Mortality

Leading Causes of Death in San Francisco

Leading Causes of Death by Age

Premature Death

While the leading causes of death are determined solely on the number of persons who die, years of life lost (YLL) is a statistic that measures both the number of deaths and the age at death. YLL increases if the number of people dying increases or if the ages of the people dying decrease. Due primarily to the high number of deaths, Ischemic Heart disease is both the leading cause of death and the leading cause of premature death in San Francisco. In fact, seventeen of the leading causes of death are also leading causes of premature death as measured by YLLs. However, despite contributing relatively few deaths, the low age of death among the deceased for HIV, accidents (drowning, fire and smoke inhalation, non-drug related poisonings, and firearms), and assault make them each leading causes of premature death in San Francisco.

Life Expectancy

Health Disparities and Inequalities Manifested at Death

Mortality by Place

Data Sources

CDPH VRBIS. State of California, California Department of Public Health, VRBIS Death Statistical Master File Plus 2006-2017, created on January 31, 2018.

Methods and Limitations

This analysis uses specific cause-of-death categories based on the World Health Organization Global Burden of Disease and Injury (WHO GBD) and the National Center for Health Statistics 113 Selected and 50 Rankable Causes of Disease [1-2]. Race/ethnicity was categorized according to San Francisco ethnicity data guidelines [3]. All mortality analyses are based on the primary cause of death and do not take into account co-morbidities.

Mortality measures used include:

• Average age of death: A measure to show the degree to which specific groups are dying prematurely, without regard to numbers of people involved. Expressed in years, for any size population.
• Average age-adjusted YLL: The age-adjusted YLL estimate divided by the number of deaths. Estimates the number of years of life lost per person.
• Deaths (numbers of deaths): Numbers of individuals dying, expressed as numbers of deaths and percentage of all deaths.
• Death rates: Overall measure of “force of mortality” in a population. Calculation of age-adjusted rates allows comparisons across time or location by applying each population’s age-specific rates of death to the age distribution of a standard population. Death rates are expressed as number of deaths per size of population (usually 100,000).
• Life expectancy (LE): Most direct summary measure of current mortality. Expressed as expected years of life for someone born today who experiences current age-specific mortality rates. While life expectancy has been increasing steadily overtime, these calculations assume mortality is constant. Therefore the life expectancies reported here may underestimate the true life expectancy of children born today.
• Morality Rate Ratios: Age-specific death rates are a measure of force of mortality in given age group. Age specific death rates for each non-White race/ethnicity were divided by the rate for Whites. Ratios higher than 1 show increased death rates for other ethnic groups as compared to whites while ratios lower than 1 show decreased death rates for other ethnic groups as compared to Whites.
• Years of life lost (YLL): Measure of burden of premature mortality. YLL weights each death by the years of remaining life expectancy at the time of death, based on a standard population. Expressed as total number of expected years of life lost.
• YLL rate: Generated by applying to YLLs the same age-adjustment that is used for age-adjusted death rates. YLL rate is a metric that allows a comparison of burden of YLLs across populations with different age structures. YLL rate is expressed as YLLs per number (usually 100,000) of population.

All rates were calculated with population data from the State of California, Department of Finance. The 2000 US standard population was used to age-standardize mortality rates and YLLs.

References

1. World Health Organization. The global burden of disease: 2004 update. http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/, 2004.
2. Centers for Disease Control and Prevention National Center for Health Statistics. Instruction manural part 9: Icd-10 cause-of-death lists for tabulating mortality statistics (updated march 2009 to include who updates to icd-10 for data year 2009). https://www.cdc.gov/nchs/data/dvs/Part9InstructionManual2009.pdf, 2009.
3. San Francisco Department of Public Health. Principles for collecting, coding, and reporting social identity data – ethnicity guidelines. https://www.sfdph.org/dph/files/PoliciesProcedures/COM3_EthnicityGuidelines.pdf, 2011.