In 2003, HHS Secretary Tommy Thompson approved the revision to the U.S. Standard Certificates of Death and Fetal Death and encouraged all states to adopt them. The process involved in this revision, as well as details of what was revised, can be found at http://www.cdc.gov/nchs/nvss/vital_certificate_revisions.htm.
Texas adopted the new U.S. Standard Certificates of Death and Fetal Death in 2006. This revision includes changes to items such as alcohol use, race/ethnicity, etc. For details regarding race/ethnicity computation, see Table 44.
A total of 162,792 Texas residents died in 2009. The leading cause of death, diseases of the heart, accounted for 23.3 percent of those deaths, while the second most common cause of death, malignant neoplasms (cancer), accounted for 21.8 percent. Accidents, cerebrovascular diseases, and chronic lower respiratory diseases, ranked third, fourth, and fifth, respectively. Together, these five leading causes of death represented 61.8 percent of all deaths in 2009.
The number of infant deaths decreased to 2,394 deaths in 2009 compared to 2,478 deaths in 2008. The infant mortality rate decreased to 6.0 infant deaths per 1,000 live births. Fetal deaths decreased from 2,474 in 2008 to 2,270 in 2009. The fetal death ratio decreased to 5.7 fetal deaths per 1,000 live births in 2009 compared to 6.1 in 2008. One hundred and sixteen women died in 2009 as a result of pregnancy or childbearing for a maternal mortality rate of 28.9 maternal deaths per 100,000 live births.
Years of potential life lost (YPLL), a measure of premature mortality, is the sum of years lost by persons who die before age 65 (see Technical Appendix). The YPLL by Texans decreased from 928,043 in 2008 to 924,888 in 2009. Accidents, malignant neoplasms, and heart disease continued to be the top three causes of premature mortality in Texas.
Leading Causes of Death
The order of the top three leading causes of death has remained the same since 1979; it changed only in 2007 and 2009 when cerebrovasular diseases and accidents exchanged their positions. In 2009, diseases of the heart claimed 38,008 lives (38,493 in 2008) and continued to be the leading cause of death followed by malignant neoplasms (cancer) with 35,531 deaths (35,618 in 2008). Diseases of the heart and malignant neoplasms have been the first and second leading causes of death in Texas and the nation since 1950.
Accidents ranked third with 9,310 deaths, compared to 9,455 in 2008. The top three leading causes of death, diseases of the heart, malignant neoplasms, and accidents, accounted for 50.9 percent of all Texas resident deaths in 2009. Cerebrovascular diseases with 9,118 deaths (9,550 in 2008) and chronic lower respiratory diseases with 8,624 deaths (8,858 in 2008) rounded out the top five leading causes of death.
The sixth leading cause was Alzheimer's disease with 5,062 deaths in 2009 (5,276 in 2008) and the number of deaths due to diabetes mellitus was 4,866 in 2009 (5,170 in 2008). Nephritis and related diseases were the eighth leading cause with 3,688 deaths in 2009. Influenza and pneumonia were the ninth leading cause with 3,380 deaths in 2009. Septicemia was the tenth leading cause with 3,085 deaths in 2009.
Although suicide is no longer one of the ten leading causes of death among all Texas residents, it is the ninth leading cause in the White/Other race/ethnicity category. The sixth leading cause of death for the Hispanic category in 2009 was chronic liver disease and cirrhosis. Leading causes of death for the Black race/ethnicity category included homicide and HIV disease in the ninth and tenth positions (see Table 16 for the leading causes of death by race/ethnicity). For details regarding race/ethnicity computation, see Table 44.
The majority of deaths (29.7 percent) in 2009 to residents ages 1 through 44 were due to accidents. Malignant neoplasms were responsible for 11.6 percent of all deaths to this age group and suicides claimed the lives of another 10.3 percent.
Beginning at age 45, accidents play a less significant role in total deaths; only 10.4 percent of all deaths to individuals 45-54 were due to accidents. However, malignant neoplasms and diseases of the heart were responsible for 44.9 percent of the deaths to this age group. Deaths due to chronic conditions (diseases of the heart, malignant neoplasms, cerebrovascular diseases, chronic lower respiratory diseases, and Alzheimer's disease) were the major causes of death in individuals 55 years and older, accounting for 64.7 percent of deaths to this age group.
Although males represented half (50.2 percent) of the Texas population in 2009, they accounted for 60.4 percent of all deaths to persons 1 through 74 years of age. Much of this difference is due to the greater likelihood of males dying at younger ages from external causes (such as accidents, homicide, and suicide) and HIV infection (see Table 17).
There were 2,394 infant deaths to Texas residents in 2009 for an infant mortality rate of 6.0 infant deaths per 1,000 live births (see Table 29). The Black infant mortality rate (11.3) continued to be considerably greater than the rate of Whites (5.1) and Hispanics (5.2).
The top five leading causes of infant death in 2009 were congenital malformations, deformations, and chromosomal abnormalities (22.6 percent of all infant deaths); disorders related to short gestation and low birth weight, not elsewhere classified (13.4 percent of all infant deaths); Sudden Infant Death Syndrome (9.5 percent); maternal complications of pregnancy (5.7 percent); and accidents (4.1 percent). For the selected causes of infant death among Texas residents, see Table 31.
The majority (1,514; 63.2 percent) of infant deaths took place during the first 27 days of life (neonatal period), and the rate of neonatal deaths in Texas was 3.8 per 1,000 live births (see Table 30). By rank, the top leading causes of neonatal deaths were congenital malformations, deformations, and chromosomal abnormalities (24.8 percent) and disorders related to short gestation and low birth weight, not elsewhere classified (20.5 percent). For the selected causes of neonatal death among Texas residents, see Table 32.
Fetal Deaths and Perinatal Mortality
In Texas, a fetal death is the death of a product of conception before complete expulsion or extraction from its mother. It is required to be registered with the Vital Statistics Unit as a fetal death for any fetus weighing 350 grams or more, or if the weight is unknown, a fetus aged 20 weeks or more. However, all reported fetal deaths, regardless of weight or length of gestation, are included in this annual report. There were 2,270 fetal deaths to Texas residents in 2009. The fetal death ratio was 5.7 fetal deaths per 1,000 live births in 2009, which is less than in 2008 (6.1).
Perinatal mortality includes fetal and neonatal deaths. The perinatal mortality rate was 8.9
per 1,000 fetal deaths and live births in 2009 (9.4 in 2008). For perinatal mortality figures, see Table 28.
In 2009, 116 women died as a result of pregnancy or childbearing, for a maternal mortality rate of 28.9 per 100,000 live births. The maternal mortality rate for Black women of 66.0 is higher in 2009 than it was in 2008 (41.5) and continues to be higher than the state value. The maternal mortality rate for White (excluding Other) women increased to 30.8 in 2009 from 25.4 in 2008. Among Hispanic women, the maternal mortality rate increased to 18.4 in 2009 from 14.8 in 2008. However, rates based on small numbers may be misleading (seeTechnical Appendix).
Life Expectancy at Birth
Texans born in 2009 had a life expectancy at birth of 77.9 years. Because males tend to die from more external causes (such as accidents, homicide, and suicide) and at younger ages than females, females had a higher life expectancy at birth than males: 80.3 years vs. 75.5. An Hispanic child born in 2009 had a life expectancy at birth of 79.2 years, while a White newborn had a life expectancy of 77.9 years. Black life expectancy remained below the average, at 74.1 years (see Table 25).
Age-Adjusted Death Rate
The age-adjusted death rate for Texas in 2009 was 789.9 deaths per 100,000 population. The age-adjusted death rate for males was 893.9 in 2009 and the rate for females was 698.4. The age-adjusted death rate for Whites and Others, regardless of gender, was 806.8 deaths per 100,000 population. The Hispanic rate of 661.3 remained the lowest of all racial/ethnic groups in 2009. The age-adjusted death rate for Blacks continued to be well above the rate for the Texas population as a whole at 969.3 per 100,000 population (see Table 26A).
Years of Potential Life Lost (YPLL)
The YPLL statistic is a way to demonstrate both gender and race/ethnicity differences in mortality risks and is the sum of years lost by persons who die before the age of 65 (see Technical Appendix). The total YPLL for Texans in 2009 was 924,888 years, down from 928,043 years in 2008 (see Table 27). Male mortality accounted for 584,178 or 63.2 percent of these years and the total YPLL for women was 340,710 or 36.8 percent. This difference is mostly due to males dying at younger ages than females from causes that are primarily external or preventable in nature, such as accidents and HIV infection.
Death by accident was the number one cause of premature mortality in 2009 and represented 181,588 YPLL, or 8.1 years per 1,000 persons ages 0-64. Malignant neoplasms were responsible for the second largest number of years lost with 132,730 YPLL, for a rate of 6.0. Diseases of the heart had a rate of 4.7 and remained the third leading cause of YPLL in Texas, with 104,888 years of potential life lost. Certain conditions originating in the perinatal period was the fourth leading cause of premature mortality with 69,811 YPLL, with a rate of 3.1. The number of years lost from suicide and homicide were the fifth and sixth leading cause of premature mortality in Texas with YPLLs of 59,684 and 46,549 respectively (or 2.7 and 2.1 years per 1,000 persons ages 0-64 respectively).