To assess excess mortality from chronic disease in the United States, state age-adjusted combined mortality rates for nine chronic diseases in 1986 were compared with three "minimum" rates—two calculated from rates actually achieved in states and a third estimated as the mortality remaining after elimination of one risk factor for each disease. Hawaii had the lowest mortality rate of combined diseases (305/100 000); state excesses ranged from 0% to 37%. The sum of lowest disease-specific rates in any state was 284 per 100 000, indicating excesses of between 7% and 41%. A minimum mortality rate of 224 per 100 000 was estimated to result from elimination of one risk factor for each of the nine diseases, indicating state excesses from 26% to 54%, or 524 000 US deaths. Reduction of US mortality from the nine diseases to the risk factor— eliminated rate is estimated to be associated with an increased life expectancy at birth of 4 years.
Hahn RA, Teutsch SM, Rothenberg RB, Marks JS. Excess Deaths From Nine Chronic Diseases in the United States, 1986. JAMA. 1990;264(20):2654-2659. doi:10.1001/jama.1990.03450200062032