Abstract 13610: Closing the Gap Between Cardiovascular and Cancer Mortality in an Integrated Health Care Delivery System, 2000-2008: The Kaiser Permanente Experience
Background: The gap in age-adjusted death rates between heart disease (HD) and cancer declined nationally by 88% between 2000-2007; the gap between combined HD and stroke (HD/stroke) and between major cardiovascular disease (CVD) and cancer mortality rates also decreased substantially. HD mortality is currently poised to drop below cancer mortality with combined HD/stroke mortality and CVD mortality likely to do so as well later this decade. HD mortality dropped below cancer mortality several years ago at Kaiser Permanente Northern California (KPNC), a large, integrated healthcare delivery system covering about 3.3 million insured members in northern California. We hypothesized that the anticipated decline between HD/stroke and all CVD mortality below cancer mortality would occur earlier in KPNC than nationally.
Methods: Age-adjusted mortality rates during 2000-2008 for HD (ICD 10 codes I00-I09, I11, I13, I20-I51), stroke (I60-I69), all CVD (I00-I99), and cancer (C00-C97) were calculated for KPNC members age ≥30 years, with age-standardization to the 2008 KPNC membership.
Results: From 2000-2008, death rates decreased by 27.4% for HD, 42.2% for stroke, 31.1% for HD/stroke, 30.4% for all CVD, and 10.9% for cancer. HD mortality was lower than cancer mortality in 2000 while HD/stroke mortality declined below cancer mortality in 2008 (26.8 vs. 27.0 per 100,000 P-Y). The relative 82% decline in gap between all CVD and cancer mortality suggests that CVD will drop below cancer mortality within a few years.
Conclusions: The HD/stroke death rate is now lower than the cancer death rate in KPNC. KPNC's success reflects, in part, the successful implementation of comprehensive prevention and risk factor management programs. If current trends continue, CVD should be replaced by cancer as the leading cause of death in KPNC and later nationally, marking an important public health milestone.
- © 2011 by American Heart Association, Inc.