Five causes of potentially preventable death in the US

Death is, ultimately, a physician’s biggest enemy. And although death inevitably prevails over even the most skilled of doctors, preventable death, by its very definition, never needs to happen.

It is discouraging, therefore, that a report released in the CDC’s weekly journal, Morbidity and Mortality Weekly Report, found that up to 40% of annual deaths in the United States from the five leading causes of death are preventable.
“Well over 100,000 Americans a year die from preventable causes,” Thomas Frieden, MD, MPH, director of the CDC, said in a press telebriefing. “As a doctor, it’s heartbreaking when we lose a single patient to a preventable disease or injury. As director of the nation’s public health agency, it is painful beyond words to know that we’re losing so many patients each year this way.”

Thomas Frieden

The extensive report is the result of an analysis of premature deaths (before age 80 years) from each of the five leading causes of death in the US: heart disease, cancer, chronic lower respiratory diseases, stroke and unintentional injury. After evaluating premature deaths from each of these causes annually in each US state from 2008 to 2010, researchers calculated the number of deaths from each cause that could have been avoided if all states had the same death rate as those with the lowest rates.

“We came up with the three healthiest states, and used them as the benchmark,” Frieden said. “If all states were closer to the benchmark states, we could have prevented a third of deaths from heart disease and a fifth of deaths from cancer.”
Cardiology Today presents a list of the top five causes of death in the US, and the degree to which they can be prevented.

1. Heart Disease

Heart disease remains the leading cause of death in the United States. According to the CDC report, if all states achieved the low rates of mortality seen in the “benchmark states,” 34% of premature heart disease deaths could have been avoided, thereby extending the lives of about 92,000 Americans. The risks of heart disease are fairly well-known, and include the use of tobacco, hypertension, high cholesterol, type 2 diabetes, poor diet, overweight and lack of physical activity. Frieden cited initiatives such as the Million Hearts initiative, a program aimed at preventing a million MIs and strokes over the next 5 years.

“We’ve seen states and communities across the country that are focusing on this, and it’s making a big difference,” Frieden said during the telebriefing.

2. Cancer

Another significant cause of death in the United States is cancer, which claims many lives before their time. Based on the data reported in the CDC analysis, if all US states had the same low cancer mortality rates as the benchmark states, 21% of premature cancer deaths could have been prevented, prolonging nearly 84,500 lives. Modifiable risk factors for cancer include tobacco use, poor diet, inactivity, being overweight, sun exposure, certain hormones, the use of alcohol, certain viral and bacterial infections, ionizing radiation and other chemicals and substances.

3. Chronic lower respiratory disease

Chronic lower respiratory diseases include diseases such as emphysema, chronic occlusive pulmonary disease and chronic bronchitis.

These conditions are strongly associated with lung cancer. The CDC reports that almost 29,000 lives could have been prolonged and 39% of premature deaths prevented from chronic lower respiratory infections if all states had achieved the low mortality rates of the benchmark states.

Disease risks for chronic lower respiratory diseases include smoking and exposure to second-hand smoke, pollutants, allergens and occupational contaminants.

4. Stroke

Stroke is another potentially deadly CV event that has several known risk factors. According to the CDC report, 33% of premature stroke deaths could have been prevented if more states had attained the mortality rates of the lowest states, thus prolonging nearly 17,000 lives. Risk factors for stroke include hypertension, high cholesterol, type 2 diabetes, poor diet, overweight, lack of physical activity, previous stroke and heart disease.

5. Unintentional Injury

A less commonly discussed cause of preventable deaths in the US is unintentional injury. The CDC study reports that if all states followed benchmark state levels, almost 37,000 lives could have been prolonged and 39% of premature deaths from unintentional injuries avoided.

Among the risk factors for unintentional injury are lack of seatbelt or motorcycle helmet use, the use of unsafe consumer products, drug and alcohol abuse and exposure to unsafe home or work environments.