Objective: To compare premature mortality due to HIV infection with that from other causes of death in the United States, so as to provide a basis for allocating public health resources among causes of death that would be more useful than either total or age-specific mortality data.
Methods: Using death certificate data, we calculated years of potential life lost (YPLL) before age 65 years for each cause of death. We defined YPLL for an individual as the difference between 65 years and the age at death if the age was < 65 years, or zero if the age was ≥ 65 years. The YPLL in the population was the sum of YPLL for individuals.
Results: In 1995, HIV infection was the fourth leading cause of YPLL nationally, accounting for 4.7 YPLL per 1000 population (all under age 65 years; 8.8% of the 53.9 YPLL from all causes per 1000 population). Among males, HIV infection ranked fourth (11.0% of YPLL) nationally and in 1994 was the top cause of YPLL in four states: New York (causing 22.7% of YPLL), Florida (18.1%), New Jersey (17.6%) and Maryland (13.9%); and in 51 cities of ≥ 100 000 total population, where it caused 12.6–50.9% of YPLL. In 1995, among females, HIV ranked sixth (4.5% of YPLL) nationally and in 1994 was the leading cause of YPLL in 11 cities (11.6–31.4%).
Conclusion: HIV infection has become the fourth leading cause of premature mortality, measured in terms of YPLL, in the United States and the leading cause in a sizeable number of United States cities.
1Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Public Health Service, United States Department of Health and Human Services, Atlanta, Georgia, USA.
2Requests for reprints to: Dr Richard M. Selik, Mail-Stop E47, Centers for Disease Control and Prevention,1600 Clifton Road, Atlanta GA 30333, USA.
Date of receipt: 27 February 1997; revised: 24 June 1997; accepted: 27 June 1997.