This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (160)  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in JAMA  Topic Collections  • Public Health, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Ahmedin Jemal, DVM, PhD; Elizabeth Ward, PhD; Yongping Hao, PhD; Michael Thun, MD, MS

JAMA. 2005;294:1255-1259.

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 100 000 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.

Author Affiliations: Epidemiology and Surveillance Research, American Cancer Society, Atlanta, Ga.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

Leading Causes of Death in the United States
, , and
JAMA. ;295():383-383.
FULL TEXT  

Leading Causes of Death in the United States
, , and
JAMA. ;295():383-384.
FULL TEXT  

Leading Causes of Death in the United States--Reply
, , and
JAMA. ;295():384-384.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Eliminating Health Disparities Through Transdisciplinary Research, Cross-Agency Collaboration, and Public Participation
Rashid et al.
AJPH 2009;99:1955-1961.
ABSTRACT | FULL TEXT  

A Prospective Study of Bone Lead Concentration and Death From All Causes, Cardiovascular Diseases, and Cancer in the Department of Veterans Affairs Normative Aging Study
Weisskopf et al.
Circulation 2009;120:1056-1064.
ABSTRACT | FULL TEXT  

Utilization of 3-month Yoga Program for Adults at High Risk for Type 2 Diabetes: A Pilot Study
Yang et al.
Evid Based Complement Alternat Med 2009;0:nep117v1-nep117.
ABSTRACT | FULL TEXT  

Anatomic Segmentectomy for Stage I Non-Small Cell Lung Cancer in the Elderly.
Kilic et al.
Ann. Thorac. Surg. 2009;87:1662-1668.
ABSTRACT | FULL TEXT  

Improving Diabetes Care: The Model for Health Care Reform
Kahn and Anderson
Diabetes Care 2009;32:1115-1118.
FULL TEXT  

Health and Functioning Among Baby Boomers Approaching 60
Martin et al.
J Gerontol B Psychol Sci Soc Sci 2009;64B:369-377.
ABSTRACT | FULL TEXT  

Chemoprevention of Lung Cancer
Keith
Proc Am Thorac Soc 2009;6:187-193.
ABSTRACT | FULL TEXT  

Glucose Control in Type 2 Diabetes: Still Worthwhile and Worth Pursuing
Kahn
JAMA 2009;301:1590-1592.
FULL TEXT  

The effects of inhaled and oral corticosteroids on serum inflammatory biomarkers in COPD: an exploratory study
Man et al.
Ther Adv Respir Dis 2009;3:73-80.
ABSTRACT  

Can Self-Reported Strokes Be Used to Study Stroke Incidence and Risk Factors?: Evidence From the Health and Retirement Study
Glymour and Avendano
Stroke 2009;40:873-879.
ABSTRACT | FULL TEXT  

Effect of atorvastatin in elderly patients with a recent stroke or transient ischemic attack
Chaturvedi et al.
Neurology 2009;72:688-694.
ABSTRACT | FULL TEXT  

Has Mortality from Acute Respiratory Distress Syndrome Decreased over Time?: A Systematic Review
Phua et al.
Am. J. Respir. Crit. Care Med. 2009;179:220-227.
ABSTRACT | FULL TEXT  

Cardiomyopathy, adult valve disease and heart failure in South America
Bocchi et al.
Heart 2009;95:181-189.
ABSTRACT | FULL TEXT  

Use Of Medical Care For Chronic Conditions
Decker et al.
Health Aff (Millwood) 2009;28:26-35.
ABSTRACT | FULL TEXT  

Introduction.
Buist
Proc Am Thorac Soc 2008;5:796-799.
ABSTRACT | FULL TEXT  

Chronic Obstructive Pulmonary Disease with Lung Cancer and/or Cardiovascular Disease
Rodriguez-Roisin and Soriano
Proc Am Thorac Soc 2008;5:842-847.
ABSTRACT | FULL TEXT  

Should we be using statistics to define disease?
Mannino
Thorax 2008;63:1031-1032.
FULL TEXT  

Inhaled Corticosteroids in Patients With Stable Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis
Drummond et al.
JAMA 2008;300:2407-2416.
ABSTRACT | FULL TEXT  

Will Recommendations against Spirometry Make Chronic Obstructive Pulmonary Disease Harder to Treat?
Petty and Mannino
ANN INTERN MED 2008;149:512-513.
FULL TEXT  

Anxiety and Depression in COPD: Current Understanding, Unanswered Questions, and Research Needs
Maurer et al.
Chest 2008;134:43S-56S.
ABSTRACT | FULL TEXT  

Diabetes and Mortality in Men With Locally Advanced Prostate Cancer: RTOG 92-02
Smith et al.
JCO 2008;26:4333-4339.
ABSTRACT | FULL TEXT  

Prospective Study of Inhaled Corticosteroid Use, Cardiovascular Mortality, and All-Cause Mortality in Asthmatic Women
Camargo et al.
Chest 2008;134:546-551.
ABSTRACT | FULL TEXT  

Advanced chronic obstructive pulmonary disease: rethinking models of care
Simpson and Rocker
QJM 2008;101:697-704.
ABSTRACT | FULL TEXT  

Longitudinal Change in the BODE Index Predicts Mortality in Severe Emphysema
Martinez et al.
Am. J. Respir. Crit. Care Med. 2008;178:491-499.
ABSTRACT | FULL TEXT  

Temporal Trends in the Management of Potentially Resectable Lung Cancer
Farjah et al.
Ann. Thorac. Surg. 2008;85:1850-1856.
ABSTRACT | FULL TEXT  

Natural History of Emphysema
Minai et al.
Proc Am Thorac Soc 2008;5:468-474.
ABSTRACT | FULL TEXT  

Comorbidities in Chronic Obstructive Pulmonary Disease
Chatila et al.
Proc Am Thorac Soc 2008;5:549-555.
ABSTRACT | FULL TEXT  

Association between early life history of respiratory disease and morbidity and mortality in adulthood
Galobardes et al.
Thorax 2008;63:423-429.
ABSTRACT | FULL TEXT  

Chronic Obstructive Pulmonary Disease in Hispanics
Brehm and Celedon
Am. J. Respir. Crit. Care Med. 2008;177:473-478.
ABSTRACT | FULL TEXT  

COPD in Asia*: Where East Meets West
Tan and Ng
Chest 2008;133:517-527.
ABSTRACT | FULL TEXT  

Sensitivity and Specificity of Death Certificates for Diabetes: As good as it gets?
Cheng et al.
Diabetes Care 2008;31:279-284.
ABSTRACT | FULL TEXT  

Factors determining the quality of life of patients with COPD in primary care
Miravitlles et al.
Ther Adv Respir Dis 2007;1:85-92.
ABSTRACT  

A Review of Yoga Programs for Four Leading Risk Factors of Chronic Diseases
Yang
Evid Based Complement Alternat Med 2007;4:487-491.
ABSTRACT | FULL TEXT  

Sex, Depression, and Risk of Hospitalization and Mortality in Chronic Obstructive Pulmonary Disease
Fan et al.
Arch Intern Med 2007;167:2345-2353.
ABSTRACT | FULL TEXT  

Review: Do we need new antibiotics for treating exacerbations of COPD?
Miravitlles
Ther Adv Respir Dis 2007;1:61-76.
ABSTRACT  

The Epidemiology and Economics of Chronic Obstructive Pulmonary Disease
Mannino and Braman
Proc Am Thorac Soc 2007;4:502-506.
ABSTRACT | FULL TEXT  

A Systematic Review of Mortality in Schizophrenia: Is the Differential Mortality Gap Worsening Over Time?
Saha et al.
Arch Gen Psychiatry 2007;64:1123-1131.
ABSTRACT | FULL TEXT  

Patterns of Prevalent Major Chronic Disease Among Older Adults in the United States
Weiss et al.
JAMA 2007;298:1160-1162.
FULL TEXT  

The Growing Burden of Chronic Obstructive Pulmonary Disease and Lung Cancer in Women: Examining Sex Differences in Cigarette Smoke Metabolism
Ben-Zaken Cohen et al.
Am. J. Respir. Crit. Care Med. 2007;176:113-120.
ABSTRACT | FULL TEXT  

Clustering of Multiple Healthy Lifestyle Habits and Health-Related Quality of Life Among U.S. Adults With Diabetes
Li et al.
Diabetes Care 2007;30:1770-1776.
ABSTRACT | FULL TEXT  

Epigenetic Modifications of RASSF1A Gene through Chromatin Remodeling in Prostate Cancer
Kawamoto et al.
Clin. Cancer Res. 2007;13:2541-2548.
ABSTRACT | FULL TEXT  

Cured Meat Consumption, Lung Function, and Chronic Obstructive Pulmonary Disease among United States Adults
Jiang et al.
Am. J. Respir. Crit. Care Med. 2007;175:798-804.
ABSTRACT | FULL TEXT  

One-Year Cardiovascular Event Rates in Outpatients With Atherothrombosis
Steg et al.
JAMA 2007;297:1197-1206.
ABSTRACT | FULL TEXT  

Treating COPD -- The TORCH Trial, P Values, and the Dodo
Rabe
NEJM 2007;356:851-854.
FULL TEXT  

Relationship Between Diabetes and Mortality Among Persons With Co-occurring Psychotic and Substance Use Disorders
Jackson et al.
Psychiatr. Serv. 2007;58:270-272.
ABSTRACT | FULL TEXT  

Uncertainty of Management of Blood Pressure and Lipids in the Elderly: Time for a Primary Prevention Trial
Gorelick
Stroke 2007;38:212-213.
FULL TEXT  

Is it Time for a Cardiovascular Primary Prevention Trial in the Elderly?
Robinson et al.
Stroke 2007;38:441-450.
ABSTRACT | FULL TEXT  

Assessing Mature Technology: What Is the Effect of High-Quality Risk Stratification Evidence With Exercise Echocardiography and Single-Photon Emission Computed Tomography Imaging?
Shaw et al.
J Am Coll Cardiol 2007;49:238-239.
FULL TEXT  

Depressive Symptoms and Chronic Obstructive Pulmonary Disease: Effect on Mortality, Hospital Readmission, Symptom Burden, Functional Status, and Quality of Life
Ng et al.
Arch Intern Med 2007;167:60-67.
ABSTRACT | FULL TEXT  

COPD Prevalence in Salzburg, Austria: Results From the Burden of Obstructive Lung Disease (BOLD) Study
Schirnhofer et al.
Chest 2007;131:29-36.
ABSTRACT | FULL TEXT  

Fish-oil esters of plant sterols improve the lipid profile of dyslipidemic subjects more than do fish-oil or sunflower oil esters of plant sterols
Demonty et al.
Am. J. Clin. Nutr. 2006;84:1534-1542.
ABSTRACT | FULL TEXT  

Nomograms Provide Improved Accuracy for Predicting Survival after Radical Cystectomy.
Shariat et al.
Clin. Cancer Res. 2006;12:6663-6676.
ABSTRACT | FULL TEXT  

Trends in hyperinsulinemia among nondiabetic adults in the u.s.
Li et al.
Diabetes Care 2006;29:2396-2402.
ABSTRACT | FULL TEXT  

Deaths from chronic obstructive pulmonary disease in France, 1979-2002: a multiple cause analysis
Fuhrman et al.
Thorax 2006;61:930-934.
ABSTRACT | FULL TEXT  

Redefinition of myocardial infarction: new challenges and opportunities
Roger
Eur Heart J 2006;27:2373-2375.
FULL TEXT  

Reproducibility and Expression of Skin Biomarkers in Sun-Damaged Skin and Actinic Keratoses
Einspahr et al.
Cancer Epidemiol. Biomarkers Prev. 2006;15:1841-1848.
ABSTRACT | FULL TEXT  

Dyslipidaemia and global cardiovascular risk: clinical issues
Assmann
Eur Heart J Suppl 2006;8:F40-F46.
ABSTRACT | FULL TEXT  

Options for therapeutic intervention: how effective are the different agents?
Barter
Eur Heart J Suppl 2006;8:F47-F53.
ABSTRACT | FULL TEXT  

Chronic Obstructive Pulmonary Disease: The Disease and Its Burden to Society
Halpin and Miravitlles
Proc Am Thorac Soc 2006;3:619-623.
ABSTRACT | FULL TEXT  

Pharmacotherapy for Mortality Reduction in Chronic Obstructive Pulmonary Disease
Sin and Man
Proc Am Thorac Soc 2006;3:624-629.
ABSTRACT | FULL TEXT  

A Proposal for Radical Changes in the Drug-Approval Process
Wood
NEJM 2006;355:618-623.
FULL TEXT  

Preventing Cardiovascular Disease and Diabetes: A call to action from the American Diabetes Association and the American Heart Association
Eckel et al.
Diabetes Care 2006;29:1697-1699.
FULL TEXT  

Preventing Cardiovascular Disease and Diabetes: A Call to Action From the American Diabetes Association and the American Heart Association
Eckel et al.
Circulation 2006;113:2943-2946.
FULL TEXT  

The emerging roles of DNA methylation in the clinical management of prostate cancer.
Perry et al.
Endocr Relat Cancer 2006;13:357-377.
ABSTRACT | FULL TEXT  

Secular Trends in Deaths From Cardiovascular Diseases: A 25-Year Community Study
Gerber et al.
Circulation 2006;113:2285-2292.
ABSTRACT | FULL TEXT  

Trends in the Prevalence, Awareness, Treatment, and Control of Cardiovascular Disease Risk Factors among Noninstitutionalized Patients with a History of Myocardial Infarction and Stroke
Muntner et al.
Am J Epidemiol 2006;163:913-920.
ABSTRACT | FULL TEXT  

Reorganizing medicare for older adults with chronic illness.
Daaleman
J Am Board Fam Med 2006;19:303-309.
ABSTRACT | FULL TEXT  

Leading Causes of Death in the United States
Tierney et al.
JAMA 2006;295:383-383.
FULL TEXT  

Leading Causes of Death in the United States
Cutler et al.
JAMA 2006;295:383-384.
FULL TEXT  

Make No Bones About It: Increasing Epidemiologic Evidence Links Vitamin D to Pulmonary Function and COPD
Wright
Chest 2005;128:3781-3783.
FULL TEXT  

Living Longer in the U.S.
JWatch Emergency Med. 2005;2005:9-9.
FULL TEXT  

What's new in the other general journals
Tonks
BMJ 2005;331:657-658.
FULL TEXT