Approximately half of all deaths in the United States can be attributed to largely preventable behaviors and exposures.
Quantifying modifiable behavioral risk factors may provide insight into the effects of recent trends and indicate missed prevention opportunities.
Dr Ali Mokdad and colleagues from the Centers for Disease Control and Prevention, Atlanta, conducted a study to identify and quantify the leading causes of death in the United States.
The team performed a comprehensive MEDLINE search of English-language articles identifying epidemiological, clinical, and laboratory studies linking risk behaviors and mortality.
The researchers used 2000 mortality data reported to the Centers for Disease Control and Prevention to identify the causes and number of deaths.
|Leading causes of death in 2000:|
- tobacco = 18%
- poor diet/inactivity = 17%
- alcohol consumption = 4%
|Journal of the American Medical Association|
The estimates of actual cause of death were computed by multiplying estimates of the cause-attributable fraction of preventable deaths with the total mortality data.
The team found that the leading causes of death in 2000 were tobacco (18%), poor diet and physical inactivity (17%), and alcohol consumption (4%).
The researchers identified other causes of death in 2000 as microbial and toxic agents, motor vehicle crashes, firearms, sexual behaviors, and illicit use of drugs.
"The rapid increase in the prevalence of overweight means that this proportion is likely to increase substantially in the next few years".
"The burden of chronic diseases is compounded by the aging effects of the baby boomer generation and the concomitant increased cost of illness at a time when health care spending continues to outstrip growth in the gross domestic product of the United States," the authors write.
"Our findings indicate that interventions to prevent and increase cessation of smoking, improve diet, and increase physical activity must become much higher priorities in the public health and health care systems."
In an accompanying editorial, Drs Michael McGinnis and William Foege write that continued progress on reducing preventable causes of death depends on a strong and vibrant public health capacity and working with the solid support and involvement of medical practitioners.
"Because a substantial proportion of early deaths among the US population is preventable through lifestyle change, the social commitment to making those changes possible must be enhanced considerably".
"National leadership and commitment at the policy level, such as suggested by Mokdad and colleagues, is an important ingredient for progress", they comment.