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The Risk to Death: The Role of Lifestyle Choices such as Smoking, Obesity, and Physical Activity



Fear is natural and healthy. It can help us respond to danger more quickly or avoid a dangerous situation altogether. It can also cause us to worry about the wrong things, especially when it comes to estimating our level of risk.


If we overestimate our risk in one area, it can lead to anxiety and interfere with carrying out our normal daily routine. Ironically, it also leads us to underestimate real risks that can injure or kill us.




The Risk to Death




It can be difficult to accurately assess the biggest risks we face. Plane crashes, being struck by lightning, or being attacked by a dog are common fears, but what about falls, the danger inside a bottle of pills, or your drive to work?


Knowing the odds is the first step in beating them. View the video for the latest odds of dying estimates. A summary table of some of the top causes of death is also provided. Please use the data details tab to explore all the odds of dying estimates.


Results: Higher cystatin C levels were directly associated, in a dose-response manner, with a higher risk of death from all causes. As compared with the first quintile, the hazard ratios (and 95 percent confidence intervals) for death were as follows: second quintile, 1.08 (0.86 to 1.35); third quintile, 1.23 (1.00 to 1.53); fourth quintile, 1.34 (1.09 to 1.66); quintile 5a, 1.77 (1.34 to 2.26); 5b, 2.18 (1.72 to 2.78); and 5c, 2.58 (2.03 to 3.27). In contrast, the association of creatinine categories with mortality from all causes appeared to be J-shaped. As compared with the two lowest quintiles combined (cystatin C level, or =1.29 mg per liter) was associated with a significantly elevated risk of death from cardiovascular causes (hazard ratio, 2.27 [1.73 to 2.97]), myocardial infarction (hazard ratio, 1.48 [1.08 to 2.02]), and stroke (hazard ratio, 1.47 [ 1.09 to 1.96]) after multivariate adjustment. The fifth quintile of creatinine, as compared with the first quintile, was not independently associated with any of these three outcomes.


All rates are relative to the 18 to 29 years age group. This group was selected as the reference group because it has accounted for the largest cumulative number of COVID-19 cases compared to other age groups. Sample interpretation: Compared with ages 18 to 29 years, the rate of death is 3.5 times higher in ages 30 to 39 years, and 350 times higher in those who are ages 85 years and older. (In the table, a rate of 1x indicates no difference compared to the 18 to 29 years age group.)


4 Includes all deaths in National Center for Health Statistics (NCHS) provisional death counts (through January 28, 2023, accessed on February 2, 2023). The denominators used to calculate rates were based on the 2019 Vintage population.


CDC conducts national pregnancy-related mortality surveillance to better understand the risk factors for and causes of pregnancy-related deaths in the United States. The Pregnancy Mortality Surveillance System (PMSS) defines a pregnancy-related death as the death of a woman while pregnant or within 1 year of the end of pregnancy from any cause related to or aggravated by the pregnancy. Medical epidemiologists review and analyze death records, linked birth records and fetal death records if applicable, and additional available data from all 50 states, New York City, and Washington, DC. PMSS is used to calculate the pregnancy-related mortality ratio, an estimate of the number of pregnancy-related deaths for every 100,000 live births. The birth data used to calculate pregnancy-related mortality ratios were obtained from the National Vital Statistics System (NVSS) via the Centers for Disease Control and Prevention, Wide-ranging Online Data for Epidemiologic Research (CDC WONDER).


Since the Pregnancy Mortality Surveillance System was implemented, the number of reported pregnancy-related deaths in the United States steadily increased from 7.2 deaths per 100,000 live births in 1987 to 17.3 deaths per 100,000 live births in 2018. The graph above shows trends in pregnancy-related mortality ratios between 1987 and 2018 (the latest available year of data).


The reasons for the overall increase in pregnancy-related mortality are unclear. Identification of pregnancy-related deaths has improved over time due to the use of computerized data linkages between death records and birth and fetal death records by states, changes in the way causes of death are coded, and the addition of a pregnancy checkbox to death records. However, errors in reported pregnancy status on death records have been described, potentially leading to overestimation of the number of pregnancy-related deaths.1 Whether the actual risk of a woman dying from pregnancy-related causes has increased is unclear, and in recent years, the pregnancy-related mortality ratios have been relatively stable.


While the contributions of hemorrhage, hypertensive disorders of pregnancy (i.e., preeclampsia, eclampsia), and anesthesia complications to pregnancy-related deaths declined, the contributions of cardiovascular, cerebrovascular accidents, and other medical conditions increased.7 Studies show that an increasing number of pregnant persons in the United States have chronic health conditions such as hypertension,8,9 diabetes,9-12 and chronic heart disease.7,13 These conditions may put a person at higher risk of complications during pregnancy or in the year postpartum. Causes of and risk factors for pregnancy-related deaths between 1987 and 2016 have been published.2-3, 14-18


A prior study found that PRMRs were higher in noncore (the most rural categorization) counties when compared to metropolitan counties.19 Variability in the risk of death by geographic location groups might reflect chronic health conditions and access to care (e.g., rural residents may face challenges such as distance from and lack of access to obstetric services and providers) including risk-appropriate care.20-21


CDC initiated national surveillance of pregnancy-related deaths in 1986 because more clinical information was needed to fill data gaps about causes of maternal death. The first year of data reporting was 1987.


Like NVSS, PMSS uses vital records for identification of deaths, including descriptions of causes of death and pregnancy status information on death records. Different from NVSS, PMSS further uses linkages of death records of women of reproductive age to birth and fetal death records within 1 year of the death, media searches, and reporting from public health agencies, health care providers and the public in the identification process. PMSS uses a time frame that includes deaths during pregnancy through 1 year after the end of pregnancy; this timeline allows evaluation of all deaths which might be pregnancy-related. In PMSS, deaths are reviewed by medical epidemiologists who perform an in-depth review of vital records and other data as available (e.g., medical records, autopsy reports) for each death to determine the pregnancy-related mortality ratio. These linkage and review processes by PMSS result in slower reporting than NVSS, but a more rigorous identification of deaths related to pregnancy.


Maternal Mortality Review is a process by which a multidisciplinary committee at the state or local-level identifies and reviews deaths that occur during or within 1 year of pregnancy. MMRCs have access to multiple sources of information that can provide a deeper understanding of the circumstances surrounding a death than PMSS is able. State and local MMRCs perform comprehensive reviews of deaths using information beyond what is available in vital records, including medical and non-medical data sources. MMRCs have the potential to get the most detailed, complete data on maternal mortality that then supports their ability to make specific recommendations for prevention. This also allows MMRCs to make determinations of pregnancy-relatedness on a broader set of deaths than is possible for PMSS, such as deaths due to injury.


Each year, CDC requests the 52 reporting areas (50 states, New York City, and Washington, DC) voluntarily send copies of death records for all women who died during pregnancy or within 1 year of pregnancy, linked live birth or fetal death records if applicable, and any additional data when available. All of the information obtained is summarized, and medically-trained epidemiologists determine the cause of death and whether the death was pregnancy-related. Causes of death are coded based on a system first established in 1986 by the American College of Obstetricians and Gynecologists and the CDC Maternal Mortality Study Group.


Importance Antipsychotic medications are associated with increased mortality in older adults with dementia, yet their absolute effect on risk relative to no treatment or an alternative psychotropic is unclear.


Objective To determine the absolute mortality risk increase and number needed to harm (NNH) (ie, number of patients who receive treatment that would be associated with 1 death) of antipsychotic, valproic acid and its derivatives, and antidepressant use in patients with dementia relative to either no treatment or antidepressant treatment.


Main Outcomes and Measures Absolute change in mortality risk and NNH over 180 days of follow-up in medication users compared with nonmedication users matched on several risk factors. Among patients in whom a treatment with medication was initiated, mortality risk associated with each agent was also compared using the antidepressant group as the reference, adjusting for age, sex, years with dementia, presence of delirium, and other clinical and demographic characteristics. Secondary analyses compared dose-adjusted absolute change in mortality risk for olanzapine, quetiapine, and risperidone.


Compared to the U.S. population, both deployed and non-deployed Veterans had a higher risk of suicide, but a lower risk of death from other causes combined. Deployed Veterans also had a lower risk of suicide compared to non-deployed Veterans. 2ff7e9595c


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