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I started medical school in 1989 and started patient care in 1991. I have now been a member of the American Academy of Family Practice for 25 years, since 1993.

The top ten causes of death in the United States in 1995 were different from 2012. Even in 17 years, medicine has changed tremendously and will continue to change tremendously. I am always wondering and guessing what will come next....

In 1995 in the US there were 2,312,132 deaths recorded.

The top ten causes of death in the US in 1995, all ages, all sexes, were:

1. Diseases of the heart: 737,563

2. Malignant neoplasms, cancer: 538,544

3. Cerebrovascular disease, stroke: 157,991

4. Chronic Obstructive Pulmonary diseases and allied conditions: 102,899

5. Accidents and adverse effects: 93,320 (and of those 43,363 were motor vehicle accidents)

6. Pneumonia and influenza: 82,923

7. Diabetes mellitus: 59,254

8. Human immunodeficiency virus infection: 43,115

9. Suicide: 31,284

10. Chronic liver disease and cirrhosis: 25,222

All other causes: 440,106

Compare that list to 2012. Look: Alzheimer's was not on the list in 1995 and HIV was, and the order has changed. Liver disease has fallen out of the top ten by 2012 and kidney disease has moved up the list. Get your flu shot. Get your pneumovax, immunization for pneumococcal pneumonia at age 65 or earlier if you have heart or lung disease. Think about risk factors and how you can lower your overall risk..... and take suicide threats seriously, too many people die that way.

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