The State of Our Health - Causes Of Death — A Closer Look

In 1999, nearly 2.4 million people died. Of those, just a shade under 80% (78.8) died of the causes shown in the chart. To get a minimal definition of the disease categories, please consult the table that completes this panel. Note, however, that among the top ten causes of death is a category called "accidents." These are unintentional, fatal injuries caused by motor vehicle crashes, air crashes, falls, drownings, accidental shootings and poisonings, death by fire or smoke inhalation, and other fatal mishaps. Homicides and suicides (intentional in nature) are counted among causes of death but don't make the top ten. Nor do military deaths on the battlefield. These data are for 1999, in actual counts. Data for 2000 were only available in very preliminary form at the time of publication.

The list used — as the Department of Health and Human Services points out (see source) — is not perfect but has long been in use. It often hides from view subcategories subsumed under larger headings. Thus it is not obvious, looking at the graphic, that the biggest killer among the cancer categories is lung cancer, associated with smoking, or that motor vehicle accidents lead the "Accidents" categories. Such deaths are, at least in theory, manageable by appropriate behavior.

But much the same may also be said of other things that kill us. Heart disease and stroke can, to some extent, be avoided by proper diet and exercise — and diabetes can be managed in the same way. Among the respiratory diseases, emphysema leads; it is also associated with smoking.

In fact, these leading causes of death are a composite portrait both of our medical/technological achievements and of our habits and follies. In the table that follows, more detail is provided about the categories. In the next panel, we look at interesting differences between men and women.

Diseases of the heart	There are some 23 disease that can affect the function of the heart muscle. The heart supplies oxygen to the cells by pumping the blood through the lungs and maintaining blood pressure. The most common heart disease is ischemic cardiomyopathy, which means that the heart itself is not getting enough blood; myopathy means that the disease affects the heart muscle. Lack of blood, in turn, may be caused by coronary artery disease. Ischemic heart disease is the top killer among the cardiac diseases.
Cancer	Also known as carcinoma, malignant tumor, or malignant neoplasm; neoplasm means tumor. This disease is caused by the abnormal multiplication of cells. There are some 200 different cancers, and they may affect most organs of the body. The leading killer is lung cancer.
Stroke	A stroke occurs when the brain fails to get sufficient blood and brain function fails, often with fatal results or permanent disability. Blocked arteries that restrict blood flow or plaques that lead to clot formation are a leading cause, hence stroke is classed as a cardiovascular disease.
Chronic lower respiratory diseases	These include obstructive lung diseases like asthma, bronchitis, and emphysema; restrictive lung diseases (lung elasticity is a problem); and diseases that result in failure properly to oxygenate the blood. There are some 35 diseases in this category, but some, like lung cancer, are classified elsewhere by the Centers of Disease Control and Prevention. The largest killer is emphysema.
Diabetes mellitus	Disease in which the body does not produce enough insulin or resists the action of insulin. High blood sugar results. Excess blood sugar can lead to renal (kidney) disease, blindness, numbness and amputation of feet, and nervous diseases. Type I diabetes is treated by insulin injections, Type II by diet and other forms of medications.
Influenza and pneumonia	Influenza is a viral infection and pneumonia is an infectious disease. See discussion on the previous panel.
Alzheimer's disease	Alzheimer's is an incurable brain disease of unknown cause associated with loss of memory and a progressive, acquired impairment of intellectual functions. The disease causes the destruction of neurons in the brain and inhibits the secretions of chemicals that transmit signals. Parts of the brain no longer communicate. Death eventually results, usually from an infection or the failure of organs.
Nephritis, nephrotic syndrome, nephrosis	Inflammation of the kidneys — diseases of the kidney or diseases that can lead to kidney damage and renal failure. Urinary tract disorders are often associated with these diseases or exhibit symptoms of their presence.
Septicemia	Poisoning of the blood through bacterial toxins caused by severe infections throughout the body, including the lungs, abdomen, and the urinary tract. It can rapidly lead to extremely low blood pressure and death (septic shock).
Source: Anderson, Robert N. "Deaths: Leading Causes for 1999." National Vital Statistics Reports. v. 49, No. 11. 12 October 2001.U.S. Department of Health and Human Services.