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      Actual causes of death in Alaska

      research-article
      ,
      International Journal of Circumpolar Health
      Taylor & Francis
      Epidemiology, health disparities, obesity, Alaska Native, smoking

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          ABSTRACT

          We estimated 2011–2015 Alaska mortality from modifiable behavioural risk factors using relative risks, hazard ratios, and population attributable fraction estimates from a comprehensive review of peer-reviewed literature; prevalence estimates from government reports; as well as data from the Alaska Department of Environmental Conservation for 2011–2015. To identify the number of deaths attributable to specified risk factors, we used mortality data from the Alaska Division of Public Health, Health Analytics & Vital Records Section. Data included actual reported deaths of Alaska residents for 2011–2015 that matched relevant underlying International Classification of Diseases and Related Health Problems 10th Revision codes. The actual causes of death in Alaska in 2011–2015 were estimated to be overweight/physical inactivity (20% of all deaths, 26% of Alaska Native deaths), smoking (18%/18%), alcohol consumption (9%/13%), firearms (4%/4%), and drug use (3%/3%). Other actual causes of death included microbial agents (3%/4%), motor vehicles (2%/2%), and environmental pollution (1%/1%). This updated methodology reveals that overweight/physical inactivity was the leading cause of death in Alaska, followed closely by smoking. Just three preventable causes made up almost 60% of all deaths, and almost 70% of deaths among Alaska Native people, both highlighting disparities and underscoring prevention needs.

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          Most cited references10

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          Actual causes of death in the United States.

          To identify and quantify the major external (nongenetic) factors that contribute to death in the United States. Articles published between 1977 and 1993 were identified through MEDLINE searches, reference citations, and expert consultation. Government reports and complications of vital statistics and surveillance data were also obtained. Sources selected were those that were often cited and those that indicated a quantitative assessment of the relative contributions of various factors to mortality and morbidity. Data used were those for which specific methodological assumptions were stated. A table quantifying the contributions of leading factors was constructed using actual counts, generally accepted estimates, and calculated estimates that were developed by summing various individual estimates and correcting to avoid double counting. For the factors of greatest complexity and uncertainty (diet and activity patterns and toxic agents), a conservative approach was taken by choosing the lower boundaries of the various estimates. The most prominent contributors to mortality in the United States in 1990 were tobacco (an estimated 400,000 deaths), diet and activity patterns (300,000), alcohol (100,000), microbial agents (90,000), toxic agents (60,000), firearms (35,000), sexual behavior (30,000), motor vehicles (25,000), and illicit use of drugs (20,000). Socioeconomic status and access to medical care are also important contributors, but difficult to quantify independent of the other factors cited. Because the studies reviewed used different approaches to derive estimates, the stated numbers should be viewed as first approximations. Approximately half of all deaths that occurred in 1990 could be attributed to the factors identified. Although no attempt was made to further quantify the impact of these factors on morbidity and quality of life, the public health burden they impose is considerable and offers guidance for shaping health policy priorities.
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            Fitness vs. fatness on all-cause mortality: a meta-analysis.

            The purpose of this study was to quantify the joint association of cardiorespiratory fitness (CRF) and weight status on mortality from all causes using meta-analytical methodology. Studies were included if they were (1) prospective, (2) objectively measured CRF and body mass index (BMI), and (3) jointly assessed CRF and BMI with all-cause mortality. Ten articles were included in the final analysis. Pooled hazard ratios were assessed for each comparison group (i.e. normal weight-unfit, overweight-unfit and -fit, and obese-unfit and -fit) using a random-effects model. Compared to normal weight-fit individuals, unfit individuals had twice the risk of mortality regardless of BMI. Overweight and obese-fit individuals had similar mortality risks as normal weight-fit individuals. Furthermore, the obesity paradox may not influence fit individuals. Researchers, clinicians, and public health officials should focus on physical activity and fitness-based interventions rather than weight-loss driven approaches to reduce mortality risk. © 2013.
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              The causes of skin cancer: a comprehensive review.

              Skin cancer is the most common type of cancer in fair-skinned populations around the world. The incidence and mortality rates of skin cancers are dramatically increasing and thus pose a threat to public health. Understanding the etiology and pathogenesis of skin cancer remains a goal for healthcare systems. A clearer understanding of causative factors is an essential step in the prevention of skin cancer. This article comprehensively reviews the causative agents which play a role in the development of skin cancer. Ultraviolet radiation (UV) from sun exposure is the most important cause of skin cancer. Sunburns and excessive exposures cause cumulative damage which induces immunosuppression and skin cancers. Ozone depletion, the level of UV light, elevation, latitude, altitude and weather conditions influence the emission of UV radiation reaching the earth's surface. Organ transplant recipients and AIDS patients have an increased incidence of skin cancers. Some treatment modalities, including radiation therapy, phototherapy and psoralen and long-wave ultraviolet radiation (PUVA) can also predispose to skin cancers. Viral infections such as the human papilloma virus can cause squamous cell carcinomas. Individuals with familial genetic syndromes are susceptible to specific types of skin cancers. Ionizing radiation, environmental pollutants, chemical carcinogens and work-related exposures have been associated with skin cancers. Exposure to artificial UV radiation (tanning beds and lamps), aging, skin color, diet and smoking are attributable risks. Skin cancers have been found in dermatoses and various types of keratoses, chronically injured or nonhealing wounds, and scars. This article provides a comprehensive and thorough overview of skin cancer, with an emphasis on understanding its epidemiology, incidence, etiology and related risk factors. Copyright 2005 Prous Science. All rights reserved.
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                Author and article information

                Journal
                Int J Circumpolar Health
                Int J Circumpolar Health
                International Journal of Circumpolar Health
                Taylor & Francis
                1239-9736
                2242-3982
                22 June 2020
                2020
                : 79
                : 1
                : 1780068
                Affiliations
                [0001]Section of Chronic Disease Prevention and Health Promotion, Division of Public Health, Alaska Department of Health and Social Services, Anchorage, AK, USA
                Author notes
                CONTACT Katie Cueva kcueva@ 123456alaska.edu Institute of Social and Economic Research, University of Alaska Anchorage, 3211 Providence Dr. Anchorage, AK 99508;
                Author information
                https://orcid.org/0000-0002-8013-9680
                Article
                1780068
                10.1080/22423982.2020.1780068
                7480475
                32567981
                898e96ae-6ada-426e-822c-ee253dd6fd89
                © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 2, Tables: 2, References: 32, Pages: 1
                Categories
                Research Article
                Original Research Article

                Medicine
                epidemiology,health disparities,obesity,alaska native,smoking
                Medicine
                epidemiology, health disparities, obesity, alaska native, smoking

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