Computation and Measurement of Risk - Mathematics and Statistics for the Environment - page 202

TABLE 8.7
Number, Proportion (Percentage), and Ranking of Deaths for Leading Causes
of Death, All Ages and Ages 25 to 44 Years—United States, 2003
All Ages Ages 25 to 44 Years

Number Percentage Rank Number Percentage Rank

All causes 2,443,930 100.0 128,924 100.0

Diseases of heart 684,462 28.0 1 16,283 3

Malignant neoplasms 554,643 22.7 2 19,041 14.8 2

Cerebrovascular disease 157,803 6.5 3 3004 2.3 8

Chronic lower respiratory diseases 126,128 5.2 4 401 0.3 — a

Accidents (unintentional injuries) 105,695 4.3 5 27,844 21.6 1

Diabetes mellitus 73,965 3.0 6 2662 2.1 9

Influenza and pneumonia 64,847 2.6 7 1337 1.0 10

Alzheimer's disease 63,343 2.6 8 0 0.0 — a

Nephritis, nephritic syndrome 33,615 1.4 9 305 0.2 — a

Septicemia 34,243 1.4 10 328 0.2 — a

Intentional self-harm (suicide) 30,642 1.3 11 11,251 8.7 4

Chronic liver disease and cirrhosis 27,201 1.1 12 3288 2.6 7

Assault (homicide) 17,095 0.7 13 7367 — a 5

HIV disease 13,544 0.5 — a 6879 5.3 6

All other 456,703 18.7 29,480 22.9

a Not among top-ranked causes.
Source: Data from CDC (2005) and Hoyert et al. (2005).

8.4.5 y ears oF p otential l iFe l ost
Years of potential life lost (YPLL) is one measure of the impact of premature mortality on a popu-
lation. Additional measures incorporate disability and other measures of quality of life. YPLL is
calculated as the sum of the differences between a predetermined end point and the ages of death
for those who died before that end point. The two most commonly used end points are age 65 years
and average life expectancy.
The use of YPLL is affected by this calculation, which implies a value system in which more
weight is given to a death when it occurs at an earlier age. Thus, deaths at older ages are “deval-
ued.” However, the YPLL before age 65 (YPLL 65 ) places much more emphasis on deaths at early
ages than does YPLL based on remaining life expectancy (YPLL LE ). In 2000, the remaining life
expectancy was 21.6 years for a 60-year-old, 11.3 years for a 70-year-old, and 8.6 for an 80-year-
old. YPLL 65 is based on the fewer than 30% of deaths that occur among persons younger than 65.
In contrast, YPLL for life expectancy (YPLL LE ) is based on deaths among persons of all ages,
so it more closely resembles crude mortality rates (Wise et al., 1988). YPLL rates can be used to
compare YPLL among populations of different sizes. Because different populations may also have
different age distributions, YPLL rates are usually age adjusted to eliminate the effect of differing
age distributions.

8.4.5.1 Method for Calculating YPLL from a Line Listing

1. Decide on an end point (65 years, average life expectancy, or other).

2. Exclude records of all persons who died at or after the end point.