Interesting data: Leading causes of death for age groups

The US Centers for Disease Control and Prevention (CDC) collects data about the recorded causes of death. This data has been analyzed by the nonprofit USAFacts in their September 2023 publication, the "America in Facts 2023" report. They calculated the leading causes of death for each state and the District of Columbia in the 2020-2021 year. Here are the results:

Ages 1 to 17*

• Transport accidents: 32 states
• Suicide: 6 states
• Homicide: 5 states and the District of Columbia
• Cancer: 4 states
• Other: 3 state

*Note: Transport accidents and suicide tied in Idaho for this age group, and transport accidents and cancer tied in Connecticut.

 

Ages 18 to 44

• Fentanyl and other synthetic opioids: 28 states and the District of Columbia
• Suicide: 14 states
• Homicide: 3 states
• Major cardiovascular disease: 4 states
• Other: 2 states

 

Ages 45 to 64

• Major cardiovascular disease: 29 states and the District of Columbia
• Cancer: 21 states
• Other: 1 state

 

Ages 65 and older

• Major cardiovascular disease: 50 states and the District of Columbia

While this data doesn’t predict how any particular individual will die, nor at what age death will occur, it can remind us to adopt healthy lifestyle habits that can address the most common causes in our age group.

For information on preventing transport accidents in children:

Child Passenger Safety: Get the Facts

https://www.cdc.gov/transportationsafety/child_passenger_safety/cps-factsheet.html

Child Safety

https://www.nhtsa.gov/road-safety/child-safety

For information on fentanyl and other synthetic opioids:

Years of Life Lost to Unintentional Drug Overdose Rapidly Rising in the Adolescent Population, 2016–2020

https://www.jahonline.org/article/S1054-139X(22)00542-0/fulltext

DEA Warns of Brightly-Colored Fentanyl Used to Target Young Americans

https://www.dea.gov/press-releases/2022/08/30/dea-warns-brightly-colored-fentanyl-used-target-young-americans

Dramatic increases in opioid overdose deaths due to fentanyl among young people in Washington State (pdf)

https://adai.uw.edu/wordpress/wp-content/uploads/youth-fentanyl-2021.pdf

For information about cardiovascular disease:

Heart Disease and Stroke

https://www.cdc.gov/chronicdisease/resources/publications/factsheets/heart-disease-stroke.htm

Cardiovascular Diseases (CVDs)

https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)

Know Your Risk for Heart Disease

https://www.cdc.gov/heartdisease/risk_factors.htm

What about health equity?

Health equity means that everyone has the opportunity to be as healthy as is possible for them. It sounds simple, but is it?

To achieve health equity, our society, collectively and as individuals, must value everyone equally. Since we are in a state of inequity now, we need to initiate ongoing, targeted activities to address those inequities which are avoidable. This means both current inequities and ones in the past that are still impacting us today. Of course, to address inequity in health, we must address it also in healthcare.

COVID and its impact highlighted many public health inequities. Most are systemic issues within the social determinants of health. Racial and ethnic minorities bore a significantly higher burden during the COVID pandemic than did other population segments.

To address healthcare inequities, the Centers for Disease Control (CDC) created a COVID-19 Response Health Equity Strategy. This document lists five guiding principles for ways to address health inequity:

• Expand the evidence-base.

• Use data-driven approaches.

• Foster meaningful engagement with community institutions and diverse leaders.

• Lead culturally responsive outreach.

• Reduce stigma, including stigma associated with race and ethnicity.

One of the ways the CDC is expanding the evidence-base is by creating the Social Vulnerability Index (SVI), using census data to map the location of socially vulnerable populations. These population groups include persons who have special needs, such as those with disabilities, the elderly, those whose English language ability is limited, and those without adequate transportation. These people lack the necessary resilience to survive and thrive in stressful situations such as natural / manmade disasters or disease outbreaks.  

The purpose of the SVI interactive map is to provide data that can assist emergency planners and public health officials at state and local levels to more equitably provide emergency response efforts.

This effort addresses the first two guiding principles set forth by the CDC to address health equity. What can we members of affected communities do to address the remaining three guiding principles?

 

Does your doctor talk with you about this?

Clinical trials are a type of medical research that is undertaken to find new ways to prevent, detect and treat diseases. Individuals or groups of human subjects are assigned according to a research protocol to one or more interventions in order to evaluate the effects on health outcomes.

Although most familiar are clinical trials of new medications, they may also test new uses for existing treatments, new medical devices, new ways to do surgery, behavioral treatments, and new ways to improve the quality of life for people with diseases or chronic conditions. The goal is to ensure that the medications and treatments are safe and effective.

The people involved as subjects of clinical trials are volunteers. Healthy volunteers want to help other people and advance medical science. Volunteers who have an illness or disability also take part to help others, but they may also possibly receive the newest treatment for their condition. Most clinical trial participants get specialized or free medical care.

Does your healthcare provider discuss clinical trials with you during your visits?

87% of Americans in a recent survey say that doctors should discuss clinical trials with patients who have been diagnosed with a disease. 61% said clinical trial participation should be discussed with patients whether healthy or ill.

Yet only 36% of those surveyed said their healthcare provider had discussed clinical research with them. 77% of survey respondents would prefer getting information about clinical trial opportunities from their physician rather than from other sources. 50% said the doctors and other medical providers have the greatest responsibility for educating the public about clinical trials.

Although over three-quarters of survey participants have heard of clinical trials, only a quarter have either participated in one or had a family member participate in one. Half of those who have not yet participated in a clinical trial would be willing to do so.

85% of those surveyed said it is important that the population of people involved in a clinical trial represent the diversity of the US population. In the past many trials rejected women or failed to attract BIPOC participants. This resulted in gaps in medical knowledge about variations in how different humans respond to disease and treatments. This led to inequities in health care decision making, treatments, and development of appropriate interventions. Diversity and inclusion in clinical trials are now recognized as an important aspect of trial design.

Perhaps we as patients can take the lead in involving more people in clinical trials. First, you will want to do some research. To find a list of clinical trials (not all in the US), check here:

https://clinicaltrials.gov/

You can also find background information about clinical trial design at the Research Pavilion on Virtual Ability’s Healthinfo Island in Second Life:

http://maps.secondlife.com/secondlife/Healthinfo%20Island/133/199/30 

In addition, the left side of the Research Pavilion features posters explaining how to access research opportunities that may interest you. Click the poster for a notecard with additional information about the study and how to apply.

Of course, you will want to understand the potential benefits and risks of participating in a clinical trial. You can print out the information about a clinical trial you are interested in, and discuss it with your healthcare provider.

Perhaps expressing your interest in clinical trials will open up a useful conversation with your healthcare provider.

 

Preparing for your doctor appointment

You know the date and time for the appointment. You’ve got transportation arranged. You have your photo ID and insurance card handy. Here is some additional information to help you prepare ahead for your next doctor visit.

• Are there any physical preparations you should make before your appointment? Should you be fasting because you will need blood tests? Should you wear loose-fitting clothing if you will be undergoing an imaging exam?

• List all your medications, including prescriptions, over-the counter medicines, vitamins, and supplements. (You should keep this list in your wallet at all times, being sure that it is updated.)

• Bring along your symptom diary. (You are keeping one, aren’t you?) Things which may seem unrelated to the reason for this doctor visit may be important for your physician to know about.

• Take a trusted family member or friend with you. This is a safety measure. It’s really difficult to remember everything the doctor talks about. The appointments are short, but packed with information. Someone else in the exam room with you might remember something that you missed, forgot, or misunderstood. They might even take notes for you to review after you return home.

• Be prepared with answers to the doctor’s likely questions. These may include:

• What are your symptoms, such as numbness, pain, tingling, or weakness?

• Where, specifically, do you feel these symptoms?

• How long have you had these symptoms?

• Do the symptoms come and go, or are they continuous?

• Is there an activity you are doing or a position your body is in that seems to set off your symptoms?

• Is there an activity you can do or a position you can move into that lessens your symptoms?

• Write down the questions you want to ask during the appointment. This will help both you and the physician to concentrate on what is most important to cover during the appointment time frame. Here are some questions you may want to include:

• What is the most likely cause of these symptoms?

• Is my condition temporary or chronic (i.e. long-lasting)?

• What kinds of tests might I need?

• What treatment are you recommending?

• Will I need to restrict any of my activities?

• What are some alternatives to your recommended treatment?

• Do you have any handouts or brochures where I can learn more? Are there any recommended websites?

• I also have these other health conditions. What’s the best way for me to deal with them all together?

Preparation before your next doctor visit will make the trip much more productive.