The five leading causes of death in the US are heart disease, cancer, chronic lower respiratory diseases, stroke, and unintentional injuries. Each year, almost 900,000 Americans die prematurely from these diseases. According to a new study that was released on May 1 by the Centers for Disease Control and Prevention (CDC), 20% to 40% of these deaths are preventable. The report is contained in the CDC’s weekly journal: Morbidity and Mortality Weekly Report
The CDC notes that the almost 900,000 Americans who die prematurely from the five leading causes of death accounted for 63% of all US deaths in 2010; the rates for each cause varied significantly from state to state. The report analyzed premature deaths (before age 80) from each cause for each state from 2008 to 2010. The authors then calculated the number of deaths from each cause that would have been prevented if all states had same death rate as the states with the lowest rates.
The study notes that, if all states had the lowest death rate observed for each cause, it would be possible to prevent: 34% of premature deaths from heart diseases, prolonging about 92,000 lives; 21% of premature cancer deaths, prolonging about 84,500 lives; 39% of premature deaths from chronic lower respiratory diseases, prolonging about 29,000 lives; 33% of premature stroke deaths, prolonging about 17,000 lives; and 39% of premature deaths from unintentional injuries, prolonging about 37,000 lives. CDC Director Tom Frieden, MD, MPH explained, “As a doctor, it is heartbreaking to lose just one patient to a preventable disease or injury–and it is that much more poignant as the director of the nation’s public health agency to know that far more than a hundred thousand deaths each year are preventable. With programs such as the CDC’s Million Hearts initiative, we are working hard to prevent many of these premature deaths.”
The study cautions that the numbers of preventable deaths from each cause cannot be added together to get an overall total because prevention of some premature deaths may transfer people to other causes of death. For example, an individual who avoids early death from heart disease still may die prematurely from another preventable cause, such as an unintentional injury.
The authors note that modifiable risk factors are mainly responsible for each of the leading causes of death: heart disease risks include tobacco use, high blood pressure, high cholesterol, type 2 diabetes, poor diet, overweight, and lack of physical activity; cancer risks include tobacco use, poor diet, lack of physical activity, overweight, sun exposure, certain hormones, alcohol, some viruses and bacteria, ionizing radiation, and certain chemicals and other substances; chronic respiratory disease risks include tobacco smoke, second-hand smoke exposure, other indoor air pollutants, outdoor air pollutants, allergens, and exposure to occupational agents; stroke risks include high blood pressure, high cholesterol, heart disease, diabetes, overweight, previous stroke, tobacco use, alcohol use, and lack of physical activity; unintentional injury risks include lack of seatbelt use, lack of motorcycle helmet use, unsafe consumer products, drug and alcohol use (including prescription drug abuse), exposure to occupational hazards, and unsafe home and community environments.
The study authors assert that many of the aforementioned risks are avoidable by making changes in personal behaviors. Others are due to inequalities due to the social, demographic, environmental, economic, and geographic attributes of the neighborhoods in which people live and work. The authors note that if health disparities were eliminated, as described in Healthy People 2020, all states would be closer to achieving the lowest possible death rates for the leading causes of death. Senior author Harold W. Jaffe, MD explained, ”We think that this report can help states set goals for preventing premature death from the conditions that account for the majority of deaths in the United States. Achieving these goals could prolong the lives of tens of thousands of Americans.”
Preventable deaths from all five leading causes were highest in southeastern states. The authors suggest that states with higher rates can review data from states with similar populations but better outcomes to determine what they are doing differently to address leading causes of death.