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Mortality and Longevity

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Mortality and Longevity

Virginians are living longer, thanks to declining death rates from chronic diseases and from reduced infant mortality rates. As preventative care, access to health care, and medical treatments all improve, the traditional leading causes of death continue to fall. At the same time, injuries and longevity-related conditions such as Alzheimer's disease are growing in relative importance.

Generally speaking, the United States has mediocre mortality outcomes when compared to other developed nations. Virginia, however, generally does fairly well when compared to US averages for these same measures. Virginians have lower death rates for cardiovascular disease, chronic lung disease, accidents, and suicide, but lag the nation for cancer, diabetes, and infant mortality. Virginia hopes to reduce these rates further by targeting behavioral risk factors and improving the health care delivery system.

Why is This Important?

Approximately 65,000 Virginians died from all causes in 2015. Four chronic diseases (cardiovascular disease, cancer, lung disease, and diabetes) accounted for 60 percent of these deaths. The economic costs of chronic diseases and early death include reduced quality of life, lost work years, and medical costs.

Accidents killed an additional 3,429 people in 2015. And although they are numerically less significant as drivers of the overall death rate, infant mortality and suicide are economically and socially important. The infant mortality rate affects the most vulnerable among us at the earliest age and is considered an important indicator of how well a nation or region's healthcare system does its job. Suicides are also more common among younger adults and exact an enormous toll in terms of lost human potential and the grief and disruption of families.

How is Virginia Doing?

Along with Life Expectancy, Virginia's leading causes of death are presented below, in order of rank. Use the quick menu below to jump to a particular topic.

Cardiovascular DiseaseCancerAccidental DeathChronic Lung DiseaseDiabetesSuicideInfant Mortality

Cardiovascular Disease

Death Rate from Cardiovascular Disease, by State. See text for explanation.

Cardiovascular disease -- blocked or weakened blood vessels, arrhythmia, and other conditions that lead to heart attacks and strokes -- is Virginia's leading cause of death. The state's death rate from diseases of the circulatory system has fallen every year since 2006 (and earlier). After adjusting for differences in age, in 2015 there were 205.5 deaths per 100,000 people in Virginia and 221.5 in the nation, giving Virginia the 23rd lowest rate in the country. Minnesota again had the lowest age-adjusted rate at 164.0 per 100,000. Virginia's rate has consistently been lower than Tennessee (269.2), Maryland (222.2), and North Carolina (222.2) -- all of whom saw their cardiovascular death rates tick up in 2015.

Death Rate from Cardiovascular Disease, by Virginia Region. See text for explanation.

Cardiovascular death rates also continue to fall across much of the Commonwealth. In 2015, the Northern (148.9), Valley (210.8), and Central (215.9) regions of Virginia again had the lowest age-adjusted death rate for major cardiovascular disease. The Southside and Southwest regions again had the highest rates in 2015, with 270.8 and 266.5 deaths per 100,000 people.

Cancer    back to menu

Cancer Death Rates by State. See text for explanation.

Cancer is the second leading cause of death in Virginia. According to the Centers for Disease Control (CDC), Virginia ranks 24th among the states for its age-adjusted annual cancer death rate. In 2015, Virginia's rate was 159.5 deaths per 100,000 people, slightly higher than the national average of 158.5. The 2015 cancer death rates in Tennessee (180.5) and North Carolina (164.7) were higher than Virginia, while Maryland (155) was slightly lower. Utah again had the lowest rate in the nation at 125.2 deaths per 100,000 people.

Cancer Death Rate by Virginia Region. See text for explanation.

CDC data reveal that cancer rates continue to fall in many regions of the state. The Northern region again had the lowest age-adjusted cancer mortality rate at 128.0 per 100,000 in 2015; the Southwest region had the highest rate in 2015 at 199.9 per 100,000 people.

Accidental Death    back to menu

Deaths from unintentional injuries (accidents) ranked 3rd among causes of death among Virginians in 2015. Accidental Deaths by State. See text for explanation.However, accidents are a leading cause of death for younger adults, ranking first for 18-24 year olds -- and therefore account for more years of potential life lost than many chronic diseases. The most common causes of injury are accidental falls, firearm discharges, drownings, traffic accidents, and poisonings.

Age-adjusted death rates have remained relatively steady over the last 15 years. Although they have been rising since 2010, Virginia ranked 10th lowest among states for accidental deaths, with 39.6 deaths per 100,000 people in 2015, compared to 43.2 for the US. Among peer states, Tennessee (56.4) and North Carolina (47.9) fared much worse than Virginia, while Maryland was lowest in the nation at 29.7 deaths per 100,000 in 2015.

Accidental Deaths by Virginia Region. See text for explanation.

The Southwest, Eastern, and Southside regions again had the highest age-adjusted accident rates at 66.5, 64.6, and 57.6 per 100,000 people in 2015, respectively. The Northern region again had the lowest rate at 29.3 deaths per 100,000 in 2015; however, this rate has risen nearly every year since the low of 21.9 per 100,000 achieved in 2010.

 

Chronic Lung Disease    back to menu

Chronic Lung Disease Deaths, by State. See text for explanation.

Virginia deaths from chronic lower respiratory (lung) disease have been trending downward and dropped from the 3rd leading cause of death in 2013 to 4th in 2014. The age-adjusted death rate was 37.1 in 2015, more than 2014's rate (35.3) but less than the 37.3 rate found in 2013. The Commonwealth ranked 13th best among the states; the national rate was 41.6 per 100,000. Maryland's death rate (30.7) was lower than Virginia, but rates were higher in Tennessee (54.9) and North Carolina (45.5). Hawaii was best in the nation at 17.3 deaths per 100,000 people in 2015.

Chronic Lung Disease Death Rate by Virginia region. See text for explanation.Although somewhat volatile from year to year, chronic lung disease rates have generally decreased in some regions of the state, but are little changed over the last 10 years in others. The Northern region again had the lowest age-adjusted lung disease rate at 22.7 per 100,000 in 2015, down from 26.4 in 2006. But the Southwest region had by far the highest rate in 2015 at 69.1 per 100,000 people -- and only slightly lower than the 70.3 deaths per 100,000 it saw in 2006.

Diabetes    back to menu

Diabetes Death Rates by State. See text for explanation.

Diabetes was the sixth leading cause of death in Virginia in 2015, accounting for 2,044 deaths. (Alzheimer's ranked 5th, but almost exclusively affects the elderly.) Thanks in part to better preventive care and public awareness, age-adjusted death rates from diabetes have been decreasing for much of the past decade. However, in Virginia, the rate in 2015 rose for the first time since 2011 to 21.9 per 100,000 people, ranking it 25th among all states. This rate was higher than the national average of 21.3 deaths. Virginia outperformed Tennessee (23.5) and North Carolina (23.6), but fell behind Maryland (18.3).

Diabetes Death Rate by Virginia Region. See text for explanation.

Death rates from diabetes had also been dropping in many regions of the state, while remaining stubbornly high in others. In 2015, the Northern region was the only area to see its diabetes death rate decline -- down to 12.9 per 100,000 population from 13.7 the year before. All other regions saw often marked increases, with the Southwest (33.0), Hampton Roads (31.0), Southside (26.8), and Eastern (25.8) regions showing the highest death rates.

Suicide    back to menu

Suicide ranks 11th among the causes of death in Virginia. However, it deserves special scrutiny because it is the second leading cause among 18-24-year olds and exacts a disproportionate toll in terms of loss of life, medical costs, grief and suffering, and disruption of families. Given that research suggests inaccurate reporting on suicides due to the social stigma attached, official figures may understate the true total costs, both emotionally and financially, of suicides and attempted suicides.

Suicide Rate by State. See text for explanation.

Suicide rates have generally been rising to some degree in both Virginia and the nation overall. In 2015, Virginia had the 15th lowest (age-adjusted) suicide rate in the country: 12.8 deaths per 100,000 people. Virginia's rate was slightly lower than the national average rate of 13.4 deaths. Peer states Tennessee (15.7) and North Carolina (13.5) had higher suicide rates than Virginia, while Maryland (9.0) had a markedly lower rate. New York was again the leading state, with 7.9 age-adjusted deaths per 100,000 people due to suicide.

Suicide Rate by Virginia Region. See text for explanation.

In 2015, the Southwest region had the highest age-adjusted suicide rate at 20.6 deaths per 100,000, followed by the Valley region at 18.7 deaths. The Northern region had the lowest rate at 9.3 deaths per 100,000.

Unlike many conditions, numerous factors influence suicide rates, making it very difficult to prevent and treat. These factors include mental health, family history, alcohol and substance abuse, access to lethal methods, cultural and religious beliefs, physical illness, and feelings of loss (illness, relational, social, work, or financial). In addition to troubled youth and the elderly. military veterans -- especially those who have served in Vietnam, Iraq or Afghanistan -- have emerged recently as a group who are at higher risk of suicide, largely due to an increased risk of developing post-traumatic stress disorder (PTSD); left untreated, PTSD can lead some to take their own lives.

In addition, suicide rates tend to rise during recessions and to decrease during periods of economic prosperity. The recent spike in suicides among regions of the state and nation experiencing higher economic hardship may be an aggravating factor for individuals who have other risk factors.

Infant Mortality    back to menu

The infant mortality rate measures the death rate during the first year of life and can be attributed to various causes. It is singled out because it serves as an overall measure of health, is used as an indicator for the larger healthcare system, and also has disproportionately large effects on average life expectancy rates.

Infant Mortality by State. See text for explanation.

According to the Organisation for Economic Co-operation and Development (OECD), in 2013 -- the most recent year available for global data -- the United States again ranked near the bottom among the world's developed nations for infant mortality, although its mortality rate improved slightly from 6.1 infant deaths per 1,000 births in 2010 to 6.0 deaths in 2013.

Things were looking a bit better in the most recent year available for national-level data. Virginia's infant mortality rate has been dropping for years, and in 2014 dropped again, to 5.8 deaths per 1,000 births, ranking the state 23rd nationally. This rate was equal to the national average of 5.8 infant deaths, and better than all peer states: Maryland (6.5), Tennessee (6.9) and North Carolina (7.1). California had the lowest infant mortality rate in the nation in 2014 at 4.3 infant deaths per 1,000 births.

Infant Mortality by Virginia Region. See text for explanation.

Since 2007, the Virginia Department of Health (VDH) has been working with local health districts and community health leaders to combat infant mortality in especially vulnerable areas of the state. Although there are sometimes marked swings in regional performance, that approach overall is yielding results. VDH data for 2015 shows the average infant mortality rate at 5.9 per 1,000 live births, a slight increase from the year before (5.7). The Northern region had the lowest rate of infant deaths at 4.2, while the Southside region had the highest rate at 10.4 deaths per 1,000 live births.

Life Expectancy    back to menu

Life Expectancy, Virginia vs. US. See text for explanation.

Life expectancy is a measure of the overall health of the population. It represents the average number of years of life that could be expected if current death rates were to remain constant. As with infant mortality, average life expectancy in the US lags behind most other developed nations; according to the OECD, US life expectancy rates across 2011-2015 ranked 26th and below nations as diverse as Costa Rica, Slovenia, and Korea.

In 2000, Virginia slightly lagged the US in overall life expectancy, but has exceeded it ever since. Life expectancy in the United States increased from 77.6 years in 2005 to 79.1 years in 2014; over the same time period, Virginia life expectancy increased from 77.7 to 79.2 years.

Life Expectancy by State. See text for explanation.

In 2014 Virginia ranked 24th nationally, with a life expectancy of 79.2 years, slightly above the national average of 79.1 years. Virginia's life expectancy exceeded peer states Tennessee (76.3) and North Carolina (77.9), and equaled Maryland (79.2). Hawaii continues to lead the nation in life expectancy; in 2014, their average life expectancy was 81.2 years.

Life Expectancy by Virginia Region. See text for explanation.

Average life expectancy has also generally increased in each of Virginia's regions during the last decade. Given its consistent lead in health outcomes, the Northern region not surprisingly led the state in 2014 with a life expectancy of 82.3 years (higher than leading state Hawaii's average); although the Valley's life expectancy declined slightly, it again came in behind the Northern region at 79.1 years. The Southwest (75.5 years) and Southside (75.9 years) regions had the lowest life expectancies.

What Influences Mortality and Longevity?

Health outcomes are influenced by a wide variety of variables, including behavior, family history/genetics, socioeconomic levels, the environment, access to health care, and support for public health services. Reducing lifestyle risk factors is paramount. A nutritious and well-balanced diet; regular exercise; and abstinence from smoking, high alcohol consumption, and substance abuse are all important. Regular checkups for early detection of metabolic problems like high blood pressure, high cholesterol, diabetes, and being overweight or obese also play a significant part in maintaining good health. Exposure to environmental pollutants (e.g., cigarette smoke, lead, asbestos, industrial chemicals, biologic agents and viruses, occupational safety hazards) have also been linked to poor health outcomes.

Access to health care for prevention and treatment is another key determinant of health quality. Communities with high rates of poverty and unemployment, substandard housing, and low levels of education are at higher risk for almost all poor health outcomes.

Life expectancy at birth is influenced by infant, child, and adult mortality rates. Gender affects longevity, as females tend to live longer than males, and longevity rates are higher in richer regions than in poorer ones. Access to health care, advances in medicine, healthier lifestyles, and better health before age 65 have contributed to the significant decline in death rates among older Americans.

Federal and state-level funding for public health services has been declining for nearly a decade. Although the amount Virginia spends in combined federal and state allocations on public health remains above the national median, it has dropped from $110.95 per capita in 2008 to $64.73 in 2015. This affects the state's ability to adequately address complex challenges such as opioid addiction and public education on the importance of preventive, rather than reactive, health care.

What is the State's Role?

State governments help to improve the overall health of the population in several different ways:

  • Detection and Monitoring. State and local public health agencies are at the forefront of detecting infectious disease outbreaks, bioterrorism and emerging health threats as varied as opioid addiction, asthma, and the Zika virus. State labs perform tests to identify infectious diseases and contaminants. They also collect health statistics and monitor epidemiological data for demographic and regional patterns.
  • Planning and Evaluation. Although Virginia currently does not align its statewide goals and plans with the national health agenda, Healthy People 2020, it does work with agencies, localities and non-profit organizations on strategic planning efforts, funding opportunities, etc. The Virginia Department of Health also works with local health departments and other organizations to evaluate the effects of prevention efforts across the state.
  • Education. State and local health agencies work to educate the public about the importance of disease prevention through healthy lifestyles and regular check-ups. These efforts can help influence behaviors, lifestyles, and conditions that affect health outcomes, such as smoking, substance abuse, poor nutrition, exercise, lack of prenatal care, medical problems, and chronic illness. Government also assists health care practitioners by giving them timely updates in guidelines for treating patients at risk. By funding medical research in its public research universities, states can expand health knowledge and treatment options.
  • Regulation. To reduce health risks, the state enacts certain regulations that help limit public exposure to environmental contaminants and infectious disease. Examples of such regulation are laws that restrict exposure to second-hand public smoking, household lead contaminants, and unsanitary dining conditions. States also typically establish, monitor, and enforce licensing and certification standards for the health professional work force, facilities, and services to ensure quality and uniformity.
  • Health Care Access. The state assists the poor or uninsured with obtaining health insurance through Medicaid and emergency care for uninsured patients who use emergency room services. The Affordable Care and Patient Protection Act has expanded opportunities for gaining health insurance coverage through public health exchanges, insurance subsidies for lower-earning households, and expanding the types of services covered by health insurance plans (such as mental health services). 
  • Tax Policy. State governments provide indirect subsidies for health care spending and insurance through the special tax treatment accorded employer-provided health insurance and health insurance savings accounts. Health insurance payments and health care expenses can also be itemized if these expenses reach a certain annual threshold.
Updated June 22, 2017
















State rankings are ordered so that #1 is understood to be the best.

Data and Definitions

Cardiovascular, Cancer, Lower Respiratory, Accidents, Diabetes, and Suicides

Centers for Disease Control and Prevention, National Center for Health Statistics. CDC WONDER On-line Database.  wonder.cdc.gov/cmf-icd10.html
All state and regional level data are age-adjusted to the 2000 US population

Cardiovascular deaths (categories I00-I78) includes deaths of the circulatory system: Acute rheumatic fever, chronic rheumatic heart diseases, hypertensive diseases, ischemic heart diseases, pulmonary heart disease and diseases of pulmonary circulation, other forms of heart disease, cerebrovascular diseases, and diseases of arteries, arterioles and capillaries.  Cancer deaths (categories C00-C97) includes malignant neoplasms. Chronic lower respiratory deaths (categories J40-J47).  Accidental deaths include (V01-V99, W00-X59, Y85-Y86) transport and other external causes.  Diabetes mellitus deaths include categories E10-E14.  Suicide includes intentional harm (U03, X60-X84, Y87).   Note: Eastern Region suicide rates for 2000-2001, 2003-2004, 2006-2007, and 2009 were interpolated because of undisclosed data.

Infant Mortality

Global Data: Organisation for Economic Cooperation and Development, OECD Data, Infant Mortality Rates
data.oecd.org/healthstat/infant-mortality-rates.htm

State Data:  National Center for Health Statistics, Centers for Disease Control and Prevention, www.cdc.gov/nchs/products/nvsr.htm

Regional Data:  Virginia Department of Health, Center for Health Statistics
www.vdh.virginia.gov/HealthStats/stats.htm

Life expectancy

Global, 2013
Organisation for Economic Cooperation and Development, OECD Data, Life Expectancy at Birth
data.oecd.org/healthstat/life-expectancy-at-birth.htm

National, 2000-2014
National Vital Statistics Report, Deaths: Final Data
US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics
www.cdc.gov/nchs/products/nvsr.htm

Virginia, 2000-2014
Source: Life Table, Virginia Department of Health
www.vdh.virginia.gov/HealthStats/stats.htm

State and Regional, 2000-2014
Source: Institute for Health Metrics and Evaluation (IHME)
www.healthmetricsandevaluation.org/

Regional life expectancies were computed by weighting IHME county male and female life expectancy estimates by corresponding county male and female populations estimates from National Cancer Institute, Surveillance Epidemiology and End Results (SEER) Population Data
seer.cancer.gov/popdata/

Public Health Spending

America's Health Rankings, 2015 Annual Report, Virginia public health spending
www.americashealthrankings.org/explore/2015-annual-report/measure/PH_Spending/state/VA

See the Data Sources and Updates Calendar for a detailed list of the data resources used for indicator measures on Virginia Performs.

At a Glance:
Mortality and Longevity
in Virginia

Performance Trend: Trend is maintaining.
State Influence:
limited

National Ranking: Virginia currently ranks as follows for mortality measures: death rates from accidents (10th), chronic lung disease (13th), suicide (15th), cardiovascular disease (23rd), infant mortality (23rd), cancer (24th), life expectancy (24th), and diabetes (25th).

Virginia by Region: The Northern region consistently has the best health outcomes in the state.

Related Agency Measures
State Programs & Initiatives

The Virginia Department of Health (VDH) is the chief state agency managing a wide range of health services for the Commonwealth, including epidemiology (disease prevention and control), emergency preparedness and health services,

The Virginia Department for Aging and Rehabilitative Services works with 25 local Area Agencies on Aging and other agencies and organizations to deliver some health, nutrition, and rehabilitative services to seniors at need.

Additional Information

The Centers for Disease Control and Prevention (CDC) is one of the key healthcare organizations in the US. As with the VDH, their mission is a big one: To detect and respond to public health threats, to use science and technology in tackling the nation's biggest health problems, and to promote healthy and safe communities. They are also one of the chief sources of reliable health data in the country. Check out their Fast Facts for some interesting details on mortality and longevity in the US.

America's Health Rankings has provided an annual assessment of the nation's health on a state-by-state basis for nearly 30 years.

The Kaiser Family Foundation offers a wealth of information on the state of health care in the US, covering topics as diverse as women's health policy, Medicaid/Medicare, and health reform. The foundation also offers detailed state-oriented data, plus various status reports for many states, including Virginia.