Leading Causes of Premature Death, Ages 1-64 For persons ages one to 64 years, years of potential life lost (YPLL) is used to describe leading causes of premature death. s of potential life lost is a statistic that measures the total number of years lost due to premature death in a population from a certain cause. Premature death is defined as death at an age less than 65 years. YPLL is calculated by subtracting the age of death from 65 years. The YPLL rate is the number of years of potential life lost before age 65 per 1, population ages one to 64. For example, a person who dies at age 27 in a motor vehicle accident has 38 years (65 27 = 38) of potential life lost, but a person who dies at age 56 of heart disease has nine years (65 56 = 9) of potential life lost. YPLL emphasizes the impact of a disease on the length of life for younger individuals; it does not describe the numbers of deaths. Trends Over Time From 1994 to 1996, HIV/AIDS was the leading cause of premature death (Figure 19). After 1995, HIV/AIDS premature death rates decreased due to improved testing and early treatment of people with HIV infection (1). The HIV/AIDS premature death rate decreased 7% from 1,377 per 1, in 1994 to 411 in 22, dropping to become the fifth leading cause of premature death in DeKalb County. Unintentional injury, heart disease, homicide and suicide had less dramatic decreases in premature death rates from 1994 through 22, and there was a small increase in premature death rates of cancer during the same period. Figure 19. Trends in premature deaths among those age 1-64 YPLL rate per 1, 16 14 12 1 8 6 4 2 1994 1995 1996 1997 1998 1999 2 21 22 Injury HIV/AIDS Suicide 36 Status of Health in DeKalb Report, 25
Trends by Race/Ethnicity and Gender Black females From 1994 to 22, the leading causes of premature death for black females, in rank order, were: (1) cancer, (2) heart disease, (3) HIV/AIDS, (4) unintentional injuries and (5) homicide (Table 12). was the leading cause of premature death in all females, regardless of race/ethnicity (Figure 2). Racial disparities exist in the premature death rates among females. Black females had a heart disease premature death rate 2.3 times higher, an HIV/AIDS premature death rate 8.7 times higher and a homicide premature death rate 3.5 times higher than white females. Table 12. Premature death rate in black females Nine-year avg % change from Cause of Premature Death YPLL rate 1994 to 22 772.1 13.7% Heart disease 516.5 1.8% HIV/AIDS 38.8-53.1% Unintentional injuries 364.3 34.1% 228.4-5.6% Figure 2. Trends in premature deaths among black females age 1-64 12 YPLL rate per 1, 1 8 6 4 2 1994 1995 1996 1997 1998 1999 2 21 22 HIV/AIDS Injury Breast and lung cancer contributed 33% and 13%, respectively, to the total cancer years of potential life lost from 1994 to 22 (Figure 21). Breast cancer deaths fluctuated and slightly increased from 1994 to 22. Lung cancer deaths increased 11% from 32.5 deaths per 1, females in 1994 to 35.6 deaths in 22. Lung cancer deaths among black females increased 39% from 1994 to 22. Status of Health in DeKalb Report, 25 37
Figure 21. Breast and lung cancer age-adjusted mortality rates among females by race Deaths per 1, females 6 5 4 3 2 1 1994 1995 1996 1997 1998 1999 2 21 22 Breast - White Breast - Black Lung - White Lung - Black H White females From 1994 to 22, the leading causes of premature death for white females, in rank order, were: (1) cancer, (2) unintentional injuries, (3) heart disease, (4) suicide and (5) stroke (Table 13). There was a significant increase of heart disease premature death rates, which increased by 7 from 29 in 1994 to 365 in 22 (Figure 22). Though fluctuating throughout the nine-year period, stroke premature death rates decreased 83% from 1994 to 22. Table 13. Premature death rate in white females Nine-year avg % change from Cause of Premature Death YPLL rate 1994 to 22 723. 6.8% Unintentional injuries 331.8 16.7% Heart disease 228.1 74. Suicide 144.2-27.9% Stroke 69.8-83.1% Figure 22. Trends in premature deaths among white females age 1-64 YPLL rate per 1, 1 9 8 7 6 5 4 3 2 1 1994 1995 1996 1997 1998 1999 2 21 22 Injury Suicide Stroke 38 Status of Health in DeKalb Report, 25
Hispanics and Asians It is difficult to analyze trends in premature deaths in the Hispanic and Asian populations of DeKalb County because of the small number of total deaths in these groups and a lack of age-specific population figures. However, an analysis of the leading causes of years of potential life lost (YPLL) for the years of 1998 to 22 by gender gives a basic understanding of the major causes of premature deaths. Generalizations should not be made from these data because the total number of deaths associated with these years of life lost is very small. Hispanic females claimed 492 years of potential life or 29% of the premature deaths for Hispanic females from 1998 to 22 (Figure 25). Leukemia accounted for 54% of premature death due to cancer, while breast and lung cancer accounted for 7% and 4%, respectively. Unintentional injuries (i.e., motor vehicle and other injuries) claimed 44 YPLL. Motor vehicle injuries represented 64% of injury YPLL among Hispanic females. The third leading cause of death among Hispanic females was homicide, accounting for 251 YPLL or 1 of premature death. Hispanic males The leading cause of premature death among Hispanic males from 1998 to 22 was unintentional injuries, accounting for 1,63 YPLL or 37% of all premature deaths (Figure 26). Motor vehicle injuries represented the majority of these injuries, accounting for 59% of all premature deaths due to injuries and claiming 968 YPLL. The second leading cause of premature death among Hispanic males was homicide, which claimed 966 YPLL. Heart disease was the third leading cause of death representing nine percent of premature deaths and 424 YPLL. Figure 25. Premature deaths among Hispanic females DeKalb County, Georgia, 1998-22 Figure 26. Premature deaths among Hispanic males DeKalb County, Georgia, 1998-22 Congenital Anomalies 3% Stroke Pregnancy/Childbirth 4% Complications Neurologic Disease 6% 6% 29% Ill-Defined 3% HIV/AIDS 7% 1% 37% 6% Suicide 8% 1 Total years of potential life lost = 1,715 26% 9% 21% Total years of potential life lost = 4,53 Status of Health in DeKalb Report, 25 41
Asian females was the leading cause of premature death among Asian females, accounting for 38% of premature death (Figure 27). From 1998 to 22, a total of 332 years of potential life (YPLL) were claimed by cancer. Brain, ovarian and liver cancers were the most prevalent of all types of cancers, representing 33% of cancer YPLL. The second leading cause of premature death was unintentional injuries with 143 YPLL. Motor vehicle injuries accounted for 71% of YPLL due to injuries. Heart disease had the third highest YPLL of 92 or 1% of total YPLL for Asian females. Asian males Unintentional injuries were the leading cause of premature death among Asian males (Figure 28). Injuries claimed 498 YPLL or 24% of premature deaths. Motor vehicles accounted for 5% of injuries to Asian males. The second leading cause of premature death among Asian males was cancer, accounting for 19% of YPLL. From 1998 to 22, cancer claimed 384 YPLL of Asian males. Brain cancer claimed the majority of YPLL, 28% of all cancers. The third leading cause of premature death among Asian males was suicide. A total of 325 years of potential life was lost from 1998 to 22, representing 16% of all premature deaths. Figure 27. Premature deaths among Asian females DeKalb County, Georgia, 1998-22 Figure 28. Premature deaths among Asian males DeKalb County, Georgia, 1998-22 Muscoskeletal & Connective Tissue Disease 4% Stroke 4% Pregnancy/Childbirth Complications 7% 9% 38% Infectious Diseases 1% 3% Stroke 1% 24% Suicide 7% 1% Total years of potential life lost = 894 16% 13% 19% Suicide 16% Total years of potential life lost = 2,67 42 Status of Health in DeKalb Report, 25