title: Hepatitis A--related mortality in California, 1989-2000: analysis of multiple cause-coded death data.
abstract: OBJECTIVE
  We estimated the hepatitis A (HA) mortality rate in California, assessed demographic differences in HA-related mortality, and examined comorbidities listed on death certificates in order to provide information for health policy and planning related to HA vaccination.
  
  
  METHODS
  We identified HA-related deaths in California from 1989 to 2000 with multiple-cause-of-death files and calculated mortality rates and rate ratios.
  
  
  RESULTS
  We identified 402 HA-related deaths between 1989 and 2000; the annual age-adjusted HA-related mortality rate was 1.20 deaths per 1 million persons. Older individuals, men, Latinos, and American Indians/Alaska Natives had elevated mortality rates. Liver conditions and non-A viral hepatitis infections were more common among HA-related deaths than among all other deaths.
  
  
  CONCLUSIONS
  Current immunization practices should be reevaluated and the expansion of current vaccination guidelines for groups that have elevated HA-related mortality rates should be considered.
authors.affiliation: Department of Epidemiology, UCLA School of Public Health, 90095-1772, USA. mawise@ladhs.org
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Wise
authors.forename: Frank
authors.initials: F
authors.lastname: Sorvillo
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003644:Death Certificates; D005006:Ethnicity; D005260:Female; D006506:Hepatitis A / Q000209:etiology / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged