AIDS No. 1 Cause of Death of Young Men in California

AIDS has surpassed cancer, heart disease and accidents to become the leading cause of death among men ages 25 to 44 in California, accounting for 24% of all such deaths in 1990, according to the first systematic study of its kind by the U.S. Centers for Disease Control and Prevention.

AIDS and related infections were also the leading cause of young male deaths in more than five dozen major U.S. cities, including Fullerton and 10 others in California, according to the report published today in the Journal of the American Medical Assn. Among women of the same age, AIDS was the main cause of death in nine cities, all on the East Coast.

San Francisco had the highest rate of AIDS-related deaths in the nation for men of the age group studied--61%. Other California cities with populations greater than 100,000 that ranked high include Pasadena, 38%; San Diego, 37%; Long Beach, 36%; Berkeley, 34%; Los Angeles, 31%; Glendale, 30%; and Fullerton, 26%.

Though its percentage was high, Fullerton had the lowest absolute number of AIDS-related deaths among the 64 cities cited in the CDC report; HIV caused the deaths of eight of the 31 young men who died there in 1990.

AIDS was also the leading cause of death for young men in Anaheim, causing 19% of the 129 deaths among young men there in 1990.

Both cities had fewer AIDS-related deaths than Laguna Beach, where AIDS was responsible 78% of the 37 deaths among young men. Laguna Beach was not mentioned in the CDC report because the city has a population of less than 100,000.

The latest county report on the epidemic showed that the rate of Orange County residents with the AIDS virus was 18.3 per 100,000 residents, compared to 27.8 statewide and 17.8 nationwide.

“With that rate, it is no big surprise that one of our cities would be included (among those) that have the top percentages,” said Dr. Rick Greenwood, deputy director of public health for Orange County’s Health Care Agency.

“It highlights the tragedy of AIDS,” Greenwood said. “The figures show that AIDS is killing the citizens of our county and our country in the prime of their life. It’s removing them from society at their most productive point.”

Although the proportion of deaths among young adults caused by AIDS is high, the researchers cautioned that deaths among young adults accounted for only 7% of all deaths in 1990, the latest year for which detailed mortality data is available.

Nonetheless, people ages 25 to 44 now constitute 54% of the U.S. civilian labor force, so their loss is “disproportionately disruptive” to U.S. society. “Such premature deaths result in the loss of many productive years of life and deprive young children of their parents,” they wrote.

In an editorial accompanying the study, Dr. Sten H. Vermund of the National Institutes of Health wrote that the AIDS epidemic still shows no sign of behaving like past epidemics, which typically peak early and then taper off.

“Unfortunately, no such HIV infection mortality peak is evident; death rates continue to rise inexorably. . . . The health crisis of AIDS/HIV is of immense significance in the United States and will remain so beyond this millennium.”

California ranked third in the nation in the share of deaths among men 25 to 44 that is attributable to AIDS and related diseases. Only New York (29%) and New Jersey (28%) had a higher rate in 1990.

AIDS was not the leading cause of death for women in any state, and caused only 2.7% of deaths among California women in the 25-to-44 age group.

Nationally, AIDS caused 16.5% of all deaths among males ages 25 to 44 in 1990, second only to accidental injuries and up from 14% the previous year. For young women, the percentages were 4.8% in 1990 and 4% in 1989.

Race played a crucial role in the death rate for young women, the study found. AIDS was only the ninth leading cause of death for young Anglo women, but was the third-leading cause of death for blacks and Latinas. The high rate of AIDS deaths among such women, Dr. Richard M. Selik and his colleagues at the Centers for Disease Control said, reflects the high rate of intravenous drug abuse in Eastern cities.

“We don’t have that problem and we’re hoping that we could prevent that with public education” said Greenwood, who helps to oversee an HIV monitoring report in Orange County.

The CDC study found that for young men, in contrast, the leading method of transmission is homosexual relations, so the deaths are distributed in a more even pattern throughout the country, the researchers said. The disparity in death rates between men and women also reflects the higher incidence of AIDS in men than in women.

For the year and age group covered by the study, the total number of AIDS deaths was 16,717 men and 2,031 women. A total of 182,275 deaths in the United States have been attributed to AIDS since federal officials began tracking the disease in 1981.

In California, there have been about 59,000 AIDS cases to date and 37,000 deaths, according to epidemiologist Michael Hughes of the Department of Health Services. The department had predicted about 10,000 new cases this year, but there have already been 11,000, he said--largely because of a broadening of the definition of AIDS that took effect at the beginning of 1993.

The Orange County HIV report showed that up to December, 1992, there were 2,306 AIDS cases in Orange County. Some 1,508 of those Orange County residents have died from the disease.

Hughes noted that the rate of AIDS deaths is relatively low among young women here because--unlike New York, New Jersey and Florida--California has a low incidence of HIV infection among intravenous drug abusers. But he added that there are pockets of high HIV incidence among drug abusers, such as the East Bay region near San Francisco, and the infection of young women can be expected to grow as a result.

The high rate of deaths in cities such as Fullerton, Pasadena and Glendale, he said, probably is a simple reflection of the fact that they are part of metropolitan Los Angeles.

Terrible Toll

AIDS and related diseases are the biggest killers of young men in five states and 64 cities nationwide. States where AIDS is the leading cause of such deaths: California, New York, New Jersey, Florida and Massachusetts. Using mortality figures from 1990, these are the percentages of men 25 to 44 who died from AIDS in a selection of Orange County cities and the top 10 statewide.

Orange County Laguna Beach: 78% Irvine: 33% Fullerton: 26% Anaheim: 19% Huntington Beach: 19% Santa Ana: 19% Garden Grove: 13% *

Statewide San Francisco: 61% Pasadena: 38% San Diego: 37% Long Beach: 36% Berkeley: 34% Los Angeles: 31% Glendale: 30% Oakland: 28% Fullerton: 26% Concord, San Jose: 19% Sources: Orange County Health Care Agency; Centers for Disease Control