The facts of death - statistics, demographics

American Demographics, April, 1997 by Brad Edmondson

Death has a contract on everyone, but 20th-century Americans have renegotiated the deal. A baby girl born in the US. in 1900 could expect to live years in 2000, she will expect to live almost 80 years. Thanks to advances in medicine, sanitation, and basic nutrition, the annual age-adjusted death rate per 100,000 Americans will decline from 2,296 in 1900 to a projected 731 in 2000. If this decline had never occurred, half of Americans alive in 2000 would never have been born.

Still, no one gets out of the contract. Sooner or later, every American's life and death is summarized on a state certificate like the one reproduced here. And as our souls float toward the afterworld, our numbers go to the National Center for Health Statistics (NCHS). From the NCHS and other sources, here is what the average Americans death looked like at the end of the 20th century.

1-2. NAME AND SEX

Jane American Decedent is the average dead American. Her husband Joe, who died six years and six months before her, was almost as average. There were 2,2378,994 deaths in the U. S. in 1994, and 51 percent of the dead were men. For most of this century, 51 percent of babies born in the U.S. have been boys. But boys are more likely than girls to have accidents, work in dangerous jobs, and smoke cigarettes. They may also have shorter-lived genes than girls do. Whatever the reason, the median age at death in 1992 was about 73.2 years for men and about 79.7 years for women, for a national average of about 76.4. At age 75 to 84 about 51 percent of deaths are to women. After that, the gender gap widens fast. More than two-thirds of Americans who die at age 85 or older are women.

Because of the age difference, women are more likely than men to die of the lingering conditions that afflict the old. Heart disease is the leading cause of death in the US. for both sexes, followed by cancer. Together, these two causes account for 85 percent of deaths. The third most common cause of death for men is accidents for women, it is cerebrovascular diseases (strokes). Human Immunodeficiency Virus infection (which causes AIDS) is seventh for men, suicide is eighth, and homicide is tenth, but none of these causes shows up on the topten list for women. Instead, women are more likely to face nephritis (kidney failure), septicemia (blood poisoning), and Alzheimer's disease.

These differences largely disappear with age, however. Among men and women aged 65 and older, the topten list is almost identical. As a result, increases in life expectancy for men will mean that fewer Americans will die suddenly, and that more will die in ways that consume a lot of healthcare services.

3A. DATE OF DEATH

Winter is deaths favorite season. In 1995, January had many more deaths than any other month (220,000). It was followed by March, April, and December. (February would have been second if it had had 31 days instead of 28). The month with the least deaths was September (178,000), followed by June, August, and May. The top day for death in 1992, the most recent year for which daily data are available, was January 3, when 7,422 Americans died. That is about 25 percent more than an average day in 1992. Death's slowest day was July 22, with just 5,347 deaths. That's about 10 percent below average.

There is less variation in deaths weekly schedule. The most likely day to die in 1992 was either Wednesday, Thursday, or Saturday, but the day with the least deaths -- Sunday -- was less than 2 percent below the daily average.

4A. PLACE OF DEATH

Seventy-seven percent of U.S. deaths in 1992 took place in some kind of health-care facility. These include the 48 percent of U.S. residents who died as hospital inpatients, 9 percent who died in emergency rooms, 3 percent who were pronounced dead on arrival at a hospital, and 17 percent who expired in a nursing home. Just 20 percent of U.S. residents died in a private home, and percent died in other places.

If your time comes prematurely, you're much more likely than average to die in a hospital. Ninety-one percent of infant deaths (under 1 year of age) were in hospitals in 1992. The proportion of hospital deaths was below average for only two age groups. Young people aged 15 to 24 are much more likely than the average American to die at the scene of a suicide, homicide, or motor-vehicle accident. Just 45 percent of deaths to those aged 85 and older took place in a hospital. But these very old were less likely than average to die at home, too, because 39 percent died in a nursing home.

Women are less likely than men to die in a hospital and more likely to depart from a nursing home. Only 56 percent of women died in hospitals in 1992, compared with percent of men. Yet 23 percent of all deaths for women were in nursing homes, compared with just 12 percent for men. This is because men are more likely to die elsewhere, such as at home or at the scene of an accident.

Most Americans say that they would prefer to die at home than in a hospital. A lingering death in a nursing home is one of the biggest fears of the elderly. But the alternative to death in a medical setting would usually be a shorter life. In 1900, only a small fraction of Americans died in hospitals, and infectious diseases like influenza were among the leading killers. For every person who dies in a modern hospital or nursing home, there are several healthy people who would have died without one.