Incidence of Death in US States – December 31, 2009

I last posted a list of the US States with incidence of death per 100,000 on September 9, 2009. Not surprisingly, the numbers have gotten much worse in the following months. Here is the current list, in descending order:

  1. South Dakota – 2.9
  2. New Mexico – 2.5
  3. Arizona – 2.0
  4. Oregon – 2.0
  5. Montana – 2.0
  6. Wyoming – 1.0
  7. Alaska – 1.7
  8. American Samoa – 1.7
  9. Nevada – 1.6
  10. Utah – 1.6
  11. California – 1.5
  12. Iowa – 1.3
  13. Idaho – 1.3
  14. Maine – 1.3
  15. Rhode Island – 1.2
  16. Washington – 1.2
  17. Colorado – 1.2
  18. Guam – 1.2
  19. West Virginia – 1.1
  20. Oklahoma – 1.1
  21. Florida – 1.1
  22. Minnesota 1.0
  23. Puerto Rico – 1.0
  24. US Virgin Islands – 0.9
  25. South Carolina – 0.9
  26. Louisiana – 0.9
  27. Kansas – 0.9
  28. Hawaii 0.9
  29. North Carolina – 0.8
  30. Kentucky – 0.8
  31. Alabama – 0.8
  32. Wisconsin – 0.8
  33. Connecticut – 0.8
  34. New York – 0.8
  35. Tennessee – 0.8
  36. Texas – 0.8
  37. Nebraska – o.8
  38. Michigan – 0.7
  39. Maryland – 0.7
  40. Arkansas – 0.7
  41. New Hampshire – 0.7
  42. Illinois – 0.6
  43. Pennsylvania – 0.6
  44. Indiana – 0.6
  45. Delaware – 0.6
  46. Mississippi – 0.5
  47. Vermont – 0.5
  48. North Dakota – 0.5
  49. Virginia – 0.4
  50. New Jersey – o.4
  51. Georgia – 0.4
  52. Massachusetts – 0.4
  53. Ohio – 0.3
  54. Missouri – 0.2
  55. District of Columbia – 0.2

The overall incidence of death per 100,000 people in the United States is 0.9.

One of the striking results from this list is the wide range in the reported incidence of death due to H1N1 in the different States and Territories. The reported incidence of death is 10 times higher in South Dakota than in Ohio, Missouri and the District of Columbia. Does this represent a true difference or is it due to variations in competency and/or honesty of public health officials? For example, Ohio health officials appear to have covered up clusters of H1N1 cases in that State. Comparisons of reported pandemic H1N1 deaths with overall pneumonia and influenza deaths as well as maternal and child deaths may allow an analysis of how honesty and/or competency of various State public health officials has affected reporting of pandemic deaths.

Although reporting errors likely account for some of the variation among States and Territories, the presence of Western/Northern Tier States among the top 10 is striking. One explanation for this may be due to relatively large numbers of Native Americans who have been disproportionately affected by this pandemic.

Although the number of reported new cases of H1N1 has been dropping in the United States, the pandemic is not over. Many observers are concerned that there will be another surge in cases in January and February of 2010.

Time will tell.

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