Amid fears that Ebola is getting out of control — with an estimated death toll of 9,000 and new cases in the U.S. and Europe — Dr. Thomas Frieden, the director of the Center for Disease Control and Prevention (CDC), met with the House of Representatives to defend the organization’s reaction to the Ebola crises on U.S. soil (at least two representatives have already asked him to resign). He stood by the statement he wrote before the hearing: “We remain confident that Ebola is not a significant public health threat to the United States.” And for this reason, the CDC will continue to spend most of its $5.8 billion budget on more pressing health concerns for U.S. citizens — namely flu, cancer, and diabetes.
Whether or not that makes the Committee happy, many health experts agree. “Our real threats at this point are the diseases we have been fighting for the last twenty years,” says Diana Silver, a Public Health professor at New York University. “And while we have made some progress in this country about addressing some of these problems, the scale of those problems is far greater than the current threat of Ebola. The CDC has done a good job of communicating exactly how people can get affected by Ebola while also attempting to put in perspective the relative risk.” Here, from a recent CDC report on the leading causes of death in America, is a look at the places the government plans to spend its budget — and why fear over Ebola as a major killer in the U.S. might be overblown.
Number of Deaths per 100,000 in 2012: 170.5
The CDC ranks heart disease as the leading cause of death in the United States. The condition — which includes coronary heart disease, irregular heartbeat, and heart failure, among others — kills about 600,000 Americans (or 1 in 4 people) every year. 49 percent of Americans have three of its main risk factors: high blood pressure, high cholesterol or a smoking habit, while less common risk factors like eating a poor diet, not exercising enough, or drinking too much alcohol can clog up the walls of your arteries, stifle blood flow and cause a heart attack or stroke. Coronary heart disease — the most common heart condition — costs the U.S. $108.9 billion a year in health care services and medication according to the American Heart Association. But the good news is that the death rate has decreased 1.8 percent since the CDC’s last report in 2011. Jiaquan Xu, an epidemiologist at the CDC’s National Center for Health Statistics says it’s probably due to better lifestyle changes and medical care in the last few years. “Americans are now more aware of their health and quality of life,” he explains. “People are doing more exercise, especially young people, and changing their eating habits.”
Number of Deaths per 100,000 in 2012: 166.5
Cancer — with lung, prostate, and breast cancer among the highest killers — nearly ties with heart disease as a top cause of death. The American Cancer Society estimates the condition, which starts with a mutated cell that gathers into a tumor and spreads throughout the body, will kill about 500,000 Americans in 2014. According to the World Health Organization (WHO), factors associated with how you live your life like alcohol use, low intake of fruits or vegetables, high body mass index, or lack of exercise account for 30 percent of cancer deaths. Smoking tobacco still ranks as the riskiest factor. But recent research continues to emerge suggesting ways you can prevent cancer by changing your lifestyle, and the CDC reported the death rate dropped to 1.5 percent from 2011.
Chronic Lower Respiratory Diseases
Number of Deaths per 100,000 in 2012: 41.5
Chronic lower respiratory diseases are any condition that hijacks your lower lungs and your ability to breathe. That includes asthma, lung cancer, chronic bronchitis, pulmonary disease, and a whole host of other respiratory illnesses. According to the Public Health Agency of Canada, the two biggest risk factors for the disease — which often lasts a lifetime for kids and teenagers — are tobacco (whether you smoke it or inhale it secondhand), and an environment with bad air quality. Chronic lower respiratory disease is expensive — a 2014 CDC study and a later report writes that adult treatment raked in a national cost of 32.1 billion, which will potentially balloon to 49 billion in 2020. Another problem with chronic respiratory diseases, according to Xu, is that it’s influenced by something we can’t control — seasonal weather. “If during some years it’s more cold, more people will die from this disease,” says Xu. “Some years there are more flu patients, some years less.”
Stroke (Cerebrovascular Disease)
Number of Deaths per 100,000 in 2012: 36.9
Stroke, a cerebrovascular disease, kills about 130,000 Americans a year. Cerebrovascular diseases form when your body has problems delivering blood to the brain. When it comes to stroke, your blood vessels can’t pump blood upwards because of blood clots, the narrowing of blood vessels or hemorrhaging (when your blood vessels become ruptured), leading to brain damage. Just like heart disease, nearly half of Americans have at least one of the three main risk factors for stroke: high blood pressure, high cholesterol, or smoking. And just like heart disease, there are ways you can help prevent stroke, including exercise, managing diabetes or heart disease, and getting enough exercise, among other things, says Xu. “Stroke is still very serious because it’s the 5th leading cause of death,” he adds. “In 2012, if 100 people died, 5 of them died from a stroke.”
Number of Deaths per 100,000 in 2012: 23.8
The CDC reported about 84,000 people died from Alzheimer’s in 2010; this year, the Alzheimer’s Association estimates that number will continue to increase as the proportion of Americans over 65 — the Baby Boomers — grows. Alzheimer’s can be fatal because the condition damages and destroys brain cells, eventually affecting your ability to walk, talk, recall memories, and swallow. The exact cause of Alzheimer’s is unknown, and there is no currently no cure, but researchers are steadily putting together a case for how you can prevent dementia by keeping your brain and body active and alert, and stave off the cognitive and behavioral symptoms of the disease.
Number of Deaths per 100,000 in 2012: 21.2
You can keep diabetes under control thanks to medication that regulates insulin, a good diet, and staying active, but when neglected, the condition can lead to heart disease like high blood pressure, heart attacks, and possibly premature death. According to the CDC, diabetes kills about 73,000 a year and if unhealthy food or lifestyle choices (like eating a sugar-rich diet, or not getting enough exercise) become the norm, that number will only rise. Diabetes affects how your body regulates insulin — a hormone that, when not working properly, leaves the sugar you consume to build up in your blood.
The Flu and Pneumonia
Number of Deaths per 100,000 in 2012: 14.4
The flu might seem pretty common today, but don’t be mistaken — the CDC continues to count it as one of the top ten leading causes of death, targeting elderly people, pregnant women, young children, and those with asthma, heart disease or diabetes. “If you have a strong person, the chance of dying is very low,” says Xu. “But the flu can still cause death.” In 2010, the flu and pneumonia killed about 54,000 people; in 2012 and 2013, about 381,000 people sick with the flu had to be hospitalized. Like all the other leading causes of death, the flu is expensive for the U.S., — it adds up to about 87 billion a year in health care costs according to the CDC. That’s because, unlike Ebola, the flu spreads easily through contact — by touching surfaces like desks and standing next to an infected person when they sneeze — making it all the more dangerous. Xu recommends protecting yourself with a flu vaccine but says it’s difficult for the CDC to tell how many of those who died from the flu were vaccinated.