Miami-Dade County Health Department

Miami-Dade County Health Department Vital and Morbidity Statistics 1999-2001 Nancy Humbert, RN, MSN Acting Executive Administrator Eleni D. Sfakianaki, MD, MSPH Medical Executive Director 1350 N.W. 14th Street Miami, Florida 33125

Acknowledgments The following individuals provided technical support and the data for this report: Miami-Dade County Health Department Tuberculosis Surveillance HIV/AIDS Surveillance Sexually Transmitted Disease Control Special Immunization Program Management Information System Zabala, Jose, MSHA. Dubuisson, Jean Robert Garcia, Luis Miguel, MD, MPH Boucugnani, Rodolfo Hardy, Cheryl Smith, Sandra, RN, BSN. Dytkowsky, Robert Sr. State of Florida Department of Health Office of Vital Statistics: Samment, Gary, BS

Office of Epidemiology and Disease Control Trepka, Mary Jo, MD, MSPH, Director Leguen, Fermin, MD, MPH, Assistant Director Ameizan, Louvia, Health Services Representative Atherley, Stephanie, RN, MPH, Senior Nurse Epidemiologist Becerra, Merardo, MD, Perinatal Epidemiologist* Cordero, Maria, BBA, Secretary Specialist Epler, Susan, RN, BSN, MPH, Nursing Program Specialist Etienne, Marie K., RN, BSN, Nursing Program Specialist Estevez, Lis, BS, MPH, Health Services Representative Eusebe, Jacques, Senior Health Educator Fernandez, Margarita Maggie, Administrative Assistant I Garcia, Raul, MD, Health Services Representative Gomez Joel, MD, Health Services Representative Gonzalez, Antonio, AST, Health Services Representative Green, Linda, Fiscal Assistant Joseph, Patrik, BS, MPH, Health Services Representative Lawrence, Jennifer, BS, Computer Programmer Martin, Pilar, MD, MPH, Senior Human Services Program Manager Martinez, Anita, BSN, Senior Community Health Nurse Matcha, Anupama, MD, MPH., Health Services Representative Mejia-Echeverry, Alvaro, MD, MPH, Health Services Representative Milazzo, Donnamarie, BA, MPH., Health Services Representative Mitruka, Kiren, MD, Senior Physician Mompoint-Augustine, Yves-Anne, RN, BSN, Nursing Program Specialist Nobles, Robert II, MPH, Prevention Specialist Nunez, Maria, MPH, Health Services Representative Pekovic, Vukosava MD, PhD, Biological Scientist III Pierre, Roland, BBA, MSMIS, Database Analyst Prieto, Rolando, DDS, Health Services Representative Raphael, Mymose, RN, BS, Senior Community Health Nurse Rico, Edhelene Gigi, BS, MPH, EIS Officer Sandoval, Lydia, RN, BSN, Nursing Program Manager Santana, Fabio, BA, Health Services Representative Santana, Juan Carlos, MD, Environmental Specialist II Seay, Alicia, Secretary Specialist Sosa, Jailene, Data Entry Operator Sotirescu, Alicia Camps, MD, MS, MSGPH, Health Services Representative Stillman, Bettye, Administrative Assistant I Suarez, Juan, BS, Environmental Epidemiologist Summers, Debbie, Health Services Representative Teague, Faye, Administrative Assistant II Urbina, Angelica, MD, MPH, Senior Health Educator Veras, Deyadira, Senior Clerk Washington, Lisa, Data Entry Operator

Zhang, Guoyan, MD, MPH, Senior Epidemiologist The following persons participated in preparing this report: Zhang, Guoyan, MD, MPH Becerra, Merardo, MD* Pierre, Roland, BBA, MSMIS Suarez, Juan, BS This report was reviewed by Trepka, Mary Jo, MD, MSPH. *: Merardo Becerra is supported by the Healthy Start Coalition for Miami-Dade County

Miami-Dade County Health Department Table of Contents Page Introduction...I GLOSSARY...II Midyear Population Estimates by Age, Race, and Sex, Miami-Dade County, 1999...VI Midyear Population Estimates by Age, Race, and Sex, Miami-Dade County, 2000...VII Midyear Population Estimates by Age, Race, and Sex, Miami-Dade County, 2001... VIII Selected Health Indicators in Miami-Dade County, Florida, and United States, 1999-2001...IX Section-1 Child and Maternal Health Table 1-1A. Table 1-1B. Table 1-1C. Table 1-2A. Table 1-2B. Table 1-2C. Table 1-3A. Table 1-3B. Table 1-3C. Table 1-4A. Table 1-4B. Table 1-4C. Live Births by Mother's Age, Race/Ethnicity, Race, Educational Level, and Marital Status, Miami-Dade County, 1999...1-1 Live Births by Mother's Age, Race/Ethnicity, Race, Educational Level, and Marital Status, Miami-Dade County, 2000...1-2 Live Births by Mother's Age, Race/Ethnicity, Race, Educational Level, and Marital Status, Miami-Dade County, 2001...1-3 Live Births by Mother's Age, Race/Ethnicity, Race, Educational Level, and Marital Status, Miami-Dade County, 1999...1-4 Live Births by Mother's Age, Race/Ethnicity, Race, Educational Level, and Marital Status, Miami-Dade County, 2000...1-5 Live Births by Mother's Age, Race/Ethnicity, Race, Educational Level, and Marital Status, Miami-Dade County, 2001...1-6 Live Births by Birth Order, Mother's Race/Ethnicity, Race, Age, Educational Level, and Marital Status, Miami-Dade County, 1999...1-7 Live Births by Birth Order, Mother's Race/Ethnicity, Race, Age, Educational Level, and Marital Status, Miami-Dade County, 2000...1-8 Live Births by Birth Order, Mother's Race/Ethnicity, Race, Age, Educational Level, and Marital Status, Miami-Dade County, 2001...1-9 Live Births by Birth Order, Mother's Age, Race/Ethnicity, Race, Miami-Dade County, 1999...1-10 Live Births by Birth Order, Mother's Age, Race/Ethnicity, Race, Miami-Dade County, 2000...1-11 Live Births by Birth Order, Mother's Age, Race/Ethnicity, Race,

Miami-Dade County, 2001...1-12 Table 1-5A. Live Births by Gestational Age, Mother's Race/Ethnicity, Race, Age, Educational Level, and Marital Status, Miami-Dade County, 1999...1-13 Table 1-5B. Live Births by Gestational Age, Mother's Race/Ethnicity, Race, Age, Educational Level, and Marital Status, Miami-Dade County, 2000...1-14 Table 1-5C. Live Births by Gestational Age, Mother's Race/Ethnicity, Race, Age, Educational Level, and Marital Status, Miami-Dade County, 2001...1-15 Table 1-6A. Live Births by Gestational Age, Mother's Age, Race/Ethnicity, and Race, Miami-Dade County, 1999...1-16 Table 1-6B. Live Births by Gestational Age, Mother's Age, Race/Ethnicity, and Race, Miami-Dade County, 2000...1-17 Table 1-6C. Live Births by Gestational Age, Mother's Age, Race/Ethnicity, and Race, Miami-Dade County, 2001...1-18 Table 1-7A. Live Births by Birthweight, Mother's Race/Ethnicity, Race, Age, Educational Level, Marital Status, and Gestational Age, Miami-Dade County, 1999...1-19 Table 1-7B. Live Births by Birthweight, Mother's Race/Ethnicity, Race, Age, Educational Level, Marital Status, and Gestational Age, Miami-Dade County, 2000...1-20 Table 1-7C. Live Births by Birthweight, Mother's Race/Ethnicity, Race, Age, Educational Level, Marital Status, and Gestational Age, Miami-Dade County, 2001...1-21 Table 1-8A. Live Births by Birthweight, Mother's Age, Race/Ethnicity, Race, Miami-Dade County, 1999...1-22 Table 1-8B. Live Births by Birthweight, Mother's Age, Race/Ethnicity, Race, Miami-Dade County, 2000...1-23 Table 1-8C. Live Births by Birthweight, Mother's Age, Race/Ethnicity, Race, Miami-Dade County, 2001...1-24 Figure 1-1. Percent Low Birthweight (<2,500 grams) in Miami-Dade County, Florida and United States 1991-2001...1-25 Figure 1-2. Percent Low Birthweight (<2,500 grams) by Maternal Race/Ethnicity, Miami-Dade County, 1991-2001...1-25 Table 1-9A. Live Births by Time of Initiation of Prenatal Care, Mother's Race/Ethnicity, Race, Age, Educational Level, Marital Status, Miami-Dade County, 1999...1-26 Table 1-9B. Live Births by Initiation of Prenatal Care, Mother's Race/Ethnicity, Race, Age, Educational Level, Marital Status, Miami-Dade County, 2000...1-27 Table 1-9C. Live Births by Initiation of Prenatal Care, Mother's Race/Ethnicity, Race, Age, Educational Level, Marital Status, Miami-Dade County, 2001...1-28 Table 1-10A. Live Births by Time of Initiation of Prenatal Care, Mother's Age, Race/Ethnicity, and Race, Miami-Dade County, 1999...1-29

Table 1-10B. Live Births by Time of Initiation of Prenatal Care, Mother's Age, Race/Ethnicity, and Race, Miami-Dade County, 2000...1-30 Table 1-10C. Live Births by Time of Initiation of Prenatal Care, Mother's Age, Race/Ethnicity, and Race, Miami-Dade County, 2001...1-31 Figure 1-3. Percent of Women Beginning Prenatal Care in the First Trimester of Pregnancy in Miami-Dade County, Florida and United States, 1991-2001...1-32 Figure 1-4. Percent of Women Beginning Prenatal Care in the First Trimester of Pregnancy by Maternal Race/Ethnicity, Miami-Dade County, 1991-2001...1-32 Map: Number of Liver Births, Miami-Dade County, 1999...1-33 Map: Number of Liver Births, Miami-Dade County, 2000...1-34 Map: Number of Liver Births, Miami-Dade County, 2001...1-35 Map: Percent of Live Births To Unwed Women, Miami-Dade County, 1999...1-36 Map: Percent of Live Births To Unwed Women, Miami-Dade County, 2000...1-37 Map: Percent of Live Births To Unwed Women, Miami-Dade County, 2001...1-38 Map: Percent of Live Births To Teens Aged 10-19 Years, Miami-Dade County, 1999...1-39 Map: Percent of Live Births To Teens Aged 10-19 Years, Miami-Dade County, 2000...1-40 Map: Percent of Live Births To Teens Aged 10-19 Years, Miami-Dade County, 2001...1-41 Map: Percent of Repeat Births To Teens Aged 10-19 Years, Miami-Dade County, 1999...1-42 Map: Percent of Repeat Births To Teens Aged 10-19 Years, Miami-Dade County, 2000...1-43 Map: Percent of Repeat Births To Teens Aged 10-19 Years, Miami-Dade County, 2001...1-44 Map: Percent of Live Births with Gestational Age Less than 37 Weeks at Delivery, Miami-Dade County, 1999...1-45 Map: Percent of Live Births with Gestational Age Less than 37 Weeks at Delivery, Miami-Dade County, 2000...1-46 Map: Percent of Live Births with Gestational Age Less than 37 Weeks at Delivery, Miami-Dade County, 2001...1-47 Map: Percent of Low Birthweight (<2.500 grams at delivery) Miami-Dade County, 1999...1-48 Map: Percent of Low Birthweight (<2.500 grams at delivery) Miami-Dade County, 2000...1-49 Map: Percent of Low Birthweight (<2.500 grams at delivery) Miami-Dade County, 2001...1-50 Map: Percent of Women Beginning Prenatal Care in the First Trimester of Pregnancy, Miami-Dade County, 1999...1-51 Map: Percent of Women Beginning Prenatal Care in the First Trimester of Pregnancy, Miami-Dade County, 2000...1-52 Map: Percent of Women Beginning Prenatal Care in the First Trimester of Pregnancy,

Miami-Dade County, 2001...1-53 Table 1-11. Maternal Mortality Rates (MMR per 100,000 live births) by Race, Miami-Dade County, 1992-2001...1-54 Table 1-12. Fetal Mortality Rates (per 1,000 live births plus fetal deaths) by Mother's Race/Ethnicity and Race, Miami-Dade County, 1999-2001...1-54 Table 1-13A. Infant, Neonatal, and Postneonatal Mortality Rates (per 1,000 live births) by Mother's Race/Ethnicity, Miami-Dade County, 1999-2001...1-55 Table 1-13B. Infant, Neonatal and Postneonatal Mortality Rates (per 1,000 live births) by Mother's Race, Miami-Dade County, 1999-2001...1-56 Figure 1-5. Infant Mortality Rates (per 1,000 live births) in Miami-Dade County, Florida and United States, 1992-2001...1-56 Figure 1-6. Infant Mortality Rates by Maternal Race/Ethnicity, Miami-Dade County, 1992-2001...1-57 Figure 1-7. Neonatal Mortality Rates in Miami-Dade County, Florida and United States, 1992-2001...1-57 Table 1-14. Five Leading Causes of Infant, Neonatal, Postneonatal Deaths, Percent of Total Deaths, and Mortality Rates, Miami-Dade County, 1999-2001...1-58 Table 1-15A. Causes of Neonatal Death, Miami-Dade County, 1999...1-59 Table 1-15B. Causes of Postneonatal Death, Miami-Dade County, 1999...1-60 Table 1-15C. Causes of Neonatal Death, Miami-Dade County, 2000...1-61 Table 1-15D Causes of Postneonatal Death, Miami-Dade County, 2000...1-62 Table 1-15F. Causes of Neonatal Death, Miami-Dade County, 2001...1-63 Table 1-15G Causes of Postneonatal Death, Miami-Dade County, 2001...1-64 Map: Infant Mortality Rates (per 1,000 live births), Miami-Dade County, 1999...1-65 Map: Infant Mortality Rates (per 1,000 live births), Miami-Dade County, 2000...1-66 Map: Infant Mortality Rates (per 1,000 live births), Miami-Dade County, 2001...1-67 Map: Neonatal Mortality Rates (per 1,000 live births), Miami-Dade County, 1999...1-68 Map: Neonatal Mortality Rates (per 1,000 live births), Miami-Dade County, 2000...1-69 Map: Neonatal Mortality Rates (per 1,000 live births), Miami-Dade County, 2001...1-70 Section-2: Mortality Table 2-1a. Deaths and Crude Death Rates (per 100,000 population) for Ten Leading Causes of Death, Miami-Dade County, Florida and United States, 1999...2-1 Table 2-1b. Deaths and Crude Death Rates (per 100,000 population) for Ten Leading Causes of Death, Miami-Dade County, Florida and United States, 2000...2-1 Table 2-1c. Deaths and Crude Death Rates (per 100,000 population) for Ten Leading Causes of Death, Miami-Dade County, Florida and United States, 2001...2-2 Table 2-2a. Ten Leading Causes of Death by Race and Sex, Miami-Dade County, 1999...2-3

Table 2-2b. Ten Leading Causes of Death by Race and Sex, Miami-Dade County, 2000...2-5 Table 2-2c. Ten Leading Causes of Death by Race and Sex, Miami-Dade County, 2001...2-7 Table 2-3a. Five Leading Causes of Death by Age Group, Miami-Dade County, 1999...2-9 Table 2-3b. Five Leading Causes of Death by Age Group, Miami-Dade County, 2000...2-11 Table 2-3c. Five Leading Causes of Death by Age Group, Miami-Dade County, 2001...2-13 Table 2-4a. Age-Adjusted Death Rates (per 100,000 population) for Selected Leading Causes of Death, Miami-Dade County, 1999...2-15 Table 2-4b. Age-Adjusted Death Rates (per 100,000 population) for Selected Leading Causes of Death, Miami-Dade County, 2000...2-16 Table 2-4c. Age-Adjusted Deaths Rates (per 100,000 population) for Selected Leading Causes of Death, Miami-Dade County, 2001...2-17 Table 2-5. Selected Deaths and Death Rates Aged 25-44 Years by Race, Miami-Dade County, 1992-2001...2-18 Table 2-6. Deaths and Death Rates due to Female Breast Cancer and Cervical Cancer, Miami-Dade County, 1999-2001...2-19 Figure 2-1. Cause-Specific Death Rates for Persons 25-44 Years of Age, Miami-Dade County, 1984-2001...2-20 Figure 2-2. Death Rates due to Female Breast Cancer by Race, Miami-Dade County, 1990-2001...2-21 Figure 2-3. Death Rates due to Female Cervical Cancer by Race, Miami-Dade County, 1990-2001...2-21 Table 2-7a. Years of Potential Life Lost (YPLL) Under 75 Years of Age, Miami-Dade County, 1999...2-22 Table 2-7b. Years of Potential Life Lost (YPLL) Under 75 Years of Age, Miami-Dade County, 2000...2-23 Table 2-7c. Years of Potential Life Lost (YPLL) Under 75 Years of Age, Miami-Dade County, 2001...2-24 Figure 2-4. Years of Potential Life Lost (YPLL) Prior to Age 75 for Selected Leading Causes of Death, Miami-Dade County, 1999...2-25 Figure 2-5. Years of Potential Life Lost (YPLL) Prior to Age 75 for Selected Leading Causes of Death, Miami-Dade County, 2000...2-25 Figure 2-6. Years of Potential Life Lost (YPLL) Prior to Age 75 for Selected Leading Causes of Death, Miami-Dade County, 2001...2-26 Figure 2-7. Years of Potential Life Lost (YPLL) Prior to Age 75 for Selected Leading Causes of Death, Miami-Dade County, 1990-2001...2-26 Section-3: Selected Notifiable Diseases Table 3-1. Chapter 64D-3, Florida Administrative Code List of State Mandated Notifiable Diseases/Conditions...3-1

Table 3-2. Selected Notifiable Diseases/Conditions Reported to Miami-Dade County Health Department, 1995-2001...3-2 Table 3-3. Reported Incidence of Selected Gastroenteric Infections by Etiology and Age Group, Miami-Dade County, 1995-2001...3-3 Table 3-4. Reported Incidence of Meningitis by Etiology and Age Group, and Meningococcemia by Age Group, Miami-Dade County, 1995-2001...3-4 Figure 3-1. Incidence of Reported Campylobacteriosis per 100,000 Population, Miami-Dade County and Florida, 1990-2001...3-5 Figure 3-2. Reported Campylobacteriosis Cases by Month, Miami-Dade County, 1997-2001...3-5 Figure 3-3. Incidence of Reported Salmonellosis per 100,000 Population, Miami-Dade County and Florida, 1990-2001...3-6 Figure 3-4. Reported Salmonellosis Cases by Month, Miami-Dade County, 1997-2001...3-6 Figure 3-5. Incidence of Reported Shigellosis per 100,000 Population, Miami-Dade County and Florida, 1990-2001...3-7 Figure 3-6. Reported Shigellosis Cases by Month, Miami-Dade County, 1997-2001...3-7 Table 3-5. Reported Hepatitis A Cases by Sex, Race/Ethnicity and Age Group, Miami-Dade County, 1995-2001...3-8 Table 3-6. Reported Hepatitis B Cases by Sex, Race/Ethnicity and Age Group, Miami-Dade County, 1995-2001...3-9 Figure 3-7. Incidence of Reported Hepatitis A per 100,000 Population, Miami-Dade County and Florida, 1990-2001...3-10 Figure 3-8. Reported Hepatitis A Cases by Month, Miami-Dade County, 1996-2001...3-10 Figure 3-9. Reported Hepatitis A Cases by Age Group, Miami-Dade County, 1996-2001...3-11 Figure 3-10. Incidence of Reported Hepatitis B per 100,000 Population, Miami-Dade County and Florida, 1990-2001...3-11 Figure 3-11. Reported Hepatitis B Cases by Age Group, Miami-Dade County, 1996-2001...3-12 Figure 3-12. Reported Lead Poisoning Cases by Class Levels, Miami-Dade County, 1995-2001...3-12 Figure 3-13. Reported Lead Poisoning Cases by Race/Ethnicity, Miami-Dade County, 2000-2001...3-13 Figure 3-14. Reported Lead Poisoning Cases by Sex, Miami-Dade County, 2000-2001...3-13 Table 3-7. Reported Cases (per 100,000 population) of Vaccine-Preventable Diseases, Miami-Dade County, 1994-2001...3-14 Table 3-8. Selected List of Pathogenic Organisms That are Transmitted Through Food...3-15 Table 3-9. Foodborne Illness Statistics, Miami-Dade County, 1996-2001...3-15 Figure 3-15. Reported Foodborne Illness, Miami-Dade County, 1996-2001...3-16 Figure 3-16. Monthly Foodborne Illnesses Complaints by Regulatory Agency, Miami-Dade County, 1999...3-16 Figure 3-17. Monthly Foodborne Illnesses Complaints by Regulatory Agency,

Miami-Dade County, 2000...3-17 Figure 3-18. Monthly Foodborne Illnesses Complaints by Regulatory Agency, Miami-Dade County, 2001...3-17 Figure 3-19. Foodborne Complaints and Outbreaks, Miami-Dade County, 1995-2001...3-18 Table 3-10. Number of Complaints of Foodborne Illnesses by Regulatory Agency, Miami-Dade County, 1996-2001...3-19 Map: Reported Cases of Campylobacteriosis per 100,000 Population, Miami-Dade County, 1999...3-20 Map: Reported Cases of Campylobacteriosis per 100,000 Population, Miami-Dade County, 2000...3-21 Map: Reported Cases of Campylobacteriosis per 100,000 Population, Miami-Dade County, 2001...3-22 Map: Reported Cases of Samonellosis per 100,000 Population, Miami-Dade County, 1999...3-23 Map: Reported Cases of Samonellosis per 100,000 Population, Miami-Dade County, 2000...3-24 Map: Reported Cases of Samonellosis per 100,000 Population, Miami-Dade County, 2001...3-25 Map: Reported Cases of Shigellosis per 100,000 Population, Miami-Dade County, 1999...3-26 Map: Reported Cases of Shigellosis per 100,000 Population, Miami-Dade County, 2000...3-27 Map: Reported Cases of Shigellosis per 100,000 Population, Miami-Dade County, 2001...3-28 Map: Reported Cases of Hepatitis A per 100,000 Population, Miami-Dade County, 1999...3-29 Map: Reported Cases of Hepatitis A per 100,000 Population, Miami-Dade County, 2000...3-30 Map: Reported Cases of Hepatitis A per 100,000 Population, Miami-Dade County, 2001...3-31 Map: Reported Cases of Hepatitis B per 100,000 Population, Miami-Dade County, 1999...3-32 Map: Reported Cases of Hepatitis B per 100,000 Population, Miami-Dade County, 2000...3-33 Map: Reported Cases of Hepatitis B per 100,000 Population, Miami-Dade County, 2001...3-34 Map: Reported Lead Poisoning Cases, Miami-Dade County, 1999-2001...3-35 Section-4: Tuberculosis Table 4-1. Table 4-2. Table 4-3. Table 4-4. Table 4-5. Reported Tuberculosis Cases and Rates (per 100,000 population), Miami-Dade County, Florida and United States, 1993-2001...4-1 Reported Tuberculosis Cases by Sex, Miami-Dade County, Florida and United States, 1993-2001...4-1 Reported Tuberculosis Cases by Race/Ethnicity, Miami-Dade County, Florida and United States, 1994-2001...4-2 Reported Tuberculosis Cases by Country of Origin, Miami-Dade County, Florida, and United States, 1994-2001...4-3 Reported Tuberculosis by Age Group in Miami-Dade County, Florida, and United States, 1994-2001...4-4

Table 4-6. Tuberculosis Cases by Form of Disease, Miami-Dade County, Florida, and United States, 1994-2001...4-5 Figure 4-1. Incidence of Reported Tuberculosis, Miami-Dade County, Florida, and United States, 1990-2001...4-6 Figure 4-1. Reported TB Cases by Age Group, Miami-Dade County, 1999-2001...4-6 Map: Reported Cases of Tuberculosis per 100,000 Population, Miami-Dade County, 1999...4-7 Map: Reported Cases of Tuberculosis per 100,000 Population, Miami-Dade County, 2000...4-8 Map: Reported Cases of Tuberculosis per 100,000 Population, Miami-Dade County, 2001...4-9 Section-5: Sexually Transmitted Diseases Table 5-1. Reported Sexually Transmitted Diseases by Sex, Miami-Dade County, 1997-2001...5-1 Table 5-2. Reported Syphilis Cases by Sex, Age Group, Miami-Dade County, 1999-2001...5-2 Table 5-3. Reported Syphilis Cases by Sex, Race/Ethnicity, Miami-Dade County, 1999-2001...5-3 Figure 5-1. Incidence of Reported Primary and Secondary Syphilis, Miami-Dade County and Florida, 1990-2001...5-4 Figure 5-2. Reported Primary and Secondary Syphilis Cases by Month in Miami-Dade County, 1999-2001...5-4 Figure 5-3. Incidence of Reported Chlamydia, Miami-Dade County and Florida, 1994-2001...5-5 Figure 5-4. Reported Chlamydia Cases by Month in Miami-Dade County, 1999-2001...5-5 Figure 5-5. Incidence of Reported Gonorrhea in Miami-Dade County and Florida, 1990-2001...5-6 Figure 5-6. Reported Gonorrhea Cases by Month in Miami-Dade County, 1999-2001...5-6 Tables 5-4. Reported Cases of Congenital Syphilis by Mother s Race/Ethnicity, Initiation of Prenatal Care, Marital Status, and Infant s Birthweight, Gestational Age, Miami-Dade County, 1997-2001...5-7 Figure 5-7. Reported Congenital Syphilis Per 100,000 Live Births, Miami-Dade County and Florid, 1991-2001...5-8 Map: Reported Cases of Primary and Secondary Syphilis per 100,000 Population, Miami-Dade County, 1999...5-9 Map: Reported Cases of Primary and Secondary Syphilis per 100,000 Population, Miami-Dade County, 2000...5-10 Map: Reported Cases of Primary and Secondary Syphilis per 100,000 Population, Miami-Dade County, 2001...5-11 Map: Reported Cases of Chlamydia per 100,000 Population, Miami-Dade County, 1999...5-12 Map: Reported Cases of Chlamydia per 100,000 Population, Miami-Dade County, 2000...5-13 Map: Reported Cases of Chlamydia per 100,000 Population, Miami-Dade County, 2001...5-14 Map: Reported Cases of Gonorrhea per 100,000 Population, Miami-Dade County, 1999...5-15 Map: Reported Cases of Gonorrhea per 100,000 Population, Miami-Dade County, 2000...5-16

Map: Reported Cases of Gonorrhea per 100,000 Population, Miami-Dade County, 2001...5-17 SECTION-6: AIDS and HIV Table 6-1: Reported AIDS Cases and Incidence per 100,000 Population by Year of Diagnosis and Sex, Miami-Dade County, 1979-2001...6-1 Figure 6-1: Reported AIDS Cases per 100,000 Population by Year of Diagnosis and Sex, Miami-Dade County, 1982-2001...6-2 Figure 6-2: Reported AIDS Cases by Age Group and Sex, Miami-Dade County, 1980-2001...6-2 Table 6-2. AIDS Cases by Sex, Age Group, Race/Ethnicity and Country of Origin, Miami-Dade County...6-3 Table 6-3. AIDS-Indicator Conditions Diagnosed in Adults/Adolescents, Miami-Dade County...6-4 Table 6-4. Table 6-5. Table 6-6. Table 6-7. Table 6-8. AIDS-Indicator Conditions Diagnosed in Pediatric Patients, Miami-Dade County...6-5 AIDS Cases among Hispanics by Country of Origin and Exposure Categories, Miami-Dade County...6-6 AIDS Cases among Persons Older than 12 Years by Race/Ethnicity and Exposure Category, Miami-Dade County...6-7 Pediatric AIDS Cases by Race/Ethnicity and Exposure Category, Miami-Dade County...6-8 Reported HIV Cases and Incidence per 100,000 Population by Year of Report and Sex Miami-Dade County, 1997-2001...6-9 Table 6-9. Reported HIV Cases by Age Group and Sex, Miami-Dade County, 1997-2001...6-10 Table 6-10. Reported HIV Cases among Adult/Adolescent by Sex, Race/Ethnicity and Exposure Categories, Miami-Dade County...6-11

Introduction This is the sixth comprehensive summary of vital statistics and morbidity data, published by the Miami-Dade County Health Department. Source of Data The population estimates presented in this report are from Florida Governor s Office and CACI Marketing System. The Governor s Office provided population by sex and race. CACI Marketing System provided zip code data. The State of Florida Department of Health Office of Vital Statistics provided death and birth data for Miami-Dade County residents for the years 1999-2001. Births and deaths recorded in Miami- Dade County for residents of other counties and states have been excluded from this report. Analysis of Data Data of live births and deaths were analyzed using Statistical Package for Social Sciences (SPSS for Windows 11.0) and Statistical Analysis System (SAS for Windows 8.02). The information of Tuberculosis (TB), HIV/AIDS data were provided by the respective programs. Staff at Office of Epidemiology and Disease Control analyzed all other data. Technical Changes Since 1999, causes of death have been classified by the Tenth Revision International Classification of Disease (ICD-10), replacing the Ninth Revision (ICD-9) used for 1979-1998 data. The change has had several consequences: 1) new cause-of-death labels and corresponding cause-of-death codes; 2) breaks in comparability over time for cause-of-death statistics; and 3) restructuring of the leading causes of death (1). Any trend analysis using years covered by ICD-9 and ICD-10 classifications must be interpreted cautiously because depending on the disease there may be an increase or decrease in the number of cases that is due to the new classification system. The age-adjusted death rates are calculated using year 2000 population, which replaces the prior standard, the estimated year 1940 population. The statistical consequences of the new standard are generally to increase the magnitude of rates and to affect differential between groups and over time but not alter trends (1). Limitations of Data Presented There may be minor discrepancies in numbers between this report and Florida Vital Statistics Annual Report due to different versions of the dataset used. For morbidity data, cases are assigned to a given year based on the onset or event date of diseases/conditions, and effort was made to ensure that our data are consistent with state data. The population that was used in this report may be not in accord with previously published reports. Based on the 2000 census, population estimates for previous years were determined to be aberrant, thus we have used the revised population estimation in this report. Mary Jo Trepka, MD, MSPH Director of Epidemiology and Disease Control 1. Hoyert DL, Arias E, Smith BL, Murphy SL, Kochanek KD. Deaths: Final Data for 1999. National vital statistics reports; vol 49 no 8. Hyattsville, Maryland: National Center for Health Statistics. 2001. I

Glossary Age-adjusted death rate: A rate that has taken into account influences on a crude death rate due to differences in the age composition of the population. In this report, the ageadjusted rates were computed by the direct method using the 2000 US standard population. Age-specific rate: Rate obtained for specific age groups (for example, age-specific fertility rate, death rate, etc.). AIDS: Acquired Immune Deficiency Syndrome caused by the human immunodeficiency virus (HIV). Birthweight: The weight of a newborn at delivery, recorded in pounds and ounces or in grams. DBPR: Florida Department of Business and Professional Regulation. Cause of death: Any condition which leads to or contributes to death and is classifiable according to the tenth revision of the International Classification of Diseases (ICD-10). Childbearing years: The reproductive age span of women; conventionally defined as 15 through 44 years of age for the U.S. population. Congenital anomaly: Physical, physiological, or metabolic abnormality existing before or at birth, but not necessarily detectable at birth. Crude rate: The rate of any demographic or vital event that is based on the total midyear population. DACS: Florida Department of Agriculture and Consumer Services DOH: Florida Department of Health Ethnicity: The classification of a population that shares common characteristics, such as religion, traditions, culture, language, and tribal or national origin. Fetal death: Death of a product of conception prior to the complete expulsion or extraction from its mother, regardless of the length of gestation. Fertility rate: The number of live births per 1,000 female population aged 15-44 years in a given year. Foodborne illness outbreak: A foodborne outbreak is an incident in which two or more persons have the same disease, have similar symptoms, or excrete the same pathogens and II

there is a time, place, and/or person association between these persons. A foodborne disease outbreak is one in which a common food has been ingested by such persons. Nevertheless, a single case of suspected botulism, mushroom poisoning, ciguatera, paralytic shellfish poisoning, a rare disease, or a case of a disease that can be definitely related to ingestion of a food can be considered as an incident of foodborne illness and warrants further investigation. Gestational age: Number of completed weeks elapsed between the first day of the last normal menstrual period and the date of delivery or clinical estimate. Homicide: Death due to injury purposefully inflicted by other individuals (ICD-10 codes, X85-Y09), death from injuries resulting from legal intervention (homicide committed by law enforcement officers; ICD-10, codes, code Y87.1). ICD-10: The International Classification of Diseases, 10th edition. A system for classifying diseases and injuries developed by the World Health Organization and used worldwide to improve comparability of cause of death statistics reported from different countries. The tenth revisions has been in use since January 1, 1999. Infant: An individual less than one year of age. Infant death: Death of an individual less than one year of age. Infant deaths are further classified as neonatal deaths and postneonatal deaths. (See also neonatal death and postneonatal death.) Live birth: The complete expulsion or extraction from its mother of a product of conception, regardless of the duration of the pregnancy, which after expulsion shows any vital signs (heart beat, breathing, umbilical cord pulsation, or movement of voluntary muscles). Live birth order: Denotes the number position of the present birth relative to previous live births. That is, whether the live birth being counted is the 1st, 2nd, 3rd, etc. live born infant to a particular mother. Low birthweight: A birth weight less than 2,500 grams or less than 5 pounds, 8 ounces. Maternal death: The death of a woman resulting from pregnancy or childbearing, while pregnant or within 42 days of termination of pregnancy. Midyear population: The estimated (except for census data) population at the midpoint of the year, which approximates the average population for the year. Morbidity: Refers to the occurrence of diseases in a population. Mortality: Death as a component of population change. III

Fetal death rate: Number of fetal deaths per 1,000 live births plus fetal deaths: ((Number of fetal deaths/(live births + fetal deaths))*1,000 Fertility rate: The number of live births per 1,000 women of reproductive age (15 to 44). (Number of live births/ Female population aged 15-44 years)*1,000 Infant mortality rate: Deaths of individuals less than 1 year of age per 1,000 live births: (Number of deaths less than 1 year/number of live births)*1,000 Maternal mortality rate: Number of maternal deaths per 100,000 live births: (Number of maternal deaths/number of live births)*100,000 Neonatal mortality rate: Number of individuals dying at less than 28 days of age per 1,000 live births: (Number of deaths among infants less than 28 days old/number of live births)*1,000 Post-neonatal mortality rate: Number of infants dying at 28 to 365 days of age per 1,000 live births: (Number of deaths among infants 28-365 days old/number of live births)*1,000 V

Midyear Population Estimates by Age, Race and Sex, Miami-Dade County 1999 Age (yrs.) White Nonwhite All Sub-total Male Female Sub-total Male Female Male Female Total 0-4 93395 48074 45321 51965 26468 25497 74542 70818 145360 5-9 97519 49927 47592 59234 30125 29109 80052 76701 156753 10-14 96369 49456 46913 59973 30197 29776 79653 76689 156342 15-19 90961 47086 43875 60806 30138 30668 77224 74543 151767 15-17 55625 28733 26892 36933 18529 18404 47262 45296 92558 18-19 35336 18353 16983 23873 11609 12264 29962 29247 59209 20-24 91337 46369 44968 52199 25098 27101 71467 72069 143536 25-29 113623 57675 55948 52352 25212 27140 82887 83088 165975 30-34 121921 61940 59981 51206 24601 26605 86541 86586 173127 35-39 135032 68233 66799 54704 25900 28804 94133 95603 189736 40-44 112178 55412 56766 51137 23763 27374 79175 84140 163315 45-49 101427 48787 52640 42546 19757 22789 68544 75429 143973 50-54 92995 44697 48298 33125 15446 17679 60143 65977 126120 55-59 79911 38126 41785 24365 11275 13090 49401 54875 104276 60-64 74713 34588 40125 21001 9648 11353 44236 51478 95714 65-69 66204 30056 36148 16210 7073 9137 37129 45285 82414 70-74 63931 28071 35860 12512 5058 7454 33129 43314 76443 75-79 49822 20257 29565 8045 3086 4959 23343 34524 57867 80-84 33737 12326 21411 4938 1732 3206 14058 24617 38675 85+ 32762 10066 22696 3988 1132 2856 11198 25552 36750 Total 1547837 751146 796691 660306 315709 344597 1066855 1141288 2208143 Source: Official April 1, 2000 Florida Population from the January, 1999 Florida Demographic Estimating Conference Miami-Dade County Health Department VI

Natality: Birth as a component of population change. Neonatal death: Death prior to the 28th day of life. (See also infant death.) Perinatal: Period from 20 weeks gestation through 27 days after birth. Postneonate: An infant between 28 days and one year of age. Postneonatal death: Death on or after the 28th day of life and before the first birthday. (See also infant death.) Preterm birth: Birth at less than 37 completed weeks of gestation. Race: A geographical population of humankind that possesses inherited distinctive physical characteristics that distinguish it from other populations. UNK: Unknown. Years of potential life lost: A measure of the impact of premature mortality on a population. It is calculated as the sum of the differences between some predetermined minimum or desired life span and the age of death for individuals who died earlier than that predetermined age. The desired age is usually set at 65 or 75 in the calculations. Rates and Formulae Rates and ratios are calculated for a specific time period, typically a calendar year or a multiple of calendar years. Age-specific rate: Number of events occurring to a specified age group per 1,000 population of the specified age group: (Number of events in specified age group/number in age group)*1,000 Cause-specific death rate: Number of deaths due to a specific cause per 100,000 population: (Number of deaths from a specified cause/ Estimated midyear population)*100,000 (Crude) birth rate: Number of live births per 1,000 population: (Number of live births/ Estimated midyear population)*1,000 Crude death rate: Number of deaths per 1,000 population: (Number of deaths/ Estimated midyear population)*1,000 IV

Midyear Population Estimates by Age, Race and Sex, Miami-Dade County 2000 Age (yrs.) White Nonwhite All Sub-total Male Female Sub-total Male Female Male Female Total 0-4 95284 48999 46285 53122 27069 26053 76068 72338 148406 5-9 97674 50015 47659 59670 30348 29322 80363 76981 157344 10-14 98509 50497 48012 62012 31271 30741 81768 78753 160521 15-19 93023 48021 45002 62582 31077 31505 79098 76507 155605 15-17 57141 29420 27721 38073 19122 18951 48542 46672 95214 18-19 35882 18601 17281 24509 11955 12554 30556 29835 60391 20-24 91529 46524 45005 54155 26137 28018 72661 73023 145684 25-29 111109 56412 54697 53147 25606 27541 82018 82238 164256 30-34 121378 61653 59725 52023 25029 26994 86682 86719 173401 35-39 135417 68458 66959 55676 26376 29300 94834 96259 191093 40-44 116748 57858 58890 53217 24728 28489 82586 87379 169965 45-49 104678 50481 54197 45310 20987 24323 71468 78520 149988 50-54 95991 46079 49912 35564 16503 19061 62582 68973 131555 55-59 82788 39429 43359 26148 12051 14097 51480 57456 108936 60-64 75611 34994 40617 21996 10092 11904 45086 52521 97607 65-69 67049 30568 36481 17076 7502 9574 38070 46055 84125 70-74 64512 28505 36007 13215 5384 7831 33889 43838 77727 75-79 51042 21033 30009 8632 3321 5311 24354 35320 59674 80-84 34510 12785 21725 5234 1846 3388 14631 25113 39744 85+ 33435 10294 23141 4296 1228 3068 11522 26209 37731 Total 1570287 762605 807682 683075 326555 356520 1089160 1164202 2253362 Source: Official April 1, 2001 Florida Population from the January, 1999 Florida Demographic Estimating Conference Miami-Dade County Health Department VII

Midyear Population Estimates by Age, Race and Sex, Miami-Dade County 2001 Age (yrs.) White Nonwhite All Sub-total Male Female Sub-total Male Female Male Female Total 0-4 98117 50375 47742 54339 27697 26642 78072 74384 152456 5-9 96810 49603 47207 58949 29981 28968 79584 76175 155759 10-14 100211 51341 48870 63170 31920 31250 83261 80120 163381 15-19 95010 48939 46071 63254 31494 31760 80433 77831 158264 15-17 58492 30042 28450 38513 19386 19127 49428 47577 97005 18-19 36518 18897 17621 24741 12108 12633 31005 30254 61259 20-24 92140 46910 45230 55335 26821 28514 73731 73744 147475 25-29 107782 54660 53122 53031 25515 27516 80175 80638 160813 30-34 119973 60869 59104 52242 25123 27119 85992 86223 172215 35-39 133779 67584 66195 55700 26386 29314 93970 95509 189479 40-44 121933 60622 61311 54615 25397 29218 86019 90529 176548 45-49 107949 52249 55700 47572 21976 25596 74225 81296 155521 50-54 98755 47308 51447 37849 17467 20382 64775 71829 136604 55-59 85901 40824 45077 27861 12773 15088 53597 60165 113762 60-64 76339 35381 40958 22678 10365 12313 45746 53271 99017 65-69 67925 31111 36814 17759 7861 9898 38972 46712 85684 70-74 64232 28564 35668 13712 5636 8076 34200 43744 77944 75-79 52273 21819 30454 9170 3534 5636 25353 36090 61443 80-84 35610 13381 22229 5455 1934 3521 15315 25750 41065 85+ 33888 10490 23398 4551 1317 3234 11807 26632 38439 Total 1588627 772030 816597 697242 333197 364045 1105227 1180642 2285869 Source: Official April 1, 2001Florida Population from the January, 1999 Florida Demographic Estimating Conference Miami-Dade County Health Department VIII

Selected Health Indicators in Miami-Dade County, Florida and United States, 1999-2001 Birth Rates (per 1,000) 1999 2000 2001 Florida United States White Nonwhite All White Nonwhite All White Nonwhite All 2001 2001 Total Population 14.0 14.9 14.3 14.0 14.9 14.3 14.2 14.1 14.2 12.5 14.5 10-17 year-old Women 9.9 14.4 11.7 9.3 14.1 11.2 7.8 12.2 9.5 10.2 9.8 18-19 year-old Women 64.6 83.4 72.6 66.1 82.1 72.9 66.3 78.7 71.7 79.7 75.5 15-44 year-old Women 65.5 58.1 63.2 66.4 58.8 64.1 67.8 56.2 63.9 62.7 66.9 Infant and Maternal Health Low Birthweight (<2500 grams) (%) 5.6 11.0 7.9 6.4 11.2 7.9 6.1 11.1 7.6 8.2 7.7 Very Low Birthweight (<1500 grams) (%) 1.1 2.6 1.6 1.1 2.4 1.6 1.1 2.9 1.6 1.6 1.4 Preterm Births (<37 weeks) (%) 8.6 12.5 9.8 8.8 13.6 10.3 8.2 12.8 9.6 N/A*** 11.9 Receiving Prenatal Care in the First Trimester (%) 89.5 78.0 85.9 89.7 78.6 86.2 91.4 79.8 87.8 83.1 83.4 Births to Teens Aged 10-17 Years (%) 3.4 7.1 4.5 3.2 6.9 4.4 2.7 6.3 3.8 4.1 3.8 Births to Teens Aged 18-19 Years (%) 5.1 10.4 6.7 5.2 10.1 6.7 5.2 10.1 6.7 7.9 7.5 Infant Mortality (per 1,000 live births) 3.7 8.2 5.1 4.4 7.6 5.8 4.0 10.1 5.8 7.3 6.9** Neonatal Mortality (per 1,000 live births) 2.9 4.3 3.3 3.2 5.4 3.9 2.6 6.6 3.8 4.8 4.6** Postneonatal Mortality (per 1,000 live births) 0.8 3.9 1.8 1.2 3.2 1.8 1.3 3.5 2.0 2.5 2.3** Fetal Mortality* 5.5 14.6 8.3 6.6 14.7 9.3 6.4 12.9 8.6 8.1 N/A*** Maternal Mortality (per 100,000 live births) 18.5 51.0 28.6 18.2 19.7 18.6 4.4 51.0 18.5 9.7 9.8** Mortality Crude Mortality (per 100,000) 1008.6 524.8 863.9 952.9 512.8 819.5 974.3 551.2 833.0 1018.7 873.1** Age-Adjusted Mortality (per 100,000) 824.2 812.9 841.1 773.5 777.5 792.8 787.0 767.0 799.8 762.0 872** * Fetal Deaths per 1,000 live births plus fetal deaths **: 2000 data ***N/A: Data not available Miami-Dade County Health Department IX