Deaths Are Not Alike
We fret over the uncommon and ignore the ordinary.
Most of us expect to die peacefully of old age. It doesn’t always happen that way, though. We die in many ways. In fact, the CDC keeps records on over 6,000 causes of death. Of those, just 20 causes—including heart diseases, strokes, cancers, COPD, Alzheimer’s, Parkinson’s, and diabetes—account for 1.4 million deaths per year in the U.S., about half of all deaths.
Some causes of death are exceedingly rare. Between 1999 and 2019, 720 causes of death occurred only once (once in 20 years), 374 occurred twice (once in 10 years), and 179 occurred four times (once in 5 years).
People don’t think much about the most common causes of death. Acute and chronic diseases account for over 90% of all deaths but they aren’t newsworthy. Newsworthy causes of death, like mass shootings and terrorist attacks, captivate the media and horrify the Nation. They are sudden, unexpected, uncommon, and emotionally gripping. Terrorism accounts for over 30% of the news coverage concerning deaths yet is responsible for less than 1% of actual deaths. All the celebrity deaths, wars, overdose deaths, and gun murders in a year don’t equal one month of heart attack deaths.
Causes of human deaths can be categorized into five groups based on the producer and the receiver of death:
- Earth-to-Human Causes: volcanoes, earthquakes, landslides, avalanches, sinkholes, liquefaction, geysers, toxic minerals, famines, droughts, floods, weather, wildfires, and environmental contaminants.
- Nonhuman-to-Human Causes: acute and chronic diseases, and epidemics.
- Human-Creation-to-Human Causes: assaults, airplane crashes, building and bridge collapses, home accidents, industrial accidents, ship wrecks, train wrecks, and vehicle accidents.
- Human-to-Human Causes: assaults, drug overdoses, medical malpractice, war, and terrorism.
- Human-to-Self Causes: drug overdoses, accidents, and suicides.
Earth-to-Human deaths occur when someone succumbs because of a geologic hazard. These events are usually covered in the news, especially if deaths are involved. They are not preventable but some may be predictable.
Nonhuman-to-Human deaths occur when forms of life other than our own—wild animals, toxic microorganisms, extraterrestrials—cause the death of a human. These events are not usually covered in the news, even if deaths are involved. Some may be preventable but are usually not predictable.
Human-Creation-to-Human deaths occur when machines and structures that humans either fail or operate in a way that causes a human death. Some of these events, like airplane crashes, collapses, and wrecks, are often covered in the news, even if deaths are involved. Home and vehicle accidents are rarely covered even if there are fatalities. These events are neither preventable nor predictable, but there are a substantial number of government regulations aimed at minimizing their occurrence and impact.
Human-to-Human deaths occur when one or more humans take the lives of other humans. Only some of these events are covered in the news. Assaults involving sensitive individuals like the young, the elderly, and the handicapped are often covered. Terrorism is always covered. War and medical malpractice are usually covered up. Most of these events are usually neither predictable nor preventable.
Human-to-Self deaths occur when individuals, either intentionally or unintentionally, cause their own deaths. These deaths are needless, highly regrettable, and almost impossible to prevent. They rarely make the news. Society does not devote enough resources to combating human-to-self deaths.
The primary causes of death are also different for people having different genetic profiles, ages, sexes, races, global locations, local environments, general health conditions, sequela effects, and many other influencers.
So, what causes of death should capture our attention and our societal funding. Here are twenty-two notable causes of death, characterized by radar plots. The spokes of the radar plots show six attributes:
The color of the radar icons refers to five categories of causes. Accidents are depicted in gray. Health-related causes are depicted in blue. Infrastructure-related causes are depicted in yellow. Natural causes are depicted in green. Weapon-related causes are depicted in red.
Floods and volcanoes affect many people over a large area, usually with some warning and relatively-short durations of days. However, they often recur over weeks and months because the conditions that caused them persist. Flood deaths are mostly attributable to drowning though there are also deaths from injuries. Volcano-related deaths are usually caused by heat, asphyxiation, and injury from falling ash and other debris. Both floods and volcanoes cause additional deaths by inducing mudflows, landslides, avalanches, and other mass earth movements.
Droughts affect many people over a large area, usually with ample warning. Droughts can be relatively mild, even barely noticeable, to very severe involving crop failures. They often last for years. They can spawn secondary effects, like wildfires and famines. These events often recur in some areas because of the interaction of topography and atmospheric circulation.
Earthquakes, landslides, and sinkholes, like most geologic hazards, affect many people over a large area. There is usually little warning beforehand. They also often recur over weeks and months because the conditions that caused them persist. Deaths most often result from injuries caused by structure collapses, falling debris, unanticipated subsidence, and fires.
Hurricanes, tornadoes, cyclones, microbursts, lightning, heat waves, cold snaps and other weather phenomena are common and affect many people over a large area. There is usually at least some warning beforehand because of the effectiveness of meteorological monitoring and modeling. Their impacts, however, are not always foreseeable. A rainstorm with uncharacteristically high winds can cause major damage. Most weather-related deaths are caused by temperature extremes, injuries from windblown debris, and drowning in floods.
Famines and wildfires usually affect many people over a large area, often with some warning. These events usually last for weeks if not longer and recovery requires considerable effort to mitigate. They are often caused by droughts and may recur and expand if the conditions that caused them are not alleviated.
Deaths from large ship wrecks are rare, and as a consequence, are especially newsworthy. Most wrecks are small private or commercial boats and do not involve fatalities. These happen every day and there are enough of them to keep the Coast Guard quite busy. The big cruise lines don’t often get into so much trouble that they can’t be rescued, though it does happen with great loss of life. Most large ship wrecks occur outside of U.S. waters.
Airplane crashes happen every day all over the world. Most involve small planes and don’t raise national attention unless some noteworthy individual is killed. But, no crash of a big commercial airliner escapes the news. They combine many of the fears people have about death—unexpectedness yet enough time to panic, no possibility of rescue, low possibility of survival, and death by falling and impact, explosion, or fire and suffocation. Air travel is common, so it is a risk most people face at one time or another.
Accidents happen to individuals everywhere, usually with little warning. They are over quickly and usually don’t lead to additional deaths although they may recur if the condition that caused the accident is not remedied. Vehicle accidents are almost too numerous to count though most are nonfatal. Likewise with home accidents. Industrial accidents, in which an individual worker is killed, occur in workplaces where hazardous machinery or substances are used. In contrast, industrial disasters involve the deaths of many workers and even people in neighboring communities. The Bhopal disaster caused the deaths of at least 3,700 and affected half a million local residents.
Drug overdoses happen to individuals every day and everywhere, usually with little warning. They are over quickly and usually don’t lead to additional deaths unless a particular batch of drugs is contaminated or dangerously formulated. Most overdoses are not fatal but can lead to more serious health challenges and sequela effects.
Epidemics affect many people over a large area, often with some warning. They are often not reported in the news outside of the affected area. In contrast, pandemics affect people around the world. Epidemics usually last for months and sometimes years. The AIDS epidemic, for instance, has continued for decades.
Chronic diseases kill more people than any other cause of death. Heart diseases, strokes, and cancers are the most deadly chronic diseases. Like epidemics, they affect individuals every day and everywhere. By definition they last for a prolonged period, often years. They are not reported in the news except as summary statistics.
Acute diseases and medical malpractice happen to individuals almost anywhere with little warning. They are over quickly and usually don’t lead to additional deaths if the condition that caused the event is remedied. Medical malpractice is not always exposed and is difficult to prove. Some researchers estimate that there are over half a million instances a year.
Suicides are a tragic cause of death everywhere in the world. Often there is some warning in the behavior of the victim but it is difficult to recognize and address successfully, even by experts. Most suicides involve firearms because of their availability and absolute effectiveness.
All methods of suicide except poisoning have uncreased with the increase in the U.S. population.
Assaults occur everywhere to anyone. They are usually sudden and unexpected. Most are non-fatal. Firearms are the predominant agent used in personal assaults. Most causes of death attributable to assaults have not increased as fast as the growth in the U.S. population with two exceptions—firearms and drugs. All the laws, policing, and imprisonment have not slowed these causes of assault deaths.
Everyone the world over fears terrorism even though it is a relatively rare cause of death. It can occur anywhere to anyone. A terrorist attack may take a single life or thousands. Terrorism always makes the news except when it is prevented. That’s the goal of terrorism, creating fear.
Rail accidents have occurred since the 1700s, all over the world, from a variety of causes. The U.S. averages about one major rail accident involving deaths per year. They typically occur without warning and can affect travel and commercial transportation for months. While uncommon, train wrecks can be catastrophic given the hazardous cargos that are often carried by rail.
Structural collapses have occurred since ancient times. Building collapses are relatively common but still often make the news especially when deaths are involved. Bridge collapses are rare but highly newsworthy even if deaths are not involved because of their impact on transportation. Bridge replacement can take years between planning, funding, and construction. Inspection programs limit fatalities from bridge collapses related to normal wear-and-tear, but sudden collapses from design flaws or unexpected events still occur.
Causes of death not only display different profiles of characteristics but also different relative numbers of instances and deaths.
The following graph contains ten pieces of information for twenty-two causes of death. The graph contains radar icons that show information on each cause of death. The positions of the icons represent the relative frequency and lethality of deaths from each cause. The horizontal axis shows the number of fatalities of a cause in a year. The vertical axis shows the relative number of instances from a cause in a year.
Deaths from a cause may change greatly from instance to instance and year to year. For example, the data provide information from before 2020, so the effects of Covid-19 are not represented. Still, the graph shows relationships between causes of death that are not often considered.
Data for nine of the causes reflect world events—airplane crashes, bridge collapses, shipwrecks, terrorism, epidemics (before Covid-19), droughts, famines, earthquakes, and volcanos. While catastrophic, they are infrequent in the U.S.. These icons are associated with small green circles. Data for the remaining thirteen causes reflect typical annual occurrences in the U.S.. These icons are associated with red, white, and blue squares.
Think of the locations of the causes on the graph as representing their commonness (horizontal axis) and their lethality (vertical axis). Deaths from diseases, injuries, and suicides are most common but usually only involve one person, though the sum of those single deaths is huge. These causes can be treated to postpone death but, in most instances, there is no cure. In contrast, famines have the potential to be horribly lethal because they involve everybody within an affected area, which is often regional. Famines can be avoided, however, if suitable action is taken. Epidemics are the worst combination of lethality and prevalence. They occur frequently, from all types of biological agents, all over the world. They can spread widely and rapidly, even becoming pandemics (like Covid-19), and are often difficult to treat.
In this graph, the horizontal axis characterizes the nature of the cause. Causes on the left side of the graph tend to be unexpected, sudden events that are over quickly, like accidents and overdoses. Causes on the right side of the graph tend to evolve and linger for some time, like epidemics and famines.
The vertical axis characterizes the exposure of potential victims. Causes on the bottom of the graph tend to affect a limited number of victims over a small area, like suicides and assaults. Causes on the top of the graph tend to affect many victims over a large area, like earthquakes and droughts.
In this depiction, causes in the lower left quadrant of the graph—diseases, accidents, suicides, overdoses, and assaults—are difficult to predict but can be minimized with preventative measures. Causes in the upper right quadrant of the graph—hurricanes, tornadoes, droughts, wildfires, famines, earthquakes, and epidemics—can be forecast to some extent and, while not preventable, can be responded to so to minimize fatalities.
We spend a considerable amount of money and resources on trying to control causes of death. We regulate transportation (planes, trains, and automobiles), drugs, consumer products, and workplace safety. We license professionals in critical positions, like doctors, lawyers, engineers, and hairdressers. We try to prevent crime and terrorism, floods, and wildfires. We monitor Earth hazards (volcanoes, earthquakes, avalanches), weather, the climate, and the safety of our infrastructure. And, we respond to physical and mental health challenges, and food insecurity.
So what causes of death should capture our attention and our societal resources?
- The most preventable? Those would be wildfires, medical malpractice, and power outages.
- The most widespread? Those would be: earthquakes, hurricanes, droughts, floods, heat waves, climate change, and famines.
- The most unexpected? Those would be: airplane crashes, shipwrecks, train wrecks, bridge collapses, industrial catastrophes, earthquakes, landslides, sinkholes, and volcanos.
- The most vulnerable victims? Those would be: drug overdoses and suicides, assaults, mass murders, people killed by police, terrorism, and war.
We worry greatly about social causes of death—accidents, assaults, suicides, and war—but nature is by far the greater agent of human deaths by disease and Earth processes.
And what should we do address the many causes of human death?
- Conduct more research into medical topics including acute, and especially, chronic diseases and epidemics.
- Improve the quality and availability of healthcare, including more support for potential suicides and better control of medical malpractice.
- Improve infrastructure, including roads, bridges, tunnels, rails, waterways, mines, and industrial facilitates, that may fail and cause a calamity. The reduction in the number of deaths would be small but these deaths tend to be horrific.
- Conduct more research into meteorological phenomenon including heat waves, droughts, wildfires, hurricanes/tornadoes, floods, and famines.
- Conduct more research into geological hazards including earthquakes, volcanos, landslides, sinkholes, mass extinctions, near-Earth phenomenon, and climate.
- Conduct more research into firearms, which until 2020 was limited by Congress.
It’s not necessary to expand authoritarian control, including more military, law enforcement and incarceration. This strategy has consumed a large percentage of our resources and the benefits are diminishing. More and stronger regulations, especially for consumer products and services, might be worthwhile. But, some approaches, such as those involving drug use and gun ownership, are only marginally effective and divide Americans over what should be done. In these cases, it might be better to focus on correcting the fundamental reasons behind the causes.
In addition to the source links provided in the article, data for this analysis came from over two dozen sources representing government and private organizations, each with their specializations, definitions, and procedures. Consequently, all of the data are approximate and relative. All graphs were created by C. Kufs except as noted.
Your Health Care May Kill You: Medical Errors – PubMed (nih.gov)