Heart disease is currently the leading cause of death in the United States. In 2022, COVID-19 was the fourth leading cause of death in the United States, accounting for almost six percent of all deaths that year. The leading causes of death worldwide are similar to those in the United States. However, diarrheal diseases and neonatal conditions are major causes of death worldwide, but are not among the leading causes in the United States. Instead, accidents and chronic liver disease have a larger impact in the United States.

Racial differences

In the United States, there exist slight differences in leading causes of death depending on race and ethnicity. For example, assault, or homicide, accounts for around three percent of all deaths among the Black population but is not even among the leading causes of death for other races and ethnicities. However, heart disease and cancer are still the leading causes of death for all races and ethnicities.

Leading causes of death among men vs women

Similarly, there are also differences in the leading causes of death in the U.S. between men and women. For example, among men, intentional self-harm accounts for around two percent of all deaths but is not among the leading causes of death among women. On the other hand, influenza and pneumonia account for more deaths among women than men.

As of 2022, the third leading cause of death among teenagers aged 15 to 19 years in the United States was intentional self-harm or suicide, contributing around 17 percent of deaths among age group. The leading cause of death at that time was unintentional injuries, contributing to around 37.4 percent of deaths, while 21.8 percent of all deaths in this age group were due to assault or homicide. Cancer and heart disease, the overall leading causes of death in the United States, are also among the leading causes of death among U.S. teenagers. Adolescent suicide in the United States In 2021, around 22 percent of students in grades 9 to 12 reported that they had seriously considered attempting suicide in the past year. Female students were around twice as likely to report seriously considering suicide compared to male students. In 2022, Montana had the highest rate of suicides among U.S. teenagers with around 39 deaths per 100,000 teenagers, followed by South Dakota with a rate of 33 per 100,000. The states with the lowest death rates among adolescents are New York and New Jersey. Mental health treatment Suicidal thoughts are a clear symptom of mental health issues. Mental health issues are not rare among children and adolescents, and treatment for such issues has become increasingly accepted and accessible. In 2021, around 15 percent of boys and girls aged 5 to 17 years had received some form of mental health treatment in the past year. At that time, around 35 percent of youths aged 12 to 17 years in the United States who were receiving specialty mental health services were doing so because they had thought about killing themselves or had already tried to kill themselves.

Rank, number of deaths, percentage of deaths, and age-specific mortality rates for the leading causes of death, by age group and sex, 2000 to most recent year.

MMWR Surveillance Summary 66 (No. SS-1):1-8 found that nonmetropolitan areas have significant numbers of potentially excess deaths from the five leading causes of death. These figures accompany this report by presenting information on potentially excess deaths in nonmetropolitan and metropolitan areas at the state level. They also add additional years of data and options for selecting different age ranges and benchmarks. Potentially excess deaths are defined in MMWR Surveillance Summary 66(No. SS-1):1-8 as deaths that exceed the numbers that would be expected if the death rates of states with the lowest rates (benchmarks) occurred across all states. They are calculated by subtracting expected deaths for specific benchmarks from observed deaths. Not all potentially excess deaths can be prevented; some areas might have characteristics that predispose them to higher rates of death. However, many potentially excess deaths might represent deaths that could be prevented through improved public health programs that support healthier behaviors and neighborhoods or better access to health care services. Mortality data for U.S. residents come from the National Vital Statistics System. Estimates based on fewer than 10 observed deaths are not shown and shaded yellow on the map. Underlying cause of death is based on the International Classification of Diseases, 10th Revision (ICD-10) Heart disease (I00-I09, I11, I13, and I20–I51) Cancer (C00–C97) Unintentional injury (V01–X59 and Y85–Y86) Chronic lower respiratory disease (J40–J47) Stroke (I60–I69) Locality (nonmetropolitan vs. metropolitan) is based on the Office of Management and Budget’s 2013 county-based classification scheme. Benchmarks are based on the three states with the lowest age and cause-specific mortality rates. Potentially excess deaths for each state are calculated by subtracting deaths at the benchmark rates (expected deaths) from observed deaths. Users can explore three benchmarks: “2010 Fixed” is a fixed benchmark based on the best performing States in 2010. “2005 Fixed” is a fixed benchmark based on the best performing States in 2005. “Floating” is based on the best performing States in each year so change from year to year. SOURCES CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and CDC WONDER (see http://wonder.cdc.gov). REFERENCES Moy E, Garcia MC, Bastian B, Rossen LM, Ingram DD, Faul M, Massetti GM, Thomas CC, Hong Y, Yoon PW, Iademarco MF. Leading Causes of Death in Nonmetropolitan and Metropolitan Areas – United States, 1999-2014. MMWR Surveillance Summary 2017; 66(No. SS-1):1-8. Garcia MC, Faul M, Massetti G, Thomas CC, Hong Y, Bauer UE, Iademarco MF. Reducing Potentially Excess Deaths from the Five Leading Causes of Death in the Rural United States. MMWR Surveillance Summary 2017; 66(No. SS-2):1–7.

During the months December 2020, January 2021, and February 2021, COVID-19 was the leading cause of death in the United States based on the average number of daily deaths. Heart disease and cancer are usually the number one and number two leading causes of death, respectively. This statistic shows the average number of daily deaths in the United States among the leading causes of death from March 2020 to September 2022.

This dataset describes injury mortality in the United States beginning in 1999. Two concepts are included in the circumstances of an injury death: intent of injury and mechanism of injury. Intent of injury describes whether the injury was inflicted purposefully (intentional injury) and, if purposeful, whether the injury was self-inflicted (suicide or self-harm) or inflicted by another person (homicide). Injuries that were not purposefully inflicted are considered unintentional (accidental) injuries. Mechanism of injury describes the source of the energy transfer that resulted in physical or physiological harm to the body. Examples of mechanisms of injury include falls, motor vehicle traffic crashes, burns, poisonings, and drownings (1,2). Data are based on information from all resident death certificates filed in the 50 states and the District of Columbia. Age-adjusted death rates (per 100,000 standard population) are based on the 2000 U.S. standard population. Populations used for computing death rates for 2011–2015 are postcensal estimates based on the 2010 census, estimated as of July 1, 2010. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for non-census years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Causes of injury death are classified by the International Classification of Diseases, Tenth Revision (ICD–10). Categories of injury intent and injury mechanism generally follow the categories in the external-cause-of-injury mortality matrix (1,2). Cause-of-death statistics are based on the underlying cause of death. SOURCES CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and CDC WONDER (see http://wonder.cdc.gov). REFERENCES National Center for Health Statistics. ICD–10: External cause of injury mortality matrix. National Center for Health Statistics. Vital statistics data available. Mortality multiple cause files. Hyattsville, MD: National Center for Health Statistics. Available from: https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm. Murphy SL, Xu JQ, Kochanek KD, Curtin SC, and Arias E. Deaths: Final data for 2015. National vital statistics reports; vol 66. no. 6. Hyattsville, MD: National Center for Health Statistics. 2017. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_06.pdf. Miniño AM, Anderson RN, Fingerhut LA, Boudreault MA, Warner M. Deaths: Injuries, 2002. National vital statistics reports; vol 54 no 10. Hyattsville, MD: National Center for Health Statistics. 2006.

Effective September 27, 2023, this dataset will no longer be updated. Similar data are accessible from wonder.cdc.gov.

Provisional counts of deaths by the month the death occurred and by select causes of death for 2020-2023.

The leading causes of death among children aged 5 to 9 years in the United States in 2022 were unintentional injuries, cancer, and congenital malformations, deformations and chromosomal abnormalities. At that time, unintentional injuries accounted for around 28 percent of all deaths among this age group. Child abuse in the U.S. Sadly, assault or homicide, was the fourth leading cause of death among those aged 5 to 9 years in the United States in 2022, accounting for around 9.4 percent of all deaths. That year, there were around 113,259 cases of child abuse in the U.S. among children aged 6 to 9 years and 129,846 cases among children aged 2 to 5 years. In 2022, there were around 5.36 child deaths per day in the United States due to abuse and neglect. Suicide among children Assault or homicide was also among the top five leading causes of death among children aged 10 to 14 years, but perhaps even more troubling is that suicide is the second leading cause of death among this age group. As with younger children, unintentional injuries are the leading cause of death among those aged 10 to 14 years, however, suicide accounts for around 13 percent of all deaths among this age group. Comparatively, suicide is not among the ten-leading causes of death among children from the age 1 to 9 years.

In the United States, the leading causes of death among women are heart disease and cancer. Heart disease and cancer are similarly the leading causes of death among U.S. men. In 2022, heart disease accounted for 20.3 percent of all deaths among women in the United States, while cancer accounted for 18.5 percent of deaths. COVID-19 was the third leading cause of death among both men and women in 2020 and 2021, and the fourth leading cause in 2022. Cancer among women in the U.S. The most common types of cancer among U.S. women are breast, lung and bronchus, and colon and rectum. In 2024, there were around 310,720 new breast cancer cases among women, compared to 118,270 new cases of lung and bronchus cancer. Although breast cancer is the most common form of cancer among women in the United States, lung and bronchus cancer causes the highest number of cancer deaths. In 2024, around 59,280 women were expected to die from lung and bronchus cancer, compared to 42,250 from breast cancer. Breast cancer Although breast cancer is the second most deadly form of cancer among women, rates of death have decreased over the past few decades. This decrease is possibly due to early detection, progress in therapy, and increasing awareness of risk factors. In 2022, the death rate due to breast cancer was 18.7 per 100,000 population, compared to a rate of 33.3 per 100,000 in the year 1990. The state with the highest rate of deaths due to breast cancer is Delaware, while Massachusetts had the lowest rates. Massachusetts is also one of the states with the highest share of women receiving a breast cancer screening in the last two years.

This dataset contains counts of deaths for California as a whole based on information entered on death certificates. Final counts are derived from static data and include out-of-state deaths to California residents, whereas provisional counts are derived from incomplete and dynamic data. Provisional counts are based on the records available when the data was retrieved and may not represent all deaths that occurred during the time period. Deaths involving injuries from external or environmental forces, such as accidents, homicide and suicide, often require additional investigation that tends to delay certification of the cause and manner of death. This can result in significant under-reporting of these deaths in provisional data.

The final data tables include both deaths that occurred in California regardless of the place of residence (by occurrence) and deaths to California residents (by residence), whereas the provisional data table only includes deaths that occurred in California regardless of the place of residence (by occurrence). The data are reported as totals, as well as stratified by age, gender, race-ethnicity, and death place type. Deaths due to all causes (ALL) and selected underlying cause of death categories are provided. See temporal coverage for more information on which combinations are available for which years.

The cause of death categories are based solely on the underlying cause of death as coded by the International Classification of Diseases. The underlying cause of death is defined by the World Health Organization (WHO) as "the disease or injury which initiated the train of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury." It is a single value assigned to each death based on the details as entered on the death certificate. When more than one cause is listed, the order in which they are listed can affect which cause is coded as the underlying cause. This means that similar events could be coded with different underlying causes of death depending on variations in how they were entered. Consequently, while underlying cause of death provides a convenient comparison between cause of death categories, it may not capture the full impact of each cause of death as it does not always take into account all conditions contributing to the death.

In 2022, the leading causes of death among children and adolescents in the United States aged 10 to 14 were unintentional injuries, intentional self-harm (suicide), and cancer. That year, unintentional injuries accounted for around 25 percent of all deaths among this age group. Leading causes of death among older teens Like those aged 10 to 14 years, the leading cause of death among older teenagers in the U.S. aged 15 to 19 years is unintentional injuries. In 2022, unintentional injuries accounted for around 37 percent of all deaths among older teens. However, unlike those aged 10 to 14, the second leading cause of death among teens aged 15 to 19 is assault or homicide. Sadly, the third leading cause of death among this age group is suicide, making suicide among the leading three causes of death for both age groups. Teen suicide Suicide remains a major problem among teenagers in the United States, as reflected in the leading causes of death among this age group. It was estimated that in 2021, around 22 percent of high school students in the U.S. considered attempting suicide in the past year, with this rate twice as high for girls than for boys. The states with the highest death rates due to suicide among adolescents aged 15 to 19 years are Montana, South Dakota, and New Mexico. In 2022, the death rate from suicide among this age group in Montana was 39 per 100,000 population. In comparison, New York, the state with the lowest rate, had just five suicide deaths among those aged 15 to 19 years per 100,000 population.

In 2019, the leading causes of death worldwide were ischemic heart disease, stroke, and chronic obstructive pulmonary disease (COPD). That year, ischemic heart disease and stroke accounted for a combined 27 percent of all deaths worldwide. Although the leading causes of death worldwide vary by region and country, heart disease is a consistent leading cause of death regardless of income, development, size, or location.

Heart disease In 2019, around 8.89 million people worldwide died from ischemic heart disease. In comparison, around 1.78 million people died from lung cancer that year, while 1.5 million died from diabetes. The countries with the highest rates of death due to heart attack and other ischemic heart diseases are Lithuania, Russia, and Hungary. Although some risk factors for heart disease, such as age and genetics, are unmodifiable, the likelihood of developing heart disease can be greatly reduced through a healthy lifestyle. The biggest modifiable risk factors for heart disease include smoking, an unhealthy diet, being overweight, and a lack of exercise. In 2019, it was estimated that around two million deaths worldwide due to ischemic heart disease could be attributed to smoking.

The leading causes of death in the United States Just as it is the leading cause of death worldwide, heart disease is also the leading cause of death in the United States. In 2020, heart disease accounted for almost 21 percent of all deaths in the United States. Cancer was the second leading cause of death in the U.S. that year, followed by COVID-19. As of 2020, the odds that a person in the United States will die from heart disease is 1 in 6. However, rates of death due to heart disease have actually declined in the U.S. over the past couple decades. From 2000 to 2019, there was a 7.3 percent decline in heart disease deaths. On the other hand, deaths from Alzheimer’s disease saw an increase of 145 percent over this period. Alzheimer’s disease is currently the seventh leading cause of death in the United States, accounting for 32.4 deaths per 100,000 population in 2020.

Analysis of ‘NCHS - VSRR Quarterly provisional estimates for selected indicators of mortality’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/ab329a72-4ce1-4b39-957b-9e0044d93d6e on 11 February 2022.

--- Dataset description provided by original source is as follows ---

Provisional estimates of death rates. Estimates are presented for each of the 15 leading causes of death plus estimates for deaths attributed to drug overdose, falls (for persons aged 65 and over), human immunodeficiency virus (HIV) disease, homicide, and firearms-related deaths.

--- Original source retains full ownership of the source dataset ---

Death rate has been age-adjusted to the 2000 U.S. standard population. Single-year data are only available for Los Angeles County overall, Service Planning Areas, Supervisorial Districts, City of Los Angeles overall, and City of Los Angeles Council Districts.Coronary heart disease is a type of heart disease in which the arteries of the heart cannot deliver enough oxygen-rich blood to the heart muscles. Over time, this can weaken the heart muscle and may lead to heart attack or heart failure. It is the most common type of heart disease in the US and has been the leading cause of death in Los Angeles County for the last two decades. Poor diet, sedentary lifestyle, tobacco exposure, and chronic stress are all important risk factors for coronary heart disease. Cities and communities can mitigate these risks by improving local food environments and encouraging physical activity by making communities safer and more walkable.For more information about the Community Health Profiles Data Initiative, please see the initiative homepage.

In 2022, the leading causes of death for children aged one to four years in the United States were unintentional injuries and congenital malformations, deformations, and chromosomal abnormalities. At that time, around 31 percent of all deaths among these children were caused by unintentional injuries. Differences in causes of death among children by age Just as unintentional injuries are the leading cause of death among children aged one to four, it is also the leading cause of death for the age groups five to nine and 10 to 14. However, congenital malformations, deformations, and chromosomal abnormalities account for fewer deaths as children become older, while the share of deaths caused by cancer is higher among those aged five to nine and 10 to 14. In fact, cancer is the second leading cause of death among five to nine-year-olds, accounting for around 15 percent of all deaths. Sadly, the second leading cause of death among children aged 10 to 14 is intentional self-harm, with 13 percent of all deaths among those in this age group caused by suicide. Leading causes of death in the United States The leading causes of death in the United States are heart disease and malignant neoplasms. Together, these two diseases accounted for around 40 percent of all deaths in the United States in 2022. That year, COVID-19 was the fourth leading cause of death, with about six percent of all deaths caused by COVID-19. In 2022, the lifetime odds that the average person in the United States would die from heart disease was one in six, while the odds for cancer were one in seven and for COVID-19 one in 23.

Data for CDC’s COVID Data Tracker site on Rates of COVID-19 Cases and Deaths by Updated (Bivalent) Booster Status. Click 'More' for important dataset description and footnotes

Webpage: https://covid.cdc.gov/covid-data-tracker/#rates-by-vaccine-status

Dataset and data visualization details:

These data were posted and archived on May 30, 2023 and reflect cases among persons with a positive specimen collection date through April 22, 2023, and deaths among persons with a positive specimen collection date through April 1, 2023. These data will no longer be updated after May 2023.

Vaccination status: A person vaccinated with at least a primary series had SARS-CoV-2 RNA or antigen detected on a respiratory specimen collected ≥14 days after verifiably completing the primary series of an FDA-authorized or approved COVID-19 vaccine. An unvaccinated person had SARS-CoV-2 RNA or antigen detected on a respiratory specimen and has not been verified to have received COVID-19 vaccine. Excluded were partially vaccinated people who received at least one FDA-authorized vaccine dose but did not complete a primary series ≥14 days before collection of a specimen where SARS-CoV-2 RNA or antigen was detected. A person vaccinated with a primary series and a monovalent booster dose had SARS-CoV-2 RNA or antigen detected on a respiratory specimen collected ≥14 days after verifiably receiving a primary series of an FDA-authorized or approved vaccine and at least one additional dose of any monovalent FDA-authorized or approved COVID-19 vaccine on or after August 13, 2021. (Note: this definition does not distinguish between vaccine recipients who are immunocompromised and are receiving an additional dose versus those who are not immunocompromised and receiving a booster dose.) A person vaccinated with a primary series and an updated (bivalent) booster dose had SARS-CoV-2 RNA or antigen detected in a respiratory specimen collected ≥14 days after verifiably receiving a primary series of an FDA-authorized or approved vaccine and an additional dose of any bivalent FDA-authorized or approved vaccine COVID-19 vaccine on or after September 1, 2022. (Note: Doses with bivalent doses reported as first or second doses are classified as vaccinated with a bivalent booster dose.) People with primary series or a monovalent booster dose were combined in the “vaccinated without an updated booster” category.

Deaths: A COVID-19–associated death occurred in a person with a documented COVID-19 diagnosis who died; health department staff reviewed to make a determination using vital records, public health investigation, or other data sources. Per the interim guidance of the Council of State and Territorial Epidemiologists (CSTE), this should include persons whose death certificate lists COVID-19 disease or SARS-CoV-2 as the underlying cause of death or as a significant condition contributing to death. Rates of COVID-19 deaths by vaccination status are primarily reported based on when the patient was tested for COVID-19. In select jurisdictions, deaths are included that are not laboratory confirmed and are reported based on alternative dates (i.e., onset date for most; or date of death or report date, where onset date is unavailable). Deaths usually occur up to 30 days after COVID-19 diagnosis.

Participating jurisdictions: Currently, these 24 health departments that regularly link their case surveillance to immunization information system data are included in these incidence rate estimates: Alabama, Arizona, Colorado, District of Columbia, Georgia, Idaho, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Nebraska, New Jersey, New Mexico, New York, New York City (NY), North Carolina, Rhode Island, Tennessee, Texas, Utah, and West Virginia; 23 jurisdictions also report deaths among vaccinated and unvaccinated people. These jurisdictions represent 48% of the total U.S. population and all ten of the Health and Human Services Regions. This list will be updated as more jurisdictions participate.

Incidence rate estimates: Weekly age-specific incidence rates by vaccination status were calculated as the number of cases or deaths divided by the number of people vaccinated with a primary series, overall or with/without a booster dose (cumulative) or unvaccinated (obtained by subtracting the cumulative number of people vaccinated with at least a primary series and partially vaccinated people from the 2019 U.S. intercensal population estimates) and multiplied by 100,000. Overall incidence rates were age-standardized using the 2000 U.S. Census standard population. To estimate population counts for ages 6-12 months, half of the single-year population counts for ages <12 months were used. All rates are plotted by positive specimen collection date to reflect when incident infections occurred.

Continuity correction: A continuity correction has been applied to the denominators by capping the percent population coverage at 95%. To do this, we assumed that at least 5% of each age group would always be unvaccinated in each jurisdiction. Adding this correction ensures that there is always a reasonable denominator for the unvaccinated population that would prevent incidence and death rates from growing unrealistically large due to potential overestimates of vaccination coverage.

Incidence rate ratios (IRRs): IRRs for the past one month were calculated by dividing the average weekly incidence rates among unvaccinated people by that among people vaccinated without an updated (bivalent) booster dose) or vaccinated with an updated (bivalent) booster dose.

Archive: An archive of historic data, including April 3, 2021-September 24, 2022 and posted on October 21, 2022 is available on data.cdc.gov. The analysis by vaccination status (unvaccinated and at least a primary series) for 31 jurisdictions is posted here: https://data.cdc.gov/Public-Health-Surveillance/Rates-of-COVID-19-Cases-or-Deaths-by-Age-Group-and/3rge-nu2a. The analysis for one booster dose (unvaccinated, primary series only, and at least one booster dose) in 31 jurisdictions is posted here: https://data.cdc.gov/Public-Health-Surveillance/Rates-of-COVID-19-Cases-or-Deaths-by-Age-Group-and/d6p8-wqjm. The analysis for two booster doses (unvaccinated, primary series only, one booster dose, and at least two booster doses) in 28 jurisdictions is posted here: https://data.cdc.gov/Public-Health-Surveillance/Rates-of-COVID-19-Cases-or-Deaths-by-Age-Group-and/ukww-au2k.

References

Scobie HM, Johnson AG, Suthar AB, et al. Monitoring Incidence of COVID-19 Cases, Hospitalizations, and Deaths, by Vaccination Status — 13 U.S. Jurisdictions, April 4–July 17, 2021. MMWR Morb Mortal Wkly Rep 2021;70:1284–1290.

Johnson AG, Amin AB, Ali AR, et al. COVID-19 Incidence and Death Rates Among Unvaccinated and Fully Vaccinated Adults with and Without Booster Doses During Periods of Delta and Omicron Variant Emergence — 25 U.S. Jurisdictions, April 4–December 25, 2021. MMWR Morb Mortal Wkly Rep 2022;71:132–138

Johnson AG, Linde L, Ali AR, et al. COVID-19 Incidence and Mortality Among Unvaccinated and Vaccinated Persons Aged ≥12 Years by Receipt of Bivalent Booster Doses and Time Since Vaccination — 24 U.S. Jurisdictions, October 3, 2021–December 24, 2022. MMWR Morb Mortal Wkly Rep 2023;72:145–152

The leading causes of death among Black residents in the United States in 2022 included diseases of the heart, cancer, unintentional injuries, and stroke. The leading causes of death for African Americans generally reflects the leading causes of death for the entire United States population. However, a major exception is that death from assault or homicide is the seventh leading cause of death among African Americans, but is not among the ten leading causes for the general population. Homicide among African Americans The homicide rate among African Americans has been higher than that of other races and ethnicities for many years. In 2023, around 9,284 Black people were murdered in the United States, compared to 7,289 white people. A majority of these homicides are committed with firearms, which are easily accessible in the United States. In 2022, around 14,189 Black people died by firearms. However, suicide deaths account for over half of all deaths from firearms in the United States. Cancer disparities There are also major disparities in access to health care and the impact of various diseases. For example, the incidence rate of cancer among African American males is the greatest among all ethnicities and races. Furthermore, although the incidence rate of cancer is lower among African American women than it is among white women, cancer death rates are still higher among African American women.

The 1997 birth cohort linked file includes several separate data files. The first file includes linked birth and death certificate data for all US infants born in 1997 who died before their first birthday - referred to as the numerator file. The second file contains information from the death certificate for all US infant death records which could not be linked to their corresponding birth certificates - referred to as the unlinked death file. The third file is the 1997 NCHS natality file for the US with a few minor modifications - referred to as the denominator-plus file. These same three data files are also available for Puerto Rico, the Virgin Islands, and Guam. For the denominator-plus file, selected variables from the numerator file have been added to the denominator file to facilitate processing. These variables include age at death (and recodes), underlying cause of death (and the 61-cause recode), place of accident, and record weight. These variables are the most widely used variables from the numerator file. With the previous file format it was sometimes necessary to combine the numerator and denominator files when performing certain multivariate statistical techniques. Now, when the number of variables required from the numerator file is limited, the denominator-plus file may be used by itself for ease of programming. Infant death identification numbers are also included, so that the same infant can be uniquely identified and matched between the numerator and denominator-plus files.

BackgroundCardiovascular diseases (CVDs) are not only the primary cause of mortality in China but also represent a significant financial burden. The World Health Organization highlight that as China undergoes rapid socioeconomic development, its disease spectrum is gradually shifting towards that of developed countries, with increasing prevalence of lifestyle-related diseases such as ischemic heart disease and stroke. We reviewed the rates and trends of CVDs incidence, mortality and disability-adjusted life years (DALYs) burden in China and compared them with those in the United States (US) and Japan for formulating CVDs control policies.MethodsData on CVDs incidence, death and DALYs in China, the US and Japan were obtained from the GBD 2019 database. The Joinpoint regression model was used to analyze the trends in CVDs incidence and mortality in China, the US and Japan, calculate the annual percentage change and determine the best-fitting inflection points.ResultsIn 2019, there were approximately 12,341,074 new diagnosed cases of CVDs in China, with 4,584,273 CVDs related deaths, causing 91,933,122 DALYs. The CVDs age-standardized incidence rate (ASIR) in China (538.10/100,000) was lower than that in the US and globally, while age-standardized death rate (ASDR) (276.9/100,000) and age-standardized DALY rate (6,463.47/100,000) were higher than those in the two regions. Compared with the US and Japan, from 1990 to 2019, the CVDs incidence rate in China showed an increasing trend, with a lower annual decrease in ASDR and a younger age structure of disease burden. Furthermore, the disease spectrum in China changed minimally, with stroke, ischemic heart disease, and hypertensive heart disease being the top three leading CVDs diseases in terms of incidence and disease burden, also being the major causes of CVDs in the US and Japan.ConclusionThe prevention and control of CVDs is a global issue. The aging population and increasing unhealthy lifestyles will continue to increase the burden in China. Therefore, relevant departments in China should reference the established practices for CVDs control in developed countries while considering the diversity of CVDs in different regions when adjusting national CVDs control programs.

Causes of Death data refer to the underlying cause which - according to the World Health Organisation (WHO) - is the disease or injury which initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury"." Copyright notice and free re-use of data on: https://ec.europa.eu/eurostat/about-us/policies/copyright