America’s 10 LEAST WANTED
You won’t find pictures of America’s deadliest killers on television shows like “America’s Most Wanted” or on post office bulletin boards. The killers responsible for more than 2 million deaths a year aren’t people: They’re diseases and accidents.
Thanks to research, new medicines, and preventive measures, the identities of these killers have changed through the years. In 1900, the leading causes of death in the United States were pneumonia and influenza, tuberculosis, and acute intestinal infections. Since then, vaccines, antibiotics, and better living conditions have knocked all of these off the top of the list.
Today, heart disease, cancer, and stroke have replaced them at the head of the list. The good news is, preventive measures reduce the threat from these and other illnesses. In the last 20 years, life expectancy at birth for the general population has increased from 67 years to 72 years for men and from 75 years to 78 years for women.
What are the top 10 killers? And what can you do to try to reduce your risk of ever encountering them?
1 Coronary Heart Disease
More than 500,000 people die in the United States from coronary heart disease each year. Even though the death rate from this ailment has fallen more than 30 percent since 1972, it remains the number-one killer of Americans. It’s one of several illnesses classified as cardiovascular diseases (cardio = heart; vascular = blood vessels), which also include high blood pressure, rheumatic heart disease, and stroke. Together, they kill more than twice the number of people who die from cancer, which ranks second. In fact, cardiovascular diseases kill almost as many people as all other causes of death combined. According to the American Heart Association, nearly one in two Americans will die from a cardiovascular disease–someone every 32 seconds.
In the last 50 years hundreds of millions of dollars have been spent in research. These studies have identified risk factors and habits that contribute to cardiovascular diseases, as well as ways to lessen a person’s risk of getting them. The major risk factors include heredity, male sex, increasing age, smoking, high blood pressure, and high blood cholesterol. Although you can’t do anything about your age, sex, or genes, you can change your lifestyle to reduce your chance of developing a cardiovascular disease.
If, for one thing, you smoke, quit. If you don’t smoke, don’t start. A smoker is twice as likely as a nonsmoker to have a heart attack. While about two-thirds of the people who have heart attacks survive, smokers are more likely than nonsmokers to die from them.
High blood pressure and high blood cholesterol are two other controllable risk factors. Proper diet, weight control, regular exercise, and low salt intake often keep blood pressure within safe levels. Sometimes medication is required. Blood cholesterol can also be controlled with a proper diet that includes foods low in cholesterol and saturated fat. Go easy on the hamburgers, french fries, whole milk, and eggs. Choose fish, poultry, grains, fruits, and vegetables, and polyunsaturated oils more often. Regular exercise also affects blood cholesterol levels.
Death rates for most forms of cancer are declining, but a steady rise in lung cancer was observed during the past 50 years. This keeps the illnesses in second place among the nation’s killers. Cancer is characterized by growth and spread of abnormal cells. The cells grow into tumors, masses of tissue. Cancer kills normal tissue. When cancer spreads unchecked throughout the body, the person usually dies. Fortunately, if the disease is discovered early, survival rates are good.
Early detection depends upon people knowing and watching for the American Cancer Society’s seven warning signs: changes in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge, a thickening or lump, chronic indigestion or difficulty swallowing, obvious change in a wart or mole, and a nagging cough or hoarseness that does not go away. Screening tests, such as colorectal tests for blood in the stool, Pap tests for cervical cancer, and mammograms for breast cancer identify problems early enough so that treatment can be successful.
You can reduce your risk of cancer by avoiding tobacco use (including smokeless tobacco), using sunscreen and avoiding excessive sun exposure, and eliminating or limiting alcohol use. Cancer has also been linked to industrial agents (such as nickel, chromate, and asbestos), and radiation, so avoid exposure to these suspects.
Careful attention to nutrition and seight control can also help prevent cancer. Limit the amount of fatty foods, as well as salt-cured, smoked, and nitrite-cured foods in your diet. Increase high-fiber foods such as whole grains, fruits, and vegetables. Foods high in vitamins A and C may also help reduce the risk of getting cancer. Choose carrots, spinach, oranges, grapefruit, strawberries, and green and red peppers. Cabbage, broccoli, brussels sprouts, and cauliflower may also reduce the risk of cancer.
STRoke is one of the cardiovascular diseases, but because it kills nearly 150,000 Americans annually, it ranks third among the top 10 killers. Stroke is the most common name for cerebrovascular accident, a disruption of the blood supply to the brain caused either by bleeding or by the same kind of blood vessel blockage that causes heart attack. In both cases, brain cells die. Stroke is also a leading cause of disability. Survivors often lose function in the areas of the body that were controlled by the brain cells that died.
Heredity plays a big part in stroke risk. So do age (over 55), sex (men have more strokes), race (blacks have a 60 percent higher risk than whites), diabetes mellitus, and having had a prior stroke. Treatable risk factors include high blood pressure, heart disease, high red blood cell count, and mini-strokes, called TIAs, that sometimes precede full-blown stroke.
The best stroke prevention is blood pressure control. Since 1972, stroke deaths have declined 5 percent per year. The improvement is credited to better ways to control blood pressure and better care after stroke. The same heart-healthy diet recommended for the other cardiovascular diseases helps control blood pressure and prevent stroke. Other preventive measures include controlling blood cholesterol and weight, avoidance of smoking and alcohol, and regular exercise.
The fourth leading causes of death is accidents. About half of the more than 95,000 accidental deaths each year involve motor vehicles. Falls, drownings, and fires make up a large portion of the remainder.
Seat belts are between 50 percent and 65 percent effective in preventing traffic fatalities, but some people forget or refuse to use them. Many people think their chances of surviving a crash are better if they are not confined by a seat belt in a wrecked or overtuned car. However, statistics show that death rates for people thrown from their vehicles are 40 times higher than those for people who aren’t ejected. Some people wear seat belts only for long-distance travel in the mistaken belief that short trips are safer than long ones. If you buckle up every time you ride in a car or other motor vehicle, you’ll reduce you risk of accidental denth.
Another entirely preventable risk factor associated with vehicle accidents is alcohol.
Other accidents cause around 47,000 deaths annually. Falls and complications from them kill thousands of poeple–most elderly–every year. Deaths from drowning and fire are also included in the total. Most drownings occur after people slip or fall into water, so careful observance of water safety rules is an important preventive measure. Alcohol is also often implicated in these deaths. Fire deaths can be avoided by installing smoke detectors on every floor of your home, and avoiding late-night use of alcohol and tobacco.
5 Lung Disease
Lung diseases rank fifth among deadly illness, killing close to 79,000 Americans a year. Coughing, wheezing, and shortness of breath are symptoms shared by two serious lung diseases: emphysema and chronic bronchitis. Emphysema destroys the lungs’ ability to expand and contract. Chronic bronchitis is an inflammation of the airways. Damage interferes with the intake of oxygen or weakens the lungs so they can’t fight infection.
Thus lungs have more direct contact with the environment than any other part of the body, including the skin, so air quality is of critical concern. But the prime suspect in most deaths from lung disease is smoking. In 1987, the U.S. Surgeon General estimated smoking was responsible for between 80 percent and 90 percent of chronic lung disease.
The most important way to avoid lung disease is to not smoke. Exercise is another way to keep lungs healthy. Regular exercise improves the body’s breathing capacity, the amount of air you can inhale in a deep breath. A third way to reduce the death rate from lung disease is to work to reduce air pollution.
Once the nation’s leading cause of death, the combination of pneumonia and influenza still rank sixth among the top 10 killers. Pneumonia is an inflammation of the lungs that interferes with breathing because tiny air sacs in the lungs are swollen and do not function properly. Unchecked, the infection can cause the lungs to lose the ability to absorb oxygen. Deaths can come from prolonged lack of oxygen.
Pneumonia has more than 30 causes, primarily bacteria, viruses, or mycoplasma (organisms with qualities similar to both bacteria and viruses). People with healthy immune systems can fight off the infection, but the very young and very old are vulnerable to it. So are people with weak immune systems, such as heavy smokers and people with diabetes, sickle-cell anemia, or AIDS.
Influenza, or flus, are illnesses common during winter. As there are various pneumonias, there are different kinds of flu. Flu often precedes pneumonia, so the first line of defense against pneumonia is flu prevention. Flu vaccine protects against the illness, and every year people considered at high risk are encouraged to get flu shots. A drug called amantadine is an effective treatment for a kind of flu known as influenza A, the most common type of flu in America. Vaccines are also available to protect against many kinds of pneumonia. Another way to avoid flu and pneumonia is to maintain overall health. The same rules apply here, too: Don’t smoke. Eat a balanced diet. EXercise regularly. Get plenty of rest.
Approximately 11 million Americans–about one person in 20–has diabetes. There is no cure for the disease, which affects the way the body changes food into energy. People with diabetes don’t produce insulin, a hormone, or produce too little for the body to process glucose and other sugars normally. A person with diabetes can have very high blood sugar levels that don’t permit normal functioning. Alone, the illness ranks seventh among the top 10 killers, and diabetes complications contribute to heart disease, kidney disease, and stroke. If you count deaths in which diabetes was a factor, this illness could rank fourth.
The two main types of diabetes are known as insulin-dependent (or Type I) and non-insulin-dependent (or Type II). Insulin-dependent diabetes occurs most often in children and young adults, which is why it was once called juvenile-onset diabetes. that term is no longer used because the disease can occur at any age.
Since insulin helps convert food to energy, those with insulin-dependent diabetes must inject the hormone daily. Those with non-insulin-dependent diabetes produce insulin, but for some reason the body can’t use it effectively. Treatment for these patients includes a carefully planned diet and regular exercise. Some oral medication may also be prescribed.
Most researchers believe many cases of diabetes have a hereditary connection. They think heredity predisposes a person to diabetes, but that genes alone don’t cause the disease. Attention to healthy living, including weight control, may be helpful in peventing or delaying the onset of Type II diabetes. Viral infections such as mumps, chicken pox, rubella, influenza, and coxsackie may tigger the onset of insulin-dependent diabetes.
Suicide ranks eight among causes of death in the general population. In North America, white males older than 35 commit 75 percent of all suicides, but women make three times as many attempts, according to Adina Wrobleski, author of Suicide: Why? Young people between the ages of 15 and 24 have a low suicide rate compared with that of adults. However, the rate for this age group rose quickly in the 30 years from 1956 to 1986.
DEpression is a contributing factor in 60 percent of all suicides. DEpression is a severe mental illness that affects people’s mood. Physical causes may include a maladjustment or imbalance of chemicals in the area of the brain responsible for controlling a person’s mood. Although depression is often treatable with medication and psychotherapy, researchers estimate only one person in five who has the disorder seeks help. Unfortunately, the longer it remains untreated, the more likely it is to become chronic and severe.
About of the suicides linked to depression also involve abuse of alcohol or other drugs. Schizophrenia, a serious, debilitating mental illness, is involved in about 10 percent of suicides. Researchers also suspect a hereditary link in some of these. Studies indicate some people who attempt suicide have a family history of suicide attempts or deaths.
Suicide prevention must involve a person’s close friends and family e bers. Clues that someone may attempt suicide include statements about hopelessness, helplessness, or worthlessness. Other symptoms include talk of suicide, a change in usual behavior, social withdrawal, increased incidents of anger and irritability, overt sadness, changes in eating or sleeping habits, and a preoccupation with death. Experts warn that suicide threats should never be ignored or kept secret.
Liver disease, the ninth leading cause of deaths, kills more than 25,000 Americans a year. The liver aids in digestion and also helps purify the blood. If the disease or injury is not too severe, the liver can produce new cells to replace diseased or damaged ones. If disease progresses, the body’s metabolism is severely affected. If the liver stops working, death results.
The two main diseases of the liver are hepatitis and cirrhosis. Hepatitis is an inflammation of the liver. At least three kinds of hepatitis have been indentified, and scientists suspect a fourth. Hepatitis A is caused by contaminated food or water. Hepatitis B spreads through hypodermic needles shared by drug abusers. It can also be spread by sexual contact. Blood transfusions were once largely responsible for the spread of the disease, but tests that are now used to detect the virus in blood donations were developed in the 1970s. A kind of hepatitis, known as toxic hepatitis, results from excessive alcohol consumption and some kinds of medications and chemicals, particularly carbon tetrachloride and other cleaning fluids.
Cirrhosis is a scarring of liver tissue often due to injury from excessive drinking of alcohol. In cirrhosis, scar tissue replaces healthy tissue and interferes with the liver’s functioning. Inhaling chemical fumes has also been implicated in cirrhosis; again, carbon tetrachloride is a cause. Although severe cases do cause death, not all cirrhosis is lifethreatening. Some cases can be treated with proper diet and by eliminating alcohol.
The kidney’s remove waste, balance the body’s fluids, and help control blood pressure, as well as performing other important body functions. When kidneys are diseased, they can no longer perform these tasks efficiently.
Sometimes kidney disease leads to complete shutdown of the kidneys. ALthough a mechanical filtering process called dialysis or an organ transplant may keep patients with kidney disease alive and functioning, kidney disease ranks tenth among the nation’s killers.
There are a number of reasons that kidney diseases develop. Some, such as polycystic kidney disease, are inherited. In other cases there are abnormalities present at birth. The most frequent causes is from infection of the urinary tract, which can cause a number of problems, including obstruction. Some kidney problems appear as a result of other diseases, such as diabetes. High blood pressure can affect the kidneys and that is something that usually can be controlled.
Although causes of many kidney diseases remain unknown, research has shown that kidney damage can occur from heavy use of pain killers, expose to toxins and pesticides, and abuse of heroin or other street drugs.
Sometimes disease is unavoidable, but many illnesses can be prevented–particularly illness on the list of the top 10 killers. The risk of early death can be reduced by following a healthy lifestyle that includes a balanced, low-fat, high-fiber diet; regular exercise and weight control; and avoidance of tobacco, alcohol, and other drugs. If you stay away from these notorious killers, you’ll improve your chances of living a long, healthy life.