Mixed News on How You'll Die

The final numbers for deaths in the U.S. have been tallied for 2004, and while the increase in life expectancy to a record 77.8 years was the headline in many news stories, not all the trends behind that single figure are positive. The report contains worrisome news too.

First, the good news, according to the National Center for Health Statistics:

Age-adjusted death rates decreased significantly from 2003 to 2004 for 9 of the 15 leading causes of death. Long-term decreasing trends for heart disease, cancer, and stroke (the three leading causes of death) continued.

But ...

Significant increases occurred for unintentional injuries, hypertension, and Alzheimer’s disease.

The data is based on almost 2.4 million deaths in 2004.

More good news: if you've made it to middle age, you've got a lot more years ahead of you. If you're 40-45, you can expect to live another 40 years; if you're 45-50, another 35; 50-55, 31 more; and 55-60, almost 27 more years.

Odds of Dying

For the entire population, the death rate of 801 deaths per 100,000 population was a 3% drop from the prior year.

Overall, the risk of death in middle age remains small. For every 100,000 people in an age group, the next table shows how many die in a year. You can see that the risk increases with each five year grouping, but is still relatively low. By comparison, out of 100,000 75-79 year olds, almost 4,200 die every year:

Adults from 35-85 have see decade after decade of improvement in these figures, second only to the improvement seen by infants and children. Two groups have seen little change in death rates over time: the very old (who may have multiple problems), and young adults (who don't die from medical problems, but accidents, homicide, and suicide).

Causes of Death

The fifteen leading causes of death account for 83% of the total, and 9 of the 15 showed significant improvements in 2004. Both heart disease (the leading cause of death) and cerebrovascular disease (stroke and related, the #3 killer) were off more than 6% from the prior year. Cancers (#2) dropped 2%.

But the report also highlights the rapid increase in mortality due to Alzheimer's disease. It's now the #7 cause of death, responsible for 66,000 deaths in 2004. 112,000 people died from unintentional accidents -- part of an upward trend that started in 1992. The reasons are unknown. Hypertension, the #13 cause of death, also killed more people in 2004 than 2003.

Over the last fifteen years, Alzheimer's, Parkinson's, and hypertension have trended significantly upward, with most other causes of death relatively stable or declining.

It's important to keep perspective: heart disease kills ten times as many people as Alzheimer's (652k vs 66k). Heart disease and cancer together killed about half of all the people who died in 2004; other causes of death aren't nearly as significant.

What kills the middle aged? For simplicity's sake, we'll look at 45-54 year olds -- out of 100,000, 427 died, split this way:

* "all other" includes chronic lower respiratory disease, Alzheimer's, flu, nephritis and similar, septicemia, hypertension, Parkinson's, homicide, and many others.

Middle age is when cancer and heart disease begin to take their toll. While they kill about 1/3 of 35-44 year olds, they kill half of 45-54 year olds, and nearly 60% of 55-64 year olds.

While the death rates from the two have dropped about 5% in five years for 45-54 year olds (and more dramatically for 55-64 year olds), middle age is the time to become paranoid about signs of those diseases, and to initiate behaviors than can prevent their onset.

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The report, "Deaths: Final Data for 2004," is available as a pdf here.