Disease Statistics: Competing for the Most Deaths

Disease statistics rise to the top when describing the urgency to solve a critical health problem. How much suffering and death is this causing? A new study in PLOS ONE finds that the number of deaths caused by diabetes may be as much as four times higher than the numbers typically reported.

Getting to Root Causes

The problem comes in defining a primary cause of death. Heart disease is number one on the list of the leading causes of death in America. When heart disease brings life to an end, it’s pretty obvious. The heart stops and so does everything else. Heart disease goes onto the death certificate.

Diabetes is more insidious, especially the most common form, type 2 diabetes. Diabetes triggers a host of other problems, including heart disease. Those other problems often wind up being counted as the cause of death on the death certificate. When counting up causes of death recorded in this way, diabetes accounts for 3.3% of all deaths.

Andrew Stokes and Samuel Preston looked at two large datasets and two different ways of identifying diabetes in those data. They found remarkable consistency between the datasets and the different definitions for diabetes. In their calculations, between 11.5% and 11.8% of deaths could be attributed to diabetes. The number increased by another 2% when they considered pre-diabetes.

A Fraught Question

Recent history tells us that this question is fraught. In 2005, considerable controversy surfaced over preventable causes of death. A CDC study in 2004 suggested that obesity might overtake smoking as the leading preventable cause of death. Nasty arguments erupted. An internal review of the study led the authors to publish a correction. The hubbub left some scars.

Hopefully we won’t get distracted by arguments about whose disease is most important. Nobody wins in the death and disease derby. The real point is to focus on promoting better health. Prevention is a critical tool for addressing the leading causes of death.

And prevention often leads back to better obesity care.

Click here for the study in PLOS ONE and here for more from the Washington Post. For background on the pitfalls of attributing deaths to a disease or a risk factor,  click here.

Death Match, photograph © Nomaan Ahgharian / flickr

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April 9, 2017