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David H. Roberson's avatar

Interesting article. Thank you. One of my big takeaways is that as an American over 45, there’s not much chance I’ll be murdered. I like that.

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Paul von Zielbauer's avatar

David, it certainly helps to be an optimist....

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Rachel Riggs's avatar

Yikes, I think I'll console myself with some dark chocolate (epicatechin for the win!).

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Paul von Zielbauer's avatar

Utterly reasonable.

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Paul Cobbin's avatar

Paul, as an Australian who has decoded prostate cancer and now decoding severe heart disease at 58, I can raise my hand as a living testimony to those statistics even though I said 'living'. I'll also say I'm aging with strength because I'm decoding my diagnoses by aligning mind, body and soul transitioning to meaningful old age as my focus, rather than modern day survival.

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Paul von Zielbauer's avatar

Paul, thanks for your note. Sounds like you've been through a lot. Keep decoding, and aging with strength.

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Paul Cobbin's avatar

Thanks Paul, I'll never stop until I become an 'all cause mortality' statistic or die of old age. If I have anything to do with it it'll be the later.

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Melissa Capers's avatar

I may be misreading your charts, but American and European death from dementia rates look identical to me (where comparable), at 4.9% for those 65+. I did not assume the US chart was 65-85; and there's not a European chart for 85+.

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Paul von Zielbauer's avatar

Melissa, Thanks for drawing attention to this. The chart for United States mortality shows Alzheimer's disease specifically, whereas the European chart shows dementia, Which is a broader category that comprises Alzheimer's, Parkinson's and other neurodegenerative diseases. So the two are not exactly comparable but you are certainly correct that the 4.9% in each of those categories for each of those charts is the same. Also confounding a direct comparison are the mismatched age groups between the United States and Europe, as you alluded to. When I first read your note I assumed I had made a mistake in my analysis that you were correcting. I didn't immediately find an error, but please let me know if I'm missing it. Thanks so much for your close read of the data.

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Melissa Capers's avatar

Hi Paul -- I was responding to this statement: "Europe lacks the dramatic Alzheimer's emergence — Only 4.9% for people 65 years or older vs 7.9% for Americans 85 years and older, either reflecting different diagnostic practices, reporting methods or actual disease patterns"

I now understand that the European category is larger, so presumably the rate of Alzheimer's after 65 is lower... But it also seems to me there is no evidence to assure that Europe's 85+ rates aren't equivalent to (or higher than) in the US. Comparing 65+ data (Europe) to 85+ data (US) seems to me to be a bit of a (albeit necessary) stretch that may not deserve the "dramatic" descriptor. At least, not until there's more comparable data.

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RANDY O’TOOLE's avatar

More than 50% of the US 25-44 cohort is due to “unintentional injuries” and “other”? That’s pretty vague attribution…

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Paul von Zielbauer's avatar

Randy, thanks for calling that out. "Unintentional injuries" typically comprise car accidents (car crashes, motorcycle accidents, pedestrian fatalities, etc.), which are very typically the largest component of this category. So if younger people (25-44) die, it stands to reason that causes of death are more likely to be non-chronic, non-communicable, non-health related and more environmental or accidental in nature.

That said, "Unintentional injuries" also includes falls — particularly significant in older adults cohorts, but also includes falls from heights, down stairs, etc.; poisoning, including drug overdoses (both prescription and illicit drugs), carbon monoxide poisoning, and other toxic exposures; drowning; fires and burns; suffocation and choking; and other accidents like workplace injuries, sports-related deaths, firearm accidents, etc. So, certainly, drug-related deaths for the younger cohort would contribute to the outsized amount of "unintentional injuries," as well.

The "Other" category, which is indeed large, would likely encompass hundreds of different causes of death that individually don't rank in the top 10, such as infectious diseases, rare cancers, congenital conditions, complications from medical procedures, other types of accidents and injuries and numerous other medical conditions that cause death.

Thanks to you, I included a footnote about those, because they are so prevalent and not well explained in the charts. Thanks again for calling this out.

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Charles R. Lightner's avatar

Thanks very much for this. I appreciate the insight that calling attention to risks can lead to risk reduction behavior. It most often does not, but when it does it’s a really big deal in the lives of those who change behaviors.

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Paul von Zielbauer's avatar

Charles, I appreciate your note. Thank you for reading. I'm glad you found this enlightning and/or helpful. I'm curious, why do you say calling attention to risks most often doesn't change behavior? I'm not challenging your assertion, just genuinely curious about what the science or the facts say. I would think that ideas or facts that capture one's attention somehow begin to influence one's behavior. But perhaps the trick is that one's attention has to be captured, which isn't easy.

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Charles R. Lightner's avatar

Hi Paul - I think it is the minority of people who actually change behavior based on information. In my experience it usually takes more than that for damaging behavior to be overcome. Especially if the damage is not yet causing problems. I can speak both from personal experience and form observing others. I have persisted in damaging behavior long after I knew it was damaging. But I was a lot younger then😀

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Paul von Zielbauer's avatar

I suppose it's true that most humans are more likely to continue unhealthy behaviors — whether due to habit, self-comfort of social approval seeking — until they begin to cause obvious problems. But I still believe that when people let an idea sit in their minds (e.g., the 5 things that are statistically most likely to kill them), it serves as a spark that can ignite a future conversation or extra attention to a related item in the news, and eventually leverage a behavioral change.

Or, none of that and I'm just a naive journalist.

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Charles R. Lightner's avatar

Sorry, Paul. I didn’t mean to suggest that there’s no point in writing about the risks. Of course there is and I think your article does a great service to your readers, myself included. Thanks very much for writing!

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Paul von Zielbauer's avatar

Charles, no apologies needed, please. I completely understand and agree with you. Just philosophizing into the weeds, as is my habit. And, also, see? We've started a conversation on the internet about thinking about how to leave this world on our own terms. It's working!

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