ORCID Profile
0000-0002-0425-015X
Current Organisation
National Institutes of Health
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Publisher: American Medical Association (AMA)
Date: 08-2023
DOI: 10.1001/JAMAINTERNMED.2023.2509
Abstract: Although deaths due to external causes are a leading cause of mortality in the US, trends over time by intent and demographic characteristics remain poorly understood. To examine national trends in mortality rates due to external causes from 1999 to 2020 by intent (homicide, suicide, unintentional, and undetermined) and demographic characteristics. External causes were defined as poisonings (eg, drug overdose), firearms, and all other injuries, including motor vehicle injuries and falls. Given the repercussions of the COVID-19 pandemic, US death rates for 2019 and 2020 were also compared. Serial cross-sectional study using national death certificate data obtained from the National Center for Health Statistics and including all external causes of 3 813 894 deaths among in iduals aged 20 years or older from January 1, 1999, to December 31, 2020. Data analysis was conducted from January 20, 2022, to February 5, 2023. Age, sex, and race and ethnicity. Trends in age-standardized mortality rates and average annual percentage change (AAPC) in rates calculated by intent (suicide, homicide, unintentional, and undetermined), age, sex, and race and ethnicity for each external cause. Between 1999 and 2020, there were 3 813 894 deaths due to external causes in the US. From 1999 to 2020, poisoning death rates increased annually (AAPC, 7.0% 95% CI, 5.4%-8.7%). From 2014 to 2020, poisoning death rates increased the most among men (APC, 10.8% 95% CI, 7.7%-14.0%). During the study period, poisoning death rates increased in all the racial and ethnic groups examined the most rapid increase was among American Indian and Alaska Native in iduals (AAPC, 9.2% 95% CI, 7.4%-10.9%). During the study period, death rates for unintentional poisoning had the most rapid rate of increase (AAPC, 8.1% 95% CI, 7.4%-8.9%). From 1999 to 2020, firearm death rates increased (AAPC, 1.1% 95% CI, 0.7%-1.5%). From 2013 to 2020, firearm mortality increased by an average of 4.7% annually (95% CI, 2.9%-6.5%) among in iduals aged 20 to 39 years. From 2014 to 2020, mortality from firearm homicides increased by an average of 6.9% annually (95% CI, 3.5%-10.4%). From 2019 to 2020, mortality rates from external causes accelerated further, largely from increases in unintentional poisoning, and homicide due to firearms and all other injuries. Results of this cross-sectional study suggest that from 1999 to 2020, death rates due to poisonings, firearms, and all other injuries increased substantially in the US. The rapid increase in deaths due to unintentional poisonings and firearm homicides is a national emergency that requires urgent public health interventions at the local and national levels.
Publisher: American Medical Association (AMA)
Date: 08-2022
DOI: 10.1001/JAMAONCOL.2022.1472
Abstract: Cancer is the second leading cause of mortality in the US. Despite national decreases in cancer mortality, Black in iduals continue to have the highest cancer death rates. To examine national trends in cancer mortality from 1999 to 2019 among Black in iduals by demographic characteristics and to compare cancer death rates in 2019 among Black in iduals with rates in other racial and ethnic groups. This serial cross-sectional study used US national death certificate data obtained from the National Center for Health Statistics and included all cancer deaths among in iduals aged 20 years or older from January 1999 to December 2019. Data were analyzed from June 2021 to January 2022. Age, sex, and race and ethnicity. Trends in age-standardized mortality rates and average annual percent change (AAPC) in rates were estimated by cancer type, age, sex, and race and ethnicity. From 1999 to 2019, 1 361 663 million deaths from cancer occurred among Black in iduals. The overall cancer death rate significantly decreased among Black men (AAPC, −2.6% 95% CI, −2.6% to −2.6%) and women (AAPC, −1.5% 95% CI, −1.7% to −1.3%). Death rates decreased for most cancer types, with the greatest decreases observed for lung cancer among men (AAPC, −3.8% 95% CI, −4.0% to −3.6%) and stomach cancer among women (AAPC, −3.4% 95% CI, −3.6% to −3.2%). Lung cancer mortality also had the largest absolute decreases among men (−78.5 per 100 000 population) and women (−19.5 per 100 000 population). We observed a significant increase in deaths from liver cancer among men (AAPC, 3.8% 95% CI, 3.0%-4.6%) and women (AAPC, 1.8% 95% CI, 1.2%-2.3%) aged 65 to 79 years. There was also an increasing trend in uterus cancer mortality among women aged 35 to 49 years (2.9% 95% CI, 2.3% to 2.6%), 50 to 64 years (2.3% 95% CI, 2.0% to 2.6%), and 65 to 79 years (1.6% 95% CI, 1.2% to 2.0%). In 2019, Black men and women had the highest cancer mortality rates compared with non-Hispanic American Indian/Alaska Native, Asian or Pacific Islander, and White in iduals and Hispanic/Latino in iduals. In this cross-sectional study, there were substantial decreases in cancer death rates among Black in iduals from 1999 to 2019, but higher cancer death rates among Black men and women compared with other racial and ethnic groups persisted in 2019. Targeted interventions appear to be needed to eliminate social inequalities that contribute to Black in iduals having higher cancer mortality.
Publisher: Oxford University Press (OUP)
Date: 19-04-2023
DOI: 10.1093/JNCI/DJAD069
Abstract: Starting in 2018, national death certificates included a new racial classification system that accounts for multiple-race decedents and separates Native Hawaiian and Pacific Islander (NHPI) in iduals from Asian in iduals. We estimated cancer death rates across updated racial and ethnic categories, sex, and age. Age-standardized US cancer mortality rates and rate ratios from 2018 to 2020 among in iduals aged 20 years and older were estimated with national death certificate data by race and ethnicity, sex, age, and cancer site. In 2018, there were approximately 597 000 cancer deaths, 598 000 in 2019, and 601 000 in 2020. Among men, cancer death rates were highest in Black men (298.2 per 100 000 n = 105 632), followed by White (250.8 n = 736 319), American Indian/Alaska Native (AI/AN 249.2 n = 3376), NHPI (205.6 n = 1080), Latino (177.2 n = 66 167), and Asian (147.9 n = 26 591) men. Among women, Black women had the highest cancer death rates (206.5 per 100 000 n = 104 437), followed by NHPI (192.1 n = 1141), AI/AN (189.9 n = 3239), White (183.0 n = 646 865), Latina (128.4 n = 61 579), and Asian (111.4 n = 26 396) women. The highest death rates by age group occurred among NHPI in iduals aged 20-49 years and Black in iduals aged 50-69 and 70 years and older. Asian in iduals had the lowest cancer death rates across age groups. Compared with Asian in iduals, total cancer death rates were 39% higher in NHPI men and 73% higher in NHPI women. There were striking racial and ethnic disparities in cancer death rates during 2018-2020. Separating NHPI and Asian in iduals revealed large differences in cancer mortality between 2 groups that were previously combined in vital statistics data.
No related grants have been discovered for Jennifer McGee-Avila.