Lifestyles and Deathstyles: Why We Hurry Death Along

Life will eventually kill all of us. That’s Life. That’s biology. But sometimes we hurry things along and accelerate the process. There is also psychology: Personal choices. There is also sociology: Cultural norms. We may be, by our personal choices and by our cultural norms, complicit in our deaths.

How, when, and where we will die is unknown, but they are often knowable, or at least we can guess. Our lifestyles inform our deathstyles.

Our habits of eating, drinking, smoking, driving, drug-using, sex, sports, and our occupational choices, including the military, can be high risk and hazardous to our health. They can, and do, kill us.

To clarify the health impact of our lifestyles, we need epidemiology of mortality rates based on the social causes of death, rather than the medical causes. At present, the national mortality data present only three social causes: suicide, homicide, and accidents; but some accidents are caused by natural disasters, rather than lifestyle, difficult calculus would be required to separate the issues. Furthermore, natural disaster and human error are sometimes mingled. The high death tolls of the earthquake in Haiti in 2010 and the hurricane in 2016 were partly due to faulty construction; as were the almost 100 deaths from the collapse of the building in Surfside, Florida, in July 2021. These were accidental deaths, but also the result of human error. Disentangling error and natural disaster (subsidence) would be difficult.

Currently, national mortality statistics are based, effectively, on the diseases and illnesses of the various parts of the body that cause death: heart (attacks), brain (strokes), lungs (cancer, COPD), breast (cancer), prostate, liver, throat, and so on. All very instructive.

It would also be instructive, and perhaps more helpful, if we had a classification of mortality, not by our body parts but by our choices and lifestyles. The three listed social causes can be supplemented by others, including workplace fatalities. Other causes, both behaviors and substances would include drinking (alcohol), eating (food), smoking (cigarettes, etc.), drugs (opioids), high-risk sports, high-risk sex, cars are lethal (drivers, really), lack of exercise. In principle, therefore, we have a start. It remains to fill in the blanks with numbers, noting that many social factors overlap.

Accidents 173,040
The third leading cause of death. This includes natural disasters and must be analysed further; also 26,000 traffic, 39,000 falls, and 66,000 poisonings. (2018 data from the NVSR) (CDC 2019). (1)

Alcohol-Drinking 95,000
About 3 million deaths occur globally due to alcohol consumption, which is about 5.3 percent of all deaths, according to the World Health Organization (WHO). Furthermore, it is a causal factor in over 200 diseases and injuries and accounts for 5.1 percent of the total costs of treating these same diseases and injuries. In the age group of 20-39, about 13.5 percent of all deaths are attributable to alcohol (WHO, 2018).

In the US, 95,000 deaths occur from alcohol use and abuse every year, 251 every day, over 70 percent to men (Centers for Disease Control (CDC):2021a).

Drugs 70,630
More than 70,000 Americans died of drug overdoses in 2019, and over 840,000 have died of overdoses since 1999. (CDC 2021b). These deaths are expected to increase dramatically in 2020 and 2021, due to the dual impacts of the pandemic and fentanyl.

Exercise NA
Lack of exercise is associated with obesity and a host of problems. But data on the proportion of Americans who do the suggested 120 minutes of exercise per week is lacking, as it is globally. Given obesity rates, presumably not many do so.(2)

Food-Overeating 112,000
Obesity is a global problem, “globesity” co-exists with malnutrition. About 39 percent of adults are overweight and 13 percent obese, and obesity levels have tripled from 1975-2016, according to the WHO. Like anorexia, it is a huge health hazard for diabetes, heart attacks, strokes, and some cancers. In the US, the number of deaths in which obesity was complicit is estimated at between 54,000 and 170,000. About 42 percent of adults had obesity in 2017-2018, up from 30.5 percent in 2000, according to the CDC (2021c), costing about $147 billion in 2018.

Homicide 19,141
Down slightly since 2018, but at 5.8/00,000, this is a far higher rate than every other wealthy nation. 75 percent by firearms. About two-thirds are men. (CDC, 2019).

Globally homicides accounted for 464,000 deaths in 2017, with an average rate of 6.1/00,000. 90 percent were committed by males who constituted 81 percent of the victims. More than half involved firearms. This contrasts with one million victims of armed conflict from 2000 to 2017, and the same number of victims due to organized crime over the same period. A special section on women and girls (19 percent) of the total, found that 42 percent were murdered by someone outside the family, 34 percent by an intimate partner, and 24 percent by another family member. (UNODC 2019). What was surprising, if not horrifying, is that the 81 percent of male victims received no such attention or interest.

A different study offers some discrepant data but a broader context. The authors estimate the number of homicides as 405,000 (excluding wars and armed conflicts) three times the number of deaths from armed conflicts and terrorism combined (2.6 by my calculation using their data), with rates less than 1 percent in some countries and 10 percent in others. It is the third-largest cause of death in Venezuela, fourth in Honduras, and fifth in Guatemala. They also put deaths in perspective: the leading cause is cardiovascular disease: 18 million, followed by cancer: 10 million. Far down are HIV-AIDS: 955,000; alcohol: 185,000; drugs: 167,000; conflict: 130,000; natural disasters: 9,600; terrorism: 26,000. (Roser and Ritchie, 2019).

Alcoholism Essential Reads

Does Alcohol Really Make Us Happier?

The Truth About the Health Benefits of Alcohol

Sex 14,708
In the US in 2019, 1.2 million people had HIV, but 13 percent do not know it, with 34,800 new infections in 2019, down 8 percent since 2015. Some 15, 815 people died of this in 2019, and 69 percent of these new infections were from men having sex with men, 7 percent were among heterosexual men, 16 percent among heterosexual women, and 7 percent from drug injectors with contaminated needles (HIV.gov). The total above is less the 1,107 who died from injecting.

Sex may be life-giving and fun, but it is also potentially dangerous. Many sexually transmitted diseases have increased in frequency recently, rather than declining with better education and health care. The CDC reports that in 2018, 1.8 million chlamydia cases were reported, up 19 percent since 2004; 583,405 gonorrhea cases up 63 percent over the same period; 35.063 primary and secondary syphilis cases (most infectious) up 71 percent; and 1,306 congenital syphilis cases up 185 percent. Sadly, the number of newborn deaths from syphilis increased 22 percent from 77 to 94 in the one year from 2017-8. (CDC 25 Jan. 2021d). A later CDC report states that one in five Americans have an STI, which is 68 million people, including 26 million new infections in 2018, with half of these among youths ages 15 to 24. The cost in direct medical care amounts to nearly $16 billion (CDC 17 June 2021e).

A report on HIV-AIDS states that in 2020 37.6 million people globally are living with the disease, with 1.5 million new infections in 2020, but this is 30 percent down from 2010. 690,000 people died from AIDS and related illnesses worldwide, again down from 1.2 million in 2010.

Smoking 480,000
Globally tobacco kills more than 8 million people every year, 7 million directly and 1.2 million due to exposure to second-hand smoke. It is “one of the biggest public health threats the world has ever seen” killing far more than homicide and suicide combined (WHO: 2020). In the US, tobacco use causes over 480,000 deaths every year, including about 41,000 from second-hand smoke. They account for one in five deaths overall, and about 58 percent of the deaths are male. The life expectancy for smokers is about 10 years less than for non-smokers (from the 2014 Surgeon General’s Report). The 2020 Fast Facts section of this CDC report states that the health costs and the lost productivity costs amount to about $300 billion p.a. and that the Tobacco industry spends about $8.2 billion p.a. on advertising, promotion and, some might say, death and profit (CDC, 2020).

Sports NA
Totals are available for specific sports, from Association football, baseball, boxing, canoeing, cricket to wingsuiting. Mountaineering has 189 pages of biographies and deaths. Everest has claimed 41 lives. Formula1 Racing 43, including training and practice runs. Billiards, golf, and tennis have none. Base-jumping and high-lining were not included. Mostly male.

Suicide 47,511
Globally, over 700,000 people complete suicide every year, accounting for 1 in 100 deaths and it is the 4th leading cause of death among 15-19 year-olds. About two-thirds are men. (WHO 2021). In the US it is the 10th leading cause of death, about two-thirds male, with a rate of 14.5 /00,000, and increasing (CDC 2021).

War 6,713
US military casualties include 2,216 in Afghanistan and 4,497 in Iraq, though estimates vary slightly, most in combat but some in accidents or by suicide or illness, virtually all men. This does not include other US military actions as in the First Gulf War, Panama, Grenada, and elsewhere. Nor does it include the psychic injuries of PTSD leading to suicide.

Work 5,333
The highest numbers were among drivers and in construction. The highest rates were in fishing and hunting, followed by loggers, pilots, and roofers. One death every 99 minutes, mostly male, and 90 percent to 95 percent men (US Bureau of Labor Statistics, 2020). These numbers only include the immediate causes of death. They do not include the long-term consequences of mining: black lung (coal), asbestosis, mesothelioma, and others. Both work fatalities and sports deaths are included in the accidents.

Conclusion

We need to develop habits and lifestyles that nurture us, not kill us. This is difficult in our somewhat homicidal and suicidal cultures, so oriented around food, alcohol, drugs, passivity, cars, guns, high-risk activities, sex, work, smoking (down from the past but still high).

Now in 2020-2021, anti-vaxxers and anti-maskers, some violent, contribute to their own and other people’s illnesses and deaths with the third wave Delta surge. There have been about 35 million cases, between 610 and 628,000 deaths, with only 48-9 percent of the total population fully vaccinated, and 59 percent of adults: partly a personal matter but mostly cultural and political. In Canada, 56 percent of the population have been fully vaccinated and 64 percent of the total. Almost 27,000 have died and the vast majority of the deaths today are among the unvaccinated.

It is sad to read about all these deaths, but also enlightening. They provide a checklist of factors to consider. Hopefully, this classification of mortality by social causes may help to clarify how our lifestyles determine our deathstyles, and how we may improve our lifestyles.

Finally, men die on average about five years earlier than women, a gap that has widened with the pandemic since the virus kills more men than women (for reasons that are not clear). Men’s death rates by all these risk factors are higher than women’s, sometimes far higher, except possibly for anorexia and obesity. This life gap requires more attention and more resources. (3)