The information on live births, fetal deaths, induced terminations of pregnancy, deaths, marriages, and divorces which is presented in this bulletin was obtained from official records submitted to the Mississippi State Department of Health as required by statute and regulation. Live birth and fetal death records were prepared by hospitals, clinics, physicians, and midwives. Reports of induced terminations of pregnancy were prepared by hospitals, clinic staff, and physicians. Responsibility for the preparation of death certificates was shared by hospitals, nursing homes and other institutions which provide care or custody, funeral homes, physicians, medical examiners, and medical examiner investigators. Marriage records were completed partly by brides and grooms, partly by persons who performed marriage ceremonies, and partly by circuit clerks. Chancery clerks prepared the statistical records of divorce.
This publication consists of three parts. The first part includes summary tables for the state as a whole for 1999; the second part contains major statistical tables for 1999. Time series tables numbered 20through 28 are presented in the third part.
Definitions of Live Birth, Fetal Death, Induced Termination, and Death
The definitions of live birth, fetal death, and induced termination of pregnancy adopted by the Mississippi State Department of Health for use in Mississippi are those formulated by the World Health Organization and recommended by the National Center for Health Statistics. The definition of death was adopted by the Mississippi Legislature in 1982, statute number 41-36-3.
Live Birth - the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy, which, after such expulsion or extraction, breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached.
Fetal Death - death prior to the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy; the death is indicated by the fact that after such expulsion or extraction the fetus does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles.
Induced Termination of Pregnancy - the intentional termination of pregnancy with the intention other than to produce a live-born infant or to remove a dead fetus.
Death - an individual who has sustained either (a) irreversible cessation of circulatory and respiratory functions or (b) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards.
Even though the definition of fetal death is all-inclusive, the State Department of Health does not require the reporting of all fetal deaths. Since January 1, 1976, fetal death reports have been required only for spontaneous fetal deaths of 20 weeks or more gestation or weight of 350 grams or more. There is a separate reporting system (with no names or addresses) for all induced terminations of pregnancy.
Occurrence and Residence Allocation
Live births, fetal deaths, and deaths were classified by place of occurrence and by place of residence. Some of the tables contain both occurrence and residence figures, but most of the tables are based on residence data only, as these data are considered more suitable for studying public health problems.
Occurrence data were obtained from certificates filed in Mississippi at the place of the event. Residence data include transcripts of records of events that occurred in other states to Mississippi residents and exclude records filed in this state for nonresidents. Residence assignment for live births and fetal deaths was determined by the usual residence of the mother. For deaths it was determined by the usual residence of the decedent except that deaths of inmates of institutions were reallocated to the location of the institution regardless of length of stay.
Figures on induced terminations of pregnancy in Tables F1, F2, F3, and 17 refer only to procedures performed in Mississippi, and do not include transcripts of records of events that occurred in other states to Mississippi residents. Residence assignment was determined by the usual residence of the patient. However, the teenage pregnancy figures in Tables 18A, 18B, and 28, which include induced termination figures, refer to induced terminations of all Mississippi resident teens, regardless of where the induced termination was actually performed.
Marriages were classified according to place of issuance of the marriage license, place of occurrence of marriage, and place of residence of the bride. However, the figures on brides who were Mississippi residents are incomplete since there is no exchange among the states of transcripts of marriage records for nonresidents and the out-of-state marriages of Mississippi brides could not be included. Divorces were classified only according to place where the decree was granted, as there is no information regarding place of residence on the record.
The population figures used in this bulletin are 1999 population estimates which were prepared by the United States Census Bureau. Estimates for small counties and small categories, such as age/race/sex groups, should be used with caution. Any slight discrepancies in the figures are due to rounding.
The two categories for race used in this publication are white and nonwhite. White includes such groups as Caucasian, Anglo-American, Canadian, Cuban, French, Greek, Hispanic, Latin American, Mexican, Puerto Rican, Swedish, etc. Nonwhite includes such groups as Black, Afro-American, American Indian, Chinese, Japanese, Hawaiian, Filipino, and all other groups not considered as white.
Prior to 1989, all statistics regarding live births and fetal deaths were broken down by race of the child or fetus; however, beginning with 1989 and continuing with subsequent years all statistics on live births and fetal deaths will be reported by race of the mother. This includes any rates or ratios that involve figures for live births or fetal deaths. For example, the infant mortality rate for white infants will now be calculated using the number of live births to white mothers as the denominator.
Population-based rates for the state include those for live births, total deaths, and deaths from specific causes, except maternal deaths and deaths from certain conditions originating in the perinatal period. Figures on live births were used as the base for calculating fetal death ratios as well as rates for maternal deaths, infant, neonatal, and postneonatal deaths, and deaths from certain conditions originating in the perinatal period, as the birth counts represent the groups at risk more accurately than do general population figures.
Classification of Cause of Death
Causes of death were assigned according to the Tenth Revision International Statistical Classification of Diseases and Related Health Problems (ICD-10). The Tenth Revision is being used for the first time in 1999, and is markedly different from the Ninth Revision. Because of this, and also because periodic changes in the classification system occurring throughout the years have resulted in an unavoidable lack of comparability for some causes, caution should be used in analyzing trends which span classification revisions. With the exception of Table 10B, all tables which show cause of death are based on the National Center for Health Statistics' List of 358 Selected Causes of Death (see Appendix A), and appear with group numbers instead of the actual ICD-10 codes. These groupings were developed to preserve traditional categories of causes of death not found in continuous ranges of codes in ICD-10 as they were in ICD-9, to maintain continuity with prior coding revisions to facilitate trend analysis, and to separately identify causes of death that are of public health and medical importance. In Table 10B, however, the cause-of-death titles shown do follow the actual coding structure of the Tenth revision, and the causes are shown with their corresponding ICD-10 codes.
Internet site
The tables contained in this book can also be found on the Internet at:
www.msdh.state.ms.us/phs