A Zero-Sum Game

Causes of death: 1900 and 2010

Interesting chart; one can see where we’ve made significant progress in reducing diseases like tuberculosis and making the world safer so that accidents account for fewer deaths per unit population. Fewer deaths implies progress. But an increase is not so clear.

We’re doing great on kidneys, but hearts not so much.

As they might say up in New England, you can’t get there from here. Death is a zero-sum game; sorry if this comes as a surprise, but everybody dies. So if you are going to drastically reduce the number of deaths by one method, then those people will eventually die via another. If you eliminate childhood diseases then average lifespans will increase and those spared will die of something else. I can recall a comment in a medicine-related blog post recently, wherein the commenter claimed that something is wrong with the system because the instances of cancer were increasing, as this chart shows. But given some probability of getting cancer as an adult, you expect that increase: if your chance is 25%, then (roughly speaking) every four childhood deaths prevented should give you an additional adult cancer death. Similarly for heart-related deaths. The chart also doesn’t tell you at what age the deaths occurred (though the decrease in rate implies that death is occurring later, on average). So a heart attack that killed a person at 50 in 1900 might translate into avoiding or surviving that attack in modern times, and finally succumbing to heart disease at 70 or 80. That would not be a lack of progress. You simply can’t glean the necessary details from the graph.

One thought on “A Zero-Sum Game

  1. That graph compares the top ten causes of death in 1900 versus the top ten causes in 2010. I’m not sure what you can infer from it, except that the top ten causes now are different, and those ten don’t kill as many people.

    So if we want to reduce death rates, the low-hanging fruit is mostly already picked. Fairly simple methods saved a whole lot of people from infectious pneumonia. There are no big items like that any more except heart disease and cancer, and neither of those look simple at all.

    Suicide is now #10. People decide to die when they don’t want to stay alive The more other causes of death are reduced, the larger that one will rise unless we find ways for more people to have lives that are worth living….

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