ESTIMATING THE CONTRIBUTIONS OF LIFESTYLE-RELATED FACTORS TO PREVENTABLE DEATH
A Workshop Summary
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This study was supported by Contract No. 200-2000-00629, Task Order No. 163 between the National Academy of Sciences and the Centers for Disease Control and Prevention. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
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PLANNING COMMITTEE ON ESTIMATING THE CONTRIBUTIONS OF LIFESTYLE-RELATED FACTORS TO PREVENTABLE DEATH
JONATHAN M. SAMET, M.D., M.S., Professor and Chair,
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
J. MICHAEL MCGINNIS, M.D., M.P.P., Senior Vice President and Director,
Health Group, Robert Wood Johnson Foundation, Washington, DC
MICHAEL A. STOTO, PH.D., Senior Statistical Scientist, and Associate Director for Public Health,
Center for Domestic and International Health Security, RAND, Arlington, VA
STAFF
ROSE MARIE MARTINEZ, Sc.D., Director,
Board on Population Health and Public Health Practice
LINDA G. MARTIN, Ph.D.,
Institute of Medicine Scholar-in-Residence
HOPE HARE, M.F.A., Administrative Assistant
Consultants
MIRIAM DAVIS, LLC, Medical Writer & Consultant
SANDRA HACKMAN, Copy Editor
REVIEWERS
This report has been reviewed in draft form by persons chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following for their review of this report:
ALFRED O. BERG, M.D., M.P.H., University of Washington School of Medicine
STEPHEN MARCUS, PH.D., National Cancer Institute, National Institutes of Health
DAVID MATCHAR, M.D., Duke University
CHRISTOPHER MAYLAHN, Chronic Disease Director, New York State Health Department
The review of this report was overseen by MELVIN WORTH, M.D., Scholar-in-Residence at the Institute of Medicine, who was appointed by the Institute of Medicine. He was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the institution.
CONTENTS
Tables and Figures
TABLE 1 |
Findings on Actual Causes of Death, 1990 |
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TABLE 2 |
Life-Years per $1 Million (1997 dollars) |
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TABLE 3 |
Examples of “Attributable” Deaths |
FIGURE 1 |
The 10 Leading Causes of Death in the United States, 2002 |
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FIGURE 2 |
Admissions for Acute Myocardial Infarction During 6-Month Periods June–November Before, During, and After the Smoke-Free Ordinance |
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FIGURE 3 |
Simulation: Prehypertension. Hospitalizations, Nursing Home Admissions, and Deaths Attributable to Prehypertension and Residual Hypertension |
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FIGURE 4 |
Relative Risk of All-Cause Mortality by Alcohol Consumption, Age, and Cardiovascular Risk, CPS-II Men and Women Combined |
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FIGURE 5 |
Body Mass Index and Probability of Death |
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FIGURE 6 |
The Effect of Age on BMI Associated with Lowest Mortality Rate |
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FIGURE 7 |
The Association between BMI and Mortality, BFMI and Mortality, and FFMI and Mortality, Adjusted for smoking (BFMI and FFMI Mutually Adjusted). |
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FIGURE 8 |
QALY Calculation |
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FIGURE 9 |
Attributable Disease Burden of 20 Risk Factors |
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FIGURE 10 |
Deaths in AMR-A Region. The region includes Canada, US, and Cuba; US population; represents 85% of the region. |
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FIGURE 11 |
Disease Burden in AMR-A Region. The region includes Canada, US, and Cuba; US population; represents 85% of the region |