The State of Our Health - Women's Health: Tracking Causes Of Death

We begin our look at women's health by examining trends in death rates for heart failure (ischemic heart disease) — the leading cause of death among women — stroke, breast cancer, and diabetes. For comparison only, the death rates of males from heart disease are also shown in a dotted line at the top (more men die of heart disease than women).

Age-adjusted death rates enable comparison of deaths from a cause over multiple years. These rates are indexes which adjust actual death rates (the "crude death rate") to a "standard population." Thus fluctuations in the age groups, one year to the next, do not produce unusual results. Data are shown on a logarithmic scale so that slopes are comparable and data are more easily seen.

A 20-year period is provided. In the field of health statistics, data that are four years old, at this level of detail, are considered to be "current." Data for 2002 will come along, slowly, around about 2006.

These indicators paint a hopeful picture. Of the four causes of death shown in this graphic, all display a declining tendency except diabetes.

Those suffering from ischemic heart disease die because their hearts do not receive sufficient oxygen. This condition is the largest killer among those who die of cardiac diseases. New pharmaceuticals that control the undesirable type of cholesterol, early detection of the condition through diagnostic means, and technological interventions (more and more non-invasive), are bringing this condition under control. But heart failure continues to be the leading killer. We shall look at it more closely in the next panel and show differences between the races.

Stroke ("cerebrovascular disease") is another of the cardiovascular diseases and is controlled by much the same treatment as heart disease generally. Stroke comes about because the brain is denied oxygen by a blockage in the arteries or because blood clots are formed in the brain. Death rate due to stroke has declined at a slightly lower rate than ischemic heart disease. Among adults, it has decreased most in the age groups between 65 and 84. It has also declined among those 85 and older, the largest group that dies of stroke.

Breast cancer is the second most common cancer among women (next to lung cancer). With the exception of skin cancer, survival rates of those who have this condition are the highest. Breast cancer is related to hormonal influences. Women 50 years and older have 77% of new cases; 84% of those who die of breast cancer are 50 or over. The slow decline in death rates is in part due to failure of early detection and an increase in the population of those most subject to this condition.

Adult-onset diabetes (Type II) accounts for 90% of cases. Type I appears in childhood and is treated by insulin injections. Type II diabetes appears most commonly with advancing age; obesity and lack of exercise are factors. As the population is aging — and with obesity dramatically on the rise (a subject we cover elsewhere) — diabetes is a disease on the march. It has an increasing death rate. Its incidence — as a cause of death — has increased most in the 55 to 64 age group. A troubling aspect of the rise in this disease is that it is closely associated as a contributor to heart disease, stroke, blindness, and kidney failure.

Females, over all, have a lower death rate from diabetes than males because white females have a lower death rate than males and whites dominate the statistics. Among minority populations, but most notably among African Americans, females have a higher diabetes death rate than do males.

We turn next to a closer look at heart disease among women, looking at racial differences.

Source: Centers for Disease Control and Prevention. National Center for Health Statistics. National Vital Statistics System. Online. Available: http://www.cdc.gov/nchs/default.htm. May 29, 2002.