Your death, cheerily explained

Oy. Doc Rubin has barely gotten blogging underway, and he’s already having issues with length. (He’s also referring to himself in the third person, which is never a good sign. Call it a weird homage of sorts to Roland Burris.) I’m working on an entry I’m calling “Has Medicine Become Industrialized?” but it’s becoming interminably long, so I’ve decided to put it on hold for the moment and provide something shorter and sweeter. At least I think it will be shorter and sweeter.

What are you going to die from? What are you worried about dying from?

Leaving aside the issue of ending questions with prepositions, the two are not altogether the same questions, as you could guess. For the moment, let’s just play with the first one so that we can have some sort of perspective on the second. Okay class, it’s quiz time:

First, how many people die every year in the US?
Second, what is the biggest killer, and how many people die from it?
Third, can you now list #2 through #5?
(Bonus question, round I: what were the top five causes of death 100 years ago?)
(Bonus question, round II: how many people are born in the US each year?)

Give yourself, I don’t know, say, five minutes. No cheating on google though.

Allright. You’re very on top of things (or you’re incredibly geeky) if you know that about 2.5 million people die every year in the US. That’s not really so important but I include the number as a reference point.

As to leading causes of death, feel proud of yourself; you got the first one right: heart disease. About 650,000 people—just about one-quarter—of people in the US die from this. Number two? Yes, most of you I imagine are still doing good: cancer (all forms combined), which clocks in at just over 550,000. I want to break the cancer numbers down in a bit but let’s put that on hold. Number three cause of death is stroke, at just under 150,000 (or, importantly, a big dropoff). Number four you’re not likely to get unless you’re involved in medicine in some way, shape or form: it’s “chronic lower respiratory diseases,” usually in the form of emphysema, which claims 130,000 victims annually. To round out our top five we encounter the grab-bag “accidents,” which covers car crashes and whatnot; just under 120,000 people fall into this unfortunate group. Thus, these top five causes of death account for about 65 percent of all deaths in the US.

Why am I going over these numbers? Because you can lower your risk of dying from these diseases in every category, and do so without any fancy-shmancy whiz-gidget medical tools or reading Deepak Chopra’s latest literary flatulence. Stop smoking: that reduces four risks (heart disease, lung cancer among others, stroke, and respiratory disease). Lose weight, be more active, and eat less: that takes care of at least two (heart disease and stroke), and possibly drops your risk of cancer. Don’t speed: don’t think I need to explain that one, or outline any of the other risky behaviors that can get you killed. You get the idea.

My point: you are not just more likely to die from fairly run-of-the-mill diseases than you are from anything exotic, you are overwhelmingly more likely to do so, and you can actually take steps to prevent or delay dying from such diseases.

Here’s what you’re not going to die from, even though you might have been worried (or at least you saw some piece on the local or national news) about it at some point in the last few years: bird flu, MRSA, “flesh-eating” bacteria, Ebola, Marburg, Eastern Equine Encephalitis, West Nile Virus, et cetera. I really can go on for a while with this list. Almost all of these diseases are beyond your control, and you stand the proverbial snowball’s chance in hell of dying from these things. So, unless you have an academic interest in flesh-eating bacteria (a goofy name anyway, but that’s a subject for another day), quit worrying about it. If you see a story that’s going to work you up about one case of someone who just died in their prime from West Nile, just stop reading or watching—um, don’t go near the dead birds, however.

About cancer: so, what’s the biggest cancer killer? “Breast cancer” is not the right answer. Again, it’s something that we could dramatically decrease if we just stopped smoking: about 165,000 people die every year from lung cancer. Colon cancer, which also may be linked to smoking though it’s less clear, is second at about 55,000. Breast cancer is third at about 40,000, followed by cancers of the pancreas and prostate, both of which claim about 30,000 lives per year. (I hope I’m not sounding anti-breast cancer awareness, I’m just trying to point out how the media can easily warp our sense of the relative risks of various diseases.)

One caveat: diabetes is probably markedly under-represented in these statistics. I’m not an epi-stats guru but the official total of deaths caused by diabetes (75,000) seems a huge undercount. Keep in mind that when someone dies of a heart attack, they might have had diabetes as an underlying cause; so too for strokes, and even a few car accidents might have been caused by people with super-low blood sugars caused by overshooting on the insulin, or super-high sugars causing ketoacidosis. Another major disease that’s fairly easily avoidable!

One last thought: I’m always amazed at the flu. I hear people say all the time, “yeah, I had the flu” in a sort of casual, I-just-toughed-it-out manner. Sometimes, of course, people knowingly use the word “flu” without really meaning “infection with the influenza virus,” but rather they mean something like they had a nondescript viral infection. But respect this virus, please! It is a killer: along with pneumonia it comes in at #8 on the mortality list (63,000 victims). And once again, you can do something about it. Get that flu shot! 2008-9 has been pretty mild (so far) but last year was scary.

All the data above unless otherwise noted is from 2005. For the geeks who want to peruse all the 2005 mortality data, here is the link: http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_10.pdf. Happy reading!