1957 - United Nations Statistics Division

treated prior to his death by a medical attendant, the
reported cause of death will reflect the opinion of that
physician based on observation of the patient while he
was alive. (3) If on the other hand, the decedent has died
without medical attendance, his body may be examined
(not autopsied) by a physician who, aided by the questioning
of persons who saw the patient before death, may
come to a decision as to the probable cause of death. (4)
Still another possibility is that a physician or other medically
trained person may question witnesses without
seeing the decedent and arrive at a diagnosis. (5) Finally,
there is the case where witnesses give the cause of death
without benefit of medical advice or questioning.
These 5 possible sources of information on cause of
death constitute in general 5 degrees of accuracy in these
data. However, data in Table 15 reflect none of these
precisely. In some countries,37 "medically certified" means
"certificate signed by a doctor", which can represent any
or all of possibilities 1-4 listed above. In other countries,
the same category may mean "attended by a doctor before
death". It will be evident that care must be taken in
comparing the percentages from country to country.
Despite their limitations, they do afford another index
to the quality of cause-of-death statistics. They also provide
insight into the causes which are receiving the attention
of medical personnel.
Table 16
Table 16 presents for the first time since 1951, deaths
by cause and age for each sex. Data for only one (the
latest available) year is included because of space limitations,
and that year refers most often to 1955 or 1956.
This, together with the pre-1950 years' experience shown
in the 1951 Demographic Yearbook, provides some information
on which comparisons may be made over time,
keeping in mind the possible lack of continuity between
the 1938 and 1948 Revisions of the List (see p. 32) .
The classification of cause of death is the same as that
used in Table 14, namely, the "Abbreviated List of 50
Causes for Tabulation of Mortality" from the International
Statistical Classification of Diseases, Injuries,
and Causes of Death-the 1948 or sixth revision of the
international lists.3s However, in this table, the stub
consists of the Abbreviated List Numbers Bl to BE50;
for the full titles and the detailed list numbers included,
reference must be made to Table 14, beginning p. 362.
Age in Table 16 is classified into 8 categories, including
under 1 year, 1-4 years, 5-14, 15-24, 25-44, 45-64, 65 and
over, and unknown. This scheme represents a consolidation
of internationally recommended age classifications,39
but the groups selected correspond to the major stages of
life from infancy to old age and reflect the characteristic
age distributions of particular diseases.
Coverage: Table 16 contains cause-age-sex distributions
for 50 geographic areas. This is somewhat fewer than the
potential capacity of the table. The first criterion employed
for inclusion was that total deaths for both sexes
combined totalled at least 1,000. The second criterion
37 El Salvador, Uruguay, Mexico.
38 Manual ... , op. cit.
39 Principles for a Vital Statistics System, op. cit., Principle 410 (e)
(10). Also, World Health Organization's Regulations No.1, Article 6.
was that deaths be coded by cause according to the 1948
Revision of the International List and tabulated by the
"Abbreviated List of 50 Causes for Tabulation of Mortality"
or by a tabulation list directly convertible to it,
e.g., the Intermediate List. A third criterion was that the
frequency in category B45 (Senility, without mention of
psychosis, ill-defined and unknown causes) accounted for
less than 25% of the total deaths for at least one of the
sexes. Finally, distributions for West Berlin, Hawaii, Macau,
Portuguese India, and the Turkish provincial capitals
were excluded; this limited the table to national figures
or an ethnic population group of the whole country
which met the previously cited criteria. Thus, Table 16
serves as an index to areas with 1,000 or more deaths
which have been tabulated by cause, age, and sex according
to the 1948 Revision of the International List and
of which less than 25% are coded B45. It should be noted
that additional distributions are available coded and
tabulated according to the 1938 Revision of the List or
by a national classification scheme. These are not included
because comparability cannot easily be achieved
between tabulations as consolidated as these. 40
Limitations: These data are subject to all the qualifications
of death statistics in general and, in addition, those produced
by errors in age reporting and in certifying and
classifying of death.
Since these have all been set forth in connexion with
other tables, they will not be repeated here. Reference
should be made to the text of Table 10 for age-reporting
problems and to Table 14 text for difficulties of cause-ofdeath
reporting and classifying.
Table 17
Current death rates by cause of death, specific for age
and sex, are set forth in Table 17 for 31 countries.
This is the first time that age-sex specific rates by cause
have been included in the Demographic Yearbook and
the first international compilation of rates for the 50
causes in the Abbreviated Tabulation List 41 in recent
years. The classification by cause is the same as that in
Table 16, as is the classification by age.
Coverage: Table 17 includes rates for 31 geographic areas.
These have been computed from statistics in Table 16.
This is, however, a much more limited coverage than was
possible for Table 16 because of the necessity of relating
the absolute numbers from that table to corresponding
population. Distributions of population by age and sex
are usually available as a result of a census, and they can
be estimated for intercensal years if birth and death data
are also available. In Table 17, only population censuses
and those estimates constructed by the natural increase
method and corresponding in coverage and time were
used as a base for rates. The lack of such population accounts
for the decrease in coverage of the rate table over
the corresponding table of absolute numbers (Table 16).
Rate computation: Rates are the number of deaths from
each cause in each age and sex group per 100,000 popula-
40 Comparability of Statistics of Causes of Death ... , op. cit.
41 Corresponding death rates for 20 selected causes are published
in the World Health Organization's Annual Epidemiological and
Vital Statistics.