North Carolina Vital Statistics Volume 1 n 2000 Division of Public Health
Publications of the State Center for Health Statistics Many of these publications are available online at http://www.schs.state.nc.us/schs/ North Carolina Health Statistics Pocket Guide (Biennial): Data for the U.S., N.C., and N.C. counties are presented in tabular and narrative forms with more than 8,000 calculations depicting patterns of various needs indicators, as well as births, deaths, abortions, diseases, health care resources, and other data from state and national reporting systems and surveys. This composite of information, contained in a compact foldout, will serve the needs of many health data users. North Carolina Vital Statistics, Volume 1: Population, Births, Deaths, Marriages, Divorces (Annual): For the state and each Perinatal Care Region (PCR), county, and major incorporated city, one-page tables summarize annual and 5-year data by race and selected variables. Maps, graphs, and narrative describe geographical patterns and statewide trends. North Carolina Vital Statistics, Volume 2: Leading Causes of Death (Annual): For the state and counties, cause-specific annual and 5-year data are given in the form of numbers of deaths, unadjusted death rates, and age-adjusted death rates. For each cause, maps depict 5-year adjusted and unadjusted county rates. Infant mortality data are also tabulated and mapped. Basic Automated Birth Yearbook, North Carolina Residents (Annual): Known as the BABY BOOK, this statewide report is comprised of multiple cross-tabulations of various maternal and infant variables such as age, race, birth order, birth weight, and number of prenatal visits as well as medical conditions of the mother, the labor/ delivery, and the newborn. Data for North Carolina counties are available on the SCHS web site. Detailed Mortality Statistics, North Carolina Residents (Annual): This statewide report provides annual counts of deaths specific for detailed underlying cause of death (4 digits) and age-race-sex group. Data for counties are available on the SCHS web site. North Carolina Reported Pregnancies (Annual): For the state, PCRs, and counties, annual estimates of pregnancy rates, live birth rates, abortion rates, and abortion fractions by age and race are followed by one-page tables displaying counts of pregnancies (abortions, live births, and fetal deaths) by race and age for total and unmarried women. Maps, graphs, and narrative describe geographical patterns and statewide trends. Cancer Incidence in North Carolina, County-Specific Numbers (Annual): Observed and expected numbers of newly diagnosed cancer cases for 26 cancer sites and total cancer are provided by county and gender. State and county tabulations of cases by race-sex and age are also provided. North Carolina Cancer Facts and Figures (Biennial): This collaborative report with the American Cancer Society is prepared specifically for use by the public. It contains tabular, graphic, and narrative materials regarding cancer in North Carolina. Information about cancer control activities and agencies in the state is also given. Local Health Department Facility and Staffing Report (Biennial): Facility-level data are compiled from health department surveys. Capacity of facilities, staffing levels, and expenditure data are provided. SCHS Studies (Intermittent): Studies on health topics of current interest are presented in newsletter form. Statistical Brief (Intermittent): These shorter reports on health topics are designed to provide quick information for health decision makers. Statistical Primer (Intermittent): Short tutorials on statistical methods are presented in newsletter form.
North Carolina VITAL STATISTICS 2000 VOLUME 1: Births Deaths Population Marriages Divorces N.C. Department of Health and Human Services Division of Public Health State Center for Health Statistics Raleigh, North Carolina www.schs.state.nc.us/schs/ i
STATE OF NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF PUBLIC HEALTH STATE CENTER FOR HEALTH STATISTICS Edited by: Manjoo Mittal Other Contributors: Paul A. Buescher Dianne Enright Ziya Gizlice Jean Stafford November 2001 550 copies of this public document were printed at a cost of $2,700.00 or $4.91 per copy. ii
TABLE OF CONTENTS I. INTRODUCTION...1-1 II. GEOGRAPHICAL PATTERNS IN VITAL STATISTICS...1-5 III. REGISTRATION OF VITAL EVENTS...1-15 Birth and Death...1-15 Fetal Death...1-15 Marriage and Divorce...1-15 IV. TECHNICAL NOTES...1-17 Residence Allocation...1-17 Occurrence Allocation...1-17 Race or Color Allocation...1-17 Completeness of Registration of Vital Events...1-17 Accuracy of Items on Certificate...1-18 Treatment of Missing Values...1-18 V. POPULATION BASES AND BIASES IN VITAL STATISTICS RATES...1-19 VI. DEFINITIONS AND FORMULAS...1-21 SYMBOLS...1-26 REFERENCES...1-27 TABLES State...2-1 Perinatal Care Regions...3-1 Counties...4-1 Page COVER: The pen and ink drawing of the lighthouse at Oak Island is used by permission of the artist, Jerry Miller of Cary. iii
I. INTRODUCTION This volume is the 85th annual vital statistics report of the State of North Carolina. It is intended to serve as a basic resource to those individuals, institutions, and agencies delivering and/or planning health services for the citizens of North Carolina. The tables of this report show annual frequencies, annual rates, and 5-year rates for the state, six Perinatal Care Regions, and the 100 counties of North Carolina. Due to incompleteness of the data and potential problems with accuracy, information for cities is not shown in this year's edition. The reader may obtain vital statistics for cities in North Carolina by special request to the Center. Section II contains maps depicting county data. Sections III-VI contain description and discussion of the terms and procedures underlying the tabular and graphical data presented. Other publications available through this office are described on the back of the front cover. If you want copies of these publications, contact Information Services at (919) 733-4728 or address correspondence to: State Center for Health Statistics Department of Health and Human Services 1908 Mail Service Center Raleigh, North Carolina 27699-1908 Caution: Any percentage or rate with a small number of events in the numerator will have substantial random variation over time. A rule of thumb is that any percentage or rate with fewer than 20 events in the numerator may be subject to serious random error. Therefore, many of the percentages and rates in this volume should be interpreted with caution. 1-1
Trends depicted in the graphs are for North Carolina and the United States. Data for the U.S. are from the National Center for Health Statistics. 20 18 16 14 12 10 8 6 Rate per 1,000 Population LIVE BIRTHS 1980-2000 10 8 6 4 LOW-WEIGHT BIRTHS 1980-2000 Percent of Live Births 4 2 0 United States North Carolina 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 Year 2 United States North Carolina 0 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 Year OUT-OF-WEDLOCK LIVE BIRTHS 1980-2000 35 Percent of Live Births 30 25 20 15 10 5 United States North Carolina 0 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 Year 1-2
TOTAL MORTALITY 1980-2000 INFANT MORTALITY 1980-2000 Rate per 1,000 Population Rate per 1,000 Live Births 10 20 18 8 16 14 6 12 10 4 8 6 2 United States North Carolina 0 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 Year 4 2 United States North Carolina 0 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 Year Rate WHITE MORTALITY NORTH CAROLINA 1980-2000 MINORITY MORTALITY NORTH CAROLINA 1980-2000 Rate 12 20 10 Fetal Neonatal Postneonatal 18 16 Fetal Neonatal Postneonatal 8 14 12 6 10 8 4 6 2 4 2 0 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 Year 0 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 Year 1-3
MARRIAGE RATES 1980-2000 DIVORCE RATES 1980-2000 Rate per 1,000 Population Rate per 1,000 Population 14 6 12 5 10 4 8 3 6 4 2 2 United States North Carolina 0 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 Year 1 United States North Carolina 0 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 Year 1-4
II. GEOGRAPHICAL PATTERNS IN VITAL STATISTICS This section contains nine maps depicting population and selected vital statistics for the state s 100 counties. Data and population bases for the vital statistics rates are for the 5-year period 1996-2000. The range of data values indicated by the map legend was formed by a clustering routine from the Statistical Analysis System. 1 This routine groups into five clusters counties that were most like each other with respect to the statistic being examined. This procedure may result in very large or very small groups, depending upon how counties differ from one another. The nine maps display the county statistics listed below. Definitions and formulas are found in Section VI and maps displaying county names are printed on the reverse sides of region and county divider sheets. It should be noted that marriage and divorce rates are not mapped because these data are tabulated only by county of occurrence, not county of residence. FIGURE 1. Estimated Population, July 2000 2. Live Births per 1,000 Population 3. Low Birthweight Live Births per 100 Live Births 4. Out-of-Wedlock Live Births per 100 Live Births 5. Fetal Deaths per 1,000 Deliveries 6. Neonatal Deaths per 1,000 Live Births 7. Postneonatal Deaths per 1,000 Neonatal Survivors 8. Infant Deaths per 1,000 Live Births 9. Deaths per 1,000 Population Although the vital statistics rates shown on the maps are 5-year rates, be careful when interpreting relatively high rates in sparsely populated counties. These counties usually have a small number of births and deaths, which may create a very unstable rate. Consult your respective county tables for the 2000 numbers involved before becoming concerned about relatively high county-level rates. 1-5
III. REGISTRATION OF VITAL EVENTS The origin, flow, and disposition of North Carolina vital records are illustrated in the flow diagram on the following page. A brief history of vital records processing and current registration practice in North Carolina is presented. The Bureau of Vital Statistics was created by an act of the General Assembly in 1913. The Vital Statistics office became a part of the Department of Human Resources in 1973. In 1989, the General Assembly combined the Department of Human Resources Division of Health Services and the environmental and natural resources divisions of the Department of Natural Resources and Community Development to create the new Department of Environment, Health, and Natural Resources. In 1997 the public health divisions, including the Vital Statistics office, were combined back with the human resources division to form a new Department of Health and Human Services. The public health authority of this department and the laws that it administers are contained in Chapter 130A, Article 4, of the General Statutes of North Carolina. Within the organizational structure of the Department of Health and Human Services, the State Registrar of Vital Statistics is appointed by the State Health Director. Duties of the State Registrar are accomplished primarily by the Vital Records Unit of the State Center for Health Statistics. Birth and Death The collection of birth and death records began on October 1, 1913. The Department of Health and Human Services is the custodian of these records. The hospital administrator or person attending a non-hospital delivery is required to file a birth certificate or fetal death report within 10 days after delivery. The funeral director or person burying or otherwise disposing of a body is responsible for filing a death certificate with the local registrar within five days after death. The local registrar is the county health director. A clerk of the county health department, designated by the local registrar as deputy registrar, carries out registration procedures locally. The deputy registrar forwards the original birth and death certificates to the Department of Health and Human Services on the fifth day of the month following the birth or death, where they are processed and permanently preserved. Microfilmed copies and computerized data from birth and death certificates are sent to the National Center for Health Statistics. North Carolina was admitted into the National Death Registration Area in 1916 and into the National Birth Registration Area in 1917. Fetal Death North Carolina law requires the filing of a fetal death report for fetal deaths (stillbirths) of 20 or more weeks gestation. Legislation enacted by the 1971 General Assembly and subsequent legislation requires that therapeutic abortions be reported separately, effective May 19, 1971. Thus, the induced abortion report form now replaces a fetal death report for the very few therapeutic abortions occurring at 20 or more weeks gestation. For this reason, counts of fetal deaths and perinatal deaths since 1971 are not strictly comparable to counts in previous years. Marriage and Divorce In 1957, the General Assembly enacted legislation requiring that the duties of the clerk of court include the registration of divorces and annulments of marriage effective January 1, 1958. Certificates of divorce and annulments are required to be sent to the Department of Health and Human Services on or before the 15th day of the month following the event. The filing of certificates of divorce rather than divorce listings was started January 1, 1984, following legislation in 1983. By virtue of legislation enacted in 1961, the duties of the county register of deeds include the registration of marriages occurring on or after January 1, 1962. Copies of the certificates of marriage are required to be forwarded to the Department of Health and Human Services on or before the 15th day of the month following the marriage. The original certificates are filed with the county register of deeds. In January 1964, North Carolina was admitted to the National Marriage Registration Area. North Carolina is not a member of the National Divorce Registration Area. 1-15
THE ORIGIN, FLOW, AND DISPOSITION OF VITAL RECORDS NORTH CAROLINA HOSPITAL ADMINISTRATOR Statutory Citation G.S. 130A-101 & 114 Completes birth certificate or fetal death report for hospital deliveries. Obtains certifier s signature. Sends birth certificate or fetal death report to county registrar. Responds to requests for information. VITAL RECORDS UNIT PHYSICIAN Statutory Citation G.S. 130A-101 & 114 Signs birth certificate or fetal death report. Completes birth certificate or fetal death report for non-hospital delivery; sends to county registrar. Completes cause of death and signs certificate for all non-medical-examiner deaths. CLERK OF COURT Statutory Citation G.S. 130A-111 Completes divorce certificate and forwards to Department of Health and Human Services. REPORT PROCESSING Receives and processes current reports of births, deaths, marriages, and divorces and delayed birth certificates. Codes demographic data. Provides consultation and assistance to individuals involved with vital records registration. CORRECTIONS Receives and processes all requests for change to prior records. SPECIAL REGISTRATION Reviews and processes all requests for adoption, legitimation, and judicial determinations of paternity. NOSOLOGY Codes all conditions at death using current revision of the ICD. Codes underlying cause on fetal death report. Codes congenital anomalies on birth certificates. s t SOCIAL SERVICES Sends adoption reports to special registration. t t FUNERAL DIRECTOR Statutory Citation G.S. 130A-112 & 115 Sends notification of death to registrar and completes death certificate. Obtains cause of death and signature of physician. Obtains burial transit permit when necessary. Delivers death certificate to county registrar within five days. t MEDICAL EXAMINER Statutory Citation G.S. 130A-114, 115 & 383 Initiates certificate for a death resulting from injury, suicide, or homicide, and for certain unattended deaths and fetal deaths. Investigates circumstances surrounding aforementioned deaths and certifies cause and manner of death. COUNTY REGISTRAR (COUNTY HEALTH DEPARTMENT) Statutory Citation G.S. 130A-97 Checks records for accuracy and completeness. Requests further information when necessary. Prepares copy of birth and death certificates for register of deeds. DEPARTMENT OF HEALTH AND HUMAN SERVICES (DHHS) STATE CENTER FOR HEALTH STATISTICS (SCHS) REGISTER OF DEEDS Statutory Citation G.S. 130A-110 Sends original birth and death certificates to the Department of Health and Human Services. Issues burial transit permits. NATIONAL CENTER FOR HEALTH STATISTICS Receives microfilm and data from state. Performs sample quality control and assures receipt of all records and corrections. Publishes United States reports. Provides technical assistance. Provides classes in registration (ASTI). t Completes marriage certificates for all marriages. Sends copy of marriage certificate to Department of Health and Human Services. Prepares delayed certificates and sends to DHHS for approval. Initiates amendment applications. MICROFILM AND PRESERVATION Microfilms all vital records. Prepares certifications, verifications, and manuscripts from microfilm and xerox. Stores and preserves all original records. STATISTICAL SERVICES AND HEALTH INFORMATICS UNITS Answers requests for vital statistics data. Publishes annual reports; conducts special studies. Keys data from vital records births, deaths, fetal deaths, marriages, and divorces. Performs selective edit of variables and maintains cumulative files. Transmits data to the National Center for Health Statistics. s t 1-16 OTHER STATES Exchange birth and death records.
IV. TECHNICAL NOTES Residence Allocation Except as otherwise indicated, births and deaths in this report are based on place of residence. In the case of a birth or fetal death, residence is the usual residence of the mother. For deaths of persons in long-term institutions (mental, penal, old age, orphan, nursing home, rest home, etc.), the institution is considered the usual residence, provided the decedent has resided in the institution at least one year. College students and military personnel are considered residents of the college or military community. North Carolina participates in an interchange program whereby photocopies of nonresident birth and death certificates are required to be sent to the state of residence within two months of the date of occurrence. The National Center for Health Statistics acts as a control for this interchange through a report from each state that lists the number of each type of vital record sent to every other state. However, delays or omissions in the interchange undoubtedly occur. Occurrence Allocation Items 9 and 18 of the tables allocate live births and deaths respectively to place of occurrence regardless of place of residence. Marriage and divorce data are compiled only by place of occurrence county of license for marriages and county of decree for divorces and annulments because (i) all states do not engage in an interchange program whereby we receive notification of North Carolina residents who marry or divorce in other states and (ii) the two parties to these proceedings are often residents of different counties or states. Race or Color Allocation Two broad categories, white and minority, are used in this report. Minority is predominantly black (>90%) in North Carolina. For births and fetal deaths, the child is considered to be the same race as the mother. Due to some cases of different races of the two parties involved in marriage and divorce/annulment proceedings and to a number of not stated race cases, frequencies and rates for these events are not shown by race. Completeness of Registration of Vital Events Completeness of registration is defined as the degree to which reported birth and death counts agree with the true counts in a given time frame. Birth registration, tested for completeness in 1940 and 1950, was found to be 86 and 96 percent complete respectively. 2 Death registration is believed to be even more complete than birth registration. Fetal death registration, tested for completeness in 1974, was found to be 99 percent complete. 3 Marriage registration was tested for completeness in 1963. Over 99 percent of performed marriages had a properly recorded certificate of marriage. 4 Delayed registration results in incomplete recording of vital events for a specific time period. Frequency counts in this report are based on 2000 events filed with the local registrar prior to April 1, 2001, and processed in the state office before the end of June 2001. Based on examinations of lagtimes in prior years, the number of calendar year events filed after April 1 of the subsequent year is considered negligible. In addition to the above, a source of incompleteness in residence data could involve failure of other states to send photocopies for North Carolina resident events occurring in their states. The extent to which this occurs is unknown. 1-17
Accuracy of Items on Certificate The Vital Records Branch maintains continuous surveillance of certificates to detect inconsistencies in related items (e.g., newborn s name vs. sex). However, the true extent of bias and unreliability of vital records data is not known. One study by the State Center for Health Statistics has addressed the issue of the validity of selected birth certificate items, as compared with information recorded in the mother's hospital medical record. 5 Treatment of Missing Values As a result of a survey to reconcile inconsistencies in the data and to complete unanswered items, missing values are rare for the characteristics included in this report. These not stated cases are treated in one of two ways: (1) not allocated because they are believed to have an unknown distribution that is different from the distribution for stated cases; or (2) randomly distributed in the same proportion as the stated cases for the state. The following table shows the number and treatment of missing values in the statistical files underlying this report. In the case of race, marital status, mother smoked, and method of delivery, most of the missing values are due to absence of these items on certificates from other states. Number of Missing Values by Item and Treatment North Carolina 2000 Treatment of Missing Values Treatment 1 Treatment 2 Live Births Sex 0 2 Birth Weight 75 0 Marital Status 22 0 Race 0 0 Mother Smoked 278 0 Method of Delivery 18 0 Deaths Age 0 0 Race 0 43 Sex 0 2 Fetal Deaths Marital Status 10 0 Race 0 0 1-18
V. POPULATION DATA AND VITAL STATISTICS RATES Every 10 years (years ending in zero) the U.S. Bureau of the Census counts the United States population, which includes a profile of the population s characteristics such as age, race, and sex. After a census year, estimates of population size and composition are based on knowledge of the population in the census year plus subsequent events such as births, deaths, and migration. In the latter years of a decade, estimates may depart considerably from true population values to the extent that assumptions, particularly about in- and out- migration, depart from what has actually occurred. Thus, vital statistics rates that are based on population counts in the denominator may be subject to some degree of error. In this report on 2000 North Carolina vital statistics, we have used population estimates based on the 2000 census for the denominators of the 2000 rates. For the denominators of the 1996-2000 rates, we have used smoothed population files where information from both the 1990 and 2000 censuses was used to adjust the previous 1996-1999 population estimates. For the state as a whole, the 2000 census data revealed that previous estimates for the late 1990s were approximately five percent too low. This error will vary by county. The general result is that use of the updated population estimates will produce rates that are slightly lower than those shown in previous editions of this publication. 1-19
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VI. DEFINITIONS AND FORMULAS Caution: Any percentage or rate with a small number of events in the numerator will have substantial random variation over time. A rule of thumb is that any percentage or rate with fewer than 20 events in the numerator may be subject to serious random error. Therefore, many of the percentages and rates in this volume should be interpreted with caution. Births and deaths are exhibited in the tables of this report by frequencies and rates. The term rate usually means the number of vital events in a given period of time divided by the average number of people at risk during that period. In this report, the average number of people at risk is usually the midyear population, the period is one year or five years, and the rate is expressed per 1,000 population. For example, the formula for a single-year birth rate is B x 1,000 P where B is the number of births in the year and P is the midyear population. Similarly, the formula for a 5-year birth rate is B 1 + B 2 + B 3 + B 4 + B 5 x 1,000 P 1 + P 2 + P 3 + P 4 + P 5 where B 1, B, etc. are the numbers of births in the particular years and P, P, etc. are the midyear populations 2 1 2 in those years. The term rate is also used in this report to mean a simple proportion expressed per 100 or per 1,000. These rates are the ratio of two related vital event counts. An example of this type of rate is the single-year infant mortality rate. The formula is D x 1,000 B where D represents deaths of infants during a year and B represents live births during the same year. Another example is the low birthweight rate which is the ratio of low birthweight births to total births expressed as a percentage. LBW x 100 B Rates are rounded to one decimal place for publication. Except for marriages and divorces for which racespecific rates are not calculated, a blank in the rate column indicates that both the numerator and the denominator are zero. A rate of 0.0 is shown for rates less than 0.05. Inaccurate reporting, under-registration, and missing values have been discussed (Section V). These factors affect the validity of information involved in rate computation. The users of vital statistics measures should be aware of these possible limitations. Furthermore, you should cautiously interpret rates that are based on small frequencies since they may be associated with relatively large chance fluctuation. For this reason, 5-year rates are included. Based on an increased number of events, these average annual rates are more stable than the single-year rates. In comparing rates, consider carefully the factors to which a difference in rates might be attributed. Unless the populations are equivalent in all factors except the one for which the comparison is made, conclusions about differences in rates may not be clearly drawn. Age-adjusted rates or other further analyses may be necessary in order to make valid comparisons. 1-21
Definitions and formulas are given in the numerical order of their appearance in the tables. Except for items 9 and 18-20, rates are for resident events. Definitions 1. Population is the expected population of an area as of July 1 of the event year. Figures shown in the tables of this report are summations over age-race-sex-specific estimates provided by the Office of State Planning. 2. Natural Increase is the excess of births over deaths among residents of an area. 3. A Live Birth is the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy, which, after separation, breathes or shows any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or any definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached (definition adopted by World Health Organization in 1950). is a physician (M.D. or D.O.) in a hospital, a physician not in a hospital, a certified nursemidwife (CNM), or other attendant. Legislation during 1983 (H.B. 814) regulates the practices of CNMs; these practitioners must have certification by the American College of Nurse-Midwives. 5. Low Birthweight includes liveborn infants weighing under 2,500 grams (5 pounds, 8 ounces or less) at birth, regardless of the period of gestation. (Birthweight index recommended by the Expert Group on Prematurity of the World Health Organization, 1950). 6. Birth Out of Wedlock is birth to a woman who has never been legally married or who has been widowed or legally divorced from her husband in excess of 280 days. 6 7. Mother Smoked is based on birth certificate reporting that the mother used tobacco during the pregnancy. 8. C-Section indicates that the method of delivery was either a primary or a repeat C-section. 9. An Occurrence Birth is one that occurs in an area irrespective of place of residence. Live births occurring in an area to residents of the area are also shown in the tables. Complementary totals, i.e., nonresident births occurring in the area and resident births occurring elsewhere, may be obtained by subtraction. 10. Perinatal Deaths are the sum of registered fetal deaths and neonatal deaths (see definitions below). 11. Fetal Death is death prior to the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy, as indicated by the fact that after such expulsion or extraction the fetus does not breathe or show any evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles (definition adopted by World Health Organization in 1950). Consistent with North Carolina law, this report includes only fetal deaths which do not qualify as therapeutic abortions and which result from pregnancies of 20 or more weeks gestation (see Section IV). 12. Neonatal Death is death of a liveborn child under 28 days of age. 13. Postneonatal Death is death of an infant age 28 days and over but less than one year of age. 14. Infant Death is defined as death of a liveborn infant under one year of age. 15. Death is defined as the permanent disappearance of any evidence of life at any time after live birth. 7 Also, North Carolina law (G.S. 90-322) defines criteria for certifying brain death. 1-22
at Death is reported age in completed years as of the last birthday. Errors in reporting are believed to include underestimates for ages 22 through middle age and overestimates for persons nearing their 21st and 65th birthdays and for those over age 65. Preferences for ages ending in certain digits (e.g., age ending in 0 and 5) may also result in undue concentrations of reported ages. 8 is the hospital, other institution, or noninstitution place of death. 18. An Occurrence Death is one that occurs in an area regardless of place of residence. 19. Marriage is defined as the legal union of a male and a female (North Carolina G.S. 51-1). Marriages are by place of occurrence; race-specific data are not shown (see Section V). 20. Divorces and Annulments can occur only by decree of an authorized court. Annulments, which void marriage from the beginning, constitute less than one percent of the sum of these events. A divorce from bed and board is a judicial separation suspending cohabitation but not otherwise affecting the marriage bond. Divorces from bed and board are not included in this report. Divorces and annulments are by place of occurrence; race-specific data are not shown (see Section V). Formulas 1. Population Percentage of N.C. population Population of area residing in area = --------------------------------------------- X 100 Population of North Carolina Percentage male population Male population of area in area = --------------------------------------------- X 100 Total population of area Percentage female population Female population of area in area = --------------------------------------------- X 100 Total population of area 2. Natural Increase Number of live births Rate of minus number of deaths natural increase = -------------------------------------------- X 1,000 Population of area 3. Live Births Number of live births Birth rate = -------------------------------------------- X 1,000 Population of area Number of male live births Male birth rate = -------------------------------------------- X 1,000 Population of area Number of female live births Female birth rate = -------------------------------------------- X 1,000 Population of area 1-23
Number of live births attended Percentage of live births attended by physician in hospital = by physician in hospital -------------------------------------------- X 100 Number of live births Number of live births attended Percentage of live births attended by physician not in hospital by physician not in hospital = -------------------------------------------- Number of live births X 100 Number of live births attended Percentage of live births attended by certified nurse-midwife by certified nurse-midwife = -------------------------------------------- X 100 Number of live births Number of live births Percentage of live births attended by other attended by other = -------------------------------------------- X 100 Number of live births 5. Low Birthweight Percentage of live births Number of low-weight live births classified as low weight = -------------------------------------------- X 100 Number of live births 6. Births out of Wedlock Number of live births Percentage of live births occurring out of wedlock occurring out of wedlock = -------------------------------------------- X 100 Number of live births 7. Mother Smoked Number of live births to mothers Percentage of live births to mothers who used tobacco who used tobacco during pregnancy = -------------------------------------------- X 100 Number of live births 8. C-Section Number of live births by C-section Percentage of live births by C-section = -------------------------------------------- X 100 Number of live births Births Number of live births Percentage of N.C. live births occurring in area occurring in area = -------------------------------------------- X 100 Number of live births occurring in N.C. Number of resident live Percentage of area live births births occurring in area occurring to residents of area = -------------------------------------------- X 100 Number of total live births occurring in area 1-24
10. Perinatal Deaths Number of fetal deaths plus number of neonatal deaths Perinatal mortality rate = -------------------------------------------- X 1,000 Number of live births plus number of fetal deaths 11. Fetal Deaths 12. Neonatal Deaths Number of fetal deaths Fetal mortality rate = -------------------------------------------- X 1,000 Number of live births plus number of fetal deaths Number of neonatal deaths Neonatal mortality rate = -------------------------------------------- X 1,000 Number of live births 13. Postneonatal Deaths 14. Infant Deaths 15. Deaths Number of postneonatal deaths Postneonatal mortality rate = -------------------------------------------- X 1,000 Number of live births minus number of neonatal deaths Number of infant deaths Infant mortality rate = -------------------------------------------- X 1,000 Number of live births Number of deaths Death rate = -------------------------------------------- X 1,000 Population of area Number of male deaths Male-specific death rate = -------------------------------------------- X 1,000 Male population of area Number of female deaths Female-specific death rate = -------------------------------------------- X 1,000 Female population of area -specific Deaths Number of deaths in age group Age-specific death rate = -------------------------------------------- X 1,000 Population in age group 1-25
Percentage of deaths Number of deaths in hospitals occurring in hospitals = -------------------------------------------- X 100 Number of deaths Number of deaths in non- Percentage of deaths occurring hospital institutions in nonhospital institutions = -------------------------------------------- X 100 Number of deaths Number of deaths in Percentage of deaths occurring home or noninstitutions in home or noninstitution = -------------------------------------------- X 100 Number of deaths Deaths Number of deaths Percentage of N.C. deaths occurring in area occurring in area = -------------------------------------------- X 100 Number of deaths occurring in North Carolina Number of resident deaths Percentage of area deaths occurring in area occurring to residents of area = -------------------------------------------- X 100 Number of total deaths occurring in area 19. Marriages Number of marriages occurring in area Marriage rate = -------------------------------------------- X 1,000 Population of area 20. Divorces and Annulments Number of divorces and annulments occurring in area Divorce/Annulment rate = --------------------------------------------- X 1,000 Population of area Symbols Quantity (frequency) is zero... 0 Rate is less than 0.05... 0.0 Rate is not applicable... blank space 1-26
REFERENCES (1) Barr, Anthony J.; Goodnight, James H.; Sals, John P.; and Helwig, Jane T. Statistical Analysis System, Cluster Procedure. SAS Institute, Inc., Raleigh, N.C. 1976. (2) U.S. Department of Health, Education, and Welfare. Birth Registration Completeness in the United States and Geographical Areas, 1950. Vol. 39, No. 2. Public Health Service, National Office of Vital Statistics. September 21, 1954. (3) Lucas, I.J. A Study of Completeness of Fetal Death Registration in North Carolina. North Carolina Department of Human Resources, Division of Health Services Statistical Report Series. No. SRS-5141-07-28-75. Raleigh, N.C. 1975. (4) North Carolina State Board of Health, Public Health Statistics Section. Test conducted in compliance with procedures of the National Office of Vital Statistics, 1963. (5) Buescher, P.A.; Taylor, K.P.; Davis, M.H.; and Bowling, J.M. "The Quality of the New Birth Certificate Data: A Validation Study in North Carolina." American Journal of Public Health, Vol. 83, 1993: 1163-1165. (6) North Carolina Department of Environment, Health, and Natural Resources, Division of Epidemiology, Vital Records Section. Hospital Handbook on Births, Deaths and Fetal Deaths Registration. Raleigh, N.C., 1993. (7) Grove, R.D. and Hetzel, A.M. Vital Statistics Rates in the United States: 1940-1960. Public Health Service Publication No. 1677. Washington, D.C.: U.S. Government Printing Office. 1968. (8) Spiegelman, M. Introduction to Demography. Cambridge, Mass.: Harvard University Press. 1969. 1-27
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1-29 STATE TABLE
1-30
NORTH CAROLINA 1. Total 8085484 100.0 100.0 5985755 100.0 100.0 2099729 100.0 100.0 Males 3926261 48.6 48.5 2943346 49.2 49.1 982915 46.8 46.8 Females 4159223 51.4 51.5 3042409 50.8 50.9 1116814 53.2 53.2 2. Natural Increase 48515 6.0 5.5 31100 5.2 4.7 17415 8.3 8.1 3. Total 120247 14.9 14.3 86341 14.4 13.7 33906 16.1 16.1 Males 61282 7.6 7.3 44046 7.4 7.0 17236 8.2 8.2 Females 58965 7.3 7.0 42295 7.1 6.7 16670 7.9 7.9 Physician in Hospital 109911 91.4 92.3 78674 91.1 92.2 31237 92.1 92.8 Physician Not in Hospital 52 0.0 0.0 34 0.0 0.0 18 0.1 0.1 Certified Nurse Midwife 9833 8.2 7.3 7241 8.4 7.4 2592 7.6 6.9 Other Attendant 451 0.4 0.4 392 0.5 0.4 59 0.2 0.3 5. Low Birthweight 10572 8.8 8.8 6150 7.1 7.1 4422 13.0 13.2 6. Out of Wedlock 40090 33.3 32.7 19430 22.5 20.9 20660 60.9 62.0 7. Mother Smoked 16786 14.0 14.8 13035 15.1 16.2 3751 11.1 11.2 8. C-Section 28198 23.5 22.2 19895 23.0 22.0 8303 24.5 22.7 Total 121347 100.0 100.0 87225 100.0 100.0 34122 100.0 100.0 To Residents 119044 98.1 98.0 85383 97.9 97.7 33661 98.6 98.7 10. Perinatal Deaths 1683 13.9 14.4 913 10.5 10.8 770 22.4 23.2 11. Fetal Deaths 937 7.7 8.0 516 5.9 6.1 421 12.3 12.8 12. Neonatal (Under 28 Days) 746 6.2 6.4 397 4.6 4.7 349 10.3 10.6 13. Postneonatal (28 Days- 1 Year) 288 2.4 2.7 148 1.7 2.0 140 4.2 4.4 14. Infant Deaths (Under 1 Year) 1034 8.6 9.1 545 6.3 6.7 489 14.4 14.9 15. Total 71732 8.9 8.8 55241 9.2 9.0 16491 7.9 8.0 Males 35227 9.0 9.0 26823 9.1 9.1 8404 8.6 8.7 Females 36505 8.8 8.5 28418 9.3 9.0 8087 7.2 7.3 00-04 Years 1178 2.1 2.1 634 1.6 1.6 544 3.0 3.0 05-14 Years 224 0.2 0.2 151 0.2 0.2 73 0.2 0.3 15-24 Years 954 0.9 0.9 606 0.8 0.8 348 1.0 1.1 25-34 Years 1384 1.2 1.2 868 1.0 1.0 516 1.7 1.8 35-44 Years 2823 2.2 2.2 1788 1.9 1.8 1035 3.2 3.6 45-54 Years 5271 4.7 4.7 3409 4.0 3.9 1862 7.1 7.4 55-64 Years 8035 10.7 11.1 5797 9.6 9.9 2238 15.5 16.0 65 and Over 51863 50.2 50.0 41988 49.6 49.1 9875 53.0 53.9 Hospital 36602 51.0 52.2 26776 48.5 49.9 9826 59.6 59.8 Other Institution 19008 26.5 25.1 15498 28.1 26.5 3510 21.3 20.3 Home or Non-Institution 16122 22.5 22.7 12967 23.5 23.6 3155 19.1 19.9 Total 72541 100.0 100.0 55928 100.0 100.0 16613 100.0 100.0 To Residents 70411 97.1 96.9 54183 96.9 96.7 16228 97.7 97.6 19. Marriages 65609 8.1 8.3 20. Divorces and Annulments 37482 4.6 4.7 2-1
1-32
Perinatal Care Regions REGION TABLES 1-31
North Carolina Perinatal Care Regions 1 2 4 3 5 6
P.C. REGION I - WESTERN 1. Total 674956 8.3 8.4 621629 10.4 10.4 53327 2.5 2.5 Males 325118 48.2 48.1 299087 48.1 48.1 26031 48.8 48.6 Females 349838 51.8 51.9 322542 51.9 51.9 27296 51.2 51.4 2. Natural Increase 177 0.3 0.2-100 -0.2-0.2 277 5.2 4.3 3. Total 8015 11.9 11.5 7321 11.8 11.4 694 13.0 13.1 Males 4125 6.1 5.9 3769 6.1 5.8 356 6.7 6.8 Females 3890 5.8 5.6 3552 5.7 5.5 338 6.3 6.3 Physician in Hospital 6975 87.0 89.9 6345 86.7 89.6 630 90.8 93.4 Physician Not in Hospital 3 0.0 0.1 3 0.0 0.1 0 0.0 0.1 Certified Nurse Midwife 976 12.2 9.3 919 12.6 9.7 57 8.2 6.1 Other Attendant 61 0.8 0.7 54 0.7 0.7 7 1.0 0.4 5. Low Birthweight 652 8.1 7.8 582 7.9 7.5 70 10.1 11.1 6. Out of Wedlock 2325 29.0 28.1 1883 25.7 24.4 442 63.7 66.8 7. Mother Smoked 1517 18.9 20.6 1416 19.3 21.1 101 14.6 15.0 8. C-Section 1754 21.9 20.3 1594 21.8 20.2 160 23.1 21.4 Total 7812 6.4 6.5 7134 8.2 8.3 678 2.0 2.0 10. Perinatal Deaths 99 12.3 12.8 81 11.0 12.1 18 25.6 20.0 11. Fetal Deaths 52 6.4 6.9 42 5.7 6.5 10 14.2 10.5 12. Neonatal (Under 28 Days) 47 5.9 6.0 39 5.3 5.6 8 11.5 9.7 13. Postneonatal (28 Days- 1 Year) 17 2.1 2.8 14 1.9 2.4 3 4.4 7.0 14. Infant Deaths (Under 1 Year) 64 8.0 8.8 53 7.2 8.0 11 15.9 16.6 15. Total 7838 11.6 11.3 7421 11.9 11.5 417 7.8 8.8 Males 3862 11.9 11.8 3639 12.2 12.0 223 8.6 9.2 Females 3976 11.4 10.9 3782 11.7 11.1 194 7.1 8.3 00-04 Years 72 1.8 2.0 60 1.7 1.8 12 2.6 2.9 05-14 Years 25 0.3 0.2 23 0.3 0.2 2 0.2 0.3 15-24 Years 60 0.8 0.9 57 0.8 0.9 3 0.4 1.1 25-34 Years 105 1.3 1.2 92 1.2 1.1 13 1.8 1.7 35-44 Years 220 2.3 2.2 192 2.2 2.1 28 3.7 4.0 45-54 Years 474 5.0 4.5 423 4.8 4.3 51 7.7 7.0 55-64 Years 717 9.4 9.8 668 9.2 9.5 49 12.2 16.0 65 and Over 6165 47.9 47.7 5906 48.0 47.6 259 45.7 51.9 Hospital 3388 43.2 44.5 3174 42.8 44.2 214 51.3 49.5 Other Institution 2676 34.1 32.2 2541 34.2 32.3 135 32.4 29.2 Home or Non-Institution 1774 22.6 23.3 1706 23.0 23.5 68 16.3 21.3 Total 7916 10.9 10.9 7492 13.4 13.3 424 2.6 2.8 19. Marriages 6154 9.1 9.6 20. Divorces and Annulments 3180 4.7 4.9 3-1
P.C. REGION II - NORTHWESTERN 1. Total 2047414 25.3 25.4 1666646 27.8 28.0 380768 18.1 18.0 Males 991532 48.4 48.4 813082 48.8 48.7 178450 46.9 46.8 Females 1055882 51.6 51.6 853564 51.2 51.3 202318 53.1 53.2 2. Natural Increase 9511 4.6 4.3 6427 3.9 3.5 3084 8.1 7.7 3. Total 28552 13.9 13.4 22712 13.6 13.0 5840 15.3 15.2 Males 14594 7.1 6.8 11588 7.0 6.6 3006 7.9 7.8 Females 13958 6.8 6.5 11124 6.7 6.3 2834 7.4 7.4 Physician in Hospital 26379 92.4 93.4 20999 92.5 93.6 5380 92.1 92.8 Physician Not in Hospital 6 0.0 0.0 5 0.0 0.0 1 0.0 0.0 Certified Nurse Midwife 1997 7.0 6.1 1552 6.8 5.9 445 7.6 6.9 Other Attendant 170 0.6 0.4 156 0.7 0.5 14 0.2 0.3 5. Low Birthweight 2478 8.7 8.9 1690 7.4 7.7 788 13.5 13.7 6. Out of Wedlock 9120 31.9 30.9 5541 24.4 23.0 3579 61.3 61.6 7. Mother Smoked 4960 17.4 18.1 4232 18.6 19.4 728 12.5 13.1 8. C-Section 6583 23.1 22.2 5247 23.1 22.3 1336 22.9 21.9 Total 28369 23.4 23.4 22528 25.8 26.0 5841 17.1 17.0 10. Perinatal Deaths 395 13.7 13.7 264 11.5 11.5 131 22.2 22.1 11. Fetal Deaths 217 7.5 7.6 147 6.4 6.6 70 11.8 11.3 12. Neonatal (Under 28 Days) 178 6.2 6.2 117 5.2 4.9 61 10.4 10.9 13. Postneonatal (28 Days- 1 Year) 69 2.4 2.7 42 1.9 2.2 27 4.7 4.8 14. Infant Deaths (Under 1 Year) 247 8.7 8.9 159 7.0 7.1 88 15.1 15.6 15. Total 19041 9.3 9.1 16285 9.8 9.4 2756 7.2 7.5 Males 9244 9.3 9.3 7866 9.7 9.6 1378 7.7 8.2 Females 9797 9.3 8.9 8419 9.9 9.3 1378 6.8 6.9 00-04 Years 273 1.9 2.0 180 1.7 1.7 93 2.8 2.8 05-14 Years 43 0.2 0.2 33 0.2 0.2 10 0.2 0.2 15-24 Years 221 0.8 0.8 170 0.9 0.8 51 0.8 0.9 25-34 Years 319 1.1 1.1 241 1.1 1.0 78 1.4 1.7 35-44 Years 700 2.2 2.1 536 2.0 1.8 164 2.8 3.1 45-54 Years 1286 4.4 4.4 994 4.1 3.9 292 6.2 7.1 55-64 Years 2066 10.2 10.8 1686 9.6 10.1 380 14.1 15.6 65 and Over 14133 50.8 49.8 12445 50.9 49.6 1688 50.6 51.6 Hospital 9644 50.6 51.7 8021 49.3 50.5 1623 58.9 58.5 Other Institution 5295 27.8 25.9 4654 28.6 26.6 641 23.3 21.5 Home or Non-Institution 4102 21.5 22.4 3610 22.2 22.8 492 17.9 20.0 Total 19327 26.6 26.4 16472 29.5 29.2 2855 17.2 17.4 19. Marriages 16135 7.9 8.3 20. Divorces and Annulments 9098 4.4 4.8 3-2
P.C. REGION III - SOUTHWESTERN 1. Total 1392487 17.2 17.0 1040837 17.4 17.2 351650 16.7 16.4 Males 674946 48.5 48.4 510856 49.1 49.0 164090 46.7 46.6 Females 717541 51.5 51.6 529981 50.9 51.0 187560 53.3 53.4 2. Natural Increase 11588 8.3 7.3 7817 7.5 6.4 3771 10.7 10.3 3. Total 22626 16.2 15.2 16473 15.8 14.6 6153 17.5 17.1 Males 11528 8.3 7.8 8441 8.1 7.5 3087 8.8 8.7 Females 11098 8.0 7.4 8032 7.7 7.1 3066 8.7 8.4 Physician in Hospital 20584 91.0 91.7 14892 90.4 91.2 5692 92.5 92.8 Physician Not in Hospital 7 0.0 0.0 4 0.0 0.0 3 0.0 0.0 Certified Nurse Midwife 1954 8.6 7.9 1501 9.1 8.3 453 7.4 6.9 Other Attendant 81 0.4 0.4 76 0.5 0.5 5 0.1 0.2 5. Low Birthweight 1941 8.6 8.7 1159 7.0 7.1 782 12.7 12.8 6. Out of Wedlock 7190 31.8 31.2 3552 21.6 19.6 3638 59.1 61.2 7. Mother Smoked 2667 11.8 12.8 2106 12.8 14.0 561 9.1 9.7 8. C-Section 5272 23.3 22.1 3753 22.8 22.0 1519 24.7 22.5 Total 24631 20.3 19.7 18202 20.9 20.3 6429 18.8 18.0 10. Perinatal Deaths 315 13.8 13.8 161 9.7 10.2 154 24.7 22.9 11. Fetal Deaths 172 7.5 8.2 87 5.3 5.8 85 13.6 14.5 12. Neonatal (Under 28 Days) 143 6.3 5.6 74 4.5 4.5 69 11.2 8.4 13. Postneonatal (28 Days- 1 Year) 59 2.6 2.4 36 2.2 1.8 23 3.8 3.9 14. Infant Deaths (Under 1 Year) 202 8.9 8.0 110 6.7 6.3 92 15.0 12.3 15. Total 11038 7.9 7.9 8656 8.3 8.2 2382 6.8 6.8 Males 5409 8.0 8.0 4136 8.1 8.1 1273 7.8 7.7 Females 5629 7.8 7.7 4520 8.5 8.3 1109 5.9 6.1 00-04 Years 225 2.2 1.9 125 1.7 1.5 100 3.1 2.6 05-14 Years 31 0.2 0.2 25 0.2 0.2 6 0.1 0.2 15-24 Years 173 1.0 0.9 105 0.9 0.8 68 1.3 1.2 25-34 Years 249 1.2 1.2 149 0.9 0.9 100 1.8 2.0 35-44 Years 516 2.2 2.1 318 1.8 1.6 198 3.5 3.8 45-54 Years 834 4.3 4.4 540 3.6 3.6 294 6.8 7.2 55-64 Years 1272 10.5 10.7 925 9.4 9.6 347 15.4 15.6 65 and Over 7738 50.5 50.5 6469 50.4 50.2 1269 51.2 52.4 Hospital 5547 50.3 51.8 4096 47.3 49.6 1451 60.9 59.9 Other Institution 2853 25.8 24.5 2370 27.4 25.8 483 20.3 19.8 Home or Non-Institution 2638 23.9 23.7 2190 25.3 24.6 448 18.8 20.3 Total 11396 15.7 15.6 8967 16.0 16.1 2429 14.6 14.1 19. Marriages 9869 7.1 7.4 20. Divorces and Annulments 7021 5.0 4.9 3-3
P.C. REGION IV - NORTHEASTERN 1. Total 1548801 19.2 18.8 1102433 18.4 18.1 446368 21.3 21.0 Males 748746 48.3 48.3 539736 49.0 48.9 209010 46.8 46.8 Females 800055 51.7 51.7 562697 51.0 51.1 237358 53.2 53.2 2. Natural Increase 12632 8.2 7.2 8860 8.0 6.9 3772 8.5 8.2 3. Total 23767 15.3 14.6 16758 15.2 14.2 7009 15.7 15.6 Males 12068 7.8 7.4 8537 7.7 7.3 3531 7.9 7.9 Females 11699 7.6 7.1 8221 7.5 6.9 3478 7.8 7.7 Physician in Hospital 22744 95.7 96.1 15956 95.2 95.6 6788 96.8 97.4 Physician Not in Hospital 17 0.1 0.1 14 0.1 0.0 3 0.0 0.1 Certified Nurse Midwife 932 3.9 3.5 729 4.4 4.0 203 2.9 2.3 Other Attendant 74 0.3 0.3 59 0.4 0.4 15 0.2 0.2 5. Low Birthweight 2049 8.6 8.5 1124 6.7 6.4 925 13.2 13.3 6. Out of Wedlock 6986 29.4 29.1 3143 18.8 17.0 3843 54.8 56.5 7. Mother Smoked 2115 8.9 9.9 1450 8.7 9.8 665 9.5 10.2 8. C-Section 5819 24.5 22.6 4003 23.9 22.4 1816 25.9 23.1 Total 24525 20.2 19.6 17299 19.8 19.0 7226 21.2 21.0 10. Perinatal Deaths 316 13.2 14.2 163 9.7 9.9 153 21.6 23.7 11. Fetal Deaths 172 7.2 8.1 99 5.9 5.7 73 10.3 13.3 12. Neonatal (Under 28 Days) 144 6.1 6.1 64 3.8 4.2 80 11.4 10.5 13. Postneonatal (28 Days- 1 Year) 48 2.0 2.6 24 1.4 1.8 24 3.5 4.2 14. Infant Deaths (Under 1 Year) 192 8.1 8.7 88 5.3 6.0 104 14.8 14.7 15. Total 11135 7.2 7.3 7898 7.2 7.3 3237 7.3 7.5 Males 5397 7.2 7.4 3764 7.0 7.1 1633 7.8 8.1 Females 5738 7.2 7.2 4134 7.3 7.4 1604 6.8 6.8 00-04 Years 220 2.0 2.0 105 1.4 1.5 115 3.1 3.0 05-14 Years 42 0.2 0.2 22 0.2 0.2 20 0.3 0.3 15-24 Years 142 0.6 0.7 83 0.6 0.7 59 0.8 0.9 25-34 Years 228 0.9 1.0 140 0.8 0.8 88 1.3 1.6 35-44 Years 491 1.9 2.0 285 1.5 1.5 206 2.9 3.4 45-54 Years 883 4.1 4.0 505 3.2 3.1 378 6.6 6.6 55-64 Years 1251 9.7 10.1 804 8.1 8.7 447 14.9 14.9 65 and Over 7878 48.0 49.2 5954 47.3 48.3 1924 50.5 52.2 Hospital 5558 49.9 50.7 3705 46.9 48.4 1853 57.2 56.3 Other Institution 3047 27.4 26.4 2325 29.4 27.9 722 22.3 22.6 Home or Non-Institution 2530 22.7 22.9 1868 23.7 23.7 662 20.5 21.1 Total 12380 17.1 17.4 8826 15.8 16.0 3554 21.4 21.7 19. Marriages 11075 7.2 7.4 20. Divorces and Annulments 6352 4.1 4.2 3-4
P.C. REGION V - SOUTHEASTERN 1. Total 1162039 14.4 14.5 747698 12.5 12.6 414341 19.7 20.0 Males 566139 48.7 48.7 371474 49.7 49.7 194665 47.0 47.0 Females 595900 51.3 51.3 376224 50.3 50.3 219676 53.0 53.0 2. Natural Increase 7791 6.7 6.8 4132 5.5 5.6 3659 8.8 9.0 3. Total 18095 15.6 15.5 11125 14.9 14.7 6970 16.8 17.0 Males 9201 7.9 7.9 5664 7.6 7.5 3537 8.5 8.6 Females 8894 7.7 7.6 5461 7.3 7.2 3433 8.3 8.4 Physician in Hospital 15707 86.8 88.4 9806 88.1 89.6 5901 84.7 86.5 Physician Not in Hospital 9 0.0 0.1 4 0.0 0.0 5 0.1 0.1 Certified Nurse Midwife 2347 13.0 11.3 1291 11.6 10.1 1056 15.2 13.1 Other Attendant 32 0.2 0.3 24 0.2 0.2 8 0.1 0.4 5. Low Birthweight 1652 9.1 9.2 777 7.0 6.9 875 12.6 12.7 6. Out of Wedlock 7131 39.4 38.1 2736 24.6 22.4 4395 63.1 62.7 7. Mother Smoked 2892 16.0 16.4 1922 17.3 18.2 970 13.9 13.6 8. C-Section 4322 23.9 22.7 2561 23.0 22.1 1761 25.3 23.7 Total 17475 14.4 14.9 10649 12.2 12.7 6826 20.0 20.3 10. Perinatal Deaths 271 14.9 15.4 115 10.3 11.2 156 22.1 22.0 11. Fetal Deaths 154 8.4 8.4 67 6.0 6.4 87 12.3 11.6 12. Neonatal (Under 28 Days) 117 6.5 7.0 48 4.3 4.7 69 9.9 10.5 13. Postneonatal (28 Days- 1 Year) 37 2.1 2.9 11 1.0 2.1 26 3.8 4.2 14. Infant Deaths (Under 1 Year) 154 8.5 9.9 59 5.3 6.9 95 13.6 14.7 15. Total 10304 8.9 8.7 6993 9.4 9.1 3311 8.0 8.0 Males 5205 9.2 9.1 3530 9.5 9.3 1675 8.6 8.7 Females 5099 8.6 8.3 3463 9.2 8.8 1636 7.4 7.4 00-04 Years 184 2.1 2.2 76 1.5 1.7 108 2.9 2.9 05-14 Years 32 0.2 0.3 18 0.2 0.2 14 0.2 0.3 15-24 Years 169 1.0 1.1 87 0.8 1.0 82 1.2 1.3 25-34 Years 232 1.4 1.5 122 1.2 1.2 110 1.9 2.0 35-44 Years 433 2.6 2.7 243 2.2 2.1 190 3.2 3.6 45-54 Years 818 5.4 5.4 448 4.4 4.4 370 7.3 7.4 55-64 Years 1275 11.9 12.0 822 10.5 10.5 453 15.7 15.9 65 and Over 7161 48.2 48.1 5177 46.1 45.9 1984 54.5 55.0 Hospital 5456 53.0 54.8 3455 49.4 51.5 2001 60.4 61.5 Other Institution 2459 23.9 22.4 1799 25.7 24.1 660 19.9 18.9 Home or Non-Institution 2389 23.2 22.9 1739 24.9 24.4 650 19.6 19.6 Total 9693 13.4 13.3 6550 11.7 11.6 3143 18.9 18.6 19. Marriages 10134 8.7 8.5 20. Divorces and Annulments 5754 5.0 5.1 3-5