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Comment on "Healthy Living Is the Best Revenge"

David L. Katz, MD, MPH

Arch Intern Med. 2009;169(15):1362-1363.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

For a span of decades prior to 1993, when asked what is the leading cause of death in the United States, there was only one reasonable answer—heart disease. The answers for the second, third, and fourth leading causes were similarly circumscribed: cancer, stroke, and diabetes. But in that year, McGinnis and Foege¹ refashioned our understanding and forever changed these answers with the publication of their seminal article, "Actual Causes of Death in the United States." As of 1993, the leading cause of death in the United States became tobacco use.

McGinnis and Foege¹ looked beyond the diseases that are proximal causes of death to the causes of those diseases, the root causes of death. They concluded that half of the annual mortality toll in this country—roughly a million deaths—was premature. These deaths could be prevented, or more accurately, deferred, with the modification of just 10 . . . [Full Text of this Article]

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