by Max Hammonds, MD

What disease condition is your greatest risk for disability or death? Is it heart disease? Cancer? Stroke? Pneumonia? Not surprisingly, it isn’t the same for everyone.

People in third world countries are most at risk from infectious disease (think – malaria or AIDS) or violence and starvation (if there is armed conflict – think Somalia or Sudan). First world countries are most at risk from lifestyle choices in diet, exercise, and smoking (think USA or Argentina).

Cultural disease risks involve genetic predispositions (think Tay-Sachs disease in Jews; Sickle cell disease in blacks) and specific habit patterns (think salted fish and stomach cancer in Japanese). Socio-economic differences determine affordability of preventive healthcare (think obstetrical care for unwed teenage pregnancies) and life patterns (think coal miners and black lung).

If these cultural or third world country patterns don’t affect you, what should you be watching out for – for yourself and your family? It depends on your age.

For your children less than one year of age: the major risks are genetic defects, especially heart deformities and accidents, especially in the home. Small children are unable to foresee accidents. Watch out for them.

For your children from one year to ten years of age: the major risks are cancer (think leukemia, renal, and brain tumors) and accidents. There is very little reliable information on prevention for children’s cancers. But accidents are happening on bicycles and on playgrounds and are preventable. Kids are active; parents should be vigilant.

For young people from ten to twenty-five: the major killer of these young lives is auto accidents (although in the black male population it is homicide). At a time when they are just beginning to gain control of motor skills, just beginning to choose harmful lifestyles (think – alcohol and no seat belts), and just becoming aware that life and speed is risky, they are hurling down highways at tremendous speeds. The combination is deadly. Life choices must be taught to these young people.

For young adults between twenty-five and thirty-five: the major killer is still accidents, mostly in automobiles, mostly self-inflicted. Learn the lessons of the previous age group; almost all of these deaths are preventable.

For middle-aged adults – thirty-five to fifty-five: This is probably the riskiest time of life. Malignant disease (think – lifestyle causes: dietary, alcohol, overweight, smoking for lung, colon, ovarian, breast cancer) is the greatest risk. Although heart disease and stroke (think – multiple lifestyle choices) are gaining strength. Auto accidents (those who do most of the driving) and AIDS deaths (lifestyle choice) are at their highest levels at this age. And deaths from other lifestyle choices (diabetes, chronic lung disease, cirrhosis) are increasing.

For those fifty-five to seventy-five: deaths from cancer still outpace heart disease and stroke. Much of these two causes are lifestyle related. But at this point, it’s the results of lifestyle choices made in the younger years.

For those over seventy-five: the major causes of death are heart disease and stroke, followed quickly by chronic lung disease and pneumonia and diabetes.

Take home message: Lifestyle choices matter. To live as long as possible while remaining as young as possible, make good lifestyle choices.