Study reveals trends in US death rate, leading causes of death over 30 years

September 13, 2005

The death rate from all causes of death combined decreased by 32 percent between 1970 and 2002, with the largest decreases for heart disease and stroke, but with an increase in death rates for diabetes and COPD, according to an article in the September 14 issue of JAMA.

Age-standardized death rates from all causes have decreased in the United States since the 1960s; however, the overall trend masks substantial variations in cause-specific rates and in the number of deaths occurring in different age groups from specific conditions, according to background information in the article. Understanding these trends and the relationship between the age-standardized death rates and the actual number of deaths that occur could provide valuable insight into the forces that shape the nation's health.

Ahmedin Jemal, D.V.M., Ph.D., of the American Cancer Society, Atlanta, and colleagues examined trends in death rates and number of deaths from the six leading causes in the United States and considered the relationship of these trends to disease prevention and health care in an aging population. The researchers analyzed vital statistics data on death in the United States from 1970 to 2002 from each of the 6 leading causes of death: heart disease, stroke, cancer, chronic obstructive pulmonary disease (COPD), accidents (i.e., related to transportation [motor vehicle, other land vehicles, and water, air, and space] and not related to transportation [falls, fire, and accidental poisoning]), and diabetes mellitus.

The researchers found that the age-standardized death rate (per 100,000 per year) from all causes combined decreased from 1,242 in 1970 to 845 in 2002 (32 percent decrease). The largest percentage decreases were in death rates from stroke (63 percent), heart disease (52 percent), and accidents (41 percent). The largest absolute decreases in death rates were from heart disease (262 deaths per 100,000), stroke (96 deaths per 100,000), and accidents (26 deaths per 100,000).

The death rate from all types of cancer combined increased between 1970 and 1990 and then decreased through 2002, yielding a net decline of 2.7 percent. In contrast, death rates doubled from chronic obstructive pulmonary disease over the entire time interval and increased by 45 percent from diabetes since 1987. Despite decreases in age-standardized death rates from 4 of the 6 leading causes of death, the absolute number of deaths from these conditions continues to increase, although these deaths occur at older ages.

"... the number of deaths continues to increase because of population growth and aging. It is the number of individuals affected by various conditions rather than the age-standardized rate that influence the planning and allocation of preventive and medical services," the authors write.

"Several important insights are suggested by these temporal trends in the death rates and number of deaths at various ages. First, the decrease in the age-standardized death rate for 4 of the 6 leading causes of death in the United States represents progress toward one of the fundamental goals of disease prevention by extending the number of years of potentially healthy life. This progress has been greater for cardiovascular disease and for accidental deaths than for cancer, yet even for cancer the age-standardized death rate has been decreasing by 1.1 percent per year since 1993. Less favorable developments are the slowing of the decline in age-standardized mortality rates from stroke and accidents since the early 1990s, and the increase in death rates from COPD and diabetes."

"The reduction in the death rate from accidents from 1970 through the early 1990s coincided with implementation of a 55 mph speed limit during the first energy crisis in the 1970s and mandated use of seat belts in most states beginning in 1984. The recent flattening of the accident mortality rate coincides with the relaxation of the maximum interstate speed limits since 1987. The biphasic [having two phases] trend in cancer mortality rates reflects both the impact of the tobacco epidemic on tobacco-related cancers through 1990, followed by reduction in cancer mortality through tobacco control and advances in early detection, in treatment, or in both. The increase in COPD death rates results largely from the long-term effects of tobacco smoking in an aging population, whereas the increase in diabetes mortality since the late 1980s reflects dramatic increases in obesity," the researchers write.

"A consequence of the large decrease in cardiovascular death rates, combined with high-birth rates that immediately followed World War II, is the growing importance of health and health care needs in an aging population. While improved detection and treatment for chronic diseases has resulted in declining mortality rates, it has also increased the prevalence of 'treated disease' and an associated increase in health care expenditures," the authors conclude.
-end-
(JAMA. 2005; 294:1255 - 1259. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: The American Cancer Society funded the analysis, interpretation, compilation of cancer surveillance data.

The JAMA Network Journals

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.