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PURPOSE AND ORGANIZATION                                                                            
                                                                                                    
This publication is devoted entirely to issues of mortality in Arkansas occurring in calendar year  
2000.  The data in this report are obtained from death certificates.  The Vital Statistics Act of   
1995 (Act Number 1254) states:                                                                      
            "A death certificate for each death which occurs in this                                
            state shall be filed with the Division of Vital Records,                                
            or as otherwise directed by the State Registrar, within                                 
            ten (10) days after death or the finding of a dead body                                 
            shall be registered if it has been completed and filed in                               
            accordance with this section."                                                          
                                                                                                    
Written on each death certificate is information relating to the cause of the decedent's death. This
information is coded according to the International Classification of Diseases, Tenth Revision      
(ICD-10).  There are thousands of possible codes.  Therefore, most of the tables collapse these     
codes into more general categories. One commonly used approach is based on 39 Selected Causes of    
Death.  Another approach, for Leading Causes of Death, uses 113 Selected Causes of Death.           
                                                                                                    
The death certificate allows for the recording of many medical conditions that contribute to the    
death. A statistician reviews this information, identifying one of those causes mentioned as the    
underlying cause of death.  For example, the underlying cause of death may be a myocardial          
infarction with hypertension and diabetes as contributing causes.  The underlying cause of death is 
the basis of all of the tables in this report.  (See APPENDICES for a sample death certificate.)    
                                                                                                    
This report uses several measures of mortality including crude (unadjusted) rates, various age, sex,
and race-specific rates, age-adjusted rates, and years of life lost.  Each measure provides         
different, but important, perspectives of the same underlying data. The crude rates are a basic     
measure of observed incidence, the total number of deaths divided by the total population (times    
100,000).  Age-sex-race specific rates permit a closer view of particular populations.  Age-adjusted
rates compensate for the bias introduced when rates are calculated for populations with very        
different age distributions.  The years-of-life-lost measure assesses the impact of premature       
mortality, based upon age 65 or life expectancy.  The particular measure on which the reader chooses
to concentrate will greatly influence his/her conclusions.   (See TECHNICAL NOTES for more          
explanation of these measures.)                                                                     
                                                                                                    
Of the 4,146 nonwhite deaths, 4,036 (97.3 percent) were black.  For this reason, most tables do not 
include the "other nonwhite" category.  Columns may not add to the totals because the totals include
eight deaths with unknown race.                                                                     
                                                                                                    
Under the terms of the Interstate Exchange Agreement, each state sends copies of nonresident death  
certificates to the states of residence of the decedents.  A total of 27,700 deaths occurred in     
Arkansas during 2000.  Of this number, 1,144, or 4.1 percent, involved nonresidents and are not     
included in the remainder of this report.  Arkansas, in turn, received 1,626 death certificates for 
Arkansas residents who died out-of-state.  This report does include those deaths.                   
                                                                                                    
WARNINGS                                                                                            
                                                                                                    
The reader should be aware of the dynamic nature of the mortality database.  The numbers and rates  
contained in this report may vary from those in subsequent reports making use of the mortality data.
The current policy is to incorporate all death certificates into the existing database as they      
arrive.  Modification of existing records may also occur if new information becomes available.      
                                                                                                    
In an effort to provide as much useful information as possible, tables present various combinations 
of age, race, sex, cause of death, and county of residence.  This may result in relatively small    

numbers of events being depicted. EXERCISE EXTREME CAUTION in interpreting such data. Consider any rate based on fewer than 20 cases as unreliable. If comparing to the data from previous years, apply a test of significance to any changes detected. OVERVIEW Of the 28,182 resident Arkansas deaths in 2000, 14,052, or 49.9 percent, were males and 14,130, or 50.1 percent, were females. Approximately eighty-five percent (24,030) of those who died were white. There were 4,146 deaths to nonwhite residents, of these 4,036 were black. During calendar year 2000, there were 317 infant deaths, representing 1.1 percent of the total deaths. Seventy-four percent of the resident deaths were 65 and older. A little over one-fourth of those (26.4 percent) were age 85 or older. The ten leading causes of death for Arkansas residents were: Heart Disease (29.3%) Cancer (21.6%) Stroke (8.0) Chronic Lower Respiratory Diseases (5.0%) Accidents (4.5%) Pneumonia/Influenza (2.8%) Diabetes (2.5%) Nephritis/Nephrosis (1.8%) Septicemia (1.5%) Alzheimer's Disease (1.5%) "Accidents and Adverse Effects" was the leading cause of death among both males and females through the age of 24. "Accidents" remained the leading cause of death for males ages 25-44, but was surpassed by "Malignant Neoplasms" for females in this age bracket. "Malignant Neoplasms" remained the leading cause of death among females ages 45-64 followed by "Diseases of Heart". These also became the top two causes for men in this age category. By age 65 and over, "Diseases of Heart" was the number one cause of death for both males and females, followed by "Malignant Neoplasms" and "Cerebrovascular Diseases". The four leading causes of death for whites in 2000 were "Diseases of the Heart", "Malignant Neoplasms", "Cerebrovascular Diseases", and "Chronic Lower Respiratory Diseases". The three leading causes of death for nonwhites paralleled those of whites, but "Accidents and Adverse Effects" replaced "Chronic Lower Respiratory Diseases" as the fourth leading cause. "Accidents and Adverse Effects", "Pneumonia and Influenza", "Diabetes Mellitus", "Alzheimer's", "Nephritis and Nephrosis", and "Septicemia" rounded out the top ten among whites. The fifth through tenth causes among nonwhites differed from those of whites with "Diabetes Mellitus", "Nephritis and Nephrosis" and "Homicide" as the fifth, sixth, and seventh causes, respectively. "Septicemia ", "Chronic Obstructive Pulmonary Diseases", and "Pneumonia and Influenza" complete the top ten for nonwhites. The leading cause of death for both white and nonwhite children up through the age of 14 was "Accidents and Adverse Effects". Racial disparity began to appear, however, among 15-24 year old males with "Homicide" topping the list for nonwhite males, while "Accidents" continued to top the list for their white male counterparts, as well as for females. Although the mortality rate due to "Homicide" among nonwhite males ages 15-24 has consistently declined, from a rate of 118.0 per 100,000 population in 1996 to 80.7 it still greatly exceeds that of the white male counterpart(6.6). Among 15-24 year old white males, the mortality rate from "Accidents" is 81.4 in 2000, while the rate continued to drop for same-aged nonwhite males from 51.0 per 100,000 population in 1999 to 45.1
in 2000. Both rates were higher than those of same-aged females, with a rate of 34.0 for white females, and 14.0 for nonwhite females. "Suicide" ranked as the second leading cause of death among white males ages 15-24, with a rate of 20.3. The leading causes of death among persons age 65 and older continues to be "Diseases of Heart" and "Malignant Neoplasms," which together accounted for 52.8 percent of the white and 52.5 percent of the nonwhite deaths. "Diseases of Heart" greatly surpassed "Malignant Neoplasms" among seniors, accounting for 6,765, or 32.4 percent, compared to 4,264, or 20.4 percent, for "Malignant Neoplasms". The crude death rate for the United States is 873.1 deaths per 100,000 population. The comparable rate in Arkansas is 1,052.1, 20.5 percent higher than the nation. When age-adjusted to the 2000 standard population, however, the Arkansas rate of 971.7 is only 11 percent higher than the U.S. rate of 872.0 (This is equivalent to a ratio of 1.11 to 1.) The Arkansas age-adjusted rate exceeded the U.S. rate for each of the following causes of death (ratios in parentheses): accidents & adverse effects (1.29), Cerebrovascular diseases (1.26), pneumonia/influenza (1.14), heart diseases (1.09), chronic lower respiratory diseases (1.08), and malignant neoplasms (1.04). The Arkansas rates for males and females are much larger than the U.S. (1042.5 and 739.1), with the male to female ratio at 1.48 versus 1.41. The 2000 age-adjusted mortality rate for Arkansas males was 1192.3, while the female rate was 804.5. A review of the tables and maps in Section VI reveals some interesting patterns concerning mortality rates and causes of death. While crude rates are included for comparative purposes in the tables and maps, the age-adjusted mortality rates are much more useful. Those counties with dark shading have mortality rates more than one standard deviation above the mean, while those with no shading have rates more than one standard deviation below the mean. ALL CAUSES OF DEATH (pp. 6-4 & 6-5) Counties with high age-adjusted mortality rates are clustered primarily along the eastern border of the state (Mississippi, Poinsett, Crittenden, St. Francis, and Phillips counties), although another cluster appears in the South (Ashley, Calhoun, Cleveland, Dallas and Nevada counties) are also in the highest rate levels. Counties with low age-adjusted mortality rates are concentrated along the Missouri border (Benton, Carroll, Boone, Marion, Baxter and Randolph counties). The other five, mostly in the North Central part of the state are Stone, Cleburne, Faulkner, Conway, and Saline counties. MALIGNANT NEOPLASMS (pp. 6-9 & 6-10) In 2000, 6,085 Arkansans died from some form of cancer. Cancer was the second leading cause of death among Arkansans in 2000, accounting for 21.6 percent of the total deaths. There is a small cluster of counties with high age-adjusted mortality rates in the south including Dallas, Cleveland, Calhoun, Bradley and Union counties. Other counties with high age-adjusted mortality rates include Chicot, Lafayette, and Howard counties also in the south; Phillips, Prairie, and Lawrence counties in the east. Counties with low age-adjusted rates are rather scattered throughout the state (Benton, Carroll, Marion and Greene counties in the north; Arkansas and Lincoln in the southeast; Cleburne, Conway, Perry and Garland in the central region; and Sevier county in the southwest). The Arkansas age-adjusted rate of 209.7 deaths per 100,000 population was 5 percent higher than the U.S. rate of 201.0. COLON AND RECTAL CANCERS (pp. 6-11 & 6-12) Colorectal cancer accounted for 627 (2.2 percent) of the total deaths in Arkansas in 2000, and 10 percent of the 2000 Arkansas cancer deaths. The age-adjusted rate was 21.6 deaths per 100,000 population; current U.S. data is 20.9 deaths per 100,000. Counties with the highest rates included Mississippi and Clay in the northeast; Scott and Yell counties in the northwest; Lafayette,
Columbia, Dallas and Calhoun in the southwest; and Lonoke, Monroe and Arkansas counties being the other three. The only county with no deaths was Prairie. TRACHEA, BRONCHUS & LUNG CANCER (pp. 6-13 & 6-14) Cancers of the trachea, bronchus, and lung took the lives of 1,992 Arkansans in 2000. Cancers of these sites led all other forms of cancer in terms of the number of lives lost, accounting for nearly one-third of all cancer deaths and seven percent of deaths from all causes. The age-adjusted mortality rate was 68.4; as compared to a U.S. rate of 56.5. Sixty-two percent of these deaths were to males (1,237 deaths), nevertheless, they were the leading cause of cancer deaths for both sexes. Four counties had an age-adjusted mortality rate over 100 per 100,000. They were Dallas (109.8), Lawrence (109.5),Woodruff (104.7) and Prairie (101.2) county. Only Sharp (42.7) and Conway (43.7) had rates below 45.0. Ten of the counties had both high crude and age-adjusted rates indicating that age was not a contributing factor to the high rates. BREAST CANCER (pp. 6-15 & 6-16) Breast cancer follows cancers of the trachea, bronchus, and lung as the second ranked cancer killer among Arkansas women, claiming the lives of 373 in 2000. This resulted in an age-adjusted mortality rate among females of 23.2 deaths per 100,000 population as compared to a U.S. rate of 27.1. Nine counties scattered across the state had no deaths due to breast cancer. There were 6 men who died of this disease in 2000, up from the 4 males who died in 1999. PROSTATE CANCER (pp. 6-17 & 6-18) Prostate cancer accounted for 333 deaths among Arkansas men in 2000. However, prostate cancer runs a very distant second to cancers of the trachea, bronchus, and lung, both in terms of numbers and rates. The age-adjusted rate for prostate cancer is 30.1, while that for trachea, bronchus and lung (for men) is 98.7. The comparable U.S. rate for prostate cancer is 29.7. Only two counties (Marion and Stone in the north central area) had no deaths resulting from this type of cancer. DISEASES OF HEART (pp. 6-21 & 6-22) Heart disease was the leading cause of death in Arkansas in 2000, with 8,260 deaths. Age-adjustment shows numerous counties with high rates. Eleven of the thirteen are in the eastern part of the state. The three highest rates were in Greene (469.5), St. Francis (465.0) and Monroe (463.1) While counties with low rates are found scattered throughout the remainder of the state, the three with a rate below 200.0 are clustered together in the center of the state. They are Faulkner (121.4), Perry (186.6) and Garland (197.1) counties. The age-adjusted rates for Arkansas and the United States are 283.2 and 257.9, respectively, with the Arkansas rate approximately 10 percent higher than the national rate. CEREBROVASCULAR DISEASES (pp. 6-23 & 6-24) With 2,252 deaths, stroke and other cerebrovascular diseases related conditions were the third leading cause of death in Arkansas. The Arkansas age-adjusted mortality rate is about 26 percent higher than the U.S. rate, at 76.7 and 60.8 deaths per 100,000 population, respectively. Although there is a group of six counties with high rates in the south (Ashley, Bradley, Union, Ouachita, Dallas, and Grant), the highest rate of 155.0 is in Cleburne county in the north. Polk county in the west had the lowest rate which is 18.6. PNEUMONIA AND INFLUENZA (pp. 6-25 & 6-26) Pneumonia and influenza resulted in 797 deaths in Arkansas in 2000. The age-adjusted mortality rate was 27.0 per 100,000 population. This was about 14 percent higher than the nation as a whole, which had a rate of 23.7. Perry county, in the central area, had the highest rate at 111.6 which is almost double the next highest (67.5) which occurred in Dallas county. The cluster of counties in the southeast - (Calhoun (0), Bradley (1), Drew (1) and Cleveland (1) - had only 4 deaths total. CHRONIC LOWER RESPIRATORY DISEASES (pp. 6-27 & 6-28)
Chronic lower respiratory diseases were the fourth leading cause of death among Arkansans in 2000, resulting in 1,400 deaths. The age-adjusted mortality rate for the state was 47.7 compared with the U.S. rate of 44.3. The low rates are scattered among the counties throughout the state whereas the high rates tend to be in the eastern part. ACCIDENTS AND ADVERSE EFFECTS (pp. 6-29 - 6-34) Accidents and adverse effects was the fifth leading cause of death among Arkansans in 2000. When adjusted for age, the 1,255 deaths resulted in a mortality rate of 45.9, 29 percent higher than the U.S. rate of 35.5. The age-adjusted mortality rate for male Arkansans is twice that of female Arkansans. Fifty-six percent (706) of the state's accident fatalities are due to transport accidents. MAJOR CARDIOVASCULAR DISEASES (p. 6-35) Almost 40 percent of all resident deaths in the state of Arkansas were caused by major cardiovascular diseases. The age-adjusted mortality rate for the state was 378.1 compared with the U.S. rate of 339.9. Although the male and female crude rates differ by only 36.3, when adjusted for age, the spread increases to 127.6 With this disease, the male crude is lower than the female crude rate, but when adjusted for age the male rate is higher. SUICIDE AND SELF-INFLICTED INJURY (p. 6-36) Suicide is the second leading cause of death for white males aged 15-24 and third for white males aged 25-44. HOMICIDE AND LEGAL INTERVENTION (p. 6-37) The homicide and legal intervention age-adjusted mortality rate was 7.6, with a rate of 12.0 for males and 3.3 for females. A total of 204 deaths were due to homicide and legal intervention. Return to Table of Contents