Trends in the leading causes of death in the United States, 1970-2002
Trends in the leading causes of death in the United States, 1970-2002
复制标题
DOI：
10.1001/jama.294.10.1255
复制
发表时间：
2005-09-14
影响因子：
120.7
通讯作者：
Thun, M
中科院分区：
文献类型：
--
作者：
Jemal, A;Ward, E;Thun, M
背景美国总体死亡率的下降可能掩盖了特定条件下死亡率的变化。目的研究美国年龄标准化死亡率和6种主要死亡原因死亡人数的时间趋势。设计和设置分析1970 - 2002年美国死亡率的生命统计数据。主要结局指标年龄-标准化死亡率和死亡人数（编码为潜在原因）的6个主要死因中的每一个：心脏病、中风、癌症、慢性阻塞性肺病、意外事故（即，与运输有关[机动车、其他陆地车辆以及水、空气和空间]，与运输无关[福尔斯、火灾和意外中毒]），结果2002年全因死亡的年龄标准化死亡率（每10万人/年）从1970年的1242人下降到2002年的845人。死亡率下降最多的是中风（63%）、心脏病（52%）和事故（41%）。死亡率绝对下降幅度最大的是心脏病（每10万人中有262人死亡）、中风（每10万人中有96人死亡）和事故（每10万人中有26人死亡）。1970年至1990年期间，所有类型癌症的死亡率都有所上升，然后在2002年下降，净下降2.7%。相比之下，自1987年以来，慢性阻塞性肺病的死亡率在整个时间间隔内翻了一番，糖尿病的死亡率增加了45%。尽管年龄标准化死亡率下降，从4的6个主要死因，从这些条件的死亡的绝对数量继续增加，虽然这些死亡发生在老年人ages.Conclusions死亡的绝对数量和死亡年龄继续增加在美国。这些时间趋势对老龄化人口的医疗保健和医疗保健成本有重大影响。
Context The decrease in overall death rates in the United States may mask changes in death rates from specific conditions.Objective To examine temporal trends in the age-standardized death rates and in the number of deaths from the 6 leading causes of death in the United States.Design and Setting Analyses of vital statistics data on mortality in the United States from 1970 to 2002.Main Outcome Measure The age-standardized death rate and number of deaths (coded as underlying cause) from each of the 6 leading causes of death: heart disease, stroke, cancer, chronic obstructive pulmonary disease, accidents (ie, related to transportation [motor vehicle, other land vehicles, and water, air, and space] and not related to transportation [falls, fire, and accidental posioning]), and diabetes mellitus.Results The age-standardized death rate (per 100000 per year) from all causes combined decreased from 1242 in 1970 to 845 in 2002. The largest percentage decreases were in death rates from stroke (63%), heart disease (52%), and accidents (41%). 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%. In contrast, death rates doubled from chronic obstructive pulmonary disease over the entire time interval and increased by 45% for 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.Conclusions The absolute number of deaths and age at death continue to increase in the United States. These temporal trends have major implications for health care and health care costs in an aging population.