TABLE 3-1 Major Causes of Death and Associated Risk Factors, United States, 1977

Cause

Percentage of All Deaths

Risk Factors

Heart disease

37.8

Smoking, hypertension, elevated serum cholesterol, diet, lack of exercise, diabetes, stress, family history

Malignant neoplasms

20.4

Smoking, work-site carcinogens, environmental carcinogens, alcohol, diet

Stroke

9.6

Hypertension, smoking, elevated serum cholesterol, stress

Non-vehicular injuries

2.8

Alcohol, drug abuse, smoking (fires), product design, handgun availability

Influenza and pneumonia

2.7

Smoking, vaccination status

Motor vehicle crashes

2.6

Alcohol, no seat belts, speed, roadway design, vehicle engineering

Diabetes

1.7

Obesity

Cirrhosis of the liver

1.6

Alcohol abuse

Arteriosclerosis

1.5

Elevated serum cholesterol

Suicide

1.5

Stress, alcohol and drug abuse, gun availability

 

SOURCE: Matarazzo, 1984. Reprinted with permission.

The Need for Surveillance

The changing demographic profile of the U.S. population and the associated patterns of disability risk demonstrate the necessity of continued surveillance of the incidence and prevalence of chronic physical and mental health conditions, injury, and disability. Some research indicates that the risk of disability has been increasing for all population age cohorts, although there is considerable debate about the reasons for this trend. There has also been a noticeable increase in work disability rates (Chirikos, 1989). In addition, the aging of the population may bring increased risks of disability.

Existing national data sets that track the prevalence of chronic conditions over time are useful for disability surveillance. The lack of data on incidence rates, however, is a serious void in disability surveillance and an impediment to fundamental understanding of the disabling process. Incidence data provide a measure of the rate at which a population develops a chronic



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