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.

From 2018 to 2023, heart disease and cancer accounted for the highest share of deaths in the United States. In 2020 and 2021, COVID-19 became the third leading cause of death, accounting for around 12 percent of all deaths in 2021. However, by 2023, COVID-19 was responsible for only 1.6 percent of deaths, making it the tenth leading cause of death. This statistic shows the distribution of the 10 leading causes of death in the United States from 2018 to 2023.

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.

This statistic shows the percentage changes in selected causes of death due to diseases in the United States, between 2000 and 2022. The number of deaths caused by prostate cancer increased by 7.4 percent during this period. Changes in selected causes of deathThere has been a decrease in the rate of death caused by many diseases, including stroke and heart disease. However, the mortality rate due to Alzheimer’s disease increased by 142 percent from 2000 to 2022. Alzheimer’s disease caused 27.7 deaths per 100,000 population in 2023, making it the sixth leading cause of death in the United States. Mortality rates due to different diseases vary by different factors, including race and ethnicity. For example, cancer is the leading cause of death among Asians and Pacific Islanders in the United States, accounting for 22 percent of total deaths among this population, while heart disease is the leading cause of death among the white population. Ischemic heart disease is the leading cause of death worldwide, accounting for around nine million deaths in 2021. In the early 1900's, the mortality rate was primarily concentrated among people of younger ages, but increasingly, this has shifted to older population groups. In recent years, decreased mortality rates are often linked to improved medical care, such as new developments in medical technologies. Shifts in lifestyle habits such as decreased smoking rates and healthier diets may also attribute to lower mortality rates.

The Detailed Mortality - Underlying Cause of Death data on CDC WONDER are county-level national mortality and population data spanning the years 1999-2009. Data are based on death certificates for U.S. residents. Each death certificate contains a single underlying cause of death, and demographic data. The number of deaths, crude death rates, age-adjusted death rates, standard errors and 95% confidence intervals for death rates can be obtained by place of residence (total U.S., region, state, and county), age group (including infants and single-year-of-age cohorts), race (4 groups), Hispanic ethnicity, sex, year of death, and cause-of-death (4-digit ICD-10 code or group of codes, injury intent and mechanism categories, or drug and alcohol related causes), year, month and week day of death, place of death and whether an autopsy was performed. The data are produced by the National Center for Health Statistics.

This dataset presents the age-adjusted death rates for the 10 leading causes of death in the United States beginning in 1999.

Data are based on information from all resident death certificates filed in the 50 states and the District of Columbia using demographic and medical characteristics. Age-adjusted death rates (per 100,000 population) are based on the 2000 U.S. standard population. Populations used for computing death rates after 2010 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 death classified by the International Classification of Diseases, Tenth Revision (ICD–10) are ranked according to the number of deaths assigned to rankable causes. 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

1. 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.

2. 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.

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.

US: Mortality from CVD, Cancer, Diabetes or CRD between Exact Ages 30 and 70: Female data was reported at 11.800 NA in 2016. This records an increase from the previous number of 11.600 NA for 2015. US: Mortality from CVD, Cancer, Diabetes or CRD between Exact Ages 30 and 70: Female data is updated yearly, averaging 11.800 NA from Dec 2000 (Median) to 2016, with 5 observations. The data reached an all-time high of 14.600 NA in 2000 and a record low of 11.600 NA in 2015. US: Mortality from CVD, Cancer, Diabetes or CRD between Exact Ages 30 and 70: Female data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s United States – Table US.World Bank.WDI: Health Statistics. Mortality from CVD, cancer, diabetes or CRD is the percent of 30-year-old-people who would die before their 70th birthday from any of cardiovascular disease, cancer, diabetes, or chronic respiratory disease, assuming that s/he would experience current mortality rates at every age and s/he would not die from any other cause of death (e.g., injuries or HIV/AIDS).; ; World Health Organization, Global Health Observatory Data Repository (http://apps.who.int/ghodata/).; Weighted average;

In 2023, there were approximately 750.5 deaths by all causes per 100,000 inhabitants in the United States. This statistic shows the death rate for all causes in the United States between 1950 and 2023. Causes of death in the U.S. Over the past decades, chronic conditions and non-communicable diseases have come to the forefront of health concerns and have contributed to major causes of death all over the globe. In 2022, the leading cause of death in the U.S. was heart disease, followed by cancer. However, the death rates for both heart disease and cancer have decreased in the U.S. over the past two decades. On the other hand, the number of deaths due to Alzheimer’s disease – which is strongly linked to cardiovascular disease- has increased by almost 141 percent between 2000 and 2021. Risk and lifestyle factors Lifestyle factors play a major role in cardiovascular health and the development of various diseases and conditions. Modifiable lifestyle factors that are known to reduce risk of both cancer and cardiovascular disease among people of all ages include smoking cessation, maintaining a healthy diet, and exercising regularly. An estimated two million new cases of cancer in the U.S. are expected in 2025.

Age-adjustment mortality rates are rates of deaths that are computed using a statistical method to create a metric based on the true death rate so that it can be compared over time for a single population (i.e. comparing 2006-2008 to 2010-2012), as well as enable comparisons across different populations with possibly different age distributions in their populations (i.e. comparing Hispanic residents to Asian residents). Age adjustment methods applied to Montgomery County rates are consistent with US Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS) as well as Maryland Department of Health and Mental Hygiene’s Vital Statistics Administration (DHMH VSA). PHS Planning and Epidemiology receives an annual data file of Montgomery County resident deaths registered with Maryland Department of Health and Mental Hygiene’s Vital Statistics Administration (DHMH VSA). Using SAS analytic software, MCDHHS standardizes, aggregates, and calculates age-adjusted rates for each of the leading causes of death category consistent with state and national methods and by subgroups based on age, gender, race, and ethnicity combinations. Data are released in compliance with Data Use Agreements between DHMH VSA and MCDHHS. This dataset will be updated Annually.

The Mortality - Multiple Cause of Death data on CDC WONDER are county-level national mortality and population data spanning the years 1999-2009. Data are based on death certificates for U.S. residents. Each death certificate contains a single underlying cause of death, up to twenty additional multiple causes (Boolean set analysis), and demographic data. The number of deaths, crude death rates, age-adjusted death rates, standard errors and 95% confidence intervals for death rates can be obtained by place of residence (total U.S., region, state, and county), age group (including infants and single-year-of-age cohorts), race (4 groups), Hispanic ethnicity, sex, year of death, and cause-of-death (4-digit ICD-10 code or group of codes, injury intent and mechanism categories, or drug and alcohol related causes), year, month and week day of death, place of death and whether an autopsy was performed. The data are produced by the National Center for Health Statistics.

This data collection is a portion of the historical data collected by the project, "Early Indicators of Later Work Levels, Disease, and Death," which is collecting military, medical, and socioeconomic data on a sample of white males mustered into the Union Army during the Civil War. During 1850, 1860, and 1870, mortality information was gathered at the county level as an addendum to the population census. These data examine the impact of environmental factors on life outcomes and look at the influence of infectious disease rates on economic and health patterns at late ages. Part 1, Disease Data, looks at cause of death from 66 disease classifications. Part 2, General Disease Data, also examines cause of death but through 18 broad disease categories. Variables included in both parts are state, county, year of death, and frequency of death by disease.

This dataset of U.S. mortality trends since 1900 highlights trends in age-adjusted death rates for five selected major causes of death.

Age-adjusted death rates (deaths per 100,000) after 1998 are calculated based on the 2000 U.S. standard population. Populations used for computing death rates for 2011–2017 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 noncensus years between 2000 and 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Data on age-adjusted death rates prior to 1999 are taken from historical data (see References below).

Revisions to the International Classification of Diseases (ICD) over time may result in discontinuities in cause-of-death trends.

SOURCES

CDC/NCHS, National Vital Statistics System, historical data, 1900-1998 (see https://www.cdc.gov/nchs/nvss/mortality_historical_data.htm); 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

1. National Center for Health Statistics, Data Warehouse. Comparability of cause-of-death between ICD revisions. 2008. Available from: http://www.cdc.gov/nchs/nvss/mortality/comparability_icd.htm.

2. 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.

3. Kochanek KD, Murphy SL, Xu JQ, Arias E. Deaths: Final data for 2017. National Vital Statistics Reports; vol 68 no 9. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf.

4. Arias E, Xu JQ. United States life tables, 2017. National Vital Statistics Reports; vol 68 no 7. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_07-508.pdf.

5. National Center for Health Statistics. Historical Data, 1900-1998. 2009. Available from: https://www.cdc.gov/nchs/nvss/mortality_historical_data.htm.

In the United States in 2021, the death rate was highest among those aged 85 and over, with about 17,190.5 men and 14,914.5 women per 100,000 of the population passing away. For all ages, the death rate was at 1,118.2 per 100,000 of the population for males, and 970.8 per 100,000 of the population for women. The death rate Death rates generally are counted as the number of deaths per 1,000 or 100,000 of the population and include both deaths of natural and unnatural causes. The death rate in the United States had pretty much held steady since 1990 until it started to increase over the last decade, with the highest death rates recorded in recent years. While the birth rate in the United States has been decreasing, it is still currently higher than the death rate. Causes of death There are a myriad number of causes of death in the United States, but the most recent data shows the top three leading causes of death to be heart disease, cancers, and accidents. Heart disease was also the leading cause of death worldwide.

This dataset describes drug poisoning deaths at the U.S. and state level by selected demographic characteristics, and includes age-adjusted death rates for drug poisoning. Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent). Estimates are based on the National Vital Statistics System multiple cause-of-death mortality files (1). Age-adjusted death rates (deaths per 100,000 U.S. standard population for 2000) are calculated using the direct method. Populations used for computing death rates for 2011–2017 are postcensal estimates based on the 2010 U.S. census. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Death rates for some states and years may be low due to a high number of unresolved pending cases or misclassification of ICD–10 codes for unintentional poisoning as R99, “Other ill-defined and unspecified causes of mortality” (2). For example, this issue is known to affect New Jersey in 2009 and West Virginia in 2005 and 2009 but also may affect other years and other states. Drug poisoning death rates may be underestimated in those instances. REFERENCES 1. National Center for Health Statistics. National Vital Statistics System: Mortality data. Available from: http://www.cdc.gov/nchs/deaths.htm. CDC. CDC Wonder: Underlying cause of death 1999–2016. Available from: http://wonder.cdc.gov/wonder/help/ucd.html.

The Mortality - Multiple Cause of Death data on CDC WONDER are county-level national mortality and population data spanning the yehttps://healthdata.gov/d/2sz9-6c59ars 1999-2006. These data are available in two separate data sets: one data set for years 1999-2004 with 3 race groups, and another data set for years 2005-2006 with 4 race groups and 3 Hispanic origin categories. Data are based on death certificates for U.S. residents. Each death certificate contains a single underlying cause of death, up to twenty additional multiple causes, and demographic data. The number of deaths, crude death rates, age-adjusted death rates, standard errors and 95% confidence intervals for death rates can be obtained by place of residence (total U.S., state, and county), age group (including infants), race, Hispanic ethnicity (years 2005-2006 only), sex, year of death, and cause-of-death (4-digit ICD-10 code or group of codes). The data are produced by the National Center for Health Statistics.

This dataset of U.S. mortality trends since 1900 highlights childhood mortality rates by age group for age at death. Age-adjusted death rates (deaths per 100,000) after 1998 are calculated based on the 2000 U.S. standard population. Populations used for computing death rates for 2011–2017 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 noncensus years between 2000 and 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Data on age-adjusted death rates prior to 1999 are taken from historical data (see References below). Age groups for childhood death rates are based on age at death. SOURCES CDC/NCHS, National Vital Statistics System, historical data, 1900-1998 (see https://www.cdc.gov/nchs/nvss/mortality_historical_data.htm); 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, Data Warehouse. Comparability of cause-of-death between ICD revisions. 2008. Available from: http://www.cdc.gov/nchs/nvss/mortality/comparability_icd.htm. 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. Kochanek KD, Murphy SL, Xu JQ, Arias E. Deaths: Final data for 2017. National Vital Statistics Reports; vol 68 no 9. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf. Arias E, Xu JQ. United States life tables, 2017. National Vital Statistics Reports; vol 68 no 7. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_07-508.pdf. National Center for Health Statistics. Historical Data, 1900-1998. 2009. Available from: https://www.cdc.gov/nchs/nvss/mortality_historical_data.htm.

This dataset contains information on the number of deaths and age-adjusted death rates for the five leading causes of death in 1900, 1950, and 2000.

Age-adjusted death rates (deaths per 100,000) after 1998 are calculated based on the 2000 U.S. standard population. Populations used for computing death rates for 2011–2017 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 noncensus years between 2000 and 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Data on age-adjusted death rates prior to 1999 are taken from historical data (see References below).

SOURCES

CDC/NCHS, National Vital Statistics System, historical data, 1900-1998 (see https://www.cdc.gov/nchs/nvss/mortality_historical_data.htm); 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

1. National Center for Health Statistics, Data Warehouse. Comparability of cause-of-death between ICD revisions. 2008. Available from: http://www.cdc.gov/nchs/nvss/mortality/comparability_icd.htm.

2. 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.

3. Kochanek KD, Murphy SL, Xu JQ, Arias E. Deaths: Final data for 2017. National Vital Statistics Reports; vol 68 no 9. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf.

4. Arias E, Xu JQ. United States life tables, 2017. National Vital Statistics Reports; vol 68 no 7. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_07-508.pdf.

5. National Center for Health Statistics. Historical Data, 1900-1998. 2009. Available from: https://www.cdc.gov/nchs/nvss/mortality_historical_data.htm.

A database based on a random sample of the noninstitutionalized population of the United States, developed for the purpose of studying the effects of demographic and socio-economic characteristics on differentials in mortality rates. It consists of data from 26 U.S. Current Population Surveys (CPS) cohorts, annual Social and Economic Supplements, and the 1980 Census cohort, combined with death certificate information to identify mortality status and cause of death covering the time interval, 1979 to 1998. The Current Population Surveys are March Supplements selected from the time period from March 1973 to March 1998. The NLMS routinely links geographical and demographic information from Census Bureau surveys and censuses to the NLMS database, and other available sources upon request. The Census Bureau and CMS have approved the linkage protocol and data acquisition is currently underway. The plan for the NLMS is to link information on mortality to the NLMS every two years from 1998 through 2006 with research on the resulting database to continue, at least, through 2009. The NLMS will continue to incorporate data from the yearly Annual Social and Economic Supplement into the study as the data become available. Based on the expected size of the Annual Social and Economic Supplements to be conducted, the expected number of deaths to be added to the NLMS through the updating process will increase the mortality content of the study to nearly 500,000 cases out of a total number of approximately 3.3 million records. This effort would also include expanding the NLMS population base by incorporating new March Supplement Current Population Survey data into the study as they become available. Linkages to the SEER and CMS datasets are also available. Data Availability: Due to the confidential nature of the data used in the NLMS, the public use dataset consists of a reduced number of CPS cohorts with a fixed follow-up period of five years. NIA does not make the data available directly. Research access to the entire NLMS database can be obtained through the NIA program contact listed. Interested investigators should email the NIA contact and send in a one page prospectus of the proposed project. NIA will approve projects based on their relevance to NIA/BSR''s areas of emphasis. Approved projects are then assigned to NLMS statisticians at the Census Bureau who work directly with the researcher to interface with the database. A modified version of the public use data files is available also through the Census restricted Data Centers. However, since the database is quite complex, many investigators have found that the most efficient way to access it is through the Census programmers. * Dates of Study: 1973-2009 * Study Features: Longitudinal * Sample Size: ~3.3 Million Link: *ICPSR: http://www.icpsr.umich.edu/icpsrweb/ICPSR/studies/00134

This dataset describes drug poisoning deaths at the U.S. and state level by selected demographic characteristics, and includes age-adjusted death rates for drug poisoning. Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent). Estimates are based on the National Vital Statistics System multiple cause-of-death mortality files (1). Age-adjusted death rates (deaths per 100,000 U.S. standard population for 2000) are calculated using the direct method. Populations used for computing death rates for 2011–2017 are postcensal estimates based on the 2010 U.S. census. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Death rates for some states and years may be low due to a high number of unresolved pending cases or misclassification of ICD–10 codes for unintentional poisoning as R99, “Other ill-defined and unspecified causes of mortality” (2). For example, this issue is known to affect New Jersey in 2009 and West Virginia in 2005 and 2009 but also may affect other years and other states. Drug poisoning death rates may be underestimated in those instances. REFERENCES 1. National Center for Health Statistics. National Vital Statistics System: Mortality data. Available from: http://www.cdc.gov/nchs/deaths.htm. CDC. CDC Wonder: Underlying cause of death 1999–2016. Available from: http://wonder.cdc.gov/wonder/help/ucd.html.