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. Years 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 100,000
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 (10). The HIV/AIDS
premature death rate decreased 70% from 1,377 per 100,000 in 1994 to 411 in 2002,
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 2002, 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
DeKalb County, Georgia, 1994-2002
YPLL rate per 100,000
1600
1400
1200
1000
800
600
400
200
0
1994
1995
Cancer
1996
Injury
1997
1998
Year
Heart Disease
1999
Homicide
2000
2001
HIV/AIDS
2002
Suicide
Data Source: Georgia Division of Public Health
36
Status of Health in DeKalb Report, 2005
Trends by Race/Ethnicity and Gender
Black females
From 1994 to 2002, 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). Cancer was the leading cause of premature
death in all females, regardless of race/ethnicity (Figure 20). 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
DeKalb County, Georgia, 1994-2002
Nine-year avg
% change from
YPLL rate
1994 to 2002
772.1
13.7%
516.5
10.8%
380.8
-53.1%
364.3
34.1%
228.4
-50.6%
Cause of Premature Death
Cancer
Heart disease
HIV/AIDS
Unintentional injuries
Homicide
Data Source: Georgia Division of Public Health
Figure 20. Trends in premature deaths among black females age 1-64
DeKalb County, Georgia, 1994-2002
YPLL rate per 100,000
1200
1000
800
600
400
200
0
1994
1995
Cancer
1996
1997
Heart Disease
1998
Year
1999
HIV/AIDS
2000
Injury
2001
2002
Homicide
Data Source: Georgia Division of Public Health
Breast and lung cancer contributed 33% and 13%, respectively, to the total cancer
years of potential life lost from 1994 to 2002 (Figure 21). Breast cancer deaths
fluctuated and slightly increased 5% from 1994 to 2002. Lung cancer deaths
increased 11% from 32.5 deaths per 100,000 females in 1994 to 35.6 deaths in 2002.
Lung cancer deaths among black females increased 39% from 1994 to 2002.
Status of Health in DeKalb Report, 2005
37
Deaths per 100,000 females
Figure 21. Breast and lung cancer age-adjusted mortality rates among females by race
DeKalb County, Georgia, 1994-2002
60
50
40
30
20
10
0
1994
1995
1996
Breast Cancer - White
1997
1998
Year
Breast Cancer - Black
1999
2000
Lung Cancer - White
2001
2002
Lung Cancer - Black
Data Source: Georgia Division of Public Health
Health
Health
White females
From 1994 to 2002, 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 75% from 209 in 1994 to 365 in 2002 (Figure 22). Though
fluctuating throughout the nine-year period, stroke premature death rates decreased
83% from 1994 to 2002.
Table 13. Premature death rate in white females
DeKalb County, Georgia, 1994-2002
Nine-year avg
% change from
Cause of Premature Death
YPLL rate
1994 to 2002
Cancer
723.0
6.8%
Unintentional injuries
331.8
16.7%
Heart disease
228.1
74.5%
Suicide
144.2
-27.9%
Stroke
69.8
-83.1%
Data Source: Georgia Division of Public Health
Figure 22. Trends in premature deaths among white females age 1-64
DeKalb County, Georgia, 1994-2002
YPLL rate per 100,000
1000
900
800
700
600
500
400
300
200
100
0
1994
1995
1996
Cancer
1997
Injury
1998
Year
Heart Disease
1999
2000
Suicide
2001
2002
Stroke
Data Source: Georgia Division of Public Health
38
Status of Health in DeKalb Report, 2005
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 2002 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
Cancer claimed 492 years of potential life or 29% of the premature deaths for
Hispanic females from 1998 to 2002 (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 440 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 15% of premature death.
Hispanic males
The leading cause of premature death among Hispanic males from 1998 to 2002 was
unintentional injuries, accounting for 1,630 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 - 2002
Congenital Anomalies
3%
Stroke
Pregnancy/Childbirth
4%
Complications
5%
Figure 26. Premature deaths among Hispanic males
DeKalb County, Georgia, 1998 - 2002
Ill-Defined
3%
All Others
6%
Cancer
29%
HIV/AIDS
5%
Cancer
7%
Neurologic Disease
6%
All Others
10%
Unintentional Injuries
37%
Suicide
8%
Heart Disease
6%
Homicide
15%
Unintentional Injuries
26%
Total years of potential life lost = 1,715
Data Source: Georgia Division of Public Health
Status of Health in DeKalb Report, 2005
Heart Disease
9%
Homicide
21%
Total years of potential life lost = 4,530
Data Source: Georgia Division of Public Health
41
Asian females
Cancer was the leading cause of premature death among Asian females, accounting
for 38% of premature death (Figure 27). From 1998 to 2002, 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 10% 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 50% 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 2002,
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 2002, representing
16% of all premature deaths.
Figure 27. Premature deaths among Asian females
DeKalb County, Georgia, 1998 - 2002
Muscoskeletal & Connective
Tissue Disease
4%
All Others
9%
Stroke
4%
Pregnancy/Childbirth
Complications
5%
Homicide
7%
Infectious Diseases
3%
Cancer
38%
Suicide
7%
Heart Disease
10%
Unintentional Injuries
16%
Data Source: Georgia Division of Public Health
All Others
10%
Unintentional Injuries
24%
Stroke
5%
Heart Disease
10%
Homicide
13%
Total years of potential life lost = 894
42
Figure 28. Premature deaths among Asian males
DeKalb County, Georgia, 1998 - 2002
Cancer
19%
Suicide
16%
Total years of potential life lost = 2,067
Data Source: Georgia Division of Public Health
Status of Health in DeKalb Report, 2005