Decline in deaths from most infectious diseases in US, large differences among counties

Bottom Line: Deaths due to most infectious diseases decreased in the United States from 1980 to 2014, although there were large differences among counties.

Why The Research Is Interesting: Infectious diseases are mostly preventable but they still pose a public health threat. Deaths from infectious diseases are mostly reported at national and state levels in the United States with no comprehensive estimates available for all counties. This study reports national rates and estimates infectious disease death rates at the county level.

Who and When: Almost 4.1 million deaths due to infectious diseases recorded in the United States between 1980 and 2014

What (Study Measures): County of residence (exposure); estimated mortality rates by county for six major infectious disease groups: lower respiratory infections, diarrheal diseases, HIV/AIDS, meningitis, hepatitis and tuberculosis (outcomes).

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.

Authors: Christopher J. L. Murray, M.D., D.Phil., Institute for Health Metrics and Evaluation, University of Washington, and coauthors

Lower respiratory infection was the leading cause of infectious disease deaths in 2014; only deaths due to diarrheal diseases increased from 2000 to 2014; and deaths from lower respiratory infection and HIV/AIDS were part of the variation among counties.

Study Limitations: All the data in the analysis are subject to error.

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Related material: The editorial, "Infectious Diseases Mortality in the United States," by Emily K. Shuman, M.D., and JAMA Associate Editor Preeti N. Malani, M.D., M.S.J., both of the University of Michigan, Ann Arbor, is also available on the For The Media website.

For more details and to read the full study, please visit the For The Media website.

(doi:10.1001/jama.2018.2089)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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