Annual Summary of Vital Statistics--1992.

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A new low in the infant mortality rate was reached in 1992, at 848.7 deaths per 100 000 live births, a decline of 5% from 894.4 in 1991. Birth, death, and marriage rates were also lower, but the divorce rate inched up to 4.8 per 1000 population, the same level as in 1988. The age-adjusted death rate was 504.9 per 100 000 population, the lowest in US history. Natural increase in the population, excess of births over deaths, decreased from 1 941 389 to 1 907 000, from 7.7 to 7.5 per 1000 population. Births outside hospital were fewer, both in numbers and in proportion to all births. Birth rates increased at both ends of the age range but declined in the principal childbearing years. Births to unmarried mothers increased again, comprising more than one fifth of white births and two thirds of black births. A higher proportion of newborns weighed less than 2500 g than in 1989.

Life expectancy at birth increased again, to 75.7 years overall, paralleled in both sexes and white and black races. The age-adjusted death rate for cardiovascular diseases declined, but malignancies of the respiratory system increased again, to almost six times what it was in 1940. Chronic obstructive pulmonary diseases, despite slight improvement since 1991, caused death more than eight times as often as in 1940.

Black and white infant mortality rates both showed a decline, greater in the white neonatal component; the black/white discrepancy widened slightly.Infant mortality in those of Hispanic origin was slightly higher than non-Hispanic whites, but the National Center for Health Statistics warns that Hispanic rates may be understated. There was little change in causes of infant mortality, or in black to white ratios for the several causes.

On the world scene, most industrialized countries showed declines in infant mortality matching the US.In 1991, 21 countries, 15 in Europe, 3 in Asia, 2 in Oceania, and 1 in North America, had infant mortality rates less than the US. The decline in most other countries has been more rapid than in the US. Pediatrics 1993;92:743-754.

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