10 leading causes of death in the US, and how they are tied to THIS common risk factor
In the United States, the life expectancy has been increasing, and overall death rates have been declining over the past 30 years. Despite this progress, a new study shows that these improvements are not evenly distributed across counties.
A new study from the American Cancer Society (ACS) reveals a growing gap in death rates across US counties, and they have also found a common risk factor that plays a significant role in health outcomes. The research is published in the journal
Med
. The study shows disparities in mortality rates for all causes, and how eight of the top 10 leading causes of death are linked to poverty.
Poverty and mortality
rates
The study analyzed death rates across US counties (excluding Alaska and Hawaii) from 1990–1994 and 2016–2020 (excluding the COVID-19 period). They measured county poverty levels by how many residents earned less than the Federal Poverty Level (FPL):
Low-poverty counties had fewer than 10% of residents below the FPL.
High-poverty counties had 20% or more of residents below the FPL.
The researchers studied the link between poverty levels and death rates across counties for all causes and for the 10 leading causes of death in 2020. The 10 causes of death, they focused on were:
Heart diseases (heart attack, heart failure, peripheral artery disease, arrhythmias, and others)
Cancer
Cerebrovascular disease (such as stroke, blood clots, or artery blockage, stenosis, aneurysm)
Pneumonia/influenza
Unintentional injury (such as falls, motor vehicle accidents, poisoning, and drug overdose)
Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis.
Alzheimer's disease
Type 2 diabetes
Suicide
Kidney disease
Improvement in death rates
The study found that the death rates improved across the US.
From 1990-1994 to 2016-2020, death rates improved across all poverty levels for all causes and four leading causes: heart disease, cancer, cerebrovascular disease, and pneumonia/influenza. However, there was a disparity among countries. The improvements were greater in counties with lower poverty levels, widening the mortality gap with higher-poverty counties.
The researchers noticed that the largest improvements occurred along the East and West coasts and parts of the northern US, while the smallest gains were in the Midwest, Appalachia, and the South regions with many high-poverty counties.
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The rates of heart disease and cancer death improved least in the South and Midwest, while pneumonia/influenza saw the smallest gains in the Mississippi Valley and Great Plains.
Worsening death rates
The study found that the death rates worsened for six conditions: unintentional injury, COPD, Alzheimer's disease, type 2 diabetes, suicide, and kidney disease.
For diseases such as COPD and type 2 diabetes, death rates improved in low-poverty counties but worsened in high-poverty ones.
Unintentional injury, driven by the opioid crisis, and Alzheimer's disease, linked to an aging population and increased dementia reporting, saw the largest increases in death rates across all poverty levels.
They also noticed a difference between the genders. Type 2 diabetes death rates improved for females across all poverty levels. In males, the COPD death rates improved.
Why disparities are growing
The researchers observed that the largest disparities in death rates between high- and low-poverty counties were for type 2 diabetes, pneumonia/influenza, COPD, kidney disease, and heart disease. The risk factors such as smoking and obesity, prevalent in the South, contribute to these disparities. Limited Medicaid expansion in some Southern states may also exacerbate inequities.
This study's findings are crucial as they could lead to further research on how poverty shapes death rates and help identify ways to reduce health inequalities.
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