Leading Causes of Death in Arizona, 2023 (thru 11/26) & Thumbnail Interventions

1. Heart Disease (10,887)

  • Don’t smoke
  • Exercise regularly
  • Manage blood pressure
  • Manage cholesterol levels
  • Lower salt/alcohol use
  • Better nutrition

2. Cancer (9,644)

  • Don’t smoke
  • Eat well balanced diet
  • Physical activity
  • Get routine screenings
  • Use sunscreen/protect skin
  • Get regular checkups

3. Chronic Lower Respiratory Illnesses (2,611)

  • Don’t smoke
  • Worker safety protection
  • Keep up to date with vaccines
  • Exercise

4. Stroke (2,362)

  • Don’t smoke
  • Manage blood pressure
  • Lower alcohol use
  • Better nutrition
  • Seek treatment medication for AFIB (atrial fibrillation)
  • Regular checkups

5. Accidents (2,324)

  • Buckle up
  • Drive a safe car with airbags
  • Don’t drive under the influence
  • Avoid recreational use of pills (fentanyl)
  • In home fall prevention strategies
  • Physical activity/balance

6. Alzheimer’s (1,977)

7. Diabetes (1,750)

  • Manage the disease
  • Physical activity/nutrition
  • Don’t smoke
  • Manage blood pressure/cholesterol
  • Modest alcohol use

8. Liver Disease (1,071)

  • Getting vaccinated for Hepatitis A and B
  • Practicing good hygiene
  • Drinking alcohol in moderation
  • Use medications as directed
  • Get routine checkups with blood tests
  • Practice harm reduction if you’ve had Hep C

9. Hypertension (809)

  • Get regular checkups & take medicine as directed
  • Don’t smoke
  • Lower salt intake
  • Improve physical activity & nutrition
  • Limit alcohol

10. Heat (775)

  • Strategies to reduce homelessness
  • Increase affordable housing
  • Limit outdoor exposure to extreme heat
  • Stay hydrated

11.   Influenza/Pneumonia (686)

  • Stay up to date on all vaccines including influenza, COVID-19, pneumonia etc.
  • Get routine checkups

12.  Parkinsons (689)

13.  COVID-19 (674)

  • Get most up to date booster vaccines for COVID-19

14.  Kidney Disease (623)

  • Stay active
  • Manage diabetes
  • Take medication as directed
  • Eat a healthy diet
  • Reduce salt intake
  • Don’t smoke
  • Check and control your blood sugar and blood pressure as part of your regular checkups
  • Get your kidney function checked if you have one or more of the ‘high risk’ factors: diabetes, hypertension, obesity, a family history.

15. Suicide (599)

  • Depression screening
  • Seek behavioral health help
  • Improve social connectedness
  • Identify persons at risk
  • Evidence based responses
  • Enhance life skills and resilience

16. Nutritional Deficiency (seniors – usually protein deficiency) 563

  • Eat healthy diet with enough protein
  • Manage diet as you age
  • Sufficient nutrition

Trends in Leading Causes of Death in Arizona (2022-2023)

Heat Deaths up 350% in Last 4 Years; COVID Drops Substantially in 2023

As you probably recall, our resident AZPHA epidemiologist Allan Willaims PhD did a deep dive into the leading causes of death in Arizona during the pandemic and discovered we were the only state where COVID-19 was the leading cause of death during the first couple years of the pandemic.

AzPHA Data Brief: Arizona is the ONLY State in the U.S. In Which COVID-19 Is the Leading Cause of Death During the Pandemic

We asked Allan to run the cause-of-death numbers again for 2023 and 2022. While COVID-19 was still the 4th leading cause of death in Arizona during 2022, it dropped way down to number 13 this year. Meanwhile, we had another dramatic jump in heat-related deaths in 2023 – moving that cause of death up to number 10 (it wasn’t even in the top 15 last year).

See: Arizona COVID-19 deaths were way down, heat-related deaths spiked in 2023 | KJZZ

An even deeper dive into the heat-related death data found that heat related deaths have increased 350% in the last 4 years (tracking the affordable housing crisis).









You might also notice that the Accident’s category appears to be decrease in 2023, going from #3 to #5. That shift downward is more of an artifact of timeline by which medical examiners can establish a cause of death for opioid and other poisonings (opioid and other drug overdoses are mostly classified in the Accidents category (accidental poisonings). Blood toxicology reports have a relatively long lag time, slowing the cause of death data for accidents.


Here are some excerpts from an interview I did this week on KJZZ’ The Show: Arizona COVID-19 deaths were way down, heat-related deaths spiked in 2023 | KJZZ

Gilger: Were you surprised by any of these trends?

WILL HUMBLE: Well, I don’t know that the increase in heat-related deaths really surprised me that much. I mean, it kind of makes sense when you look at the numbers for homelessness in Arizona and the problems with affordable housing that’s putting people out into the street. Combine that with the July that we had.

We had a just a continuing big increase in heat-related deaths. And if you look at 2022, heat-related deaths wasn’t even in the top 20. This year, it’s No. 10. So, a big increase. Part of that’s homelessness. It’s a combination really of homelessness and the extreme temperatures that we had that were unusually high, especially the low temperatures at night.

Gilger: The other biggest shift when you look at these breakdowns is the big drop we saw in deaths related to COVID-19, which makes sense as well.

HUMBLE: Yeah. Right. So if you look, if you go back to 2020, 2021 Arizona was the only state where to COVID-19 was the No. 1 leading cause of death — even more than heart disease and cancer in 2020. That dropped a little bit in 2022. So that it was the fourth-leading cause of death. This year, 2023, so far it’s way down the list at No. 13. So big drop in the death from COVID-19, but a big increase in the death from heat-related illnesses.

Gilger: So much of what we talk about when we talk about deaths in the news is related to the opioid epidemic, the fentanyl crisis. How big of a chunk of the picture are those right now?

HUMBLE: It’s a big chunk. So the top two are, will always probably be — unless we have another pandemic — heart disease and cancer. But the third category is what’s called accidents. And initially you think, well, accidents mean car crashes.

Well, it’s accidental poisonings is what dominates that category, and it’s the third-leading cause of death in 2022. Right now, it’s classified as like fifth in 2023. But that’s going to go up because the toxicology reports, it takes so long to finish, they can’t establish the cause of death until that blood work comes back.

Gilger: We hear a lot about suicides in the news and about the rise in suicides, particularly among certain populations. This was lower down the list this year. How does this compare to recent years?

HUMBLE: It’s about the same as recent years in terms of the causes of death. If you look inside that data, demographically, it really is dominated by men over 70 that use a firearm as the method to end their life. So that’s demographics. If you look at where are the numbers of in suicides, it’s men over 70. Of course, there’s suicides across the board of all the age groups and genders. But that’s the, that’s the biggest chunk. It’s about the same as last year.

Gilger: Let’s talk for a few more minutes about heat-related deaths. We know that it was hotter. But we also know that there’s a housing crisis and more people are on the street and living on the street. Do we know, though, though much comorbidities play into this — things like drug use, mental illness, disability. How are those categorized?

HUMBLE: So, when you look at a death certificate, it’ll say heat-related death, there might be two to three different causes. So in other words, when you’re making the final determination … it’s about like what’s the No. 1 leading cause of death.

So, for a heat death, most likely there’s something else going on as well. Drugs is a big part, and Maricopa County did a a survey that found methamphetamine especially, but also fentanyl, are big co-factors for people who die from heat-related illnesses. But there’s the dominant reason of course is that they’re outside in the summer.

Ok…  then what can we learn from these data? Public health and policy-makers can use this info to set intervention priorities etc. But individuals can learn about things they can do to improve their chances of staving off these causes of mortality.

The big factors are of course stop smoking if you smoke. Make sure to go to your annual checkup where you can learn about things like high blood pressure or early signs of diabetes & take actions to prevent bad a bad outcome. Make sure to get your routine recommended cancer screenings and stay up to date with your vaccinations.

Western Region Public Health Training Center’s Public Health & Primary Care Leadership Institute!

January 26 – April 26, 2024

Are you interested in exploring a range of critical topics to enhance your leadership and communication skills, help better cross-sector collaboration, and develop more fair and effective approaches to improving population health? If so, you’re in luck, as the Western Region Public Health Training Center has just the training for you (free).

Program Overview:

  • Friday, January 26, 2024, 1pm – 6pm MST: Leading through Turbulence: New Leadership Styles for Today
  • Friday, February 9, 2024, 1pm – 3pm MST: Leading Organizational Change
  • Friday, March 1, 2024, 1pm – 3pm MST: Leading Organizational Change (cont.)
  • Friday, March 15, 2024, 1pm – 5pm MST: Collaboration: Innovative Techniques
  • Friday, April 5, 2024, 1pm-5pm MST: Strategic Communication and Collaboration
  • Friday, April 26, 2024, 1pm-3pm MST: Building Resilience

Who Should Apply?
Early- to mid-career professionals in public health and community-based primary care, especially those in rural areas or serving medically underserved populations.

Application criteria:  Along with your contact information, role, and agency, we require a letter of support from your supervisor to ensure the support and facilitation of your attendance at all virtual learning sessions.

Questions? Submit any questions to wrphtc@arizona.edu.

Application deadline: Applications are due by January 5, 2024

Western Region Leadership Institute | Western Region Public Health Training Center

New Process for Requesting Data from ADHS

ADHS launched a process for requesting data from the Department. Details and request portals are on a new webpage that lists public data assets and the form to request data.

ADHS says “…  this form does not guarantee the fulfillment of the request, but it will connect the requester with the right program within ADHS to respond to the request”. Once the request goes to the right ADHS program they say there may be added programmatic processes where more information or forms are requested.

They say that from now on people should submit all new data requests through the new ADHS Data Request Submission Form. For questions, please contact the Enterprise Data Management Office at edmo@azdhs.gov


Call for Oral Presentations: AZPHA Annual Conference | “Addressing the Opioid Crisis in Arizona”

 Desert Willow Conference Center |  Leap Day: 2/29/2024

Thank you for your interest in presenting your work at the 2024 – Arizona Public Health Association Annual Conference, which will take place on February 29, 2024, at Desert Willow Conference Center in Phoenix, Arizona: “Addressing the Opioid Crisis in Arizona

We are seeking proposals presenting cross-sector collaboration initiatives relating to the opioid crisis addressing prevention, intervention, treatment, and harm reduction through various lens of service, support, and collaboration.

Presentations may highlight interventions using OneArizona opioid settlement funding, community  coalition efforts, initiatives based on best practices (i.e. Strategic Prevention Framework)/promising practices, municipal engagement, and other relevant efforts.

Submit Your Proposal Here

You may propose a solo presenter or as a team. The breakout sessions will be 45 minutes, there will be a morning and an afternoon session. We will be able to confirm your session time once we have finalized all the breakout sessions. Plan on attending the full conference. Depending on your selection, you may be asked to present twice.

Presenting teams: Please identify the primary presenter for your team presentation. This individual will communicate conference-related information with the rest of the team.

If you are submitting this proposal as part of a team, please confirm the following before applying:

  • Proposed speakers have agreed to participate.
  • Proposed speakers will be available on Thursday, February 29, 2024
Deadline for submission is January 2, 2024

We look forward to reviewing your proposal for the 2023 AZPHA Annual Conference!

Submit Your Proposal!

Dr. Marcy Flanagan Tapped as Deputy Maricopa County Manager; Jeanene Fowler to Serve as Interim Maricopa County Public Health Department Director

Congrats to AzPHA member Dr. Marcy Flanagan who has been appointed as a Deputy County Manager for Maricopa County government. For the last several years Dr. Flanagan has been serving as the director for the Maricopa County Department of Public Health. Marcy also served as the director of the Pima County Health Department for several years.

Marcy is a veteran public health practitioner with more than 23 years of public health work behind her.  She’s been a champion for the thousands of Pima and Maricopa County residents her agencies have served.

In addition to being a member of AzPHA, she’s a member of the APHA and serves on the Metropolitan Education Commission and National Association of City and County Health Officials. She has also been the President of the Arizona Association of Local Health Officers Association.

Marcy grew up in a small farm town in Michigan and came to Arizona for her freshman year of high school. After graduating from Paradise Valley High School, she moved to Tucson to attend the U of A. She fell in love with Arizona and has lived here ever since.

Outside of spending time with her family, she loves reading, going to the movies, walking in Reid Park, golfing, and taking girl trips with her friends. Marcy earned a BS in Sociology from the U of A and a master’s in administration from NAU. She also earned a Ph.D. in Business Administration Leadership from Walden University.

AzPHA is delighted to have Marcy in her important leadership position within Arizona’s public health system!

Jeanene Fowler will now serve as the Interim Director of Maricopa County Department of Public Health. Jeanene is a household name in Arizona’s public health world, a nearly 20-year veteran of Maricopa County Department of Public Health, the 3rd largest health jurisdiction in the U.S.  With a background in marketing & communications, she started her service in 2005 as the Public Information Officer.

This position laid a solid foundation in learning public health programming as well as the principles of risk communications allowing her to flourish into a true public health practitioner. Since then, she has served in roles that included Public Information Supervisor, Program Operation Administrator and most recently, Assistant Director.

Throughout the years, Jeanene has held leadership roles in MCDPH’s response to numerous emergencies such as H1N1 and COVID 19. She has had the opportunity to help the agency in becoming an accredited health department and also growing its capacity by completing numerous county-wide community health needs assessments. Over the last few years, much of her work has been focused on leading the department’s effort with developing and implementing a strategic plan focused on combatting the issue of substance use and misuse.

A native of Massachusetts, Jeanene has called Arizona home for more than 25 years. She is a proud graduate of Syracuse University with a degree in marketing and public relations. Please join us in welcoming Jeanene in her new interim role as Maricopa County’s Director of Public Health…  a role that she has earned after more than two decades in public health in leadership positions!

Solid choices by the Maricopa County Board of Supervisors & County Manager Jen Pokorski!

Valleywise Turns the Key on ‘First Episode’ Centers

What is the First Episode Center?

An innovative treatment and support program that serves adolescents and young adults who are experiencing psychosis.   Research shows that seeking treatment early will improve life overall and help the young person achieve their life goals.  The sooner care is sought, the sooner a person will feel better.

Adolescent and Teen Psychosis | Valleywise Health

How does the First Episode Center work?

The FEC uses evidence-based practices to provide a comprehensive array of recovery-oriented services over a period of about 5 years from the onset of symptoms. 

They use a team approach to assist a person and their family in a time efficient manner, eliminating long delays between onset of experiences and engagement in effective treatment.

Who is the First Episode Center for?

  • Adolescents and young adults age 15-25
  • People who experience:
    • unusual thoughts or behaviors that seem strange to themselves or others
    • becoming fearful or suspicious
    • hearing voices or seeing things others don’t
    • withdrawing from family and friends
  • People who want help to recovery from psychosis to help achieve their life goals for school, work, family, and relationships

What services are provided at the First Episode Center?

  • Recovery Coaching and Peer Support
  • Individualized Goal Setting
  • School and Employment Support
  • Family Education and Support
  • Individual, Group, and Family Therapy, including Cognitive Enhancement Therapy, Cognitive Behavioral Therapy
  • Medication Treatment if a person and their doctor decides it is needed.


Recovery is different for each person and can vary depending on many factors.  The First Episode Center believes everyone can and will recover to lead a full and meaningful life.  

  • Movement toward important personal life goals
  • Building connections in the community, including school, work, social activities, hobbies, volunteer work, and fun
  • Improved relationships with family, friends, and any significant supports in one’s life
  • Reduction in experiences and roadblocks that prevent pursuing life goals
  • Feeling more hopeful about the future

This center has an Valleywise Health primary care and dental clinic, where preventative and regular medical care are available.  There is also a First Things First Family Resource Center, to support parents and families to learn, grow, and thrive.

Adolescent and Teen Psychosis | Valleywise Health

Arizona Supreme Court to Decide the Fate of Abortion Care in AZ: Oral Arguments Tuesday, December 12

Now that the U.S. Supreme Court removed constitutional protections for abortion rights the question becomes… what’s the law of the land in Arizona?

The answer to that question hinged on whether SB1164 (restricting abortions to the first 15 weeks’ gestation) is the law of the land or whether the territorial-era law [ARS 13-3603] takes precedence as well as whether ARS 13-3603 is found to be unconstitutional on grounds other than those covered in the Dobbs decision.

During the summer of 2022 Attorney General Brnovich moved to begin implementation of the abortion ban in ARS 13-3603 by filing a motion in Pima County Superior Court to remove the injunction from the Nelson v. Planned Parenthood Center of Tucson case.

On September 22, 2022, Pima County Superior Court Judge Kellie Johnson ordered the lifting of the injunction in the Nelson v. PP case. In her decision she dismissed the relevance of the new law limiting abortions to those at less than 15 weeks of gestation because the state legislature included in the session law that the 15-week gestation age limitation does not “… repeal by implication or otherwise Section 13-3603 or any other applicable state law regulating or restricting abortion.”

By lifting the injunction, Judge Johnson turned the clock back to January 1973 when abortions were illegal to perform “… unless it is necessary to save her (the patient’s) life.”

From September 23 to December 30, 2022, any clinician in Arizona who performed an abortion (whether medication or surgical) that is not necessary to save the life of the patient could have been an be charged with and convicted of a violation of ARS 13-3603 and if found guilty, punished with between 2 and 5 years in the state penitentiary.

Planned Parenthood appealed to the Superior Court ruling, and on December 30, 2022, held that doctors can’t be prosecuted for performing abortions because other Arizona laws passed over the years allow them to perform the procedure. See the appellate court ruling.

The ruling from the three-member Court of Appeals panel temporarily cleared up two months of controversy, and abortion care providers were again allowed to provide abortion care up to 15 weeks of gestation (beginning December 30, 2022).

The intervening plaintiffs in the case (the Alliance Defending Freedom & Yavapai County Attorney Dennis McGrane) appealed the appellate court ruling to the Arizona Supreme Court, who agreed to hear the case, with oral arguments on December 12, 2023. Meet The Justices who will decide the case (note that Justice Montgomery has recused himself because of his historic actions and statements opposing abortion care).

Note: Attorney General Mayes and Pima County Attorney Conover are not defending the territorial-era ban, which is why the Alliance Defending Freedom and McGrane are called ‘intervenor plaintiffs.

A decision by the Arizona Supreme Court could take weeks or even months.

The AZ Supreme Court could uphold the Court of Appeals ruling that abortion is legal up to 15 weeks, they could agree with the Superior Court ruling that abortion is illegal except when the mother’s life is in danger, or they could come up with some other hybrid ruling.

In the meantime, a voter initiative changing the Arizona Constitution guaranteeing the right to abortion services is gathering signatures for the 2024 ballot. The signature gathering effort is being organized by Arizona for Abortion Access. The campaign must collect 383,923 valid signatures from Arizona voters by July 3, 2024. If the organizers are able to collect the required valid signatures, and if the initiative survives the inevitable legal challenges to keep it off the ballot, Arizona voters would have an opportunity make abortion care (up to the point of viability) a constitutional right in Arizona regardless of how the Arizona Supreme Court rules in the coming weeks.

Note: The Arizona Supreme Court may decide abortion is illegal except to save the life of the mother in the coming weeks. If that were to happen, Arizona women would again be forced to seek abortion care in neighboring states like California, Nevada, New Mexico, or Colorado, all of which allow abortion services.

See Our Comprehensive Report:

Women’s Reproductive Rights in Arizona: 1864-2023

Is the Rural Physician Workforce Production Act of 2023 A Policy Answer to Arizona’s Physician Shortage?

Rural Arizonans face challenges accessing that care, including getting routine check-ups or seeing a specialist, and the problem has been getting worse year after year.

We’ve written several blogs about the policy interventions that would help improve access to care such as building more residency programs in rural Arizona – especially those in primary care and family medicine. Ideal locations for those are at the many Federally Qualified Health Centers in AZ in association with their local hospitals.

But providing financial incentives remains a key…  and has yet to be addressed. A shovel ready bill is sitting in the hopper in Congress called the Rural Physician Workforce Production Act of 2023.

The Rural Physician Workforce Production Act lifts the current cap on Medicare reimbursement payments to rural hospitals that cover the cost of taking on residents, helping to alleviate the serious disadvantage that rural hospitals face when recruiting new medical professionals.

The bill would also allow Medicare to reimburse urban hospitals that send residents to train at rural health care facilities during a resident rotation, and it would set up a per resident payment initiative to ensure rural hospitals have the resources to bring on added residents.

Last week Representative Ruben Gallego announced his support for the Rural Physician Workforce Production Act of 2023. Let’s hope thew rest of Arizona’s delegation gets on board too!

AZ Grant Opportunity Update

Nonprofits have a unique ability to engage in developing meaningful public policy that builds healthier communities. This can range from sharing of information to conducting research to grassroots or direct lobbying.

Vitalyst keeps running tabs on lots of grant opportunities to help nonprofits etc. stay informed about the possibilities. Below is their latest compiled list:

NEW Due December 5th: WITH Grant

Due December 7th: Agriculture and Food Research Initiative Competitive Grants Program Education and Workforce Development

Due December 7th: Seventh Generation Fund for Indigenous People

NEW Due December 12th: State of Housing Trust Fund NOFA – 4% Projects without prior ADOH gap financing

Due December 12th: Teaching Health Center Planning and Development Program

Due December 13th: State Primary Care Offices

Due December 14th: Eliminating Disparities in Perinatal Health

Due December 15th: Sundt Foundation Grant

Due December 15th: Nonprofit Security Grant Program (NSGP)

Due December 16th: Nina Mason Pulliam Charitable Trust funds – Helping People in Need, Protecting Animals and Nature, & Enriching Community Life

Due December 17th: Justice Reinvestment Grants for Maricopa County

Due December 17th: Resident Opportunity and Self-Sufficiency (ROSS) Service Coordinator Program

Due December 19th: State of Housing Trust Fund NOFA – 4% LIHTC Projects seeking additional gap financing for cost overruns

Due December 21st: Suicide Prevention Capacity Building

Due December 31st: Yavapai County – Industrial Development Authority Grant

Due December 31st: Honor the Earth