In 1997, there were about 2.3 million deaths in the United States. Heart disease and cancer accounted for over half of these deaths, mostly at older ages. Among younger adults, ages 25 to 44, the leading cause of death is accidents, followed by cancer, heart disease, suicide, human immunodeficiency virus infection (HIV), and homicide. Four of the top six causes of death � accidents, suicide, homicide, and HIV � are closely linked to behavior that increases the likelihood of injury, disease, or mortality. These causes of death are of special concern to policymakers because they are viewed as preventable through public health initiatives.

In 1997, African American adults were more likely to die from accidents, homicide, and HIV compared with either whites or Hispanics. The black homicide rate in 1997 was 40 deaths per 100,000, compared with 15 deaths per 100,000 among Hispanics and only 5 deaths per 100,000 among whites. The death rate for HIV was over 50 per 100,000 among blacks, 16 per 100,000 among Hispanics, and 6 per 100,000 among whites. The suicide rate is the only cause that was lower among blacks (9.7) than it is for whites (17.0). Higher death rates among minorities, particularly among those infected with HIV, stem in part from their limited access to health insurance, and consequently, to medical care.