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The stark disparities in how infectious diseases kill Americans

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.

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