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In life, death is the ending point. In much of biomedical science and health policy, death is often the starting point. As the saying goes, the finality of death tends to focus the mind—as it does the attention of policy makers and resource allocation. Although health progress depends on understanding and action far beyond that singular event, concise and reliable information about death as a touchstone reference point is necessary, but is not sufficient.
In this issue of JAMA, Ma and colleagues1 contribute important data to help advance understanding of death rates in the United States and the progress reflected in the trends. Their comprehensive assessment of the mortality component of vital statistics data from 1969 to 2013 offers valuable insights on the trends over nearly half a century in deaths from all causes, as well as for 6 leading causes of death. During that period, age-standardized death rate per 100 000 for all causes decreased by 42.9% (from 1278.8 to 729.8), with the most substantial relative reduction in deaths from stroke (down 77%, from 156.8 to 36.0) and heart disease (down 67.5%, from 520.4 to 169.1). Impressive declines were also documented in mortality from unintentional injures (down 39.8%, from 65.1 to 39.2), cancer (down 17.9%, from 198.6 to 163.1), and diabetes (down 16.5%, from 25.3 to 21.1). On the other hand, the authors report that the death rate for chronic obstructive pulmonary disease (COPD) doubled (from 21.0 to 42.2) in that period.
McGinnis JM. Mortality Trends and Signs of Health Progress in the United States: Improving Understanding and Action. JAMA. 2015;314(16):1699–1700. doi:10.1001/jama.2015.12391
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