Between 1969 and 2013 in the United States, an overall decreasing trend in age-standardized death rates occurred for all causes (combined) and for the individual causes of heart disease, cancer, stroke, unintentional injuries, and diabetes, a new analysis of vital statistics data finds. In fact, of the six leading causes of death, five showed declines during that period, with only mortality from chronic obstructive pulmonary disease (COPD) increasing. And all the leading causes of death, with the exception of chronic obstructive pulmonary disease, or COPD, claimed fewer lives in 2013 than in 1969.
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The reason the researchers use age-standardized death rates is because the general population is unevenly distributed across age groups.
The progress against heart disease and stroke is believed to be due to improvements in control of hypertension and hyperlipidemia, smoking cessation and medical treatment. But COPD deaths are still increasing among women, who took up smoking later and began quitting later, the researchers said.
Suicide rates also increased by one-third from 2000 to 2013, “highlighting the importance of mental health and depression as prominent health challenges”, McGinnis said.
What’s more, death rates among black people were about double those for white people in infant mortality, heart disease, diabetes and prostate cancer in 2013, he said. This data tends to be more accurate for cancer and injuries, but underreports deaths from COPD, stroke and diabetes and overreports deaths from heart disease.
For heart disease, the figure declined from 28.8 to 9.1, or 68.3%. Injury-related deaths fell 40 percent, and deaths from cancer and diabetes dropped 18 and 17 percent, respectively. Accidental deaths have gone down largely because motor vehicle-related deaths have declined.
Analyzing death rates in this way, say the study authors, is critical to better understanding where our health system is improving the health of Americans, and, perhaps more importantly, where it is not. One is that we have better treatments, such as medications for blood pressure and cholesterol, to stave off heart disease, stroke and diabetes; the other is that we have less exposure to risk factors, especially smoking, than in previous decades.
In an editorial published today in JAMA alongside the study, Dr. James McGinnis, an epidemiologist at the National Academy of Medicine in Washington, D.C., said the report “offers valuable insights on the trends over almost half a century in deaths from all causes”.
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“We need to modernize our view to focus on the most important things we now know and can measure about what really makes people, communities, and the nation healthy or not”, McGinnis said.
