighter clusters (i.e., clusters with smaller within-cluster variances) than the other methods examined. Consequently, we plan to use this method hence-forth to cluster county rates in all SCHS publications. 1-1 II. INTERPRETATION OF MORTALITY RATES To assess an area's relative mortality conditions during a five-year period, both the unadjusted rate and the adjusted rate can be compared to the state rate for a particular cause of death. Then, provided the area's unadjusted rate represents a relatively stable situation, viz., the rate has not fluctuated widely in recent years, the following .liternative diagnoses will apply: Relative Status Of Unadjusted Adjusted Rate Rate Diagnosis Low Low High Low High Low Low mortality is not due to age, race, and sex fac-tors; other mortality conditions are favorable. Low mortality is due to favorable age, race, and sex factors; other mortality conditions are unfavorable. High mortality is due to unfavorable age, race, and sex factors; other mortality conditions are favor-able. High High High mortality is not due to age, race, and sex fac-tors; other mortality conditions are unfavorable. In usmg adjusted rates, it is important that the user understand the reason for adjustment. The following hypothetical example illustrates. Here, A and B stand for population subgroups, e.g., whites and nonwhites, males :ind females, etc. Ptipulation A Population B Total County Population Deaths 300,000 1,000 10,000 10 310,000 1,010 Death Thus, as rates specific for A and B imply, the county's rate is lower than the state's rate after adjustment for the factor represented by A and B. Caution! In assessint^ the relative mortality conditions of a county, one should he particularly aware of rates based on small numbers of deaths since, in such cases, random fluctuation in the rate may render rate comparisons risky. The reader should read very carefully the next section entitled "Flagging Biased Rates." 2-2 III. FLAGGING BIASED RATES The age-race-sex adjusted rates in this pubhcation that have been determined to be biased are flagged with an asterisk to suggest caution in their use. A complete description of the rationale and method for flagging biased rates can be found in the 1981 Leading Causes of Mortality. A short summary is provided below. Any rate with a small number of events (deaths) in the numerator will have substantial random variability over time, or a large standard error. A useful rule of thumb is that any rate based on fewer than 20 events in the numerator may involve serious random error and should be used very cautiously in making comparisons or assessing trends (2). Many of the rates in this volume do have numerators smaller than 20. In addition to the problem of a large standard error, the age-race-sex-adjusted rates in this volume may be biased due to one or more deaths in a small age-race-sex population group. One death out of an estimated population of 5, for example, would produce a death rate of 20,000 per 100,000 population. If this rate were applied to the appropriate age-race-sex group of the standard population, a very large number of expected deaths would result and the adjusted rate would be biased. In this volume an adjusted rate is flagged if: a) applying the age-race-sex-specific rates of a county for a given cause to the standard population results in more than 25 percent of the total expected deaths being generated by one cell, and b) the denominator of the rate is also less than 50 (an average of 10 per year). These criteria will catch only the worst problems. Only thirty-three out of a total of 2500 county adjusted rates in this volume are flagged by this method. In addition to putting asterisks by those 1980-84 adjusted rates with a large bias due to an extremely high age-race-sex-specific rate, the rates have been recomputed by substituting the appropriate North Carolina age-race-sex- cause-specific rate in the problem cell. The table on the next page compares the flagged rates with the rates where the state rate has been substituted. The reader who must use one of these flagged rates is advised to use the rate in this table with the substitution instead. If the latter rate is clearly out of line with the North Carolina rate in the last column, the rate should be treated as missing data. 3-1 u IV. NORTH CAROLINA MORTALITY HIGHLIGHTS In the 1981 Leading Causes of Mortality extensive analyses of North Carolina's mortality experience were presented. That volume contained statistical tables, maps, and graphs as well as cause-specific discussions of trends, geographic patterns, risk factors, and recent research. We do not expect that the general mortality picture has changed very much in three years. Thus in this section, we will highlight 1984 unadjusted death rates for selected causes and the changes in rates from 1981 through 1984. The reader should consult the 1981 volume for a detailed discussion of each cause. As shown in Table 1, a total of 51,032 North Carolinians died in 1984, a rate of 8.27 deaths per 1,000 population. The 1984 rate is equivalent to the 1983 rate which was 2.4 percent above the 1982 rate. The median ageat death was 71. 7 years, up from 7 1.4 years in 1983, 70.7 in 1982, 70.4 in 1981, 66.4 in 1970, and 28. 1 in 1914 when deaths were first centrally recorded. The median age at death for whites was 72. 1 years compared to 68.1 years for nonwhites. The ten leading causes of death are heart disease, cancer, cerebrovascular disease, accidents, chronic obstruc-tive pulmonary disease, pneumonia and influenza, diabetes, suicide, chronic liver disease/cirrhosis, and nephritis/nephrotic syndrome/nephrosis. Of the selected causes of death shown in this volume, cancer, cerebrovascular disease, and homicide were the only causes to show consistent changes in rates between 1981 and 1984. The cancer rate increased each year (from 166.23 to 172.75 per 100,000 population) while the rates for cerebrovascular disease and homicide declined (from 79.2 to 73.2 and 10.5 to 8.5, respectively). Other causes involving large percent changes between 1981 and 1984 were chronic liver disease/cirrhosis (—13%), atherosclerosis (—11%), all other accidents (—8% ), motor vehicle accidents (—6%), diabetes ( +6% ), and chronic obstructive pulmonary disease ( + 11%). These changes were statistically significant at the .05 level for cerebrovascular disease, total cancer, chronic obstructive pulmonary disease, chronic liver disease/cirrhosis, all other accidents, and homicides. With the exception of nonwhite females whose rate declined only 3 percent, each race-sex group experienced at least a 20 percent decline in homicide rates between 1 98 1 and 1 984. Despite these declines, the unadjusted rate for nonwhite males continues to be at least three times the rate of any other race-sex group. Among the nine site-specific cancers referenced in this volume, the unadjusted rates for ovarian, breast and lung cancers increased each year between 1 98 1 and 1 984 and declined each year for cancer of the cervix uteri. The percent changes for the increasing rates were 13.6, 11.1 and 10.8 respectively, and 10.2 for the declining rate. Of these four causes, only the changes for lung and female breast cancers were statistically significant at the .05 level . Rates for the other site-specific cancers fluctuated between 1 98 1 and 1 984; however, their 1 984 rates did not deviate more than 5% from the 1981 rates. Comparisons of female breastand ovarian cancer rates by race are risky since they are based on small numbers of events. However, between 1981 and 1984 female breast cancer increased each year among both race groups, with the 1984 white and nonwhite rates being 9.8 and 16.4 percent, respectively, above the 1981 rates. No discernible pattern was noted for ovarian cancer death for either race group. While the unadjusted lung cancer rate increased each year from 1981 to 1984, the rates fluctuated for each race-sex group except nonwhite females. White females, whose rate increased in both 1983 and 1984, experienced the largest percent increase from 1981 to 1984 (25 percent), followed by nonwhite males (11 percent ) and white males ( 7 percent). For nonwhite females, the unadjusted rate continues to remain relatively stable. 4-1 After increasing 4.0 percent from 1981 to 1982, the overall infant mortality rate declined 3.4 percent in 1983 and another 5.3 percent in 1984 to a rate of 12.5 deaths per 1000 live births. The rate reductions were due primarily to reductions in nonwhite neonatal mortality (from 14.2 in 1982 to 12.5 in 1983 to 1 1.5 in 1984). Provisionally, North Carolina's infant rate was exceeded by only five states in 1984 (3). The nonwhite postneonatal mortality rate remained unchanged in 1984 following a large increase in 1983 (21.8%). Due to the small numbers involved, this increase was not statistically significant. After declining in 1983 to 748 cases, the number of suicides increased to 820 recorded cases in 1984, the highest number of cases ever recorded for North Carolina residents. White males still account for a preponderance of North Carolina's suicides, comprising 7 1 % of all recorded cases in 1 984. Among teenagers, the number of suicides increased from 36 to 55 from 1983 to 1984; however, the 1984 number is comparable to the 1981 and 1982 numbers (54 and 62, respectively). Since 1 960 North Carolina has experienced rapid increases in the septicemia death rate, a pattern also evident for the U.S. The 1970-80 average annual percent increase (19.4%) was almost twice the 1960-70 average annual increase (10.0%). Between 1981 and 1984, the rate increased another 46 percent (from 5.0 to 7.3 deaths per 100,000 population). Approximately 72 percent of these decedents in 1984 were 65 years of age or over, down from 74 percent in 1983 but up from 65 percent in 1982 and 60 percent in 1981. After declining each year since 1981, the state's motor vehicle mortality rate increased 14.1 percentfrom 1983 to 1984 to a rate of 24. 1 deaths per 100,000 population. However, the 1984 rate continues to be below the 1981 rate (24.1 vs. 25.6, respectively). With the exception of 1983, the state's non-motor-vehicle accident mortality rate declined each year. The 1984 rate (22.7 deaths per 100,000 population) was 8.1 percent below the 1981 rate, a decline that is statistically significant at the .05 level. The leading causes of fatal non-motor-vehicle accidents were submer-sions/ suffocations, falls, and fires. Among infants dying from a non-motor-vehicle accident (18), most (83 percent) died as a result of submersion/suffocation or fire. Almost all of these decedents (93 percent) were over 28 days of age. Certain chronic diseases contribute to death far more often than they are considered the underlying cause of death. Specifically, atherosclerosis, hypertension, diabetes, and nephritis/nephrosis were listed on the death certificates of 25.8, 8.1, 7.8, and 5.1 percent, respectively, of all 1984 decedents. As underlying causes, the percentages were 1.1, 0.5, 1.7, and 1.1, respectively. 4-2 00 o 00 o QZ< 00 o Pi O w V. TABLES AND FIGURES: MORTALITY STATISTICS FOR 1980-84 TABLE 2 MORTALITY STflllSTICS FOR 1984 NORTH CAROLINA RESIDENTS TOTAL DEATHS (PER 1000 POPULATION) GEOGRAPHICAL AREA NORTH CAPOLIMA NUMBER UEATH NUMBER DEATH OF DEATHS RaTE* OF DEATHS RATE* 1984 19e<t 1980-8t 1980-84 5103? 8.27 24739i 6.21 ADJUSTED DEATH RATE+ 1980-84 REGIONS DHR I WESTERN DHH II N. CENTRAL DHR III S. CENTRAL DHR IV EASTERN HSA HSA HSA III HSA HSA HSA I WESTERN II PIEDMONT S. PIEDMONT IV CAPITAL V CARDINAL VI EASTERN 17697 11204 10886 11245 9i»26 9664 8269 6814 7603 9?54 8.39 MORTALITY STATISTICS FOR 19et. NORTH CAROLINA RESIDENTS lOTAL UtATHS (PER 1000 POPULATION) COI^T'D. LOUNTIt? ICONT '0) HH HflLIFrtX ^i HARNETT ''4 HAYl^OGD tti HEML'EHSON i+b HERTFORD 4? HOKf <*« HYDE "^ IREOELL 50 JACKSON 51 JOH^ST0N 5i? JONf b 55 LEE bH LENCIR 55 LINCOLN 5b MCDOWELL 57 MACON 56 MADISON 5V MARTIN 6U MECKLENBURG 61 MITCHELL (,k MONTbOMERY 65 MOORL 6H NASH 65 NEW HANOVER 6b NORTHAMPTON 6/ ONSl OW 6(5 ORAMbE &•» PAMl ICO 70 PASQUOTANK 71 PENPER 7i! PERQUIMANS 75 PERSON 74 PITT 75 POLK 7b RANOOLPH 7? RICHMOND 7B ROBtSON 7y ROCKINGHAM 80 ROWAN Bl RUTHERFORD Si; SAMPSON «5 SCOTLAND a** STArjLY 85 STOKES 86 SURRY «7 SWAIN flb TRANSYLVANIA flV TYRRELL 90 UNION 91 VANCE 92 WAKE 93 WARREN 94 WASHINGTON 95 WATAUGA 9b WAYNE 97 WILKES 90 WILSON 99 YADKIN 100 YANCEY NUMBER >- I — cc CD CC CC UJ 2: UJ CD CE LU CC QDD ai >- CC \— CC CD az CC UJ LU ..J TABLE 3 f'ORTALlTY STATISTICS FOR 1 9 & >* NORTH CAROLINA RESIDENTS DISEASES OF HEART (jEOGRaHHICAL ArLA NORTH CAROLINA NUMBER MORTALITY STATISTICS FOR 1904, NORTH CAKOLINA RESIDENTS UISEASLS OF HE.ART CONT'D. -ZL CC 1 CE a: _J TABLE ' MORTALITY STATISTICS FOR 1984 NORTH CAROLINA RESIDEr^TS ACUTE MYOCARDIAL INFARCTION NUMBER MORTALITY STATISTICS FOR 19et, NORTH CAROLINA RESIDENTS ACUTE MYOCARDlHL INFARCTION CONT'D. 2: cr _J az az Li_ ai Q QC CE CJ o>- LU a: UJ in TABLE 5 MORTALITY STATISTICS FOR igBH NORTH CAROLINA RESIOLNTS OTHER FORMS OF ISCHEMIC HEART DISEASE NUMBER MORTALITY STATISTICS TOR 1984, NORTH CAROLINA RESIDENTS UTHER (-OKMS OF ISCHEMIC HEART DISEASE CONT'D. COUNTIES LU CO a: LoJ Q cc CE LU C_J cc UJ o ID LU QC CD Li_ QDD -23 -Z. CE ._) TABLE 6 MORTALITY STATISTICS FOR iga** NORTH CAROLINA RESIDENTS HYPLRTENSION WITH OR WITHOUT RENAL DISEASE bEOGRAHHICAL APLA MORTAIITY STATISTICS FOR 19P4, NORTH CAROLINA RESIDENTS HYPEKTLWSION WITH OR WITHOUT RENAL DISEASE CONT'D. LOUNT Its (CONT'D) 4if HALIFAX tS HARMLTT >*<* HAYWOOD •b HENDERSON 4b HERIFOHD 7 HOKE <*« HYDE "V IREPtLL 50 JACKSON 51 JOHMSTON b^ JONES 5i LEE 54 LENCIR 5b LINCOLN 56 MCDOWELL 57 MACON 5B MADISON 5V MARTIN 60 MECKLENBURG 61 MITCHELL e-^ MONTGOMERY 6i MOORE 64 NASH 65 NEW HANOVER 66 NORTHAMPTON 67 ONSLOW 6b ORANGE 6V PAML ICO 7U PASQUOTANK 71 PENDER 72 PERQUIMANS 75 PERSON 74 PITT 7b POLK 76 RANDOLPH 77 RICHMOND 78 ROBESON Ti ROCKINGHAM 80 ROWAN 81 RUTHERFORD 82 SAMPSON 83 SCOTLAND 84 STANLY 8b STOKES 8b SURKY 87 SWAIN 88 TRANSYLVANIA ay TYRRELL 90 UNION 91 VANCE 92 WAKE 9d WAKREN 94 WASHINGTON 9b WATAUGA 9b WAYNE 97 WILKES 98 WILSON 99 YADKIN 100 YANCEY NUMBER TABLE 7 MORTALITY STATISTICS FOR 1984 NORTH CAROLINA RESIDENTS CEREBROVASCULAR DISEASE NUMBER MORTALITY STATISTICS FOR 19Pt. NORTH CAROLINA RESIDENTS CERE.BHOVASCULAK DISEASE CONT'D. COUNTIES (CONT'U) 12 HALIFAX 1+5 HARMETT tH HAYWOOD tb HENDERSON 16 HERTFORD <? HOKE 48 HYDE ly IREDELL 5u JACKSON 51 JOHNSTON 52 JONES 53 LEE 51 LENOIR 5b LINCOLN 5b MCDOWELL 57 MACON 5B MADISON 59 MARTIN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 63 MOORE 61 NASH 65 NEW HANOVER 6b NORTHAMPTON 67 ONSLOW 6B ORAMGE 6V PAMLICO 7U PASQUOTANK 71 PENDER 72 PERQUIMANS 73 PERSON 71 PITT 75 POLK 7b RANDOLPH 77 RICHMOND 78 ROBESON Ti ROCKINGHAM 80 ROWAN 81 RUTHERFORD 82 SAMPSON 83 SCOTLAND 81 STANLY 8b STOKES 8b SURRY 87 SWAIN 88 TRANSYLVANIA e>-i TYRRELL 90 UNION 91 VANCE 92 WAKE 93 WARREN 91 WASHINGTON 9b WATAUGA 9b WAYNE 97 WILKES 96 WILSON 99 YADKIN 100 YANCEY NUMBER zz. cc _J -z. GI _J TABLE 6 MORTALITY STATISTICS FOR 198H NORTH CAROLINA RESIDENTS ATHEROSCLEROSIS NUMBER MORTALITY STATISTICS FOR 19e<t, NORTH CAROLINA RESIDENTS ATHEROSCLEROSIS CONT'D. COUNTIES (CONT'D) «t2 HALIFAX ^i HARNETT t1 HAYWOOD 4b HENDERSON 16 HERTFORD 17 HOKE 16 HYDE 19 IREDELL 5U JACKSON 51 JOHNSTON 5i! JONES 55 LEE 51 LENOIR 5b LINCOLN 56 MCDOWELL 57 MACON 56 MADISON 59 MARTIN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 63 MOORt 61 NASH 6b NEW HANOVER 66 NORTHAMPTON 67 ONSLOW 6B ORANGE 69 PAMLICO 70 PASOUOTANK 71 PENDER 72 PERQUIMANS 73 PERSON 71 PITT 7b POLK 76 RANDOLPH 77 RICHMOND 78 ROBESON 79 ROCKINGHAM 80 ROWAN 81 RUTHERFORD 82 SAMPSON 8i SCOTLAND 81 STANLY 8b STOKES 86 SURRY 87 SWAIN 88 TRANSYLVANIA 89 TYRRELL 90 UNION 91 VANCE 92 WAKE 93 WARREN 91 WASHINGTON 9b WATAUGA 96 WAYNE 97 WILKES 98 WILSON 99 YADKIN 100 YANCEY * SEE SECTION I NUMBER TABLE 9 MORTALITY STATISTICS FOR 1984 NORTH CAROLINA RESIDENTS CANCER GEOGRAPHICAL AREA NORTH CAROLINA RLGIONS DHR I WESTERN DHR II N. CENTRAL DHR III S. CENTRAL DHR IV EASTERN NUMBER MORTALITY STATISTICS FOR 19S4, CANCER CONT'D. NORTH CAROLINA RESIDENTS cc a-> LU cc —��� (33 CD en ' vn ua en (Ti isi v~ OO CM —< —I — CD — • c^ I I I c^ CD '3- in OJ CT' CD CO CD CNJ . cr- en (XI 00 '- (JO 'J- O C^ CM 00 (D CM CM -< '-• cn r~ !QQD 3^ cc LU en (^ —1 cr I— o CD o> CC D O i-41 TABLE 10 MORTALITY STATISTICS FOR 1984 NORTH CAROLINA RESIDENTS CANCER OF STOMACH MORTALITY STATISTICS FOR 19^^, NORTH CAROLINA RESIDENTS CANCER OF STOMACH CONT'D. a: en _J a: 2: en LJ o I— CO LJ O CC cc LJ _J TABLE 11 MORTALITY STATISTICS FOR 198'+ NORTH CAROLINA RESIDENTS CANCER OF COLON, RECTUM ANO ANUS GEOGRAPHICAL AREA NORTH CAWOLINA NUMBER MORTALITY STATISTICS FOR 198t. NORTH CAROLINA RESIDENTS CANCER OF COLON, RECTUM AND ANUS CONT'D. COUNTIES (CONT'D) tZ HALIKAX Ui HARNETT 1H HAYWOOD 4S HENDERSON tb HERTFORD 47 HOKF te HYDE 49 IREDELL 50 JACKSON 51 JOHNSTON 52 JONES 54 LEE 5H LENOIR 5b LINCOLN 56 MCDOWELL 57 MACON 5e MADISON 59 MARTIN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 63 MOORE 61 NASH 66 NEW HANOVER 66 NORTHAMPTON 67 ONSLOW 68 ORANGE 69 PAMLICO 70 PASQUOTANK 71 PENDER 72 PERQUIMANS 74 PERSON 7H PITT 75 POLK 7b RANDOLPH 77 RICHMOND 78 ROBESON 79 ROCKINGHAM eu ROWAN 81 RUTHERFORD 82 SAMPSON 84 SCOTLAND 84 STANLY 85 STOKES 86 SURRY 87 SWAIN 86 TRANSYLVANIA 89 TYRRELL 90 UNION 91 VANCE 92 WAKE 94 WARREN 94 WASHINGTON 95 WATAUGA 9b WAYNE 97 WILKES 98 WILSON 99 YADKIN 100 YANCEY • SEE SECTION I NUMBER cn a: LU QC. o UJ o GC LU C_3 UJ az O C^ 00 OO IT) O^ '»" ^ — 00 . o •.}- O U3 OJ IT) ro oj CM — cn i:^ EQD 5-51 CO ID GC Q LU O Li_ O QC LU CJ CE CJ J TABLE 12 MORTALITY STATISTICS FOR ige"* NORTH CAROLINA RESIDENTS CAMCER OF PANCREAS GEOGRAPHICAL ARtA NORTH CAROLINA NUMBER MORTALITY STATISTICS FOR 198t. NORTH CAROLINA RESIDENTS CANCER OF PANCREAS CONT'D. COUNTIES (CONT'D) 42 HALIFAX ita HARNETT <+t HAYWOOD 4b HENDERSON 4b HERTFORD 47 HOKE 48 HYDE 49 IREDELL 50 JACKSON 51 JOHNSTON 52 JONES 53 LEE 54 LENOIR 5b LINCOLN 5b MCDOWELL 57 MACON 58 MADISON 59 MARTIN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 63 MOORE 64 NASH 6b NEW HANOVER 6b NORTHAMPTON 67 ONSLOW 68 ORANCE 69 PAMLICO 70 PASQUOTANK 71 PENDER 72 PERQUIMANS 73 PERSON 74 PITT 75 POLK 7b RANDOLPH 77 RICHMOND 78 ROBESON 79 ROCKINGHAM 80 ROWAN 81 RUTHERFORD 82 SAMPSON 83 SCOTLAND 84 STANLY 8b STOKES 8b SURRY 67 SWAIN 88 TRANSYLVANIA 89 TYRRELL 90 UNION 91 VANCE 92 WAKE 93 WARREN 94 WASHINGTON 9b WATAUGA 9b WAYNE 97 WILKES 98 WILSON 99 YADKIN 100 YANCEY » SEE SECTION I NUMBER a: cc CO cc UJ cc (_) a: LU m cc LU CJ CJ J CE _J TABLE 13 l«10RTALlTY STATISTICS FOR 1984 NORTH CAROLINA RTSIOENTS CANCER OF TRACHEA. BRONCHUS AND LUNG NUMBER MORTALITY STATISTICS FOR ISe'*' NOHTH CAROLINA RESIDENTS CANCER OF TRACHEA, BRONCHUS AND LUNG CONT'D. COUNTIES (CONT'D) H^ HALIFAX Hi HARMETT tm HAYWOOD ^b HENDERSON 46 HERTFORD H? HOKE He HYDE 49 IREDELL 50 JACKSON 51 JOHNSTON 52 JONES 5i LEE 5«f LENOIR 5b LINCOLN 56 MCDOWELL 5V MACON 58 MADISON 59 MARTIN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 6d MOORt 6t NASH 6b NEW HANOVER 66 NORTHAMPTON 67 ONSLOW 68 ORANGE 69 PAMLICO 70 PASQUOTANK 71 PENDER 72 PERQUIMANS 73 PERSON 74 PITT 7b POLK 76 RANDOLPH 77 RICHMOND 78 ROBESON 79 ROCKINGHAM 80 ROWAN 61 RUTHERFORD 82 SAMPSON 8a SCOTLAND 84 STANLY 8b STOKES 86 SURRY 87 SWAIN 88 TRANSYLVANIA 89 TYRRELL 90 UNION 91 VANCE 92 WAKE 93 WARREN 94 WASHINGTON 9b WATAUGA 96 WAYNE 97 WILKES 96 WILSON 99 YADKIN 100 YANCEY SEE SECTION I NUMBER CE CD -z. ZD _J en CO n: o 2: o oc CE LU DI CJ cn o oc LU CJ -z. CE ._J cr a: CD zz. ZD _J Q "Z. CE CO ZD in iz: o QC LU m CJ a: o QC UJ cr LJ _) TABLE 14 MORTALITY STATISTICS FOR igp"* NORTH CAROLINA RESIOEMTS CANCER Of- FEMALE HRLAST tEOGRcPHICAL AREA NORTH CAROLINA NUMBER MORTALITY STATISTICS FOR 19at, NORTH CAROLINA RESIDENTS CANCER OF FEMALE BREAST CONT'D. COUNTIES (CONT'D) 1+2 HALIFAX 43 HARNETT <»< HAYWOOD Hb HENDERSON tb HERTFORD tV HOKE HS HYDE "y IREDELL 5y JACKSON 51 JOHNSTON 52 JONES 5a LEE 5t LENOIR 5b LINCOLN 56 MCDOWELL 57 MACON 56 MADISON 5V MARTIN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 63 MOORE 6'* NASH 6b NEW HANOVER 66 NORTHAMPTON 67 ONSLOW 68 ORANGE 69 PAMLICO 70 PASQUOTANK 71 PENDER 72 PERQUIMANS 73 PERSON 7'* PITT 7b POLK 7b RANDOLPH 77 RICHMOND 78 ROBESON 79 ROCKINGHAM 80 ROWAN 81 RUTHERFORD 82 SAMPSON 83 SCOTLAND 8H STANLY 8b STOKES 86 SURRY 87 SWAIN 88 TRANSYLVANIA 89 TYRRELL 90 UNION 91 VANCE 92 WAKE 93 WARREN 91 WASHINGTON 9b WATAUGA 9b WAYNE 97 WILKES 96 WILSON 99 YADKIN 100 YANCEY » SEE SECTION I NUMBER en cc CE UJ CC m LU _l cn LU CD QC LU cc .J cc 21 cc _J TABLE 15 MORTALITY STATISTICS FOR ige"* NORTH CAROLINA RESIDENTS CANCER OF CERVIX UTERI bEOGHAHHICAL AREA NORTH CAROLINA NUMBER MORTALITY STATISTICS FOR IBS'*, NORTH CAROLINA RESIDENTS CANCER OF CERVIX UTERI CONT'D. COUNTIES (CONT'D) 42 HALIFAX Hd HARNETT <m HAYWOOD Hb HENDERSON 4b HERTFORD 47 HOKE 4a HYDE 4y IREDELL 50 JACKSON 51 JOHNSTON 52 JONES 5i LEE 54 LENOIR 5b LINCOLN 5fa MCDOWELL 57 MACON 58 MADISON 59 MARTIN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 63 MOORE 64 NASH 6b NEW HANOVER 66 NORTHAMPTON 67 ONSLOW 6B ORANGE 69 PAMLICO 70 PASQUOTANK 71 PENDER 72 PERQUIMANS 73 PERSON 74 PITT 7b POLK 76 RANDOLPH 77 RICHMOND 78 ROBESON 79 ROCKINGHAM 60 ROWAN 81 RUTHERFORD 82 SAMPSON 83 SCOTLAND 84 STANLY 85 STOKES 86 SURRY 87 SWAIN 88 TRANSYLVANIA 89 TYRRELL 90 UNION 91 VANCE 92 WAKE 93 WARREN 94 WASHINGTON 9b WATAUGA 96 WAYNE 97 WILKLS 98 WILSON 99 YADKIN 100 YANCEY NUMBER cr J cc X cc LU CJ O CC LU CJ 2: CE »o LU CO D g Q TABLE 16 MORTALITY STATISTICS FOR 1984 NORTH CAROLINA RESIDENTS CANCER OF OVARY AND OTHER UTERINE ADNEXA GEOGRAPHICAL AREA MORTALITY STATISTICS FOR ISe^, NORTH CAROLINA RESIDENTS CANCER OF OVARY AND OTHER UTERINE AONEXA CONT'D. COUNTILS (CONT'D) 42 HALIFAX 45 HARNETT 44 HAYWOOD 4b HENDERSON 4fe HERTFORD 47 HOKE 4U HYDE 4y IREDELL 50 JACKSON 51 JOHNSTON 52 JONES 5A LEE 54 LENOIR 55 LINCOLN 5b MCDOWELL 57 MACON 5B MADISON 59 MARTIN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 63 MOORE 64 NASH 65 NEW HANOVER 66 NORTHAMPTON 67 ONSLUW 6« ORANGE 69 PAMLICO 70 PASQUOTANK 71 PENDLR 72 PERQUIMANS 7d PERSON 74 PITT 75 POLK 76 RANDOLPH 77 RICHMOND 7a ROBESON 79 ROCKINGHAM flu ROWAN 81 RUTHERFORD 82 SAMPSON 85 SCOTLAND 64 STANLY 85 STOKES 86 SURRY 87 SWAIN 88 TRANSYLVANIA 89 TYRRELL 90 UNION 91 VANCE 92 WAKE 93 WARREN 94 WASHINGTON 95 WATAUGA 96 WAYNE 97 WILKES 98 WILSON 99 YADKIN 100 YANCEY SEE SECTION I NUMBER (X cc X UJ Q CC LU az LU ID cc UJ oQ CE a: o o QC LD C_J cr. , J CE X ai cc LU HI I— o CD 2: CE >- OI CE >O Ll_ O CC LU CJ CE CJ m UJ cc 5-83 NUMBER MORTAlITt STATISTICS FOR ige**. NORTH CAROLINA RESIDENTS LANCER OF PROSTATE CONT'D. COUNTIES (CONT '0) 2 HALIFAX ^a HARMtTT t4 HAYWOOD <& HENDERSON 46 HERTFORD <? HOKE "e HYDE ty IREDELL 5U JACKSON 51 JOHNSTON 52 JONES 5a LEE 5<t LENOIR 55 LINCOLN 5b IWCDOWELL 57 MACON 5B MADISON 59 MARTIN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 65 MOORE 6'* NASH 65 NEW HANOVER 66 NORTHAMPTON 67 ONSLOW 6B ORANGE 69 PAMLICO 70 PASQUOTANK 71 PENDER 72 PERQUIMANS 7i PERSON 7H PITT 75 POLK 76 RANDOLPH 77 RICHMOND 78 ROBESON Ti ROCKINGHAM ftO ROWAN 61 RUTHERFORD 82 SAMPSON 83 SCOTLAND S"* STANLY 85 STOKES 66 SURRY 87 SWAIN 88 TRANSYLVANIA 89 TYRRELL 90 UNION 91 VANCE 92 WAKE 93 WARREN 94 WASHINGTON 95 WATAUGA 96 WAYNE 97 WILKES 98 WILSON 99 YADKIN 100 YANCEY * SEE SECTION I NUMBER cc cc LU I— CE \— CO o cc Q_ LjJ CD CC LU :2 CE CJ _J CE I— CO o cc Q_ LU O CC LU LJ 00 UJ cc D g >r UD 00 O) LP IT' r- ^ (Ti o • u- CD CO ID O CO •<*• 00 00 —< (x> r\j EQD 5-89 bfOGRftPHICAL ArLA TABLE IB MORTALITY STATISTICS FOR igSt NORTH CAROLINA RESIDENTS LEUKEMIA NUMBER DEATH OF DEATHS RATE* 1980-8'+ igso-ai NORTH CAROLINA NUMBER MORTALITY STATISTICS FOR I'ie'*' NORTH CAROLINA RESIDENTS LEUKLMA CONT'D. COUNTILS (CONT'U) <t2 HALIFAX 43 HARNtTT tt HAYWOOD 46 HENDtRSON Hb HEKTf-ORD 47 HOKE 4e HYDE 49 IREDELL 50 JACKSON 51 JOHMSTON 52 JONES 53 LEE 54 LENOIR 5b LINCOLN 56 MCDOWELL 57 MACON SB MADISON 59 MART IN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 63 MOORE 64 NASH 65 NEW HANOVER 66 NORTHAMPTON 67 ONSLOW 6S ORANGE 69 PAMLICO 70 PASQUOTANK 71 PENDER 72 PERQUIMANS 73 PERSON 74 PITT 7b POLK 76 RANDOLPH 77 RICHMOND 78 ROBESON 79 ROCKINGHAM 60 ROWAN 81 RUTHERFORD 82 SAMPSON 83 SCOTLAND 84 STANLY 8b STOKES 8b SURRT 87 SWAIN 88 TRANSYLVANIA 89 TYRRELL 90 UNION 91 VANCE 92 WAKE 93 WARREN 94 WASHINGTON 9b WATAUGA 96 WAYME 97 WILKES 96 WILSON 99 YADKIN 100 YANCEY NUMBER az CE ai UJ ID LxJ ._J (X CD CO UJ CO o ,- faEOGRePHICAL At^Lfl TABLE 19 ^"ORTALITY STATISTICS FOR 196'+ NORTH CAROLINA RESIDENTS DiABETEi. MELLITUS NUWpER DEATH NUMBER DEATH OF DFATHS RATE* OF DEATHS RATE* i9e«4 i98t igeo-st i9eo-8'* NORTH CAROLINA 873 1'*.16 nn2 13.84 ADJUSTED DEATH RBTE* 1980-6«t 13. et REGIONS MORTALITY STATISTICS FOR 19et, NORTH CAROLINA RESIDENTS OlABETtS HELLITUS CONT'D. COUNTIES (CONT'D) 42 HALIFAX Hi HARNETT " HAYWOOD i+b HENDERSON Hb HEKThORD >i7 HOKE ta HYDE ty IREDELL 5U JACKSON 51 JOHNSTON b^ JONES 53 LEE 54 LENOIR 55 LINCOLN 5b MCDOWELL 57 MACON 5H MADISON 59 MARTIN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 63 MOORE 64 NASH 6b NEW HANOVER 66 NORTHAMPTON 67 ONSLOW 66 0RAM6E 69 PAMLICO 70 PASQUOTANK 71 PENDER 72 PERQUIMANS 73 PERSON 74 PITT 75 POLK 7b RANDOLPH 77 RICHMOND 7a ROBESON Ti ROCKINGHAM 80 ROWAN 81 RUTHERFORD 82 SAMPSON 83 SCOTLAND 84 STANLY 8b STOKES 8b SURRY 87 SWAIN ee TRANSYLVANIA 89 TYRRELL 90 UNION 91 VANCE 92 WAKE 93 WARREN 94 WASHINGTON 9b WATAUGA 9b WAYNE 97 WILKES 9B WILSON 99 YADKIN 100 YANCEY SEE SECTION I NUMBER T A H L E ? MORTALITY STATISTICS FOR 198t NORTH CAROLINA RESIOtNTS PNEUMONIA AMD INFLUENZA CEOGRAPHICAL ARLA numrer MORTALITY STATISTICS FOR 198it, NORTH CAROLINA RESIDENTS PNEUMONIA AND INFLUENZA CONT'D. COUNTIES ICONT '0) ti! HALII-AX "i HARNLTT tt HAYKOOD tb HENDtKSON 16 HERTFORD <* I HOKE 46 HYDE <>:* IREDELL 50 JACKSON 51 JOHNSTON 52 JONES 54 LEE 5<+ LENOIR 5b LINCOLN 56 MCDOWELL 57 MACON 58 MADISON by MARTIN 6U MECKLENBURG 61 MITCHELL 62 MONTGOMERY 6i MOORE 6'* NASH 6b NEW HANOVER 66 NORTHAMPTON 67 ONSLUW 66 ORANGE 69 PAMLICO 70 PASQUOTANK 71 PENDER 72 PERQUIMANS 7i PERSON 7'* PITT 7b POLK 76 RANDOLPH 77 RICHMOND 7B ROBtSON T^ ROCKINGHAM 80 ROWAN 81 RUTHERFORD 82 SAMPSON 83 SCOTLAND 81 STANLY 8b STOKES 86 SURRY 87 SWAIN 88 TRANSYLVANIA 8V TYRRELL 90 UNION 91 VANCE 92 WAKt 95 WARREN gi WASHINGTON 9b WATAUGA 96 WAYNE 97 WILKES 9B WILSON 99 YADKIN 100 YANCEY « SEE SECTION I NUMBER az CE I— I o ID LU CL. CD OI CE LU _J CE ._l NUMBER MORTALITY STATISTICS FOR 198^, NORTH CAROLINA RESIDENTS CHRONIC OBSTRUCTIVE PULMONARY DISEASES CONT'D. COUNTIES (CONT'D) 42 HALIFAX Hi HARNETT 4H HAYWOOD 4t) HENDERSON 1+6 HERTFORD ty HOKE 46 HYDE tV IREDELL 5U JACKSON 51 JOHNSTON 5-^ JONES 5a LEE 54 LENOIR 5b LINCOLN 5fc MCDOWELL 57 MACON 58 MADISON b'i MARTIN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 63 MOORE 64 NASH 65 NEW HANOVER 6b NORTHAMPTON 67 ONSLOW 68 ORANGE 6";* PAMLICO 70 PASQUOTANK 71 PENDER 72 PERQUIMANS 73 PERSON 7H PITT 7b POLK 76 RANDOLPH 77 RICHMOND 78 ROBESON Ti ROCKINGHAM 80 ROWAN 81 RUTHERFORD 82 SAMPSON 83 SCOTLAND 84 STANLY 8b STOKES fl6 SURRY 87 SWAIN 88 TRANSYLVANIA 8** TYRRELL 90 UNION 91 VANCE 92 WAKE 93 WARREN 94 WASHINGTON 9b WATAUGA 96 WAYNE 97 WILKES 98 WILSON 99 YADKIN 100 YANCEY NUMBER -ZL QL LU a: LU ui Q >- cc a: :z o CL-LU CJ =3 CC CO CD o o IE .-J CO UJ CO CE UJ CO I— « Q >- cc cc o a_ CJ ZD QC CO DQ O CJ O QC 31 CJ 00 CJ UJ tr Z) g u. QDD 5-109 NUMBER MORTALITY STATISTICS FOR ige"*. NORTH CAHOLINA RESIDENTS CHRONIC LIVER DISEASE AND CIRRHOSIS CONT'D. COUNTIES (CONT'D) <*i! HALIFAX 43 HARNETT ^H HAYWOOD lb HENDERSON 4b HERTFORD 47 HOKE 46 HYDE 49 IREDELL 5U JACKSON 51 JOHNSTON 52 JONES 5A LEE 54 LENOIR 5b LINCOLN 56 MCDOWELL 57 MACON 5B MADISON 59 MARTIN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 63 MOORL 64 NASH 6b NEW HANOVER 66 NORTHAMPTON 67 ONSLOW 66 ORANGE 69 PAMLICO 70 PASQUOTANK 71 PENDER 72 PERQUIMANS 73 PERSON 74 PITT 7b POLK 76 RANDOLPH 77 RICHMOND 76 ROBESON 79 ROCKINGHAM 80 ROWAN 81 RUTHERFORD az SAMPSON 83 SCOTLAND 84 STANLY 8b STOKES 86 SURRY 87 SWAIN 86 TRANSYLVANIA 89 TYRRELL 90 UNION 91 VANCE 92 WAKE 93 WARREN 94 WASHINGTON 9b WATAUGA 9b WAYNE 97 WILKES 96 WILSON 99 YADKIN 100 YANCEY * SEE SECTION I NUMBER 2: CE CO CO o in cc cc CJ :2 cc LU CO CC LU CO CD QC CJ o cc in CJ _) CO CO o in cc CO CJ Q 2: CE LjJ CO CC LU CO CD CC L±J CJ O QC IC CJ CO cvj CM UJ QC Dg u. 0DD 5-115 NUMBER MORTALITY STATISTICS FOR 196t, NORTH CAROLINA RESIDENTS NEPHRITIS. NEPHROTIC SYNDROME AND NEPHROSIS CONT'D, COUNTILS (CONT '0) t2 HALIFAX 45 HARNETT 4<t HAtwOOD 4b HENOLRSON 46 HERTFORD "+7 HOKE 4« HYDE 4y IREDELL 50 JACKSON 51 JOHNSTON 52 JONES bi LEE 54 LENOIR 55 LINCOLN 5b MCDOWELL 57 MACON 56 MADISON 5V MARTIN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 65 MOORE 64 NASH 65 NEW HANOVER 6fo NORTHAMPTON 67 ONSLOW 6S ORANGE 69 PAMLICO 70 PASQUOTANK 71 PENDER 72 PERQUIMANS 7i PERSON 74 PITT 75 POLK 7b RANDOLPH 77 RICHMOND 7b ROBESON Ti ROCKINGHAM flO ROWAN 81 RUTHERFORD 82 SAMPSON 8i SCOTLAND S4 STANLY 85 STOKES 8b SURRY 87 SWAIN 8b TRANSYLVANIA 89 TYRRELL 90 UNION 91 VANCE 92 WAKE 93 WARREN 94 WASHINGTON 9b WATAUGA 9b WAYNE 97 WILKES 9b WILSON 99 YADKIN 100 YANCEY * SEE SECTION I NUMBER 2: a: CO ui CD CC. IC Q_ LU UJ 21 O CC CD >- o QC Q_ UJ CO QI Q_ LU _l CE (X CD ai JZ. Q_ LU o O QC HI LU CO QC ni Q_ LlJ _J TABLE ? >* MORTALITY STATISTICS FOR 19ai+ WORTH CAROLINA RESIDLNTS MOTOR VLMItlF ACCIDENTS bEO&PA^'HICAL NORTH CAROLINA NUMrFR MORTALITY STATISTICS FOR 196<*< NORTH CAROLINA RESIDENTS MOTOR VEHICLE ACCIDENTS CONT'D. COUNTIES (CONT'U) 42 HALIFAX 1*5 HARNETT It HAYWOOD 4b HENDERSON 4b HERTFORD 47 HOKE 46 HYDE 4y IREDELL 5U JACKSON 51 JOHNSTON 52 JONES 5i LEE 54 LENOIR 5b LINCOLN 5b MCDOWELL 57 MACON 5B MADISON 59 MARTIN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 65 MOORE 64 NASH 6b NEW HANOVER 6b NORTHAMPTON 67 ONSLOW 6b ORANGE b-i PAMLICO 70 PASQUOTANK 71 PENPER 72 PERQUIMANS 73 PERSON 74 PITT 7b POLK 7b RANDOLPH 77 RICHMOND 76 ROPESON Ti ROCKINGHAM 80 ROWAN 81 RUTHERFORD 82 SAMPSON 8a SCOTLAND 84 STANLY 8b STOKES 8b SURRY 87 SWAIN 86 TRANSYLVANIA 8y TYRRELL 90 UNION 91 VANCE 92 WAKE 95 WARREN 94 WASHINGTON 9b WATAUGA 9b WAYNE 97 WILKES 96 WILSON 99 YADKIN 100 YANCEY SEE SECTION I NUMBER '^. a: CO I — ^. LU CD LJ LJ OI LU _J CJ n: UJ QI o o _l CO LU LJ OI UJ _J CJ) UJ CC CD t— CD m CVJ UJ CO o EIQD 5-127 TABLE 25 MORTALITY STATISTICS FOR ISBt NORTH CAROLINA RESIDENTS ALL OTHER ACCIDENTS AND ADVERSE EFFECTS bEOI^KAHHICAL AkLA NUMpEP MORTALITY STATISTICS FOR 19P4, NORTH CAROLIMA RESIDENTS ALL OTHER ACCIUENTS AMD ADVERSE EFFECTS CONT'D. CE Zi CE C_) UJ LU LU CO QC CD CE Q 2: CE CO I — LxJ CD CJ CC CC LU IE O ._J _J CE _l 2: en CO UJ LU UJ CO CO Q CE Q a: CO LU Q I— ( CJ CJ CE CO CD az -_l bCOGRAPHICAL flRtrt TABLE 26 MORTALITY STATISTICS FOR igflt NORTH CAROLINA RESIDtNTS S U I C I D F NUMBER DEATH NUMBER DEATH OF DEATHS RATE* OF DEATHS RATE* 1984 i9&<i igao-et i98o-e4 NORTH CAROLINA P20 13.30 3791 12. 5E ADJUSTED DEATH RATE* 19flO-8it 12.58 DHR I WESTERN DHR II N. CENTRAL DHR III S. CENTRAL DHR IV EASTLRN MORTALITY STATISTICS FOR 198"*. NORTH CAROLINA RESIDENTS SUICint CONT'D. LOUNTILS a: Q CO _J ac LU Q I— I =D CO _l table: 27 r«ORTALlTY STATISTICS FOR igS"* NORTH CAROLINA RESIDENTS HOMICIDE bEOGRPKHICAL ARLA NORTH CAROLINA NUMpER MORTALITY STATISTICS FOR l^&'*, NORTH CAROLIMA RESIDENTS HOMICIUE CONT'D. COUNTILS (CONT'U) 12 HALll-flX m HARNETT m HAYWUOU 4b HENDERSON 16 HERTFORD 17 HOKE 16 HYDE iy IREIIELL 5u JACKSON 51 JOHNSTON Si; JONES 53 LEE 51 LENOIR bb LINCOLN 56 MCDOWELL 57 MACON 5e MADISON 59 MARTIN 60 MECKLENBURG 61 MITCHELL 62 MONTGOMERY 63 MOORL 61 NASH 6b NEW HANOVER 66 NORTHAMPTON 67 ONSl OW 6a ORANGE 69 PAMLICO 70 PASQUOTANK 71 PENDER 72 PERQUIMANS 73 PERSON 71 PITT 7b POLK 76 RANDOLPH 77 RICHMOND 70 ROBESON 79 ROCKINGHAM PO ROWAN 61 RUTHERFORD 82 SAMPSON 83 SCOTLAND 81 STAMLY 8b STOKES 86 SURRY 67 SWAIN 88 TRANSYLVANIA 89 TYRRELL 9 UNION 91 VANCE 92 WAKE 93 WARREN 91 WASHINGTON 9b WATAUGA 96 WAYNE 97 WILKES 98 WILSON 99 YADKIN 100 YANCEY NUMBER LU QC IS) U3 r~ O r~ m CD '— • LP I O 03 (D c^ CM • r- ^r —• in m tT5 u> in m T 00 ro IT) irj . « CD CD Q^Q n^o o^ UD 00 -• lEQD 5-143 :zL cc Q I— I O J TABLE 28 MORTALITY STATISTICS FOR 1981* NORTH CAROLINA RESIDLNTS INFANT DEATHS bEOGRAPHlCAL ARLfl NUMBER MORTALITY STATISTICS FOR igflt, NORTH CAROLINA RESIDENTS INFANT DEATHS CONT'D. COUNT Its (CONT'D) 'i! HALIFAX m HARMLTT tH HAYWOOD 4b HENOt-RSON 16 HERTFORD 17 HOKf ttt HYDE 4^ IREPtLL 5U JACKSON 51 JOHNSTON bH JONES 53 LEE 54 LENOIR 55 LINCOLN 5b MCDOWELL 57 MACON 5b MADISON ^•i MARTIN 60 MECKLENBURG 61 MITCHELL 6i? MONTGOMERY 63 MOORE 6H NASH 65 NEW HANOVER 6b NORTHAMPTON 67 ONSLOW 6a ORANGE 6y PAMLICO 7U PASQUOTANK 71 PENDER la PERQUIMANS 73 PERSON 74 PITT 7b POLK 76 RANDOLPH 77 RICHMOND 78 ROBESON Ti ROCKINGHAM 8U ROWAN Bl RUTHERFORD 6^ SAMPSON 83 SCOTLAND 84 STANLY 8b STOKES 86 SURRY 87 SWAIN 88 TRAriSYLVANIA 8V TYRRELL 90 UNION 91 VANCE 'i^ WAKE 93 WARREN 94 WASHINGTON 9b WATAUGA 9b WAYME 97 WILKES 98 WILSON 99 YADKIN 100 YANCEY * SEE SECTION I NUMBER CE CH _l VI. TABLES AND FIGURES: MULTIPLE CONDITIONS PRESENT AT DEATH 1980-84 —• r-J r-r^ rj ^ — <l-r^O'^or^oo—'i~viorg'N00iO'^-^O QwZoHzuS O T^ 02 I"' W Q X OS ^5 w J c« O D OS < < u u OK So oi uQ Z Z w Q H Z ^Su u oa KH< Q -« U -K ^D-- U X iri—'Tt-oi/^OOOO^—'OOO — O—'—'^0--0f^'-0 u-1 o —' �� o o ^ On 0\ Ou^OOOOOrj'^O—'OOOOO 00 r^ 1^ r- r~4 %0 u~\ -^ — — \0 OmOO — rsivOfO — 00 o 9. '<^ r.j -- -H OOOOOOOOOOOOOOOOOOOOOOOOrr, --—iQOOOOOOOOOOOOOOOOOOOOOO \0 On rsi Tt- T^ ^ .-. ce: r~^roOOO—'00000000000000-*-000 zoHzu o ^ §§ W Q w tn o < < SiZ hz S8 w oa en Q XI 1^ (J 0^ 00 S i2 O j= ^OOm^^r^r^'-^O'^'^ooON'^mr^ un ^ rg ^^ tNi o f^ m -^ Ov O r~j — ' "^ *- O O O rsi -^ U~l -H — . QO r^ r^ \0 (Ni rj >»- Tj-r^—.—.r*^OQ[^^Hr^m^-T}-\0'^ O'^mvDOOOOOO-^MiriOr^OOmO'^-^Orqr^ O 0-. r- oo r-4 oo 00 O oo (^) r^ r<~i <l- r^ m ro O-^r~4OO-^O\-^00'-f^ ^ \o in — —I u-l o o momrvi>nT)-r^Or<~iro00OOOC0"*-'^001--^—'-^Oi^O OO^f^iOrjOino OOOOi^OOOOOO—'O'-OO ^ m m — < f^OOOO(-^^OsOOOOO—'OOOrvlOO — ' o E e s S 4> "L* = <^i S E =5 -^i S .2 < o I u < 1) ^ s ^ ^ S r\ *^ ^J — o -S 2 o '2 E U U Z 2 < c^ I r E ���i(s)rOTj-in\Ot^QOONO — (Sr^'<J-i/ivOr^ ^ £ 6-4 Z 00 U PES £ z < X h u ^ d 00 00 r^ •^ rsi fO QO rsiorsiOr^iO'-'OOOOOOO <j--<j-ir^u^O—'^u^OOO r-i _ _ ro — I <t- OS OS -ZL a: o I— I CO UJ h— QC LU Q_ >- Q LxJ 2: O I— h-l_ iJ CO 2: o ^— CD 21 O ..J cr cr. O CO 2: LU h-cc LU Ql. >- in I Q LU -z. CD I— I I— LU 21 CO o h- Q 2: O CJ _l CE dl :z. a: CO CO o LU _J o CO o q: LU X I- < Q LU LU CO zoHQZoo _l en CO o q: LU -J o CO o a: LU X Q LU LU CO zo oo .._l CO UJ I— LU QD CH Q LU O LU 51. C/^ oI— I CD :z: o CJ LU QC CD SGD 5-15 dl -^ oz CO UJ I— UJ CD a: I CD LiJ o LiJ CO o I ( H— CD 2: O C_J _J REFERENCES 1. SAS Institute Inc. SAS User's Guide: Statistics, 1982 Edition, Cluster Procedure. Cary, N.C., 1982. 2. Kleinman, J.C. "Infant Mortality," Statistical Notes /or Health Planners. Number 2, National Center for Health Statistics, Rockville, Maryland, July 1976. 3. United States Departnnent of Health and Human Services, Public Health Service, National Center for Health Statistics. "Births, Marriages, Divorces, and Deaths for 1984," MontKI> Vital Statistics Report. (PHS) 85-1 120, Volume 33, Number 12, Hyattsville, Maryland, March 26, 1985. 7-1 Department of Human Resources Division of Health Services State Center for Health Statistics P.O. Box 2091 Raleigh, N.C. 27602-2091 919/733-4728 BULK RATE U.S. Postage PAID Raleigh, N.C. 27602-2091 Permit No. 1862 JEFFREY T. HICKS V
Object Description
Description
Title | North Carolina vital statistics, vol 2 |
Other Title | Leading causes of mortality |
Contributor | North Carolina. |
Date | 1984 |
Subjects |
Mortality--North Carolina Vital Statistics--North Carolina North Carolina--Statistics, Vital--Periodicals North Carolina--Statistics Public health--North Carolina |
Place |
Raleigh, Wake County, North Carolina, United States North Carolina, United States |
Time Period |
(1945-1989) Post War/Cold War period |
Description | Vols. for <1971>- issued in 2 vols.: vol. 1: Population, births, deaths, marriages, divorces (changed to: Births, deaths, population, marriages, divorces, 1974- ); vol. 2: Leading causes of mortality (changed to: Leading causes of death, 1994- ).; Vol. for 1972 issued by the N.C. Dept. of Human Resources, Public Health Statistics Services; 1973-1978 by the N.C. Dept. of Human Resources, Public Health Statistics Branch; 1979-1987 by the State Center for Health Statistics; 1988-1989 by the Center for Health and Environmental Statistics; 1990-1994 by the State Center for Health and Environmental Statistics; 1995- by the State Center for Health Statistics. |
Publisher | Raleigh, N.C. :State Board of Health, Public Health Statistics Section,1965- |
Agency-Current | North Carolina Department of Health and Human Services |
Rights | State Document see http://digital.ncdcr.gov/u?/p249901coll22,63754 |
Physical Characteristics | v. ;28 cm. |
Collection | Health Sciences Library. University of North Carolina at Chapel Hill |
Type | text |
Language |
English |
Format |
Annual reports Statistics Periodicals |
Digital Characteristics-A | 6782 KB; 214 p. |
Digital Collection |
Ensuring Democracy through Digital Access, a North Carolina LSTA-funded grant project North Carolina Digital State Documents Collection |
Digital Format | application/pdf |
Related Items | Vol. for 1972 issued by the N.C. Dept. of Human Resources, Public Health Statistics Services; 1973-1978 by the N.C. Dept. of Human Resources, Public Health Statistics Branch; 1979-1987 by the State Center for Health Statistics; 1988-1989 by the Center for Health and Environmental Statistics; 1990-1994 by the State Center for Health and Environmental Statistics; 1995- by the State Center for Health Statistics. |
Title Replaces | North Carolina. Public Health Statistics Section..Annual report of Public Health Statistics Section |
Audience | All |
Pres File Name-M | pubs_edp_ncvitalstatistics1984v2.pdf |
Pres Local File Path-M | \Preservation_content\StatePubs\pubs_edp\images_master\ |
Full Text |
THE LIBRARY OF THE
UNIVERSITY OF
NORTH CAROLINA
AT CHAPEL HILL
THE COLLECTION OF
NORTH CAROLINIANA
C614.1
N87v5
1984
UNIVERSITY OF N.C AT CHAPEL HILI
llllllilillill
00034018731
FOR USE ONLY IN
THE NORTH CAROLINA COLLECTION
Digitized by tine Internet Archive
in 2009 with funding from
Ensuring Democracy through Digital Access (NC-LSTA)
http://www.archive.org/details/northcarolinavit198402nort
LEADING CAUSES
OF MORTALITY
North Carolina
Vital Statistics
1984—Volume 2
>
LEADING CAUSES
OF MORTALITY
North Carolina
Vital Statistics
1984—Volume 2
State Center For Health Statistics
EC Departmentd Hnnuui Resooreaf
Diviskm of Health SerfiMt
STATE OF NORTH CAROLINA
James G. Martin, Governor
DEPARTMENT OF HUMAN RESOURCES
Phillip J. Kirk, Jr., Secretary
DIVISION OF HEALTH SERVICES
Ronald H. Levine, M.D., M.P.H., State Health Director
OFHCE OF MANAGEMENT SERVICES
Margaret Woodcock, M.A., M.P.A, Assistant Director
STATE CENTER FOR HEALTH STATISTICS
Charles J. Rothwell, M.B.A., M.S., Director
October 1985
750 copies of this public document were
printed at a cost of $1,283.00 or $1.71 per copy.
TABLE OF CONTENTS
Page
FIGURE l.A—Department of Human Resources Regions v
FIGURE 1 .B—Health Service Areas . . . . vi
PREFACE vii
I. COMPUTATION OF MORTALITY RATES 1- i
II. INTERPRETATION OF MORTALITY RATES 2- 1
III. FLAGGING BIASED RATES 3. 1
IV. NORTH CAROLINA MORTALITY HIGHLIGHTS 4. l
V. TABLES AND RGURES: MORTALITY STATISTICS FOR 1980-84
Total Deaths 5, 3
Heart Disease 5, 9
Acute Myocardial Infarction 5, 15
Other Forms of Ischemic Heart Disease 5, 21
Hypertension with or without Renal Disease 5. 27
Cerebrovascular Disease 5, 29
Atherosclerosis 5, 35
Cancer 5-37
Cancer of Stomach 5, 43
Cancer of Colon, Rectum, and Anus 5- 49
Cancer of Pancreas 5- 55
Cancer of Trachea, Bronchus, and Lung 5- 61
Cancer of Female Breast 5. 67
Cancer of Cervix Uteri 5. 73
Cancer of Ovary and Other Uterine Adnexa 5- 79
Cancer of Prostate 5-85
Leukemia 5-91
Diabetes Mellitus 5- 97
Pneumonia and Influenza 5, 99
Chronic Obstructive Pulmonary Disease 5-105
Chronic Liver Disease and Cirrhosis 5-111
Nephritis, Nephrotic Syndrome, and Nephrosis 5-117
Motor Vehicle Accidents 5-123
All Other Accidents and Adverse Effects 5-129
Suicide 5-135
Homicide 5-141
Infant Mortahty 5-147
VI. TABLES AND HGURES: MULTIPLE CONDITIONS PRESENT AT DEATH, 1980-84
REFERENCES
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PREFACE
The State Center for Health Statistics has produced periodically a major publication describing North Carolina's
mortality experience for a five-year period. The 1981 Leading Causes of Mortality, the third major publication of this
type, included statistical tables, maps, and graphs as well as an analysis for each leading cause of death in North
Carolina. In the interim years, the State Center publishes supportive reports of mapped and tabular data only.
This edition o( Leading Causes of Mortality is a supportive report which should be used in conjunction with the
1981 edition for purposes of health planning and analysis. Another report that can be used is Detailed Mortality
Statistics which provides annual counts of deaths classified according to detailed underlying causes of death and the
age, race, and sex of decedents.
The tables and maps in this report show selected mortality statistics for counties. Department of Human
Resources regions. Health Services Areas, and the state (see maps on preceding pages). More than a dozen of North
Carolina's leading causes of mortality are depicted in these tables and maps. In addition, the site-specific cancers and
total infant mortality are also tabled and mapped. Table 1 on page 4-3 describes the selected cause-of-death
categories in terms of codes from International Classification of Diseases (Ninth Revision). Altogether, the causes
included in this report accounted for 86.1 percent of all North Carolina deaths during 1984.
As with previous editions, multiple conditions present at death are included in this volume. Three diseases in
particular—hypertension, atherosclerosis, and diabetes—are considered associated conditions far more often than
they are considered an underlying cause. Hence, Figures 29.A through 3 1 .B display 1980-84 county rates for deaths
associated with a mention of each of these diseases.
IN USING THIS VOLUME PARTICULAR ATTENTION IS CALLED TO THE SECTIONS ON INTERPRE-TATION
OF MORTALITY RATES AND FLAGGING BIASED RATES.
I. COMPUTATION OF MORTALITY RATES
In this report, total death rates are expressed as resident deaths per 1,000 population while all cause-specific
mortality rates are expressed as resident deaths per 1 00,000 population . All rates in Tables 1-27 use total population
in the denominator, except rates for the sex-specific cancer sites, which use male or female population in the
denominator. The infant mortality rates of Table 28 and Figure 28 are computed as the number of resident deaths
under one year of age per 1 ,000 resident live births. Population bases for the rates of this report were provided by the
Office of State Budget and Management in the Governor's Office.
Vital events in this report are allocated to place of residence. For deaths of inmates of long-term institutions
(mental, penal, old age, orphan, nursing home, rest home, etc.), the institution is considered the usual residence
provided the decedent had resided in the institution at least one year. College students and military personnel are
considered residents of the college or military community.
The following definitions apply to the rates of Tables 1-27.
Unadjusted Annual Death Rate: the annual death rate computed as resident deaths per 1,000 or 100,000
population. These rates permit the user knowledge of an area's status with respect to the observed incidence of
mortality during the given year.
Unadjusted 5-Year Death Rate: the average annual death rate computed as average resident deaths per 1 ,000 or
1 00,000 average population. These rates permit the user knowledge of an area's status with respect to the observed
incidence of mortality during the 5-year period. These rates are depicted in the Series A maps (e.g.. Figures 2. A, 3. A,
etc.) printed in blue.
Adjusted 5-Year Death Rate: the average annual age-race-sex-adjusted rates computed by the direct method. Also
expressed as deaths per 1 ,000 or 100,000 population, these rates are those which would be expected if the average
annual age, race, and sex composition of each county's population were the same as that estimated for the state.
These rates are free of differing effects of age, race, and sex and thus permit the user knowledge of an area's status
with respect to other determinants of mortality during the 5-year period. However, the user should not compare an
adjusted death rate with an unadjusted death rate. Also, adjusted rates for different time periods cannot be directly
compared unless they were adjusted by the same standard population. The adjusted rates are depicted in the Series B
maps (e.g., Figures 2.B., 3.B., etc.) printed in red.
For the maps, a clustering routine* from the Statistical Analysis System (SAS) was used to group counties that are
"most like each other" with respect to their unadjusted rate and then their adjusted rate ( 1 ). These maps show six
levels of death rates, where level one is the lowest rate interval and level six the highest.
*In 1 983 the State Center for Health Statistics conducted an evaluation of several clustering methods. It was found
that one method, called "Average Linkage Method," produced tighter clusters (i.e., clusters with smaller
within-cluster variances) than the other methods examined. Consequently, we plan to use this method hence-forth
to cluster county rates in all SCHS publications.
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II. INTERPRETATION OF MORTALITY RATES
To assess an area's relative mortality conditions during a five-year period, both the unadjusted rate and the
adjusted rate can be compared to the state rate for a particular cause of death. Then, provided the area's unadjusted
rate represents a relatively stable situation, viz., the rate has not fluctuated widely in recent years, the following
.liternative diagnoses will apply:
Relative Status Of
Unadjusted Adjusted
Rate Rate Diagnosis
Low
Low
High
Low
High
Low
Low mortality is not due to age, race, and sex fac-tors;
other mortality conditions are favorable.
Low mortality is due to favorable age, race, and sex
factors; other mortality conditions are unfavorable.
High mortality is due to unfavorable age, race, and
sex factors; other mortality conditions are favor-able.
High High High mortality is not due to age, race, and sex fac-tors;
other mortality conditions are unfavorable.
In usmg adjusted rates, it is important that the user understand the reason for adjustment. The following
hypothetical example illustrates. Here, A and B stand for population subgroups, e.g., whites and nonwhites, males
:ind females, etc.
Ptipulation A
Population B
Total
County
Population Deaths
300,000 1,000
10,000 10
310,000 1,010
Death
Thus, as rates specific for A and B imply, the county's rate is lower than the state's rate after adjustment for the
factor represented by A and B.
Caution!
In assessint^ the relative mortality conditions of a county, one should he particularly aware of rates based on small
numbers of deaths since, in such cases, random fluctuation in the rate may render rate comparisons risky. The reader
should read very carefully the next section entitled "Flagging Biased Rates."
2-2
III. FLAGGING BIASED RATES
The age-race-sex adjusted rates in this pubhcation that have been determined to be biased are flagged with an
asterisk to suggest caution in their use. A complete description of the rationale and method for flagging biased rates
can be found in the 1981 Leading Causes of Mortality. A short summary is provided below.
Any rate with a small number of events (deaths) in the numerator will have substantial random variability over
time, or a large standard error. A useful rule of thumb is that any rate based on fewer than 20 events in the numerator
may involve serious random error and should be used very cautiously in making comparisons or assessing trends (2).
Many of the rates in this volume do have numerators smaller than 20.
In addition to the problem of a large standard error, the age-race-sex-adjusted rates in this volume may be biased
due to one or more deaths in a small age-race-sex population group. One death out of an estimated population of 5,
for example, would produce a death rate of 20,000 per 100,000 population. If this rate were applied to the
appropriate age-race-sex group of the standard population, a very large number of expected deaths would result and
the adjusted rate would be biased. In this volume an adjusted rate is flagged if: a) applying the age-race-sex-specific
rates of a county for a given cause to the standard population results in more than 25 percent of the total expected
deaths being generated by one cell, and b) the denominator of the rate is also less than 50 (an average of 10 per year).
These criteria will catch only the worst problems. Only thirty-three out of a total of 2500 county adjusted rates in
this volume are flagged by this method.
In addition to putting asterisks by those 1980-84 adjusted rates with a large bias due to an extremely high
age-race-sex-specific rate, the rates have been recomputed by substituting the appropriate North Carolina age-race-sex-
cause-specific rate in the problem cell. The table on the next page compares the flagged rates with the rates where
the state rate has been substituted. The reader who must use one of these flagged rates is advised to use the rate in this
table with the substitution instead. If the latter rate is clearly out of line with the North Carolina rate in the last
column, the rate should be treated as missing data.
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IV. NORTH CAROLINA MORTALITY HIGHLIGHTS
In the 1981 Leading Causes of Mortality extensive analyses of North Carolina's mortality experience were
presented. That volume contained statistical tables, maps, and graphs as well as cause-specific discussions of trends,
geographic patterns, risk factors, and recent research. We do not expect that the general mortality picture has
changed very much in three years. Thus in this section, we will highlight 1984 unadjusted death rates for selected
causes and the changes in rates from 1981 through 1984. The reader should consult the 1981 volume for a detailed
discussion of each cause.
As shown in Table 1, a total of 51,032 North Carolinians died in 1984, a rate of 8.27 deaths per 1,000
population. The 1984 rate is equivalent to the 1983 rate which was 2.4 percent above the 1982 rate.
The median ageat death was 71. 7 years, up from 7 1.4 years in 1983, 70.7 in 1982, 70.4 in 1981, 66.4 in 1970,
and 28. 1 in 1914 when deaths were first centrally recorded. The median age at death for whites was 72. 1 years
compared to 68.1 years for nonwhites.
The ten leading causes of death are heart disease, cancer, cerebrovascular disease, accidents, chronic obstruc-tive
pulmonary disease, pneumonia and influenza, diabetes, suicide, chronic liver disease/cirrhosis, and
nephritis/nephrotic syndrome/nephrosis.
Of the selected causes of death shown in this volume, cancer, cerebrovascular disease, and homicide were the
only causes to show consistent changes in rates between 1981 and 1984. The cancer rate increased each year
(from 166.23 to 172.75 per 100,000 population) while the rates for cerebrovascular disease and homicide
declined (from 79.2 to 73.2 and 10.5 to 8.5, respectively). Other causes involving large percent changes
between 1981 and 1984 were chronic liver disease/cirrhosis (—13%), atherosclerosis (—11%), all other
accidents (—8% ), motor vehicle accidents (—6%), diabetes ( +6% ), and chronic obstructive pulmonary disease
( + 11%). These changes were statistically significant at the .05 level for cerebrovascular disease, total cancer,
chronic obstructive pulmonary disease, chronic liver disease/cirrhosis, all other accidents, and homicides.
With the exception of nonwhite females whose rate declined only 3 percent, each race-sex group experienced
at least a 20 percent decline in homicide rates between 1 98 1 and 1 984. Despite these declines, the unadjusted
rate for nonwhite males continues to be at least three times the rate of any other race-sex group.
Among the nine site-specific cancers referenced in this volume, the unadjusted rates for ovarian, breast and
lung cancers increased each year between 1 98 1 and 1 984 and declined each year for cancer of the cervix uteri.
The percent changes for the increasing rates were 13.6, 11.1 and 10.8 respectively, and 10.2 for the declining
rate. Of these four causes, only the changes for lung and female breast cancers were statistically significant at
the .05 level . Rates for the other site-specific cancers fluctuated between 1 98 1 and 1 984; however, their 1 984
rates did not deviate more than 5% from the 1981 rates.
Comparisons of female breastand ovarian cancer rates by race are risky since they are based on small numbers
of events. However, between 1981 and 1984 female breast cancer increased each year among both race groups,
with the 1984 white and nonwhite rates being 9.8 and 16.4 percent, respectively, above the 1981 rates. No
discernible pattern was noted for ovarian cancer death for either race group.
While the unadjusted lung cancer rate increased each year from 1981 to 1984, the rates fluctuated for each
race-sex group except nonwhite females. White females, whose rate increased in both 1983 and 1984,
experienced the largest percent increase from 1981 to 1984 (25 percent), followed by nonwhite males (11
percent ) and white males ( 7 percent). For nonwhite females, the unadjusted rate continues to remain relatively
stable.
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After increasing 4.0 percent from 1981 to 1982, the overall infant mortality rate declined 3.4 percent in 1983
and another 5.3 percent in 1984 to a rate of 12.5 deaths per 1000 live births. The rate reductions were due
primarily to reductions in nonwhite neonatal mortality (from 14.2 in 1982 to 12.5 in 1983 to 1 1.5 in 1984).
Provisionally, North Carolina's infant rate was exceeded by only five states in 1984 (3). The nonwhite
postneonatal mortality rate remained unchanged in 1984 following a large increase in 1983 (21.8%). Due to
the small numbers involved, this increase was not statistically significant.
After declining in 1983 to 748 cases, the number of suicides increased to 820 recorded cases in 1984, the
highest number of cases ever recorded for North Carolina residents. White males still account for a
preponderance of North Carolina's suicides, comprising 7 1 % of all recorded cases in 1 984. Among teenagers,
the number of suicides increased from 36 to 55 from 1983 to 1984; however, the 1984 number is comparable
to the 1981 and 1982 numbers (54 and 62, respectively).
Since 1 960 North Carolina has experienced rapid increases in the septicemia death rate, a pattern also evident
for the U.S. The 1970-80 average annual percent increase (19.4%) was almost twice the 1960-70 average
annual increase (10.0%). Between 1981 and 1984, the rate increased another 46 percent (from 5.0 to 7.3
deaths per 100,000 population). Approximately 72 percent of these decedents in 1984 were 65 years of age or
over, down from 74 percent in 1983 but up from 65 percent in 1982 and 60 percent in 1981.
After declining each year since 1981, the state's motor vehicle mortality rate increased 14.1 percentfrom 1983
to 1984 to a rate of 24. 1 deaths per 100,000 population. However, the 1984 rate continues to be below the
1981 rate (24.1 vs. 25.6, respectively).
With the exception of 1983, the state's non-motor-vehicle accident mortality rate declined each year. The
1984 rate (22.7 deaths per 100,000 population) was 8.1 percent below the 1981 rate, a decline that is
statistically significant at the .05 level. The leading causes of fatal non-motor-vehicle accidents were submer-sions/
suffocations, falls, and fires. Among infants dying from a non-motor-vehicle accident (18), most (83
percent) died as a result of submersion/suffocation or fire. Almost all of these decedents (93 percent) were
over 28 days of age.
Certain chronic diseases contribute to death far more often than they are considered the underlying cause of
death. Specifically, atherosclerosis, hypertension, diabetes, and nephritis/nephrosis were listed on the death
certificates of 25.8, 8.1, 7.8, and 5.1 percent, respectively, of all 1984 decedents. As underlying causes, the
percentages were 1.1, 0.5, 1.7, and 1.1, respectively.
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V. TABLES AND FIGURES:
MORTALITY STATISTICS
FOR 1980-84
TABLE 2
MORTALITY STflllSTICS FOR 1984
NORTH CAROLINA RESIDENTS
TOTAL DEATHS (PER 1000 POPULATION)
GEOGRAPHICAL
AREA
NORTH CAPOLIMA
NUMBER UEATH NUMBER DEATH
OF DEATHS RaTE* OF DEATHS RATE*
1984 19e |
OCLC number | 4242828 |