title: Wisconsin trends in pneumonia and influenza mortality, 1980-2003.
abstract: BACKGROUND
  Mortality due to pneumonia and influenza continues to be a serious public health threat, especially among those aged > or = 65. Continued monitoring of these high-risk populations is necessary for evaluating the impact of public health prevention activities, determining vaccine distribution policies, and ensuring that existing guidelines reflect the populations at risk.
  
  
  OBJECTIVE
  We characterized pneumonia and influenza mortality in Wisconsin from 1980 to 2003, including trend analysis, identification of high risk populations, and assessment of Wisconsin's progress toward state and national goals for vaccination.
  
  
  METHODS
  We examined mortality trends for pneumonia and influenza as underlying causes of death among all Wisconsin residents who died in the state from 1980 to 2003.
  
  
  RESULTS
  The pneumonia and influenza (P&I) mortality rate increased from 27/100,000 to 38/100,000 during 1980 through 1988, and then decreased to 26/100,000 through 2003. The decline in the mortality rate after 1988 was temporally associated with improving pneumococcal and influenza vaccination among those > or = 65. By 2003, all age groups except those aged > or = 85 had lower P&I mortality than in 1980.
  
  
  CONCLUSIONS
  In Wisconsin, the increase in pneumonia and influenza mortality demonstrated during the 1980s was reversed. However, there was relatively little change in mortality among those aged 65-84 and rates among those > or = 85 years have increased. Novel improvements in public health interventions are needed to improve the focus on the elderly, including efforts to increase vaccination, prevent pneumococcal disease, and explore other evidence-based strategies to reduce pneumonia and influenza mortality.
authors: University of Wisconsin-Madison Medical School, Department of Population Health Sciences, USA. cschumann@wisc.edu
authors: Casey L
authors: CL
authors: Schumann
authors: Neil J
authors: NJ
authors: Hoxie
authors: James M
authors: JM
authors: Vergeront