public health and injuries, aging, and bone health

2020 leading causes of death

unintentional injuries

leading cause of death 15-24 and 25-34 yo

unintentional injuries, homicide, suicide

biggest causes of injury deaths

• unintentional poisoning

• unintentional fall

• unintentional motor vehicle traffic

• suicide firearm

• homicide fire arm suicide suffocation

overdose deaths

• major contributor to unintentional poisoning deaths

• more male deaths than female

Other causes of poisoning deaths

• Carbon monoxide

• Pesticides

• Adults: legal drugs taken in error or at the wrong dose, e.g., acetaminophen

• Child accidental overdose, e.g., iron-containing vitamins

Carbon monoxide

Fuel-burning products in a poorly ventilated area (generators, heating systems, charcoal grills, etc.)

Pesticides

usually unintentional exposure (occurs especially children under 6 yrs and adults > 20 yrs) – especially rat poisons

Alcohol-Related Deaths

• highest among 55-64 yo in females and males

• more deaths among male than females

Non-Fatal Injuries

• 2021: Unintentional falls dominate as the overall cause of nonfatal emergency department visits

• followed falls, struck by/against, motor vehicle occupant

Traumatic Brain Injuries (TBIs) can be caused by

• Bump or blow to head

• Penetrating injury (e.g., gunshot)

• affects how the brain works

Common causes of TBIs

• Falls (approx. half of TBI-related hospitalizations)

• Firearm-related injuries

• Motor vehicle crashes

• Assaults including domestic violence

chronic traumatic encephalopathy

Chronic Traumatic Encephalopathy (CTE) is a progressive brain disease caused by repeated head trauma, often seen in athletes and military personnel. Symptoms, which include mood disorders, cognitive decline, and dementia, emerge years after injuries and worsen over time. CTE is diagnosed only post-mortem by detecting tau protein buildup, which damages brain cells.

Originally identified in boxers as "pugilistic dementia" in 1928, CTE gained attention in the 2000s when Dr. Bennet Omalu diagnosed former NFL player Mike Webster. Subsequent studies, including a 2017 study by Dr. Ann McKee, found CTE in 110 out of 111 former NFL players. Research links early exposure to tackle football (before age 12) with an increased risk of cognitive and behavioral issues later in life.

Despite safety reforms in football, such as rule changes and concussion protocols, the NFL and other organizations have been criticized for downplaying CTE's risks. Efforts to ban youth tackle football under age 12 have faced legislative hurdles. Ongoing research seeks to develop a living diagnosis for CTE, which could lead to early detection and treatment.

Work-related deaths

• most from transportation incidents

• equal incidents of falls slips and trips, violence and other injuries by persons or animals, exposure to harmful substances/environments, contact with objects and equipment

• least are fire and explosions

injuries/illnesses by event or exposure

• most form exposure to harmful substances or environments

• equal incidents of overexertion and bodily reaction, falls slips and trips, and contact with objects and equipment

• least from violence and other injuries but persons or animals and transportation incidents

Osteoporosis

• skeletal disorder

• Diminished bone strength

• Increased risk of fracture

Osteoporosis is characterized by

decrease in bone mass and density

• enlarged spaces within bone that produce fragility

Diminished bone strength

• Quality

• Density

• Increased risk of fracture

Wrist • Spine • Hip

treatment for Osteoporosis

remodeling

resorption

remodeling

bone removal and replacement

resorption

• removing bone thats damages or needed for minerals

minerals like calcium are essential to

cell function and are taken from bones as needed

prevalence of Osteoporosis

• more among older adults

• more among women

Osteoporosis risk factors include:

Physical inactivity

• Excess alcohol consumption

• Tobacco use

Gender (women more vulnerable)

• Age

• Race (greatest if white or Asian)

• Family history

• Small body frame size (less bone mass to draw on during aging)

• Sex hormones, e.g., drop in estrogen during menopause

• Low calcium intake

• Eating disorders

• Gastrointestinal surgery, e.g., for weight loss (limits surface area for nutrient absorption)

• Certain medications

Prevention & treatment for osteoporosis

• Healthy balanced diet including calcium and vitamin D

• Exercise

• Weight bearing

• Resistance training

• No smoking

• Low alcohol intake

• Check medication side effects

• Limit caffeine to < 2 cups/day

Arthritis

• Includes > 100 diseases & conditions that affect joints, tissues surrounding joints, & other connective tissue

• Major cause of disability & chronic pain

• Typically involves pain, stiffness around joint(s)

• Major cause of limitations to usual activities

Arthritis prevalence

• US adults aged ≥18 years (2019-2021): 21.2% reported diagnosed arthritis

• 88.3% of US adults with arthritis were ≥45 years

• More common among women than men

Osteoarthritis

• Affects > 30 million US adults

• Also called degenerative joint disease or “wear and tear” arthritis

• Degeneration of cartilage from bone rubbing tgt

• Leads to bone degeneration

• Gradual

Osteoarthritis Symptoms

pain

inflammation

stiffening

decreased range of motion

swelling

Osteoarthritis risk factors

• Age (>40)

• Gender (female)

• Obesity

• Trauma

• Joint injury/overuse

• Infection

• Poor alignment

• Occupation & repetitive motions

• Genetics

joint friendly activities

• low risk of injury

• walking

• biking

• swimming

• water aerobics

• muscle strengthening with resistance bands

Rheumatoid Arthritis

Autoimmune disease

• Mainly attacks joints, usually many joints at once

• Causes inflammation of the synovial membrane (joint lining)

• Can affect other organs, e.g., lungs, heart, eyes

Symptoms Rheumatoid Arthritis

pain

inflammation

redness

fatigue

stiffness

same symptoms on both sides of body

weight loss

Rheumatoid arthritis risk factors

Any age; likelihood increases with age

• Female

• Smoking

• Obesity

• Genetic

Gout

• Common type of inflammatory arthritis

• Usually affects one joint at a time

• Bouts of flares (symptoms are present) and remission (no symptoms)

• Deposition of uric acid crystals in tissues and fluids

• Recurring acute flares can lead to gouty arthritis (type of arthritis that worsens over time)

Symptoms Gout

acute flares:

• Red, hot swollen joints

• Extreme pain

Gout risk factors

• Male

• Obesity

• Medications including diuretics

• Alcohol

• Certain health conditions, e.g., hypertension, diabetes, poor kidney function, insulin resistance

• Diet high in fructose (type of sugar) & purines (e.g., in red meat, alcohol)

Arthritis pain

Severe joint pain adults

• Higher in women

• Highest among non-Hispanic blacks (50.9%), then Hispanics & Native Americans/Alaska Natives (42.0%), Asians (27.7%), and non-Hispanic whites (27.4%)

• More common in adults with arthritis who also have other chronic conditions

severe joint pain definition

when an individual rates his or her pain as a 7 or higher out of 10

persistent pain definition

when an individual reports having pain of any severisty on most or all days in the past 3 months

Fibromyalgia

Condition causing pain all over body, sleep problems, fatigue

• Symmetrical tender points (pressure is painful)

Symptoms Fibromyalgia

Pain, stiffness

• Fatigue

• Depression & anxiety

• Sleep problems

• Difficult with thinking, memory & concentration

• Headaches

• Digestive problems

• Tingling or numbness in hands and feet

Risk factors Fibromyalgia

Age

• Preexisting lupus or rheumatoid arthritis (RA)