A total of 154,501 Texas residents died in 2003. The leading cause of death, diseases of the heart, accounted for 27.0 percent of those deaths, while the second most common cause of death, malignant neoplasms (cancer), accounted for 21.9 percent. Cerebrovascular diseases, accidents, and chronic lower respiratory diseases, ranked third, fourth, and fifth, respectively. Together, these five leading causes of death represented 65.8 percent of all deaths in 2003.
The number of infant deaths increased to 2,483 deaths in 2003 compared to 2,369 deaths in 2002. The infant mortality rate increased to 6.6 infant deaths per 1,000 live births. Fetal deaths decreased from 2,277 in 2002 to 2,258 in 2003 for a fetal death ratio of 6.0 fetal deaths per 1,000 live births. Sixty women died in 2003 as a result of pregnancy or childbearing for a maternal mortality rate of 15.9 maternal deaths per 100,000 live births.
Years of potential life lost (YPLL), a measure of premature mortality, is the sum of years lost by persons who die before age 65 (see Technical Appendix). The YPLL by Texans increased from 893,780 in 2002 to 909,333 in 2003. Accidents, malignant neoplasms, and heart disease continued to be the top three causes of premature mortality in Texas.
Leading Causes of Death
The order of the top three leading causes of death has remained the same since 1979. Heart disease claimed 41,654 lives (43,373 in 2002) and continued to be the leading cause of death followed by malignant neoplasms (cancer) with 33,782 deaths (34,122 in 2002). Diseases of the heart and malignant neoplasms have been the first and second leading causes of death in Texas and the nation since 1950.
Cerebrovascular diseases ranked third with 10,286 deaths, compared to 10,534 in 2002. The top three leading causes of death, diseases of the heart, malignant neoplasms, and cerebrovascular disease, accounted for 55.5 percent of all Texas resident deaths in 2003. Accidents and adverse effects with 8,341 deaths (8,182 in 2002) and chronic lower respiratory diseases with 7,548 deaths (7,713 in 2002) rounded out the top five leading causes of death.
The sixth leading cause was diabetes mellitus with 5,663 deaths in 2003 (5,650 in 2002) and the number of deaths due to Alzheimer's disease was 4,012 in 2003 (3,787 in 2002). Influenza and pneumonia was the eighth leading cause with 3,603 deaths in 2003. Nephritis and related diseases were the ninth leading cause with 2,671 deaths in 2003. Suicide was the tenth leading cause with 2,355 deaths in 2003.
Although homicide is no longer one of the ten leading causes of death among all Texas residents, it is the eighth and ninth leading cause among Hispanics and blacks. (See Table 16 for the leading causes of death by race/ethnicity.)
The majority of deaths (30.3 percent) in 2003 to residents ages 1 through 44 were due to accidents and adverse effects. Malignant neoplasms were responsible for 11.8 percent of all deaths to this age group and diseases of the heart claimed the lives of another 10.2 percent.
Beginning at age 45, accidents play a less significant role in total deaths; only 9.4 percent of all deaths to individuals 45-54 were due to accidents. However, diseases of the heart and malignant neoplasms were responsible for 48.3 percent of the deaths to this age group. Deaths due to chronic conditions (diseases of the heart, malignant neoplasms, cerebrovascular diseases, chronic lower respiratory diseases, and diabetes mellitus) were the major causes of death in individuals 55 years and older, accounting for 70.2 percent of deaths to this age group.
Although males represented slightly less than half (49.8 percent) of the Texas population in 2003, they accounted for 60.3 percent of all deaths to persons 1 through 74 years of age. Much of this difference is due to the greater likelihood of males dying at younger ages from external causes (such as accidents, homicide, and suicide) and HIV infection (see Table 17).
There were 2,483 infant deaths to Texas residents in 2003 for an infant mortality rate of 6.6 infant deaths per 1,000 live births (see Table 29). The black infant mortality rate (13.8) continued to be considerably greater than the rate of whites (5.8) and Hispanics (5.7).
Congenital anomalies were responsible for 22.8 percent of all infant deaths and Sudden Infant Death Syndrome (SIDS) claimed another 8.2 percent. Disorders related to length of gestation and fetal malnutrition claimed 16.1 percent of infant deaths and accidents claimed 2.7 percent of infant deaths. (See Table 31 for the selected causes of infant death among Texas residents.)
The majority (1,649; 66.4 percent) of infant deaths took place during the first 27 days of life (neonatal period), and the rate of neonatal deaths in Texas was 4.4 per 1,000 live births (see Table 30). Of all neonatal deaths, 24.0 percent were due to congenital malformations, deformations, and chromosomal abnormalities. Disorders relating to length of gestation and fetal malnutrition also accounted for 24.0 percent of all neonatal deaths. See Table 32 for the selected causes of neonatal death among Texas residents.
Fetal Deaths and Perinatal Mortality
In Texas, a fetal death is the death of a product of conception before complete expulsion or extraction from its mother. It is required to be registered with the Vital Statistics Unit as a fetal death if the length of gestation is 20 weeks or more. However, all reported fetal deaths, regardless of the length of gestation, are included in this annual report. There were 2,258 fetal deaths to Texas residents in 2003 and the fetal death ratio was 6.0 fetal deaths per 1,000 live births in 2003 compared to 6.1 in 2002.
Perinatal mortality includes fetal and neonatal deaths. The perinatal mortality rate was 10.0 per 1,000 fetal deaths and live births in 2003 (9.5 in 2002). (See Table 28 for fetal and perinatal mortality figures.)
In 2003, 60 women died as a result of pregnancy or childbearing, for a maternal mortality rate of 15.9 per 100,000 live births. The maternal mortality rate for black women of 33.6 continues to be more than double the state value. White and Hispanic women had maternal mortality rates of 15.9 and 10.4, respectively. However, rates based on small numbers may be misleading (see Technical Appendix).
Life Expectancy at Birth
Texans born in 2003 had a life expectancy at birth of 77.2 years. Because males tend to die from more external causes (such as accidents, homicide, and suicide) and at younger ages than females, females had a higher life expectancy at birth than males: 79.8 years vs. 74.5. An Hispanic child born in 2003 had a life expectancy at birth of 78.6 years, while a white newborn had a life expectancy of 77.4 years. Black life expectancy remained below the average, at 72.2 years (see Table 25).
Age-Adjusted Death Rate
The age-adjusted death rate for Texas in 2003 was 853.8 deaths per 100,000 population. The age-adjusted death rate for males was 981.1 in 2003 and the rate for females was 746.7. The age-adjusted death rate for whites and others, regardless of gender, was 856.2 deaths per 100,000 population. The Hispanic rate of 697.4 remained the lowest of all racial/ethnic groups in 2003. The age-adjusted death rate for blacks continued to be well above the rate for the Texas population as a whole at 1,141.0 per 100,000 population (see Table 26A).
Years of Potential Life Lost (YPLL)
The YPLL statistic is a way to demonstrate both gender and race/ethnicity differences in mortality risks and is the sum of years lost by persons who die before the age of 65 (see Technical Appendix). The total YPLL for Texans in 2003 was 909,333 years, up from 893,780 years in 2002. Male mortality accounted for 575,316 or 63.3 percent of these years and the total YPLL for women was 334,017 or 36.7 percent. This difference is mostly due to males dying at younger ages than females from causes that are primarily external or preventable in nature, such as accidents and HIV infection.
Death by accident was the number one cause of premature mortality in 2003 and represented 186,106 YPLL, or 9.3 years per 1,000 persons ages 0-64. Malignant neoplasms were responsible for the second largest number of years lost with 129,208 YPLL, for a rate of 6.5. Heart disease had a rate of 5.2 and remained the third leading cause of YPLL in Texas, with 103,759 years of potential life lost. Certain Conditions Originating in the Perinatal Period was the fourth leading cause of premature mortality with 76,797 YPLL, with a rate of 3.9. The number of years lost from suicide and homicide remained the fifth and sixth leading cause of premature mortality in Texas with a combined 101,105 YPLL for a rate of 5.1 years per 1,000 persons ages 0-64.