There were 5,122 resident deaths in 2003, 53 more than in 2002. The crude death rate increased slightly to 8.3 per 1,000 population. The death rate has fluctuated between 8.1 and 8.5 since 1988; prior to then it had been slowly declining from 11.2 in 1960, to 10.0 in 1970, down to 9.0 in 1980. The Vermont crude death rate was slightly higher than the U.S. white crude death rate until 1970 when the rates converged and remained similar through 1980. Since 1981, Vermont's death rate has been slightly lower than the U.S. white rate. The 2002 U.S. white crude death rate was 9.0, as was the preliminary U.S. white rate for 2003. Comparisons are made to the U.S. white rate because 99.5 percent of Vermont residents who died in 2003 were white (Table C-9).
For the past 40 years, the three leading causes of death in Vermont have been heart disease, cancer and stroke. Heart disease and cancer accounted for 50.0 percent of the deaths in 2003 (Table C-11). The heart disease crude death rate peaked in the 1960's at 439.5 deaths per 100,000 population. Since then, the rate has declined, and was 218.1 per 100,000 in 2003. The crude death rate from stroke (or cerebrovascular disease), the third leading cause, has also decreased significantly from a peak of 131.9 in the early 1960's to 49.6 in 2003 (Table C-1). Contrary to the dramatic declines in the rates for heart disease and stroke, and aside from decreases to 198.7 in 2002 and to 195.6 in 2003, the crude death rate for cancer (or malignant neoplasms) has risen steadily over the past few decades from 188.1 in the period from 1979 to 1981 to 204.0 in 2001. This trend is in part a result of the aging population and the continued rise in crude death rates for lung cancer (44.7 in 1979-81, to 51.4 in 1994-96, to 56.5 in 2001).
Chronic lower respiratory disease (formerly referred to as chronic obstructive pulmonary disease) has been the fourth leading cause of death in Vermont since 1985. The crude death rate from this cause increased from 33.0 in the period from 1979 to 1981 to 50.9 in 2000, then decreased to 45.0 by 2002, and increased again in 2003 to 48.8.
Accidents (or unintentional injuries) and diabetes have been the fifth and sixth leading causes of deaths in Vermont since 1999. The crude death rate from accidents peaked at 58.4 in the period from 1969 to 1971 and declined to 31.3 in 1994 to 1996. Since the mid 90’s, however; the death rate from accidents has gradually increased to 37.6 in 2003. Vermont has also experienced an increasing trend in the crude death rate from diabetes over the past 10 years. The rate has moved up from 22.0 in the period 1989 to 1991 to 26.9 in 2000 to 29.6 in 2003.
The crude death rate from Alzheimer's disease steadily increased throughout the 90's and, after moving up from the tenth leading cause to the seventh in 1999, it remained the seventh leading cause with a crude rate of 27.8 in 2003. Influenza and pneumonia remained the eighth leading cause, with a crude rate of 18.7 deaths per 100,000 in 2003.
After slipping from the ninth to the tenth leading cause of death in Vermont in 2001, intentional self-harm (or suicide) returned to the ninth position with a rate of 14.9 in 2002 and 13.4 in 2003. The tenth leading cause of death in 2003 was chronic liver disease and cirrhosis with a crude rate of 9.2 deaths per 100,000 populations. Two-thirds of these deaths were due to alcoholic liver disease.
The leading causes of death varied with age (Table C‑2) and (Table C‑14). Unintentional injuries were the leading cause of death for people age 15 to 44. Cancer was the leading cause of death, followed by heart disease for 45-74 year olds. At age 75 and higher, the causes were reversed with heart disease as the leading cause, followed by cancer.
Death rates dramatically increase after age 75. People age 75 and over accounted for over 60 percent of total deaths, but comprised only 6.3 percent of the total population. Except for accidents and influenza and pneumonia, the leading causes of death in this age group are all chronic diseases.
The leading causes of death varied by sex as well (Table C-1) and (Table C-11). The top two causes for males and females were the same: heart disease and cancer. Accidents, chronic lower respiratory diseases and cerebrovascular disease ranked third, fourth, and fifth for males while cerebrovascular disease, chronic lower respiratory diseases and alzheimer’s disease were the third, fourth, and fifth leading causes of death for females. Diabetes was ranked sixth for both males and females. The seventh leading cause for males was suicide and for females it was accidents while influenza and pneumonia was the eighth leading cause for both males and females. Alzheimer’s disease and chronic liver disease and cirrhosis were the ninth and tenth leading causes for males, while nephritis, nephrotic syndrome and nephrosis and chronic liver disease and cirrhosis were tied for ninth among females.
Deaths occurring in a hospital accounted for 41.9 percent of Vermont resident deaths (Table C‑21) down from 62 percent in 1980 and 53 percent in 1990 but slightly higher than 41.2 in 2000. In 2003, 23.1 percent of Vermont resident deaths occurred at home, and 25.6 percent occurred in a nursing home.