Excess deaths from nine chronic diseases in the United States, 1986

Article Abstract:

Many deaths from the nine diseases that killed 1.1 million people in the United States in 1986 could have been prevented if risk factors had been reduced. The nine diseases are: stroke (sudden loss of blood to part of the brain, caused by a clot or hemorrhage); diabetes; coronary heart disease (affecting the coronary arteries which supply blood to the heart itself); chronic obstructive pulmonary disease (a disease of many causes that leads to inadequate lung function); lung cancer; female breast cancer; cervical cancer; colorectal cancer; and chronic liver disease or cirrhosis of the liver. To evaluate excess mortality from these disorders in the 50 states and Washington, D.C. during 1986, data were collected from the National Center for Health Statistics Mortality Detail. Age-adjusted mortality was calculated for the diseases. To calculate excess mortality, two measures of the lowest mortality achieved in that state, and one measure of the risk-eliminated mortality (calculated after eliminating the largest risk factor for the disease) were used. Excess mortality was the difference between the observed rate for the state and the minimum rate. Results showed that the overall mortality for the nine diseases was 427.4 per 100,000, with Michigan's rate being the highest (483.1) and Hawaii's, the lowest (304.7). Cigarette smoking was the risk factor with the largest contribution to deaths from these diseases; obesity, sedentary life-style, high cholesterol levels, high blood pressure, and diabetes also contributed significantly. Excess mortality varied, depending on which minimum was used in calculating it; the values ranged between zero and 37 percent. If each disease's major risk factor were eliminated, a minimum mortality of 224 per 100,000 could be anticipated, associated with a life expectancy of 77.6 years. The major risk factors that could be remedied are known: they include cigarette smoking, high blood pressure, overweight, high cholesterol, lack of exercise, heavy alcohol consumption, and failure to use screening tests such as mammography and Pap smears (to detect cervical cancer). Mortality will fall if people act on what they know and if access to health care is provided for all. (Consumer Summary produced by Reliance Medical Information, Inc.)

United States, Prevention, Chronic diseases

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The effect of known risk factors on the excess mortality of black adults in the United States

Article Abstract:

Data from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study were used to examine the effect of known risk factors upon black adult mortality rates. The mortality of black adults in the United States exceeds that of whites by 97 percent in the 45- to 54-year-old age group, and by 149 percent in the 35- to 44-year-old age group. Adjustments were made for six known risk factors, including smoking, high blood pressure, high cholesterol, alcohol intake, obesity, and diabetes. Vital statistics for 10,783 individuals were available; 95 percent of this group between the ages of 35 and 77 were evaluated, and follow-up examinations were made. Mortality was assessed by race, age, income, and known risk factors. When the adult black population was examined, 31 percent of the deaths were attributable to the known risk factors for chronic disease; family income or associated factors were associated with 38 percent; and 31 percent of the deaths that occurred were unaccounted for. Out of the six known risk factors, high blood pressure had a significant impact upon the mortality of the 34- to 54-year-old age group. Smoking, obesity, and diabetes were less influential. Family income and risk factors were interdependent, which supports the conclusions of previous research. A significant portion of the differential mortality observed in blacks is preventable by reduction of known risk factors through behavior modification. However, in approximately two-thirds of the incidence of death in the black population, preventative measures have no effect. The development of effective preventative programs will require a focus upon additional social factors which influence mortality. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, African Americans

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Causes of declining life expectancy in Russia

Article Abstract:

Cardiovascular diseases and alcohol-related diseases appear to be largely responsible for the increase in mortality in the Russian Federation. Researchers analyzed mortality data from the Russian vital statistics system. The Russian mortality rate increased 33% between 1990 and 1994. In those four years, life expectancy fell six years among men and three years among women. Cardiovascular diseases accounted for 65% of the decline, and alcohol-related diseases made up about 12%. Deaths from injuries accounted for one-third of the decline in men and one-fifth in women.

Russia, Russians, Life expectancy

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