Top-4 Leading Causes of Death Show A Decreasing Combined Overall Share: Individually, only 1 of the top 4 causes has increased

by Scott Richter and Dr. Patrick Jones

Leading causes of death vary for different age groups. It is a safe assumption that younger people have a higher share of deaths from accidents (unintentional injuries) and intentional self-harm (suicide) than older people. Older folks experience a higher share of deaths from heart disease, stroke, and a variety of physical health issues than their younger counterparts.

Typically, the top causes of death will represent older age groups than younger age groups. Ultimately, when the top causes of death are known, they identify areas within a community where possible prevention or health maintenance activities can be directed.

Looking at Indicator 4.1.2 on Walla Walla Trends, the Top-4 Causes of Death indicator, we see they are Cancers, Heart Disease, Alzheimer’s Disease, and Stroke.

This indicator uses the "List of 113 Selected Causes of Death," which was developed by the National Center for Health Statistics and is based on their level of public health and medical importance. The list includes common major conditions such as (but not limited to): heart disease, respiratory diseases, hypertension, and chronic liver disease. It also includes less common but still major causes of death such as (but not limited to): legal interventions, hernia, and peptic ulcer. The full list can be found here (see page 22).

When state benchmarks are used in Indicators like the Top-4 Causes of Death, they are not necessarily the top causes in the state. Instead, the state benchmarks reflect the overall state shares within the same categories as the top causes of death within the county to allow direct comparison of the county and state. 

Deaths occurring at the Washington State Penitentiary, located within the county border, are also included. 

Not shown in the graph are Accidents - a top-4 cause of death in both Walla Walla County and Washington State. This Indicator only shows deaths resulting from health-related diseases, excluding other causes of death such as by accident and by intentional self-harm (suicides).  

For example, during 2018 in Washington State, chronic lower respiratory diseases held a higher ranking than cerebrovascular diseases, a top-4 cause of death in the county.

While individual counties are not offered within the state benchmarks, the Compare feature provides a similar look for counties across the state with a Trends project. Counties include Benton, Chelan, Douglas, Franklin, Grant, Skagit, Spokane, and Yakima.   

Looking again at Walla Walla County only, we see that from 2000 to 2018 Alzheimer’s Disease was the only cause of death with an increasing share (5.8% to 11.4%). This increasing share might partially be explained by the share of the population ages 65+ in Walla Walla County increasing by more than five-percentage-points from 2000 to 2018 (14.8% to 20.2%).

Also, from 2000 to 2018, the share of deaths in Walla Walla County caused by:

  • Stroke decreased from 9.6% to 5.9%, while the state decreased from 8.4% to 5.1%.
  • Heart Disease decreased from 25.0% to 20.4%, while the state decreased from 25.8% to 20.5%.
  • Cancers decreased from 23.5% to 20.9%, while the state decreased from 24.3% to 22.5%.

It should also be noted the combined shares of the top-4 causes of death have decreased in both the county and state since 2000. More specifically, the Walla Walla County total has decreased from 64.0% in 2000 to 58.6% in 2018 (-5.4 percentage points), and the state has decreased from 62.7% to 54.6% (-8.1 points).

While decreases are good, as individual shares for different causes of death, they account for all deaths. If one or more causes of death show significant increases but are not one of the top-4 causes, they are still potentially affecting the shares of the top-4 causes. In Walla Walla County, a few examples include: diabetes, chronic liver disease, gallbladder disease, and peptic ulcer. Specifically, these are not a top-4 cause of death but have registered a higher number of people dying from them in 2018 than 2000.