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Deaths Attributable to Obesity: Making Sense of the Numbers

Explore the concept of attributable deaths and their relationship to risk factors like obesity, smoking, and alcohol. Understand the limitations of attributing deaths to a single factor and consider the importance of multiple risk factors. Discover better approaches to quantify and reduce the number of attributable deaths.

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Deaths Attributable to Obesity: Making Sense of the Numbers

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  1. 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

  2. Deaths attributable to Obesity • Obesity 300,000 deaths • What does “attributable” mean? • Contributing factor? • Principal factor? • Only factor?

  3. Deaths attributable to Obesity • Obesity 300,000 deaths • What does “attributable” mean? • Contributing factor • Principal factor? • Only factor?

  4. Attributable Deaths • Obesity 300,000 • Smoking 400,000 • Alcohol 100,000

  5. Attributable Deaths • Smoking 400,000 • Obesity 300,000 • Alcohol 100,000 ?

  6. Attributable Deaths • Smoking 400,000 • Obesity 300,000 • Alcohol 100,000 Total 800,000 ?

  7. Attributable Deaths • Smoking 400,000 • Obesity 300,000 • Alcohol 100,000 Total 800,000 ? Are the categories mutually exclusive?

  8. 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?

  9. Multiple Risk Factors

  10. Multiple Risk Factors S ∩ O = Obese smokers

  11. 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?

  12. Multiple Risk Factors

  13. Is There a Better Way To Approach This?

  14. 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

  15. Number of Deaths with mention of IHD and Diabetes Source: National Vital Statistics System, 2002

  16. Number of Deaths with mention of IHD and Diabetes Source: National Vital Statistics System, 2002

  17. 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

  18. Source: National Vital Statistics System, 2002

  19. 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

  20. Source: National Vital Statistics System, 2002

  21. Source: National Vital Statistics System, 2002

  22. Attributable Deaths • Obesity 300,000 • Smoking 400,000 • Alcohol 100,000

  23. Avoid • Quantitative comparisons • Ranking attributable deaths • Adding attributable deaths together

  24. Focus should be on: • Are the number of attributable deaths increasing or decreasing? • What can we do to reduce the number of attributable deaths?

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