The Epidemic of Despair Among White Americans: Trends in the Leading Causes of Premature Death, 1999-2015.

• Autores: Elizabeth M. Stein, Keith P. Gennuso, Donna C. Ugboaja, Patrick L Remington
• Localización: American journal of public health, ISSN 0090-0036, Vol. 107, Nº. 10, 2017, págs. 1541-1547
• Idioma: inglés
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• Resumen

  • Objectives: To evaluate trends in premature death rates by cause of death, age, race, and urbanization level in the United States. Methods: We calculated cause-specific death rates using the Compressed Mortality File, National Center for Health Statistics data for adults aged 25 to 64 years in 2 time periods: 1999 to 2001 and 2013 to 2015. We defined 48 subpopulations by 10-year age groups, race/ethnicity, and county urbanization level (large urban, suburban, small or medium metropolitan, and rural). Results: The age-adjusted premature death rates for all adults declined by 8% between 1999 to 2001 and 2013 to 2015, with decreases in 39 of the 48 subpopulations. Most decreases in death rates were attributable to HIV, cardiovascular disease, and cancer. All 9 subpopulations with increased death rates were non-Hispanic Whites, largely outside large urban areas. Most increases in death rates were attributable to suicide, poisoning, and liver disease. Conclusions: The unfavorable recent trends in premature death rate among non-Hispanic Whites outside large urban areas were primarily caused by self-destructive health behaviors likely related to underlying social and economic factors in these communities. [ABSTRACT FROM AUTHOR]