Top health issues

Before we can determine how we can go about changing our health care system and make it work for us as consumers we need to understand what the most important health care issues are. Epidemiologists helps us understand this by compiling statistics about the causes of diseases. These health outcomes can be measured by a variety of ways and then ranking them including: causes of death, disability, quality of life and health-care associated costs among other measures. We can start by analyzing what the leading causes of death in the USA are, as most people would argue that diseases that kill us would be important to tackle first. You can find this information out at the Centers for Disease Control and Prevention (CDC), the national organization that compiles statistics on diseases (one of their many functions). If we look at data for the Leading Causes of Death from 2007 (the latest full report available from the CDC), we can appreciate that the following four conditions account for approximately 2/3 of all causes of death:
1. Heart Disease
2. Cancers
3. Stroke
4. Chronic lower respiratory diseases

It is also important to note that diabetes ranks as the sixth leading cause of death in the USA.

If one looked at the leading causes of death at the turn of last century, the list would be in sharp contrast to the current one because in the early 1900's infectious diseases (for example tuberculosis, pneumonia, diarrheal diseases and others) accounted for most of the deaths seen in society.  The comparison for the leading causes of death between 1900 and 2004 is striking.

At first glance, it would be difficult to determine what the leading causes of death in 2007 have in common. For one, they are all considered chronic diseases because most people have to live with them for many years and unfortunately this is often associated with a poor quality of life.   Most importantly, though and after decades of research, epidemiologists and physicians have been able to determine that most of these "top killer diseases" are also mostly preventable.

I want to highlight this last two points again so that everyone is able to understand and we can frame the issue:
1. The top leading causes of death in our country (and in most developed countries) are due to chronic diseases.
2. These diseases are mostly preventable.


A natural question then is: How preventable are these diseases? The answer to this question has also been elucidated by myriad epidemiological studies and the following has been found:
1. Heart Disease - 80% preventable as per the WHO Report: Preventing chronic diseases: a vital investment
3. Stroke - 80% preventable (as per the National Stroke Association)
4. Chronic lower respiratory disease - 80-90% preventable (as per the National Heart, Lung and Blood Institute)
5. Diabetes - 90% preventable (as per the Nurses Health Study - HU, F.B. et al. Diet, Lifestyle, and the Risk of Type 2 Diabetes Mellitus in Women N Engl J Med 2001; 345:790-797. September 13, 2001).
5. Cancer- over 70% preventable (as per Preetha, A. et al. Cancer is a Preventable Disease that Requires Major Lifestyle Changes. Pharm Res. 2008 September; 25(9): 2097–2116).


Again, at first glance, this is surprising to most, since the emphasis of most visits to the doctor is on treatment rather than prevention, but maybe this should be rethought based on this data. Would it not make sense to visit the doctor before developing these killer diseases ? And if so, why is this not happening? I will answer these questions in subsequent blogs. Stay tuned.

In the next blog, I will present some data on what the actual causes of these diseases are that lead to their preventability and hence the way we can prevent from developing these deadly diseases.