Premature death(Potentially years of life lost)

Definition: Years of potential life lost before age 75 per 100,000 population at one-year estimate.

Premature death is a measure of years of potential life lost due to death occurring before the age of 75. 

Deaths at younger ages contribute more to the premature death rate than deaths occurring closer to age 75. 

For example, a person dying at age 70 would lose five years of potential life, whereas a child dying at age five would lose 70 years of potential life. 

Years of Potential Life Lost (YPLL) Report: cancer, unintentional injury, heart disease, suicide, deaths in the perinatal period and homicide were the leading causes of years of potential life lost before age 75 in 2019. Potential Years of Life Lost (PYLL) is a public health measure that quantifies premature mortality by calculating the years of life lost when someone dies before reaching a reference age.

PYLL emphasizes deaths at younger ages.

If someone dies at 25 with a reference age of 75, that represents 50 years lost.

Someone dying at 70 would contribute only 5 years lost.

The reference age varies by context but is commonly set at 70, 75, or life expectancy.

Total PYLL for a population sums across all premature deaths.

Unlike simple mortality counts that treat all deaths equally, PYLL provides insight into diseases and causes that disproportionately affect younger people.

It helps prioritize interventions where years of life can be saved

PYLL rate is often expressed per 1,000 or 100,000 population for comparison across regions

Premature death is primarily caused by cardiovascular diseases (ischemic heart disease and stroke), cancers, respiratory infections, and injuries, though the specific leading causes vary substantially by geographic region and income level.

Globally, ischemic heart disease and stroke consistently rank as the top two causes of premature mortality, accounting for 15.9% and 4.3% of years of life lost (YLLs) respectively.

These cardiovascular diseases have maintained their dominance despite declining age-standardized rates in many regions.

Lung cancer, chronic obstructive pulmonary disease, and lower respiratory infections also contribute substantially to premature death worldwide.

Regional variations are pronounced. In high-income countries, lung cancer, self-harm, Alzheimer disease, and cirrhosis feature prominently among leading causes.

In sub-Saharan Africa, HIV/AIDS and malaria dominate, with HIV/AIDS being the leading cause in 28 countries.

Latin America shows high rates of interpersonal violence and road injuries, while several Middle Eastern countries have experienced war as a primary cause of early death.

In south Asia and sub-Saharan Africa, neonatal disorders frequently rank among the top five causes.

Modifiable risk factors collectively account for a substantial proportion of premature deaths.

In the United States, the top 10 risk factors—including dietary risks (19.1%), tobacco use (17.8%), high blood pressure (17.4%), obesity (13.9%), and high fasting glucose (13.6%)—contribute to 57.3% of deaths.

European cohort data suggests that smoking, poor diet, obesity, hypertension, physical inactivity, and excessive alcohol consumption together account for 57% of premature mortality, rising to 74% among current smokers.

COVID-19 dramatically altered mortality patterns in 2020-2021, becoming the second leading cause of age-standardized death globally in 2021.

Recent U.S. data shows persistent elevation in early adult mortality through 2023, driven by drug poisoning, COVID-19, transport deaths, alcohol-related deaths, and homicide.

Since 2000, increases have occurred in suicide and drug deaths, both contributing to the rise in premature death. 

Many premature deaths may be preventable through lifestyle modifications such as smoking cessation or healthy eating and exercise. 

Passive smoke associated with an increased risk of death in both adults, where it is estimated to kill 53,000 nonsmokers per year, making it the third leading cause of preventable death in the U.S, and in children.

The Centers for Disease Control and Prevention (CDC) estimate that 20-40% of premature deaths are preventable.

Risk factors for premature death include obesity, smoking and exposure to environmental hazards such as reduced air quality. 

Risk factors for heart disease, such as high blood pressure, high cholesterol, Type 2 diabetes and physical inactivity are also risk factors for premature death. 

Occupational hazards and certain behaviors, including not wearing seatbelts or motorcycle helmets and misusing drugs can increase the risk of unintentional injuries and premature death.

Social factors such as low education, poverty, racial segregation and inadequate social support also contribute to premature death. 

Social factors can play a role in how and why a person dies. 

Populations at higher risk for premature death include:

American Indian/Alaska Native populations: have premature death rates persistently 50% greater than those of non-Hispanic whites. 

Infant mortality rates are almost two times higher among American Indian/Alaska Natives than non-Hispanic whites and are a major contributor to premature deaths. 

Risk factors contributing to a higher rate of unintentional injuries among American Indian/Alaska Natives include rural environments, lack of traffic safety and higher rates of alcohol-related accidents. 

Black individuals had a premature mortality rate double that of white individuals from 1960 through 2009. 

Racial disparities in cardiovascular disease and homicide have long been the leading drivers of higher rates of premature mortality, as well persistent gaps in birth outcomes. 

Black populations have the highest infant mortality rates, more than twice those of  white and Asian populations.

People who live in rural counties compared with urban counties. 

Black adults in rural counties have the highest mortality rate; however, white adults in rural areas had the largest increase in mortality rates: largely due to increased poisonings, including drug overdoses and suicides.

Lifestyle changes can help prevent premature deaths:  changes in diet, exercise, alcohol consumption and tobacco use, as well as medical treatment for chronic conditions such as depression, diabetes or hypertension.

WHO suggest that individuals can meet recommended levels of physical activity have a 20 to 30% reduce risk of premature death