Premature Death in Texas

Texas

Premature death is a measure of years of potential life lost due to death occurring before the age of 75. It is a key marker of overall health and well-being. Deaths at younger ages contribute more to the premature death rate than deaths occurring closer to age 75. For example, a person dying at age 70 would lose five years of potential life, whereas a child dying at age five would lose 70 years of potential life. 

According to the National Center for Health Statistics WISQARS Leading Causes of Death Visualization Tool, unintentional injury (including drug overdose deaths), cancer, heart disease, suicide, COVID-19, homicide, liver disease, perinatal deaths, diabetes and cerebrovascular deaths were, in order, the 10 leading causes of years of potential life lost before age 75 in 2022. 

Risk factors for premature death include obesity, smoking and exposure to environmental hazards such as poor air quality. Risk factors for heart disease, such as high blood pressure, high cholesterol, Type 2 diabetes and physical inactivity, are also risk factors for premature death. Occupational hazards and risky behaviors like not wearing seatbelts or motorcycle helmets and misusing drugs can increase the risk of unintentional injuries and premature death. Social factors such as low education, poverty, racial segregation and inadequate social support also contribute to premature death.

Populations at higher risk for premature death include:

• American Indian/Alaska Native populations, who have premature death rates 40% greater than non-Hispanic white populations. Infant mortality rates are 2.6 and 2.0 times higher among American Indian/Alaska Native infants compared with Asian and white infants, respectively and are a major contributor to the premature death rate. American Indian/Alaska Native populations also have a disproportionately high rate of unintentional injury deaths due to several factors, including living in rural environments, lack of traffic safety and higher rates of alcohol-related accidents. 
• Black populations, whose premature mortality rates were consistently double those of white populations from 1960 through 2009, and remain higher than most other racial/ethnic groups today. Racial disparities in cardiovascular disease and homicide have long been the leading drivers of higher rates of premature mortality among Black populations, as well as staggering and persistent gaps in birth outcomes. Black populations have the highest infant mortality rate in the United States — more than double non-Hispanic white and Asian populations.

The conditions that contribute to premature death differ from community to community and local solutions need to be found that account for specific health needs. Health officials can encourage lifestyle changes to help prevent premature deaths by reducing risk factors. These may include changes in diet, exercise, alcohol consumption and tobacco use, as well as medical treatment for chronic conditions such as depression, diabetes or hypertension. 

Intervention strategies that encourage individuals to seek preventive medical care and achieve healthy lifestyles can be effective in reducing premature death by:

• Screening for certain health risks, such as alcohol misuse, diabetes, depression, high blood pressure, and breast, cervical and colorectal cancers.
• Raising vaccination rates. Vaccines are a safe and cost-effective way of protecting infants, adolescents and adults from potentially life-threatening preventable diseases. A complete list of vaccine-specific recommendations is available from the Advisory Committee on Immunization Practices and the Centers for Disease Control and Prevention (CDC) publishes vaccine schedules by age.

The CDC has sponsored many health equity interventions, including:

• The Traditional Foods Project, aimed at reducing rates of Type 2 diabetes in American Indian/Alaska Native populations.
• The Boston Children’s Hospital’s Community Asthma Initiative, an intervention for Black and Hispanic children at risk of asthma complications.
• Initiatives funded by the CDC’s Colorectal Cancer Control Program (CRCCP), which implements multicomponent interventions to increase colorectal cancer screening among racial and ethnic minority populations.

Increasing access to care for currently underserved minority populations is critical for decreasing premature death rates. More research is needed to determine effective methods of increasing access to behavioral health and primary care for racial and ethnic minority populations.

One of the overarching goals of Healthy People 2030 is to “attain healthy, thriving lives and well-being free of preventable disease, disability, injury and premature death.” While Healthy People 2030 does not have a specific goal for reducing premature death, it does set goals for many contributors to premature death, including: 

• Reducing the cancer death rate.
• Reducing fatal injuries. 
• Reducing deaths related to tobacco use.
• Improving cardiovascular health and reducing deaths from heart disease and stroke.
• Reducing maternal deaths.
• Reducing the rate of infant deaths. 
• Reducing the rate of child and adolescent deaths.

Alegría, Margarita, Kiara Alvarez, Rachel Zack Ishikawa, Karissa DiMarzio, and Samantha McPeck. “Removing Obstacles to Eliminating Racial and Ethnic Disparities in Behavioral Health Care.” Health Affairs 35, no. 6 (June 1, 2016): 991–99. https://doi.org/10.1377/hlthaff.2016.0029.

Bundy, Joshua D., Katherine T. Mills, Hua He, Thomas A. LaVeist, Keith C. Ferdinand, Jing Chen, and Jiang He. “Social Determinants of Health and Premature Death Among Adults in the USA from 1999 to 2018: A National Cohort Study.” Lancet Public Health 8, no. 6 (July 15, 2023): E422–31. https://doi.org/10.1016/S2468-2667(23)00081-6.

Findling, Mary G., Logan S. Casey, Stephanie A. Fryberg, Steven Hafner, Robert J. Blendon, John M. Benson, Justin M. Sayde, and Carolyn Miller. “Discrimination in the United States: Experiences of Native Americans.” Health Services Research 54, no. S2 (December 2019): 1431–41. https://doi.org/10.1111/1475-6773.13224.

Gangavelli, Apoorva, and Alanna A. Morris. “Premature Cardiovascular Mortality in the United States: Who Will Protect the Most Vulnerable Among Us?” Circulation 144, no. 16 (October 19, 2021): 1280–83. https://doi.org/10.1161/CIRCULATIONAHA.121.056658.

Hill, Latoya, Samantha Artiga, and Usha Ranji. “Racial Disparities in Maternal and Infant Health: Current Status and Efforts to Address Them.” Issue Brief. KFF, November 1, 2022. https://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-in-maternal-and-infant-health-current-status-and-efforts-to-address-them/.

Joseph, Djenaba A. “Use of Evidence-Based Interventions to Address Disparities in Colorectal Cancer Screening.” MMWR Supplements 65, no. 1 (2016). https://doi.org/10.15585/mmwr.su6501a5.

Krieger, Nancy, Jarvis T. Chen, Brent A. Coull, Jason Beckfield, Mathew V. Kiang, and Pamela D. Waterman. “Jim Crow and Premature Mortality Among the US Black and White Population, 1960–2009: An Age–Period–Cohort Analysis.” Epidemiology 25, no. 4 (July 2014): 494–504. https://doi.org/10.1097/EDE.0000000000000104.

Quiñones, Ana R., Maya O’Neil, Somnath Saha, Michele Freeman, Stephen R. Henry, and Devan Kansagara. Interventions to Improve Minority Health Care and Reduce Racial and Ethnic Disparities. VA Evidence-Based Synthesis Program Reports. Washington, D.C.: Department of Veterans Affairs, 2011. http://www.ncbi.nlm.nih.gov/books/NBK82564/.

Roy, Brita, Catarina I. Kiefe, David R. Jacobs, David C. Goff, Donald Lloyd-Jones, James M. Shikany, Jared P. Reis, Penny Gordon-Larsen, and Cora E. Lewis. “Education, Race/Ethnicity, and Causes of Premature Mortality Among Middle-Aged Adults in 4 US Urban Communities: Results From CARDIA, 1985–2017.” American Journal of Public Health 110, no. 4 (April 2020): 530–36. https://doi.org/10.2105/AJPH.2019.305506.

Satterfield, Dawn, Lemyra DeBruyn, Marjorie Santos, Larry Alonso, and Melinda Frank. “Health Promotion and Diabetes Prevention in American Indian and Alaska Native Communities — Traditional Foods Project, 2008–2014.” MMWR Supplements 65, no. 1 (February 12, 2016): 4–10. https://doi.org/10.15585/mmwr.su6501a3.

Stein, Elizabeth M., Keith P. Gennuso, Donna C. Ugboaja, and Patrick L. Remington. “The Epidemic of Despair Among White Americans: Trends in the Leading Causes of Premature Death, 1999–2015.” American Journal of Public Health 107, no. 10 (August 17, 2017): 1541–47. https://doi.org/10.2105/AJPH.2017.303941.

Waidyatillake, Nilakshi T., Patricia T. Campbell, Don Vicendese, Shyamali C. Dharmage, Ariadna Curto, and Mark Stevenson. “Particulate Matter and Premature Mortality: A Bayesian Meta-Analysis.” International Journal of Environmental Research and Public Health 18, no. 14 (July 19, 2021): 7655. https://doi.org/10.3390/ijerph18147655.

Woods, Elizabeth R., Urmi Bhaumik, Susan J. Sommer, Elaine Chan, Lindsay Tsopelas, Eric W. Fleegler, Margarita Lorenzi, et al. “Community Asthma Initiative to Improve Health Outcomes and Reduce Disparities Among Children with Asthma.” MMWR Supplements 65, no. 1 (February 12, 2016): 11–20. https://doi.org/10.15585/mmwr.su6501a4.

Yoon, Paula W., Brigham Bastian, Robert N. Anderson, Janet L. Collins, Harold W. Jaffe, and Centers for Disease Control and Prevention (CDC). “Potentially Preventable Deaths from the Five Leading Causes of Death--United States, 2008-2010.” MMWR. Morbidity and Mortality Weekly Report 63, no. 17 (May 2, 2014): 369–74. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4584887/.