Year per 1,000 adults 2008 244.34 2009 242.28 2010 235.41 2011 228.52 2012 230.45 2013 222.03 2014 213.17 2015 215.58 2016 208.72 2017 210.33 2018 225.31 2019 235.57 2020 232.99 2021 234.13