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Technical Notes

Age-Adjusted Death Rate: When comparing rates over time or across different populations, crude rates (the number of deaths per 100,000 persons) can be misleading, because differences in the age distributions of the various populations are not considered.  Since death is age-dependent, the comparison of crude rates of death can be especially deceptive.

Age-adjusted rates take into account the diverse age distributions of the populations. Valid comparisons between age-adjusted rates can be made, provided the same standard population and age groups have been used in the calculation of the rates.  The direct method of adjustment was used to produce the age-adjusted rates for this report.  In this method, the population is first divided into reasonable homogeneous age ranges, and the age-specific rate is calculated for each age range. Then, each age-specific rate is weighted by multiplying it by the proportion of the standard population in the respective age group. The age-adjusted rate is the sum of the weighted age-specific rates.  Further information regarding the calculation of age-adjusted rates can be found in The Methods and Materials of Demography by Henry S. Shryock, Jacob S. Siegel and Associates, U.S. Department of Commerce.

Indiana Mortality Reports prior to 1999 used the 1940 standard million population for age adjusting.  Beginning with the 1999 report, the 2000 standard million population was used for age-adjusting death rates.  Since different standard populations were used in 1998 and previous reports, those rates are not comparable to the rates published in reports since 1999. State-level rates based on the 2000 standard million population were calculated for 113 selected causes of death for the years 19951998 and are available in Table 1a of the 1999 Indiana Mortality Report.

Cause of Death Classification: The death statistics presented in reports since 1999 were compiled in accordance with the World Health Organization regulations, which specify that member nations classify causes of death by the current International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10).  Mortality Reports for 1978 through 1998 used ICD-9.

Tabulation Lists: The ICD-10 mortality tabulation lists were created by a team of health statisticians and medical officers.  The ICD-10 codes were first mapped to ICD-9 codes, and then aggregated into groups that were most comparable with ICD-9, except when medical or public health requirements and concerns warranted new combinations or groups of codes.  These draft lists were then sent to key federal and state health agencies for review and comment.  These comments and suggestions were analyzed carefully to make decisions on which causes or cause groups should be included in the final tabulations.

The "List of 113 Selected Causes of Death" is used for the general analysis of mortality and for ranking leading causes of death.  The "List of 130 Selected Causes of Infant Death," which is used for the analysis of infant mortality and for ranking leading causes of infant death, shows more detailed titles for the categories of "Certain conditions originating in the perinatal period" and "Congenital malformations, deformations and chromosomal abnormalities" than any other list except the "Each Cause List."  The "List of 39 Selected Causes of Death," which is used to show mortality data for geographic areas, was created by combining categories in the "List of 113 Selected Causes of Death."  A complete description of all tabulation lists can be found in the Instruction Manual, Part 9, from the National Center for Health Statistics with two exceptions.  The lists for Tables 9 and 10b were constructed by the Data Analysis Team staff in the Epidemiology Resource Center at the Indiana State Department of Health.

Population: July 1, 2015, population estimates were prepared by the United States Bureau of the Census for the National Center for Health Statistics (NCHS).  These estimates are bridged race estimates that take into account persons marking more than one race on a record.  These data were obtained from the NCHS Web site on September 12, 2016. For more information on methodology go to U.S. Census Populations With Bridged Race Categories.

Reliability of Rates: Some of the rates shown in this report are based on a small population, a small number of deaths, or both.  The rates based on small numbers may be unstable due to random chance factors and should be used with caution. Rates for counties with small populations also may vary considerably from year to year.  In addition, allowances must be made for differences in age distributions, etc., when rates are not age-adjusted.

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