US Pharm. 2007;32(8):8.

According to the CDC's 2003 mortality statistics, the top two causes of death--heart diseases and cancers--accounted for 51% of all deaths, compared with 59% in 1980. Stroke has ranked third since the 1950s, despite an overall decline in the proportion of deaths due to this cause. Chronic lower respiratory diseases (CLRDs) and accidents/unintentional injuries ranked fourth and fifth, respectively; the proportion of deaths due to CLRDs has increased over time, while that due to accidents/unintentional injuries declined during the 1980s, hovered around 4% in the 1990s, and has incrementally increased since 2001. In 2003, the top five causes of death accounted for about 67% of all deaths, while the top 10, which also included diabetes, influenza/pneumonia, Alzheimer's disease, nephritis, and septicemia, accounted for 78%.

Gender Differences: Over time, men have experienced a decline in the proportion of deaths due to heart diseases. Since the 1980s, men have persistently had a higher relative burden of cancer mortality than women despite an identical ranking in both groups. Diabetes and kidney disease also have identical rankings--sixth and ninth, respectively--between men and women, although women have a higher burden of mortality.

In 2003, accidents/unintentional injuries were the third leading cause of death among men but the seventh among women. While the proportion of deaths due to accidents/unintentional injuries declined in both groups between 1980 and 2003, the burden of mortality was typically higher among men; accidents/unintentional injuries have remained in the top four causes of death for men. Stroke, CLRDs, and influenza/pneumonia--which ranked third, fourth, and eighth, respectively, among women--ranked fourth, fifth, and seventh, respectively, among men. Suicide ranked eighth, and Alzheimer's disease ranked 10th among men, moving up one position since 2002. Chronic liver disease and cirrhosis, which ranked 10th in 2002, dropped out of the top 10, and septicemia did not rank in the top 10.

Racial Differences in Men: Hispanics, Asians/Pacific Islanders, American Indians, black non-Hispanics, and white non-Hispanics shared six leading causes of death in common, although relative disease burden differed. Across all races, heart diseases and cancers were the first and second leading causes of death, respectively, with white non-Hispanic males having the highest rate of mortality due to heart diseases. Accidents/unintentional injuries were the third leading cause of death among black non-Hispanics, American Indians, and Hispanics. Cerebrovascular diseases ranked third among Asians/Pacific Islanders, fourth among black non-Hispanics and Hispanics, fifth among white non-Hispanics, and sixth among American Indians. CLRDs ranked third among white non-Hispanics, fifth among American Indians and Asians/Pacific Islanders, and sixth among black non-Hispanics and Hispanics. Diabetes ranked fourth among American Indians, fifth among Hispanics and black non-Hispanics, and sixth among white non-Hispanics and Asians/Pacific Islanders. Kidney disease ranked ninth among both white non-Hispanics and Asians/Pacific Islanders, seventh among black non-Hispanics, and 10th among American Indians.

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