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The overall chances of dying from an infectious disease are decreasing in the U.S., but the probability can vary greatly from county to county, according to data recently published in the Journal of the American Medical Association.

The bottom line: Overall death rates dropped between 1980 and 2014 for HIV/AIDS, tuberculosis and other infectious diseases. But from 2000 to 2014, deaths from diarrhea-related diseases increased in the U.S. That may be largely because of bacteria that has become resistant to antibiotics.

"We want people at the local level to take this information and use it to make decisions, and not to be fooled by state average numbers."
— Charbel el Bcheraoui, assistant professor at the University of Washington

Key takeaways from the University of Washington's Institute for Health Metrics and Evaluation study:

  • There were almost 4.1 million deaths from infectious disease recorded in the U.S. between 1980 and 2014.
  • Overall, the death rate from infectious diseases dropped 18.7% over those 34 years.
  • Diarrhea-related deaths — typically considered a problem for the developing world— increased in more than 99% of U.S. counties, with the highest growth in the Rust Belt, Washington, Arizona, California and New Mexico.
  • Many of those deaths may be related to infection with Clostridium difficile, a bacterium that's a particular threat to elderly people. "It’s an important message for physicians... to consider when they should use antibiotics because there is more and more [antibiotic] resistance from this particular bacteria, "el Bcheraoui says.
  • Nearly 57% of U.S. counties saw a decrease in mortality from lower respiratory tract infections, but about 12% saw an increase.
  • Stark inequalities were also seen for HIV/AIDS. In 2014, there were 3.51 deaths from the disease per 100,000 men vs. 1.35 for women.
  • And, while the death rate from HIV/AIDS dropped in the affluent areas of the U.S. where the disease first emerged in the 1980s, it increased in some of the country's poorest southeastern counties.

How they did it: The researchers used de-identified death records from the National Center for Health Statistics (NCHS) and U.S. Census Bureau population data to determine mortality rates from lower respiratory infections, diarrheal diseases, HIV/AIDS, meningitis, hepatitis, and tuberculosis.

Go deeper: Check out health data for a particular county.

Get more stories like this by signing up for our weekly science newsletter, Axios Science. 

Go deeper

Oct 13, 2020 - Health

Where the U.S. has been hit hardest by the coronavirus

Expand chart
Data: JAMA; Map: Danielle Alberti/Axios

There was a 20% increase over expected deaths in the U.S. between March 1 and Aug. 1., per a study published in JAMA on Monday.

Why it matters: Experts say that excess deaths are the best way to measure the true impact of the pandemic, as the number accounts for people who died of the virus itself without being counted and those who died of causes that could have been prevented in non-pandemic times.

8 hours ago - Health

FDA advisory panel recommends Pfizer boosters for those 65 and older

A healthcare worker prepares a dose of the Pfizer-BioNTech Covid-19 vaccine at the Key Biscayne Community Center on Aug. 24, 2021. Photo: Eva Marie Uzcategui/Bloomberg via Getty Images

A key Food and Drug Administration advisory panel on Friday overwhelmingly voted against recommending Pfizer vaccine booster shots for younger Americans, but unanimously recommended approving the third shots for individuals 65 and older, as well as those at high-risk of severe COVID-19.

Why it matters: While the votes are non-binding, and the FDA must still make a final decision, Friday's move pours cold water on the Biden administration's plan to begin administering boosters to most individuals who received the Pfizer vaccine later this month.

8 hours ago - World

France recalls ambassadors from U.S. and Australia over submarine deal

Secretary of State Antony Blinken (L), French Foreign Minister Jean-Yves Le Drian (C), and French ambassador to the U.S. Philippe Etienne. Photo: Nicholas Kamm/AFP via Getty Images

France has taken the extraordinary step of recalling its ambassadors to the U.S. and Australia after both countries blindsided their French allies with a new military pact and submarine contract, the French Foreign Ministry announced on Friday.

The backstory: While sealing an agreement with the U.S. and U.K. to acquire nuclear submarines, Australia ripped up an existing $90 billion submarine deal with France. That led senior French officials to accuse the U.S. of a "stab in the back."