Mortality Rates, U.S.

Mortality rate (also referred to as the death or fatality rate) is used to describe the ratio of total deaths to the total population in a particular community over an established period of time. It is often expressed as the number of deaths per 100,000 of the population in a given year. When thinking specifically about U.S. mortality rates across time, dramatic changes have occurred over the past 300 years. U.S. mortality rates during the colonial period are considerably different than those that characterize present-day society. Mortality rates within a given year also vary [Page 749]significantly due to specific characteristics that include demographic, economic, geographic, sociocultural, and political factors. Differences based on age, gender, race and ethnicity, income, education, and occupation all serve to influence U.S. mortality rates. This entry explores U.S. mortality rates across time, and it details group-specific differences in mortality rates at certain periods.

U.S. Mortality Rates: 1600s through 1800

Prior to 1800, there is limited information available on U.S. mortality rates; information about mortality rates during this period is often pieced together from a range of sources that include newspaper articles, government documents, speeches, public records, individual letters, and diaries. When the U.S. Census first started recording data in 1790, deaths and causes of death had not been uniformly recorded.

The early colonial period is generally characterized by a young population profile and high rates of death, affecting the young and old alike. Harsh conditions paired with the contamination of food and water, high risk of intestinal worms and infection, along with infectious disease had deleterious effects for many. Epidemics involving infectious diseases, including smallpox, measles, mumps, malaria, dysentery, scarlet fever, venereal diseases, typhus, bubonic plague, and yellow fever, are documented throughout the 17th and 18th centuries. U.S. death rates attributed to epidemics were significant during this period. For example, the smallpox epidemic, which hit Massachusetts in 1677, killed hundreds, or around 12#x0025; of the state's population.

Native Americans suffered greatly from European colonization in terms of mortality rates, with the combined deleterious effect from infectious disease, as the result of war, slavery, and genocide. And, while there is little data on African American mortality rates during the colonial period, it is widely thought that mortality rates across the life course, from infancy through adulthood, were as much as four times higher in the African American community. A wide range of factors explain these higher mortality rates, including lack of access to adequate medical care, nutrition, and shelter, paired with widespread mistreatment.

U.S. Mortality Rates: 1800s

Information on U.S. mortality rates during the 19th century is typically derived from census data. Mortality statistics based on death registrations were first published in 1850. These data are incomplete because the information was not uniformly recorded in all U.S. jurisdictions. Further insights into late-19th-century mortality rates are provided by morbidity reports on contagious diseases authorized by the U.S. Congress.

Notable changes in science, medicine, technology, and the practice of public health practices during the 19th century inspired shifts in U.S. mortality rates. While traditional religious explanations for disease, sickness, and death were in the past commonplace, this perspective was increasingly eclipsed by scientific discourse aimed at identifying and ameliorating illness, and ultimately, death. During the mid-19th century, the fields of bacteriology and microbiology gained significant knowledge, and the germ theory of disease served to link certain diseases to specific pathogens. With research from scientists like Great Britain's Edward Jenner and the French-born Louis Pasteur, vaccines were developed (based on the experimentation with disease-preventing inoculation that first occurred in China and India more than 2,000 years ago) to help prevent a number of devastating diseases, including smallpox. By the mid-1880s, the cholera organism was identified and contained. General anesthetics were also introduced during this period, which further enabled life-saving surgical interventions, as antimicrobial substances were applied to the body to reduce the possibility of lethal infection.

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