Edition: U.S. / Global

New Yorkers Can't Beat Death, But Data Says They're Gaining

Published: January 31, 2004

For the first time since the 19th century, when New York was a far different, far smaller place, fewer than 60,000 people died in the five boroughs in 2002, continuing a steady decline that began in the early 1990's and setting a record low for the city's death rate.

Infant mortality, too, reached a record low -- less than half the rate of the 1980's. AIDS persisted as a leading killer of black and Hispanic New Yorkers -- but less so in Queens. People in Manhattan were more likely than those in the other boroughs to take their own lives, but less likely to die of diabetes. New Yorkers were more likely than ever to die in nursing homes, and less likely to die at home. Men were more likely than women to be run over while crossing the street, and elderly pedestrians were much more likely to be killed than younger ones.

These nuggets and thousands more are found in the city's Summary of Vital Statistics for 2002, released yesterday by the Department of Health and Mental Hygiene. To the statistically minded or just plain morbid, the report is a treasure, 67 pages of revealing, quirky and sometimes startling numbers that illustrate how New Yorkers live and, mostly, how they die, broken down by cause, age, sex, race, borough and even neighborhood (see for yourself at www.nyc.gov/html/doh/pdf/vs/2002sum.pdf).

News reports can give the impression that life in the city is dominated by ways to meet an early end -- being hit by a cab, stabbed by a mugger, slipping on the ice. The civic culture tends to send the same signals, as New Yorkers compare urban horror stories and tell themselves what hardy souls they must be to survive.

But the main message that emerges from the hard data is that New Yorkers are on the whole safer and healthier than they used to be. Last year, the Health Department reported that a city resident's life expectancy had hit 77.6 years, up by five years in a decade, and that for the first time in six decades, New Yorkers were living longer than other Americans.

But like any good clinician, Thomas R. Frieden, the city health commissioner, is more interested in addressing the bad news that remains.

''The thing that's striking to me is causes of death under 65, which, no one would argue, are premature deaths,'' Dr. Frieden said. ''When you look at them, it's just so dramatic, the things we can do something about: H.I.V., lung cancer, colon cancer, breast cancer, drug use, cardiovascular disease, liver disease. So many of those deaths are preventable.''

In New York City, 59,651 people died in 2002 (compiling the report is an enormous task, and it always lags about a year behind). Even at the turn of the last century, when the five boroughs were newly united into a single city with less than half the population of eight million it has today, many more people died each year in New York City.

For 70 years, the city's death rate seemed almost impervious to change, fluctuating around 10 to 11 deaths for every 1,000 residents. Then, in the early 1990's, it began a long, steady slide, that continued in 2002, when the death rate hit 7.4 per 1,000, the lowest ever recorded. The difference between 10 and 7.4 may sound small, but in a city the size of New York, it translates to about 20,000 fewer deaths each year.

The year 2001 would have set the previous record low death rate, if not for the World Trade Center terror attack. (This year's Vital Statistics report includes a special section devoted to 9/11, including the fact that the birth rate dropped a bit nine months afterward, then rose again shortly after.)

In 2002, 122,937 babies were born in the city, the lowest birth rate since the ''baby bust'' of the 1970's and early 80's.

So how is it that New Yorkers -- more obese, more sedentary and more likely to be uninsured than in years past -- are living longer? The obvious factors are the steep drops in AIDS deaths and homicides, which together claimed 2,300 lives in 2002, down from more than 8,000 in some years in the 1990's.

With better prenatal and newborn care, infant mortality has dropped steadily for three decades, and the 2002 rate of 6 deaths per 1,000 babies was barely half what it was in 1990. Fewer New Yorkers smoke cigarettes, fewer smoke crack and fewer die in traffic accidents, thanks largely to increased use of air bags, seat belts and motorcycle helmets. For those with health care, there have been any number of technical advances.

But the benefits of all this progress are unevenly distributed among ethnic groups and neighborhoods. The Fort Greene section of Brooklyn had an infant mortality rate of 13.9 per 1,000, more than double the city average; citywide, black babies are most likely to die. Teenage motherhood is down sharply among women of Puerto Rican descent over the last decade, as it is in the city population over all, but it is up just as sharply among other Hispanics.

H.I.V. infection, which kills more than 1,700 New Yorkers yearly, also accounts for one of the most striking ethnic disparities. Among people under 65, it was blamed for 1.4 percent of deaths in Asians, 4 percent in non-Hispanic whites, 12 percent in non-Hispanic blacks, 16.4 percent in people of Puerto Rican heritage, and 8.6 percent in other Hispanics.

''Not only are blacks and Latinos more likely to have H.I.V., they are much more likely to die of it,'' Dr. Frieden said. ''The tremendous advances in H.I.V.-AIDS treatment have not been spread equally.''

Some differences are easily explained. Manhattan residents are less likely to be obese than residents of the other boroughs, so it makes sense that they would be less likely to die from heart disease and diabetes.

Other items are trickier, like the 209 pedestrian deaths in 2002. People over 65 accounted for nearly half the victims -- no surprise, since they move more slowly, and are more likely to have trouble hearing or seeing.

But how to explain that among the pedestrian dead under age 55, men outnumbered women 3 to 1? Are men more likely to be too aggressive afoot, or less likely to be paying attention to their surroundings?

''I'm not going to touch that,'' Dr. Frieden said.

Chart: ''Tracking Deaths in New York City'' The city's summary of vital statistics, released yesterday, reported that the death rate in 2002 was the lowest in New York City's history. A declining death rate . . . Deaths per 1,000 people Graph tracks the amount of deaths in New York City since 1960. 2001, excluding victims of 9/11 terror attack . . . And one reason for it Total deaths from H.I.V. Graph tracks the amount of deaths from H.I.V. in New York City since 1993. (Source by New York City Department of Health and Mental Hygiene)(pg. B2)