Mortality Narrative

In 2003, HHS Secretary Tommy Thompson approved the revision to the U.S. Standard Certificates of Death and Fetal Death and encouraged all states to adopt them. The process involved in this revision, as well as details of what was revised, can be found at the National Vital Statistics System web site 2003 Revisions of the U.S. Standard Certificates of Live Birth and Death and the Fetal Death Report.

Texas adopted the new U.S. Standard Certificates of Death and Fetal Death in 2006. This revision includes changes to items such as alcohol use, race/ethnicity, etc. For details regarding race/ethnicity computation, see Table 44.

Highlights

A total of 173,935 Texas residents died in 2012. The leading cause of death, diseases of the heart, accounted for 22.4 percent of those deaths, while the second most common cause of death, malignant neoplasms (cancer), accounted for 21.9 percent. Chronic lower respiratory diseases, cerebrovascular disease, and accidents ranked third, fourth, and fifth, respectively. Together, these five leading causes of death represented 60.5 percent of all deaths in 2012.

The number of infant deaths increased to 2,224 deaths in 2012 compared to 2,136 deaths in 2011. The infant mortality rate increased to 5.8 infant deaths per 1,000 live births. Fetal deaths decreased from 2,087 in 2011 to 2,028 in 2012. The fetal death ratio decreased to 5.3 fetal deaths per 1,000 live births in 2012 compared to 5.5 in 2011. A total of 121 women died in 2012 as a result of pregnancy or childbearing for a maternal mortality rate of 31.6 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 886,387 in 2011 to 902,889 in 2012. Accidents, malignant neoplasms, and diseases of the heart continued to be the top three causes of premature mortality in Texas.

Leading Causes of Death

Until 2007, the order of the top three leading causes of death had remained the same since 1979; it changed only in 2007 and again in 2009 when cerebrovasular diseases and accidents exchanged their positions. That exchange occurred again this year. Diseases of the heart claimed 38,987 lives (37,955 in 2011) and continued to be the leading cause of death followed by malignant neoplasms (cancer) with 38,096 deaths (37,121 in 2011). Diseases of the heart and malignant neoplasms have been the first and second leading causes of death in Texas and the nation since 1950.

Accidents moved down from third rank in 2011 to fifth in 2012 with 9,267 deaths (9,301 in 2011). Chronic lower respiratory diseases and cerebrovascular disease rounded out the top five leading causes of death, but their positions also changed from previous years. Chronic lower respiratory diseases raised from fifth rank in 2011 (9,115 deaths) to third rank in 2012 (9,520 deaths). Cerebrovascular disease was fourth in rank this year, with 9,297 deaths (9,058 in 2011). The top three leading causes of death, diseases of the heart, malignant neoplasms, and chronic lower respiratory diseases, accounted for 49.8 percent of all Texas resident deaths in 2012. The next two leading causes of death, cerebrovascular disease and accidents, accounted for another 10.7 percent of all Texas resident deaths in 2012.

The sixth leading cause was Alzheimer's disease with 5,168 deaths in 2012 (5,394 in 2011) and diabetes mellitus was the seventh leading cause in 2012 with 5,127 deaths (5,060 in 2011). Septicemia was the eighth leading cause with 3,616 in 2012. Nephritis and related diseases were the ninth leading cause with 3,522 deaths. Finally, chronic liver disease and cirrhosis were the tenth leading cause with 3,298 deaths in 2012.

The top ten causes of death varied slightly when broken down by race/ethnicity. Although suicide is no longer one of the ten leading causes of death among all Texas residents, it is the eighth leading cause in the White/Other race/ethnicity category. For the Black race/ethnicity category, homicide ranked ninth among leading causes of death (see Table 16 for the leading causes of death by race/ethnicity). For details regarding race/ethnicity computation, see Table 44.

The majority of deaths (30.0 percent) in 2012 to residents ages 1 through 44 were due to accidents. Malignant neoplasms were responsible for 12.0 percent of all deaths to this age group and suicides claimed the lives of another 11.4 percent.

Beginning at age 45, accidents play a less significant role in total deaths; only 10.3 percent of all deaths to individuals 45-54 were due to accidents. However, malignant neoplasms and diseases of the heart were responsible for 45.1 percent of the deaths to this age group. Deaths due to chronic conditions (diseases of the heart, malignant neoplasms, chronic lower respiratory diseases, cerebrovascular diseases, and Alzheimer's disease) were the major causes of death in individuals 55 years and older, accounting for 62.7 percent of deaths to this age group.

Although males represented 49.6 percent of the Texas population in 2012, they accounted for 60.5 percent of all deaths to persons 1 through 74 years of age. In 2012, the mortality rate for diseases of the heart was 88.9 per 100,000 males and 45.0 per 100,000 females in the 1-74 age group. External causes (such as accidents, homicide, and suicide) also contributed to the gender difference in mortality. Males were more likely than females to die at younger ages from these causes (see Table 17).

Infant Mortality

There were 2,224 infant deaths to Texas residents in 2012 for an infant mortality rate of 5.8 infant deaths per 1,000 live births (see Table 29). The Black infant mortality rate (11.6) continued to be considerably greater than the rate of Whites (5.3) and Hispanics (5.2).

The top five leading causes of infant death in 2012 were congenital malformations, deformations, and chromosomal abnormalities (24.6 percent of all infant deaths); disorders related to short gestation and low birth weight, not elsewhere classified (13.1 percent of all infant deaths); Sudden Infant Death Syndrome (7.9 percent); newborns affected by maternal complications of pregnancy (5.4 percent); and unintentional injuries (4.0 percent). For the selected causes of infant death among Texas residents, see Table 31.

The majority (1,414; 63.6 percent) of infant deaths took place during the first 27 days of life (neonatal period), and the rate of neonatal deaths in Texas was 3.7 per 1,000 live births (see Table 30). By rank, the top leading causes of neonatal death were congenital malformations, deformations, and chromosomal abnormalities (26.5 percent) and disorders related to short gestation and low birth weight, not elsewhere classified (20.3 percent). For the selected causes of neonatal death among Texas residents, see Table 32.

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 for any fetus weighing 350 grams or more, or if the weight is unknown, a fetus aged 20 weeks or more. However, all reported fetal deaths, regardless of weight or length of gestation, are included in this annual report (numbers). There were 2,028 fetal deaths to Texas residents in 2012. The fetal death ratio was 5.3 fetal deaths per 1,000 live births in 2012, which is less than in 2011 (5.5).

Perinatal mortality includes fetal and neonatal deaths. The perinatal mortality rate was 8.5 per 1,000 fetal deaths and live births in 2012 (8.8 in 2011). For calculating perinatal mortality rate, only fetal deaths that are 20 or more weeks gestation are included (see Table 28).

Maternal Mortality*

In 2012, 121 women died as a result of pregnancy or childbearing, for a maternal mortality rate of 31.6 per 100,000 live births. The maternal mortality rate for Black women of 92.8 is higher in 2012 than it was in 2011 (90.5) and continues to be higher than the state value. The maternal mortality rate for White (excluding Other) women decreased to 31.0 in 2012 from 38.6 in 2011. Among Hispanic women, the maternal mortality rate increased to 19.7 in 2012 from 12.6 in 2011. However, rates based on small numbers may be misleading (see Technical Appendix).

Life Expectancy at Birth

Texans born in 2012 had a life expectancy at birth of 78.3 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: 80.7 years vs. 75.8. An Hispanic child born in 2012 had a life expectancy at birth of 79.5 years, while a White newborn had a life expectancy of 78.3 years. Black life expectancy remained below the average, at 74.7 years (see Table 25).

Age-Adjusted Death Rate

The age-adjusted death rate for Texas in 2012 was 763.2 deaths per 100,000 population. The age-adjusted death rate for males was 866.4 in 2012 and the rate for females was 672.8. The age-adjusted death rate for Whites and Others, regardless of gender, was 783.8 deaths per 100,000 population. The Hispanic rate of 629.7 remained the lowest of all racial/ethnic groups in 2012. The age-adjusted death rate for Blacks continued to be well above the rate for the Texas population as a whole at 929.5 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 2012 was 902,889 years, up from 886,387 years in 2011 (see Table 27). Male mortality accounted for 567,069 or 62.8 percent of these years and the total YPLL for women was 335,820 or 37.2 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 2012 and represented 176,462 YPLL, or 7.6 years per 1,000 persons ages 0-64. Malignant neoplasms were responsible for the second largest number of years lost with 136,937 YPLL, for a rate of 5.9. Diseases of the heart had a rate of 4.5 and remained the third leading cause of YPLL in Texas, with 103,505 years of potential life lost. Certain conditions originating in the perinatal period was the fourth leading cause of premature mortality with 66,200 YPLL, with a rate of 2.9. The number of years lost from suicide and homicide were the fifth and seventh leading cause of premature mortality in Texas with YPLLs of 62,614 and 41,217 respectively (or 2.7 and 1.8 years per 1,000 persons ages 0-64 respectively). The number of years lost from congenital malformations remained sixth in 2012 from 2011 (40,064). Years lost from congenital malformations were 44,509 with a rate of 1.9. 

*Information and statistics on maternal mortality and morbidity in Texas can be found on the DSHS Maternal and Child Health section website: DSHS Maternal and Child Health.

2012 Annual Report Table of Contents

Annual Reports for Other Years

Center for Health Statistics