Annual summary of vital statistics - 1998

Most vital statistics indicators of the health of Americans were stable or showed modest improvements between 1997 and 1998. The preliminary birth rat e in 1998 was 14.6 births per 1000 population, up slightly from the record low reported for 1997 (14.5). The fertility rate, births per 1000 women age d 15 to 44 years, increased 1% to 65.6 in 1998, compared with 65.0 in 1997. The 1998 increases, although modest, were the first since 1990, halting th e steady decline in the number of births and birth and fertility rates in t he 1990s. Fertility rates for total white, non-Hispanic white, and Native American wo men each increased from 1% to 2% in 1998. The fertility rate for black wome n declined 19% from 1990 to 1996, but has changed little since 1996. The ra te for Hispanic women, which dropped 2%, was lower than in any year for whi ch national data have been available. Birth rates for women 30 years or old er continued to increase. The proportion of births to unmarried women remai ned about the same at one third. The birth rate for teen mothers declined again for the seventh consecutive year, and the use of timely prenatal care (82.8%) improved for the ninth co nsecutive year, especially for black (73.3%) and Hispanic (74.3%) mothers. The number and rate of multiple births continued their dramatic rise; the n umber of triplet and higher-order multiple births jumped 16% between 1996 a nd 1997, accounting, in part, for the slight increase in the percentage of low birth weight (LBW) births. LBW continued to increase from 1997 to 1998 to 7.6%. The infant mortality rate (IMR) was unchanged from 1997 to 1998 (7.2 per 10 00 live births). The ratio of the IMR among black infants to that for white infants (2.4) remained the same in 1998 as in 1997. Racial differences in infant mortality remain a major public health concern. In 1997, 65% of all infant deaths occurred to the 7.5% of infants born LBW. Among all of the st ates, Maine, Massachusetts, and New Hampshire had the lowest IMRs. State-by -state differences in IMR reflect racial composition, the percentage LBW, a nd birth weight-specific neonatal mortality rate for each state. The United States continues to rank poorly in international comparisons of infant mor tality. Expectation of life at birth increased slightly to 76.7 years for all gende r and race groups combined. Death rates in the United States continue to de cline, including a drop in mortality from human immunodeficiency virus. The age-adjusted death rate for suicide declined 6% in 1998; homicide declined 14%. Death rates for children from all major causes declined again in 1998 . A large proportion of childhood deaths, however, continue to occur as a r esult of preventable injuries.