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Deaths Attributable to Obesity: Making Sense of the Numbers. Robert N. Anderson, Ph.D. Mortality Statistics Branch Division of Vital Statistics. Centers for Disease Control and Prevention National Center for Health Statistics. Deaths attributable to Obesity. Obesity 300,000 deaths

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deaths attributable to obesity making sense of the numbers
Deaths Attributable to Obesity: Making Sense of the Numbers

Robert N. Anderson, Ph.D.

Mortality Statistics Branch

Division of Vital Statistics

Centers for Disease Control and Prevention

National Center for Health Statistics

deaths attributable to obesity
Deaths attributable to Obesity
  • Obesity 300,000 deaths
  • What does “attributable” mean?
    • Contributing factor?
    • Principal factor?
    • Only factor?
deaths attributable to obesity3
Deaths attributable to Obesity
  • Obesity 300,000 deaths
  • What does “attributable” mean?
    • Contributing factor
    • Principal factor?
    • Only factor?
attributable deaths
Attributable Deaths
  • Obesity 300,000
  • Smoking 400,000
  • Alcohol 100,000
attributable deaths5
Attributable Deaths
  • Smoking 400,000
  • Obesity 300,000
  • Alcohol 100,000

?

attributable deaths6
Attributable Deaths
  • Smoking 400,000
  • Obesity 300,000
  • Alcohol 100,000

Total 800,000

?

attributable deaths7
Attributable Deaths
  • Smoking 400,000
  • Obesity 300,000
  • Alcohol 100,000

Total 800,000

?

Are the categories mutually exclusive?

multiple risk factors
Multiple Risk Factors
  • It is difficult to control for all confounding factors when calculating PAFs
  • Detail in the mortality data is often lacking to appropriately apply the PAFs
  • Should these categories even be mutually exclusive?
multiple risk factors10
Multiple Risk Factors

S ∩ O = Obese smokers

multiple risk factors11
Multiple Risk Factors
  • What do we do with the obese smokers?
  • Is it appropriate to choose a single risk factor over another?
  • If so, which should be chosen?
    • The one most likely to cause death?
    • The one consistent with the underlying cause of death?
slide13

Is There a Better Way

To Approach This?

multiple causes of death
Multiple Causes of Death
  • It is common to have more than one injury or disease reported on the death certificate.
  • Multiple cause counts measure any mention of the specified condition.
  • Diabetes and Ischemic heart disease
number of deaths with mention of ihd and diabetes
Number of Deaths with mention of IHD and Diabetes

Source: National Vital Statistics System, 2002

number of deaths with mention of ihd and diabetes16
Number of Deaths with mention of IHD and Diabetes

Source: National Vital Statistics System, 2002

underlying vs multiple causes of death
Underlying vs. Multiple Causes of Death
  • Choosing a single underlying cause of death
    • The sequence of diseases or injuries leading to death reported on the death certificate
    • Set of standardized rules
  • Facilitates comparisons between causes of death
underlying vs multiple causes of death19
Underlying vs. Multiple Causes of Death
  • Underlying cause is not necessarily the best strategy for showing the overall burden of disease or injury for any particular cause of death
attributable deaths22
Attributable Deaths
  • Obesity 300,000
  • Smoking 400,000
  • Alcohol 100,000
avoid
Avoid
  • Quantitative comparisons
  • Ranking attributable deaths
  • Adding attributable deaths together
focus should be on
Focus should be on:
  • Are the number of attributable deaths increasing or decreasing?
  • What can we do to reduce the number of attributable deaths?