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1988 Annual Report 

Vital Statistics of Massachusetts 



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Michael S. Dukakis 
Governor 

Philip W. Johnston 
Secretary 

David H. Mulligan 
Commissioner 



September, 1990 



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BOSTON PUBLIC LIBRARY 

GOVERNMENT DOCUMENTS DEPARTMENT 



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To tho Honorable Senate and 
House of Representatives: 



MAR 27 1991 



We have the honor to submit as required by Chapter 111, Section 2 of the General Laws, the one 
hundred forty-seventh annual report on statistics of births, deaths, fetal deaths, marriages and 
divorces In Massachusetts for the calendar year 1988. 

This Is the twenty-fifth Annual Report of Vital Statistics published by the Department of Public Health 
and is intended to assist In the development of policy and programmatic Initiatives within the 
Department, as well as to provide State officials and agencies, and the general public, with valuable 
statistical Information. 



Sincerely, 




z*^ 



David H. Mulligan 
Commissioner 



SW&ftlAL REPORT 

Vital statistics 07 MASSA&tusEflS 

(PUBLIC T>OCUM<E*& #1) 

1988 



THE COMMONWEALTH OF MASSACHUSETTS 
DEPARTMENT OF PUBLIC HEALTH 



MICHAEL S. DUKAKIS, GOVERNOR 

PHILIP W. JOHNSTON, SECRETARY, EXECUTIVE OFFICE OF HUMAN SERVICES 

DAVID H MULLIGAN, COMMISSIONER, DEPARTMENT OF PUBLIC HEALTH 



DANIEL J. FRIEDMAN, PHD, ASSISTANT COMMISSIONER, 
BUREAU OF HEALTH STATISTICS, RESEARCH AND EVALUATION 

ELAINE R TRUDEAU, REGISTRAR, 
REGISTRY OF VTTAL RECORDS AND STATISTICS 

ISO TREMONT STREET 
BOSTON, MASSACHUSETTS 02111 



SEPTEMBER, 1990 



Publication of this document approved by Ric Murphy, State Purchasing Agent 



ACKNOWLEDGEMENTS 

This publication of the 1988 ANNUAL REPORT OF VITAL STATISTICS Is the result of the combined 
efforts of all data providers, Including the 351 city and town clerks, hospital personnel, physicians, 
funeral directors, probate courts, clinics, and Department of Public Health personnel. We gratefully 
acknowledge the assistance provided by all data providers, without whose efforts there would be no 
vital statistics. 

Department of Public Health staff most significantly involved in the production of the 1988 ANNUAL 
REPORT OF VITAL STATISTICS Include: 

Robert Danley, Bureau of Health Statistics, Research and Evaluation: population statistics; 

Joan Gancarski, Bureau of Health Statistics, Research and Evaluation: assistance and 
technical data from Advance Data: Births 1988 and Advance Data: Deaths 1988: 

Michael Healey, Division of Data Processing: data file management and vital events series 
printouts: 

Duke Rhoden, Bureau of Health Statistics. Research and Evaluation: supervision of computer 
graphics and special table production, with programming by Robert S. Woodburn and 
Charlene Zion; 

Dennis Sterzin and Roger Davenport. Graphic Design Center: graphics layout and assistance: 

Phyllis Zeuli. Assistant Registrar for Statistics: supervision of data collection, coding and 
editing, with technical assistance from Lisa Varnerin (Statistics Unit Supervisor) and Robert 
Coffin (Chief Nosologist). 

The joint efforts of all the staff of the Registry of Vital Records and Statistics are necessary to 
produce the data contained in this publication. Special acknowledgement Is made to the following 
Registry supervisors: 

Karin Barrett, Data Quality Assurance Coordinator, who oversees the hospital query program 
for birth certificate data and provides assistance in developing specialized table production; 

Alan Goldin, Director of Automation, who is responsible for the installation and supervision 
of the Automated Vital Statistics System (AVSS) and all computer-based systems in the 
Registry office; 

Harold Leonard, Supervisor of the Records Unit, which is responsible for maintaining all 
records and issuing certified copies; 

James Orseno, Supervisor of the Operations Unit, which is responsible for all printing and 
mailing of forms; 

Phyllis Rotman, Supervisor of the Registration Unit, which is responsible for coordination 
with cities and towns to produce the data in a timely fashion. 



The 1988 ANNUAL REPORT OF VITAL STATISTICS has been compiled and produced under the 
general supervision and direction of: 

Daniel J. Friedman, Ph.D., Assistant Commissioner, 
Bureau of Health Statistics, Research and Evaluation; 
Bruce B. Cohen, Ph.D., Director, Research and Epidemiology; 
Victoria Vespe Ozonoff, Ph.D., Director, Health Resources Statistics; 
Susan T. Gershman, Ph.D., Director, Massachusetts Cancer Registry: 
Elaine B. Trudeau, Registrar, Vital Records and Statistics. 






Elaine B. Trudeau, Registrar 
Frances A. Vitagliano, AsstiReglstrar 




VI 



CONTENTS 



TRANSMITTAL LETTER 
ACKNOWLEDGEMENTS 
TABLE OF CONTENTS 
INTRODUCTION 



l 

v 

vii 

1 



SECTION A — VITAL EVENTS 

Highlights 



Table A-l 

Figure A-l 
Table A-2 

Figure A-2 

Table A-3 

Table A-4A 
Table A-4B 



Selected Facts in Vital Statistics, 
Massachusetts: 1988 11 

1988 Massachusetts Daily Vital Events 12 

Number and Crude Rates of Vital Events, 

Massachusetts and United States: 

1988 and 1987 13 

Rate of Natural Increase, Massachusetts 

and United States: 1910-1988 14 

Vital Events by Month, Massachusetts 
Residents: 1988 15 

Vital Events by Community: 1988 16 

Vital Events by County: 1988 27 



SECTION B — NATALITY 

Figure B-l 
Table B-l 



Table B-2 

Figure B-2 
Figure B-3 



Highlights 

1988 Massachusetts Daily Birth Statistics 

Trends in Natality Characteristics, 
Massachusetts Residents: 1980-1988 

Age-Specific and Crude Birth Rates, 
Massachusetts Resident Births: 
1987-1988 

Resident Live Births hy Race of Infant: 1988 

Resident Live Births hy Mother's Age: 1988 



31 
39 

40 

41 
42 
42 



VII 



SECTION B — NATALITY, cont. 

Table B-3 



Table B-4 
Table B-5 

Table B-6 

Figure B-4 
Figure B-5 
Table B-7 
Table B-8 

Table B-9 

Table B-10 
SECTION C — MORTALITY 



Births by Mother's Age, Race and Marital 

Status, Massachusetts Resident Births: 

1988 43 

Resident Births to Teenage Mothers: 
1970-1988 44 

Births by Birthweight, Maternal Race 
and Ethnicity, Massachusetts Resident 
Births: 1988 45 

Natality Characteristics by Maternal Race 
and Ethnicity, Massachusetts Resident 
Births: 1988 46 

Trends in Adequacy of Prenatal Care by 

Maternal Race, Massachusetts: 1980-1988 47 

Adequacy of Prenatal Care by Prenatal Care 

Source of Payment. Massachusetts: 1988 47 

Parity by Age of Mother, Massachusetts 
Resident Births: 1988 48 

Number of Primary and Repeat Caesarean 
Sections by Age, Massachusetts Resident 
Births: 1988 49 

Birthweight in Grams by Age of Mother, 
Number and Rate Per Thousand Live Births, 
Massachusetts Resident Births: 1988 50 

Hospital Profiles, Massachusetts 
Occurrence Births: 1988 51 



Figure C-l 
Figure C-2 

Table C-l 

Table C-2 



Highlights 65 

1988 Massachusetts Daily Death Statistics 71 

Five Leading Underlying Causes of Death, 

Massachusetts: 1988 72 

Trends in Mortality Characteristics, 
Massachusetts Residents: 1980-1988 73 

Five Leading Underlying Causes of Death, 
Age-Adjusted Rates, Massachusetts and 
United States: 1980-1988 74 



VIII 



SECTION C — MORTALITY, cont. 
Table C-3 



Table C-4 



Table C-5 



Table C-6 



Table C-7 



Table C-8 
Table C-9 
Figure C-3 
Table C-10 

Figure C-4 
Table C-ll 

Table C-12 

Figure C-5 

Figure C-6 



Leading Underlying Causes of Death by 

Age, Massachusetts Residents: 1988 75 

Resident Deaths by Age, Sex and Race, 
Massachusetts Residents: 1988 76 

Deaths by Underlying Cause and Mentioned 

Conditions, Massachusetts Residents: 

1988 77 

Malignant Neoplasm Deaths by Underlying 
Cause and Mentioned Conditions, 
Massachusetts Residents: 1988 78 

Atherosclerosis, Hypertensive Disease 

and Diabetes, Underlying Cause and 

Mentioned Conditions by Age Group 

and Sex, Massachusetts Residents: 

1988 79 

Suicides by Cause, Sex and Age, 
Massachusetts Residents: 1988 80 

Motor Vehicle Deaths by Type, 
Massachusetts Residents: 1988 81 

Motor Vehicle Deaths, Age-Specific Rates, 

Massachusetts: 1988 82 

AIDS and HIV-Related Deaths by Cause, 
Sex and Race, Massachusetts Resident 
Deaths: 1987-1988 83 

Heart Disease Deaths by Race and Sex, Age- 
Adjusted Rates, Massachusetts: 1970-1988 84 

Malignant Neoplasm Deaths, Age-Adjusted 

Rates, Massachusetts Resident Deaths: 

1988 85 

Medical Examiner Certified Deaths 

by Cause, Race, Sex and Age, 

Massachusetts Occurrence: 1988 86 

Malignant Neoplasm Deaths by Race and Sex, 

Age-Adjusted Rates, Massachusetts: 

1970-1988 88 

Proportion of Deaths Certified 

by Medical Examiner for Selected Causes 

of Death, Occurrence Deaths, Massachusetts: 

1988 89 



IX 



SECTIOM C — MORTALITY, cont. 
Table C-13 



Table C-14A 
Table C-14B 
Table C-15 



Medical Examiner Certified Deaths by 
County, Massachusetts Occurrence: 
1988 

Selected Causes of Death by City 
and Town of Residence: 1988 

Selected Causes of Death by County 
of Residence: 1988 

Resident Deaths by Cause, Sex, 
and Race: 1988 



SECTIOM D-- INFANT fc NEONATAL MORTALITY 

Highlights 



Figure D-l 
Figure D-2 
Table D-l 

Table D-2 

Table D-3 

Table D-4 



Infant Mortality Rates. Massachusetts: 
1980-1988 

Neonatal Mortality Rates, Massachusetts: 
1980-1988 

Resident Infant and Neonatal Deaths, 
Massachusetts and United States 
Resident Deaths: 1970-1988 

Trends in Infant and Neonatal Mortality 
Race of Infant, Massachusetts Resident 
Deaths: 1980-1988 

Neonatal and Infant Deaths by Selected 
Underlying Causes, Massachusetts 
Resident Deaths: 1988 

Infant and Neonatal Deaths by Age, 
Sex, and Race, Massachusetts 
Resident Deaths: 1988 



SECTIOM E — MARRIAGES & DIVORCES 

Highlights 



Table E-l 



Figure E-l 



Table E-2 



Marriages and Divorces by County, 
Massachusetts Occurrence: 1988 

Rates of Marriages and Divorces per 
Thousand Population: 1900-1988 

Marriages and Divorces and Rates 
per 1,000 Population, Massachusetts 
Occurrence: 1900-1988 



90 
92 

100 
101 

119 
121 
121 

122 

by 

123 

124 

125 

129 
131 
132 

133 



SECTION E — MARRIAGES & DIVORCES, cont 

Table E-3 



Table E-4 



Table E-5 



Marriages by Age and Marital Status, 
Massachusetts Occurrence: 1988 

Number of Marriages by Age of Bride and 
Age of Groom, Massachusetts Occurrence: 
1988 

Number of Marriages for Bride by 
Number of Marriages for Groom, 
Massachusetts Occurrence: 1988 



SECTION P — POPULATION 

Highlights 



Figure F-l 
Table F-l 

Figure F-2 
Figure F-3 
Table F-2 

Table F-3 

Table F-4 



APPENDICES 



Massachusetts Population: 1900-1988 

Population by Race, Age and Sex, 
Massachusetts: 1980 

1980 Massachusetts Population by Age 

1980 Massachusetts Population by Race 

Massachusetts Population by 
Counties: 1960-1985 

Massachusetts Population by City and 
Town: 1970 and 1980 

Population Estimates, Massachusetts: 
1980-1988 



134 

135 

135 

139 
141 

142 

144 
144 

145 

146 

149 



// 



Source Documents 

Standard Certificate of Live Birth 157 

Standard Certificate of Death 158 

Report of Fetal Death 159 

Certificate of Marriage 160 

Certificate of Absolute Divorce 

or Annulment 161 

Registry of Vital Records and Statistics Staff 163 



XI 



INTRODUCTION 



The ANNUAL REPORT OF VITAL STATISTICS (Public Document No. 1) has been continuously 
published since 1842. This is the 25th edition produced by the Department of Public Health. This 
report, required under the provisions of Chapter 111, section 2, of the Massachusetts General Laws, 
tabulates data on Massachusetts births, fetal deaths, deaths, marriages, divorces, and population for 
calendar year 1988. Approximately 2,000 copies of the report are distributed to federal, state, and 
local governmental agencies, private and public health planners and researchers, students, and 
members of the general public. The report provides its users with an overview of the health status 
of the Massachusetts population. 

Vital statistics data may be tabulated either in terms of resident data or occurrence data. Resident 
data Include all events which occur to residents of the Commonwealth, wherever the events occur. 
Occurrence data include all those events which occur within the state, including those which occur 
to out-of-state residents. There is an interstate exchange of copies of birth, death and fetal death 
records among the fifty states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, and 
all Canadian provinces. These records are exchanged for statistical purposes only, for events which 
occur In states other than where the Individual resides. This exchange allows each of the states and 
provinces to track the births and deaths of their residents. The majority of the data presented in this 
report for births and deaths is based on resident data. Marriage and divorce data, however, only 
reflect events which occurred within the Commonwealth. 

REGISTRATION 

The first government-operated system of vital events registration anywhere in the world began in the 
Commonwealth of Massachusetts in 1639 under colonial administration. Prior to that time, in 
countries such as England with a vital registration system, the responsibility for the registration of 
vital events had been placed on church officials. The Massachusetts system mandated the 
registration of vital events by the clerks of the communities. In 1843, the Massachusetts legislature 
established the first statewide coordination for the registration of these events by requiring that 
copies of the events registered in the local cities and towns be sent to the Secretary of State. The 
first year of collection was designated for 1841. In 1976, the responsibility for the state coordination 
was transferred to the Department of Public Health. This was accomplished to rejoin the statistical 
and registration functions which had been separated by the 1964 transfer of the statistical function 
to the Department of Public Health. With the exception of the administrative location of the State 
Registry, the actual mechanics of the system have changed remarkably little over the years. 

With limited exceptions, most vital records in Massachusetts are open, public records. The figure 
on the next page illustrates the registration process In Massachusetts. For open birth and death 
records, there is a triple registration process in Massachusetts. The event is first recorded in the 
city or town where the event occurred. The clerk of that community is then required to forward a 
certified copy of the record to both the community where the person resided at the time of the event 
and to the State Registry. Certified copies of the records may be issued from local or state records. 
If the record is a restricted record, such as those of out-of-wedlock births, the registration occurs 
only in the community where the event occurred and In the state office. 

In addition to receiving a legal copy of each birth record from the city or town in which the birth 
occurred, the State Registry also receives a confidential copy of the birth record directly from the 
hospital or birth center where the birth occurred. This copy Includes confidential medical Information 
In addition to the legal information. It is this copy of the record which is processed to produce the 
statistical information on births contained in this report. 



Since 1986, the State Registry has developed a program of direct electronic transmission of birth 
records from hospitals. The system used In Massachusetts Is called the Automated Vital Statistics 
System (AVSS). It was developed at the University of California, Santa Barbara. More than 50 
percent of all birth records are now received through this method. AVSS has contributed to reducing 
processing time at both the hospital and the State Registry, while the built-in edits of the system 
Increase the quality of the data. 

Anyone wishing to be married In the Commonwealth may receive their license from any of the 351 
cities or towns In the state, regardless of where they reside or where the marriage is to take place 
In the Commonwealth. The community issuing the license Is required to send an attested copy of 
the marriage record to the State Registry. 

The Registry of Vital Records and Statistics receives directly from hospitals or physicians the reports 
of fetal deaths of either twenty or more weeks gestation or a weight of at least 350 grams. There are 
no local filings of fetal death reports. 

Abstracts of divorces granted are also sent directly to the State Registry from the Registers of 
Probate from each county probate court. 

STATISTICAL PROCESSING AND TABULATING 

The records received In the State Registry are carefully examined for legal errors and 
inconsistencies. As part of the computerization process, significant computer editing is also done. 
A computerized hospital query program is part of the AVSS program. The Registry also has a data 
quality assurance program that Includes the on-site Instruction of clerks and hospital personnel who 
have difficulties in reporting, and training to all groups involved In the data collection process. 

Annually, when registration is considered as complete as possible, statistics are aggregated for 
presentation In this report, special studies, and program monitoring and surveillance. 

Anyone using statistical information for comparisons over time should be aware of inconsistencies 
and changing conventions for classification and coding. This is particularly important when using 
cause of death Information. Codes used for classifying cause of death in this report are based on 
the Ninth Revision of the International Classification of Diseases, World Health Organization. 
Classification of variables such as race, nativity, and marital status may also differ over time. 

It Is hoped that this report will be useful to a wide range of health data users in the Commonwealth, 
as well as to educational planners, demographers, and historians. Questions concerning these data 
and requests for more detailed findings should be directed to: 

Massachusetts Department of Public Health 

Bureau of Health Statistics, Research and Evaluation 

150 Tremont Street 

Boston, Massachusetts 0211 1 

(617) 727-DATA 



VITAL EVENTS 



SECTION A 
VITAL EVENTS 

HIGHLIGHTS 

UVE BIRTHS 

• In 1988, there were 88,047 live births to Massachusetts residents. 

• Live births increased by 4.4% from 1987 to 1988. 

• The 1988 live birth rate In Massachusetts per 1,000 population increased from 14.4 
In 1987 to 15.0 in 1988. 

• Massachusetts' 1988 live birth rate of 15.0 per 1,000 population remains below the 
1988 U.S. rate of 15.9. 

• The largest number of births occurred in July (9.0% — 7,944), and the fewest occurred 
In February (7.4%— 6,526). 

DEATHS 

• In 1988, 56,407 Massachusetts residents died. 

• The number of deaths Increased by 1.5% from 1987 to 1988. 

• The rate of deaths per 1,000 population also Increased slightly from 9.5 in 1987 to 9.6 
in 1988. 

• The U.S. death rate increased In 1988 to 8.8. (Differences between the crude death 
rates In Massachusetts and the U.S. may reflect differences in the age distribution 
of the population.) 

• The largest number of deaths occurred in March (9.3% — 5,230), and the fewest 
occurred in September (7.6% — 4,292). 

FETAL DEATHS 

• There were 529 reportable fetal deaths to Massachusetts residents In 1988. 

• Reportable fetal deaths increased by 6.2% from 1987 to 1988, resulting in a fetal 
death rate of 6.0 per 1,000 live births and fetal deaths. 



INFANT DEATHS 

• In 1988, 693 Infant deaths (those less than 1 year) occurred to Massachusetts 
residents. 

• The Massachusetts Infant mortality rate increased from 7.2 deaths per 1,000 live 
births in 1987 to 7.9 deaths in 1988. 

• In 1988, the black Infant mortality rate Increased from 15.5 in 1987 to 17.2 in 1988. 

• The Massachusetts 1988 Infant mortality rate of 7.9 per 1,000 live births was 20 
percent below the U.S. rate of 9.9. 

MARRIAGES 

• In 1988, there were 49,941 marriages in Massachusetts. 

• The number of marriages Increased by 1.8% from 1987 to 1988. Nationally, the 
number of marriages decreased by 1.3% during the same period. 

• The 1988 Massachusetts rate of 8.5 marriages per 1,000 population was below the 
U.S. rate of 9.7. 

• For the second year in a row, June was replaced by October as the favorite month 
for marriages. In October, 1988, there were 6,739 occurrence marriages (12.6% of all 
marriages), and the fewest again occurred in January (1,682 — 3.4%). 

DIVORCES 

• In 1988, 17,676 divorces were granted In Massachusetts. 

• Divorces in Massachusetts increased by 4.2% from 1987 to 1988. 

• The 1988 Massachusetts divorce rate of 3.0 divorces per 1,000 population was below 
the U. S. rate of 4.8. 

• The largest number of divorces was finalized in August with 1,636 (9.3%), and the 
fewest In May (1,275—7.2%). 

NATURAL INCREASE 

• The rate of natural Increase In Massachusetts reflected an increase to 5.4 per 1,000 
residents in 1988 from a rate of 4.9 in 1987. 

• The 1988 U.S. rate of natural increase of 7.1 remains far above that of Massachusetts. 

The Vital Events section provides basic information on all vital events. In addition to the information 
highlighted above, this section contains summary birth and death data by city, town and county. 
More detailed Information is contained In the sections on the Individual events. 



DEFINITIONS AND RATES IMPORTANT FOR THIS SECTION INCLUDE: 



OCCURRENCE 



RESIDENCE 



NATURAL INCREASE 



Occurrence data reflect where the event took place without 
regard to residence. In Massachusetts, place will be one 
of 351 cities or towns. 

The usual place of residence as reported by the mother 
(for births) or the informant (for deaths). An infant's 
residence Is considered that of the mother. While 
occurrence data Include only events that occurred within 
Massachusetts, residence data for births and deaths 
Include those which may or may not have occurred within 
Massachusetts. 

The difference between the number of resident live births 
and the number of resident deaths. 



CRUDE RATES OF VITAL EVENTS 



BIRTHRATE 
FETAL MORTALITY 
INFANT MORTALTTY 
NEONATAL MORTALITY 
DEATH RATE 
MARRIAGE RATE 
DIVORCE RATE 



No. of Resident Live Births x 1,000 
Total Population 

No. of Resident Fetal Deaths x 1,000 

Resident Uve Births + Resident Fetal Deaths 

No. of Resident Deaths <1 Year x 1,000 
Resident Live Births 

No. of Resident Deaths <28 Days x 1,000 
Resident Live Births 

No. of Resident Deaths x 1,000 
Total Population 

No. of Occurrence Marriages x 1,000 
Total Population 

No. of Occurrence Divorces x 1,000 
Total Population 



TABLE A-l 

SELECTED FACTS IN VITAL STATISTICS 

MASSACHUSETTS 

1988 



NATALITY 



Ages of Mothers: 13 - 51 years 

Sets of Twins: 1,012 
Sets of Quadruplets: 2 

Most Births Occurred on: September 20, 1988 (323 births) 

Highest # of Births at: Brigham and Women's Hospital (9,982 births) 



Ages of Fathers: 14-76 years 

Sets of Triplets: 21 
Sets of Quintuplets: 1 

Fewest Births Occurred on: December 24, 1988 (162 births) 

Lowest # of Births at: Nantucket Cottage Hospital (89 births) 



Ten Most Popular Names For Babies 



Boys ' Names 


Numbe 


Michael 


2,044 


Matthew 


1,478 


Christopher 


1,442 


Daniel 


1,088 


Andrew 


1,000 


David 


952 


Nicholas 


927 


John 


909 


Joseph 


878 


James 


847 



Girls 'Names 


Numl 


Jessica 


1,093 


Ashley 


1,057 


Amanda 


1,055 


Nicole 


766 


Jennifer 


750 


Sarah 


742 


Stephanie 


640 


Elizabeth 


619 


Lauren 


582 


Samantha 


544 



NUMBER OF BIRTHS OCCURRING AT SPECIFIED 
TIMES OF DAY* 

Number 
of Births 



□ c 



aesarean 



Vaginal 




12:OOAM 

to 
7:59 AM 

'Unknown times of birth = 73 



MORTALITY 



Male Decedents 100 Years and Older: 58 

Most Deaths Occurred on: March 18, 1988 (198 deaths) 

Month most Suicides Occurred: March and October (51 each month) 



Female Decedents 100 Years and Older: 314 

Fewest Deaths Occurred on: June 25, 1988 (113 deaths) 

Month most Homicides Occurred: May (29) 



Month most Motor Vehicle Deaths Occurred: May (84) 
Weekday Most Deaths Occurred: Monday (8,301 deaths) Weekday Fewest Deaths Occurred: Wednesday (7,758 deaths) 



MARRIAGE 

Ages of Brides: 13 - 88 years Ages of Grooms: 16-90 years 

Most Popular Month for Marriages: October (6,739 marriages) Least Popular Month for Marriages: January (1,682 marriages) 

Greatest Age Difference When Bride Older than Groom: 36 years Greatest Age Difference When Groom Older than Bride: 45 years 



DIVORCE 

Length of Marriages Involved in Divorces: <1 Year to 56 Years of Marriage Most Common Length of Marriage Prior to Divorce: 3 Years 
Month Most Divorces Granted: August (1,637 divorces) Month Fewest Divorces Granted: May (1,275 divorces) 



11 



FIGURE A-l 

1988 MASSACHUSETTS VITAL EVENTS 

Each day Massachusetts residents had approximately: 




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13 



FIGURE A-2 

RATE OF NATURAL INCREASE 
1910 - 1988 



MASSACHUSETTS 



2 

e 
as 



8 

as 



ao 

28 
26 
24 
22 
20 
18 
16 
14 
12 
10 
8 



25.7 



Crude Birth Rate 




Crude Death Rate 



10 -0 9.6 9.6 9.5 9 .6 



1910 1920 1930 1940 1950 1960 1970 1980 1986 1987 1988 



32 
30 
28 
26 

24 

22 

i is 

I 16 

14 

12 

10 

8 



06 



UNITED STATES 

Crude Birth Rate 

23.5 23.7 




13.0* 

/ 11.3 10.7 
'—Crude Death Rate 



15.9 



15.6 15.7 15.9 



| |fl| 



9.5 8.8 8.7 8.7 8.8 



1910 1920 1930 1940 1950 1960 1970 1980 1986 1987 1988 



14 



TABIE A-3 

VITAL EVENTS BY MONTH 

MASSACHUSETTS RESIDENTS 

1988 





BIRTHS 


FETAL 
DEATHS 


DEATHS 


Infant 
Deaths* 


Neonatal 
Deaths* 


MARRIAGES 


DIVORCES 


TOTALS 


88,047 


529 


56,407 


693 


477 


49,941 


17,676 


January N 
Rank 


6,839 
11 


43 
6 


5,048 
2 


40 
11 


25 
10 


1,682 
12 


1,493 
6 


February N 
Rank 


6,526 

12 


44 
5 


4,819 

4 


61 
5 


39 
6 


2,339 
10 


1,512 
4 


March N 
Rank 


7,303 
7 


34 
10 


5,230 

1 


62 
4 


50 
2 


2,108 
11 


1,504 
5 


April N 
Rank 


7,282 
8 


43 
6 


4,657 
6 


58 
6 


40 
5 


3,876 

7 


1,415 
9 


May N 
Rank 


7,826 
3 


61 

1 


4,525 
9 


74 
2 


55 

1 


5,475 
4 


1,275 
11 


June N 
Rank 


7,460 
5 


40 

8 


4,503 
10 


45 
10 


31 
9 


5,861 
3 


1,483 

7 


July N 
Rank 


7,944 

1 


56 
2 


4,453 
11 


51 
8 


38 

7 


4,788 
6 


1,625 
2 


August N 
Rank 


7,845 
2 


47 
4 


4,585 
7 


49 
9 


39 
6 


5,232 
5 


1,637 

1 


September N 
Rank 


7,680 
4 


39 
9 


4,292 
12 


68 
3 


46 

3 


6,113 
2 


1,590 
3 


October N 
Rank 


7,377 
6 


33 
11 


4,718 
5 


54 
7 


39 
6 


6,739 

1 


1,429 
8 


November N 
Rank 


6,984 
9 


48 
3 


4,564 
8 


80 

1 


43 
4 


3,348 
8 


1,298 
10 


December N 
Rank 


6,981 
10 


41 

7 


5,013 
3 


51 
8 


32 
8 


2,380 
9 


1,415 
9 



♦Infant and neonatal 
neonatal deaths are 



deaths are included in total 
included in infant deaths. 



resident deaths; 



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27 



NATALITY 



SECTION B 



NATALITY 

An eleven-year trend of increased births to Massachusetts residents continued In 1988. There were 
88,047 live births to Massachusetts residents In 1988, a 4.4% Increase over the 84,343 resident live 
births In 1987. Live births to Massachusetts residents Include all births to Massachusetts residents, 
regardless of the state In which they occurred. Most data presented In this section are resident data. 
Table B-10 presents births by hospital of occurrence. 

OCCURRENCE BIRTHS 

In 1988, 89,955 births occurred in Massachusetts. All but 522 births occurred at the 58 hospitals with 
maternity units. The number of babies delivered at these hospitals ranged from 89 at Nantucket 
Cottage Hospital in Nantucket to 9,982 at Brigham and Women's Hospital in Boston. The median 
number of births per hospital was 1,182, an increase from the median number of 1,098 in 1987. The 
four hospitals with the largest number of births — Brigham and Women's (9,982), Bay State Medical 
Center (6,021), Beth Israel (5,449) and Worcester Memorial (3,559) represent almost 28% of all births 
occurring in Massachusetts. The distribution of Massachusetts births by hospital size Is presented 
below. These data have shown little change In the past several years. 

1988 DISTRIBUTION OF MASSACHUSETTS 
OCCURRENCE BIRTHS BY HOSPITAL 



NUMBER OF BIRTHS 
AT HOSPITAL 


NO. OF HOSPITALS 
IN CATEGORY 


TOTAL NO. OF 
BIRTHS IN 
CATEGORY 


% OF TOTAL BIRTHS 


<500 


8 


2,016 


2.2 


500-999 


15 


10,912 


12.1 


1000-1499 


16 


19,461 


21.6 


1500-1999 


5 


8,623 


9.6 


>2000 


14 


48,421 


53.8 


ALL OTHER 1 




522 


0.6 


TOTAL 


58 


89,955 


100.0 2 



'Includes all other hospitals, birthing centers, home births and births en route to a hospital. 
2 Percents do not sum to 100.0 due to rounding. 



31 



HOME BIRTHS 

What appears to be a growing public Interest In home births Is not reflected in the reported numbers: 
only 293 births, or 0.3% of all Massachusetts resident births, occurred at home. However, home 
births may be under-counted in the data presented. Home births, much more than hospital births, 
tend to be recorded as delayed records (more than one year after the event) rather than reported at 
the time of birth. Delayed record statistics are not Included in this report. 

BIRTHS BY RACE/ETHNICITY 

The number of births by race/ethnlclty remained relatively constant, with 80% of Massachusetts 
resident births occurring to white women. There are a number of points to keep In mind when 
analyzing 1988 data by race. In 1987, the first full year in which a new birth certificate was utilized, 
1.1% of the certificates received had no information on race. In 1988, 1.3% of the birth certificates 
recorded had no Information on race and ethnicity. Another major problem occurred with the lack 
of precise data on Massachusetts' Hispanic population prior to June, 1986. The question on race 
as asked on the certificate prior to June, 1986 was limited to a race question. In many cases, 
Individuals with an Hispanic ethnicity appropriately selected a race code rather than responding as 
Hispanic. If the response was Hispanic, however, these births were formerly included in the larger 
category of "white". The new birth certificate collects Information on both race and ethnicity and 
provides improved data on Hlspanlcs. Presented below are resident birth data for calendar year 1988 
utilizing maternal race and ethnicity information: 



RACE AND ETHNICfTY OF MOTHER 
JANUARY - DECEMBER, 1988 



MATERNAL RACE/ETHNICITY 


TOTAL BIRTHS 


% OF TOTAL 


White non-Hispanic 


70,417 


80.0 


Black non-Hispanic 


6,547 


7.4 


Hispanic 


6,593 


7.5 


Asian 


3,127 


3.6 


Other 


241 


0.3 


Unknown 


1,122 


1.3 


TOTAL 


88,047 


100.0 1 



'Percents do not sum to 100.0 due to rounding. 



32 



The final point which must be considered Is the method used to present data by race. On the birth 
certificate, Information Is collected on mother's race and father's race. From these two Items, a race 
for the Infant may be generated using an algorithm set by the National Center for Health Statistics. 

With the exception of Infant mortality data, race/ethnlcity data are presented by race/ethnicity of 
mother. If, for example, access to prenatal care Is being analyzed, the Information Is better 
presented by race of mother rather than race of Infant. Although the differences In the numbers 
when comparing race of mother to race of infant are not substantial, the Impact on statistical rates 
may be significant because of the relatively small percentage of births to non-whites In 
Massachusetts. 

TEEN BIRTHS 

The number of births to mothers between the ages of 15 and 19 Increased from 6,923 births In 1987 
to 7,1 13 births in 1988. This is the second consecutive year that the actual number of births to teens 
increased. However, the percent of teen births decreased slightly to 8.1% from 8.3% in 1987. The 
age-specific birth rate increased slightly from 32.0 to 34.2. 

BIRTHS BY MARITAL STATUS 

The proportion of unmarried mothers continued to increase to 22.2% of total births in 1988 from 
20.8% In 1987. More than 78.0% of the births to women under the age of 20 were out-of-wedlock 
births. Births to women under the age of 20 represent 8.2% of total births, but more than 29% of the 
births to unmarried mothers. 

BIRTHS BY AGE OF MOTHER 

The largest percentage of the increase in births between the years 1987 and 1988 (63.9%) were to 
mothers aged 30 and older, as demonstrated below: 



AGE OF MOTHER 


DIFFERENCE IN BIRTHS 
1987-1988 


% CHANGE 


<20 


+241 


+3.4 


20-24 


+87 


+0.5 


25-29 


+1,017 


+3.6 


30-34 


+1,389 


+6.3 


35-39 


+912 


+12.3 


40-44 


+66 


+6.0 


>44 


+13 


+39.4 



BIRTHS BY C-SECTION 

The number of Caesarean section deliveries to Massachusetts residents continued to rise from 
19,918 in 1987 to 21,060 in 1988. The rate per 1,000 live births also increased from 236.2 to 239.2. 
The lowest rate of C-sectlons (when the mother's age is known) was for mothers under the age of 
15 (136.0 per 1,000 live births), and the highest was for women aged 40-44 (344.3). 



33 



HOSPITAL PROFILES 

The following Is a synopsis of the data presented in Table B-10, Hospital Profiles, Massachusetts 
Occurrence Births: 

• The percentage of Caesarean sections per hospital ranged from 12.8% to 37.5% of total 
births. 

• The highest percentage of low blrthwelght babies was at St. Margaret's Hospital in Boston 
(17.1%), the lowest percentage at Qulncy City Hospital in Quincy (1.4%). By race/ethniclty, 
the proportion of low blrthwelght Infants by hospital had major variations. For white non- 
Hispanic Infants, the range went from 1.4% to 17.1%; for black non-Hispanic Infants, from 
2.3% to 20.9% ; for Hispanic infants, from 1.3% to 22.2%; and for Asian infants, from 2.0% to 
20.0%. 

• Based on total occurrence births, adequate prenatal care received by mothers by hospital 
ranged from a low of 19.4% to a high of 95.1%. When comparing prenatal care by race per 
hospital, white non-Hispanic mothers received 20.9% to 95.3% adequate care; black non- 
Hispanic mothers received 18.6% to 91.7% adequate care; Hispanic mothers received 24.2% 
to 95.3% adequate care; and Asian mothers received 9.4% to 93.2% adequate care. 

• When race/ethnlclty Is known, the highest percent of mothers who breast fed their babies 
occurred at Martha's Vineyard Hospital In Oak Bluffs (82.4%), and the lowest percent 
occurred at South Shore Hospital In Weymouth (19.7%). Statewide, 51.0% of all new mothers 
breast fed their babies. By known race/ethnicity, 52.2% of white, non-Hispanic mothers 
nursed their babies, followed by Hispanic mothers (51.7%), Asian mothers (43.8%), and black, 
non-Hispanic mothers (43.5%). 

• The source of payment for delivery by private Insurers (Blue Cross/Blue Shield, Health 
Maintenance Organizations, commercial Insurers) showed the highest percentage at St. 
Joseph's Hospital in Lowell (92.7%) and the lowest percentage at Boston City Hospital In 
Boston (9.6%). Statewide, 73.4% of all deliveries were paid by private Insurers. Private 
insurers paid for delivery for 81.2% of white, non-Hispanic mothers, 60.5% of Asian mothers, 
42.0% of black, non-Hispanic mothers, and 28.9% of Hispanic mothers. 

LOW BIRTHWEIGHT BABIES 

The percent of low blrthwelght babies (less than 2,500 grams or five pounds eight ounces) Increased 
from 5.7% of total births In 1987 to 6.0% In 1988 (5,270 births). The percent of low blrthwelght babies 
born to mothers under the age of 20 Increased from 8.0% in 1987 to 8.3% In 1988. 

DEFINITIONS IMPORTANT FOR THIS SECTION INCLUDE: 

ADEQUACY OF PRENATAL CARE 

The Index of Adequacy of Prenatal Care (using the Kessner Index) is a classification of prenatal care 
Into five categories (adequate, intermediate, Inadequate, no prenatal care, and unknown), based upon 
the trimester In which prenatal care begins and number of prenatal visits. The general classification 
scheme is as follows: 



34 



TRIMESTER CARE BEGAN 


# of visrrs 


1 


9 or more 


1 


5-8 


2 


5 or more 


1 


1-4 


2 


1-4 


3 


1 or more 


— 





Unknown 


Unknown 



CATEGORY 

Adequate 

Intermedate 

Inadequate 



No prenatal care 
Unknown 

This classification Is adjusted for gestational age to allow for proper classification of premature 
births. 

BIRTHWEIGHT 

The weight of an infant or fetus at the time of delivery. It may be recorded in either pounds/ounces 
or grams. If It is pounds/ounces, it is converted to grams for use in this report. 

1 pound = 453.6 grams; 1,000 grams = 2 pounds, 3 ounces 

BIRTHWEIGHT CATEGORIES 

Normal birthwelght (NBW): An Infant's weight, recorded at birth, of 2,500 grams or more. 

Low birthwelght (LBW): An Infant's weight, recorded at birth, of less than 2,500 grams. 

Very low birthwelght (VLBW): An Infant's weight, recorded at birth, of less than 1,500 grams. 

CAESAREAN SECTION or C-SECTION 

Primary: A mother's first occurrence of a Caesarean section delivery. 

Repeat: A Caesarean delivery which has been preceded by at least one Caesarean delivery. 

ETHNICITY 

See Race. 

INFANT 

A child whose age Is less than one year (365 days). 

LIVE BIRTH 

A live birth is the complete expulsion or extraction from its mother of a product of conception, 
regardless of the duration of pregnancy, which, after separation, 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. 



35 



LOW BIRTHWEIGHT 

See Blrthwelght Categories. 

NEONATE 

A child whose age Is less than 28 days. 

NORMAL BIRTHWEIGHT 

See Blrthwelght Categories. 

OCCURRENCE BIRTH 

A birth occurring in the Commonwealth of Massachusetts, regardless of the residencies of the 
parents, in Massachusetts, the place will be one of the 351 cities or towns. See Resident Birth. 

PARITY 

The number of live births, including the present birth. 

PRIMARY 

See Caesarean Section. 

R ACE 

Race of Infant: For birth data presented In this publication, infant's race is derived from parent's race, 
according to algorithms provided by the National Center for Health Statistics. (Race on a death 
certificate Is determined by the certifier of the death.) 

Race of mother: For data presented in this publication, mother's race is as reported by the infant's 
mother. 

Race-ethniclty: Data on race-ethniclty are available starting In June 1986, using the new birth 
certificate implemented on June 1, 1986. This birth certificate Includes separate questions on race 
and ethnicity of each parent. The categories are then assigned based on a cross classification of 
the 38 ethnicity and 6 race codes (White, Black, Asian Indian, other Asian, American Indian, and 
Other). The major impact of this modification Is the more precise specification of Hispanic ethnicity, 
resulting In a decrease in births previously classified as births to white mothers and an increase in 
Hispanic births. 

REPEAT 

See Caesarean Section. 



36 



RESIDENT BIRTH 

The usual place of residence as reported by the mother. An Infant's residence Is considered to be 
that of the mother. In Massachusetts, a resident Is a person with a permanent address In one of the 
351 cities or towns. Vital statistics data may be presented either In terms of residence or occurrence. 
Unless otherwise noted, all data In this publication are resident data. Resident data include all 
events which occur within the state, Including those which occur to non-residents. There Is an 
Interstate exchange agreement among the 50 states, Canada, Puerto Rico, Guam, the Virgin Islands, 
and the District of Columbia which provides for exchange of copies of birth and death records. 
These records are used for statistical purposes only, and allow each state or province to track the 
births and deaths of Its residents. 

VERY LOW BIRTHWEIGHT 

See Blrthwelght Categories. 

RATES IMPORTANT FOR THIS SECTION INCLUDE: 



AGE-SPECIFIC BIRTH RATE 



No. of Resident Live Births for 
a Specific Age of Mother x 1,000 

Total Female Population of 
That Specific Age 



CRUDE BIRTH RATE 



No. of Resident Live Births x 1,000 
Total Resident Population 



GENERAL BIRTH RATE 



No. of Resident Live Births x 1,000 
Total Female Population of 
Childbearlng Age (15-44) 



37 



FIGURE B-l 
Every day in 1988, residents of Massachusetts experienced an average of: 



(241) 
Births 



<^4)Births Weighing 
<2500 Grams 
(Low Birthweight) 




(l9)Births to Women 

Aged 15 through 19 



(26)Births to Women 
Aged 35 or Older 



lJBirths with less 
than Adequate 
Prenatal Care 




^Births by 

Caesarean Section 



39 



TABLE B-1 

TRENDS IN NATALITY CHARACTERISTICS 

MASSACHUSETTS RESIDENTS 

1980-1988 



Births* 




1980 


1981 


1982 


Yea 

1983 


r 

1984 


1985 


1986 


1987 


1988 


72,591 


73,930 


75,749 


76,031 


78,197 


81,781 


82,163 


84,343 


88,047 


Rate per 1,000 


J omen 


53.4 


54.1 


55.1 


55.0 


56.2 


58.5 


58.4 


59.6 


61.8 


aged 15-44 






















Race of Infant 






















White 


(#) 


65,515 


66,093 


67.077 


67,390 


68,441 


71,106 


70,953 


73,270 


75,516 




(X) 


90.2 


89.4 


88.6 


88.6 


87.5 


86.9 


86.4 


86.9 


85.8 


Black 


(#) 


5,176 


5,227 


5,255 


5,170 


5,420 


5,702 


6,064 


7,036 


7,620 




(X) 


7.1 


7.1 


6.9 


6.8 


6.9 


7.0 


7.4 


8.3 


8.6 


Other 


(#) 


1,236 


1,485 


1,704 


1,789 


1,916 


1,992 


2,663 


3,063 


3,780 




<x> 


1.7 


2.0 


2.2 


2.4 


2.4 


2.4 


3.2 


3.6 


4.3 


Unknown 


(#) 


664 


1.125 


1,713 


1,682 


2,420 


2,981 


2,484 


974 


1,131 




(X) 


0.9 


1.5 


2.3 


2.2 


3.1 


3.6 


3.0 


1.2 


1.3 


Teenage Births 


(#) 


7,694 


7,334 


7,263 


6.833 


6,932 


6,859 


6,754 


6,923 


7,113 




(Rate) 


28.1 


27.7 


28.3 


27.5 


28.8 


29.5 


30.1 


32.0 


34.2 


(per 1,000 females aged 15-19) 




















Low Birthweight 


(#)** 


4,413 


4,428 


4,447 


4,461 


4,597 


4,751 


4,642 


4,846 


5,270 




(X) 


6.1 


6.0 


5.9 


5.9 


5.9 


5.8 


5.6 


5.7 


6.0 


prenatal Care 


(X adequate)*** 


79.6 


80.4 


79.9 


78.4 


79.2 


78.6 


76.2 


75.4 


76.0 



•Differences in birth numbers and rates from prior publications are the result of updating 
of data files and modifications of population estimates and projections. 

"Low Birthweight: <2500 grams. 

***Percents are based on total number of births. 



40 



TABLE B-2 
AGE-SPECIFIC AND CRUDE BIRTH RATES 
MASSACHUSETTS RESIDENT BIRTHS 
1987-1988 





1987 


1988 


Percent 


Births 




Births 




Maternal Age 


Population* 


Rate 


Population* 


Rate 


Change 


13-14 


94 
73,216 


1.3 


147 
70,787 


2.1 


+61.5 


15-19 


6.923 
216,225 


32.0 


7.113 
208,068 


34.2 


+ 6.9 


20-24 


18.438 
249,582 


73.9 


18 . 526 
244,937 


75.6 


+ 2.3 


25-29 


28.331 
266,417 


106.3 


29.346 
268,780 


109.2 


+ 2.7 


30-34 


21.956 
261,952 


83.8 


23.347 
266,689 


87.5 


+ 4.4 


35-39 


7.405 
220,812 


33.5 


8.317 
226,754 


36.7 


+ 9.6 


40-44 


1.093 
197,057 


5.5 


1.159 
204,647 


5.7 


+ 3.6 


Age-specific Birth Rate,+ 


84.146 


59.6 


87,808 


61.8 


+ 3.7 


ages 15-44 


1,412,045 




1,419,875 






Crude Birth Rate,++ 


84.343 


14.4 


88.047 


15.0 


+ 4.2 


per 1,000 residents 


5,845,118 




5,860,283 







♦Population data are interpolations of the 1980 U.S. Bureau of the Census 
counts and the 1990 MISER projections. 

+Births per 1,000 females aged 15-44. 

-H-Births per 1,000 residents. 



41 



FIGURE B-2 


RESIDENT LIVE BIRTHS BY RACE OF INFANT* 


1988 


> — JX ASIAN (L4%) 1,Z61 


/ ^ s S8iilv iiispANic ,8 - 2%,7 - 25s 


WHITE NON-HISPANIC [ ^HijjjjBB UNKNOWN (1.3%) 1,131 
(77.5%) 68,261 i ^^^ 

l\ ^^CtB BLACK NON-HISPANIC 


yV >>fF (8.6%) 7,620 


X^ ' ^s' OTHER (2.9%) 2,519 


•Percents do not sum to 100.0 due to rounding. 


FIGURE B-3 


RESIDENT LIVE BIRTHS BY MOTHER'S AGE* 


1988 


2ft-24 YRS ( 21 -0%) 18,526 


idfllii i^^»w 5 " 19YRS(8 - 1%)7 * 113 




Mother (i.6%) i,398 


25-29 YRS (33.3 % ) 29,346 1 ^^^ffiUli 


35-39 YRS (9.4%) 8,317 


"*- ISSSSS^30-34 YRS (26.5%) 23,347 


•Percents do not sum to 100.0 due to rounding. 



42 



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=3 
















*o 


fM 












1 




•"" 






























































-o 


o 


-* 


in 


Kl 


Kl 


o 


•& 


o 


in 


in 


P 


in 


O 


X 


"8 

3 


N- 






ro 






<\J 


o 


o 


in 


o 


CM 


CM 


' 


Kl 








^" 


Kl 


o 


in 


■— 


O 


h- 


CO 








































O 














O' 


(M 


co 


>o 








c 




u-i 
















fM 










































*-» 


— * 


rV 


•— 


«— 


O 


Kl 


CO 


in 


fM 


m 


w— 


NO 


o 


o 


-0 




a 




in 


>* 


CO 


CM 




3 


»* 


«o 




o 


•o 


Kl 


Kl 


3 


*-■■ 
o 


»* 




"" 


Ki 


CO 


Kl 


in 


Kl 


o 




o 








►— 


o 










*~ 


■" 


Kl 


fM 


o 

fM 


N- 












CO 


in 


C-- 


Kl 


2 

cm 


O 


CO 


co 


N* 


O 


m 


in 


O 


in 




"8 


CM 

m 


>» 


ki 


8 


3 


3 


c§ 


O 


8 


R 


•*» 








2 


o* 








,_ 


,_ 


^ 


NO 


N» 


^ 












3 


•~ 






























o 


N 


in 


O 


cm 


CO 


Kl 


CO 


(M 


r^- 


CM 


vj 


•o 


^_ 












o 


CO 


rj 


8 


m 


■^ 


o 


CO 




Kl 


Kl 


0) 


? 


in 








"~ 


■J- 


•o 


(M 


Kl 


in 


o 






o 


3 


8 














^ 


in 

fM 


fM 


rV 


•~ 








r- 


r- 


CM 


CM 


o 


8 


w - 


o 


>o 


r^. 


h- 


o 


O 


•O 






^» 


>* 


in 


R 


in 




*M 


N» 


^ 




m 


■s* 


•*t 




(0 


o 




ki 


** 


O 


in 


1/1 


ki 


Kl 


Kl 










































o 


8 








■" 


fNJ 


OJ 


00 


o 

fM 


Kl 
CM 


CO 


•" 










m 
























c 


<4- (_ 
















^» 


o 


>* 


O 


»* 




3 


O 4) 
















r\j 


CM 


Kl 


Kl 


-j 


+ 


o 


JE 


Q 


u 


in 


o 


r»- 


CO 


O 












in 


c 


4> t- 




01 












o 


m 


O 


in 


o 


nJ 


_* 


en o 


O 


"2 

13 












(M 


rg 


K» 


Kl 


•s* 




c 

3 



43 



TABLE B-4 

RESIDENT BIRTHS TO TEENAGE MOTHERS 

1970-1988 





TOTAL 








AGE OF 


MOTHER 




























TOTAL 


X OF TOTAL 


YEAR 


BIRTHS 


12 


13 


14 


15 


16 


17 


18 


19 


12-19 


BIRTHS 


1970 


93,582 


3 


8 


70 


320 


802 


1,726 


3,043 


4,285 


10,257 


11.0 


1971 


86,755 


3 


23 


84 


313 


875 


1,738 


2,981 


4,000 


10,017 


11.5 


1972 


76,835 


1 


20 


103 


348 


955 


1,841 


2,834 


3,690 


9,792 


12.7 


1973 


72,237 





12 


93 


393 


959 


1,759 


2,584 


3,282 


9,082 


12.6 


1974 


70,071 


2 


16 


79 


333 


895 


1,762 


2,524 


3,181 


8,792 


12.5 


1975 


68,070 


2 


18 


84 


325 


915 


1,678 


2,560 


3,085 


8,667 


12.7 


1976 


65,947 


7 


12 


96 


336 


807 


1,478 


2,332 


2,923 


7,991 


12.1 


1977 


67,838 


1 


18 


68 


270 


792 


1,477 


2,293 


2,913 


7,832 


11.5 


1978 


68,526 


3 


15 


67 


303 


737 


1,445 


2,252 


2,979 


7,801 


11.4 


1979 


70,568 


2 


9 


70 


283 


773 


1,413 


2,306 


2,916 


7,772 


11.0 


1980 


72,591 


1 


14 


56 


300 


740 


1,360 


2,202 


3,092 


7,765 


10.7 


1981 


73,931 


1 


12 


82 


275 


722 


1,357 


2,164 


2,816 


7,429 


10.0 


1982 


75,749 


1 


14 


83 


299 


753 


1,328 


2,161 


2,722 


7,361 


9.7 


1983 


76,031 





8 


78 


255 


726 


1,278 


2,053 


2,521 


6,919 


9.1 


1984 


78,198 


1 


8 


75 


265 


714 


1,307 


2,061 


2,585 


7,016 


9.0 


1985 


81,776 


4 


12 


97 


295 


698 


1,283 


1,986 


2,595 


6,970 


8.5 


1986 


82,163 





15 


82 


334 


712 


1,233 


1,954 


2,521 


6,851 


8.3 


1987 


84,343 


2 


15 


79 


327 


796 


1,337 


1,965 


2,498 


7,019 


8.3 


1988 


88,047 





27 


120 


352 


732 


1,450 


2,068 


2,511 


7,260 


8.2 



44 



TABLE B-5 

BIRTHS BY BIRTHUEIGHT, MATERNAL RACE AND ETHNICITY 

MASSACHUSETTS RESIDENT BIRTHS 

1988 









White 


Blac 


k 
















Birthweight 


Total 


non-His 


panic 


non- Hispanic 


Hispanic 


Asian 


Oth 


er 


Unknown 






























( in grams) 


n 


X 


# 


X 


# 


X 


tt 


51 


# 


% 


tt 


% 


tt 


X 


STATE TOTAL 


88,047 


100.0 


70,417 


100.0 


6,547 


100.0 


6,593 


100.0 


3,127 


100.0 


241 


100.0 


1,122 


100.0 


< 500 


107 


0.1 


66 


0.1 


21 


0.3 


11 


0.2 


4 


** 





** 


5 


0.4 


500 - 999 


390 


0.4 


245 


0.3 


82 


1.2 


47 


0.7 


9 


0.3 


2 


** 


5 


0.4 


1,000-1,499 


479 


0.5 


302 


0.4 


90 


1.4 


54 


0.8 


24 


0.8 


7 


2.9 


2 


** 


VLBW*(0- 1,499) 


976 


1.1 


613 


0.9 


193 


3.0 


112 


1.7 


37 


1.2 


9 


3.7 


12 


1.1 


1,500-1,999 


992 


1.1 


679 


1.0 


165 


2.5 


90 


1.4 


40 


1.3 


5 


2.1 


13 


1.2 


2,000-2,499 


3,297 


3.7 


2,318 


3.3 


457 


7.0 


321 


4.9 


151 


4.8 


13 


5.4 


37 


3.3 


LBU*+<0-2,499) 


5,265 


6.0 


3,610 


5.1 


815 


12.4 


523 


7.9 


228 


7.3 


27 


11.2 


62 


5.5 


2,500-2,999 


13,012 


14.8 


9,312 


13.2 


1,490 


22.8 


1,273 


19.3 


725 


23.2 


37 


15.4 


175 


15.6 


3,000-3,499 


30,990 


35.2 


24,271 


34.5 


2,390 


36.5 


2,534 


38.4 


1,326 


42.4 


88 


36.5 


381 


33.9 


3,500-3,999 


27,476 


31.2 


23,300 


33.1 


1,377 


21.0 


1,715 


26.0 


684 


21.9 


63 


26.1 


337 


30.0 


4,000-4,499 


9,140 


10.4 


8,054 


11.4 


380 


5.8 


452 


6.8 


140 


4.5 


21 


8.7 


93 


8.3 


4,500-4,999 


1,668 


1.9 


1,509 


2.1 


53 


0.8 


70 


1.1 


12 


0.4 


4 


** 


20 


1.8 


5,000+ 


196 


0.2 


178 


0.2 


6 


0.1 


6 


0.1 


3 


** 





* * 


3 


** 


Unknown 


300 


0.3 


183 


0.3 


36 


0.6 


20 


0.3 


9 


0.3 


1 


** 


51 


4.5 



"Calculations based on fewer than 5 events are excluded. 

*VLBW: very low birthweight 
*+LBU: low birthweight 



45 



TABLE B-6 

NATALITY CHARACTERISTICS BY MATERNAL RACE AND ETHNICITY 

MASSACHUSETTS RESIDENT BIRTHS 

1988 





Total 


Teenage Births 


Birthwei 


ght* 


Adequate 


First Trimester 


Prenatal Care 


Maternal Race and Ethnicity 


Births 


<18 yrs 


<20 yrs 


Very Low 


Low 


Prenatal Care+ 


Prenatal Care++ 


Visits 


Number 


X 


X 


X 


X 


X 


X 


Average Number 


STATE TOTAL 


88,047 


3.0 


8.2 


1.1 


6.0 


78.8 


80.8 


11.5 


WHITE NON-HISPANIC 


70,417 


2.0 


6.2 


0.9 


5.1 


82.4 


84.9 


11.7 


BLACK NON- HISPANIC 


6,547 


7.5 


16.0 


3.0 


12.4 


60.1 


60.2 


10.0 


Haitian 


919 


1.1 


3.0 


2.7 


8.9 


65.4 


63.5 


10.4 


Other Black non-Hispanic 


5,628 


8.5 


18.1 


3.0 


13.0 


59.3 


59.6 


10.0 


HISPANIC 


6,593 


10.0 


22.3 


1.7 


7.9 


62.4 


64.7 


10.5 


Puerto Rican 


4,040 


13.8 


29.4 


1.6 


8.9 


58.6 


61.1 


10.4 


Dominican 


903 


3.9 


10.8 


1.4 


5.5 


64.4 


67.8 


10.7 


Central American 


571 


5.2 


11.9 


2.4 


7.4 


65.9 


66.7 


10.4 


Other Hispanic 


1,079 


3.5 


10.6 


1.8 


6.7 


73.1 


74.3 


11.0 


ASIAN 


3,127 


2.2 


6.6 


1.2 


7.3 


67.1 


68.4 


10.8 


Southeast Asian 


1,052 


4.8 


13.4 


1.0 


8.5 


44.9 


47.7 


9.6 


Ch i nese 


867 


** 


•• 


*• 


4.7 


80.6 


80.7 


11.5 


Other Asian 


1,208 


1.6 


5.1 


1.8 


8.1 


76.9 


77.6 


11.2 


OTHER 


241 


2.9 


16.2 


3.7 


11.2 


64.6 


61.8 


10.2 


UNKNOWN 


1,122 


4.6 


11.8 


1.1 


5.5 


80.4 


77.8 


11.3 


•Very low birthweight: <1,500 grams. 










Lou birthweight: <2,500 grams. 










"Calculations based on fewer than 5 events are excluded. 










♦Calculations are based on births with known adequacy of 


prenatal c 


are scores: 






♦♦Mothers who registered for prenatal care during the fir 


st trimest 


er and had nine or more 




prenatal care visits. 


46 



























FIGURE B-4 



TRENDS IN ADEQUACY OF PRENATAL CARE 

by Maternal Race 2 
Massachusetts: 1980-1988 



S 100% 
90% 
80% 
70% 
60% 
50% 



gg 

U 



■n 

S 

■o 

< 



82.7% 83 - 8% 82.5% 



zz; 



Black 



White 



zz: 



iz 



2i 



1 



80.6% 80.7% 80.9% 80.6% 80.1% 80.8% 




1980 1981 1982 1983 1984 1985 1986 1987 1988 

1. Calculations are based on births with known adequacy of prenatal care scores, using the 
Kessner adequacy index. 

2. When calculating statistics which include data before June 1986, the race classifications do not 

include an ethnicity component; most Hispanics are included in the race category of white. 

FIGURE B-5 

ADEQUACY OF PRENATAL CARE 
by Prenatal Care Source of Payment l 
Massachusetts: 1988 




Private 2 Public 3 



Free & 
Self-Paid 



Other 4 



State 
Total 



1. The source of payment for prenatal care is a self-reported item on the birth certificate. As with 
all such data, they are subject to the limitations of self-reported information and should be 
interpreted with the usual caution. 

2. Private: Blue Cross/Blue Shield, Commercial Insurers and Health Maintenance Organizations. 

3. Public: Medicaid, Medicare, Healthy Start and Other Government. 

4. Other: Worker's Compensation and Other. 



47 



TABLE B-7 

PARITY* BY AGE OF MOTHER 

MASSACHUSETTS RESIDENT BIRTHS 

1988 



Age of 
Mother 


Total 


1st 


2nd 


3rd 


4th 


5th 


6th 


7th 


8th 


>9th 


Unknown 


Total 


N 

X 


88,047 
100.00 


39,089 
44.39 


28,517 
32.39 


12,937 
14.70 


4,029 
4.58 


1,307 
1.48 


428 
0.49 


182 

0.21 


91 
0.10 


81 
0.09 


1,386 
1.57 


10-14 


N 

X 


147 
0.17 


141 
0.16 


5 
0.01 


-- 


-- 


-- 


-- 


-- 


-- 


-- 


1 

** 


15-19 


N 
X 


7,113 
8.08 


5,575 
6.33 


1,164 
1.32 


198 
0.22 


34 
0.04 


1 
** 


-- 


-- 


-- 




141 
0.16 


20-24 


N 

% 


18,526 
21.04 


9,943 
11.29 


5,699 
6.47 


1,932 
2.19 


492 
0.59 


116 
0.13 


23 
0.03 


6 
0.01 


2 

** 


1 

** 


312 
0.35 


25-29 


N 
X 


29,346 
33.33 


13,107 
14.89 


9,893 
11.24 


4,206 
4.78 


1,185 
1.35 


361 
0.41 


107 
0.12 


33 

0.04 


14 
0.02 


4 

** 


436 

0.50 


30-34 


N 

% 


23,347 
26.52 


7,766 
8.82 


8,551 
9.71 


4,587 
5.21 


1,394 
1.58 


432 
0.49 


159 
0.18 


60 
0.07 


29 
0.03 


18 
0.02 


351 
0.40 


35-39 


N 
X 


8,317 
9.45 


2,235 
2.54 


2,853 
3.24 


1,773 

2.01 


796 
0.90 


318 
0.36 


105 
0.12 


57 
0.06 


30 
0.03 


29 
0.03 


121 
0.14 


40-44 


N 
X 


1,159 
1.32 


294 
0.33 


331 
0.38 


226 

0.26 


121 
0.14 


73 
0.08 


30 
0.03 


22 

0.02 


15 
0.02 


26 
0.03 


21 
0.02 


>45 


N 
% 


46 
0.05 


8 
0.01 


9 
0.01 


10 
0.01 


3 

** 


4 

** 


3 

** 


3 

** 


1 

** 


3 

** 


2 

** 


Unknown 
Age 


N 

% 


46 
0.05 


20 
0.02 


12 

0.01 


5 

0.01 


4 

** 


2 

** 


1 

** 


1 

** 


-- 


-- 


1 

** 



"The number of live births including this birth. 

"Percentage less than 0.01%. All percentages are based on total births. 

--Indicates zero events. 



48 



TABLE B-8 
NUMBER OF PRIMARY AND REPEAT CAESAREAN SECTIONS BY AGE 
MASSACHUSETTS RESIDENT BIRTHS 
1988 





Primary 


Repeat 


Age of 
Mother 


Total 
Caesarean 
Del iveries 


Total 
Births 


Rate per 
1,000 Live 
Births 


Caesarean 
Del iveries 


Percent 
of Total 
Caesarean 


Caesarean 
Deliveries 


Percent 
of Total 
Caesarean 


Total 


21,060 


88,047 


239.2 


13,188 


62.6% 


7,872 


37.4% 


<15 


20 


147 


136.0 


20 


100.0 


-- 


-- 


15-19 


1,138 


7,113 


160.0 


983 


86.4 


155 


13.6 


20-24 


3,883 


18,526 


209.6 


2,697 


69.5 


1,186 


30.5 


25-29 


6,997 


29,346 


238.4 


4,426 


63.3 


2,571 


36.7 


30-34 


6,106 


23,347 


261.5 


3,406 


55.8 


2,700 


44.2 


35-39 


2,501 


8,317 


300.7 


1,403 


56.1 


1,098 


43.9 


40-44 


399 


1,159 


344.3 


242 


60.6 


157 


39.4 


>45 


13 


46 


282.6 


9 


69.2 


4 


30.8 


Unknown 


3 


46 


65.2 


2 


66.7 


1 


33.3 



49 



TABLE B-9 

BIRTHWEIGHT IN GRAMS BY AGE OF MOTHER 

NUMBER AND RATE PER THOUSAND LIVE BIRTHS 

MASSACHUSETTS RESIDENT BIRTHS 

1988 



Bi rthweight 
( in grams) 














Age 


of Moth 


er 












Total 


<15 


15 


16 


17 


18 


19 


20-24 


25-29 


30-34 


35-39 


40-44 


>45 


Unknown 


Total 


# 


88,047 


147 


352 


732 


1,450 


2,068 


2,511 


18,526 


29,346 


23,347 


8,317 


1,159 


46 


46 


<500 


Rate 


112 
1.3 


1 
6.8 


1 
2.8 


2 
2.7 


1 
0.7 


4 
1.9 


4 
1.6 


26 

1.4 


31 

1.1 


31 
1.3 


10 
1.2 


1 
0.9 


-- 


-- 


500-999 


# 
Rate 


390 
4.4 


3 
20.4 


3 
8.5 


7 
9.6 


10 
6.9 


19 
9.2 


11 
4.4 


89 
4.8 


110 
3.8 


94 
4.0 


35 

4.2 


7 
6.0 


1 
21.7 


1 
21.7 


1000-1499 


# 
Rate 


479 
5.4 


1 
6.8 


2 
5.7 


12 

16.4 


12 
8.3 


23 

11.1 


20 
8.0 


103 
5.6 


125 
4.3 


111 
4.8 


54 
6.5 


11 
9.5 




5 
108.7 


VLBU* 


# 
Rate 


981 
11.1 


5 
34.0 


6 

17.0 


21 
28.7 


23 

15.9 


46 
22.2 


35 
13.9 


218 

11.8 


266 

9.1 


236 

10.1 


99 
11.9 


19 
16.4 


1 
21.7 


6 
130.4 


1500-1999 


Rate 


992 
11.3 


5 
34.0 


5 
14.2 


5 
6.8 


24 
16.6 


28 
13.5 


35 

13.9 


203 
11.0 


308 

10.5 


241 
10.3 


119 
14.3 


18 
15.5 


1 
21.7 


-- 


2000-2499 


# 
Rate 


3,297 
37.4 


10 
68.0 


19 
54.0 


46 
62.8 


76 
52.4 


105 
50.8 


108 
43.0 


803 
43.3 


1,011 
34.4 


746 
32.0 


332 

39.9 


40 
34.5 


-- 


1 
21.7 


LBW** 


Rate 


5,270 
59.8 


20 
136.0 


30 
85.2 


72 
98.4 


123 
84.8 


179 
86.6 


178 
70.9 


1,224 
66.1 


1,585 
54.0 


1,223 
52.4 


550 
66.1 


77 
66.4 


2 

43.5 


7 
152.2 


2500-2999 


M 
RATE 


13,012 
147.8 


39 
265.3 


86 
244.3 


170 
232.2 


313 
215.9 


422 
204.1 


490 
195.1 


3,117 
168.2 


4,098 
139.6 


3,027 
129.6 


1,058 
127.2 


177 
152.7 


10 
217.4 


5 
108.7 


3000-3499 


# 
Rate 


30,990 
352.0 


43 
292.5 


132 
375.0 


285 
389.3 


551 

380.0 


779 
376.7 


962 
383.1 


6,835 
368.9 


10,292 
350.7 


7,995 
342.4 


2,703 
325.0 


384 
331.3 


11 
239.1 


18 
391.3 


3500-3999 


# 
Rate 


27,476 
312.1 


34 
231.3 


79 
224.4 


165 
225.4 


352 

242.8 


513 
248.1 


678 
270.0 


5,315 
286.9 


9,510 
324.1 


7,740 
331.5 


2,719 
326.9 


342 
295.1 


17 
369.6 


12 
260.9 


4000-4499 


# 
Rate 


9,140 
103.8 


8 
54.4 


21 
59.7 


34 

46.4 


92 
63.4 


146 
70.6 


153 
60.9 


1,641 
88.6 


3,186 
108.6 


2,683 
114.9 


1,031 
124.0 


138 
119.1 


5 
108.7 


2 
43.5 


4500-4999 


# 
Rate 


1,668 
18.9 


1 
6.8 


2 

5.7 


3 

4.1 


15 
10.3 


19 
9.2 


33 

13.1 


288 
15.5 


536 
18.3 


533 
22.8 


206 
24.8 


31 
26.7 


1 
21.7 


-- 


5000-8164 


# 
Rate 


196 
2.2 


-- 


-- 


1 
1.4 


-- 


1 
0.5 


-- 


38 

2.0 


61 
2.1 


62 
2.7 


28 

3.4 


5 
4.3 


-- 


-- 


Unknown*** 


# 
Rate 


295 
3.4 


2 
13.6 


2 
5.7 


2 

2.7 


4 
2.8 


9 

4.4 


17 
6.8 


68 
3.7 


78 
2.7 


84 
3.6 


22 
2.6 


5 

4.3 


-- 


2 
43.5 



*VLBU--very low birthweight (0-1499 grams) 

**LBw--low birthweight (0-2499 grams) 

•"Unknown includes birthweights greater than 8164 grams. 

--Indicates zero events. 



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61 



MORTALITY 



SECTION C 
MORTALITY 

Resident deaths Increased by 1.5% in Massachusetts from 55,562 in 1987 to 56,407 in 1988. The rate 
of deaths per 1,000 population also increased from 9.5 In 1987 to 9.6 in 1988. As with live births, 
deaths to Massachusetts residents Include all deaths to Massachusetts residents regardless of the 
state in which they occurred. Most data presented in this section are residence data. Occurrence 
data are used only with medical examiner data. 

DEATHS BY RACE 

The number of deaths by race remained relatively constant, with white residents comprising 96.1% 
of total deaths in Massachusetts. 

Race information obtained from death certificates Is very different from that provided on birth 
certificates. On birth certificates, race is provided as part of the confidential, statistical portion of 
the record. As such, there Is a significant problem with non-respondents. On the death certificate, 
however, race Information (as is all information on the death certificate) Is part of the legal record 
and must be provided by the funeral director in order to register the death. An unknown or non- 
response In the race item might be the result of a case In which a body is badly decomposed, rather 
than a refusal to provide the information. 

As with birth certificate data prior to June, 1986, there is a problem Identifying those deaths to 
individuals of Hispanic ethnicity. The question as asked on the 1988 death certificate was limited to 
a race question and, In many cases, Individuals with an Hispanic ethnicity were identified using a 
race designation, for example, white or black, and not an ethnicity response of Hispanic. If the 
response was Hispanic, however, these deaths are included In the category of "white". Race 
Information on the death certificate is provided by the informant, which In most cases is a close 
relative. An additional Item on Hispanic origin was added to the death record on January 1, 1989. 



65 



DEATHS BY AGE 

Persons 75 years of age or older accounted for 53.7% of deaths. The percent of deaths to residents 
In this age group vary widely by race and sex. 



SEX 


RACE 


% OF DEATHS 

UNDER AGE 

75 


%OF 

DEATHS 75 

YEARS AND 

OLDER 


MALE 


WHITE 


56.6 


43.4 


BLACK 


80.8 


19.2 


TOTAL 


57.7 


42.3 


FEMALE 


WHITE 


34.6 


65.4 


BLACK 


64.6 


35.4 


TOTAL 


35.6 


64.4 


TOTAL 


WHITE 


45.2 


54.8 


BLACK 


73.4 


26.6 


TOTAL 


46.3 


53.7 



DEATHS BY PLACE OF OCCURRENCE 

Between 1987 and 1988, there was little variation in where deaths occurred, as shown In the data 
presented below: 



SITE 


% OF DEATHS 
1988 


% OF DEATHS 
1987 


HOSPrTAL 


62.0 


61.8 


AT HOME 


15.7 


15.3 


NURSING OR REST 
HOME 


15.5 


15.6 


EN ROUTE TO 
HOSPITAL OR 
DEAD ON ARRIVAL 


5-8 


6-2 


UNKNOWN 


1.0 


1.0 


TOTAL 


100.0 


100.0 1 



'Percent does not sum to 100.0 due to rounding. 



66 



DEATHS BY CAUSE 

Cause of death statistics in this report are based on the Ninth Revision of the International 
Classification of Diseases (ICD-9). The methodology of coding cause of death from death certificates 
Is consistent nationally, using the Automated Classification of Medical Entities (ACME), developed 
by the National Center for Health Statistics (NCHS). The ACME system requires every disease or 
condition mentioned on the record to be coded. The underlying cause Is then selected by a 
computer program which Incorporates the ICD-9 rules and conventions. Cause of death information 
In this report Is based on underlying cause, except where otherwise noted. 

Three tables (C-5, C-6, and C-7) present data based on multiple conditions rather than underlying 
cause data. These tables are presented to Illustrate the use of multiple cause data by extending the 
utility of mortality data. This Is particularly true when utilizing mortality data as a method of 
surveillance. For example, In 1988 there were 13,142 deaths resulting from cancer as an underlying 
cause of death. However, an additional 2,308 deaths where cancer was not the underlying cause did 
Include cancer as a mentioned condition; thus Increasing the utilization of the mortality file as a 
surveillance data base for cancer. 

Table C-7 demonstrates the ability of multiple cause data to enhance the function of mortality data 
as a morbidity tool In cases of diseases that are not traditional underlying causes of death. In the 
case of diabetes, for example, 921 deaths had this condition listed as an underlying cause, but an 
additional 3,443 had diabetes listed as a mentioned condition, thus increasing the ability to determine 
the prevalence of diabetes In the population. 

The five leading causes of death differ somewhat by race. Among white and non-white 
Massachusetts residents, heart disease, cancer, diseases of the respiratory system, and 
cerebrovascular disease rank as the first four leading causes. However, in 1988, pneumonia and 
Influenza rank as the fifth leading cause of death for white Massachusetts residents, while homicide 
ranks fifth among the leading causes for non-white residents. 



CAUSE 


WHITE 


RANK 


NON- WHITE 


RANK 


HEART DISEASE 


19,682 


1 


536 


1 


36.3% 


24.8% 


MAI IGNANT NEOPLASMS 


12,659 


2 


378 


2 


23.4% 


17.5% 


DISEASES OF THE RESPIRATORY SYSTEM 


5,173 


3 


147 


3 


9.5% 


6.8% 


CEREBROVASCULAR DISEASE 


3,605 


4 


126 


4 


6.7% 


5.8% 


PNEUMONIA & INFLUENZA 


2,454 


S 


NOT LEADING CAUSE 


4.57. 


HOMICIDE 


NOT LEADING CAUSE 


89 


5 


4.1% 


ALL OTHER CAUSES 1 


10,651 


NA 


887 


NA 


19.6% 


41,0% 



All Other Causes includes diabetes meatus, chronic iver disease and cirrhosis, suicide, intentional and unintentional injuries, and all other causes not 
speciftcaity mentioned above. 



67 



ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS) 

The Ninth Revision of the International Classification of Diseases was developed before the 
Identification of AIDS. Classification of this disease and related diseases has evolved since 1981 

T ^!™ h ! pre8 ^ ted '" Tab,e C " 10 were coded by U8,n fl the most current schedule, which began 
with 1987 data. Therefore, comparison data prior to 1987 are not available. 

DEATHS CERTIFIED BY MEDICAL EXAMINERS 

The total number of deaths certified by medical examiners decreased from 10,235 In 1987 to 9 430 
In 1988. Of the deaths certified by medical examiners, 71.9% were reported as a result of natural 
causes The percentage of deaths due to natural causes (I.e., non-Injury related causes) certified 
5 ^T? °f. exam,ners varles w| dely by county, from a high of 82.2% in Middlesex County to a low of 
50.7% in Worcester County. Worcester County had the greatest number of deaths (1 179) that were 
referred to medical examiners, but with the certification retained by the attending physician. 

DEFINITIONS IMPORTANT FOR THIS SECTION INCLUDE: 

AGE-ADJUSTED RATE 

A procedure for adjusting rates, designed to minimize the effects of differences In age distribution 
when comparing rates for different populations. This procedure is accomplished by the 
computational process known as age standardization, whereby mortality statistics are adjusted to a 
reference population. For this publication, the reference population is the 1940 U.S. population the 

£,« » a h 8 I' 8 " 1 k' thaNational Center for HeaHh Statistics. The results of the processes a fummarj 
Index that can be used to compare rates of different populations throughout the nation and over time. 

CAUSE OF DEATH 

The underlying condition which gives rise to a series of events leading to death. The code used for 
S2 1 " 9 CaUSe °! ? at !l ! S the " inth ReV ' Sl0n ° f thfl '"l*™""™ 1 SteSS! flcation of DjgJs^The 
ESfSSZ Statts 5 grated by a computer software program developed by the National 

DEATH CERTIFICATF 

tT!i£?l?L 9 T b l a " C9nS !? phyS,Cian that ,ncludes cause of death ' decedent's name, sex, 
birth date, place of residence, and place of occurrence. 

INTERNATIONAL CLASSIFI CATION OF DISEASES. NINTH RFVISinN 

The International Classification of Disease (ICD) classifies mortality information for statistical 
purposes The ICD was first used In 1900 and has since been revised about every 10 years The 
Ninth Revision, published In 1977, Is used to code mortality data beginning with 1^79 

MISER 

toSZZS^ ,nSt 'i Ute f ° r S ° C,a ' and Ec0n0m,C Resea "*- This research Institute, located at 

Zt?r u aSSaC . hU8e " S '" Amh6rSt ' pr0duces the PoP"' a «on estimates and projections used 
officially by the Massachusetts Department of Public Health. 



68 



OCCURRENCE DEATH 

Occurrence death includes all deaths that occur within the state, Including deaths that occur to non- 
residents. An Interstate exchange agreement among the 50 states, Canada, Puerto Rico, Guam, the 
Virgin Islands, and the District of Columbia provides for exchanges of copies of birth and death 
records. These records are used for statistical purposes only, and allow each state or province to 
track the births and deaths of its residents. 

RACE 

For death records: the response of the death record informant, for example, spouse or next of kin. 

RESIDENT DEATH 

The usual place of residence as reported by the informant. In Massachusetts, a resident is a person 
with a permanent address in one of the 351 cities or towns. Unless otherwise noted, all data in this 
publication are resident data. Resident deaths Include all deaths that occur to residents of the 
Commonwealth, wherever they occur. An Interstate exchange agreement among the 50 states, 
Canada, Puerto Rico, Guam, the Virgin Islands, and the District of Columbia provides for exchanges 
of copies of birth and death records. These records are used for statistical purposes only, and allow 
each state or province to track the births and deaths of its residents. 

UNDERLYING CAUSE OF DEATH 

The underlying cause of death is: 1.) the disease or injury that Initiated the series of events leading 
to death, or 2.) the circumstances of the unintentional or Intentional injury that resulted In the death. 
See Death Certificate. 

RATES IMPORTANT FOR THIS SECTION INCLUDE: 

AGE-SPECIFIC DEATH RATE 

Number of Resident Deaths In Specific Age Group x 100,000 
Total Population of Specific Age Group 

CAUSE-SPECIFIC DEATH RATE 

Number of Resident Deaths for a Specific Cause x 100,000 
Total Population 

CRUDE DEATH RATE 

Number of Resident Deaths In A Year x 1,000 
Total Population 



69 



FIGURE C - 1 

Every day in 1988, residents of Massachusetts experienced an average of: 




71 



FIGURE C -2 



Five Leading Underlying Causes of Death 
Massachusetts: 1988 



Diseases of 
the Heart 
35.8% 




Malignant 
Neoplasms 
23.3% 



Other Causes 
26.7% 



"j Pneumonia & 
Influenza 4.5% 

Unintentional 
Injuries 3.1% 
Cerebrovascular 
Diseases 6.6% 



Number of Deaths: 56,407 



72 



TABLE C-1 

TRENDS IN MORTALITY CHARACTERISTICS 

MASSACHUSETTS RESIDENTS 

1980-1988 







Year 




1980 


1981 


1982 


1983 


1984 


1985 


1986 


1987 


1988 


Resident Deaths 
Age-adjusted Death 
Race of Decedent: 


<#) 


54,934 


52,813 


52,867 


54,150 


55,189 


55,597 


55,860 


55,562 


56,407 


Rate 


566.3 


543.4 


536.7 


540.2 


543.7 


541.6 


534.8 


527.8 


533.3 






















White 


<#> 


53,251 


51,190 


51,202 


52,412 


53,309 


53,580 


53,903 


53,522 


54,224 




(X) 


96.9 


96.9 


96.8 


96.8 


96.6 


96.4 


96.5 


96.3 


96.1 


Black 


(#) 


1,508 


1,447 


1,462 


1,497 


1,644 


1,779 


1,731 


1,786 


1,909 




(X) 


2.8 


2.8 


2.8 


2.8 


3.0 


3.2 


3.1 


3.2 


3.4 


Other 


(#) 


141 


153 


168 


199 


188 


214 


211 


252 


254 




(X) 


0.3 


0.3 


0.4 


0.4 


0.4 


0.4 


0.4 


0.5 


0.4 


Unknown 


(#) 


34 


23 


35 


42 


48 


24 


15 


2 


20 




(X) 


-- 


-- 


-- 


-- 


-- 


-- 


-- 


-- 


-- 


Age of Decedent: 






















< 1 year 


(#) 


748 


710 


764 


682 


699 


746 


695 


608 


693 


1 - 4 years 


<#) 


127 


120 


113 


121 


97 


112 


131 


96 


103 


5 - 19 years 


(#) 


547 


541 


497 


478 


472 


466 


440 


404 


407 


20 - 44 years 


(#) 


2,680 


2,594 


2,423 


2,546 


2,628 


2,734 


2,900 


3,041 


3,243 


45-64 years 


(#) 


10,504 


10,303 


10,141 


10,087 


9.947 


9,691 


9,150 


9,052 


9,051 


65 - 74 years 


<#) 


12,411 


12,193 


12,373 


12,393 


12,750 


12,790 


12,638 


12,530 


12,593 


75-84 years 


(#) 


15,506 


14,775 


14,673 


15,132 


15,435 


15,515 


15,984 


16,091 


16,003 


85+ years 


(#) 


12,409 


11,572 


11,874 


12,704 


13,158 


13,538 


13,918 


13,737 


14,309 



■- Percentage less than 0.1. 



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74 



TABLE C-3 

LEADING UNDERLYING CAUSES OF DEATH BY AGE 

MASSACHUSETTS RESIDENTS 

1988 



Deaths 


Jnder lying Cause 


ICD-9 


Number 


< 1 year old* 


371 


Certain conditions originating in the perinatal period 


760-779 




138 


Congenital anomalies 


740-759 




79 


Sudden infant death syndrome 


798.0 




1 - 4 years old 


20 Vehicle-related injuries, excluding motor vehicle 


E800-E807.E826-E849 




18 Congenital anomalies 


740-759 




11 


Infectious & parasitic diseases, excluding TB, polio & syphilis 


001-009,020-041,045-088,098 


139 


10 Malignant neoplasms 


140-208 




10 Motor vehicle-related injuries 


E810-E825 




5-14 years old 


32 Vehicle-related injuries, excluding motor vehicle 


E800-E807.E826-E849 




23 Motor vehicle-related injuries 


E810-E825 




20 Malignant neoplasms of the bone, skin, oral cavity, rare sites & other 


140-149,170-173,190-203 




11 


Congenital anomalies 


740-759 




8 


Leukemia 


204-208 




15 - 24 years old 


243 


Motor vehicle-related injuries 


E810-E825 




94 


Suicide 


E950-E959 




77 


Homicide and legal intervention 


E960-E978 




73 


Vehicle- related injuries, excluding motor vehicle 


E800-E807,E826-E849 




45 


Malignant neoplasms 


140-208 




25 - 44 years old 


524 


Malignant neoplasms 


140-208 




433 


Major cardiovascular diseases 


390-448 




251 


Motor vehicle-related injuries 


E810-E825 




238 


AIDS and HIV-related diseases 


042-044 




209 


Suicide 


E950-E959 




45 - 64 years old 


2,005 


Ischemic heart disease 


410-414 




1,084 


Malignant neoplasms of respiratory & intrathoracic organs 


160-165 




751 


Diseases of pulmonary circulation & other forms of heart disease 


415-429 




740 


Malignant neoplasms of digestive organs & peritoneum 


150-159 




736 


Malignant neoplasms of the bone, skin, oral cavity, rare sites & other 


140-149,170-173,190-203 




65 - 74 years old 


3,244 


Ischemic heart disease 


410-414 




1,228 


Malignant neoplasms of respiratory & intrathoracic organs 


160-165 




1,206 


Diseases of pulmonary circulation & other forms of heart disease 


415-429 




1,029 


Malignant neoplasms of digestive organs & peritoneum 


150-159 




767 


Malignant neoplasms of the bone, skin, oral cavity, rare sites & other 


140-149,170-173,190-203 




75 - 84 years old 


4,479 


Ischemic heart disease 


410-414 




1,654 


Diseases of pulmonary circulation & other forms of heart disease 


415-429 




1,278 


Cerebrovascular disease 


430-438 




961 


Malignant neoplasms of digestive organs & peritoneum 


150-159 




849 


Malignant neoplasms of respiratory & intrathoracic organs 


160-165 




85+ years old 


4,038 


Ischemic heart disease 


410-414 




1,887 


Diseases of pulmonary circulation & other forms of heart disease 


415-429 




1,471 


Cerebrovascular disease 


430-438 




1,239 


Pneumonia and influenza 


480-487 




552 


Malignant neoplasms of digestive organs and peritoneum 


150-159 





'More complete information on causes of infant death is found in Table D-4. 



75 



TABLE C-4 

RESIDENT DEATHS BY AGE, SEX AND RACE 

MASSACHUSETTS RESIDENTS 

1988 



AGE 


TOTAL 


WHITE 


BLACK 


OTHER 


TOTAL 


HALE 


FEMALE 


TOTAL 


MALE 


FEMALE 


TOTAL 


MALE 


FEMALE 


TOTAL 


MALE 


FEMALE 


TOTAL* 


56,407 


27,282 


29,120 


54,224 


26,081 


28,140 


1,909 


1,044 


864 


254 


151 


103 


0-4 


796 


469 


327 


628 


375 


253 


149 


83 


66 


17 


11 


6 


5-9 


79 


47 


32 


63 


36 


27 


13 


8 


5 


3 


3 


-- 


10-14 


57 


37 


20 


48 


34 


14 


7 


3 


4 


2 


-- 


2 


15-19 


271 


194 


77 


233 


164 


69 


34 


28 


6 


3 


2 


1 


20-24 


421 


324 


97 


364 


281 


83 


51 


38 


13 


6 


5 


1 


25-29 


568 


414 


154 


488 


359 


129 


70 


47 


23 


10 


8 


2 


30-34 


593 


425 


168 


500 


362 


138 


82 


53 


29 


11 


10 


1 


35-39 


761 


555 


206 


674 


492 


182 


83 


60 


23 


4 


3 


1 


40-44 


900 


595 


305 


798 


529 


269 


91 


59 


32 


9 


6 


3 


45-49 


1,144 


709 


435 


1,034 


646 


388 


101 


58 


43 


8 


5 


3 


50-54 


1,495 


929 


566 


1,388 


865 


523 


94 


56 


38 


13 


8 


5 


55-59 


2,470 


1,455 


1,015 


2,335 


1,388 


947 


121 


61 


60 


12 


5 


7 


60-64 


3,942 


2,428 


1,514 


3,763 


2,309 


1,454 


149 


97 


52 


29 


21 


8 


65-69 


5,494 


3.175 


2,319 


5,292 


3,063 


2,229 


176 


94 


82 


25 


18 


7 


70-74 


7,099 


3,981 


3,118 


6,895 


3,871 


3,024 


180 


98 


82 


22 


11 


11 


75-79 


7,771 


3,962 


3,809 


7,587 


3,874 


3,713 


153 


73 


80 


28 


14 


14 


80-84 


8,232 


3,411 


4,821 


8,068 


3,345 


4,723 


146 


57 


89 


16 


9 


7 


85-89 


7,232 


2,423 


4,809 


7,112 


2,380 


4,732 


102 


34 


68 


17 


8 


9 


90-94 


4,799 


1,307 


3,492 


4,721 


1,276 


3,445 


67 


29 


38 


11 


2 


9 


95-99 


1,906 


384 


1,522 


1,871 


377 


1,494 


28 


6 


22 


6 


1 


5 


>100 


372 


58 


314 


359 


55 


304 


11 


2 


9 


2 


1 


1 



*The total includes 
Unknown Race total 



5 male deaths of unknown age--three in the White total, one in the Black total, and one in 
The total also includes 19 deaths of unknown race--6 males and 13 females. 



76 





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77 



TABLE C-6 
MALIGNANT NEOPLASM DEATHS BY UNDERLYING CAUSE AND MENTIONED CONDITIONS 
MASSACHUSETTS RESIDENTS 









1988 










Mentioned Conditions 


Underlying Cause 


Total 


Digestive 
Organs & 
Peritoneum 
(150-159) 


Respiratory 

& Intrathoracic 

Organs 

(160-165) 


Bone, Con- 
nective Tissue, 
Skin & Breast 
(170-175) 


Genito- 
urinary 
Organs 
(179-189) 


Lymphatic 
& Haemato- 
poietic Tissue 
(200-208) 


All Other 
Mai ignant 
Neoplasms 


Total Mentioned 
Conditions 


30,047 


7,636 


7,768 


3,559 


4,493 


2,821 


3,770 


Mean Number of 
Mentioned Conditions 
Per Record 


2.29 


2.27 


2.26 


2.18 


2.36 


2.49 


2.26 


Deaths 


13,142 


3,369 


3,436 


1,635 


1,902 


1,131 


1,669 


1. Malignant Neo- 
plasms (140-208) 


16,535 


4,275 


4,268 


2,206 


2,447 


1,236 


2,103 


2. Diabetes 

Mellitus (250) 


472 


149 


100 


55 


65 


51 


52 


3. Diseases of the 
Heart (390-398, 
402, 404-429) 


3,600 


885 


928 


398 


559 


331 


499 


4. Cerebrovascular 
Disease (430-438) 


291 


64 


70 


24 


57 


39 


37 


5. Atherosclerosis 
(440) 


46 


17 


15 


5 


4 


4 


1 


6. Pneumonia & 

Influenza (480-487) 


842 


132 


309 


75 


108 


133 


85 


7. COPD 

(490-496) 


605 


82 


343 


27 


64 


27 


62 


B. Other Respiratory 
Disease (460-466, 
470-478, 500-508, 
510-519) 


463 


101 


148 


38 


57 


46 


73 


9. Chronic Liver 
Disease & Cir- 
rhosis (571) 


75 


37 


11 


3 


5 


7 


12 


10. Unintentional 
Injuries (E800- 
E949) 


226 


63 


54 


25 


28 


40 


16 


11. All Other 
Causes 


6,892 


1,831 


1,522 


703 


1,099 


907 


830 



78 



TABLE C-7 

ATHEROSCLEROSIS, HYPERTENSIVE DISEASE AND DIABETES 

UNDERLYING CAUSE AND MENTIONED CONDITIONS BY AGE GROUP AND SEX 

MASSACHUSETTS RESIDENTS 

1988 









Atherosclerosis 


Hypertensive Disease 


Diabetes Mellitus 










(440) 






(401-405) 






(250) 




Under- 




Total 


Under- 




Total 


Under- 




Total 






# of 


lying 


Ment i oned 


X of 


lying 


Mentioned 


X of 


lying 


Mentioned 


X of 


Age 


Sex 


Deaths 


Cause 


Conditions 


Deaths 


Cause 


Conditions 


Deaths 


Cause 


Conditions 


Deaths 




Total 


56,407* 


630 


1,516 


2,146 
3.8 


610 


2,646 


3,256 
5.8 


921 


3,443 


4,364 
7.7 




Male 


27,287 


222 


593 


815 
3.0 


255 


1,011 


1,266 
4.6 


419 


1,527 


1,946 
7.1 




Female 


29,120 


408 


923 


1,331 
4.6 


355 


1,635 


1,990 
6.8 


502 


1,916 


2,418 
8.3 


0-39 


Total 


3,546 


-- 


5 


5 

0.1 


3 


15 


18 
0.5 


23 


21 


44 
1.2 




Male 


2,465 




2 


2 

0.1 


3 


10 


13 
0.5 


15 


14 


29 

1.2 




Female 


1,081 




3 


3 

0.3 




5 


5 

0.5 


8 


7 


15 
1.4 


40-49 


Total 


2,044 


2 


12 


14 
0.7 


15 


59 


74 
3.6 


38 


65 


103 
5.0 




Male 


1,304 


2 


10 


12 
0.9 


11 


44 


55 
4.2 


23 


40 


63 

4.8 




Female 


740 




2 


2 

0.3 


4 


15 


19 
2.6 


15 


25 


40 
5.4 


50-59 


Total 


3,965 


14 


38 


52 
1.3 


55 


149 


204 
5.1 


59 


220 


279 
7.0 




Male 


2,384 


10 


29 


39 

1.6 


41 


89 


130 
5.4 


38 


126 


164 
6.9 




Female 


1,581 


4 


9 


13 
0.8 


14 


60 


74 
4.7 


21 


94 


115 
7.3 


60-69 


Total 


9,436 


44 


161 


205 
2.2 


107 


460 


567 
6.0 


185 


729 


914 
9.7 




Male 


5,603 


26 


103 


129 
2.3 


66 


256 


322 
5.7 


93 


386 


479 
8.5 




Female 


3,833 


18 


58 


76 
2.0 


41 


204 


245 
6.4 


92 


343 


435 

11.4 


70-79 


Total 


14,870 


110 


369 


479 
3.2 


148 


802 


950 
6.4 


293 


1,106 


1.399 
9.4 




Male 


7,943 


56 


186 


242 
3.0 


66 


392 


458 
5.8 


141 


553 


694 
8.7 




Female 


6.927 


54 


183 


237 
3.4 


82 


410 


492 
7.1 


152 


553 


705 
10.2 


>80 


Total 


22,541 


460 


931 


1.391 
6.2 


282 


1,161 


1,443 
6.4 


323 


1,302 


1,625 
7.2 




Male 


7,583 


128 


263 


391 
5.2 


68 


220 


288 
3.8 


109 


408 


517 
6.8 




Female 


14,958 


332 


668 


1.000 
6.7 


214 


941 


1,155 
7.7 


214 


894 


1,108 
7.4 



*Total includes 5 deaths of unknown age. 
--Indicates zero events. 



79 



TABLE C-8 

SUICIDES BY CAUSE, SEX AND AGE 

MASSACHUSETTS RESIDENTS 

1988 











Age 


UNDERLYING 


























CAUSE 


ICD-9 




TOTAL 


10-14 


15-19 


20-29 


30-39 


40-49 


50-59 


60-69 


70-79 


>80 


All Suicides 


E950- 


M 


373 


1 


26 


98 


80 


64 


34 


31 


20 


19 




E958 


F 


127 





9 


21 


23 


25 


23 


10 


6 


10 






I 


500 


1 


35 


119 


103 


89 


57 


41 


26 


29 






X 


100.0 


100.0 


100.0 


100.0* 


100.0 


100.0 


100.0 


100.0 


100.0 


100.0* 


Poisoning by 


E950 


M 


19 


-- 


-- 


3 


8 


2 


2 


4 


-- 


-- 


sol id or 




F 


44 


-- 


4 


7 


7 


10 


8 


3 


2 


3 


I iquid 




T 


63 


-- 


4 


10 


15 


12 


10 


7 


2 


3 


substances 




X 


12.6 


-- 


11.4 


8.4 


14.6 


13.5 


17.5 


17.1 


7.7 


10.3 


Gases in 


E951 


A 


1 


-- 


-- 


1 


-- 


-- 


-- 


-- 


-- 


-- 


domestic use 




F 
T 

X 


1 
0.2 


-- 


-- 


1 
0.8 


-- 


-- 


-- 


-- 


-- 


-- 






-- 


-- 


-- 


-- 


-- 


-- 


-- 


-- 


Poisoning by 


E952 


A 


56 


-- 


5 


11 


12 


14 


5 


2 


5 


2 


gases & vapors 




F 


19 


-- 


3 


2 


2 


2 


6 


1 


2 


1 


(not domestic 




T 


75 


-- 


8 


13 


14 


16 


11 


3 


7 


3 


gas) 




X 


15.0 


-- 


22.9 


37.1 


13.6 


18.0 


19.3 


7.3 


26.9 


10.3 


Hanging, 


E953 


A 


118 


1 


11 


36 


23 


16 


15 


6 


5 


5 


Strangulation 




F 


27 





2 


5 


4 


3 


5 


4 


1 


3 


& Suffocation 




T 


145 


1 


13 


41 


27 


19 


20 


10 


6 


8 






X 


29.0 


100.0 


37.1 


34.4 


26.2 


21.4 


35.1 


24.4 


23.1 


27.6 


Submersion 


E954 


A 


14 


-- 


-- 


2 


1 


2 


-- 


3 


1 


5 


(Drowning) 




F 


8 


-- 


-- 


1 


1 


2 


2 


-- 


-- 


2 






T 


22 


-- 


-- 


3 


2 


4 


2 


3 


1 


7 






X 


4.4 


-- 


-- 


2.5 


1.9 


4.5 


3.5 


7.3 


3.8 


24.1 


Firearms & 


E955 


A 


127 


-- 


7 


36 


26 


25 


10 


12 


6 


5 


Explosives 




F 


18 


-- 


-- 


5 


6 


5 


2 


-- 


-- 


-- 






T 


145 


-- 


7 


41 


32 


30 


12 


12 


6 


5 






X 


29.0 


-- 


20.0 


34.4 


31.1 


33.7 


21.0 


29.3 


23.1 


17.2 


Cutting & 


E956 


A 


16 


-- 


-- 


3 


7 


3 


1 


1 


-. 


1 


Piercing 




F 


4 


-- 


-- 


-- 


2 


1 


-- 


-- 


-- 


1 


Instruments 




T 


20 


-- 


-- 


3 


9 


4 


1 


1 


-- 


2 






X 


4.0 


-- 


-- 


2.5 


8.7 


4.5 


1.8 


2.4 


-- 


6.9 


Jumping from 


E957 


A 


17 


-- 


2 


5 


2 


1 


1 


2 


3 


1 


high places 




F 


6 


-- 


-- 


1 


1 


1 


-- 


2 


1 


-- 






T 


23 


-- 


2 


6 


3 


2 


1 


4 


4 


1 






X 


4.6 


-- 


5.7 


5.0 


2.9 


2.2 


1.8 


9.8 


15.4 


3.4 


Other & 


E958 


A 


5 


.- 


1 


1 


1 


1 


_. 


1 


__ 




Unspecified 




F 


1 


-- 


-- 


-- 


-- 


1 


-- 


-- 


-- 


-- 


Means 




T 


6 


-- 


1 


1 


1 


2 


-- 


1 


-- 


-- 






X 


1.2 


-- 


2.9 


0.8 


1.0 


2.2 


-- 


2.4 


-- 


-- 



•Percents do not sum to 100.0 due to rounding. 
-- Indicates zero events. 



80 



TABLE C-9 

MOTOR VEHICLE DEATHS BY TYPE 

MASSACHUSETTS RESIDENTS 

1988 



Underlying Cause 


ICD-9 




Victim 


Total 


Driver 


Passenger 


Motor- 
cyclist 


Passenger, 
Motorcycle 


Pedestrian 


Pedal 
Cyclist 


Dther & 
Llnspec. 


Total 


E810- 
E825 


M 
X* 


560 
215 
775 

100.0 


254 

87 

341 

100.0 


99 

65 

164 

100.0 


46 

1 

47 

100.0 


3 

3 

100.0 


106 

50 

156 

100.0 


9 

9 

100.0 


43 
12 
55 

100.0 


Col I ision with 
t ra i n 


E810 




2 

2 

0.3 


-- 


-- 


-- 


-- 


-- 


-- 


2 

2 
3.6 


Collision with 
another motor 
vehicle 


E812 




165 

85 

250 

32.3 


107 

44 

151 

44.3 


27 

36 

63 

38.4 


22 

1 

23 

48.9 


-- 


-- 


-- 


9 
4 

13 
23.6 


Col I ision with 
another vehicle 


E813 




9 

9 
1.2 


-- 


-- 


-- 


-- 


-- 


9 

9 

100.0 


-- 


Motor vehicle 
with pedestrian 


E814 




106 

50 

156 

20.1 


-- 


-- 


-- 


-- 


106 

50 

156 

100.0 


-- 


-- 


Other motor 
vehicle 
col I ision/ 
highway 


E815 




175 

44 

219 

28.2 


104 

24 

128 

37.5 


48 

20 

68 

41.5 


19 

19 
40.4 


3 

3 

100.0 


-- 


-- 


1 

1 
1.8 


Lost control 

without 

collision 


E816 


X 


58 

25 

83 

10.7 


36 

16 

52 

15.2 


16 

7 

23 

14.0 


3 

3 

6.4 


-- 


-- 


-- 


3 
2 
5 

9.1 


Other non- 
collision motor 
vehicle 


E818 


X 


8 

8 
1.0 


1 

1 
0.3 


3 

3 

1.8 


1 

1 

2.1 


-- 


-- 


-- 


3 

3 

5.4 


Motor vehicle of 

unspecified 

nature 


E819 


X 


29 

11 

40 

5.2 


6 

3 

9 

2.6 


5 

2 

7 

4.3 


-- 


-- 


-- 


-- 


18 

6 

24 

43.6 


Motor-driven 
snow vehicle 


E820 


X 


3 

3 

0.4 


-- 


-- 


-- 


.-- 


-- 


-- 


3 

3 

5.4 


Other off- road 
motor vehicle 


E821 


X 


5 

5 
0.6 


-- 


-- 


1 

1 

2.1 


-- 


-- 


-- 


4 

4 
7.3 



•Percents may not sum to 
-- indicate zero events. 



100.0 due to rounding. 



81 



FIGURE C-3 

Motor Vehicle Deaths 

Age-specific Rates 
Massachusetts: 1988 






0-9 


10-14 


15-19 


20-29 


30-44 


45-54 


55-64 


65+ 


State 
Total 


Male 


4.0 


6.6 


43.2 


37.8 


18.4 


13.5 


14.4 


23.7 


20.3 


Female 


1.5 


1.1 


13.9 


7.4 


5.2 


6.5 


7.3 


12.4 


6.9 


Total 


2.6 


3.9 


28.4 


22.1 


11.6 


9.8 


10.5 


16.5 


13.2 



Age-specific populations are estimated by the Massachusetts Department of Public Health based on 1980 census 
counts and 1990 projections from the Massachusetts Institute for Social and Economic Research (MISER). 



82 





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83 



FIGURE C-4 



Heart Disease Deaths by Race and Sex 

Age-adjusted Rates 
Massachusetts: 1970 - 1988 



400t 



300- 



200- 



100- 




1970 



1975 



1980 



1985 



y/- 



1988 



-m- Black Males -°- White Males 
-•- Black Females -o- White Females 



84 



TABLE C-11 

MALIGNANT NEOPLASM DEATHS 

AGE-ADJUSTED RATES 

MASSACHUSETTS RESIDENT DEATHS 

1988 



Cause 



Total Deaths 



Total Malignant Neoplasm Deaths (Underlying Cause) 



Esophagus 

Stomach 

Colon, rectum, rectosigmoid junction, and anus 

Pancreas 

Trachea, bronchus, and lung 

Female breast 

Ovary and other uterine adnexa 

Prostate 

Brain 

Lymphosarcoma & reticulosarcoma, Hodgkin's disease, and 
other malignant neoplasms of lymphoid & histiocytic tissue 

All other malignant neoplasms 



I CD -9 



140-208 



150 

151 

153-154 

157 

162 

174 

183 

185 

191 

200-202 
Residual 



Total 



Rate 



533.3 



137.8 



3.1 

4.1 
15.7 

5.9 
36.4 
25.5 

6.9 
15.5 

3.5 

5.1 
39.8 



Number 



56,407 



13,142 



284 

416 

1,673 

600 

3,309 

1,285 

346 

710 

274 

493 
3,752 



Male 



Rate 



704.3 



171.2 



5.3 
5.6 

20.2 
6.9 

54.9 



Number 



27,287 



6,560 



15.5 

4.0 

6.8 
52.0 



188 
217 
811 
262 
2,058 



Female 



Rate 



Number 



409.2 



117.4 



710 
131 

246 
1,937 



1.5 

3.0 
12.9 

5.1 
24.0 
25.5 

6.9 

3.2 

3.9 
31.5 



29,120 



6,582 



96 
199 
862 
338 
1,251 
1,285 
346 

143 

247 
1,815 



■Indicates zero events. 



85 



TABLE C-12 

MEDICAL EXAMINER CERTIFIED DEATHS 

BY CAUSE, RACE, SEX AND AGE 

MASSACHUSETTS OCCURRENCE 

1988 







Total 


Motor 






Legal 


All Other 




1 1 1 -Defined 






Deaths 


Vehicle 






Intervention/ 


Injuries 


Non-violent 


& Unknown 






Certified 


Injuries 


Suicide 


Homicide 


Undeter. Inj. 


(E800-E807, 


Causes 


Causes 


AGE 


RACE/SEX 


by M.E. 


(E810-E825) 


(E950-E959) 


(E960-E969) 


(E970-E999) 


E826-E949) 


(000-778) 


(780-796) 




White M 


5,411 


503 


364 


89 


134 


347 


3,764 


210 






3,367 


199 


118 


49 


36 


197 


2,661 


107 


Total 


Non-W M 


436 


35 


15 


76 


17 


37 


207 


49 






215 


8 


7 


16 


5 


12 


144 


23 




Total* 


9,430* 


745 


504 


230 


193* 


593** 


6,776*** 


389** 




White M 


70 


1 


-- 


3 


-- 


2 


16 


48 






36 


1 


-- 


3 


-- 


3 


9 


20 


<1 


Non-W M 


26 


-- 


-- 


2 


-- 


1 


7 


16 






19 


-- 


-- 


-- 


-- 


-- 


6 


13 




Total 


151 


2 


-- 


8 


-- 


6 


38 


97 




White M 


22 


6 


-- 


3 


-- 


7 


5 


1 






18 


2 


-- 


2 


1 


9 


2 


2 


1-4 


Non-W M 


8 


2 


-- 


2 


-- 


3 


1 


-- 






2 




-- 


-- 


-- 


1 


1 


-- 




Total 


50 


10 


-- 


7 


1 


20 


9 


3 




White M 


23 


5 


-- 


2 


-- 


10 


4 


2 






11 


3 


-- 


-- 


-- 


5 


2 


1 


5-9 


Non-W M 


11 


1 


-- 


2 


-- 


7 


1 


-- 






3 


1 


-- 


-- 


-- 


2 


-- 


-- 




Total 


48 


10 


-- 


4 


-- 


24 


7 


3 




White M 


19 


11 


1 


-- 


-- 


3 


3 


1 






5 


2 


-- 


1 


1 


1 


-- 


-- 


10-14 


Non-W M 


3 


-- 


-- 


-- 


-- 


2 


-- 


1 






3 


1 


-- 


1 


-- 


-- 


-- 


1 




Total 


30 


14 


1 


2 


1 


6 


3 


3 




White M 


148 


85 


29 


3 


6 


14 


8 


3 






50 


23 


9 


4 


3 


7 


3 


1 


15-19 


Non-W M 


26 


2 


2 


17 


2 


2 


1 


-- 






6 


2 


-- 


-- 


1 


2 


1 


-- 




Total 


230 


112 


40 


24 


12 


25 


13 


4 




White M 


472 


157 


89 


35 


40 


60 


51 


40 






131 


33 


18 


19 


10 


14 


22 


15 


20-29 


Non-W M 


69 


11 


4 


33 


6 


4 


4 


7 






23 


3 


3 


6 


-- 


3 


4 


4 




Total 


695 


204 


114 


93 


56 


81 


81 


66 




White M 


506 


76 


76 


20 


62 


63 


147 


62 






121 


21 


20 


11 


8 


10 


34 


17 


30-39 


Non-W M 


71 


11 


6 


14 


5 


4 


18 


13 






19 


-- 


2 


5 


1 


-- 


7 


4 




Total 


717 


108 


104 


50 


76 


77 


206 


96 




White M 


247 


31 


35 


6 


9 


23 


123 


20 






84 


14 


8 


2 


2 


11 


38 


9 


40-44 


Non-W M 


34 


3 


2 


-- 


2 


3 


19 


5 






10 


-- 


2 


4 


1 


-- 


2 


1 




Total 


375 


48 


47 


12 


14 


37 


182 


35 




White M' 


270 


17 


31 


3 


3 


18 


185 


13 






87 


8 


15 


1 


4 


5 


46 


8 


45-49 


Non-W M 


23 

8 
388 


2 


-- 


4 


1 


1 


11 

8 

250 


4 




Total 


27 


46 


8 


8 


24 


25 



•Total includes one male of unknown race and age. 

"Total for this category includes one white male of unknown age. 

***Total for this category includes one white male and one non-white male of unknown age. 

Of the 651 non-white deaths certified by medical examiners, 579 were black and 72 were classified as Asian 
or other. 



-- Indicates zero events. 



86 



TABLE C-12 (continued) 

MEDICAL EXAMINER CERTIFIED DEATHS 

BY CAUSE, RACE, SEX AND AGE 

MASSACHUSETTS OCCURRENCE 

1988 







Total 


Motor 






Legal 


All Other 




Ill-Defined 






Deaths 


Vehicle 






Intervention/ 


Injuries 


Non-violent 


& Unknown 






Certified 


Injuries 


Suicide 


Homicide 


Undeter. Inj. 


(E800-E807, 


Causes 


Causes 


AGE 


RACE/SEX 


by M.E. 


(E810-E825) 


(E950-E959) 


(E960-E969) 


(E970-E999) 


E826-E949) 


(000-778) 


(780-796) 




White M 


263 


18 


18 


2 


4 


14 


204 


3 






97 


12 


10 


1 


1 


2 


64 


7 


50-54 


Non-U M 


20 


1 


-- 


-- 


-- 


1 


18 








14 


-- 


-- 


-- 


1 


-- 


13 


-. 




Total 


394 


31 


28 


3 


6 


17 


299 


10 




Uh i te M 


400 


14 


15 


5 


3 


17 


343 


3 






175 


13 


12 


1 


1 


5 


139 


4 


55-59 


Non-U M 


26 


-- 


-- 


2 


1 


4 


18 


1 






11 


-- 


-- 


-- 


-- 


-- 


11 


.- 




Total 


612 


27 


27 


8 


5 


26 


511 


8 




White M 


544 


18 


14 


2 


2 


20 


484 


4 






200 


9 


3 


1 


1 


11 


167 


8 


60-64 


Non-W M 


33 


-- 


1 


-- 


-- 


-- 


31 


1 






9 


-- 


-- 


-- 


-- 


-. 


9 






Total 


786 


27 


18 


3 


3 


31 


691 


13 




White M 


580 


16 


17 


2 


2 


10 


531 


2 






325 


14 


6 


1 


1 


14 


289 




65-69 


Non-W M 


34 


1 


-- 


-- 


-- 


1 


32 








19 


-- 


-- 


-- 


-- 


-- 


19 






Total 


958 


31 


23 


3 


3 


25 


871 


2 




White M 


584 


14 


13 


2 


2 


20 


529 


4 






403 


16 


4 


1 


1 


17 


360 


A 


70-74 


Non-W H 


21 


-- 


-- 


-- 


-- 


1 


20 








15 


-- 


-- 


-- 


1 


1 


13 






Total 


1,023 


30 


17 


3 


4 


39 


922 


8 




White M 


516 


11 


7 


1 


1 


14 


481 


1 






448 


11 


3 


-- 


-- 


20 


410 


4 


75-79 


Non-W M 


10 


-- 


-- 


-- 


-- 


-- 


10 








18 


-- 


-- 


-- 


-- 


1 


17 






Total 


992 


22 


10 


1 


1 


35 


918 


5 




White M 


744 


23 


19 


-- 


-- 


51 


649 


2 






1,176 


17 


10 


1 


2 


63 


1,076 


7 


>80 


Non-W M 


20 


1 


-- 


-- 


-- 


3 


15 


1 






36 


1 


-- 


-- 


-- 


2 


33 






Total 


1,976 


42 


29 


1 


2 


119 


1,773 


10 



87 



FIGURE C-5 



Malignant Neoplasm Deaths by Race and Sex 

Age-adjusted Rates 
Massachusetts: 1970 - 1988 

250t 



2004 
150 
100- 
50- 




-o- 



-o- 



-a 




1970 



1975 



1980 



1985 



7*^ 

1988 



-*■ Black Males -°- White Males 
-•- Black Females -o- White Females 



88 



FIGURE C-6 



PROPORTION OF DEATHS CERTIFIED BY MEDICAL 
EXAMINER FOR SPECIFIC CAUSES OF DEATH 

OCCURRENCE DEATHS 

MASSACHUSETTS:! 988 



Diseases of the Heart 



Malignant Neoplasms 

Chronic Obstructive 
Pulmonary Disease 

Injuries: (icd-9: 

E800-E949, E970-E999) 

Suicides & Homicides 



Pneumonia/Influenza 



22.9% 




99.7% 



20 40 60 80 

Percent of Specific Underlying Cause 



100 



89 



TABLE C-13 

MEDICAL EXAMINER CERTIFIED DEATHS BY COUNTY 

MASSACHUSETTS OCCURRENCE 

1988 



County 




Population 


Occurrence 
Deaths 


Medical 

Examiner 

Certified* 


Referred-- 
Not Cert. 
By M.E.* 


Natural 
Cause Deaths 
Cert, by M.E.** 


TOTAL 


# 
X 
R 


5,860,283 
100.0+ 


57,024 
100.0+ 


9,430 
16.5 


6,743 

11.8 


6,776 
71.9 


Barnstable 


# 
X 
R 


177,407 

3.0 

9 


2,123 

3.7 

9 


443 

20.9 

2 


150 
7.1 

11 


353 

79.7 
5 


Berkshire 


# 
X 
R 


141,188 

2.4 

11 


1,617 
2.8 

10 


222 

13.7 

9 


229 

14.2 

4 


126 

56.8 

12 


Bristol 


# 
X 
R 


490,518 

8.4 

6 


4,496 
7.9 

7 


844 

18.8 

5 


373 
8.3 

9 


634 

75.1 

6 


Dukes 


# 
X 
R 


11,378 

0.2 

13 


92 

0.2 

13 


15 

16.3 

7 


2 
2.2 

13 


12 

80.0 

4 


Essex 


# 
X 
R 


645,672 

11.0 

4 


6,125 

10.7 

4 


1,181 

19.3 

4 


275 

4.5 

12 


946 

80.1 
3 


Franklin 


# 
X 
R 


66,619 

1.1 
12 


612 

1.1 

12 


85 

13.9 
8 


66 

10.8 
7 


58 

68.2 

9 


Hampden 


n 

X 
R 


441,172 
7.5 

7 


5,081 
8.9 

5 


686 

13.5 

10 


752 

14.8 

3 


440 

64.1 

11 


Hampshire 


# 

X 
R 


146,512 
2.5 

10 


873 

1.5 

11 


108 

12.4 

12 


114 

13.1 

5 


70 

64.8 

10 


Middlesex 


# 
X 
R 


1,366,365 
23.3 

1 


11,352 

19.9 

1 


2,344 

20.6 

3 


914 

8.1 

10 


1,927 
82.2 

1 


Nantucket 


# 
X 
R 


6,116 

0.1 

14 


61 

0.1 

14 


10 

16.4 

6 




0.0 

14 


7 

70.0 

8 


Norfolk 


# 
X 
R 


603,952 

10.3 

5 


4,733 

8.3 

6 


660 

13.9 

8 


592 

12.5 

6 


468 
70.9 

7 


Plymouth 


# 
X 
R 


440,583 

7.5 

8 


3,146 

5.5 

8 


818 

26.0 

1 


325 

10.3 

8 


667 

81.5 

2 


Suffolk 


tt 
X 
R 


660,401 

11.3 

3 


10,059 

17.6 

2 


1,330 

13.2 

11 


1,772 

17.6 
2 


721 
54.2 

13 


Worcester 


# 
X 
R 


662,400 

11.3 

2 


6,654 

11.7 

3 


684 

10.3 

13 


1,179 

17.7 

1 


347 

50.7 
14 



•The percentage and rank in the Medical Examiner Certified Deaths and the Referred-- 
Not Certified by Medical Examiner columns are based on the totals in the Occurrence 
Deaths Columns. 

"The percentage and rank of natural cause deaths certified by medical examiners is 
based on the total number of medical examiner certified deaths for the county. 

♦Percents do not sum to 100.0 due to rounding. 



90 



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116 



NEONATAL AND INFANT 

MORTALITY 



SECTION D 
INFANT AND NEONATAL DEATHS 

The total number of resident infant deaths (deaths less than 1 year of age) increased by 14.0% in 
Massachusetts from 608 In 1987 to 693 in 1988. The rate of Infant deaths also increased from 7.2 
per 1,000 live births In 1987 to 7.9 In 1988. As with live births and other deaths, all Massachusetts 
resident Infant deaths are Included regardless of the state in which they occurred. Neonatal deaths 
(deaths under 28 days of age) also Increased, from 432 in 1987 to 477 in 1988, an increase of 10.4%. 
The rate of neonatal deaths per 1,000 live births showed an Increase from 5.1 in 1987 to 5.4 in 1988. 

INFANT DEATHS BY RACE 

In 1988, the white Infant mortality rate was 7.1 per 1,000 live births, an Increase from the 1987 rate 
of 6.6. The black Infant mortality rate was 17.2, reflecting an Increase from the 1987 rate of 15.5. The 
neonatal mortality rate for white infants was 5.0 deaths per 1,000 live births, and the neonatal 
mortality rate for black infants was 11.3 per 1,000 live births. 

INFANT DEATHS BY AGE 

Of all Infant deaths, 46.8% occurred within the first 24 hours of life and 59.0% within the first week 
of life. 

INFANT DEATHS BY CAUSE 

The leading cause of infant deaths was certain conditions originating In the perinatal period (medical 
conditions arising from approximately 28 weeks gestation to 28 days of age). These deaths 
accounted for 53.5% of all infant deaths in 1988, a slight decrease from the 1987 percentage of 
54.1%. The second leading cause of Infant deaths was congenital anomalies, which accounted for 
19.8% of infant deaths. The third leading cause of Infant deaths was sudden infant death syndrome 
(SIDS), which Increased in number from 57 infant deaths in 1987 (9.4% of all Infant deaths) to 79 
Infant deaths In 1988 (11.4% of all infant deaths). 

NEONATAL MORTALITY BY BIRTHWEIGHT 

Neonatal mortality Is highly correlated to low blrthweight. Low birthweight babies (under 2,500 grams 
or 5 pounds, 8 ounces) accounted for 6.0% of all babies born In Massachusetts in 1988. 

DEFINITIONS IMPORTANT FOR THIS SECTION INCLUDE: 

INFANT DEATH 

Death of a child whose age Is less than one year (365 days). 

NEONATAL DEATH 

Death of a child whose age is less than 28 days. 



119 



FETAL DEATH 

A fetal death Is a death prior to the complete expulsion or extraction from Its mother of a product of 
conception, irrespective of the duration of the pregnancy; the death is indicated by the fact that after 
such separation the fetus does not breathe or show any other evidence of life, such as the beating 
of the heart, pulsation of the umbilical cord, or definite movement of the voluntary muscles. 

Massachusetts law requires that fetal deaths of 20 or more weeks gestation or of a weight of at least 
350 grams be reported; therefore, the fetal deaths referred to in this report are of that gestational age 
or weight. 

RATES IMPORTANT FOR THIS SECTION INCLUDE: 

INFANT MORTALITY RATE (IMR) 

Number of Resident Deaths at Less than 1 Year of Age x 1,000 
Total Resident Live Births 

NEONATAL MORTALITY RATE (NMR) 

Number of Resident Deaths at Less Than 28 Days of Age x 1,000 
Total Resident Live Births 



120 



FIGURE D-l 

INFANT MORTALITY RATES 

MASSACHUSETTS 
1980-1988 




1980 1981 1982 1983 1984 1985 1986 1987 1988 



White I Black 



FIGURE D-2 

NEONATAL MORTALITY RATES 

MASSACHUSETTS 
1980 - 1988 

144 14.2 



11.3 




1980 1981 1982 1983 1984 1985 1986 1987 1988 



White I Black 



121 



TABLE D-1 

RESIDENT INFANT AND NEONATAL DEATHS 

MASSACHUSETTS AND UNITED STATES RESIDENT DEATHS 

1970-1988 





Death 


s Under One Year 




Deaths Under 28 Days 




Number of 
Massachusetts 


Rate Per 1.00C 


Live Births 


Number of 


Rate Per 1.00C 


Live Births 








Massachusetts 






Year 


Infant Deaths 


Massachusetts 


United States 


Neonatal Deaths 


Massachusetts 


United States 


1970 


1,583 


16.9 


20.0 


1,231 


13.1 


15.1 


1971 


1,462 


16.8 


19.1 


1,130 


13.0 


14.2 


1972 


1,164 


15.1 


18.5 


896 


11.6 


13.6 


1973 


1,104 


15.2 


17.7 


861 


11.9 


13.0 


1974 


976 


13.9 


16.7 


763 


10.8 


12.3 


1975 


903 


13.2 


16.1 


678 


9.9 


11.6 


1976 


799 


12.1 


15.2 


585 


8.9 


10.9 


1977 


806 


11.8 


14.1 


616 


9.1 


9.9 


1978 


753 


11.0 


13.8 


552 


8.1 


9.5 


1979 


760 


10.8 


13.1 


564 


8.0 


8.9 


1980 


748 


10.3 


12.6 


550 


7.6 


8.5 


1981 


710 


9.6 


11.9 


510 


6.9 


8.0 


1982 


764 


10.1 


11.5 


573 


7.6 


7.7 


1983 


682 


9.0 


11.2 


482 


6.3 


7.3 


1984 


699 


8.9 


10.8 


472 


6.0 


7.0 


1985 


745 


9.1 


10.6 


538 


6.6 


7.0 


1986 


695 


8.4 


10.4 


478 


5.8 


6.7 


1987 


608 


7.2 


10.0+ 


432 


5.1 


6.5 


1988 


693 


7.9 


9.9* 


477 


5.4 


6.4* 



♦Revised. 



♦Provisional . 



122 



TABLE D-2 

TRENDS IN INFANT AND NEONATAL MORTALITY 

BY RACE OF INFANT 

MASSACHUSETTS RESIDENT DEATHS 

1980-1988 

INFANT 





Deaths Under One Year 


Total 


Race 


White 


Black 


Other 


Year 


Number 


Rate 


Number 


Rate 


Number 


Rate 


Number 


Rate 


1980 


748 


10.3 


655 


9.9 


87 


16.6 


5 


4.0 


1981 


710 


9.6 


616 


9.2 


85 


16.0 


8 


5.3 


1982 


764 


10.1 


656 


9.6 


102 


19.0 


5 


2.9 


1983 


682 


9.0 


579 


8.4 


89 


16.8 


12 


6.6 


1984 


699 


8.9 


601 


8.5 


82 


14.7 


13 


6.6 


1985 


745 


9. 1 


608 


8.2 


126 


21.3 


11 


5.3 


1986 


695 


8.4 


560 


7.6 


123 


19.7 


11 


4.0 


1987 


608 


7.2 


486 


6.6 


110 


15.5 


12 


3.9 


1988 


693 


7.9 


546 


7.1 


133 


17.2 


13 


3.4 



NEONATAL 







Deaths Under 28 Days 






Total 


Race 


White 


Black 


Other 


Year 


Number 


Rate 


Number 


Rate 


Number 


Rate 


Number 


Rate 


1980 


550 


7.6 


483 


7.3 


62 


11.9 


5 


4.0 


1981 


510 


6.9 


442 


6.6 


59 


11.1 


5 


3.3 


1982 


573 


7.6 


494 


7.2 


75 


13.9 


3 


* * 


1983 


482 


6.3 


411 


6.0 


63 


11.9 


7 


3.8 


1984 


472 


6.0 


411 


5.8 


49 


8.8 


8 


4.0 


1985 


538 


6.6 


447 


6.0 


85 


14.4 


5 


2.4 


1986 


478 


5.8 


383 


5.2 


89 


14.2 


5 


1.8 


1987 


432 


5.1 


343 


4.6 


80 


11.2 


9 


2.9 


1988 


477 


5.4 


383 


5.0 


87 


11.3 


6 


1.6 



♦♦Calculations based on fewer than 5 events are excluded 

Note: Deaths of infants of unknown race are excluded except for 
the total calculation. Births of infants of unknown race 
are allocated into the race categories according to the 
distribution of births of known races for rate computations 



123 



TABLE D-3 

NEONATAL AND INFANT DEATHS 

BY SELECTED UNDERLYING CAUSES 

MASSACHUSETTS RESIDENT DEATHS 

1988 









Neonatal 


Infant 








<28 


days 


<1 year 


Underlying Cause 


ICD- 


9 


# 


X 


# 


% 


TOTAL 


477 


100.0 


693 


100.0 


Septicaemia 


038 




1 


** 


3 


* * 


Diseases of the Nervous System and Sense Organs 


320 


- 329 





** 


5 


0.7 


Diseases of the Circulatory System 


390 


- 459 


5 


1.0 


16 


2.3 


Diseases of the Respiratory System 


460 


- 519 


1 


#* 


6 


0.9 


Diseases of the Digestive System 


520 


- 579 


1 


** 


7 


1.0 


Congenital Anomalies 


740 


- 759 


102 


21.4 


138 


19.9 


Congenital Anomalies of the Nervous System 


740 


- 742 


9 




14 




Congenital Anomalies of the Heart 


745 


- 746 


37 




56 




Other Congenital Anomalies of the Circulatory System 


747 




5 




7 




Congenital Anomalies of the Respiratory System 


748 




19 




22 




Congenital Anomalies of the Digestive System 


749 


- 751 


1 




2 




Congenital Anomalies of the Musculoskeletal System 


753 


- 756 


23 




23 




Chromosomal Anomalies 


758 




4 




6 




Other and Unspecified Congenital Anomalies 


759 




4 




6 




Certain Conditions Originating in the Perinatal Period 


760 


- 779 


350 


73.4 


371 


53.5 


Newborn Affected by Maternal Complications of Pregnancy 


761 




34 




34 




Newborn Affected by Complications of Placenta, Cord & Membranes 


762 




24 




24 




Disorders Relating to Short Gestation & Unspecified Low Birthweight 


765 




59 




61 




Intrauterine Hypoxia and Birth Asphyxia 


768 




24 




26 




Respiratory Distress Syndrome 


769 




51 




54 




Other Respiratory Conditions 


770 




78 




87 




Infections Specific to the Perinatal Period 


771 




12 




13 




Other & Ill-defined Conditions Originating in the Perinatal Period 


779 




51 




54 




Sudden Infant Death Syndrome 


798. 





4 


** 


79 


11.4 


Injuries 


E800 


- E999 


1 


** 


17 


2.4 


All Other Causes 


Resi 


dual 


13 


2.7 


51 


7.4 



"Calculations based on fewer than five events are excluded. 



124 



TABLE D-4 

INFANT AND NEONATAL DEATHS BY AGE, SEX, AND RACE 

MASSACHUSETTS RESIDENT DEATHS 

1988 





Total 


White 


Black 


Other 


Total 


Male 


c emale 


Total 


Male 


Female 


Total 


Male 


Female 


Total 


Male 


Female 


Total (less than 


























one year)* 


693 


408 


285 


546 


326 


220 


133 


75 


58 


13 


7 


6 


Rate 


7.9 


9.1 


6.6 


7.1 


8.3 


5.9 


17.2 


19.3 


15.2 


3.4 


3.7 


3.1 


Less Than One Day* 


324 


188 


136 


248 


145 


103 


71 


40 


31 


5 


3 


2 


1 Day 


31 


18 


13 


26 


16 


10 


5 


2 


3 


-- 


.. 


.. 


2 Days 


23 


13 


10 


20 


12 


8 


3 


1 


2 


-- 


-- 


-- 


3 Days 


15 


10 


5 


15 


10 


5 














4 Days 


10 


3 


7 


9 


2 


7 


1 


1 










5 Days 


4 


2 


2 


3 


1 


2 


1 


1 










6 Days 


2 


1 


1 


2 


1 


1 














Less Than One Ueek* 


409 


235 


174 


323 


187 


136 


81 


45 


36 


5 


3 


2 


Rate 


4.6 


5.2 


4.0 


4.2 


4.8 


3.6 


10.5 


11.6 


9.4 


1.3 


1.6 


1.0 


7-13 Days 


35 


20 


15 


30 


18 


12 


4 


1 


3 


1 


1 




14-27 Days 


33 


19 


14 


30 


19 


11 


2 


-■ 


2 


-- 


-- 


-- 


Less Than 28 Days* 


477 


274 


203 


383 


224 


159 


87 


46 


41 


6 


4 


2 


Rate 


5.4 


6.1 


4.7 


5.0 


5.7 


4.2 


11.3 


11.8 


10.7 


1.6 


2.1 


1.0 


1 Month 


51 


30 


21 


35 


20 


15 


15 


10 


5 


1 




1 


2 Months 


44 


31 


13 


33 


25 


8 


10 


6 


4 


1 


-- 


1 


3 Months 


26 


16 


10 


23 


14 


9 


2 


1 


1 


1 


1 


-- 


4 Months 


22 


13 


9 


18 


11 


7 


4 


2 


2 


-- 


-- 


-- 


5 Months 


21 


11 


10 


15 


7 


8 


5 


4 


1 


1 


-- 


1 


6 Months 


13 


8 


5 


7 


3 


4 


4 


3 


1 


2 


2 


-- 


7 Months 


7 


5 


2 


6 


4 


2 


1 


1 










8 Months 


14 


7 


7 


11 


7 


4 


2 


-- 


2 


1 


-- 


1 


9 Months 


5 


2 


3 


3 


1 


2 


2 


1 


1 


-- 


-- 


-. 


10 Months 


5 


5 


-- 


5 


5 
















11 Months 


8 


6 


2 


7 


5 


2 


1 


1 











-- Indicates zero events. 

•Total includes one female of unknown race. In calculating the infant mortality rate by race, births 
of unknown race have been allocated to white, black, and other based on their percents of total 
births with reported race. 



125 



MARRIAGES AND DIVORCES 



SECTION E 

MARRIAGES AND DIVORCES 

Marriages and divorces are reported by place of occurrence in Massachusetts. For example, If two 
Boston residents are married in Barnstable, this marriage will be reported by place of occurrence 
(Barnstable) rather than the residence of the couple (Boston). Marriages have traditionally been 
reported in this manner because of the number of couples who live In different communities. 
Additionally, out-of-state residents who marry In Massachusetts are Included In these data. 

Marriages and divorces which Involve Massachusetts residents, but occur In other states, are not 
included In these figures. No system of Interstate exchange exists for these events. Unlike some 
states, Massachusetts marriage and divorce laws neither encourage out-of-state residents to come 
to the state nor discourage residents from using the Massachusetts system by imposing long waiting 
periods, etc. This allows the marriage data to be used to estimate resident marriages. 

In 1988, 49,941 marriages occurred In Massachusetts, compared to 49,034 in 1987, an increase of 
1.8%. The rate of marriages was 8.5 per 1,000 population in 1988, a slight increase from the 1987 rate 
of 8.4. The U.S. rate of marriages per 1,000 population decreased from 9.9 per 1,000 population in 
1987 to 9.7 in 1988. Of the brides, 75.0% had never previously married. This percentage was slightly 
less among the grooms — 73.4%. 

In 1988, 17,676 divorces were granted in Massachusetts, an increase of 4.2% from the 16,994 
divorces granted in 1987. The 1988 rate of divorce per 1,000 population in Massachusetts was 3.0. 
This rate was well below the 1988 U.S. rate of 4.8 divorces per 1,000 population, which did not change 
from the 1987 U.S. rate of divorces per 1,000 population. 

RATES IMPORTANT FOR THIS SECTION INCLUDE: 

MARRIAGE RATE Number of Occurrence Marriages x 1,000 

Total Population 

DIVORCE RATE Number of Occurrence Divorces x 1,000 

Total Population 



129 



TABLE E-l 
MARRIAGES AND DIVORCES BY COUNTY 
MASSACHUSETTS OCCURRENCE 
1988 





Marriages 


Divorces 


STATE 


49,941 


17,676 


Counties 






Barnstable 


2,147 


648 


Berkshire 


1,235 


464 


Bristol 


4,163 


1,730 


Dukes 


290 


49 


Essex 


5,938 


2,109 


Franklin 


545 


237 


Hampden 


3,646 


1,527 


Hampshire 


1,058 


326 


Middlesex 


11,639 


3,997 


Nantucket 


192 


34 


Norfolk 


5,062 


1,311 


Plymouth 


3,437 


1,664 


Suffolk 


4,946 


1,134 


Worcester 


5,643 


2,446 



131 



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132 



TABLE E-2 
MARRIAGES AND DIVORCES AND RATES PER 1,000 POPULATION 
MASSACHUSETTS OCCURRENCE 
1900-1988 



Year 


Marriages 


Divorces 


Number 


Rate 


Number 


Rate 


1900 


24,342 


8.7 


1,258 


0.4 


1905 


27,184 


9.1 


1,554 


0.5 


1910 


30,710 


9.1 


1,929 


0.6 


1915 


31,301 


8.5 


2,252 


0.6 


1920 


38,048 


9.9 


3,647 


1.0 


1925 


31,238 


7.5 


3,395 


0.8 


1930 


27,431 


6.5 


3,746 


0.9 


1935 


30,019 


6.9 


4,081 


0.9 


1940 


44,836 


10.4 


4,502 


1.0 


1945 


38,197 


8.5 


6,833 


1.5 


1950 


41,711 


8.9 


6,365 


1.4 


1955 


35,585 


7.3 


5,601 


1.2 


1960 


34,050 


6.6 


5,592 


1.1 


1965 


38,281 


7.2 


7,728 


1.5 


1970 


47,292 


8.3 


10,818 


1.9 


1975 


42,103 


7.3 


16,460 


2.8 


1980 


46,273 


8.1 


17,873 


3.1 


1981 


47,802 


8.3 


19,502 


3.4 


1982 


48,654 


8.4 


19,531 


3.4 


1983 


48,789 


8.4 


18,477 


3.2 


1984 


50,302 


8.7 


17,123 


3.0 


1985 


49,849 


8.6 


21,573 


3.7 


1986 


49,990 


8.6 


19,809 


3.4 


1987 


49,034 


8.4 


16,994 


2.9 


1988 


49,941 


8.5 


17,676 


3.0 



133 



TABLE E-3 
MARRIAGES BY AGE AND MARITAL STATUS 
MASSACHUSETTS OCCURRENCE 
1988 



DTlTr\D 












Age 


Number 


%* 


Number 


% 


Number 


% 


Number 


% 


TOTAL 


49,941 


100.0- 


- 37,461 


75.0 


1,088 


2.2 


11,392 


22.8 


<20 


2,927 


5.9 


2,909 


5.8 


2 


** 


16 


** 


20-29 


31,068 


62.2 


28,207 


56.5 


59 


0.1 


2,802 


5.6 


30-39 


11,268 


22.6 


5,708 


11.4 


187 


0.4 


5, 373 


10.8 


40-49 


3,253 


6.5 


521 


1.0 


243 


0.5 


2,489 


5.0 


50-59 


896 


1.8 


76 


0.2 


242 


0.5 


578 


1.2 


60-69 


393 


0.8 


35 


0.1 


245 


0.5 


113 


0.2 


>7 


136 


0.3 


5 


** 


110 


0.2 


21 


** 




/-•n r\r\\M 




Tn-f- t 1 








Age 


Number 


% 


Number 


% 


Number 


% 


uivorr 
Number 


% 


TOTAL 


49,941 


100.0 


36,677 


73.4 


1,128 


2.3 


12, 136 


24.3 


<20 


936 


1.9 


935 


1.9 


— 


** 


1 


** 


20-29 


27,974 


56.0 


26,266 


52.6 


17 


** 


1,691 


3.4 


30-39 


13,992 


28.0 


8,531 


17.1 


82 


0.2 


5,379 


10.8 


40-49 


4,342 


8.7 


772 


1.6 


155 


0.3 


3,415 


6.8 


50-59 


1,601 


3.2 


114 


0.2 


252 


0.5 


1,235 


2.5 


60-69 


791 


1.6 


49 


0.1 


387 


0.8 


355 


0.7 


>70 


305 


0.6 


10 


** 


235 


0.5 


60 


0.1 



*A11 percentages are based on the total number of marriages, e.g., single 
brides between the ages of 20 and 29 egual 56.5% of all brides married 
in Massachusetts in 1988. 

**Percentage less than 0.1. 

— Egual to zero events. 

+Percents do not sum to 100.0 due to rounding. 

134 



TABLE E-4 
NUMBER OF MARRIAGES BY AGE OF BRIDE AND AGE OF GROOM 
MASSACHUSETTS OCCURRENCE 
1988 





»^-n r\T< ^•n/lz-.u 


AGE OF 
BRIDE 


TOTAL 


<20 


20-29 


30-39 


40-49 


50-59 


60-69 


>70 


TOTAL 


49,941 


936 


27,974 


13,992 


4,342 


1,601 


791 


305 


<20 


2,927 


650 


2, 186 


82 


8 


1 








20-29 


31,068 


276 


23,296 


6,743 


674 


70 


8 


1 


30-39 


11,268 


10 


2,368 


6,401 


2,083 


343 


57 


6 


40-49 


3,253 





120 


733 


1,440 


755 


189 


16 


50-59 


896 





3 


33 


134 


383 


294 


49 


60-69 


393 





1 





3 


46 


215 


128 


>70 


136 














3 


28 


105 



TABLE E-5 
NUMBER OF MARRIAGES FOR BRIDE BY NUMBER OF MARRIAGES FOR GROOM 

MASSACHUSETTS OCCURRENCE 
1988 







— WTTMRFT? 


OF MARR] 


■ * rpn 






BRIDE 












GROOM 


TOTAL 


TOTAL 


l 


2 


3 


4 


>5 


49,941 


36,676 


11,459 


1,623 


166 


17 


1 


37,458 


31,767 


5,165 


486 


34 


6 


2 


10,695 


4,475 


5,297 


826 


91 


6 


3 


1,588 


390 


906 


257 


31 


4 


4 


172 


41 


81 


41 


8 


1 


>5 


28 


3 


10 


13 


2 






135 



POPULATION 



SECTION F 
POPULATION 



The population data In this section are presented for use In computing rates for small areas and for 
reporting changes over time by municipality and county. They are based primarily on the federal 
census for decennial years, e.g., 1980, and on the Commonwealth census for Intercensal years, e.g., 
1975, and on the Massachusetts Institute for Social and Economic Research (MISER) estimates for 
1985 (see Table F-2). 

Prior to 1985, the Massachusetts State Census method of enumeration differed from the federal 
census. Generally, the state figures excluded non-resident students and military families residing 
in the Commonwealth; they are Included in the U.S. Census definition of resident. 

The Massachusetts population estimates for 1980-1988 (Table F-4) are Interpolations based on the 
1980 federal census and the 1990 population projections provided by MISER. 



139 















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141 



TABLE F-l 

POPULATION BY RACE, AGE AND SEX 

MASSACHUSETTS 

1980 



AGE 



UNDER 1 



1-4 



5-9 



10-14 



15-19 



20-24 



>5-29 



30-34 



35-39 



40-44 



SEX 



TOTAL 



WHITE 



MALE 

FEMALE 

TOTAL 



36,771 
34,959 
71,730 



MALE 

FEMALE 

TOTAL 



136,258 
129,227 
265,485 



MALE 

FEMALE 

TOTAL 



191,602 
183,132 
374,734 



MALE 

FEMALE 

TOTAL 



235,669 
225,663 
461,332 



MALE 

FEMALE 

TOTAL 



274,859 
273,380 
548,239 



MALE 

FEMALE 

TOTAL 



MALE 

FEMALE 

TOTAL 



MALE 

FEMALE 

TOTAL 



MALE 

FEMALE 

TOTAL 



MALE 

FEMALE 

TOTAL 



270,713 
282,189 
552,902 



239,341 
249,834 
489,175 



217,649 
228,746 
446,395 



169,502 
179,050 
348,552 



134,925 
143,823 
278,748 



32,822 
31,174 
63,996 



122,083 
115,440 
237,523 



173,505 
165,337 
338,842 



216,445 
206,831 

423,276 



253,767 
252,117 
505,884 



250,616 
260,612 
511,228 



221,554 
230,586 
452,140 



202,785 
211,798 
414,583 



158,362 
166,127 
324,489 



126,332 
134,182 
260,514 



BIJiCK 



2,076 
1,938 
4,014 



7,454 

7,190 

14,644 



9,866 

9,819 

19,685 



11,636 
11,429 
23,065 



12,934 
13,106 
26,040 



11,558 
12,809 
24,367 



9,952 
11,031 
20,983 



8,306 

9,634 

17,940 



6,577 

7,956 

14,533 



5,013 

5,866 

10,879 



OTHER & UNKNOWN 

1,873 
1,847 
3,720 



6,721 

6,597 

13,318 



8,231 

7,976 

16,207 



7,588 

7,403 

14.991 



8,158 

8,157 

16,315 



8,539 

8,768 

17,307 



7,835 

8,217 

16,052 



6,558 

7,314 
13.872 



4,563 
4,967 
9,530 



3,580 
3,775 
7,355 



142 







TABLE F-l (continued) 






POPULAT RAC 


AGE AND SEX 








MASSACHUSETTS 










1980 






AGE 


SEX 


TOTAL 


WHITE 


BLACK OTHER & UNKNOWN 


45-49 


MALE 


134,444 


127,300 


4,329 


2,815 




FEMALE 


143,817 


135,730 


5,030 


3,057 




TOTAL 


278,261 


263,030 


9,359 


5,872 


50-54 


MALE 


146,211 


139,828 


4,057 


2,326 




FEMALE 


160,363 


152,917 


4,793 


2,653 




TOTAL 


306,574 


292,745 


8,850 


4,979 


55-59 


MALE 


145,603 


140,132 


3,587 


1,884 




FEMALE 


165,392 


159,005 


4,304 


2,083 




TOTAL 


310,995 


299,137 


7,891 


3,967 


60-64 


MALE 


126,323 


122,160 


2,803 


1,360 




FEMALE 


151,061 


145,859 


3,510 


1,692 




TOTAL 


277,384 


268,019 


6,313 


3,052 


65-69 


MALE 


101,023 


98,076 


1,953 


994 




FEMALE 


134,551 


130,398 


2,810 


1,343 




TOTAL 


235,574 


228,474 


4,763 


2,337 


70-74 


MALE 


73,235 


71,293 


1,285 


657 




FEMALE 


113,806 


110,942 


1,892 


972 




TOTAL 


187,041 


182,235 


3,177 


1,629 


75-79 


MALE 


48,145 


46,859 


810 


476 




FEMALE 


89,683 


87,573 


1,441 


669 




TOTAL 


137,828 


134,432 


2,251 


1,145 


80-84 


MALE 


28,513 


27,747 


480 


286 




FEMALE 


63,667 


62,351 


899 


417 




TOTAL 


92,180 


90,098 


1,379 


703 


85 & OVER 


MALE 


20,107 


19,485 


374 


248 




FEMALE 


53,801 


52,706 


772 


323 




TOTAL 


73,908 


72,191 


1,146 


571 


TOTAL 


MALE 


2,730,893 


2,551,151 


105,050 


74,692 




FEMALE 


3,006,144 


2,811,685 


116,229 


78,230 




TOTAL 


5,737,037 


5,362,836 


221,279 


152,922 






(100.0%) 


(93.4%) 


(3.9%) 


(2.7%) 


Source: U.S. 


Bureau of the Census 









143 



FIGURE F - 2 



1980 MASSACHUSETTS POPULATION BY AGE 



20 • 29 YEARS 
1,042,077 (18.2%) 



30 - 39 YEARS 
794,947 (13.8%) 



40 • 49 YEARS 

557,009(9.7%) 



10 - 19 YEARS 
1,009,571 (17.6%) 




0-9 YEARS 

711,949(12.4%) 



70+ YEARS 

490,957 (8.6%) 



50 ■ 59 YEARS 
617,569 (10.8%) 



60 • 69 YEARS 

512,958(8.9%) 



FIGURE F - 3 



1980 MASSACHUSETTS POPULATION BY RACE 



WHITE 

5^62,836(93.5%) 




OTHER 
152,922 (2.6%) 

BLACK 

221,279 (3.9%) 



144 



TABLE F-2 
MASSACHUSETTS POPULATION BY COUNTIES 

1960-1985 




Federal 
1960 


State 
1965 


Federal 
1970 


State 
1975 


Federal 
1980 


Estimate 
1985* 


STATE 


5,148,578 


5,295,281 


5,689,170 


5,789,478 


5,737,037 


5,814,873 


Counties 














Barnstable 


70,286 


73,557 


96,656 


126,481 


147,925 


166,406 


Berkshire 


142,135 


145,597 


149,402 


148,069 


145,110 


142,694 


Bristol 


398,488 


415,242 


444,301 


461,852 


474,641 


484,635 


Dukes 


5,829 


5,948 


6,117 


7,951 


8,942 


10,476 


Essex 


568,831 


608,996 


637,887 


631,627 


633,632 


641,226 


Franklin 


54,864 


57,687 


59,210 


63,420 


64,317 


65,790 


Hampden 


429,353 


435,281 


459,050 


461,659 


443,018 


441,908 


Hampshire 


103,229 


100,065 


123,981 


122,729 


138,813 


143,661 


Middlesex 


1,238,742 


1,280,235 


1,397,268 


1,397,524 


1,367,034 


1,366,744 


Nantucket 


3,559 


3,714 


3,774 


5,559 


5,087 


5,739 


Norfolk 


510,256 


560,137 


605,051 


620,346 


606,587 


605,013 


Plymouth 


248,449 


292,697 


333,314 


377,500 


405,437 


427,488 


Suffolk 


791,329 


706,216 


735,190 


724,703 


650,142 


656,557 


Worcester 


583,228 


609,909 


637,969 


640,058 


646,352 


656,536 


*Source: Massac 


husetts Institute f 


or Social anc 


Economic R( 


ssearch (MIS 


ER). 





145 



TABLE F-3 
MASSACHUSETTS POPULATION BY CITY AND TOWN 

1970 and 1980 



CilylTown 

Abmglon 

Acton 

Acushnet 

Adams 

Agawam 

Alford 

Amesbury 

Amherst 

Andover 

Arlington 

Ashbumham 

Ashby 

Ashfield 

Ashland 

Athol 

Attleboro 

Auburn 

Avon 

Aver 

Barnstable 

Barre 

Becket 

Bedford 

Belchertown 

Bellingham 

Belmont 

Berkley 

Berlin 

Bemardston 

Beverly 

Billenca 

Blackstone 

Blandford 

Bolton 

Boston 

Bourne 

Boxborough 

Boxford 

Boylston 

Braintree 

Brewster 

Bndgewater 

Brimfield 

Brockton 

Brookfield 

Brookline 

Buckland 

Burlington 

Cambndge 

Canton 

Carlisle 

Carver 

Charlemont 

Charlton 

Chatham 

Chelmsford 

Chelsea 

Cheshire 

Chester 

Chesterfield 

Chicopee 

Chilmark 

Clarksburg 

Clinton 



1970 U.S. Census 


1980 U.S. Census 


CilylTown 


1970 U.S. Census 


19X0 U.S. Census 


12,334 


13.517 


Cohasset 


6,954 


7,174 


14,770 


17,544 


Colrain 


1,420 


1,552 


7,767 


8,704 


Concord 


16,148 


16,293 


11,772 


10,381 


Conway 


998 


1,213 


21,717 


26,271 


Cummington 


562 


657 


302 


394 


Dalton 


7,505 


6,797 


11.388 


13,971 


Danvers 


26,151 


24.100 


26,331 


33,229 


Dartmouth 


18,800 


23.966 


23,695 


26,370 


Dedham 


26,938 


25,298 


53,524 


48,219 


Deerfield 


3,850 


4,517 


3,484 


4,075 


Dennis 


6,454 


12,360 


2,274 


2,311 


Dighton 


4,667 


5,352 


1,274 


1,458 


Douglas 


2,947 


3,730 


8,882 


9,165 


Dover 


4,529 


4,703 


11,185 


10,634 


Dracut 


18.214 


21,249 


32,907 


34,196 


Dudley 


8,087 


8,717 


15,347 


14,845 


Dunstable 


1.292- 


1,671 


5,295 


5,026 


Duxbury 


7,636 


11,807 


8.325 


6,993 


Hast Bridgcwater 


8,347 


9,945 


19,842 


30,898 


East Brookfield 


1,800 


1,955 


3,825 


4,102 


East Longmeadow 


13,029 


12,905 


929 


1,339 


Eastham 


2,043 


3,472 


13,513 


13,067 


Easthampton 


13,012 


15,580 


5,936 


8,339 


Easlon 


12,157 


16,623 


13,967 


14,300 


Edgartown 


1,481 


2,204 


28,285 


26,100 


Egremonl 


1,138 


1,311 


2,027 


2,731 


Erving 


1,260 


1,326 


2,099 


2,215 


Essex 


2,670 


2,998 


1,659 


1,750 


Everett 


42,485 


37,195 


38,348 


37,655 


Hairhaven 


16,332 


15.759 


31,648 


36,727 


Fall River 


96,898 


92,574 


6,566 


6,570 


Falmouth 


15,942 


23,640 


863 


1,038 


Fitchburg 


43,343 


39,580 


1.905 


. 2,530 


Florida 


672 


730 


641.071 


562,994 


Foxborough 


14,218 


14,148 


12,636 


13,874 


Framingham 


64,048 


65.113 


1,451 


3,126 


Franklin 


17,830 


18,217 


4.032 


5,374 


Freetown 


4,270 


7,058 


2,774 


3,470 


Gardner 


19,748 


17,900 


35,050 


36,337 


Gay Head 


118 


220 


1,790 


5,226 


Georgetown 


5,290 


5,687 


11,829 


17,202 


Gill 


1,100 


1.259 


1,907 


2,318 


Gloucester 


27,941 


27,768 


89,040 


95,172 


Goshen 


483 


651 


2,063 


2,397 


Gosnold 


83 


63 


58,886 


55,062 


Grafton 


11.659 


11,238 


1,892 


1,864 


Granby 


5,473 


5,380 


21,980 


23,486 


Granville 


1,008 


1,204 


100,361 


95,322 


Great Barrmglon 


7,537 


7,405 


17,100 


18,182 


Greenfield 


18,116 


18,436 


2,871 


3,306 


Groton 


5,109 


6,154 


2,420 


6,988 


Groveland 


5.382 


5,040 


897 


1,149 


Hadley 


3,750 


4,125 


4,654 


6,719 


Halifax 


3,537 


5,513 


4,554 


6,071 


Hamilton 


6,373 


6,960 


31,432 


31,174 


Hampden 


4,572 


4,745 


30,625 


25,431 


Hancock 


675 


643 


3,006 


3,124 


Hanover 


10,107 


11,358 


1,025 


1,123 


Hanson 


7,148 


8,617 


704 


1,000 


Hardwick 


2,379 


2,272 


66,676 


55,112 


Harvard 


12,494 


12,170 


340 


489 


Harwich 


5,892 


8.971 


1,987 


1.871 


Hatfield 


2,825 


3.045 


13,383 


12,771 


Haverhill 


46,120 


46,865 



146 



TABLE F-3 (Continued) 
MASSACHUSETTS POPULATION BY CITY AND TOWN 

1970 and 1980 



City/Town 


1970 U.S. Census 


1980 U.S. Census 


City /Town 


1970 U.S. Census 


1980 U.S. Census 


Hawley 


224 


280 


Montgomery 


446 


637 


Healh 


383 


482 


Mount Washington 


52 


93 


Hingham 


18,845 


20,339 


Nahant 


4,119 


3,947 


Hinsdale 


1,588 


1,707 


Nantucket 


3,774 


5,087 


Holbrook 


11,775 


11,140 


Nalick 


31,057 


29.461 


Holden 


12.564 


13,336 


Needham 


29,748 


27,901 


Holland 


931 


1,589 


New Ashford 


183 


159 


Holliston 


12,069 


12,622 


New Bedford 


101,777 


98,478 


Holyoke 


50,112 


44,678 


New Brainlree 


631 


671 


Hopedale 


4,292 


3,905 


New Marlborough 


1,031 


1,160 


Hopkinton 


5,981 


7,114 


New Salem 


474 


688 


Hubbardston 


1,437 


1,797 


Newbury 


3,804 


4,529 


Hudson 


16,084 


16,408 


Newbury port 


15,807 


15,900 


Hull 


9,961 


9,714 


Newton 


91,066 


83,622 


Hunlinglon 


1,593 


1,804 


Norfolk 


4,656 


6,363 


Ipswich 


10,750 


11,158 


North Adams 


19,195 


18,063 


Kingston 


5,999 


7,362 


North Andover 


16,284 


20,129 


Lakeville 


4,376 


5,931 


North Attleboro 


18,665 


21,095 


Lancaster 


6,095 


6,334 


North Brookfield 


3,967 


4,150 


Lanesborough 


2,972 


3,131 


North Reading 


11,264 


11,455 


Lawrence 


66,915 


63,175 


Northampton 


29,664 


29,286 


Lee 


6,426 


6,247 


North bo rough 


9,218 


10,568 


Leicester 


9,140 


9,446 


Northbridge 


11,795 


12,246 


Lenox 


5,804 


6,523 


Northfield 


2,631 


2,386 


Leominster 


32,939 


34,508 


Norton 


9,487 


12,690 


Leverett 


1,005 


1,471 


Norwell 


7,796 


9,182 


Lexington 


31,886 


29,479 


Norwood 


30,815 


29,711 


Leyden 


376 


498 


Oak Bluffs 


1,385 


1,984 


Lincoln 


7,567 


7,098 


Oakham 


730 


994 


Littleton 


6,380 


6,970 


Orange 


6,104 


6,844 


Longmeadow 


15,630 


16,301 


Orleans 


3,055 


5,306 


Lowell 


94,23 


992,418 


Otis 


820 


963 


Ludlow 


17,580 


18,150 


Oxford 


10,345 


11,680 


Lunenburg 


7,419 


8,405 


Palmer 


11,680 


11,389 


Lynn 


90,294 


78,471 


Paxton 


3,731 


3,762 


Lynnfield 


10,826 


11.267 


Peabody 


48,080 


45,976 


Maiden 


56,127 


53,386 


Pelham 


937 


1,112 


Manchester 


5,151 


5,424 


Pembroke 


11,193 


13,487 


Mansfield 


9,939 


13,453 


Pepperell 


5,887 


8,061 


Marblehead 


21,295 


20,126 


Peru 


256 


633 


Marion 


3,466 


3,932 


Petersham 


1.014 


1,024 


Marlborough 


27,936 


30,617 


Phillipsum 


872 


953 


Marshfield 


15,223 


20.916 


Pittsfield 


57,020 


51,974 


Mashpee 


1,288 


3,700 


Plainfield 


287 


425 


Mattapoisett 


4,500 


5,597 


Plainville 


4,953 


5,857 


Maynard 


9,710 


9.590 


Plymouth 


18,606 


35,913 


Medfield 


9,821 


10.220 


Plympton 


1,224 


1,974 


Medford 


64.397 


58.076 


Princeton 


1,681 


2,425 


Medway 


7,938 


8,447 


Provincetown 


2,911 


3,536 


Melrose 


33.180 


30.055 


Quincy 


87,966 


84,743 


Mendon 


2,524 


3,108 


Randolph 


27,035 


28,218 


Merrimac 


4,245 


4,451 


Raynham 


6,705 


9,085 


Methuen 


35,456 


36,701 


Reading 


22.539 


22,678 


Middleborough 


13.607 


16,404 


Rehoboth 


6,512 


7,570 


Middlefield 


288 


385 


Revere 


43,159 


42,423 


Middleton 


4,044 


4,135 


Richmond 


1,461 


1,659 


Milford 


19,352 


23,390 


Rochester 


1,770 


3.205 


Millbury 


11.987 


11,808 


Rockland 


15.674 


15.695 


Millis 


5,686 


6,908 


Rockport 


5.636 


6,345 


Millville 


1,764 


1,693 


Rowe 


277 


336 


Milton 


27,190 


25.860 


Rowley 


3,040 


3,867 


Monroe 


216 


179 


Royalston 


809 


955 


Monson 


7.355 


7,315 


Russell 


1,382 


1,570 


Montague 


8.451 


8,011 


Rutland 


3,198 


4,334 


Monterey 


600 


818 


Salem 


40,556 


38.220 



147 



TABLE F-3 (Continued) 
MASSACHUSETTS POPULATION BY CITY AND TOWN 

1970 and 1980 



City/Town 


7970 U.S. Census 


1980 U.S. Census 


City IT own 


1970 U.S. Census 


1980 U.S. Census 


Salisbury 


4,179 


5,973 


West Newbury 


2,254 


2,861 


Sandisfield 


547 


720 


West Springfield 


28,461 


27,042 


Sandwich 


5,239 


8,727 


West Stockbridge 


1,354 


1,280 


Saugus 


25,110 


24.746 


West Tisbury 


453 


1,010 


Savoy 


322 


644 


Wcstbo rough 


12,594 


13,619 


Sciluatc 


16,973 


17,317 


Wcslfield 


31,433 


36,465 


Scckonk 


11,116 


12,269 


Wcsiford 


10,368 


13.434 


Sharon 


12,367 


13,601 


Weslhampton 


793 


1,137 


Sheffield 


2,374 


2,743 


Westminster 


4,273 


5,139 


Shclburne 


1,836 


2,002 


Weston 


10,870 


11,169 


Sherbom 


3,309 


4,049 


Wcstport 


9,791 


13,763 


Shirley 


4,909 


5,124 


Westwood 


12,750 


13,212 


Shrewsbury 


19,196 


22,674 


Weymouth 


54.610 


55,601 


Shutesbury 


489 


1 ,049 


Whalcly 


1,145 


1,341 


Somcrsci 


18,088 


18,813 


Whitman 


13,059 


13,534 


Somervillc 


88,779 


77,372 


Wilbraham 


11,984 


12,053 


South Iladlcy 


17,033 


16,399 


Williamsburg 


2,342 


2 ""37 


Southampton 


3,069 


4,137 


Williamstown 


8,454 


8,741 


Southborough 


5,798 


6,193 


Wilmington 


17,102 


17,471 


Southbndge 


17,057 


16,665 


Winchendon 


6,635 


7,019 


Southwick 


6,330 


7,382 


Winchester 


22.269 


20.701 


Spencer 


8,779 


10,774 


Windsor 


468 


598 


Springfield 


163,905 


152,319 


Winlhrop 


20,335 


19,294 


Sterling 


4.247 


5,440 


Wobum 


37,406 


36,626 


Stockbndge 


2,312 


2,328 


Worcester 


176,572 


161,799 


Stoneham 


20,725 


21,424 


Worthington 


712 


932 


Stoughlon 


23,459 


26,710 


Wrenlham 


7,315 


7,580 


Slow 


3,984 


5,144 


Yarmouth 


12,033 


18,449 


Slurbridge 


4,878 


5,976 








Sudbury 


13,506 


14,027 


STATEWIDE TOTALS 


5,689,170 


5,737,037 


Sunderland 


2,236 


2.929 








Sutton 


4,590 


5,855 








Swampscott 


13,578 


13,837 








Swansea 


12,640 


15,461 








Taunton 


43,756 


45,001 








Templeton 


5,863 


6,070 








Tewksbury 


22,755 


24,635 








Tisbury 


2,257 


2,972 








Tolland 


172 


235 








Topsfield 


5,225 


5,709 








Townsend 


4,281 


7,201 








Truro 


1,234 


1.486 








Tyngsborough 


4,204 


5,683 








Tyringham 


234 


344 








Upton 


3,484 


3,886 








Uxbridge 


8,253 


8,374 








Wakefield 


25,402 


24,895 








Wales 


852 


1,177 








Walpole 


18,149 


18,859 








Waltham 


61,582 


58,200 








Ware 


8,187 


8,953 








Wareham 


11,492 


18,457 








Warren 


3,633 


3,777 








Warwick 


492 


603 








Washington 


406 


587 








Watertown 


39,307 


34,384 








Wayland 


13,461 


12,170 








Webster 


14,917 


14,480 








Wellesley 


28,051 


27,209 








Wellfleet 


1,743 


2,209 








Wendell 


405 


694 








Wenham 


3,849 


3,897 








West Boylston 


6,369 


6,204 








West Bridgewaler 


7,152 


6,359 








West Brookfield 


2,653 


3,026 









148 





TABLE F-4 






POPULATION ESTIMATES, MASSACHUSETTS* 






1980-1988 






AGE GROUP 


TOTAL 


MALE 


FEMALE 


0-4 1980 


337,215 


173,029 


164,186 


1981 


342,815 


175,696 


167,119 


1982 


348,357 


178,322 


170,035 


1983 


353,950 


180,977 


172,973 


1984 


359,499 


183,609 


175,890 


1985 


365,227 


186,336 


178,891 


1986 


370,644 


188,911 


181,733 


1987 


376,252 


191,570 


184,682 


1988 


381,786 


194,198 


187,588 


5-9 1980 


374,734 


191,602 


183,132 


1981 


382,783 


195,479 


187,304 


1982. 


390,776 


199,324 


191,452 


1983 


398,807 


203,201 


195,606 


1984 


406,798 


207,044 


199,754 


1985 


414,982 


210,993 


203,989 


1986 


422,817 


214,769 


208,048 


1987 


430,881 


218,653 


212,228 


1988 


438,839 


222,489 


216,350 


10-14 1980 


461,332 


235,669 


225,663 


1981 


448,375 


228,815 


219,560 


1982 


435,497 


222,005 


213,492 


1983 


422,551 


215,154 


207,397 


1984 


409,663 


208,337 


201,326 


1985 


396,601 


201,433 


195,168 


1986 


383,806 


194,672 


189,134 


1987 


370,866 


187,825 


183,041 


1988 


357,972 


181,004 


176,968 


15-19 1980 


548,239 


274,859 


273,380 


1981 


531,132 


265,930 


265,202 


1982 


514,073 


257,012 


257,061 


1983 


496,969 


248,091 


248,878 


1984 


479,891 


239,169 


240,722 


1985 


462,673 


230,178 


232,495 


1986 


445,754 


221,347 


224,407 


1987 


428,617 


212,392 


216,225 


1988 


411,572 


203,504 


208,068 



149 







TABLE F-4 (continued) 






POPULATION ESTIMATES, MASSACHUSETTS* 








1980-1988 






AGE GROUP 




TOTAL 


MALE 


FEMALE 


20-24 


1980 


552,902 


270,713 


282,189 




1981 


542,736 


265,216 


277,520 




1982 


532,642 


259,763 


272,879 




1983 


522,468 


254,260 


268,208 




1984 


512,367 


248,792 


263,575 




1985 


502,121 


243,261 


258,860 




1986 


492,076 


237,835 


254,241 




1987 


481,926 


232,344 


249,582 




1988 


471,801 


226,864 


244,937 


25-29 


1980 


489,175 


239,341 


249,834 




1981 


493,044 


240,846 


252,198 




1982 


496,921 


242,357 


254,564 




1983 


500,792 


243,854 


256,938 




1984 


504,652 


245,353 


259,299 




1985 


508,596 


246,889 


261,707 




1986 


512,411 


248,366 


264,045 




1987 


516,289 


249,872 


266,417 




1988 


520,142 


251,362 


268,780 


30-34 


1980 


. 446,395 


217,649 


228,746 




1981 


457,542 


224,039 


233,503 




1982 


468,636 


230,411 


238,225 




1983 


479,789 


236,803 


242,986 




1984 


490,905 


243,186 


247,719 




1985 


502,135 


249,625 


252,510 




1986 


513,131 


255,936 


257,195 




1987 


524,287 


262,335 


261,952 




1988 


535,400 


268,711 


266,689 


35-39 


1980 


348,552 


169,502 


179,050 




1981 


359,341 


174,328 


185,013 




1982 


370,113 


179,129 


190,984 




1983 


380,898 


183,950 


196,948 




1984 


391,654 


188,748 


202,906 




1985 


402,564 


193,633 


208,931 




1986 


413,195 


198,363 


214,832 




1987 


424,014 


203,202 


220,812 




1988 


434,736 


207,982 


226,754 



150 





TABLE F-4 (continued) 






POPULATION ESTIMATES, MASSACHUSET 








1980-1988 








AGE GROUP 


TOTAL 


MALE 


FEMALE 




40-44 1980 


278,748 


134,925 


143,823 




1981 


292,647 


141,203 


151,444 




1982 


306,457 


147,434 


159,023 




1983 


320,348 


153,710 


166,638 




1984 


334,166 


159,940 


174,226 




1985 


348,205 


166,286 


181,919 




1986 


361,903 


172,459 


189,444 




1987 


375,788 


178,731 


197,057 




1988 


389,612 


184,965 


204,647 




45^9 1980 


278,261 


134,444 


143,817 




1981 


282,833 


136,275 


146,558 




1982 


287,346 


138,073 


149,273 




1983 


291,899 


139,901 


151,998 




1984 


296,417 


141,708 


154,709 




1985 


301,088 


143,582 


157,506 




1986 


305,517 


145,343 


160,174 




1987 


310,083 


147,175 


162,908 




1988 


314,588 


148,978 


165,610 




50-54 1980 


306,574 


146,211 


160,363 




1981 


301 ,594 


143,584 


158,010 




1982 


296,655 


140,958 


155,697 




1983 


291,665 


138,318 


153,347 




1984 


286,727 


135,704 


151,023 




1985 


281,677 


133,039 


148,638 




1986 


276,790 


130,444 


146,346 




1987 


271,823 


127,817 


144,006 




1988 


266,862 


125,190 


141,672 




55-59 1980 


310,995 


145,603 


165,392 




1981 


305,203 


142,750 


162,453 




1982 


299,475 


139,931 


159,544 




1983 


293,700 


137,078 


156,622 




1984 


287,965 


134,260 


153,705 




1985 


282,086 


131,356 


150,730 




1986 


276,401 


128,548 


147,853 




1987 


270,622 


125,709 


144,913 




1988 


264,891 


122,877 


142,014 





151 





TABLE F-4 (continued) 




POPULATION ESTIMATES, MASSACHUSETTS* 






1980-1988 






AGE GROUP 


TOTAL 


MALE 


FEMALE 


60-64 1980 


277,384 


126,323 


151,061 


1981 


276,091 


125,512 


150,579 


1982 


274,784 


124,707 


150,077 


1983 


273,496 


123,894 


149,602 


1984 


272,181 


123,073 


149,108 


1985 


270,891 


122,260 


148,631 


1986 


269,624 


121,478 


148,146 


1987 


268,307 


120,655 


147,652 


1988 


267,021 


119,844 


147,177 


65-69 1980 


235,574 


101,023 


134,551 


1981 


238,038 


101,871 


136,167 


1982 


240,454 


102,695 


137,759 


1983 


242,917 


103,538 


139,379 


1984 


245,344 


104,370 


140,974 


1985 


247,853 


105,241 


142,612 


1986 


250,240 


106,059 


144,181 


1987 


252,690 


106,899 


145,791 


1988 


255,130 


107,734 


147,396 


70-74 1980 


187,041 


73,235 


113,806 


1981 


189,630 


74,235 


115,395 


1982 


192,183 


75,222 


116,961 


1983 


194,759 


76,222 


118,537 


1984 


197,323 


77,210 


120,113 


1985 


199,983 


78,250 


121,733 


1986 


202,448 


79,192 


123,256 


1987 


205,049 


80,195 


124,854 


1988 


207,588 


81,180 


126,408 


75-79 1980 


137,828 


48,145 


89,683 


1981 


140,300 


48,996 


91,304 


1982 


142,752 


49,844 


92,908 


1983 


145,222 


50,699 


94,523 


1984 


147,694 


51,545 


96,149 


1985 


150,251 


52,437 


97,814 


1986 


152,579 


53,227 


99,352 


1987 


155,087 


54,094 


100,993 


1988 


157,521 


54,928 


102,593 



152 







TABLE F-4 (continued) 






POPULATION ESTIMATES, MASSAC! 






1980-1988 






AGE GROUP 




TOTAL 


MALE 


FEMALE 


80-84 


1980 


92,180 


28,513 


63,667 




1981 


93,363 


28,809 


64,554 




1982 


94,522 


29,101 


65,421 




1983 


95,692 


29,393 


66,299 




1984 


96,841 


29,682 


67,159 




1985 


98,073 


29,995 


68,078 




1986 


99,160 


30,242 


68,918 




1987 


100,350 


30,547 


69,803 




1988 


101,479 


30,823 


70,656 


85+ 


1980 


73,908 


20,107 


53,801 




1981 


75,099 


20,191 


54,908 




1982 


76,276 


20,277 


55,999 




1983 


77,449 


20,351 


57,098 




1984 


78,611 


20,426 


58,185 




1985 


79,867 


20,539 


59,328 




1986 


81,008 


20,614 


60,394 




1987 


82,187 


20,695 


61,492 




1988 


83,343 


20,763 


62,580 


TOTAL 


1980 


5,737,037 


2,730,893 


3,006,144 




1981 


5,752,566 


2,733,775 


3,018,791 




1982 


5,767,919 


2,736,565 


3,031,354 




1983 


5,783,371 


2,739,394 


3,043,977 




1984 


5,798,698 


2,742,156 


3,056,542 




1985 


5,814,873 


2,745,333 


3,069,540 




1986 


5,829,504 


2,747,805 


3,081,699 




1987 


5,845,118 


2,750,710 


3,094,408 




1988 


5,860,283 


2,753,396 


3,106,887 


•THESE ESTIMATES ARE DERIVED FROM 1980 U.S. CENSUS COUNTS AND PROJECTIONS FOR 1990 PREPARED BY 


THE MASSACHUSETTS INSTITUTE FOR SOCIAL AND ECONOMIC RESEARCH (MISER). 





153 



APPENDICES 



1 RECORD NUMBER 

002823 



1A CERTIFICATE NUMBER 

lOPH USE ONLYI 



2 FACILITY NUMBER 



2E3C COUNTY 



;3B CITY/TOWN 



^ 



fl 



H[\t (Commanuiealtli of ffla88atr|UBttt6 

DEPARTMENT OF PUBLIC HEALTH 
REGISTRY OF VITAL RECORDS AND STATISTICS 

STANDARD CERTIFICATE OF LIVE BIRTH 



3A FACILITY NAME-IF NOT IN FACILITY NUMBER AND STREET 



NAME 



4A FIRST 



4B MIDDLE 



4C LAST 



3D CITY/TOWN MAKING RETURN 



3E REGISTERED NUMBER 



5 SEX 



6A PLURALITY 
(Specify S'ngle Twin etc I 



| 6B BIRTH ORDER lit not single. 
SDeoly Order Firsl Second etc I 



7 TIME 



I 8 DATE OF BIRTH (Month. Day. Year) 



OCCURRENCE | 
s 

i 



22A SOCIAL SECURITY CARD 



INITIALS 
22B RESIDENT CC°Y 



INITIALS 
22C CENSUS 



9A SIGNATURE U Cemty that (he Child was Born Alive al Date and Time and 9B TYPE OR PRINT NAME 
Place Staled I 



9D NO 4 STREET 



9E CITYiTOWN 



9F STATE 



9G ZIP CODE 



9C LICENSE NUMBER 



9H DATE SIGNED (Month. Day Yean 



91 TYPE 



9J TITLE 



NAME 



10A FIRST 



10B MIDDLE 



IOC LAST 



10D MAIDEN SURNAME 



BIRTHPLACE 11A CITY/TOWN 



11B STATE/COUNTRY 



12 DATE OF BIRTH iMonth Day Yean 



RESIDENCE 13A NUMBER AND STREET 
(Do not use 
mailing address! 



13B CITY/TOWN 



13C COUNTY 



13D STATE 13E ZIP CODE 



NAME 14A FIRST 



14B MIDDLE 



14C LAST 



BIRTHPLACE 15A CITY/TOWN 



15B STATE/COUNTRY 



I7A I (WE) CERTIFY THAT THE PERSONAL INFORMATION APPEARING ABOVE IS TRUE AND CORRECT 



16 DATE OF BIRTH (Month, Day, Year) 



17B RELATIONSHIP TO CHILD 



17C DATE SIGNED iMoniti Da» 



17D MAILING ADDRESS NUMBER AND STHEET 

(It ditlerent from 
item »13 abovel 



CITY 



STATE 



ZIP CODE 



18 DATL OF RECORD iMomr Day Year) 



19 SUPPLEMENT FILED (Month Day fean 



21 CLERK/REGISTRAR DPH USE ONLY 



20 CLERK/REGISTRAR 



CONFIDENTIAL INFORMATION - CHAPTER 111 SECTION 24B AS AMENDED 



23A OCCUPATION PAST YEAR 



26A OCCUPATION PAST YEAR 



23B INDUSTRY PAST YEAR 



26B INDUSTRY PAST YEAR 



24A RACE 



27A RACE 



24B ANCESTRY 



25 .EDUCATION. 



Elem/Sec (0-12) . B College (0-4,5 + ) 



27B ANCESTRY 28 EDUCATION 

A Elem/Sec (0-12) , B College (0-4,5 + ) 



29 PRIOR LIVE BIRTHS A NOW LIVING 8 BOHN LIVE-NOW DEAD C DATE OF LAS" LIVE BIRTH 

| (Month Day Yean 



30 TERMINATIONS DATE LAST TERMINATION 
| IMonth. Day, Year) 



31A DATE LAST MENSES BEGAN 
(Month. Day. Year) 



31B CLINICAL EST 
GEST 



(WKSI 



32 MONTH OF PREG PRENATAL 
CARE BEGAN (First Second etc I 



33 TOTAL NUMBER 

PRENATAL VISITS 
# n NONE 



34 WEIGHT GAINED 
DURING PREG 

LBS 



35A TYPE OF PRACTITIONER PROVIDING PRENATAL CARE 



35B SITE OF PRENATAL CARE 



35C PRENATAL CARE METHOD OF PAYMENT 



36A ALCOHOL 



36B TOBACCO 



36C MEDICAL RISK FACTORS (Seoarate by commas-Include uo to 8 items) 



37 METHOO OF DELIVERY 


38 COMPLICATIONS OF LABOR (Separate by commas-Include up to 10 items) 
AND DELIVERY 


39 OBSTETRIC PROCEDURES (Seoarate by commas-include uo to 10 .lemsj 


40 BIRTHWEIGHT 


41 APGAR SCORE (0-10) 
A 1 Minute B 5 Minute 


42 DELIVERY METHOD OF PAYMENT 


43 IS MOTHER MARRIED' 


44 CONGENITAL ANOMALIES finciuoe uo to 5 items) 


45 ABNORMAL CONDITIONS OF NEWBORN (Include up to 5 items) 


46 AT TIME OF THIS REPORT, CHILD IS 


47 IS MOTHER BREASTFEEDING' [ 48 MOTHER TRANSFERRED PRIOR TO DELIVERY' 


49 INFANT TRANSFERRED' 



Detach and Return to Department ot Public Health — Registry of Vital Records and Statistics. 

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DEFINITION: "Fetal death" per chaoter 111 section 202 of the M G.L means death prior to the 

complete expulsion or extraction from its mother of a fetus, irrespective of the duration 
of pregnancy, as 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 muscle* A fetal death doe* 
NOT include an induced abortion as defined in section 12K of chaoter 1 12 of M.G.L. 
Spontaneous abortions are to be included 

TO BE REPORTED: Only fetal deaths of twenty weeks or more gestation or of a weight of 350 grams or more 

are to be reported. 

INSTRUCTIONS: Return completed reported within 10 days to the Registry of Vital Records and 

Statistics, Room B-3, 130 Tremor. t St., Boston, MA 02111 
form r-jo.-"^/ _ f /"79 -ttt 

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Ibr Cammantirillb of Jlaf*arbufrtt« 
DEPARTMENT OF PUBLIC HEALTH 

REGISTRY OF VITAL RECORDS ANO STATISTICS 

CERTIFICATE OF ABSOLUTE 
DIVORCE OR ANNULMENT 

(Chap. 208, Sec. 46 G.L.) 
R-408 



HU4SAN0 - NAME 



USUAL NESIOENCE - STNEET »0O»(55 






CITY, TOWN OR LOCATION 








Ik. 


COUNTT 




STATE 




DATE OF 1INTM IUm ,0*,Tr.) 


NUMMN Of THIS NAAAiAOE <IMji*,S—cHfl 






H. 




J. 


4. 


•in - ■.»«» n*n 


• IMX.I 


LAST 


MAIOEN NAM 








»» 


USUAL NESIOENCE - STNEET AOONESS 






Ci tt, Town 0* LOCATION 

St. 


COUNTY 




STATE 




DATE OF tlNTN (mt.,D*,rr.l 


■until Or THIS MAJINIASE "«'./•*. l—cll/l 


f. r 




U. 




'• F— ■ 


'■ 


DATE Of THIS UANNIAftE 

l—..Otr,ril 


NUM6CN Of CHILDNEN SOWN ALIVE OF 


THIS NA»»:««« 


KMtll Of CNILONEN UNOCN AOI 1* IN THIS FAMILY 


» 


10*. 






IOA. 




161 



REGISTRY OF VITAL RECORDS AND STATISTICS 

STAFF 

REGISTRAR 
Elaine B. Trudeau 



ASSISTANT REGISTRAR 
FOR REGISTRATION AND 
CERTIFICATION 
Frances A. Vitagliano 



ASSISTANT REGISTRAR 
FOR STATISTICS 
Phyllis J. Zeuli 



ADMINISTRATION 

Alan S. Goldin, Director 
of Automation 
Mary Ann Nardizzi 
Michael Puangco 

REGISTRATION UNIT 

Phyllis A. Rotman, Supervisor 
Waleska Ortiz, Asst. Supervisor 
Richard T. Hegarty 
Mary E. Risser 

RECORDS UNIT 

Harold L. Leonard, Supervisor 
June A. Deloney, Asst. Supervisor 
Carlisle B. Corbin 
Dean DiMartino 
Susan C. Indresano 
Donald T. McHugh 

OPERATIONS UNIT 

James C. Orseno, Supervisor 
John R. Bussey, Asst. Supervisor 
Kevin B. Roche 



DATA QUALITY ASSURANCE 

Karin A. Barrett, Coordinator 
Sally A. Woster, Field 
Representative 



STATISTICS UNIT 

Lisa M. Varnerin, Supervisor 
Joan M. Burgess 
Yuen Fei Chan-Lee 
Kathleen Geary 
Robert A. Coffin III 
Paul DiCesare 
Audrey T. Figueiredo 
Ramona Irving 
Judy Y. Lim 
Marie MacMillan 
Maureen L. McKean 
Linda M. Mosesso 
Ann-Marie Neault 
Glenda R. Sally 
Maryanne Victoria 



163 



BOSTON PUBLIC LIBRARY 



3 9999 06351 809 4 



v5* <* ** 




Michael S. Dukakis 

Governor 

Philip W. Johnston 

Secretary, Executive Office of Human Services 

David H. Mulligan 

Commissioner, Department of Public Health 

Daniel J. Friedman, Ph.D. 

Assistant Commissioner, Bureau of Health Statistics, Research and Evaluation 



[