Chronic Diseases: The Leading Causes of Death
New York

Profiling the Leading Causes of Death in the United States
Heart Disease, Stroke and Cancer

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The Leading Causes of Death United States and New York, 1995 and 2001

 

The Burden of Chronic Disease

Chronic diseases—such as heart disease, stroke, cancer, and diabetes—are among the most prevalent, costly, and preventable of all health problems. Seven of ten Americans who die each year, or more than 1.7 million people, die of a chronic disease.

Reducing the Burden of Chronic Disease

Chronic diseases are not prevented by vaccines, nor do they just disappear. To a large degree, the major chronic disease killers are an extension of what people do, or not do, as they go about the business of daily living. Health-damaging behaviors—in particular, tobacco use, lack of physical activity, and poor nutrition—are major contributors to heart disease and cancer, our nation’s leading killers. However, tests are currently available that can detect breast cancer, colon cancer, heart disease, and other chronic diseases early, when they can be most effectively treated.

The Leading Causes of Death and Their Risk Factors

Heart Disease and Stroke

Heart disease and stroke are the first and third leading causes of death for both men and women in the United States. Heart disease is the leading cause of death in New York, accounting for 56,643 deaths or approximately 36% of the state’s deaths in 2001 (the most recent year for which data are available). Stroke is the third leading cause of death, accounting for 7,706 deaths or approximately 5% of the state’s deaths in 2001.

Prevention Opportunities

Two major independent risk factors for heart disease and stroke are high blood pressure and high blood cholesterol. Other important risk factors include diabetes, tobacco use, physical inactivity, poor nutrition, and being overweight or obese. A key strategy for addressing these risk factors is to educate the public and health care practitioners about the importance of prevention. All people should also partner with their health care providers to have their risk factor status assessed, monitored, and managed in accordance with national guidelines. People should also be educated about the signs and symptoms of heart attack and stroke and the importance of calling 911 quickly. Forty-seven percent of heart attack victims and about the same percentage of stroke victims die before emergency medical personnel arrive.

Risk Factors for Heart Disease and Stroke, 2003

 

Cancer

Cancer is the second leading cause of death and is responsible for one of four deaths in the United States. In 2004, over 560,000 Americans—or more than 1,500 people a day—will die of cancer. Of these annual cancer deaths, 36,340 are expected in New York. About 1.4 million new cases of cancer will be diagnosed nationally in 2004 alone. This figure includes 88,190 new cases that are likely to be diagnosed in New York.

Prevention Opportunities

The number of new cancer cases can be reduced and many cancer deaths can be prevented. Adopting healthier lifestyles— for example, avoiding tobacco use, increasing physical activity, achieving a healthy weight, improving nutrition, and avoiding sun overexposure—can significantly reduce a person’s risk for cancer. Making cancer screening, information, and referral services available and accessible is essential for reducing the high rates of cancer and cancer deaths. Screening tests for breast, cervical, and colorectal cancers reduce the number of deaths by detecting them early.

Preventive Screening Trends, 2002

 

New York’s Chronic Disease Program Accomplishments

Examples of New York’s Prevention Successes

• Statistically significant decreases in cancer deaths among African American men (345.0 per 100,000 in 1990 versus 269.2 per 100,000 in 2000) and African American women (192.1 per 100,000 in 1990 and 163.6 per 100,000 in 2000).
• A 19.3% decrease in the number of women older than age 50 who reported not having had a mammogram in the last 2 years (from 37.2% in 1992 to 17.9% in 2002).
• A higher prevalence rate than the corresponding national rate for individuals who reported that they were neither overweight nor obese (43.7% in New York versus 40.0% nationally).

CDC’s Chronic Disease Prevention and Health Promotion Programs

In collaboration with public and private health organizations, CDC has established a national framework to help states obtain the information, resources, surveillance data, and funding needed to implement effective chronic disease prevention programs and ensure that all Americans have access to quality health care. CDC funding and support enable state health departments to respond efficiently to changing health priorities and effectively use limited resources to meet a wide range of health needs among specific populations. The table below is a breakdown of the CDC’s funding awards to New York in the areas of cancer, heart disease, stroke, and related risk factors.

Additional Funding

CDC’s National Center for Chronic Disease Prevention and Health Promotion funds additional programs in New York that fall into other health areas. A listing of these programs can be found at http://www.cdc.gov/nccdphp/states/index.htm.

Opportunities for Success

Chronic Disease Highlight:
Cardiovascular Disease

In 1999, cardiovascular disease (CVD) was the primary cause of death for all New Yorkers. Although CVD is a problem for all adults, in 1999 mortality was especially high for older age groups. However, disparities in CVD mortality are most obvious when examining rates of premature mortality (death before the age of 75); African Americans in New York in 1999 were almost 30% more likely than whites to die prematurely from CVD and were 48% more likely to die specifically from stroke than their white counterparts.

Many believe that CVD is a man’s disease, but a greater number of women die from CVD than men. This is partly explained by the large number of women in older age groups in New York where CVD deaths are concentrated. CDC heart disease mortality data from 1996 to 2000 indicate that the heart disease death rate for women in New York was 529 per 100,000, compared with the rate for women in the United States, 438 per 100,000. These data also show that in 2001, heart disease was the leading cause of death for women age 65 and over and was the second leading cause of death for women in the 45 to 54 age group and the 55 to 64 age group.

Tobacco use, physical inactivity, poor nutrition, obesity, hypertension, high blood cholesterol, and diabetes are known and modifiable risk factors for CVD. According to 2003 data from CDC’s Behavioral Risk Factor Surveillance System, the overall rate of adult smokers in New York was 22%. Almost one third of New York’s adult population was estimated to be physically inactive, 74.2% were consuming fewer than 5 servings of fruits and vegetables a day, 20.9% were obese, and 7.4% were reported to have diabetes. In 2003, 25.3% of the state’s adult population had high blood pressure, and 34.9% had high blood cholesterol. African Americans, those in lowerincome populations, and those with lower levels of education tended to have higher rates of smoking, physical inactivity, high blood pressure, obesity, and diabetes.

Hospital expenditure data provide an indication of the direct costs of CVD in New York State. CVD hospitalization costs in 2000 were in excess of $6.8 billion. Sixty-one percent of these costs were for people under age 75. Seventy-five percent of all CVD hospitalizations were paid for with public funds. Direct and indirect expenditures for CVD in New York were estimated to be approximately $16 billion in 2002.

Text adapted from The Burden of Cardiovascular Disease in New York: Mortality, Prevalence, Risk Factors, Costs, and Selected Populations (no date).

Disparities in Health

Hispanics are the fastest growing minority population in the country; in 2000 they comprised almost 17% of New York’s population. Like other racial and ethnic minorities, Hispanics in New York experience health disparities for some critical risk factors and chronic diseases, such as nutrition, physical activity, overweight and obesity, and heart disease. In other areas, such as diabetes, high blood pressure and stroke, Hispanics have better health status than other groups.

In 2003, CDC Behavioral Risk Factor Surveillance System (BRFSS) data indicate that African Americans (20.6%) and Hispanics (20.7%) were less likely to consume 5 servings of fruits and vegetables per day than whites (24.4%). Hispanics also had lower rates of participation in leisure time physical activity (61.8%, compared with 67.6% for African Americans and 75.4% of whites). Based on these risk factors, Hispanics were also more likely to be overweight than whites (41.7% versus 38.5%) and more likely to be obese than whites (21.6% versus 19.1%). From 1996 to 2000, Hispanics in New York had a higher heart disease death rate than Hispanics nationally (369 per 100,000 versus 348 per 100,000).

However, from 1991 to 1998, Hispanics had a lower stroke death rate (66 per 100,000) than whites (97 per 100,000) or African Americans (102 per 100,000). In addition, Hispanics in New York had a lower stroke death rate than Hispanics nationally (66 per 100,000 versus 79 per 100,000). BRFSS data from 2003 also indicate that Hispanics in New York were less likely than whites to report having been told that they have diabetes (6.0%, compared to 8.6% for whites). The state of New York passed a law in 2000 that provided funding for a grant program to begin to address disparities in health. Grants are provided to local counties and organizations with the intent to increase community-based health promotion and disease prevention activities.

Other Disparities

• Cervical Cancer: Although in 2002 African American women in New York were more likely to report having had a Pap smear in the last 3 years (12.7%, compared with 15.8% for white women), from 1997 to 2000 African American women had higher cervical cancer death rates (5.2 per 100,000) than white women (3.2 per 100,000).
• Prostate Cancer: In 2000, African American men had prostate cancer death rates more than twice that of white men (61.2 per 100,000 for African American men versus 27.2 per 100,000 for white men).

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Page last reviewed: November 14, 2005
Page last modified: November 14, 2005
Content source: National Center for Chronic Disease Prevention and Health Promotion