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Why we Die (scientificamerican.com)
86 points by Grovara123 on Sept 5, 2012 | hide | past | favorite | 71 comments



'The article starts "A baby born in the U.S. this year is likely to live to blow out 78 birthday candles . . . " That would mean he or she would make it to age 12.'

I like this comment :)


That doesn't account for inflation over time in the value of candles.


Even if you take 78 birthday candles to mean reach the age of 78, then there is still an issue with that statement. Likely to reach the age of 78 implies that the median age is 78, not the average. The median age is likely different than 78 (my guess is lower due to the distribution being skewed left - but that is just a guess)


A left skew would imply that the median is to the right of the mean.


I totally mean skewed right. The big part of the curve is on the left.



Seems to be more of a "How we die" rather than why, but regardless it's a well done visualization.


It was a "well done visual," and does put some things into perspective. For example, the "War on Cancer" began in about 1971. While I'm optimistic about the near-term future in cancer treatment, the chart doesn't reflect much historic clinical success.


I'd encourage a different interpretation of the data: Cancer holding steady actually is an improvement.

Everyone is guaranteed to die of something, and the longer you live the likelihood of that something being cancer greatly increases. So as people shift away from other categories, i.e. heart disease and childbirth, and live longer, they're going to shift towards the cancer category. I'm actually amazed that cancer hasn't gone up significantly.


This is a very good point. Although the data (at this link) are not isolated, using a GUI window as a ruler, you can see a clear decrease, just not a visually compelling one. And yes, I agree that as you reduce the mortality associated with other diseases, getting cancer becomes more likely.

What would be more interesting to see, in this particular context, is the mortality associated with different disease groups for different age cohorts. For example, how has the treatment for cancer progressed for people between 40 and 50, rather than all cohorts at once.


The yellow band is also getting eaten from below by the blue (presumably AIDS deaths?).

US median age grew by about 2 years per decade between 1990-2000 so that also supports thisisnotmyname's point.

Some of the decline may be due to lifestyle changes (e.g. lung cancer has probably peaked in the US) but there has also been dramatic progress in treatment for some cancers (Breast, testicular, Hodkin's).


Agreed.

Also, some of the recent treatment modalities are genuinely revolutionary. For example, Gleevec (subsequently exposed problems aside) is pretty damn amazing. Obviously, new things are becoming possible because of a long-growing body of research. The question is whether we have reached the tipping point. As I said previously, I'm optimistic -- I think we have. That being said, cancer is fucking complex and even if we were at some tipping point, progress is measured in years and decades, not weeks as the breathless popsci articles always seem to imply.


If people were to shift away from heart disease, etc, towards cancer over time, the death rate due to cancer would be going up, not holding steady.

I think you're making a poor assumption that if people move away from heart disease, etc, that they would automatically move towards cancer. If such a move happens, there would have to be an external causation factor for that.

Holding steady would indicate to me that either our efforts to combat cancer haven't improved at all, or our efforts to combat cancer are only keeping pace with the increase in cancer rates due to increased toxins in our daily environment or whatever. This talks about death rates due to cancer, not cancer incident rates, so either of these 2 scenarios are plausible (and I'm sure there are other possibilities I'm not able to imagine).


In most cases, cancer progression results from cumulative genetic damage, which is strongly linked to aging. See, e.g. http://www.nature.com/nature/journal/v448/n7155/full/nature0...


Thank you, I did not know that. That changes the picture quite a bit, though I'd be curious by how much.

This is quite a long article, which I can't afford the time to read right now. Can someone answer the critical question for me, which is: is aging found to be a causative factor in cumulative genetic damage and also cancer, or is it only known to be correlated at this point?


This is an interesting point. It makes you wonder about the general macro considerations around life pro-longing technology. You solve one risk, but then something like cancer either remains or even increases.

Tackling the cancer problem is exciting but also worrisome at the same time. It’s an old problem. Nixon said in 1970 that we’d win the War on Cancer by ’76. People have been working on it for 40 years. So while we’re 40 years closer to a solution, it also seems farther away than ever. Doesn’t the fact that it’s taken so long mean that it’s an incredibly hard problem that won’t be solved soon?

http://blakemasters.tumblr.com/post/24253160557/peter-thiels...

edit: reference


Aging is a defense against cancer. There is a 'cancer probability hump' that tops up around your 60s. After that age, your probability of having cancer actually decreases significantly.


"Cancer" is a fairly wide range of diseases. There are specific diseases that have had significant success. I don't have historical data handy, but I recall reading that Hodgkin's Lymphoma went from something like a 10% survival rate 30 years ago to something like 80-90% today.


Looking at the chart, the only things that have significantly changed are heart disease, birth defects and perinatal conditions of newborns.


Not to mention their definition of "Global" is a little odd/dishonest ("Gloabal = OECD")!


i actually read the title as "How we die" and i was confused reading your comment, and then i saw the title my eyes wide open!!:D


I saw a presentation from an evolutionary biologist who may the point that we die because there is no evolutionary pressure not to die. Once we've birthed and raised out young, we are no longer relevant from an evolutionary perspective. He tested this with fruit flies by separating the young by gender for increasingly longer periods of time effectively delaying breeding so only the longer lived specimens could live to breed. By doing that over many generations, I believe he tripled the life expectancy of his test group.


Would you happen to have a link? I've been interested in toying around with this idea (just for fun) for a while, but I haven't started doing the actual research.

My instinct would be that (biological) immortality is (mostly) non-existant not only because there is no evolutionary pressure not to die, but because there is evolutionary pressure to die after begetting offspring. Very long lived progenitors would homogenize the gene pool, if not by incest then by sheer number of offspring. This would make them fragile in the face of both genetic errors and environmental shifts.

To counter this fragility, child birth might be infrequent. However, if child birth is infrequent, there is an increased probability of death before child birth.


No, that's group selection. If a progenitor could live a very long time and continue to produce offspring, it might be worse for the species, but it would be so much massively better for the individual's genes that those would be passed on.


In The Selfish Gene, Dawkins proposed that grandparents - obviously well beyond child bearing - can affect their gene propagation by caring for their grandchildren, at least indirectly.

What a true scientist; most people are content to think we dote on grandchildren as a civilized people with innate appreciation for new life. Rather, our genes will eradicate those who fail to help their offspring's offspring survive.

http://musingsofscience.wordpress.com/2010/07/21/book-review...


Sounds like an interesting experiment to read about. Do you remember the biologist's name?


If you live longer you can have more offspring. Maybe constraints on your time and resources for raising offspring are really what prevent longevity from being much of an advantage?


> If you live longer you can have more offspring.

I'm pretty sure this is untrue; the likelihood of offspring drops pretty precipitously after certain ages.


>the likelihood of offspring drops pretty precipitously after certain ages.

That's a bit of circular logic though. We can't explain why we age (and thus die) by pointing out that we age (and thus are less able to reproduce).


Right. The relevant metric is how long you remain fertile, not how long you live.


You don't have to go into biology to explain why we die; the physics is sufficient. Everything is subject to entropy.


Closed systems. Entropy is a hard to defend answer.


There are plenty of examples of (admitted, simpler than humans) organisms which are effectively "immortal". The heat death of the universe will get them all, but human mortality is nevertheless a good deal more complicated than just entropy.


Right, so the question is why we die when we die, not why we die at all.


We die because we are born.

"Our birth and death are just one thing. You can't have one without the other .It's a little funny to see how at a death people are so tearful and sad, and at a birth how happy and delighted. It's delusion .I think if you really want to cry. Then it would be better to do so when someone born. Cry at the root, for if there were no birth, there would be no death. Can you understand this?"

-Ajahn Chah


Dying is one of the most important things a person can do. I was in the airport last week sitting near a little fog-tornado machine and guess which age group was curious enough to go over to it and mess with it? Only the kids. The grumpy old men were angrily waiting for their flight, the stressed-out moms telling their kids to be quiet, and all the people my age were mesmerized by their phones.

Over time we get too world-weary and cynical. How many innovative startups that push us forward are started by people over 50, or even 40 for that matter?


How much value -- how many stories, how many glimmers-of-an-idea, how many things-I-learned-growing-up-in-the-thirties are lost when an old person dies?

I wouldn't wish death on a single person.


> I wouldn't wish death on a single person.

I wouldn't either. I hope I didn't imply that. And the "grumpy old men" are just a stereotype I often see. My grandfather, for example, is the happiest (and wisest) man I know. But he isn't going to go start a company tomorrow that will revolutionise the way we communicate.

Can you really deny that the curiosity that children have is essential to society moving forward and staying youthful, and has to always be replenished?


I really think the reason why grumpy old men are grumpy is because they don't have the energy and capable bodies of youth. I think a 70 year old with the body and hormones of a healthy 20 year old will still party like it's the 60s.

Mental scar tissue is another issue too.


> But he isn't going to go start a company tomorrow that will revolutionise the way we communicate.

Maybe he won't do that because he thinks he doesn't have enough time left to properly grow such a company, to see it flourish and observe the impact it would have on the world? Maybe he doesn't have enough physical endurance and health to endure the challenges of being an enterpreneur? Or maybe his wisdom allows him to see that all of his ideas of 'revolutionizing the way we communicate' (assuming he ponders that problem) would not fare well if realized, and he didn't have the one that could work yet?

There are many possibilities here and the postulated lack of curiosity is just one of them.


I was in the airport last week sitting near a little fog-tornado machine and guess which age group was curious enough to go over to it and mess with it? Only the kids.

Maybe that's because we "grumpy old men" have seen the vortices elsewhere at other science museums and more than a few in real life? Maybe the kids weren't playing with their phones because they didn't have any?

Over time we get too world-weary and cynical.

The weariness is very much physical. As I've progressed into my 40s, I've had more and more difficulty finding the energy to code as long and into the night. I'm not looking forward to my energy levels as I move toward my 50s.

No, the good thing about aging is that it's nice for natural evolution. If the old monkeys hadn't grown old and died, they would have dominated the young monkeys and had no real pressure to produce heirs.

Once we mankind can control the degeneration of aging and take control of our own genetic modifications, the "grumpy old men" will dominate society with their knowledge and experience in ways that currently aren't possible... well, until the robot overlords rise up from our home networks and kill us all.


https://www.youtube.com/watch?v=I-jk9ni4XWk&feature=g-vr... This talk shows 4 instances of societies where very old people are being active and happy.

Maybe 'mental' aging is a big byproduct of the culture and not only biology.


Everything dies. From old age or fate. Even the universe will die. Reminds of that great line Death said (from the TV show Supernatural). It went something like,

"Neither of us remember who is older." Referring to himself and god. "But I'll reap god too".

The more we are capable of prolonging life the more "fate" is capable of ending it. Sure, we might be able to prolong it - maybe to 200 years. But in the end, there is always an end.

I think we'd be better off as a society if we accepted death happily - as we accept life. You can't have one without the other.


> a little fog-tornado machine Ah, That the one in the SFO united terminal? I love that thing! I make a fool of myself every time I'm there, being the only adult childish enough to play with it. Can't wait to show it to my kids some day.


Yep that's the one! Good to hear I'm not the only one who enjoys it.


>How many innovative startups that push us forward are started by people over 50, or even 40 for that matter?

This has been discussed quite a bit on HN but most successful startups are run by people >40, the young hip megastartup is somewhat of a myth (not that's it's stopping anyone).


I'm sure lots of successful companies are started by the over-40 group. They have lots of connections, business experience, and don't take huge risks. That's a formula for "success" without innovation. It's been HP's and Xerox's formula for years.


The data here seems to fly in the face of another story on HN (a week or two ago) that suggested that the increase in life expectancy was almost completely from reducing infant/child mortality. This data shows a very different story.


Both can still be true.

The majority of people do not die as children, but the effect of those who do is disproportionately large on "life expectancy" because it's an average.

Let's say that 23% of children die in their first year (true in Sweden in 1751). Let's say everyone else dies at 80. Life expectancy is 61.6 years.

Now let's say time passes and now 0.2% of children die in their first year (true in Sweden today) and everyone else dies at 80. Life expectancy is now 79.7 years. It jumped over 18 years (30%) with no one living any longer than before. Additionally, the percentage of children dying was never even 1/4 of the total, so the vast majority of people still died from other causes.

The point is that the linked chart represents numeric percentages of people dying, while life expectancy weights younger years much more heavily.

Most of the progress that has been made in life expectancy is from young children, but most of the progress in "what actually kills people" has been for older people.


On phone... Short reply. Life expectancy since 40 increased at a rate comparable to expectancy since birth. That is, we've made huge gains in keeping ppl alive even starting from age 40.


1960 is fairly 'modern' in terms of birth survival rates. We have still gained 8 years from birth vs 6 years at 40. But, compared to a primitive an expected lifespan of ~40 that's mostly about survival at birth.


I think you've made a mistake, the infographic opens in US only view.

Switch to the 'global' view, that shows very clearly a massive drop because of pregnancy related problems.

It's by far the largest contributor, about 95% as far as I can tell by looking at a graphic.


that shows very clearly a massive drop because of pregnancy related problems.

I think you saw a red band on the chart, which I am looking at as I type this, and thought that red band referred to "pregnancy, childbirth and other obstetric complications," when it is actually the red band that corresponds to "heart disease, hypertension, and other circulatory system disease." The legend for which disease category is which is helpfully arranged in the same vertical order in which mortality from diseases is cumulatively shown on the chart--that's why I'm sure the broad red band that has declined the most is heart disease rather than complications of pregnancy. (My reality check is that I know the approximate base rate of both causes of death during the time period shown on the chart, which corresponds to my lifetime.)


"A baby born in the U.S. this year is likely to live to blow out 78 birthday candles."

Considering you blow out a candle for each year since you were born every birthday, I think they just said that we're all going to live until age 12.


How hard is it for them to make the key colors match the graph colors? They're off by quite a bit and it makes this chart very difficult for my eyes to parse.


Not just that, but I'm really sick of these stacked graphs where data floats on top of other data. It makes the image "prettier" at the expense of being harder to read. It makes it extremely difficult to compare the trends for the graph lines floating on the top of all the others, because they're moving all over the fucking place.

Why not just start all the graph lines from the bottom? If you really need the total, just have it be its own line?


What is that bump in worldwide deaths around 1985?


I think the bump you're referring to is 1996. A World Bank sourced Life Expectancy chart[1] seems to indicate problems in both South Africa in general and the economic depression in Russia coincide roughly with that time period.

//edit: Events in Korea, Kazakhstan, Ukraine and Congo caused dips as well. I guess the next question (and an interesting one) would be if there was a human condition of some sort that unified these different situations.

[1] http://www.google.com/publicdata/explore?ds=d5bncppjof8f9_&#...


It's actually a bump around 1981 or so, and then a sharp decline, followed by a resurgence in 1985.

It seems to occur in the "Heart and Circulatory Disease" category.

I'm not sure what this translates to specifically, but if they are classifying AIDS deaths as a "circulatory disease" and not pneumonia, it could be that.

There was also a severe famine in Africa in the 80's. Do you die of a heart attack if you are starving? Not sure.

It could also just be the pattern of heart disease/healthy living/research was playing out... notice that afterwards, the category accounts for decreasing amounts of death.


The introduction of New Coke!

http://en.wikipedia.org/wiki/New_Coke


IMO, too much money is being spent attacking the proximate causes of death (cancer, heart disease, etc.) but not enough is being spent attacking the root cause: aging. Yeah, if we cure cancer then life expectancy will go up some. But those who would have died of cancer are still going to grow older, become weak, and die of something. It seems like a more efficient use of resources to fight aging than to fight all the problems it causes individually.

http://www.nickbostrom.com/fable/dragon.html


Reduced mortality from heart disease seems to account for essentially all the mortality reduction. How are we reducing deaths so much in the face of rising obesity, etc.?


Better emergency care and smoking awareness probably have something to do with it.


Statins are probably one major reason.


I don't disagree that they're probably a major contributor, but the first statin came on the market in 1987 (Mevacor, by Merck), and the line is well on the down-slope by that point. In fact, more than half its drop (for US data) comes before that point.


Smoking rates have declined significantly since the 60's


Something in the charts doesn't make sense to me. Death rates per 100,000 are about 1.5x higher in 'global' vs. 'U.S.', yet life expectancy for 'global' and 'U.S.' is almost the same. Any explanations?


Something seems wrong: 1e5 /(deaths per 1e5) should be about equal to the life expectancy. But the drop in deaths per 1e5 is much bigger than the increase in life expectancy.

Am I missing something, or is the data SNAFU?


The charts show plainly that either in the United States, or in OECD countries

http://www.oecd.org/general/listofoecdmembercountries-ratifi...

as a whole, life expectancy is going up throughout the human age span. Life expectancy at birth is up quite a lot over the decades shown in the charts, but life expectancy at ages 40, 60, 65, and 80 have also increased.

The New England Journal of Medicine has a free access article from earlier this year (to celebrate its 200th anniversary)

http://www.nejm.org/doi/full/10.1056/NEJMp1113569

with much information on changes in mortality in the United States over the last two centuries.

The current prediction by demographers who specialize in life expectancy research is that a girl born after the year 2000 in a developed country has a 50:50 chance of personally living to the age of 100.

http://www.demogr.mpg.de/en/projects_publications/publicatio...

http://www.prb.org/Journalists/Webcasts/2010/humanlongevity....

http://www.demogr.mpg.de/en/projects_publications/publicatio...

(I'm glad for that news on my daughter's behalf.) That's based on steady improvement in mortality and morbidity outcomes across the age span in those countries, and what can reasonably be expected simply from more thorough provision of existing preventive treatments and treatments of acute and chronic diseases. Already it is hard for twenty-first century Americans to remember that once even kings and queens had many children die in early childhood from communicable diseases, and someday it will be difficult to remember that children ever died from much besides volitional human behavior (accidents, suicide, or homicide), with even those causes of death being in decline.

AFTER EDIT:

Several of the other comments in this thread refer to cancer mortality rates. An excellent article by a cancer researcher, "Why haven’t we cured cancer yet?"

http://www.sciencebasedmedicine.org/index.php/why-havent-we-...

which was submitted to HN when it was first put on the Web, discusses the several reasons why cancer mortality has declined only a little over the last few decades, despite much research devoted to finding more effective treatments for cancer and preventive measures against cancer.


When you switch from US to Global, the lifespans all stay roughly the same, or go up a bit. Yet the deaths per 100,000 in practically all categories go way up. How does this make sense?


1. We die because we accept it. 2. < dramatic pause > 3. ???? 4. Enlightenment




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