Trends in infectious diseases mortality in the United States

Objective.-To evaluate recent trends in infectious diseases mortality in the United States. Design.-Descriptive study of infectious disease mortality, classifying International Classification of Diseases, Ninth Revision codes as infectious diseases, consequence of infectious diseases, or not infectious diseases. Multiple cause-of-death tapes from the National Center for Health Statistics for the years 1980 through 1992 were used, with a focus on underlying cause-of-death data and on codes that exclusively represent infectious diseases. Setting.-United States. Subjects.-All persons who died between 1980 and 1992. Main Outcome Measure.-Death. Results.-Between 1980 and 1992, the death rate due to infectious diseases as the underlying cause of death increased 58%, from 41 to 65 deaths per 100 000 population in the United States. Age-adjusted mortality from infectious diseases increased 39% during the same period. Infectious diseases mortality increased 25% among those aged 65 years and older (from 271 to 338 per 100 000), and 6.3 times among 25- to 44-year-olds (from six to 38 deaths per 100 000). Mortality due to respiratory tract infections increased 20%, from 25 to 30 deaths per 100 000, deaths attributed to human immunodeficiency virus increased from virtually none to 13 per 100 000 in 1992, and the rate of death due to septicemia increased 83% from 4.2 to 7.7 per 100 000. Conclusions.-Despite historical predictions that infectious diseases would wane in the United States, these data show that infectious diseases mortality in the United States has been increasing in recent years.