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.

Sources:a National Institute for Population Research and Training, MEASURE Evaluation, International Centre for Diarrhoeal Disease Research (2012) Bangladesh Maternal Mortality and Health Care Survey 2010. Available: http://www.cpc.unc.edu/measure/publications/tr-12-87. Accessed October 15, 2012.b World Health Organization (ND) WHO Maternal Mortality Country Profiles. Available: www.who.int/gho/maternal_health/en/#M. Accessed 1 March 2015.c Lozano R, Wang H, Foreman KJ, Rajaratnam JK, Naghavi M, Marcus JR, et al. (2011) Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. Lancet 378(9797): 1139–65. 10.1016/S0140-6736(11)61337-8d UNFPA, UNICEF, WHO, World Bank (2012) Trends in maternal mortality: 1990–2010. Available: http://www.unfpa.org/public/home/publications/pid/10728. Accessed 7 October 2012.e Bangladesh Bureau of Statistics, Statistics Informatics Division, Ministry of Planning (December 2012) Population and Housing Census 2011, Socio-economic and Demographic Report, National Series–Volume 4. Available at: http://203.112.218.66/WebTestApplication/userfiles/Image/BBS/Socio_Economic.pdf. Accessed 15 February, 2015.f Mozambique National Institute of Statistics, U.S. Census Bureau, MEASURE Evaluation, U.S. Centers for Disease Control and Prevention (2012) Mortality in Mozambique: Results from a 2007–2008 Post-Census Mortality Survey. Available: http://www.cpc.unc.edu/measure/publications/tr-11-83. Accessed 6 October 2012.g Ministerio da Saude (MISAU), Instituto Nacional de Estatística (INE) e ICF International (ICFI). Moçambique Inquérito Demográfico e de Saúde 2011. Calverton, Maryland, USA: MISAU, INE e ICFI.h Mudenda SS, Kamocha S, Mswia R, Conkling M, Sikanyiti P, et al. (2011) Feasibility of using a World Health Organization-standard methodology for Sample Vital Registration with Verbal Autopsy (SAVVY) to report leading causes of death in Zambia: results of a pilot in four provinces, 2010. Popul Health Metr 9:40. 10.1186/1478-7954-9-40i Central Statistical Office (CSO), Ministry of Health (MOH), Tropical Diseases Research Centre (TDRC), University Teaching Hospital Virology Laboratory, University of Zambia, and ICF International Inc. 2014. Zambia Demographic and Health Survey 2013–14: Preliminary Report. Rockville, Maryland, USA. Available: http://dhsprogram.com/pubs/pdf/PR53/PR53.pdf. Accessed February 26, 2015.j Centers for Disease Control and Prevention (2014) Saving Mothers, Giving Life: Maternal Mortality.Phase 1 Monitoring and Evaluation Report. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services. Available at: http://www.savingmothersgivinglife.org/doc/Maternal%20Mortality%20(advance%20copy).pdf. Accessed 26 February 2015.k Central Statistical Office (CSO), Ministry of Health (MOH), Tropical Diseases Research Centre (TDRC), University of Zambia, and Macro International Inc. 2009. Zambia Demographic and Health Survey 2007. Calverton, Maryland, USA: CSO and Macro International Inc.Comparison of Maternal Mortality Estimates: Zambia, Bangladesh, Mozambique.

Crude death rate: number of deaths over a given period divided by the person-years lived by the population over that period. It is expressed as number of deaths per 1,000 population.

This dataset includes counts of infant births and deaths within Austin city limits by year. The counts are calculated into an infant mortality rate for each year. Both infant deaths and infant births are reported through the Office of Vital Records.

View more details and insights related to this data set on the story page: https://data.austintexas.gov/stories/s/HE-B-3-Infant-mortality-rate-number-of-deaths-of-i/jwg4-2djc/

Distribution of deaths by age group and country/platform, weighted

VITAL SIGNS INDICATOR Life Expectancy (EQ6)

FULL MEASURE NAME Life Expectancy

LAST UPDATED April 2017

DESCRIPTION Life expectancy refers to the average number of years a newborn is expected to live if mortality patterns remain the same. The measure reflects the mortality rate across a population for a point in time.

DATA SOURCE State of California, Department of Health: Death Records (1990-2013) No link

California Department of Finance: Population Estimates Annual Intercensal Population Estimates (1990-2010) Table P-2: County Population by Age (2010-2013) http://www.dof.ca.gov/Forecasting/Demographics/Estimates/

CONTACT INFORMATION vitalsigns.info@mtc.ca.gov

METHODOLOGY NOTES (across all datasets for this indicator) Life expectancy is commonly used as a measure of the health of a population. Life expectancy does not reflect how long any given individual is expected to live; rather, it is an artificial measure that captures an aspect of the mortality rates across a population. Vital Signs measures life expectancy at birth (as opposed to cohort life expectancy). A statistical model was used to estimate life expectancy for Bay Area counties and Zip codes based on current life tables which require both age and mortality data. A life table is a table which shows, for each age, the survivorship of a people from a certain population.

Current life tables were created using death records and population estimates by age. The California Department of Public Health provided death records based on the California death certificate information. Records include age at death and residential Zip code. Single-year age population estimates at the regional- and county-level comes from the California Department of Finance population estimates and projections for ages 0-100+. Population estimates for ages 100 and over are aggregated to a single age interval. Using this data, death rates in a population within age groups for a given year are computed to form unabridged life tables (as opposed to abridged life tables). To calculate life expectancy, the probability of dying between the jth and (j+1)st birthday is assumed uniform after age 1. Special consideration is taken to account for infant mortality. For the Zip code-level life expectancy calculation, it is assumed that postal Zip codes share the same boundaries as Zip Code Census Tabulation Areas (ZCTAs). More information on the relationship between Zip codes and ZCTAs can be found at https://www.census.gov/geo/reference/zctas.html. Zip code-level data uses three years of mortality data to make robust estimates due to small sample size. Year 2013 Zip code life expectancy estimates reflects death records from 2011 through 2013. 2013 is the last year with available mortality data. Death records for Zip codes with zero population (like those associated with P.O. Boxes) were assigned to the nearest Zip code with population. Zip code population for 2000 estimates comes from the Decennial Census. Zip code population for 2013 estimates are from the American Community Survey (5-Year Average). The ACS provides Zip code population by age in five-year age intervals. Single-year age population estimates were calculated by distributing population within an age interval to single-year ages using the county distribution. Counties were assigned to Zip codes based on majority land-area.

Zip codes in the Bay Area vary in population from over 10,000 residents to less than 20 residents. Traditional life expectancy estimation (like the one used for the regional- and county-level Vital Signs estimates) cannot be used because they are highly inaccurate for small populations and may result in over/underestimation of life expectancy. To avoid inaccurate estimates, Zip codes with populations of less than 5,000 were aggregated with neighboring Zip codes until the merged areas had a population of more than 5,000. In this way, the original 305 Bay Area Zip codes were reduced to 218 Zip code areas for 2013 estimates. Next, a form of Bayesian random-effects analysis was used which established a prior distribution of the probability of death at each age using the regional distribution. This prior is used to shore up the life expectancy calculations where data were sparse.

Analysis of ‘Population Health Measures: Age-Adjusted Mortality Rates’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/ee3e6dd8-3d28-43b1-98e9-1d49f084649a on 12 February 2022.

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

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.

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

This is a source dataset for a Let's Get Healthy California indicator at https://letsgethealthy.ca.gov/. Infant Mortality is defined as the number of deaths in infants under one year of age per 1,000 live births. Infant mortality is often used as an indicator to measure the health and well-being of a community, because factors affecting the health of entire populations can also impact the mortality rate of infants. Although California’s infant mortality rate is better than the national average, there are significant disparities, with African American babies dying at more than twice the rate of other groups. Data are from the Birth Cohort Files. The infant mortality indicator computed from the birth cohort file comprises birth certificate information on all births that occur in a calendar year (denominator) plus death certificate information linked to the birth certificate for those infants who were born in that year but subsequently died within 12 months of birth (numerator). Studies of infant mortality that are based on information from death certificates alone have been found to underestimate infant death rates for infants of all race/ethnic groups and especially for certain race/ethnic groups, due to problems such as confusion about event registration requirements, incomplete data, and transfers of newborns from one facility to another for medical care. Note there is a separate data table "Infant Mortality by Race/Ethnicity" which is based on death records only, which is more timely but less accurate than the Birth Cohort File. Single year shown to provide state-level data and county totals for the most recent year. Numerator: Infants deaths (under age 1 year). Denominator: Live births occurring to California state residents. Multiple years aggregated to allow for stratification at the county level. For this indicator, race/ethnicity is based on the birth certificate information, which records the race/ethnicity of the mother. The mother can “decline to state”; this is considered to be a valid response. These responses are not displayed on the indicator visualization.

The Global Subnational Infant Mortality Rates, Version 2.01 consist of Infant Mortality Rate (IMR) estimates for 234 countries and territories, 143 of which include subnational Units. The data are benchmarked to the year 2015 (Version 1 was benchmarked to the year 2000), and are drawn from national offices, Demographic and Health Surveys (DHS), Multiple Indicator Cluster Surveys (MICS), and other sources from 2006 to 2014. In addition to Infant Mortality Rates, Version 2.01 includes crude estimates of births and infant deaths, which could be aggregated or disaggregated to different geographies to calculate infant mortality rates at different scales or resolutions, where births are the rate denominator and infant deaths are the rate numerator. Boundary inputs are derived primarily from the Gridded Population of the World, Version 4 (GPWv4) data collection. National and subnational data are mapped to grid cells at a spatial resolution of 30 arc-seconds (~1 km) (Version 1 has a spatial resolution of 1/4 degree, ~28 km at the equator), allowing for easy integration with demographic, environmental, and other spatial data.

a All numbers are weighted unless otherwise specified.b The INCAM report provides an estimate of the MMR among women age 15–49 of 489.3 per 100,000 live births (Table 32) but this estimate is based on the 2007 census data not on the INCAM data [16].Maternal mortality statistics by country and survey platform.a

Premature death rate measures mortality by counting deaths at earlier ages more than deaths at later ages. For example, when a person dies at 20, this death contributes 55 years of potential life lost. In contrast, when a person dies at age 70, this death contributes only five years of potential life lost to a county. For our purposes, premature deaths occur before age 75. Counties with older populations are more likely to have higher crude premature death rates than counties with younger populations. Therefore, when age-adjusted, we remove the effect of differently aged populations as a risk factor for premature death. This allows us to make a fair comparison of premature death rates across counties.

In 2023, the infant mortality rate in Malaysia was approximately 6.7 deaths per 1,000 live births, a slight decrease compared to the previous year. The infant mortality rate measures the probability of deaths for children aged less than one year per 1,000 births.

Since the beginning of the 2000s, the number of deaths in Italy remained rather stable. In 2020, on the contrary, the death rate reached 12.5 per 1,000 inhabitants, a notable increase compared to previous years. Four years after the pandemic, the figure remains above 10 deaths per 1,000 residents. From the perspective of the single regions, the highest number of deaths was registered in Liguria, whereas the lowest death rate in the country was reported in Trentino-Alto Adige. Coronavirus in Italy In Italy, the first cases of coronavirus (COVID-19) were registered at the end of January 2020. Then, since the end of February, the virus started to spread among the Italian population. Data on the infected patients show that COVID-19 has hit every age group uniformly, but the mortality rate appears to be much higher for elderly patients. Death rates in Europe Despite being the fourth-largest country in Europe in terms of population size, Italy was the state with the second-highest number of deaths, preceded only by Germany, the most populated country on the continent.

Infant mortality rate is number of infant deaths per 1,000 live births. Data are for Santa Clara County residents. The measure is summarized for total county population, by race/ethnicity and Asian/Pacific Islander subgroups. Data are presented for single years at county level and pooled years combined for population subgroups. Source: Santa Clara County Public Health Department, 2007-2015 Birth Statistical Master File; Santa Clara County Public Health Department, VRBIS, 2007-2015. Data as of 05/26/2017.METADATA:Notes (String): Lists table title, sourceYear (String): Year of death. Pooled data years are used for certain categories to meet the minimum data requirements.Category (String): Lists the category representing the data: Santa Clara County is for total population, race/ethnicity: African American, Asian/Pacific Islander, Latino and White (non-Hispanic White only), and Asian/Pacific Islander subgroups: Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese and Pacific Islanders.Rate per 1,000 live births (Numeric): Infant mortality rate is number of infant (under the age of 1 year) deaths in a year per 1,000 live births in the same time period.

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

Background Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. Methods We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0.5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Sociodemographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. Findings Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates-a measure of relative inequality-increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86.9 years (95% UI 86.7-87.2), and for men in Singapore, at 81.3 years (78.8-83.7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, and the gap be...

Age-Adjusted Death Rates

Death Rates and Life Expectancy in the United States, 2011-2013

By Health [source]

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How to use the dataset

In order to use this dataset, start by selecting a particular set of variables to investigate. You can choose from Measure Names (e.g., Death Rates or Life Expectancy), Race (e.g., All Races), Sex (Male/Female) and Year (2011-2013). Once you have selected your desired variables, you can begin analyzing the data by looking at mortality rates and life expectancy averages amongst different populations in the United States over time.

You may also wish to perform more detailed analyses such as identifying trends or examining correlations between features, regional disparities in mortality rates or changes in average life expectancies over time. If so, you can do so by creating line graphs plotted against one or more independent variables such as Race and Sex to see how demographics impact these statistics overall and on a yearly basis using the Year variable computed from July 1st 2010 estimates

Research Ideas

• Analyzing mortality and life expectancy trends among certain races and sexes over time.
• Examining the effects of different socioeconomic factors on death rates and life expectancies.
• Making predictions about future mortality rates and average life expectancies with machine learning algorithms

Acknowledgements

If you use this dataset in your research, please credit the original authors. Data Source

License

License: Open Database License (ODbL) v1.0 - You are free to: - Share - copy and redistribute the material in any medium or format. - Adapt - remix, transform, and build upon the material for any purpose, even commercially. - You must: - Give appropriate credit - Provide a link to the license, and indicate if changes were made. - ShareAlike - You must distribute your contributions under the same license as the original. - Keep intact - all notices that refer to this license, including copyright notices. - No Derivatives - If you remix, transform, or build upon the material, you may not distribute the modified material. - No additional restrictions - You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.

Columns

File: rows.csv | Column name | Description | |:----------------------------|:----------------------------------------------------------------------| | Measure Names | The type of measure being reported. (String) | | Race | The race of the population being reported. (String) | | Sex | The gender of the population being reported. (String) | | Year | The year the data was collected. (Integer) | | Average Life Expectancy | The average life expectancy of the population being reported. (Float) | | Mortality | The mortality rate of the population being reported. (Float) |

Acknowledgements

If you use this dataset in your research, please credit the original authors. If you use this dataset in your research, please credit Health.

BackgroundThere has been increasing interest in measuring under-five mortality as a health indicator and as a critical measure of human development. In countries with complete vital registration systems that capture all births and deaths, under-five mortality can be directly calculated. In the absence of a complete vital registration system, however, child mortality must be estimated using surveys that ask women to report the births and deaths of their children. Two survey methods exist for capturing this information: summary birth histories and complete birth histories. A summary birth history requires a minimum of only two questions: how many live births has each mother had and how many of them have survived. Indirect methods are then applied using the information from these two questions and the age of the mother to estimate under-five mortality going back in time prior to the survey. Estimates generated from complete birth histories are viewed as the most accurate when surveys are required to estimate under-five mortality, especially for the most recent time periods. However, it is much more costly and labor intensive to collect these detailed data, especially for the purpose of generating small area estimates. As a result, there is a demand for improvement of the methods employing summary birth history data to produce more accurate as well as subnational estimates of child mortality.Methods and FindingsWe used data from 166 Demographic and Health Surveys (DHS) to develop new empirically based methods of estimating under-five mortality using children ever born and children dead data. We then validated them using both in- and out-of-sample analyses. We developed a range of methods on the basis of three dimensions of the problem: (1) approximating the average length of exposure to mortality from a mother's set of children using either maternal age or time since first birth; (2) using cohort and period measures of the fraction of children ever born that are dead; and (3) capturing country and regional variation in the age pattern of fertility and mortality. We focused on improving estimates in the most recent time periods prior to a survey where the traditional indirect methods fail. In addition, all of our methods incorporated uncertainty. Validated against under-five estimates generated from complete birth histories, our methods outperformed the standard indirect method by an average of 43.7% (95% confidence interval [CI] 41.2–45.2). In the 5 y prior to the survey, the new methods resulted in a 53.3% (95% CI 51.3–55.2) improvement. To illustrate the value of this method for local area estimation, we applied our new methods to an analysis of summary birth histories in the 1990, 2000, and 2005 Mexican censuses, generating subnational estimates of under-five mortality for each of 233 jurisdictions.ConclusionsThe new methods significantly improve the estimation of under-five mortality using summary birth history data. In areas without vital registration data, summary birth histories can provide accurate estimates of child mortality. Because only two questions are required of a female respondent to generate these data, they can easily be included in existing survey programs as well as routine censuses of the population. With the wider application of these methods to census data, countries now have the means to generate estimates for subnational areas and population subgroups, important for measuring and addressing health inequalities and developing local policy to improve child survival.Please see later in the article for the Editors' Summary

The indicator measures the standardised death rate of homicide and injuries inflicted by another person with the intent to injure or kill by any means, including ‘late effects’ from assault (International Classification of Diseases (ICD) codes X85 to Y09 and Y87.1). It does not include deaths due to legal interventions or war (ICD codes Y35 and Y36). Data on causes of death (COD) 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". COD data are derived from death certificates. The medical certification of death is an obligation in all Member States. The data are presented as standardised death rates, meaning they are adjusted to a standard age distribution in order to measure death rates independently of different age structures of populations. This approach improves comparability over time and between countries. The standardised death rates used here are calculated on the basis of the standard European population referring to the residents of the countries.

VITAL SIGNS INDICATOR Life Expectancy (EQ6)

FULL MEASURE NAME Life Expectancy

LAST UPDATED April 2017

DESCRIPTION Life expectancy refers to the average number of years a newborn is expected to live if mortality patterns remain the same. The measure reflects the mortality rate across a population for a point in time.

DATA SOURCE State of California, Department of Health: Death Records (1990-2013) No link

California Department of Finance: Population Estimates Annual Intercensal Population Estimates (1990-2010) Table P-2: County Population by Age (2010-2013) http://www.dof.ca.gov/Forecasting/Demographics/Estimates/

U.S. Census Bureau: Decennial Census ZCTA Population (2000-2010) http://factfinder.census.gov

U.S. Census Bureau: American Community Survey 5-Year Population Estimates (2013) http://factfinder.census.gov

CONTACT INFORMATION vitalsigns.info@mtc.ca.gov

METHODOLOGY NOTES (across all datasets for this indicator) Life expectancy is commonly used as a measure of the health of a population. Life expectancy does not reflect how long any given individual is expected to live; rather, it is an artificial measure that captures an aspect of the mortality rates across a population that can be compared across time and populations. More information about the determinants of life expectancy that may lead to differences in life expectancy between neighborhoods can be found in the Bay Area Regional Health Inequities Initiative (BARHII) Health Inequities in the Bay Area report at http://www.barhii.org/wp-content/uploads/2015/09/barhii_hiba.pdf. Vital Signs measures life expectancy at birth (as opposed to cohort life expectancy). A statistical model was used to estimate life expectancy for Bay Area counties and ZIP Codes based on current life tables which require both age and mortality data. A life table is a table which shows, for each age, the survivorship of a people from a certain population.

Current life tables were created using death records and population estimates by age. The California Department of Public Health provided death records based on the California death certificate information. Records include age at death and residential ZIP Code. Single-year age population estimates at the regional- and county-level comes from the California Department of Finance population estimates and projections for ages 0-100+. Population estimates for ages 100 and over are aggregated to a single age interval. Using this data, death rates in a population within age groups for a given year are computed to form unabridged life tables (as opposed to abridged life tables). To calculate life expectancy, the probability of dying between the jth and (j+1)st birthday is assumed uniform after age 1. Special consideration is taken to account for infant mortality.

For the ZIP Code-level life expectancy calculation, it is assumed that postal ZIP Codes share the same boundaries as ZIP Code Census Tabulation Areas (ZCTAs). More information on the relationship between ZIP Codes and ZCTAs can be found at http://www.census.gov/geo/reference/zctas.html. ZIP Code-level data uses three years of mortality data to make robust estimates due to small sample size. Year 2013 ZIP Code life expectancy estimates reflects death records from 2011 through 2013. 2013 is the last year with available mortality data. Death records for ZIP Codes with zero population (like those associated with P.O. Boxes) were assigned to the nearest ZIP Code with population. ZIP Code population for 2000 estimates comes from the Decennial Census. ZIP Code population for 2013 estimates are from the American Community Survey (5-Year Average). ACS estimates are adjusted using Decennial Census data for more accurate population estimates. An adjustment factor was calculated using the ratio between the 2010 Decennial Census population estimates and the 2012 ACS 5-Year (with middle year 2010) population estimates. This adjustment factor is particularly important for ZCTAs with high homeless population (not living in group quarters) where the ACS may underestimate the ZCTA population and therefore underestimate the life expectancy. The ACS provides ZIP Code population by age in five-year age intervals. Single-year age population estimates were calculated by distributing population within an age interval to single-year ages using the county distribution. Counties were assigned to ZIP Codes based on majority land-area.

ZIP Codes in the Bay Area vary in population from over 10,000 residents to less than 20 residents. Traditional life expectancy estimation (like the one used for the regional- and county-level Vital Signs estimates) cannot be used because they are highly inaccurate for small populations and may result in over/underestimation of life expectancy. To avoid inaccurate estimates, ZIP Codes with populations of less than 5,000 were aggregated with neighboring ZIP Codes until the merged areas had a population of more than 5,000. ZIP Code 94103, representing Treasure Island, was dropped from the dataset due to its small population and having no bordering ZIP Codes. In this way, the original 305 Bay Area ZIP Codes were reduced to 217 ZIP Code areas for 2013 estimates. Next, a form of Bayesian random-effects analysis was used which established a prior distribution of the probability of death at each age using the regional distribution. This prior is used to shore up the life expectancy calculations where data were sparse.