Deaths
Year: 1989
Place of Residence: California
Cause of Death: NCHS Rankable Causes, and Non-Rankable

Underlying Cause Male Female Total
Diseases of the Heart 34,489 34,968 69,457
Malignant Neoplasms [Cancer] 24,767 23,343 48,110
Non-Rankable Causes 9,426 9,119 18,545
Cerebrovascular Diseases [Stroke] 6,169 9,556 15,725
Accidents [Injuries] 7,683 3,108 10,791
Influenza and Pneumonia 4,735 5,744 10,479
Chronic Lower Respiratory Diseases 5,125 4,634 9,759
Human Immunodeficiency Virus [HIV] 4,205 162 4,367
Chronic Liver Disease and Cirrhosis 2,690 1,310 4,000
Intentional Self-Harm [Suicide] 2,924 908 3,832
Diabetes Mellitus 1,500 1,864 3,364
Homicide and Legal Intervention 2,699 656 3,355
Atherosclerosis 768 1,371 2,139
Conditions Arising in Perinatal Period 1,203 934 2,137
Congenital Malformations 835 780 1,615
Nephritis, Nephrotic Syndrome, Nephrosis 738 766 1,504
Alzheimer's Disease 430 707 1,137
Hypertension [Primary and Renal] 395 549 944
Gastric and Duodenal Ulcer 427 443 870
Septicemia 347 403 750
Non-Malignant Neoplasms 318 340 658
Hernia and Obstruction 175 310 485
Anemias 123 162 285
Viral Hepatitis 173 94 267
Cholelithiasis, Gallbladder Disorders 125 135 260
Tuberculosis 154 80 234
Infections of Kidney 63 135 198
Nutritional Deficiencies 56 102 158
Meningitis 82 66 148
Acute Bronchitis and Bronchiolitis 43 60 103
Meningococcal Infection 38 39 77
Hyperplasia of Prostate 64 0 64
Diseases of Appendix 26 24 50
Pregnancy, Childbirth, Puerperium 0 33 33
Measles 6 6 12
Syphilis 4 5 9
Shigellosis and Amebiasis 3 2 5
Streptococcal Infection 1 2 3
Whooping Cough 0 1 1
Acute Poliomyelitis 0 0 0
Total 113,009 102,921 215,930



Deaths
Year: 1990
Place of Residence: California
Cause of Death: NCHS Rankable Causes, and Non-Rankable

Underlying Cause Male Female Total
Diseases of the Heart 33,742 33,683 67,425
Malignant Neoplasms [Cancer] 25,318 23,578 48,896
Non-Rankable Causes 9,548 9,153 18,701
Cerebrovascular Diseases [Stroke] 6,029 9,433 15,462
Accidents [Injuries] 7,218 2,952 10,170
Influenza and Pneumonia 4,333 5,353 9,686
Chronic Lower Respiratory Diseases 5,081 4,566 9,647
Human Immunodeficiency Virus [HIV] 4,832 209 5,041
Chronic Liver Disease and Cirrhosis 2,613 1,277 3,890
Homicide and Legal Intervention 3,112 660 3,772
Intentional Self-Harm [Suicide] 2,872 863 3,735
Diabetes Mellitus 1,467 1,911 3,378
Conditions Arising in Perinatal Period 1,193 882 2,075
Atherosclerosis 768 1,299 2,067
Congenital Malformations 937 776 1,713
Nephritis, Nephrotic Syndrome, Nephrosis 759 761 1,520
Alzheimer's Disease 414 775 1,189
Hypertension [Primary and Renal] 392 546 938
Gastric and Duodenal Ulcer 381 425 806
Non-Malignant Neoplasms 318 353 671
Septicemia 306 342 648
Hernia and Obstruction 185 285 470
Anemias 118 158 276
Cholelithiasis, Gallbladder Disorders 119 153 272
Viral Hepatitis 176 89 265
Tuberculosis 129 82 211
Infections of Kidney 67 130 197
Nutritional Deficiencies 55 96 151
Meningitis 68 62 130
Acute Bronchitis and Bronchiolitis 32 46 78
Hyperplasia of Prostate 66 0 66
Diseases of Appendix 42 19 61
Pregnancy, Childbirth, Puerperium 0 55 55
Meningococcal Infection 18 28 46
Measles 21 18 39
Syphilis 6 3 9
Shigellosis and Amebiasis 1 5 6
Streptococcal Infection 0 3 3
Whooping Cough 0 1 1
Acute Poliomyelitis 0 0 0
Total 112,736 101,030 213,766



Deaths
Year: 1991
Place of Residence: California
Cause of Death: NCHS Rankable Causes, and Non-Rankable

Underlying Cause Male Female Total
Diseases of the Heart 33,671 33,469 67,140
Malignant Neoplasms [Cancer] 25,686 24,315 50,001
Non-Rankable Causes 9,503 9,205 18,708
Cerebrovascular Diseases [Stroke] 6,163 9,187 15,350
Influenza and Pneumonia 4,464 5,261 9,725
Chronic Lower Respiratory Diseases 4,942 4,761 9,703
Accidents [Injuries] 6,622 2,798 9,420
Human Immunodeficiency Virus [HIV] 5,316 217 5,533
Homicide and Legal Intervention 3,392 736 4,128
Intentional Self-Harm [Suicide] 2,919 846 3,765
Chronic Liver Disease and Cirrhosis 2,424 1,304 3,728
Diabetes Mellitus 1,504 1,804 3,308
Atherosclerosis 801 1,219 2,020
Conditions Arising in Perinatal Period 1,104 854 1,958
Congenital Malformations 948 778 1,726
Nephritis, Nephrotic Syndrome, Nephrosis 737 721 1,458
Alzheimer's Disease 431 685 1,116
Hypertension [Primary and Renal] 393 590 983
Gastric and Duodenal Ulcer 403 442 845
Non-Malignant Neoplasms 319 331 650
Septicemia 289 312 601
Hernia and Obstruction 204 328 532
Viral Hepatitis 227 121 348
Anemias 115 146 261
Cholelithiasis, Gallbladder Disorders 104 150 254
Tuberculosis 124 77 201
Infections of Kidney 42 136 178
Nutritional Deficiencies 49 113 162
Meningitis 57 48 105
Acute Bronchitis and Bronchiolitis 46 45 91
Pregnancy, Childbirth, Puerperium 0 65 65
Hyperplasia of Prostate 51 0 51
Diseases of Appendix 25 23 48
Meningococcal Infection 21 19 40
Measles 5 3 8
Syphilis 2 4 6
Shigellosis and Amebiasis 4 0 4
Whooping Cough 0 0 0
Streptococcal Infection 0 0 0
Acute Poliomyelitis 0 0 0
Total 113,107 101,113 214,220



Deaths
Year: 1992
Place of Residence: California
Cause of Death: NCHS Rankable Causes, and Non-Rankable

Underlying Cause Male Female Total
Diseases of the Heart 33,320 33,348 66,668
Malignant Neoplasms [Cancer] 25,662 24,241 49,903
Non-Rankable Causes 9,764 9,342 19,106
Cerebrovascular Diseases [Stroke] 6,020 9,091 15,111
Chronic Lower Respiratory Diseases 5,142 4,898 10,040
Influenza and Pneumonia 4,515 5,278 9,793
Accidents [Injuries] 6,526 2,725 9,251
Human Immunodeficiency Virus [HIV] 5,685 311 5,996
Homicide and Legal Intervention 3,476 683 4,159
Chronic Liver Disease and Cirrhosis 2,517 1,220 3,737
Intentional Self-Harm [Suicide] 2,800 900 3,700
Diabetes Mellitus 1,608 1,951 3,559
Atherosclerosis 760 1,263 2,023
Conditions Arising in Perinatal Period 1,005 810 1,815
Congenital Malformations 839 754 1,593
Nephritis, Nephrotic Syndrome, Nephrosis 713 763 1,476
Alzheimer's Disease 422 763 1,185
Hypertension [Primary and Renal] 441 645 1,086
Gastric and Duodenal Ulcer 419 457 876
Non-Malignant Neoplasms 305 338 643
Septicemia 300 333 633
Hernia and Obstruction 176 292 468
Viral Hepatitis 212 128 340
Anemias 135 145 280
Cholelithiasis, Gallbladder Disorders 100 158 258
Tuberculosis 108 94 202
Infections of Kidney 42 115 157
Nutritional Deficiencies 55 99 154
Meningitis 56 36 92
Acute Bronchitis and Bronchiolitis 36 30 66
Pregnancy, Childbirth, Puerperium 0 57 57
Hyperplasia of Prostate 56 0 56
Diseases of Appendix 33 19 52
Meningococcal Infection 15 22 37
Syphilis 4 3 7
Shigellosis and Amebiasis 4 0 4
Whooping Cough 2 1 3
Streptococcal Infection 0 0 0
Acute Poliomyelitis 0 0 0
Measles 0 0 0
Total 113,273 101,313 214,586



Deaths
Year: 1993
Place of Residence: California
Cause of Death: NCHS Rankable Causes, and Non-Rankable

Underlying Cause Male Female Total
Diseases of the Heart 34,155 34,448 68,603
Malignant Neoplasms [Cancer] 26,022 24,729 50,751
Non-Rankable Causes 9,784 9,846 19,630
Cerebrovascular Diseases [Stroke] 6,132 9,063 15,195
Chronic Lower Respiratory Diseases 5,326 5,299 10,625
Influenza and Pneumonia 4,865 5,643 10,508
Accidents [Injuries] 6,819 2,717 9,536
Human Immunodeficiency Virus [HIV] 5,901 386 6,287
Homicide and Legal Intervention 3,541 744 4,285
Diabetes Mellitus 1,776 2,055 3,831
Intentional Self-Harm [Suicide] 3,000 818 3,818
Chronic Liver Disease and Cirrhosis 2,436 1,245 3,681
Atherosclerosis 739 1,247 1,986
Conditions Arising in Perinatal Period 894 795 1,689
Congenital Malformations 820 724 1,544
Nephritis, Nephrotic Syndrome, Nephrosis 725 798 1,523
Alzheimer's Disease 417 808 1,225
Hypertension [Primary and Renal] 396 683 1,079
Gastric and Duodenal Ulcer 427 478 905
Non-Malignant Neoplasms 306 345 651
Septicemia 242 293 535
Hernia and Obstruction 179 282 461
Viral Hepatitis 283 176 459
Anemias 103 182 285
Cholelithiasis, Gallbladder Disorders 118 165 283
Tuberculosis 118 84 202
Infections of Kidney 45 130 175
Nutritional Deficiencies 48 90 138
Meningitis 51 45 96
Acute Bronchitis and Bronchiolitis 47 37 84
Hyperplasia of Prostate 52 0 52
Pregnancy, Childbirth, Puerperium 0 45 45
Meningococcal Infection 25 19 44
Diseases of Appendix 21 21 42
Syphilis 8 1 9
Shigellosis and Amebiasis 2 2 4
Whooping Cough 1 2 3
Streptococcal Infection 0 2 2
Acute Poliomyelitis 0 0 0
Measles 0 0 0
Total 115,824 104,447 220,271



Deaths
Year: 1994
Place of Residence: California
Cause of Death: NCHS Rankable Causes, and Non-Rankable

Underlying Cause Male Female Total
Diseases of the Heart 33,816 34,496 68,312
Malignant Neoplasms [Cancer] 26,103 25,144 51,247
Non-Rankable Causes 10,266 10,257 20,523
Cerebrovascular Diseases [Stroke] 6,282 9,421 15,703
Chronic Lower Respiratory Diseases 5,457 5,560 11,017
Influenza and Pneumonia 4,679 5,558 10,237
Accidents [Injuries] 6,421 2,812 9,233
Human Immunodeficiency Virus [HIV] 6,261 478 6,739
Diabetes Mellitus 2,256 2,662 4,918
Homicide and Legal Intervention 3,316 586 3,902
Intentional Self-Harm [Suicide] 2,872 818 3,690
Chronic Liver Disease and Cirrhosis 2,451 1,179 3,630
Atherosclerosis 727 1,263 1,990
Conditions Arising in Perinatal Period 966 726 1,692
Alzheimer's Disease 571 950 1,521
Congenital Malformations 766 746 1,512
Hypertension [Primary and Renal] 504 765 1,269
Nephritis, Nephrotic Syndrome, Nephrosis 579 614 1,193
Gastric and Duodenal Ulcer 458 467 925
Non-Malignant Neoplasms 277 345 622
Viral Hepatitis 373 184 557
Hernia and Obstruction 199 308 507
Septicemia 233 252 485
Cholelithiasis, Gallbladder Disorders 130 167 297
Anemias 114 136 250
Tuberculosis 119 80 199
Nutritional Deficiencies 52 108 160
Infections of Kidney 39 96 135
Meningitis 53 39 92
Hyperplasia of Prostate 72 0 72
Acute Bronchitis and Bronchiolitis 30 36 66
Pregnancy, Childbirth, Puerperium 0 55 55
Meningococcal Infection 25 21 46
Diseases of Appendix 30 15 45
Syphilis 4 2 6
Shigellosis and Amebiasis 3 1 4
Whooping Cough 0 3 3
Streptococcal Infection 0 0 0
Acute Poliomyelitis 0 0 0
Measles 0 0 0
Total 116,504 106,350 222,854



Deaths
Year: 1995
Place of Residence: California
Cause of Death: NCHS Rankable Causes, and Non-Rankable

Underlying Cause Male Female Total
Diseases of the Heart 33,575 34,415 67,990
Malignant Neoplasms [Cancer] 26,365 24,852 51,217
Non-Rankable Causes 10,151 10,275 20,426
Cerebrovascular Diseases [Stroke] 6,551 9,625 16,176
Chronic Lower Respiratory Diseases 5,290 5,475 10,765
Influenza and Pneumonia 4,726 5,822 10,548
Accidents [Injuries] 6,525 2,847 9,372
Human Immunodeficiency Virus [HIV] 5,962 488 6,450
Diabetes Mellitus 2,385 2,711 5,096
Intentional Self-Harm [Suicide] 2,999 824 3,823
Homicide and Legal Intervention 3,074 628 3,702
Chronic Liver Disease and Cirrhosis 2,372 1,203 3,575
Atherosclerosis 738 1,189 1,927
Alzheimer's Disease 604 1,113 1,717
Congenital Malformations 815 700 1,515
Conditions Arising in Perinatal Period 811 662 1,473
Hypertension [Primary and Renal] 561 815 1,376
Nephritis, Nephrotic Syndrome, Nephrosis 610 537 1,147
Gastric and Duodenal Ulcer 397 422 819
Viral Hepatitis 386 219 605
Non-Malignant Neoplasms 278 327 605
Hernia and Obstruction 211 317 528
Septicemia 196 237 433
Cholelithiasis, Gallbladder Disorders 128 177 305
Anemias 117 134 251
Tuberculosis 124 66 190
Infections of Kidney 42 108 150
Nutritional Deficiencies 37 88 125
Meningitis 40 35 75
Hyperplasia of Prostate 57 0 57
Acute Bronchitis and Bronchiolitis 21 31 52
Pregnancy, Childbirth, Puerperium 0 47 47
Diseases of Appendix 25 21 46
Meningococcal Infection 18 13 31
Syphilis 3 1 4
Shigellosis and Amebiasis 1 2 3
Whooping Cough 2 1 3
Streptococcal Infection 1 0 1
Measles 1 0 1
Acute Poliomyelitis 0 0 0
Total 116,199 106,427 222,626



Deaths
Year: 1996
Place of Residence: California
Cause of Death: NCHS Rankable Causes, and Non-Rankable

Underlying Cause Male Female Total
Diseases of the Heart 33,502 34,174 67,676
Malignant Neoplasms [Cancer] 25,930 24,974 50,904
Non-Rankable Causes 10,782 11,381 22,163
Cerebrovascular Diseases [Stroke] 6,593 9,888 16,481
Chronic Lower Respiratory Diseases 5,515 5,858 11,373
Influenza and Pneumonia 5,009 6,125 11,134
Accidents [Injuries] 6,349 2,868 9,217
Diabetes Mellitus 2,564 2,816 5,380
Human Immunodeficiency Virus [HIV] 3,838 369 4,207
Chronic Liver Disease and Cirrhosis 2,324 1,177 3,501
Intentional Self-Harm [Suicide] 2,663 745 3,408
Homicide and Legal Intervention 2,553 512 3,065
Alzheimer's Disease 661 1,311 1,972
Atherosclerosis 716 1,169 1,885
Hypertension [Primary and Renal] 622 848 1,470
Congenital Malformations 751 700 1,451
Conditions Arising in Perinatal Period 729 609 1,338
Nephritis, Nephrotic Syndrome, Nephrosis 571 604 1,175
Gastric and Duodenal Ulcer 419 398 817
Viral Hepatitis 398 285 683
Non-Malignant Neoplasms 324 344 668
Hernia and Obstruction 182 306 488
Septicemia 224 251 475
Cholelithiasis, Gallbladder Disorders 140 165 305
Anemias 112 153 265
Tuberculosis 116 68 184
Infections of Kidney 45 97 142
Nutritional Deficiencies 35 91 126
Meningitis 52 51 103
Hyperplasia of Prostate 80 0 80
Acute Bronchitis and Bronchiolitis 25 28 53
Diseases of Appendix 31 15 46
Meningococcal Infection 10 22 32
Pregnancy, Childbirth, Puerperium 0 30 30
Syphilis 3 2 5
Shigellosis and Amebiasis 3 1 4
Streptococcal Infection 2 0 2
Whooping Cough 0 0 0
Acute Poliomyelitis 0 0 0
Measles 0 0 0
Total 113,873 108,435 222,308



Deaths
Year: 1997
Place of Residence: California
Cause of Death: NCHS Rankable Causes, and Non-Rankable

Underlying Cause Male Female Total
Diseases of the Heart 33,753 34,520 68,273
Malignant Neoplasms [Cancer] 26,571 25,247 51,818
Non-Rankable Causes 10,918 11,631 22,549
Cerebrovascular Diseases [Stroke] 6,706 9,943 16,649
Influenza and Pneumonia 5,534 6,752 12,286
Chronic Lower Respiratory Diseases 5,657 6,080 11,737
Accidents [Injuries] 5,960 2,802 8,762
Diabetes Mellitus 2,667 2,944 5,611
Chronic Liver Disease and Cirrhosis 2,304 1,198 3,502
Intentional Self-Harm [Suicide] 2,651 773 3,424
Homicide and Legal Intervention 2,359 477 2,836
Alzheimer's Disease 684 1,373 2,057
Atherosclerosis 769 1,210 1,979
Human Immunodeficiency Virus [HIV] 1,640 217 1,857
Hypertension [Primary and Renal] 646 906 1,552
Congenital Malformations 762 722 1,484
Conditions Arising in Perinatal Period 749 614 1,363
Nephritis, Nephrotic Syndrome, Nephrosis 600 675 1,275
Gastric and Duodenal Ulcer 337 414 751
Non-Malignant Neoplasms 322 383 705
Viral Hepatitis 426 278 704
Hernia and Obstruction 187 297 484
Septicemia 226 252 478
Cholelithiasis, Gallbladder Disorders 140 159 299
Anemias 86 130 216
Tuberculosis 108 86 194
Infections of Kidney 35 85 120
Nutritional Deficiencies 35 66 101
Meningitis 48 44 92
Hyperplasia of Prostate 76 0 76
Acute Bronchitis and Bronchiolitis 20 38 58
Diseases of Appendix 23 29 52
Pregnancy, Childbirth, Puerperium 0 45 45
Meningococcal Infection 22 19 41
Syphilis 3 1 4
Shigellosis and Amebiasis 1 1 2
Whooping Cough 1 0 1
Streptococcal Infection 0 1 1
Acute Poliomyelitis 0 0 0
Measles 0 0 0
Total 113,026 110,412 223,438



Deaths
Year: 1998
Place of Residence: California
Cause of Death: NCHS Rankable Causes, and Non-Rankable

Underlying Cause Male Female Total
Diseases of the Heart 34,225 34,721 68,946
Malignant Neoplasms [Cancer] 26,287 24,899 51,186
Non-Rankable Causes 11,493 12,667 24,160
Cerebrovascular Diseases [Stroke] 6,556 9,829 16,385
Influenza and Pneumonia 5,942 7,374 13,316
Chronic Lower Respiratory Diseases 5,882 6,379 12,261
Accidents [Injuries] 5,918 2,702 8,620
Diabetes Mellitus 2,842 2,954 5,796
Chronic Liver Disease and Cirrhosis 2,349 1,111 3,460
Intentional Self-Harm [Suicide] 2,519 696 3,215
Homicide and Legal Intervention 1,896 422 2,318
Alzheimer's Disease 684 1,403 2,087
Atherosclerosis 730 1,207 1,937
Hypertension [Primary and Renal] 698 989 1,687
Human Immunodeficiency Virus [HIV] 1,233 199 1,432
Congenital Malformations 719 694 1,413
Conditions Arising in Perinatal Period 754 592 1,346
Nephritis, Nephrotic Syndrome, Nephrosis 631 654 1,285
Viral Hepatitis 549 311 860
Gastric and Duodenal Ulcer 341 402 743
Non-Malignant Neoplasms 294 338 632
Septicemia 253 269 522
Hernia and Obstruction 199 322 521
Cholelithiasis, Gallbladder Disorders 150 187 337
Anemias 128 130 258
Tuberculosis 105 60 165
Infections of Kidney 32 87 119
Nutritional Deficiencies 39 70 109
Meningitis 42 37 79
Hyperplasia of Prostate 72 0 72
Acute Bronchitis and Bronchiolitis 25 35 60
Diseases of Appendix 34 18 52
Pregnancy, Childbirth, Puerperium 0 34 34
Meningococcal Infection 14 14 28
Syphilis 2 4 6
Shigellosis and Amebiasis 1 0 1
Whooping Cough 1 0 1
Streptococcal Infection 0 1 1
Acute Poliomyelitis 0 0 0
Measles 0 0 0
Total 113,639 111,811 225,450



Deaths
Year: 1989-1998
Place of Residence: California
Cause of Death: NCHS Rankable Causes, and Non-Rankable

Underlying Cause Male Female Total
Diseases of the Heart 338,248 342,242 680,490
Malignant Neoplasms [Cancer] 258,711 245,322 504,033
Non-Rankable Causes 101,635 102,876 204,511
Cerebrovascular Diseases [Stroke] 63,201 95,036 158,237
Influenza and Pneumonia 48,802 58,910 107,712
Chronic Lower Respiratory Diseases 53,417 53,510 106,927
Accidents [Injuries] 66,041 28,331 94,372
Human Immunodeficiency Virus [HIV] 44,873 3,036 47,909
Diabetes Mellitus 20,569 23,672 44,241
Chronic Liver Disease and Cirrhosis 24,480 12,224 36,704
Intentional Self-Harm [Suicide] 28,219 8,191 36,410
Homicide and Legal Intervention 29,418 6,104 35,522
Atherosclerosis 7,516 12,437 19,953
Conditions Arising in Perinatal Period 9,408 7,478 16,886
Congenital Malformations 8,192 7,374 15,566
Alzheimer's Disease 5,318 9,888 15,206
Nephritis, Nephrotic Syndrome, Nephrosis 6,663 6,893 13,556
Hypertension [Primary and Renal] 5,048 7,336 12,384
Gastric and Duodenal Ulcer 4,009 4,348 8,357
Non-Malignant Neoplasms 3,061 3,444 6,505
Septicemia 2,616 2,944 5,560
Viral Hepatitis 3,203 1,885 5,088
Hernia and Obstruction 1,897 3,047 4,944
Cholelithiasis, Gallbladder Disorders 1,254 1,616 2,870
Anemias 1,151 1,476 2,627
Tuberculosis 1,205 777 1,982
Infections of Kidney 452 1,119 1,571
Nutritional Deficiencies 461 923 1,384
Meningitis 549 463 1,012
Acute Bronchitis and Bronchiolitis 325 386 711
Hyperplasia of Prostate 646 0 646
Diseases of Appendix 290 204 494
Pregnancy, Childbirth, Puerperium 0 466 466
Meningococcal Infection 206 216 422
Syphilis 39 26 65
Measles 33 27 60
Shigellosis and Amebiasis 23 14 37
Whooping Cough 7 9 16
Streptococcal Infection 4 9 13
Acute Poliomyelitis 0 0 0
Total 1,141,190 1,054,259 2,195,449


Links to Additional Output Formats:
  · ASCII Text · dBASE III (Database) · CSV (Spreadsheet)

Unique ID, for keeping track of analyses: 213SGNYE
Compiled / run: Feb 11 2012 / Feb 13 2012 (10 seconds) (VitalWeb Wizard)
Data Scenario: California County Level ICD-9 Underlying Cause Deaths
ICD-9 Codes for Rankable Causes (Leading Causes):
  http://www.ehdp.com/epigram/nchs-icd-09-lcd.htm
Row Sorting: Sort Totals, High to Low
Death data source: California Department of Health Services