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In the United States, the leading cause of death is moving from heart disease to cancer, but the transition is occurring at different rates in the country and affects racial and ethnic groups differently, according to a new report. Stanford study.
Overall, the news is good: cancer mortality rates fell by 16% between 2003 and 2015 and heart disease death rates dropped by another 28%. If trends continue, cancer will replace heart disease as the leading cause of death in the country, and this could happen as early as 2020, according to US Centers for Disease Control and Prevention.
In the new study, which appears in the Annals of Internal MedicineLeading author, Latha Palaniappan, MD, and his colleagues, follow the evolution of more than 10 years of county-level mortality data covering all 50 states of the country.
The change, which public health researchers have referred to as part of a fourth stage of an epidemiological transition, marks the beginning of a new era. Years ago, in an earlier development, chronic diseases replaced infectious diseases as the leading cause of death in many countries. Now, with advances in preventative care and the treatment of coronary heart disease and risk factors, such as high blood pressure and diabetes, the threat of heart disease is becoming more manageable.
The benefits seem to affect the richest first. An editorial accompanying the Stanford document states:
An aspect of the fourth stage of the epidemiological transition has been described as the diseases of wealth turning into diseases of poverty. This is what happened first for cardiometabolic disorders: in the early twentieth century, they were considered "diseases of the businessmen," but they became more common in people at the end of the century, at least in high-income countries.
Palaniappan and colleagues found the same effect in their analysis. The death rate from heart disease has decreased by 30% in high-income countries, compared to 22% in low-income countries. while cancer mortality fell by 18% in the richest areas, compared to 11% in the less affluent countries.
In 2015, heart disease continued to be the leading cause of death in the lowest-income counties of all racial / ethnic groups; However, in the highest-income countries, cancer has become the leading cause of death among Americans of Asian descent, Hispanics and non-Hispanic whites, according to the study.
In addition, the researchers found that blacks had the highest overall mortality rate, although they also had the largest improvements over the study period. The American / Alaska Indians were the only group to experience an increase in the all-cause mortality rate between 2003 and 2015.
Palaniappan said she hoped the study would be useful in identifying the geographic areas that could benefit most from public health efforts. "Prevention and treatment efforts are not reaching every corner of the United States at the same time," she said, adding:
There are definitively pockets that we miss. Thanks to our country's investments in cardiovascular research and cancer over the last 50 years, we have made tremendous progress. We need to work harder so that the benefits of this research benefit everyone in the United States.
Some of the differences documented in the study could be explained by the varying levels of access to health care and by the divergent trends in risky behaviors, such as smoking, said Palaniappan.
Regularly scheduled cancer screenings and other preventive tests (such as screening for blood pressure, cholesterol, and blood sugar) are essential to reduce the risk of cancer and heart disease, she said. .
There are many ways for people with a tight budget to reduce their health risks, added Palaniappan: "The most economical way to prevent cancer and heart disease is to quit smoking, to to exercise and eat nine servings of vegetables and fruit a day. "
Photo by leonie wise
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