Re-run of 1990s Study Confirms Burden of Preventable Mortality

摘要

The International Classification of Diseases (ICD), now in its 10th revision, has been around in various forms for 150 years and has proved a useful tool for epidemiologists and statisticians—for example, in making between-country comparisons of mortality due to specific illnesses. However, the ICD codings do not always reveal the underlying cause. In 1993 Dr. J. Michael McGinnis and Dr. William H. Foege explored beneath the ICD by measuring the "major external (nongenetic) factors that contribute to death in the United States" and they called them the "actual" causes of death. Their paper (JAMA, 270[18]: 2207-12, 1993) proved influential. Indeed, in 1999 the report prompted the Robert Wood Johnson Foundation to change its focus from health-care services to the behavioral and social causes of poor health—in other words, to prevention.