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.

As of 2023, the third leading cause of death among teenagers aged 15 to 19 years in the United States was intentional self-harm or suicide, contributing to around 17 percent of deaths among this age group. The leading cause of death at that time was unintentional injuries, contributing to around 38.6 percent of deaths, while 20.7 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 2023, New Mexico had the highest rate of suicides among U.S. teenagers, with around 28 deaths per 100,000 teenagers, followed by Idaho with a rate of 22.5 per 100,000. The states with the lowest death rates among adolescents are New Jersey and New York. 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.

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.

Number of deaths and mortality rates, by age group, sex, and place of residence, 1991 to most recent year.

The leading causes of death among Black residents in the United States in 2023 included diseases of the heart, cancer, unintentional injuries, and stroke. The leading causes of death for African Americans generally reflect 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 2023, around 13,350 Black people died by firearms. 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.

Number of deaths and age-specific mortality rates for selected grouped causes, by age group and sex, 2000 to most recent year.

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.

ObjectiveTo determine the long-term survival of patients receiving home hemodialysis (HHD) through self-punctured arteriovenous access.MethodsWe conducted an observational study of all patients receiving HHD at our facility between 2001 and 2020. The primary outcome was treatment survival, and it was defined as the duration from HHD initiation to the first event of death or technique failure. The secondary outcomes were the cumulative incidence of technique failure and mortality. Cox proportional hazard models were used to identify the predictive factors for treatment survival.ResultsA total of 77 patients (mean age, 50.7 years; 84.4% male; 23.4% with diabetes) were included. The median dialysis duration was 18 hours per week, and all patients self-punctured their arteriovenous fistula. During a median follow-up of 116 months, 30 treatment failures (11 deaths and 19 technique failures) were observed. The treatment survival was 100% at 1 year, 83.5% at 5 years, 67.2% at 10 years, and 34.6% at 15 years. Age (adjusted hazard ratio [aHR], 1.07) and diabetes (aHR, 2.45) were significantly associated with treatment survival. Cardiovascular disease was the leading cause of death, and vascular access-related issues were the primary causes of technique failure, which occurred predominantly after 100 months from HHD initiation.ConclusionThis study showed a favorable long-term prognosis of patients receiving HHD. HHD can be a sustainable form of long-term kidney replacement therapy. However, access-related technique failures occur more frequently in patients receiving it over the long term. Therefore, careful management of vascular access is crucial to enhance technique survival.

Among men in the United States, those aged 75 years and older have the highest death rate from suicide among all age groups. In 2023, the suicide death rate among men aged 75 years and older was 40.7 per 100,000 population. In comparison, the death rate from suicide among men aged 25 to 44 years was 29.8 per 100,000. Suicide is a significant problem in the United States, with rates increasing over the past decade. Suicide among men In the United States, the suicide rate among men is almost four times higher than that of women. In 2022, the rate of suicide among U.S. men was 23 per 100,000 population, the highest rate recorded over the past 70 years. Firearms account for the vast majority of suicide deaths among men, accounting for around 60 percent of male suicides in 2021. The reasons why U.S. men have higher rates of suicide than women are complex and not fully understood, but may have to do with the more violent means by which men carry out suicide and the stigma around seeking help for mental health issues. Suicide among women Although the suicide rate among women in the U.S. is significantly lower than that of men, the rate of suicide among women has increased over the past couple of decades. Among women, those aged 45 to 64 years have the highest death rates due to suicide, followed by women 25 to 44 years old. Interestingly, the share of women reporting serious thoughts of suicide in the past year is higher than that of men, with around 5.5 percent of U.S. women reporting such thoughts in 2023. Similarly to men, firearms account for most suicide deaths among women, however suffocation and poisoning account for a significant share of suicides among women. In 2021, around 35 percent of suicides among women were carried out by firearms, while suffocation and poisoning each accounted for around 28 percent of suicide deaths.

Find data on deaths of Massachusetts residents. Information is obtained from death certificates received by the Registry of Vital Records and Statistics.

In 2023, the age-specific death rate for men aged 90 or over in England and Wales was 248.1 per one thousand population, and 215.1 for women. Except for infants that were under the age of one, younger age groups had the lowest death rate, with the death rate getting progressively higher in older age groups.

ObjectiveTo determine the long-term survival of patients receiving home hemodialysis (HHD) through self-punctured arteriovenous access.MethodsWe conducted an observational study of all patients receiving HHD at our facility between 2001 and 2020. The primary outcome was treatment survival, and it was defined as the duration from HHD initiation to the first event of death or technique failure. The secondary outcomes were the cumulative incidence of technique failure and mortality. Cox proportional hazard models were used to identify the predictive factors for treatment survival.ResultsA total of 77 patients (mean age, 50.7 years; 84.4% male; 23.4% with diabetes) were included. The median dialysis duration was 18 hours per week, and all patients self-punctured their arteriovenous fistula. During a median follow-up of 116 months, 30 treatment failures (11 deaths and 19 technique failures) were observed. The treatment survival was 100% at 1 year, 83.5% at 5 years, 67.2% at 10 years, and 34.6% at 15 years. Age (adjusted hazard ratio [aHR], 1.07) and diabetes (aHR, 2.45) were significantly associated with treatment survival. Cardiovascular disease was the leading cause of death, and vascular access-related issues were the primary causes of technique failure, which occurred predominantly after 100 months from HHD initiation.ConclusionThis study showed a favorable long-term prognosis of patients receiving HHD. HHD can be a sustainable form of long-term kidney replacement therapy. However, access-related technique failures occur more frequently in patients receiving it over the long term. Therefore, careful management of vascular access is crucial to enhance technique survival.

The 2008 National Demographic and Health Survey (2008 NDHS) is a nationally representative survey of 13,594 women age 15-49 from 12,469 households successfully interviewed, covering 794 enumeration areas (clusters) throughout the Philippines. This survey is the ninth in a series of demographic and health surveys conducted to assess the demographic and health situation in the country. The survey obtained detailed information on fertility levels, marriage, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutritional status of women and young children, childhood mortality, maternal and child health, and knowledge and attitudes regarding HIV/AIDS and tuberculosis. Also, for the first time, the Philippines NDHS gathered information on violence against women. The 2008 NDHS was conducted by the Philippine National Statistics Office (NSO). Technical assistance was provided by ICF Macro through the MEASURE DHS program. Funding for the survey was mainly provided by the Government of the Philippines. Financial support for some preparatory and processing phases of the survey was provided by the U.S. Agency for International Development (USAID). Like previous Demographic and Health Surveys (DHS) conducted in the Philippines, the 2008 National Demographic and Health Survey (NDHS) was primarily designed to provide information on population, family planning, and health to be used in evaluating and designing policies, programs, and strategies for improving health and family planning services in the country. The 2008 NDHS also included questions on domestic violence. Specifically, the 2008 NDHS had the following objectives: Collect data at the national level that will allow the estimation of demographic rates, particularly, fertility rates by urban-rural residence and region, and under-five mortality rates at the national level. Analyze the direct and indirect factors which determine the levels and patterns of fertility. Measure the level of contraceptive knowledge and practice by method, urban-rural residence, and region. Collect data on family health: immunizations, prenatal and postnatal checkups, assistance at delivery, breastfeeding, and prevalence and treatment of diarrhea, fever, and acute respiratory infections among children under five years. Collect data on environmental health, utilization of health facilities, prevalence of common noncommunicable and infectious diseases, and membership in health insurance plans. Collect data on awareness of tuberculosis. Determine women's knowledge about HIV/AIDS and access to HIV testing. Determine the extent of violence against women. MAIN RESULTS FERTILITY Fertility Levels and Trends. There has been a steady decline in fertility in the Philippines in the past 36 years. From 6.0 children per woman in 1970, the total fertility rate (TFR) in the Philippines declined to 3.3 children per woman in 2006. The current fertility level in the country is relatively high compared with other countries in Southeast Asia, such as Thailand, Singapore and Indonesia, where the TFR is below 2 children per woman. Fertility Differentials. Fertility varies substantially across subgroups of women. Urban women have, on average, 2.8 children compared with 3.8 children per woman in rural areas. The level of fertility has a negative relationship with education; the fertility rate of women who have attended college (2.3 children per woman) is about half that of women who have been to elementary school (4.5 children per woman). Fertility also decreases with household wealth: women in wealthier households have fewer children than those in poorer households. FAMILY PLANNING Knowledge of Contraception. Knowledge of family planning is universal in the Philippines- almost all women know at least one method of fam-ily planning. At least 90 percent of currently married women have heard of the pill, male condoms, injectables, and female sterilization, while 87 percent know about the IUD and 68 percent know about male sterilization. On average, currently married women know eight methods of family planning. Unmet Need for Family Planning. Unmet need for family planning is defined as the percentage of currently married women who either do not want any more children or want to wait before having their next birth, but are not using any method of family planning. The 2008 NDHS data show that the total unmet need for family planning in the Philippines is 22 percent, of which 13 percent is limiting and 9 percent is for spacing. The level of unmet need has increased from 17 percent in 2003. Overall, the total demand for family planning in the Philippines is 73 percent, of which 69 percent has been satisfied. If all of need were satisfied, a contraceptive prevalence rate of about 73 percent could, theoretically, be expected. Comparison with the 2003 NDHS indicates that the percentage of demand satisfied has declined from 75 percent. MATERNAL HEALTH Antenatal Care. Nine in ten Filipino mothers received some antenatal care (ANC) from a medical professional, either a nurse or midwife (52 percent) or a doctor (39 percent). Most women have at least four antenatal care visits. More than half (54 percent) of women had an antenatal care visit during the first trimester of pregnancy, as recommended. While more than 90 percent of women who received antenatal care had their blood pressure monitored and weight measured, only 54 percent had their urine sample taken and 47 percent had their blood sample taken. About seven in ten women were informed of pregnancy complications. Three in four births in the Philippines are protected against neonatal tetanus. Delivery and Postnatal Care. Only 44 percent of births in the Philippines occur in health facilities-27 percent in a public facility and 18 percent in a private facility. More than half (56 percent) of births are still delivered at home. Sixty-two percent of births are assisted by a health professional-35 percent by a doctor and 27 percent by a midwife or nurse. Thirty-six percent are assisted by a traditional birth attendant or hilot. About 10 percent of births are delivered by C-section. The Department of Health (DOH) recommends that mothers receive a postpartum check within 48 hours of delivery. A majority of women (77 percent) had a postnatal checkup within two days of delivery; 14 percent had a postnatal checkup 3 to 41 days after delivery. CHILD HEALTH Childhood Mortality. Childhood mortality continues to decline in the Philippines. Currently, about one in every 30 children in the Philippines dies before his or her fifth birthday. The infant mortality rate for the five years before the survey (roughly 2004-2008) is 25 deaths per 1,000 live births and the under-five mortality rate is 34 deaths per 1,000 live births. This is lower than the rates of 29 and 40 reported in 2003, respectively. The neonatal mortality rate, representing death in the first month of life, is 16 deaths per 1,000 live births. Under-five mortality decreases as household wealth increases; children from the poorest families are three times more likely to die before the age of five as those from the wealthiest families. There is a strong association between under-five mortality and mother's education. It ranges from 47 deaths per 1,000 live births among children of women with elementary education to 18 deaths per 1,000 live births among children of women who attended college. As in the 2003 NDHS, the highest level of under-five mortality is observed in ARMM (94 deaths per 1,000 live births), while the lowest is observed in NCR (24 deaths per 1,000 live births). NUTRITION Breastfeeding Practices. Eighty-eight percent of children born in the Philippines are breastfed. There has been no change in this practice since 1993. In addition, the median durations of any breastfeeding and of exclusive breastfeeding have remained at 14 months and less than one month, respectively. Although it is recommended that infants should not be given anything other than breast milk until six months of age, only one-third of Filipino children under six months are exclusively breastfed. Complementary foods should be introduced when a child is six months old to reduce the risk of malnutrition. More than half of children ages 6-9 months are eating complementary foods in addition to being breastfed. The Infant and Young Child Feeding (IYCF) guidelines contain specific recommendations for the number of times that young children in various age groups should be fed each day as well as the number of food groups from which they should be fed. NDHS data indicate that just over half of children age 6-23 months (55 percent) were fed according to the IYCF guidelines. HIV/AIDS Awareness of HIV/AIDS. While over 94 percent of women have heard of AIDS, only 53 percent know the two major methods for preventing transmission of HIV (using condoms and limiting sex to one uninfected partner). Only 45 percent of young women age 15-49 know these two methods for preventing HIV transmission. Knowledge of prevention methods is higher in urban areas than in rural areas and increases dramatically with education and wealth. For example, only 16 percent of women with no education know that using condoms limits the risk of HIV infection compared with 69 percent of those who have attended college. TUBERCULOSIS Knowledge of TB. While awareness of tuberculosis (TB) is high, knowledge of its causes and symptoms is less common. Only 1 in 4 women know that TB is caused by microbes, germs or bacteria. Instead, respondents tend to say that TB is caused by smoking or drinking alcohol, or that it is inherited. Symptoms associated with TB are better recognized. Over half of the respondents cited coughing, while 39 percent mentioned weight loss, 35 percent mentioned blood in sputum, and 30 percent cited coughing with sputum. WOMEN'S STATUS Women's Status and Employment.

Infection and sepsis are leading causes of death worldwide but the epidemiology and outcomes are not well understood in resource-limited settings. We conducted a four-year prospective observational study from March 2013 to February 2017 to examine the clinical epidemiology and outcomes of adults admitted with community-acquired infection in a resource-limited tertiary-care hospital in Ubon Ratchathani province, Northeast Thailand. Hospitalized patients with infection and accompanying systemic manifestations of infection within 24 hours of admission were enrolled. Subjects were classified as having sepsis if they had a modified sequential organ failure assessment (SOFA) score ≥2 at enrollment. This study was registered with ClinicalTrials.gov, number NCT02217592. A total of 4,989 patients were analyzed. Of the cohort, 2,659 (53%) were male and the median age was 57 years (range 18–101). Of these, 1,173 (24%) patients presented primarily to the study hospital, 3,524 (71%) were transferred from 25 district hospitals or 8 smaller hospitals in the province, and 292 (6%) were transferred from one of 30 hospitals in other provinces. Three thousand seven hundred and sixteen (74%) patients were classified as having sepsis. Patients with sepsis had an older age distribution and a greater prevalence of comorbidities compared to patients without sepsis. Twenty eight-day mortality was 21% (765/3,716) in sepsis and 4% (54/1,273) in non-sepsis patients (p<0.001). After adjusting for gender, age, and comorbidities, sepsis on admission (adjusted hazard ratio [HR] 3.30; 95% confidence interval [CI] 2.48–4.41, p<0.001), blood culture positive for pathogenic organisms (adjusted HR 2.21; 95% CI 1.89–2.58, p<0.001) and transfer from other hospitals (adjusted HR 2.18; 95% CI 1.69–2.81, p<0.001) were independently associated with mortality. In conclusion, mortality of community-acquired sepsis in Northeast Thailand is considerable and transferred patients with infection are at increased risk of death. To reduce mortality of sepsis in this and other resource-limited setting, facilitating rapid detection of sepsis in all levels of healthcare facilities, establishing guidelines for transfer of sepsis patients, and initiating sepsis care prior to and during transfer may be beneficial.

Between the beginning of January 2020 and June 14, 2023, of the 1,134,641 deaths caused by COVID-19 in the United States, around 307,169 had occurred among those aged 85 years and older. This statistic shows the number of coronavirus disease 2019 (COVID-19) deaths in the U.S. from January 2020 to June 2023, by age.

Since the 1950s, the suicide rate in the United States has been significantly higher among men than women. In 2022, the suicide rate among men was almost four times higher than that of women. However, the rate of suicide for both men and women has increased gradually over the past couple of decades. Facts on suicide in the United States In 2022, the rate of suicide death in the United States was around 14 per 100,000 population. The suicide rate in the U.S. has generally increased since the year 2000, with the highest rates ever recorded in the years 2018 and 2022. In the United States, death rates from suicide are highest among those aged 45 to 64 years and lowest among younger adults aged 15 to 24. The states with the highest rates of suicide are Montana, Alaska, and Wyoming, while New Jersey and Massachusetts have the lowest rates. Suicide among men In 2023, around 4.5 percent of men in the United States reported having serious thoughts of suicide in the past year. Although this rate is lower than that of women, men still have a higher rate of suicide death than women. One reason for this may have to do with the method of suicide. Although firearms account for the largest share of suicide deaths among both men and women, firearms account for almost 60 percent of all suicides among men and just 35 percent among women. Suffocation and poisoning are the other most common methods of suicide among women, with the chances of surviving a suicide attempt from these methods being much higher than surviving an attempt by firearm. The age group with the highest rate of suicide death among men is by far those aged 75 years and over.

Abstract

The 1999 Nigeria Demographic and Health Survey (NDHS) is a nationally representative survey of 8,199 women age 15-49 and 3,082 men age 15-64, designed to provide information on levels and trends of fetility, family planning practice, maternal and child health, infant and child mortality, and maternal mortality, as well as awareness of HIV/AIDS and other sexually transmitted diseases (STDs) and female circumcision. Fieldwork for the survey took place between March and May 1999.

OBJECTIVES

The main objective of the 1999 Nigeria Demographic and Health Survey (NDHS) is to provide up-to-date information on reality and childhood mortality levels; nuptiality; fertility preferences; awareness, approval, and use of family planning methods; breastfeeding practices; nutrition levels; and maternal and child health. This information is intended to assist policymakers and administrators in evaluating and designing programmes and strategies for improving health and family planning services in Nigeria.

MAIN RESULTS

Fertility

The total fertility rate during the five years before the survey is 5.2 births per woman. This shows a drop from the level of 6.0 births per woman as reported in the 1990 NDHS and 5.4 from the 1994 Sentinel Survey. The total fertility rate may, however be higher due to evidence that some births were probably omitted in the data. Fertility is substantially higher in the Northeast and Northwest regions and lower in the Southeast, Southwest, and Central regions. Fertility rates are also lower for more educated women.

Childbearing begins early in Nigeria, with about half of women 25 years and above becoming mothers before reaching the age of 20. The median age at first birth is 20.

The level of teenage childbearing has declined somewhat, with the proportion of girls age 15-19 who have either given birth or are pregnant with their first child declining from 28 percent in 1990 to 22 percent in 1999.

Teenage childbearing is higher in rural than urban areas and for those with no education than those with education.

The data from the survey indicate that there is a strong desire for children and a preference for large families with 66 percent of married women and 71 percent of married men indicating a desire to have more children. Even among those with six or more children, 30 percent of married women and 55 percent of married men want to have more children. This indicates a decline for women from the 35 percent reported in the 1990 NDHS. Overall, women report a mean ideal number of children of 6.2, compared with 7.8 children for men.

Despite the increasing level of contraceptive use, the 1999 NDHS data show that unplanned pregnancies are common, with almost one in five births reported to be unplanned. Most of these (16 percent of births) are mistimed (wanted later), while 3 percent were unwanted at all.

Family Planning

Knowledge about family planning methods is increasing in Nigeria, with about 65 percent of all women and 82 percent of all men having heard of at least one method of contraception.

Among women, the pill is the best known method (53 percent) while among men, the condom is the best known method (70 percent). Radio is a main source of information about family planning, with 35 percent of women and 61 percent of men reporting that they heard a family planning message on the radio in the few months before interview. The proportions of women and men who have seen a television message are 23 and 40 percent, respectively. Only 17 percent of women had seen a family planning message in the print media.

The contraceptive prevalence rate in Nigeria has also increased, with 15 percent of married women and 32 percent of married men now using some method of family planning. The use of modem methods is lower at 9 percent for married women and 14 percent for men. Although traditional contraceptive methods are not actively promoted, their use is relatively high with about 6 percent of married women and 17 percent of married men reporting that they are using periodic abstinence or withdrawal. In 1990, only 6 percent of married women were using any method, with only 4 percent using a modern method.

There are significant differentials in levels of family planning use. Urban women and men are much more likely to be using a method than rural respondents. Current use among married women is higher in the Southwest regions (26 percent), Southeast (24 percent), and Central (18 percent) regions than in the Northwest and Northeast (3 percent each). The largest differences occur by educational attainment. Only 6 percent of married women with no education are using a method of contraception, compared with 45 percent of those with more than secondary school.

Users of modern contraception are almost as likely to obtain their methods from government as private sources. Forty-three percent of users obtain their methods from the public sector--mostly government hospitals and health centres--while 43 percent use private medical sources such as pharmacies and private hospitals and clinics; 8 percent get their methods from other private sources like friends, relatives, shops and non-governmental organisations.

Maternal Health

The results of the survey show that antenatal care is not uncommon in Nigeria, with mothers receiving antenatal check-ups from either a doctor, nurse or midwife for two out of three births in the three years preceding the survey. However, the content of antenatal care visits appears to be lacking in at least one respect: survey data indicate deficiencies in tetanus toxoid coverage during pregnancy. Mothers reported receiving the recommended two doses of tetanus toxoid for only 44 percent of births and one dose for I 1 percent of births. Almost 40 percent of births occurred without the benefit of a tetanus vaccination.

In Nigeria, home deliveries are still very common, with almost three in five births delivered at home. Compared with 1990, the proportion of home deliveries has declined, with more births now taking place in health facilities. Increasing the proportion of births occurring in facilities is important since they can be attended by medically trained personnel which can result in fewer maternal deaths and delivery complications. Currently, 42 percent of births are attended by doctors, nurses or midwives.

The 1999 NDHS data show that about one in four Nigerian women age 15-49 reported being circumcised. The practice of female genital cutting is more prevalent in the south and central parts of the country and is almost non-existent in the north.

Child Health

The 1999 NDHS data indicate a decline in childhood vaccination coverage, with the proportion of children fully immunised dropping from 30 percent of children age 12-23 months in 1990 to only 17 percent in 1999. Only a little over half of young children receive the BCG vaccine and the first doses of DPT and polio vaccines. Almost 40 percent of children have not received any vaccination.

Diarrhoea and respiratory illness are common causes of childhood death. In the two weeks before the survey, 11 percent of children under three years of age were ill with acute respiratory infections (ARI) and 15 percent had diarrhoea. Half of children with ARI and 37,percent of those with diarrhoea were taken to a health facility for treatment. Of all the children with diarrhoea, 34 percent were given fluid prepared from packets of oral rehydralion salts (ORS) and 38 percent received a home-made sugar-salt solution.

The infant mortality rate for the five-year period before the survey (early 1994 to early 1999) is 75 per thousand live births. The under-five mortality is 140 deaths per 1,000 births, which means that one in seven children born in Nigeria dies before reaching his/her fifth birthday. However, both these figures are probably considerably higher in reality since an in-depth examination of the data from the birth histories reported by women in the NDHS shows evidence of omission of births and deaths. For this reason, the dramatic decline observed in childhood mortality between the 1990 and 1999 NDHS surveys needs to be viewed with considerably skepticism. Based on the reported birth history information, the infant mortality rate fell from 87 to 75 deaths per 1,000 births, while the under-five mortality rate dropped from 192 to 140.

Problems with the overall levels of reported mortality are unlikely to severely affect differentials in childhood mortality. As expected, mother's level of education has a major effect on infant and child mortality. Whereas the lowest infant mortality rate was reported among children of mothers with post- secondary education (41 per thousand live births), the corresponding figure among infants of mothers with no schooling is 77 per thousand live births.

Data were also collected in the NDHS on the availability of various health services. The data indicate that the vast majority of Nigerian households live within five kilometres of a health facility, with health centres being the closest, followed by clinics and hospitals.

Breasffeeding and Nutrition

Breastfeeding is widely practiced in Nigeria, with 96 percent of children being breastfed. The median duration of breastfeeding is 19 months. Although it is recommended that children be exclusively breastfed with no supplements for the first 4 to 6 months, only 20 percent of children 0-3 months are exclusively breasffed, as are 8 percent of children 4-6 months. Two-thirds of children 4-6 months are being given supplements in addition to breast milk.

In the NDHS, interviewers weighed and measured children under three born to women who were interviewed. Unfortunately, data were either missing or implausible for more than half of these children. Of the half with plausible data, 46 percent of children under 3 are classified as stunted (low height-for-age), 12 percent are wasted (low

Number and percentage of deaths, by month and place of residence, 1991 to most recent year.

In England and Wales, the definition of suicide is a death with an underlying cause of intentional self-harm or an injury or poisoning with undetermined intent. In 2023, the age group with the highest rate of suicide was for those aged 50 to 54 years at 16 deaths per 100,000. The age groups 45 to 49 years with 15.9 deaths per 100,000 population had the second highest highest rate of suicides in the UK. Gender difference in suicides The suicide rate among men in England and Wales in 2023 was around three times higher than for women, the figures being 17.4 per 100,000 population for men compared to 5.7 for women. Although among both genders, the suicide rate increased in 2023 compared to 2022. Mental health in the UK Over 53 thousand people in England were detained under the Mental Health Act in the period 2020/21. Alongside this, there has also been an increase in the number of workers in Great Britain suffering from stress, depression or anxiety. In 2022/23, around 875 thousand workers reported to be suffering from these work-related issues.

During the 2023-2024 flu season in the United States, an estimated 27,965 people died from influenza. The vast majority of deaths due to influenza occur among the elderly, with those aged 65 years and older accounting for 19,038 deaths during the 2023-2024 flu season. During this time, the mortality rate from influenza among those aged 65 years and older was around 32 per 100,000 population, compared to a mortality rate of two per 100,000 population among those aged 18 to 49 years. Influenza deaths Although most people recover from influenza without the need of medical care, influenza and pneumonia are still major causes of death in the United States. Influenza is a common cause of pneumonia and cases in which influenza develops into pneumonia tend to be more severe and more deadly. However, the impact of influenza varies from year to year depending on which viruses are circulating. For example, during the 2017-2018 flu season around 52,000 people died due to influenza, whereas in 2023-2024 total deaths amounted to 28,000. Preventing death The most effective way to prevent influenza is to receive an annual influenza vaccination. These vaccines have proven to be safe and are usually cheap and easily accessible. Each year, flu vaccinations prevent thousands of influenza cases, hospitalizations and deaths. It was estimated that during the 2022-2023 flu season, vaccinations prevented the deaths of around 2,479 people aged 65 years and older.