Death rates in the US have fallen by 32% in the last 30 years. But the news is not all good, particularly for women and the obese.
Age-standardised death rates for heart disease, stroke, cancer and accidents have all fallen, but death rates for diabetes and chronic obstructive pulmonary disease (COPD) have increased, a new report reveals.
In men, deaths from tobacco-related diseases such as COPD are now declining as more men stop smoking, but with more women taking up smoking the situation is different, says Ahmedin Jemal, an epidemiologist at the American Cancer Society, in Atlanta, Georgia. “In women, deaths from some tobacco-related diseases, such as cancer, have just reached a plateau, and deaths from COPD continue to increase.”
Similarly the obesity epidemic, which started in the late 1980s, needs to be reversed before a decline can be seen in the death rate for diabetes.
Doubled deaths
Jemal analysed mortality data for the six leading causes of death in the US between 1970 and 2002. For all causes combined, rates (per 100,000 per year) have decreased from 1242 in 1970 to 845 in 2002. But death rates for COPD doubled over the same time period, and deaths through diabetes increased 45% since 1987. Deaths from homicide were not included in the study.
The reduction in cancer deaths is down to both tobacco control measures and improvements in early detection. Jemal attributes a reduction in the death rate from traffic accidents from 1970 to the early 1990s to the implementation of a 55 mile per hour speed limit during the first energy crisis, in the 1970s.
Safety was augmented further by the mandated use of seat belts in most US states from 1984. The accident mortality rate has flattened off recently, however, coinciding with the relaxation of the maximum speed limits on interstate roads since 1987.
Journal reference: Journal of the American Medical Association (vol 294, p 1255).