The overall death rate in America and other developed countries has dropped one or two percent per year since 1900 until 2013 but has risen since in the last decade. That is sad news.
Interestingly, this news cannot be completely explained by different lifestyles, earlier and better diagnoses, or more efficacious treatment up to 2013. Since then, the three diseases of despair—alcoholism, drug-related deaths, and suicide have reversed the trend. Perhaps, gun violence will be added to the diseases of despair shortly.
For instance, there has been a fifty percent drop in colon cancer deaths since its peak in the 1980s. As encouraging, effective, and necessary as colon cancer screening is, colonoscopy and other early detection tests cannot be the sole explanation for the welcome improvement. There must be other factors involved, according to a paper from
Dartmouth’s Atlas.
Stomach cancer has become much less common. In the 1930s stomach cancer was the number one cause of cancer deaths. Now, stomach cancer deaths have dropped to 1.8% of all cancer deaths. Perhaps diets have changed with less food preserved by salt or smoking or a greater use of antibiotics that kill H. pylori. We don’t really know.
Hip fractures carry a significant one-year mortality for the elderly. Fortunately, the rates of hip fractures have been dropping by 15 to 20 percent per decade for the past three decades. Multiple factors have helped the rate of improvement: Medications to treat osteoporosis, encouraging those at risk to exercise and improve their diet, and new anti-osteoporosis bone-forming medications. But the rate of improvement cannot be solely explained by these positive advances. Obesity is associated with stronger bones. Perhaps our obesity epidemic has some positives—although this is certainly not a reason to overeat.
When we look at dementia, there has been a 20 percent per decade decrease in the chance of having dementia since 1997. Please note that the overall number of older people with dementia has increased, simply because the number of older people is now much larger. A lower incidence with a larger number of people at risk can still result in more people with the condition—which is what is happening.
Heart disease has been declining for more than half a century. Deaths from heart disease have fallen 60% from its peak around the nation fifty years ago due to several factors including reduced smoking, better treatment, and diagnosis. But these good influences are not enough to account for the half-century decrease.
Another significant cause for overall lower death rates is the prevention of death caused by low birth weight infants. Nonetheless, we still have a great opportunity to help everyone live a longer, happier, and healthier life. The journey to better health and a better national healthcare system will be never-ending. Prevention is central to improvement going forward.