Unnecessary morbidity and mortality is an important problem which leads to increased health-care costs and can ultimately result in premature death. It has been estimated that approximately two thirds of mortality is due to potentially preventable causes- 1.2 million deaths (65%) and 8.4 million years of life lost before age 65 (63%). Principal factors associated with unnecessary morbidity and mortality include tobacco use, high blood pressure, improper nutrition, lack of screening and prevention services, alcohol abuse, and injury. This project uses longitudinal data from the Baltimore Longitudinal Study of Aging (BLSA) and other studies such as the Johns Hopkins' Nursing Home Study to examine the influence of modifiable risk factors on the occurrence of premature deaths and unnecessary morbidity and disability. Results from a risk factor study of hearing loss indicates that hearing declines less rapidly in women than in men. At the higher speech range frequencies (approximately 2 kHz), the rates of decline in hearing sensitivity are about two times greater in men than in women. Also, the estimates of the age-specific prevalence rates of hearing loss increase from 26% in 20 year-olds to 81% in participants over 70 years of age. An examination of modifiable risk factors, such as smoking, alcohol consumption and blood pressure suggests that while smoking and alcohol had no association with hearing loss, systolic blood pressure did. The relative risk and 95% confidence interval for each 10 mm Hg increase in systolic blood pressure in men was 1.17 (1.09, 1.25) and in women was 1.42 (1.24, 1.62) for the non age-adjusted results, with less conclusive age- adjusted relative risk estimates for both men (1.01 (0.93, 1.08)) and women (1.11 (0.89, 1.32)).
