Photo by Carmen Jost via Flickr (Creative Commons License)

We often think that plane crashes and random acts of violence in our country are the causes most to be feared and don’t focus on recognizing and preventing some of the most frequent causes of death.  Random acts of violence as a cause of death are certainly not in the Top Ten.  We asked Dr. Baxter Allen to give us a list of the Top Ten Causes of Death in America in 2013 ( the last year for which these numbers are available). —Editors WVFC

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The data used in this article come from the Centers for Disease Control and Prevention’s annual National Vital Statistics Report, Deaths: Final Data for 2013 ( 2013 is the most recently reported year).

1.

Heart Disease

Total Deaths in 2013 — 611,105

Over the last 15 years, the death rate from heart disease has fallen from 259.9 to 193.3 per 100,000 people. This decline is likely due to decreasing rates of smoking and improved medications for some modifiable risk factors (high cholesterol and blood pressure). Decrease your own risks of heart disease by not smoking cigarettes, having a healthy diet, managing your weight, exercising, and seeing your doctor regularly. If you are instituting a new exercise regimen, discuss it with your healthcare provider before you start.

2.

Cancer

Total Deaths in 2013 — 584,881

According to the American Society of Clinical Oncology, cancer will be the No. 1 cause of death in the United States by 2030. The  total number of new cancer cases is expected to increase by nearly 50 percent over the same time period. This is largely due to the increasing age of the population, with age being the most important non-modifiable risk factor for the development of cancer.  Despite this, with improving treatment and earlier detection methods, mortality rates have been decreasing overall during the past 15 years, down to 185 deaths per 100,000 people from 197. There are multiple modifiable risk factors that can decrease the risk of cancer, such as avoidance of smoking and tobacco products, minimal alcohol consumption, a healthy diet low in red and smoked meats, and avoidance of sun radiation.

3.

Chronic Lung Diseases

Total Deaths in 2013 — 149,205

Unlike the top two causes of death, heart disease and cancer, there has been a slight increase in the death rate due to chronic lung diseases between 1999 and 2013, increasing from 44.5 deaths per 100,000 to 47.2. The main contributors to this category of disease are asthma and chronic obstructive pulmonary disease (COPD). Smoking and secondhand smoke exposure, air pollution, toxin exposure, and obesity are all significant risks for chronic lung disease.

4.

Accidents/Unintentional Injury

Total Deaths in 2013 –130,557

The death rate from accidents has risen from 35.1 per 100,000 to 41.3 over the 15-year period from 1999 through 2013. The top cause of accidental death is poisoning, followed by motor vehicle accidents, and falls. The death rate is over twice as high in men from traffic accidents, and nearly twice as high from poisoning. The vast majority of deaths due to poisoning is due to ingestion of drugs, both prescription and recreational, with roughly one-third of accidental poisonings due to opioids (e.g. morphine, oxycodone, heroin). This also includes accidental overdose of drugs, like Tylenol, as well as lethal side effects or allergic reactions to the normal use of medications. While rare, this category also includes deaths from ingestion of caustic household substances (e.g. bleach).

5.

Stroke

Total Deaths in 2013 — 128,978

Over the last 15 years, the death rate from stroke has declined faster than any of the other causes of death in the top 10, decreasing from 60.0 deaths per 100,000 in 1999 to 40.8 in 2013. As with the concomitant decrease in deaths from heart disease, much of this can be attributed to decreases in smoking, and improvement in the treatment of high blood pressure and cholesterol. While some of the decrease may be attributed to the acute treatment of stroke with a clot-busting medication (tPA) or a mechanical removal of the clot, these treatments are rather rare (less than 5% of total strokes); the majority of the health and mortality benefit after an initial stroke comes from the proper management of underlying medical conditions and thus the prevention of additional strokes.

6.

Alzheimer’s Disease

Total Deaths in 2013 — 84,767

As of 2015, there are more than 5 million Americans living with Alzheimer’s disease, roughly two-thirds of whom are women. This number is expected to rise to 13 million as of 2050, unless significant improvements are made, either toward prevention, treatment or cure. Over the 15-year period from 1999 through 2013, the death rate from Alzheimer’s disease increased from 16.0 to 26.8 per 100,000. Based on evidence published in Lancet Neurology in 2014, approximately one-third of these cases can be attributed to modifiable risk factors, high blood pressure, diabetes and physical inactivity, and are potentially preventable.

7.

Diabetes Mellitus

Total Deaths in 2013 — 75,578

The death rate attributed to diabetes has remained mostly stable over the 15-year reporting period from 1999 through 2013, decreasing slightly from 24.5 to 23.9 deaths per 100,000. However, this is likely an under-reporting of the true burden of diabetes, as only 10% of those with a diabetes diagnosis have the disease recorded on their death certificates. Diabetes is a significant risk factor for stroke, heart disease, kidney disease, infection and other diseases.. Over the same time period, the number of people with a diagnosis of diabetes more than doubled, from 10.9 million to 22.3 million people. The number of deaths due to complications of diabetes is likely to increase substantially unless improvements  in prevention and treatment are made.

8.

Influenza and Pneumonia

Total Deaths in 2013 — 56,979

While the flu and pnuemonia are the most common infectious causes of death in America, mortality attributed to these causes has decreased significantly over the past 15 years, from 22.8 to 18 per 100,000. In 2000, the FDA approved a childhood vaccine (PCV7) to help prevent the most common cause of pnuemonia in childhood, the bacteria streptococcus pneumoniae; this was updated in 2010 and expanded to adult use in 2011. In 2011, a separate vaccine, PPV-23 (known under the brand name Pneumovax), was approved for use in the elderly. According to the World Health Organization, vaccinations overall save roughly 6 million people per year in the world, many of which are due to the prevention of the flu and various infectious pnuemonias.

9.

Chronic Kidney Disease

Total Deaths in 2013 — 47,112

The most common causes of renal failure are chronic diabetes and high blood pressure. The prevalence of high blood pressure has decreased substantially, from roughly 20 percent to 12 percent between 1999 and 2010. However, likely due to the increasing prevalence of diabetes, the death rate from chronic kidney diseases has increased from 12.7 to 14.9 deaths per 100,000 over the period of 1999 through 2013. Improvements in blood pressure control, controlling the diabetes epidemic, and a decrease in smoking would go a long way toward decreasing death from kidney failure. Patients with  diabetes who are treated with certain medications (ACE-inhibitors and ARBs) have been shown to have a  decrease in the chance of developing kidney failure.

10.

Suicide

Total Deaths in 2013 — 41,149

The mortality rate from suicide has been steadily increasing, from 10.5 deaths per 100,000 in 1999 to 13.0 as of 2013. Over half the suicides are committed with a gun. Men are three times more likely to die due to suicide than women, and more than six times more likely to use a gun to commit suicide. Gun ownership itself is a risk factor for suicide. In addition, the failure of suicide by gun is very low, while prompt treatment is successful in preventing suicide attempts from other causes. This is an important distinction, because only 10 percent of people who have failed a suicide attempt end up dying due to suicide. Survival of an attempt allows for the underlying problems to be treated and addressed. These underlying issues include mental illness, substance abuse, physical or emotional abuse, chronic illnesses or pain, incarceration, as well as both prolonged (e.g., long-term unemployment) and acute (e.g., losing a job) stressors.