Epidemiology for Public Health Practice 5th Edition by Robert Friis,Thomas Sellers

Exercise 9

The following questions refer to Table 1.
a. Calculate the percentage decline in the death rate for all causes. What generalizations can be made about changes in disease rates that have occurred between 1900 and the present?
b. Contrast the changes in death rates due to cancer, heart disease, and cerebrovascular diseases. What additional information would be useful to specify better the changes in these conditions?
c. Note the decline in mortality for the four communicable diseases (1, 2, 3, and 10) since 1900. With the exception of pneumonia and influenza, these are no longer among the 10 leading causes of death. Can you speculate regarding how much of each is due to environmental improvements and how much to specific preventive and curative practices?
d. Among the 10 leading causes of death in 2009 were chronic lower respiratory diseases (44.7 per 100,000-rank 3), diabetes (22.3 per 100,000-rank 7), Alzheimer's disease (25.7 per 100,000-rank 6), and suicide (11.9 per 100,000-rank 10). (Note: Data are not shown in Table 1.) In 1900, these were not among the 10 leading causes of death. How do you account for these changes?
Table 1 Leading Causes of Death and Rates for Those Causes in 1900 and 2009, United States
* Some categories may not be strictly comparable because of change in classification.
† NA: These are no longer listed among the top 10 causes of death.
1 Crude death rate
2 Accidents (unintentional injuries)Sources : U.S. Bureau of the Census. Statistical Abstract of the United States: 1957. Washington, D.C: U.S. Bureau of the Census; 1957: 69; U.S. Public Health Service. Vital Statistics Rates in the United States, 1900-1940. Washington, D. C.: U.S. Government Printing Office: 1947; Kochanek KD, Xu JQ, Murphy SL, et al. Deaths: Preliminary data for 2009. National vital statistics reports; 59(4):5. Hyattsville, MD: National Center for Health Statistics: 2011.