TABLE 2.2 Leading Causes of Years of Potential Life Lost (YPLL), Costs to Society, and Deaths

Disease or Condition

Age-Adjusted YPLL Before Age 75, 1996 (per 100,000 (population)a

Cost Estimate ($ billions, constant 1996 dollars)b

Number of Deaths (1996)a

Injuryc

1,919.0

260d

147,126e

Cancer

1,554.2

115.4

539,533

Heart diseases

1,222.6

144.9

733,361

HIV infection and AIDS

401.9

NA

31,130

Stroke; cerebrovascular diseases

210.2

32.6

159,942

Chronic obstructive pulmonary diseases

161.1

31.8

106,027

Diabetes

153.5

102.7

61,767

Chronic liver disease and cirrhosis

145.7

4.8

25,047

Pneumonia and influenza

114.5

25.4

83,727

a SOURCE: NCHS (1998).

b These cost estimates were prepared by different authors, using different years as points of reference: heart disease (1991); cancer (1990); stroke (1993); pulmonary disease (1991); pneumonia (1991); diabetes (1992); liver disease (1985); and kidney disease (1985). All estimates (except injury) have been calculated to 1996 dollars and encompass both direct costs and indirect costs attributable to patient mortality (premature death), patient morbidity (reduced productivity), and other non-health care costs. NA = Not available. SOURCE: IOM (1998).

c Injury includes unintentional injuries, suicide, and homicide.

d The 1985 cost of injury in the United States estimates (Rice et al., 1989) were updated to 1995 separately by type of cost. Direct costs were inflated using the appropriate component of the Consumer Price Index (hospital and related services, physicians' services, prescription drugs, professional medical services, and medical care services). Indirect costs were inflated using the index of hourly compensation in the business sector.

e SOURCE: Peters et al. (1998).

Estimates of the economic cost of injury combine information on the incidence and impact of both fatal and nonfatal injuries into a single measure that is readily understandable by policy makers, employers, and the insurance industry. Using a cost-of-illness or human capital approach to valuing health, estimates of the cost of injury have been derived for several major categories (e.g., motor vehicles, firearms, falls, fires and burns, poisonings) of injury (Rice et al., 1989; Max and Rice, 1993; Miller et al., 1995; NSC, 1997; Blincoe, 1997; Leigh et al.,



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