Monthly Vital Statistics
July 1997, Vol. 31, No. 5
1996 Missouri Health Statistics
Final 1996 Missouri mortality statistics reveal a one-third decline in AIDS deaths from 502 in 1995 to 339 in 1996. The rate of AIDS mortality in 1996 (6.3 per 100,000 population) was the lowest in Missouri in six years.
Overall mortality data for Missouri shows a slight decrease of about one percent from 54,222 in 1995 to 53,766 in 1996. The life expectancy for Missourians increased from 75.3 years in 1995 to 75.5 years in 1996. This matches the 1992 Missouri record life expectancy. As Table 2 shows life expectancies for Missouri men increased from 71.8 to 72.4 years in 1996 while for Missouri women, it decreased from 78.6 to 78.5 years. The 1996 male-female difference of 6.1 years is the smallest since the 1950s. The largest difference of 8.2 years occurred in 1976.
The three leading causes of death (heart, cancer and stroke) all decreased slightly in 1996, with cancer showing the largest decrease (2.5 percent). Deaths due to pneumonia and influenza, septicemia, homicide and liver disease also decreased in 1996. Contrarily, mortality increased for chronic obstructive pulmonary disease, unintentional injuries (accidents), diabetes, suicides and kidney disease (nephritis and nephrosis).
The decline in AIDS-related deaths in Missouri appears to refelct a national trend. The Centers for Disease Control and Prevention (CDC) has reported that the national age-adjusted death rate from HIV/AIDS dropped an estimated 26 percent between 1995 and 1996, from 15.6 deaths per 100,000 population in 1995 to 11.6 in 1996.
The decreased mortality in Missouri and elsewhere is believed to be related to improvements in medical care for persons with HIV disease, the increasing use of medicine to prevent the onset of infections, and the use of combination therapy with antiretroviral agents (including protease inhibitors.) However, Department of Health officials still stress the importance of prevention.
The decrease in the life expectancy advantages of women over men is reflected in the 2.6 percent decrease in male deaths in 1996 and 0.6 percent increase in female mortality. About one-fourth of the male decrease is due to the AIDS mortality decrease as over 90 percent of AIDS deaths in Missouri are to men. Another one-quarter of the male decrease is reflected in a 3 percent decrease in smoking-related deaths. Smoking-related deaths for females did not change in 1996. These differentials reflect smoking behavior changes by gender from 20 to 30 years ago. Forty percent of the male mortality decrease was due to a 3 percent decrease in heart disease deaths.
Maternal and Child Health Statistics
Final 1996 Missouri vital statistics show a slight increase in infant mortality from 7.4 in 1995 to 7.6 per 1,000 live births in 1996, according to data released today by the Missouri Department of Health. The 7.6 rate is the second lowest infant death rate ever recorded in Missouri (second only to the 1995 rate). Infant mortality increased slightly in the city of St. Louis, Kansas City and non-metro Missouri while decreasing in St. Louis County.
The Missouri rate of inadequate prenatal care reached a record low in 1996 (12.0 percent) compared with 12.4 percent in 1995. The rate of low birth weight (less than 5.5 pounds) decreased slightly from 7.6 to 7.5 percent. The disparity between whites and African Americans decreased for inadequate prenatal care and low birth weight in 1996, but the disparity increased for infant mortality. In 1996 the ratio between the African-American and white rates was 2.9 for inadequate prenatal care, 2.0 for low birth weight and 2.5 for infant mortality.
As Table 4 shows abortions increased 2.6 percent from 13,635 in 1995 to 13,989 in 1996 with the largest increase in the Kansas City area. Out-of-wedlock births increased in 1996 following two years of declines. After dropping by one-third from 1991 to 1995, the number of short spacing births (less than 18 months between births) increased 2.6 percent in 1996 to 4,413 from 4,301 the previous year. The total number of teen births (10,477) did not change substantially in 1996, but births to early teens (under 18) decreased by 2.4 percent, from 3,910 to 3,816.
Other maternal and child health indicators show the following:
The rate of maternal smoking during pregnancy decreased from 20.0 percent in 1995 to 19.5 percent in 1996, the lowest rate ever reported.
The numbers of women on Medicaid during their pregnancy remained about the same, (29,423 in 1996 compared with 29,318 in 1995).
The number of women on the Supplemental Food Program for Women, Infants and Children (WIC) during their pregnancy increased by 4.2 percent from 28,415 in 1995 to 29,604 in 1996.
Food Stamps recipients during pregnancy (15,146) decreased by 2.7 percent in 1996.
Maternal deaths in 1996 (12) matched the 1995 figure which was the highest number in 20 years. A large proportion of these deaths occurred to African-American women in the St. Louis area.
Communicable Disease Data:
Reports of early syphilis (primary, secondary, and early latent) cases decreased from 1,090 in 1995 to 480 in 1996, a 56 percent decrease. Reported cases of congenital syphilis decreased 74 percent from 46 in 1995 to 12 in 1996. These decreases are probably the results of increased follow-up resources devoted to the St. Louis area and southeast Missouri.
Gonorrhea continues to decline with 8,415 cases reported in 1996 compared to 11,302 reported in 195, a decrease of 26 percent.
A total of 11,952 cases of Chlamydia were reported in 1996, a slight decrease from the 12,084 cases reported in 1995.
Eight hundred and forty-five (845) AIDS cases and 536 HIV cases were reported in Missouri residents. It is estimated there are currently 8,000 to 11,000 HIV infected persons living in Missouri.
From 1982 through 1996, a total of 7,181 AIDS cases have been reported; 4,126 (57.5 percent) of these individuals are known to have died.
Seventy-five cases of pertussis (whooping cough) were reported in 1996. This was an increase from 1995 in which there were 63 reported cases.
In 1996, three confirmed cases of measles were reported. This was an increase from 1995 in which two cases on confirmed cases of measles were reported.
One case of tetanus was reported in 1996 in an adult, compared to 1995 when 3 cases were reported.
Provisional data for 1996 indicate there were no rubella, diptheria, polio, or Haemophilus influenzae Type b (Hib) meningitis cases were reported to the Bureau of Immunization.
With data for 1996 still provisional, Hepatitis A at 1,414 cases accounts for the largest proportion of 5,124 communicable disease cases reported to the Bureau of Communicable Disease Control (BCDC) in 1996. This is an 18.4 percent reduction from the 6,444 diseases reported to the BCDC in1995.
The largest area of reduction was for shigellosis with 1,138 cases reported in 1995 and 387 cases reported in 1996. This reversed an upward trend and is 41.0 percent below the five year median of 654 cases and the lowest it has been since 1991. The eastern and northwestern health districts of the state have shown the greatest reduction in the number of reported cases of shigellosis.
Hepatitis B cases fell from 437 cases in 1995 to 327 cases in 1996, continuing its downward trend since 1990. It is 39.0 percent below the five year median of 538 cases.
Hepatitis A showed a geographic shift. Incidence decreased in the Northwestern Health District (mainly the Kansas City metro area) from 742 cases in 1995 to 305 cases in 1996. In the Southwestern Health District, Hepatitis A increased 127 cases in 1995 to 629 in 1996.
Meningococcal disease continues to increase in the state following a three year trend. The disease has shifted from the southwest to the larger Kansas City and St. Louis metro areas. Meningococcal meningitis at 63 cases is 70.0 percent above the five year median of 37 cases.
For two years in a row, Missouri's tuberculosis cases have declined. In 1996, 224 new tuberculosis cases were reported for a case rate of 4.2 per 100,000 population. This represents an 8.2 percent decrease from 1995 when 244 cases were reported.
While the number of tuberculosis cases in the nonmetro areas of Missouri decreased from 117 to 83, three out of four major metropolitan areas accounted for increases. Specifically, St. Louis city increased from 40 to 44 cases, Springfield-Greene County increased from 10 to 17 and Kansas City increased from 43 to 48.
Whites accounted for 52 percent of all reported tuberculosis cases in 1996 followed by African-Americans with 31 percent, Asians with 14 percent and Hispanics with 3 percent. These percentage of cases occurring among foreign born increased from 11 percent to 18 percent. The case rate for Asians was 62.1 per 100,000, followed by 12.0 African-Americans, 9.5 for Hispanics and 2.5 for whites.
Although anyone can develop tuberculosis, particular groups are more susceptible or are at high-risk for developing active disease if infected with tuberculosis. In Missouri, these groups include the elderly, foreign-born persons from countries with a high prevalence of tuberculosis, the homeless, persons with HIV infection or AIDS, inmates in correctional facilities and close contacts of those with active disease. In addition, persons with certain medical conditions, such silicosis or diabetes, are at increased risk for developing tuberculosis if infected.
Table 1
Missouri Final 1996 Death Data for Annual News Release
(Including Comparisons with 1986 and 1995 Data)
Numbers Rates per 100,000 Pop.
1986 1995 1996 1986 1995 1996
(Final) (Final)
Leading Causes of Death
Heart 18,114 18,335 18,174 360.5 344.7 339.1
Cancer 10,813 12,319 12,014 215.2 231.6 224.2
Lung Cancer 3,125 3,756 3,687 62.2 70.6 68.8
Stroke 3,612 3,937 3,866 71.9 74.0 72.1
Chronic Pulmonary 1,913 2,447 2,516 38.1 46.0 46.9
Dis
Accidents 2,221 2,201 2,253 44.2 41.4 42.0
Motor 1,140 1,102 1,145 22.7 20.7 21.4
Vehicle
Other 1,081 1,099 1,108 21.5 20.7 20.7
Pneumonia & 1,726 2,238 2,179 35.0 42.1 40.7
Influenza
Diabetes 847 1,237 1,289 16.9 23.3 24.1
Suicide 728 726 768 14.5 13.6 14.3
Nephritis & 574 612 647 11.3 11.5 12.1
Nephrosis
Septicemia 442 510 500 8.8 9.6 9.3
Homicide 487 482 476 9.7 9.1 8.9
Liver Disease 404 413 408 8.0 7.8 7.6
AIDS 63 502 339 1.3 9.4 6.3
Tuberculosis 36 23 18 0.7 0.4 0.3
Maternal Deaths 4 12 12 3.9** 16.5** 16.3**
Total Deaths 49,971 54,222 53,766 10.6* 10.2* 10.0*
Population 5,024 5,319 5,359
(1,000s)
* Per 1,000 population
** Per 100,000 live births
Table 2
Trends in Life Expectancies (Years) by Gender: Missouri 1950-1996
Year Male Female Difference
1950 65.6 71.3 5.7
1960 66.9 73.6 6.7
1970 66.8 74.7 7.9
1975 68.4 76.4 8.0
1980 69.9 77.6 7.7
1985 71.2 78.3 7.1
1990 71.7 78.9 7.2
1991 71.5 78.9 7.4
1992 71.8 79.1 7.3
1993 71.6 78.7 7.1
1994 71.7 78.6 6.9
1995 71.8 78.6 6.8
1996 72.4 78.5 6.1
Table 3
Trends in Maternal and Child Health Statistics: Missouri 1986, 1995,
1996
Numbers Percent of Live
Births
1986 1995 1996 1986 1995 1996
Infant Deaths 799 539 558 10.6 7.4 7.6
White 574 384 381 9.1 6.4 6.2
Black 218 150 175 19.1 13.7 15.8
Inadequate Prenatal 12,089 8,786 8,577 16.6 12.4 12.0
Care
White 8,580 5,616 5,560 14.0 9.5 9.3
Black 3,332 2,964 2,763 30.9 28.5 26.8
Low Birth Weight 5,118 5,547 5,537 6.8 7.6 7.5
White 3,600 3,893 3,987 5.7 6.5 6.5
Black 1,461 1,546 1,426 12.8 14.1 12.9
Out-of-Wedlock Births 16,884 23,361 24,454 22.5 32.1 33.2
Teen (10-19) Live 10,101 10,487 10,477 13.4 14.4 14.2
Births
Early Teen (10-17) Live 3,716 3,910 3,816 4.9 5.4 5.2
Births
Smoking During 20,266 14,577 14,409 27.9 20.0 19.5
Pregnancy
Medicaid Birth NA 29,318 29,423 NA 41.6 41.3
WIC Births NA 28,415 29,604 NA 40.3 41.6
Food Stamp Births NA 15,567 15,146 NA 22.1 21.3
Table 4
Trends in Resident Abortions, Spacing Less than 18 Months and
Out-of-Wedlock Births by Race: Missouri 1989 - 1996
Abortions Spacing <18 months Out-of-Wedlock
Births
Yearly Yearly Yearly
Missouri Percent Percent Percent
Total Number Change Number Change Number Change
1989 18,639 -- 5,979 -- 21,105 --
1990 17,947 -3.7 6,303 +5.4 22,597 +7.1
1991 17,171 -4.3 6,480 +2.8 23,673 +4.8
1992 16,240 -5.4 6,188 -4.5 23,981 +1.3
1993 15,415 -5.1 5,677 -8.3 24,320 +1.4
1994 14,119 -8.4 4,923 -13.3 23,845 -2.0
1995 13,635 -3.7 4,301 -12.7 23,361 -2.2
1996 13,989 +2.6 4,413 +2.6 24,454 +4.7
(Final)
Provisional Vital Statistics for May 1997
Live births decreased in May as 5,902 Missouri babies were born compared with 6,286 in
May 1996.
Cumulative births, however, for the first five months of 1997 show a slight increase
from 30,592 in 1996 to 31,198. The birth rate for these periods increased from 13.8
to 14.2 per 1,000 population.
Deaths decreased in May as 4,270 Missourians died compared with 4,543 in May 1996.
The monthly death rate decreased from 10.3 to 10.0 per 1,000 population.
The Natural increase for Missouri in May was 1,632 (5,902births minus 4,270 deaths)
compared with 1,743 one year earlier. For January-May, the natural increase rose from
6,254 in 1996 to 6,838 in 1997.
Marriages decreased in May, but increased for the cumulative 5- and 12-month periods
ending with May.
Dissolutions of marriage decreased for all three time periods shown below.
Infant deaths increased for all three time periods shown below. For the five months
ending with May the infant death rate increased from 7.7 to 8.8 per 1,000 live
births.
PROVISIONAL RESIDENT VITAL STATISTICS FOR THE STATE OF MISSOURI
May Jan. - May cumulative 12 months ending with May
Item Number Rate* Number Rate* Number Rate* 1996 1997 1996 1997 1996 1997 1996 1997 1996 1997 1995 1996 1997 Live 6,286 5,902 14.3 13.8 30,592 31,198 13.8 14.2 73,919 73,149 13.9 13.9 13.6 births Deaths 4,543 4,270 10.4 10.0 24,338 24,360 11.0 11.1 54,511 54,115 10.1 10.2 10.1 Natural 1,743 1,632 4.0 3.8 6,254 6,838 2.8 3.1 19,408 19,034 3.8 3.6 3.5 increase Marriages 3,779 3,602 8.6 8.4 14,892 14,950 6.7 6.8 44,475 44,964 8.5 8.3 8.4 Dissolution 2,212 2,095 5.0 4.9 11,306 10,142 5.1 4.6 26,535 25,544 4.9 5.0 4.8 s Infant 40 46 6.3 8.5 242 266 7.7 8.8 544 590 8.1 7.4 8.1 deaths Population -- -- 5,359 5,395 -- -- 5,359 5,395 -- -- 5,239 5,336 5,374 base (in thousands)
*Rates for live births, deaths, natural increase, marriages and dissolutions are computed on the number per 1000 estimated population. The infant death rate is based on the number of infant deaths per 1000 live births. Rates are adjusted to account for varying lengths of monthly reporting periods. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER Services provided on a nondiscriminatory basis. Alternate forms of this publication for persons with disabilities may be obtained by contacting the Missouri Department of Health, Center for Health Information Management & Epidemiology/Bureau of Health Data Analysis, P.O. Box 570, Jefferson City, MO 65102; phone (573) 751-6278. Hearing impaired citizens telephone 1-800-735-2966.