File Living And Dying In America[1]

Living and Dying in America Approximately 2.4 million Americans died in 2004. For the last 20 years, 50-60% of all deaths have been attributable to three major diseases, heart attacks, cancer and strokes. (Table I) Table I: Leading Causes of Death in 2004 Cause of Death

Total Deaths

Percent Of total

All Causes

2,397,615

100

Heart Disease

652,486

27.2

Cancer

533,888

23.1

Stroke

150,074

6.3

COPD

121,987

5.1

Accidents

112,012

4.7

Diabetes

73,138

3.1

Alzheimers

65,965

2.8

Pneumonia/Flu

59,664

2.5

Kidney Dz

42,480

1.8

Infection

33,373

1.4

Suicide

32,439

1.4

Liver Dz

27,013

1.1

Hypertension

23,076

1.0

Parkinsons

17,989

0.8

Homicide

17,357

0.7

National Vital Statistics Reports, Vol. 55, No. 19, August 21, 2007.

While genetics play a role and it is important to choose your parents wisely, the fact remains that lifestyle choices have a profound effect in terms of risk for death due to the top three causes. Specifically tobacco is associated with every major killer with sedentary lifestyle and poor diet running a close second. When you consider the fourth through the sixth leading causes of death, lifestyle issues remain incredibly prominent given the direct correlation between emphysema/ tobacco abuse, accidents/ alcohol use, adult onset diabetes/ obesity. (Table II)

Table II: Risk Factors Associated with Leading Causes of Death Cause of Death

Percent Of total

Heart Disease

27.2

●

●

Cancer

23.1

●

Stroke

6.3

●

COPD

5.1

●

Accidents

4.7

●

Diabetes

3.1

Smoking

Sedentary High fat Lifestyle Diet

Obesity

High Cholesterol

●

●

●

●

●

●

●

●

●

Diabetes

●

Alcohol Abuse

● ●

●

● ●

●

●

Surgeon Generals Report on Nutrition and Health, 1988 and National Center for Health Statistics Monthly Vital Statistics Report 31:1, 1988 with multiple revisions.

Therefore, fully two-thirds of all deaths may be preventable based solely on common sense daily decisions in terms of nutrition, exercise and toxin avoidance. A small percentage of even the healthiest of individuals still succumb to the ravages of cancer which unfortunately is capable of crossing the boundaries erected by any and all preventative measures. Strokes and heart attacks are extremely rare in the absence of multiple risk factors. While reducing risk factors does not guarantee a disease-free life; quality of life is markedly improved in terms of preservation of function and avoidance of suffering.

America has a major health problem. We like to complain about the rising cost of healthcare, but the problem with our healthcare system is that it is solely reactionary with no preventative component. THE problem with the healthcare system is the American lifestyle itself. Only three percent of us live a healthy lifestyle as defined by the Archives of Internal Medicine. (Table III)

Table III: How Many Americans Lead Healthy Lifestyles?

Lifestyle Factor

% of Americans

Non-Smoker

76%

Healthy Weight (BMI 18.5-25.0) 5 Fruit/Vegetable Servings/Day Regular Exercise (30 min/ 5days/wk)

40% 23% 22%

All of the Above

3%

Reeves and Rafferty, Health lifestyle characteristics among adults in the U.S., 2000, Archives of Internal Medicine, 2005; 165: 854857. BRFSS 2000 data, N=153,000.

Keep in mind, this 3% figure is based on survey driven data and therefore, the true percentage may be significantly lower. Burden your finely tuned automobile with watered down gasoline, low quality oil, fouled plugs, a clogged air filter, flat tires and no shocks…see how well it runs or how long it remains finely tuned. Your body is no different! Where does modern medicine fit in? Sticking with the automotive analogy…checkups/service/maintenance. Your doctor can listen to you, examine you, check labs and images to make sure you are running smoothly and that all of your components are in balance. This is where hormone replacement therapy can make a huge difference. Who is going to pay for a preventative/ wellness program? Private insurance is not going to pay. It will remain reactionary only. The consumer has to pay. You have choices day after day: spend or save, compete or quit, love or hate, eat healthy or eat junk, exercise or couch potato. You choose…suffer the consequences or enjoy the benefits. L. Todd Stewart, M.D.