Magnitude, Distribution, and Trends of Potentially Avoidable Premature Mortality in the Region of the Americas

The mortality profile in countries within the Americas has changed markedly in recent decades. Noncommunicable and chronic diseases and external causes have replaced communicable diseases as the main causes of death. In 2000, neonatal conditions were the third-leading cause of death, but in 2019 they had dropped to seventh. Among the factors contributing to this change have been improvements in access and quality of primary health care and health services, successful immunization programs, improved nutrition, increased control of infectious diseases, population aging, increased life expectancy, and the reduction of extreme poverty in the Region. However, these changes have not occurred at the same pace and intensity in all countries within the Region.

Despite improvements in avoidable mortality in the Region in the past two decades, avoidable causes of death are still prevalent in the Americas. In 2019, more than 2.5 million potentially avoidable premature deaths occurred in the 33 countries in the Region with data on the topic, accounting for about 35% of the total number of deaths. The proportion of men dying of avoidable causes represented 41% of overall deaths, while for women the corresponding share was 29%.

In 2019, the five leading causes of death for potentially avoidable premature mortality in the Region were ischemic heart disease; interpersonal violence; diabetes mellitus; stroke; and trachea, bronchus, and lung cancer. All of them are potentially avoidable causes of death. Except for interpersonal violence, these same causes are consistently present as the leading causes of deaths in all subregions. However, subtle differences can be seen by subregion. For example:

• Andean Area: Homicide was the leading cause of death in 2019, with the risk of men dying due to homicide 10 times higher than that for women.
• Central America: Interpersonal violence was the leading cause of avoidable death for both sexes.
• Brazil: Ischemic heart disease and interpersonal violence are also high in this country.
• Latin Caribbean: This is the only subregion where neonatal conditions are still included among the five leading causes of avoidable deaths, especially in Haiti and the Dominican Republic.
• Mexico: Diabetes mellitus is the number one killer for both men and women, with the highest rates in the Americas and more than twice the rates of any other subregion.
• Non-Latin Caribbean: HIV/AIDS is among the top five causes of avoidable death.
• North America: Drug use and suicide were among the top causes of avoidable death, flagging a need for mental health interventions as more than 90% of suicide victims have a diagnosable chronic mental disorder such as depression and substance use disorders.
• Southern Cone: Tobacco use is a major public health problem, as it is a risk factor leading to four out of the five leading causes of avoidable mortality (ischemic heart disease, stroke, trachea, bronchus and lung cancer, and chronic obstructive pulmonary disorders).

Furthermore, in the Region, motor vehicle ownership is on the rise and, as a result, walking and cycling have become more dangerous. Pedestrians, motorcyclists, and cyclists represent 45% of all road traffic premature deaths in the Region.