Annual summary of vital statistics - 1997

Many positive trends in the health of Americans continued into 1997. In 199 7, the preliminary birth rate declined slightly to 14.6 births per 1000 pop ulation, and the fertility rate, births per 1000 women 15 to 44 years of ag e, was unchanged from the previous year (65.3). These indicators suggest th at the downward trend in births observed since the early 1990s may have aba ted. Fertility rates for white, black, and Native American women were essentiall y unchanged between 1996 and 1997. Fertility among Hispanic women declined 2% in 1997 to 103.1, the lowest level reported since national data for this group have been available. For the sixth consecutive year, birth rates dro pped for teens. Birth rates for women 30 years or older continued to increa se. The proportion of births to unmarried women (32.4%) was unchanged in 19 97. The trend toward earlier utilization of prenatal care continued for 1997; 8 2.5% of women began prenatal care in the first trimester. There was no chan ge in the percentage with late (third trimester) or no care in 1997. The ce sarean delivery rate rose slightly to 20.8% in 1997, a reversal of the down ward trend observed since 1989. The percentage of low birth weight (LBW) in fants rose again in 1997 to 7.5%. The percentage of very low birth weight w as up only slightly to 1.41%. Among births to white mothers, LBW increased for the fifth consecutive year, to 6.5%, whereas the rate for black mothers remained unchanged at 13%. Much, but not all, of the rise in LBW for white mothers during the 1990s can be attributed to an increase in multiple birt hs. In 1996, the multiple birth rate rose again by 5%, and the higher-order multiple birth rate climbed by 20%. Infant mortality reached an all time low level of 7.1 deaths per 1000 birth s, based on preliminary 1997 data. Both neonatal and postneonatal mortality rates declined. In 1996, 64% of all infant deaths occurred to the 7.4% of infants born at LBW. Infant mortality rates continue to be more than two ti mes greater for black than for white infants. Among all the states in 1996, Maine, Massachusetts, and New Hampshire had the lowest infant mortality ra tes. Despite declines in infant mortality, the United States continues to r ank poorly in international comparisons of infant mortality. Expectation of life at birth reached a new high in 1997 of 76.5 years for a ll gender and race groups combined. Age-adjusted death rates declined in 19 97 for diseases of the heart, accidents and adverse affects (unintentional injuries), homicide, suicide, malignant neoplasms, cerebrovascular disease, chronic liver disease and cirrhosis, and diabetes. In 1997, mortality due to HIV infection declined by 47%. Death rates for children from all major c auses declined again in 1997. Motor vehicle traffic injuries and firearm in juries were the two major causes of traumatic death. A large proportion of childhood deaths continue to occur as a result of preventable injuries.