Wellness efforts may be having an effect. Deaths from stroke, heart disease, cancer, diabetes and unintentional injuries are decreasing, according to a new analysis published in the latest issue of JAMA, but the rate of decrease appears to be slowing.

Jiemin Ma, Ph.D., M.H.S., of the American Cancer Society, Atlanta, and colleagues looked at deaths in the United States between 1969 and 2013 and found that five of the six leading causes of death saw an overall decline in death rate per 100,000 during that time:

  • Stroke. The rate of death decreased by 77%.
  • Heart disease, 68%.
  • Unintentional injuries, 40%.
  • Cancer, 18%.
  • Diabetes, 17%.

The death rate for chronic obstructive pulmonary disease increased by 101% during this period, but researchers note that during the last time segment in the analysis, the death rate for COPD in men began to decrease.

Progress against heart disease and stroke, according to the researchers, is due to improvements in the control of hypertension and hyperlipidemia, smoking cessation and medical treatment. Cancer deaths have decreased due to tobacco control efforts as well as advances in early detection and treatment, they said.

The annual decline for heart disease, however, slowed from 3.9% during the 2000-2010 period to 1.4% during the 2010-2013 period, and rates also have slowed for stroke and diabetes. This slowing of decline may reflect the lagged consequences of increased obesity prevalence since the 1980s, the researchers write.

“Regardless of the changes in death rates, the increasing numbers of old persons in the United States and growth of the U.S. population will pose a considerable challenge for health care delivery in the coming decades, in view of the shortage of primary care physicians and geriatricians, increasing cost of health care, and the lag between healthy life and life expectancies,” they write.