An article published online on April 28, 2009 in the journal Public Library of Science Medicine (PLoS Medicine) estimates 1,977,000 deaths each year in the United States are due to preventable risk factors. Smoking, hypertension and being overweight top the list, with 1,078,000 yearly deaths attributed to these preventable causes.
For their report, researchers at the Harvard School of Public Health, along with colleagues from the University of Toronto and the Institute for Health Metrics and Evaluation at the University of Washington, utilized data from U.S. health surveys as well as mortality statistics from the National Center for Health Statistics. Deaths were categorized as preventable if the subjects would not have died at the time they did if they did not have a particular modifiable risk factor. In addition to smoking, high blood pressure and overweight/obesity, the team listed the following risk factors as among the top preventable causes of death: inadequate physical activity, elevated glucose, high low density lipoprotein (LDL) cholesterol, insufficient omega-3 fatty acid intake, high trans fatty acid intake, alcohol abuse, low vegetable and fruit intake, and low dietary polyunsaturated fatty acids. While alcohol use is protective against mortality from cardiovascular disease and diabetes, alcohol-related deaths from traffic and other accidents, violence, cancer and other diseases outweighed its benefits, leading to an estimated 64,000 yearly deaths.
When men and women were separately examined, smoking emerged as the leading preventable cause of death among men, while high blood pressure was responsible for more deaths in women. Twenty-one percent of male deaths were attributable to smoking, and 19 percent of female deaths to hypertension. The majority of deaths from alcohol use occurred in men, due to their higher intake of the beverage and greater incidence of binge drinking.
By examining a wide range of causes, the study is the most comprehensive yet to evaluate the impact of dietary, lifestyle and metabolic risk factors on chronic disease mortality in the U.S. "The large magnitude of the numbers for many of these risks made us pause," noted lead author and Harvard School of Public Medicine doctoral student Goodarz Danaei. "To have hundreds of thousands of premature deaths caused by these modifiable risk factors is shocking and should motivate a serious look at whether our public health system has sufficient capacity to implement interventions and whether it is currently focusing on the right set of interventions."
"The findings should be a reminder that although we have been effective in partially reducing smoking and high blood pressure, we have not yet completed the task and have a great deal more to do on these major preventable factors," senior author Majid Ezzati added. "The government should also use regulatory, pricing, and health information mechanisms to substantially reduce salt and trans fats in prepared and packaged foods and to support research that can find effective strategies for modifying the other dietary, lifestyle, and metabolic risk factors that cause large numbers of premature deaths in the U.S."