Actual causes of death in the United States, 2000
Actual causes of death in the United States, 2000
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DOI：
10.1001/jama.291.10.1238
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发表时间：
2004-03-10
影响因子：
120.7
通讯作者：
Gerberding, JL
中科院分区：
文献类型：
--
作者：
Mokdad, AH;Marks, JS;Gerberding, JL
在美国，可改变的行为风险因素是导致死亡的主要原因。量化这些将提供洞察最近的趋势和错过的预防机会的影响的影响。Objectives To identify and quantify the leading causes of mortality in the UnitedStates.Design综合MEDLINE检索英语文章，确定流行病学，临床和实验室研究的风险行为和死亡率。检索最初仅限于1990年期间或之后发表的文章，但我们后来纳入了1980年至2002年12月31日发表的相关文章。在文献检索期间确定了患病率和相对风险。我们使用2000年报告给疾病控制和预防中心的死亡率数据来确定死亡原因和死亡人数。死亡原因的估计值是通过将可预防死亡的归因于原因的比例估计值乘以总死亡率数据来计算的。主要结果测量实际死亡原因结果2000年的主要死亡原因是烟草（435000例死亡;占美国总死亡人数的18.1%）、不良饮食和缺乏身体活动（400000例死亡; 16.6%）和饮酒（85000例死亡; 3.5%）。其他实际的死亡原因是微生物剂（75000），有毒物质（55000），机动车碰撞（43000），涉及枪支（29000），性行为（20000），和非法使用药物（17000）。结论这些分析表明，吸烟仍然是导致死亡的主要原因。然而，不良的饮食和缺乏身体活动可能很快就会超过烟草，成为导致死亡的主要原因。这些发现，沿着不断上升的医疗保健费用和人口老龄化，令人信服地认为，在美国医疗保健和公共卫生系统中建立更具预防性的导向的必要性变得更加紧迫。
Context Modifiable behavioral risk factors are leading causes of mortality in the United States. Quantifying these will provide insight into the effects of recent trends and the implications of missed prevention opportunities.Objectives To identify and quantify the leading causes of mortality in the United States.Design Comprehensive MEDLINE search of English-language articles that identified epidemiological, clinical, and laboratory studies linking risk behaviors and mortality. The search was initially restricted to articles published during or after 1990, but we later included relevant articles published in 1980 to December 31, 2002. Prevalence and relative risk were identified during the literature search. We used 2000 mortality data reported to the Centers for Disease Control and Prevention to identify the causes and number of deaths. The estimates of cause of death were computed by multiplying estimates of the cause-attributable fraction of preventable deaths with the total mortality data.Main Outcome Measures Actual causes of death.Results The leading causes of death in 2000 were tobacco (435000 deaths; 18.1% of total US deaths), poor diet and physical inactivity (400000 deaths; 16.6%), and alcohol consumption (85000 deaths; 3.5%). Other actual causes of death were microbial agents (75000), toxic agents (55000), motor vehicle crashes (43000), incidents involving firearms (29000), sexual behaviors (20000), and illicit use of drugs (17000).Conclusions These analyses show that smoking remains the leading cause of mortality. However, poor diet and physical inactivity may soon overtake tobacco as the leading cause of death. These findings, along with escalating health care costs and aging population, argue persuasively that the need to establish a more preventive orientation in the US health care and public health systems has become more urgent.