Death Dataset Details
To
contact the board with suggestions or comments, you may send an email
to the following address: cohid@state.co.us
A
note about Broomfield County data
Source of Death Data
Death data are compiled from information reported on the Certificate of Death. Data items are presented as reported. Information on the certificate concerning time, place, and cause of death is typically supplied by medical personnel or coroners. Demographic information, such as age, race/ethnicity, or occupation, is generally reported on the certificate by funeral directors from information supplied by the available next of kin. Training of physicians, coroners, other medical personnel, and funeral directors is conducted on an ongoing basis to maintain and improve the quality of data supplied on death certificates.
CoHID only reports data for Colorado resident deaths. Resident deaths are deaths to those individuals who reported being residents of Colorado, even if the death occurred to residents while outside of Colorado. Interstate agreements allow for the exchange of vital information about deaths to Colorado residents that occurred in other states. County-specific data are for deaths reported as occurring for residents of those counties.
Clarifications on Death Data
Race/Ethnicity
Race and ethnic background is determined by responses to race and Hispanic origin questions on the death certificate. In order to best approximate the race and ethnic groups found among the Colorado population, and to follow standard measures of race, CoHID presents the following race categories: all, white, black, Asian, and American Indian. Used together with ethnicity (all, Hispanic, and non-Hispanic), most combinations of race and ethnicity found in Colorado can be constructed.
The unknown category is used to classify those cases where race was either stated as unknown or left blank on the certificate.
Cause of Death Classification
The International Classification of Diseases (ICD) is a system developed collaboratively between the World Health Organization (WHO) and 10 international centers so that the medical terms reported by physicians, medical examiners, and coroners on death certificates can be grouped together for statistical purposes. Revisions of the ICD are implemented periodically so that the classification reflects advances in medical science. Effective with deaths occurring in 1999, the United States replaced ICD-9, in use for deaths from 1979 to 1998, with ICD-10. Publications showing mortality data coded under ICD-10 will differ substantially from those under ICD-9 because of changes in coding rules, changes in category names and ICD numbers, and changes in the tabulation lists used to group mortality data.
Mortality data users should be aware of those changes and are encouraged to contact the National Center for Health Statistics (NCHS) or the Health Statistics Section at the Colorado Department of Public Health and Environment (303-692-2160) for assistance or see "Brief #41, New International Classification of Diseases (ICD-10): The History and Impact, March 2001" in the publications section on our Website at www.cdphe.state.co.us/hs. The NCHS has also posted information about the new coding at www.cdc.gov/nchs/about/major/dvs/icd10des.htm.
The list of causes of death on CoHID was developed by the National Center for Health Statistics. It combines the relevant ICD-9 and ICD-10 codes to derive the 113 leading causes of death.
Underlying Cause of Death Classification
As described above in "Cause of Death Classification," all causes of death listed on a death certificate must be coded. The underlying cause of death is defined by World Health Organization as the disease or injury that initiated the sequence of events leading directly to the death, or the circumstance of the accident or violence that caused the injury.
When more than one death cause is listed on the death certificate, the underlying cause is determined by rules that take into account the sequence of conditions on the certificate and provisions of the ICD-10. To select the underlying cause of death, the Automated Classification of Medical Entities (ACME) system is used. All cause-of-death codes (ACME codes) serve as inputs to the computer software that employs WHO rules to select the underlying cause of death.
Age-Adjusted Death Rates
Age standardization, often referred to as "age-adjustment," has been used for over half a century as a way for official United States mortality statistics to eliminate the confounding effects of differences in the age composition among different populations or across time.
The age-adjusted death rate is defined as the death rate that would occur if the observed age-specific death rates were present in a population with an age distribution equal to a standard population. The age-adjusted death rate is calculated by multiplying each age-specific rate by the standard population weight and summing the weighted age-specific death rates. Because each population or time period shares a common age distribution represented by the age-specific standard population weights, the effects of variation in the age distribution are eliminated.
CoHID calculates age-adjusted rates for the pre-defined age groups used by the National Center for Health Statistics. These groups are: less than 1 year, 1-4 years and nine 10-year age groups beginning at age 5. In order to return an age-adjusted rate, you must select all ages or one or more of the pre-defined age groups on the search screen
Until 1998,The 1940 U.S. population was the standard population in reporting Colorado vital statistics. A new population standard, the projected year 2000 U.S. population, has been approved for use by the U.S. Department of Health and Human Services (DHHS) and has been implemented by the National Center for Health Statistics (NCHS) in all states for deaths occurring in 1999.
Because the U.S. population aged substantially between 1940 and 2000, changing from the 1940 standard population to the year 2000 standard will affect the magnitude of age-adjusted death rates, and for some causes, trends in mortality.
CoHID will allow you to use the 1940, the 1970, or the 2000 standard population to allow for comparability to other data sets adjusted to these various standards.
For more information about age adjustment, please contact the Health Statistics Section at the Colorado Department of Public Health and Environment (303-692-2160) or see "Brief #40, Age-adjusted Death Rates in Colorado Vital Statistics: Implementation of the Year 200 Standard, March 2001" in the publications section on our Website at www.cdphe.state.co.us/hs.
Confidence Intervals
The age-adjusted death rates reported on this site approximate the percent of people within that age range who died. Setting a confidence interval (CI) around a rate allows users to evaluate the estimate. This interval establishes a range of plausible values within which there is a 90%, 95%, or 99% probability that the unknown parameter will fall.
Narrow CIs for rates indicate with greater certainty that the calculated rate is a reliable approximation of the true rate, while wide CIs signal greater variability and less certainty that the calculated rate is a good estimation of the true rate.
Data Quality
Many quality control edits are built into the data reporting and compilation system on CoHID. However, as with all large, complex data sets, completeness and accuracy of reporting may vary by individual data item. Death data are presented as reported on the death certificates. The unknown category is used to classify those cases where the value or characteristic was either stated as unknown or left blank on the certificate.
Confidentiality
Death records are confidential in accordance with Colorado statutes (Section 25-2-117). To maintain confidentiality and prevent the identification of an individual, the results of any search returning fewer than three events will be suppressed.
Definitions
Age-Adjusted Rate: A rate that has been standardized to the age distribution of a particular population so that it is, in effect, independent of the age distribution of the population it represents. Age-adjusted rates are used to compare rates over time or among different geographical areas.
Cause of Death: All the diseases, conditions, or injuries that either resulted in or contributed to death, and/or the circumstances of the accident or violence that produced such injuries. Most standard mortality data are compiled by underlying cause of death (see definition).
Crude Death Rate: The number of deaths per a specified number of population (i.e., per 1,000 or 100,000). Crude rates are not adjusted for differences in demographic distributions among populations, such as age distributions.
Death: The permanent disappearance of any evidence of life at any time after live birth.
Firearm Death: Causes of death attributable to firearm mortality include the following underlying causes by ICD-10 code: W32-W34 accidental injury due to firearm discharge; X72-X74 intentional self-harm by firearm discharge; X93-X95 assault by firearm discharge; Y22-Y24 firearm discharge of undetermined intent; Y35.0 legal intervention involving firearm discharge. Injury by firearm excludes explosives and other causes indirectly related to firearms.
ICD-10: International Classification of Diseases, 10th Revision.
Infant Death: Death in the 1st year of life.
For more information on death data not contained on CoHID, or for data prior to 1990, please contact the Health Statistics Section of the Colorado Department of Public Health and Environment at (303) 692-2160.
Colorado Department of Public Health and Environment
Health Statistics Section
4300 Cherry Creek Drive South
Denver, Colorado 80246-1530