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 the National Vital Statistics System web site 2003 Revisions of the U.S. Standard Certificates of Live Birth and Death and the Fetal Death Report.
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 167,997 Texas residents died in 2011. The leading cause of death, diseases of the heart, accounted for 22.6 percent of those deaths, while the second most common cause of death, malignant neoplasms (cancer), accounted for 22.1 percent. Accidents, chronic lower respiratory diseases, and cerebrovascular disease ranked third, fourth, and fifth, respectively. Together, these five leading causes of death represented 61.0 percent of all deaths in 2011.
The number of infant deaths decreased to 2,136 deaths in 2011 compared to 2,362 deaths in 2010. The infant mortality rate decreased to 5.7 infant deaths per 1,000 live births. Fetal deaths decreased from 2,144 in 2010 to 2,087 in 2011. The fetal death ratio decreased to 5.5 fetal deaths per 1,000 live births in 2011 compared to 5.6 in 2010. A total of 116 women died in 2011 as a result of pregnancy or childbearing for a maternal mortality rate of 30.7 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 898,205 in 2010 to 886,387 in 2011. Accidents, malignant neoplasms, and diseases of the heart continued to be the top three causes of premature mortality in Texas.
Leading Causes of Death
Until 2007, the order of the top three leading causes of death had remained the same since 1979; it changed only in 2007 and again in 2009 when cerebrovascular diseases and accidents exchanged their positions. That exchange occurred again this year. Diseases of the heart claimed 37,955 lives (38,096 in 2010) and continued to be the leading cause of death followed by malignant neoplasms (cancer) with 37,121 deaths (36,652 in 2010). 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 moved up from fourth rank in 2010 to third in 2011 with 9,301 deaths (9,133 in 2010). Chronic lower respiratory diseases and cerebrovascular diseases rounded out the top five leading causes of death, but their positions also changed from previous years. Cerebrovascular diseases dropped from third rank in 2010 (9,154 deaths) to fifth rank in 2011 (9,058 deaths). Chronic lower respiratory diseases was fourth in rank this year, with 9,115 deaths (8,910 in 2010). The top three leading causes of death, diseases of the heart, malignant neoplasms, and accidents, accounted for 50.2 percent of all Texas resident deaths in 2011. The next two leading causes of death, chronic lower respiratory diseases and cerebrovascular disease, accounted for another 10.8 percent of all Texas resident deaths in 2011.
The sixth leading cause was Alzheimer's disease with 5,394 deaths in 2011 (5,200 in 2010) and diabetes mellitus was the seventh leading cause in 2011 with 5,060 deaths (4,738 in 2010). Septicemia was the eighth leading cause with 3,420 in 2011. Nephritis and related diseases were the ninth leading cause with 3,405 deaths. Finally, chronic liver disease and cirrhosis were the tenth leading cause with 3,093 deaths in 2011.
The top ten causes of death varied slightly when broken down by race/ethnicity. Although suicide is no longer one of the ten leading causes of death among all Texas residents, it is the eighth leading cause in the White/Other race/ethnicity category. For the Black race/ethnicity category, homicide ranked ninth among leading causes of death (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 (30.6 percent) in 2011 to residents ages 1 through 44 were due to accidents. Malignant neoplasms were responsible for 12.1 percent of all deaths to this age group and suicides claimed the lives of another 10.8 percent.
Beginning at age 45, accidents play a less significant role in total deaths; only 10.2 percent of all deaths to individuals 45-54 were due to accidents. However, malignant neoplasms and diseases of the heart were responsible for 45.8 percent of the deaths to this age group. Deaths due to chronic conditions (diseases of the heart, malignant neoplasms, chronic lower respiratory diseases, cerebrovascular diseases, and Alzheimer's disease) were the major causes of death in individuals 55 years and older, accounting for 63.5 percent of deaths to this age group.
Although males represented 49.6 percent of the Texas population in 2011, they accounted for 60.2 percent of all deaths to persons 1 through 74 years of age. In 2011, the mortality rate for diseases of the heart was 87.7 per 100,000 males and 45.1 per 100,000 females in the 1-74 age group. External causes (such as accidents, homicide, and suicide) also contributed to the gender difference in mortality. Males were more likely than females to die at younger ages from these causes (see Table 17).
There were 2,136 infant deaths to Texas residents in 2011 for an infant mortality rate of 5.7 infant deaths per 1,000 live births (see Table 29). The Black infant mortality rate (11.0) continued to be considerably greater than the rate of Whites (4.8) and Hispanics (5.2).
The top five leading causes of infant death in 2011 were congenital malformations, deformations, and chromosomal abnormalities (22.5 percent of all infant deaths); disorders related to short gestation and low birth weight, not elsewhere classified (15.4 percent of all infant deaths); Sudden Infant Death Syndrome (8.4 percent); newborns affected by maternal complications of pregnancy (6.2 percent); and unintentional injuries (4.2 percent). For the selected causes of infant death among Texas residents, see Table 31.
The majority (1,411; 66.1 percent) of infant deaths took place during the first 27 days of life (neonatal period), and the rate of neonatal deaths in Texas was 3.7 per 1,000 live births (see Table 30). By rank, the top leading causes of neonatal death were congenital malformations, deformations, and chromosomal abnormalities (24.3 percent) and disorders related to short gestation and low birth weight, not elsewhere classified (22.9 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 2,087 fetal deaths to Texas residents in 2011. The fetal death ratio was 5.5 fetal deaths per 1,000 live births in 2011, which is less than in 2010 (5.6).
Perinatal mortality includes fetal and neonatal deaths. The perinatal mortality rate was 8.8 per 1,000 fetal deaths and live births in 2011 (9.0 in 2010). For the perinatal mortality rate, see Table 28.
In 2011, 116 women died as a result of pregnancy or childbearing, for a maternal mortality rate of 30.7 per 100,000 live births. The maternal mortality rate for Black women of 90.5 is higher in 2011 than it was in 2010 (53.9) and continues to be higher than the state value. The maternal mortality rate for White (excluding Other) women increased to 38.6 in 2011 from 27.0 in 2010. Among Hispanic women, the maternal mortality rate decreased to 12.6 in 2011 from 17.5 in 2010. However, rates based on small numbers may be misleading (see Technical Appendix).
Life Expectancy at Birth
Texans born in 2011 had a life expectancy at birth of 78.3 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: 80.6 years vs. 75.8. An Hispanic child born in 2011 had a life expectancy at birth of 79.5 years, while a White newborn had a life expectancy of 78.3 years. Black life expectancy remained below the average, at 74.8 years (see Table 25).
Age-Adjusted Death Rate
The age-adjusted death rate for Texas in 2011 was 755.3 deaths per 100,000 population. The age-adjusted death rate for males was 854.5 in 2011 and the rate for females was 668.2. The age-adjusted death rate for Whites and Others, regardless of gender, was 777.3 deaths per 100,000 population. The Hispanic rate of 615.1 remained the lowest of all racial/ethnic groups in 2011. The age-adjusted death rate for Blacks continued to be well above the rate for the Texas population as a whole at 918.6 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 2011 was 886,387 years, down from 898,205 years in 2010 (see Table 27). Male mortality accounted for 558,719 or 63.0 percent of these years and the total YPLL for women was 327,668 or 37.0 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 2011 and represented 177,299 YPLL, or 7.7 years per 1,000 persons ages 0-64. Malignant neoplasms were responsible for the second largest number of years lost with 134,603 YPLL, for a rate of 5.9. Diseases of the heart had a rate of 4.6 and remained the third leading cause of YPLL in Texas, with 104,323 years of potential life lost. Certain conditions originating in the perinatal period was the fourth leading cause of premature mortality with 67,076 YPLL, with a rate of 2.9. The number of years lost from suicide and homicide were the fifth and seventh leading cause of premature mortality in Texas with YPLLs of 58,326 and 38,956 respectively (or 2.5 and 1.7 years per 1,000 persons ages 0-64 respectively). The number of years lost from congenital malformations moved from seventh in 2010 (41,547) to sixth in 2011. Years lost from congenital malformations were 40,064 with a rate of 1.8.