On August 26, 1998, the U.S. Department of Health and Human Services (DHHS) adopted a policy to begin using a single new population standard for age-adjusting death rates. The new standard, which will be effective for deaths occurring in 1999, is based on the 2000 U.S. population.
Since 1943, the National Center for Health Statistics (NCHS) and state health departments have used a population standard based on the 1940 U.S. population for age-adjusting death rates. However, at least three different standards are used by federal and state agencies. Use of a single age-adjustment standard by federal agencies will help alleviate confusion and misunderstanding among data users and the news media.
In 1991 and 1997, NCHS sponsored workshops to examine issues associated with age standardization of death rates. The first workshop examined technical issues and problems related to the calculation and interpretation of age-adjusted death rates.1 The second workshop focused on policy issues related to a coordinated approach to age standardization within DHHS.2 Workshop participants concluded that although compelling technical reasons existed to change population standards, the public health community would be better served by a new, uniform, and more contemporary standard. The reports of both workshops are available on the World-Wide Web at http://www.cdc.gov/nchswww/products/pubs/pubd/series/sr4/pre-21/pre-21.htm.
Age-adjusted death rates calculated before implementation of the 2000 standard will not be comparable with rates based on the new standard. In addition, mortality time series at all geographic levels will have to be recomputed. Long-range goals (e.g., national health objectives for 2000) will have to be recalibrated in terms of age-adjusted death rates. Use of the 2000 standard will result in rates that are often substantially higher than those based on the 1940 standard. The new standard also will affect trends in age-adjusted death rates for certain causes of death and will narrow race differentials in age-adjusted death rates. The NCHS report on these changes3 is available on the World-Wide Web, http://www.cdc.gov/nchswww/products/pubs/pubd/nvsr/47-pre/47-pre.htm.
The decision by DHHS to adopt a uniform policy to age-adjust death rates represents a major change in statistical practice that has implications for federal, state, and local health programs. The adoption of a uniform standard will reduce the burden on state and local health departments to produce multiple time series to match federal statistical benchmarks. In addition, the adoption of a current population standard will improve the usefulness of health statistics issued by DHHS.
New Population Standard for Age-Adjusting Death Rates. JAMA. 1999;281(13):1167. doi:10.1001/jama.281.13.1167-JWR0407-3-1