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County-level study reveals wide variation across US counties for all infectious diseases

SEATTLE – Deaths from infectious diseases have declined overall in the United States over the past three decades. However, the rates of decline varied significantly by counties, according to a new scientific study.

The number of deaths attributed to diarrheal diseases has increased substantially as well. While that number is relatively small (about 8,000), diarrhea-related deaths increased in nearly all counties from 1980 to 2014 and were ranked the second-leading cause of all infectious disease mortality behind lower respiratory infections (LRIs) such as pneumonia and bronchitis.

The full study, published today in JAMA, can be found here:

LRI-related deaths accounted for more than three-quarters of all infectious disease deaths in 2014. A substantial proportion of those is likely due to the effects of an aging population.

“Our findings are relevant in examining local differences, which often are masked by national or state-level averages,” said Dr. Charbel El Bcheraoui, lead author on the study and Assistant Professor at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. “These large disparities are due to variation in risk factors such as alcohol, drugs, or smoking, as well as socioeconomic factors and access to quality medical care. They underscore the need to monitor the transmission of infectious diseases carefully and to help prevent outbreaks.”

Numerous counties within a corridor of states between Missouri and Maine were among the highest in the nation in 2014 for diarrhea-related deaths, with rates nearly 4 per 100,000 people.  

Nationally, the death rate from infectious diseases decreased about 19%, from 42 to 34 deaths per 100,000 people, from 1980 to 2014.

Six major infectious disease groups were included in this analysis and each accounted for at least 1% of all deaths from infectious diseases nationally from 1980 to 2014. In addition to LRI, diarrheal diseases, and HIV/AIDS, these groups were hepatitis, meningitis, and tuberculosis. Deaths from chronic hepatitis B and chronic hepatitis C were excluded from the hepatitis grouping.

 

MORTALITY RATES PER 100,000 PEOPLE IN 2014

“Worst” county / “Best” county / US overall

Lower respiratory infections: East Feliciana Parish, LA (87.7) / Collier County, FL (7.2) / US (26.9)

Diarrheal diseases: Ross County, OH (6.1) / Kalawao County, HI, and Maui County, HI (both 0.5) / US (2.4)

HIV/AIDS: Union County, FL (54.9) / Saint Croix, WI (0.2) / US (2.4)

Meningitis: Oglala Lakota County, SD (1.2) / Marin County, CA (0.2) / US (0.4)

Hepatitis: Union County, FL (5.2) / Steel County, ND, and Waukesha County WI (both 0.1) / US (0.3)

Tuberculosis: Oglala Lakota County, SD (3.5) / Rich County, UT, and Hinsdale County, CO (both 0.1) / US (0.3)

 

Media contacts:

IHME

JAMA

 

About the Institute for Health Metrics and Evaluation

The Institute for Health Metrics and Evaluation (IHME) is an independent global health research organization at the University of Washington that provides rigorous and comparable measurement of the world’s most important health problems and evaluates the strategies used to address them. IHME makes this information widely available so that policymakers have the evidence they need to make informed decisions about how to allocate resources to improve population health.