Preventable causes of death

However, causes of death may also be classified in terms of preventable risk factors—such as smoking, unhealthy diet, sexual behavior, and reckless driving—which contribute to a number of different diseases.

[5]In 2017, The Lancet published a large study by Swiss epidemiologist Silvia Stringhini and her collaborators, analysing the impact of the most important causes of preventable death in Western societies.

The multicohort study and meta-analysis used individual-level data from 48 independent prospective cohort studies with information on socioeconomic status, high alcohol consumption, physical inactivity, current smoking, hypertension, diabetes and obesity, and mortality, for a total population of 1,751,479 from seven high-income WHO member countries.

The unique advantage of the huge amount of individual data in the Stringhini study is that it allows (estimation of) the relative contribution of each separate risk factor.

As shown in summary Table 2, at an individual level, smoking is the single greatest risk of avoidable death, followed by diabetes and high alcohol consumption.

Physical inactivity, smoking and low socioeconomic status (SES) are then the top three preventable causes of early death.

The WHO definition of 'normal' adult BMI (between 18.5 and 24.9 kg/m2) is based on a normal weight and height distribution of US citizens in the 1960s, not on the associated risk of death in 2023.

The three risk factors most commonly leading to preventable death in the population of the United States are smoking, high blood pressure, and being overweight.

Figure 1: In 2011, deaths from potentially avoidable causes accounted for approximately 24% of all deaths registered in England and Wales. The leading cause of avoidable deaths was ischaemic heart disease in males and lung cancer in females.
Figure 2: The association between body mass index (BMI) and relative risk of all-cause mortality (data from Aune et al., BMJ 2016; curve fitting by L. Stalpers, Amsterdam UMC, 2023).