What kills Americans across the United States differs widely by region and even by county, according to a recent analysis by researchers at the University of Washington.
Its study, published in the Journal of the American Medical Association, used death records from the National Center for Health Statistics from 1980-2014. The study breaks down mortality rates at the county level for 21 categories of death causes, ranked according to which killers reduce Americans’ years of life by the greatest number.
Cardiovascular diseases and cancers led the pack of top killers. However, the analysis found that states saw wide variations within their own borders in what is killing residents.
Northeast Indiana was no exception. The region saw wide variations from county to county. According to the 2014 data that was compiled for the analysis, LaGrange County’s mortality rates for several categories of death causes were much lower than the state and national average, while Wabash County’s rates were much higher.
The LaGrange County Health Department did not respond to requests for comment. Dr. David Roe, health officer for the Wabash County Health Department, declined to comment on the study.
Wells County led the region in deaths from communicable, maternal, neonatal and nutritional diseases. DeKalb County led in deaths from cirrhosis and other chronic liver disease, at 16.88 deaths per 100,000 population, the same rate as the state average.
Allen County led the region in deaths from self-harm and interpersonal violence, but it had the lowest rate of deaths from transport injuries. The latter might be consistent with a geographical pattern researchers noted that deaths from transport injuries were lower in urban areas and higher in rural areas.
Dr. Deborah McMahan, commissioner of the Allen County Department of Health, said it comes as no surprise that causes of death vary from place to place. When she looks at the top four causes of death in Allen County — cancer, heart disease, chronic obstructive lung disease and pneumonia — she sees conditions linked to lifestyle behaviors that are prevalent in the region as well as the state.
Smoking is a leading cause of these preventable conditions. About 20 percent of adults in Indiana smoke, higher than the national average of 16 percent. In addition, an increasing number of young people are starting to smoke, starting the habit with electronic cigarettes and “loosies,” flavored and scented cigarettes that can be bought individually so that they’re cheaper than an entire pack.
The vast majority of chronic obstructive lung disease deaths is caused by tobacco use, McMahan said.
“It’s a very unpleasant medical condition,” she said. “It make people short of breath, even at rest. It’s a very unpleasant way to die, to be honest.”
Nicotine is a hard addiction to kick, but McMahan said there are medications that can help with cravings.
Exercise and diet also play an important role in helping people live longer and healthier lives. Heart disease, diabetes (which McMahan said is more common here than in other parts of the country) and some cancers are influenced by these lifestyle behaviors.
“We’re really fortunate here,” she said. “We have a good park system, trails, a great (YMCA), but we just have to get more people moving. Only about 26 percent of people exercise on a regular basis.”
Some cancer deaths are preventable with early screening. However, a little more than half of residents who should have had a colonoscopy have had one, McMahan said.
“Colon cancer is always one of the top three causes of cancer deaths in Indiana,” she said. “By and large, you can prevent that by catching it at an early stage. It’s unfortunate that so few people take advantage of that.”
Vaccinations for influenza and pneumonia can also save lives she said.
Public health officials are tasked with increasing access to these resources, but that’s just one part of the puzzle, she said.
“Part of it is people disciplining themselves to take advantage of those resources,” she said. “That’s the challenging part.”
Looking forward, McMahan anticipates that antibiotic-resistant bacteria will pose a larger risk to public health. Right now, it’s something health care professionals are seeing in very small numbers, but it’s a problem that could grow in the next decade, she said.
What kills Americans today is very different from what used to kill Americans 100 years ago. Whereas now the top killers are heart disease and cancer, in 1900, the leading causes of death were tuberculosis and pneumonia or influenza.
“Some of these big diseases from the 1900s have disappeared to almost nothing,” said Delia Bourne, genealogy librarian at the Allen County Public Library Genealogy Center. “Some of these diseases have stayed, and now there are new diseases like AIDS. Alzheimer’s is also more identified as a disease.”
Bourne recently presented “What Doesn’t Kill Us: Historical Illnesses and Causes of Death,” an overview of the medical conditions that plagued Americans’ ancestors and how to find out what some of those causes of death listed in newspapers and on death records really meant.
For her, family history is not just about how people lived, but about how they died. Illnesses like tuberculosis shaped people’s lives.
This information is especially of interest to adoptees, who have been known to use the Genealogy Center’s collection to piece together a family health history.
“Even if they don’t want to know who their birth parents were, it’s good for them to know the health history because most people (are predisposed to certain conditions), so it’s good to know what those issues are to begin with,” Bourne said.
Keeping death records is a relatively new practice that started in the mid- to late 1800s. In recent years, death records contain more biographical information, making them a valuable source for those researching their family history.
In the past, many preventable deaths were caused by occupational hazards, Bourne said. However, people didn’t understand the danger at the time.
One example is the radium girls: young women who contracted radiation poisoning from painting watch dials with self-luminous paint at a factory in New Jersey around 1917.
They needed their paintbrushes to have a sharp point to paint the small numbers, so they licked their paintbrushes as they worked. As if that wasn’t bad enough, “They had fun with it. They would paint their nails, and they would put it on their lips and around their eyes, and they would go out on dates, and they would be glowing,” Bourne said.
Several of the women developed cancer of the jaw and died terrible deaths, she said.
Today, people are more aware of occupational hazards, but they still pose a risk, even for professions that most people don’t consider dangerous, she said.
“If you’re a baker, you’re exposed to flour all day, and that’s a dust that can get into the lungs and sinuses and cause problems,” she said. “Librarians are also exposed to dust and mold, and for people with asthma and allergies, that can be very hard.”