MetaFilter posts tagged with death and health

"A law should serve the people, but it didn't protect me."

kliuless — Mon, 04 Mar 2013 01:12:04 -0800

In Korea, Changes in Society and Family Dynamics Drive Rise in Elderly Suicides - "The epidemic is the counterpoint to the nation's runaway economic success, which has worn away at the Confucian social contract that formed the bedrock of Korean culture for centuries."

That contract was built on the premise that parents would do almost anything to care for their children — in recent times, depleting their life savings to pay for a good education — and then would end their lives in their children's care. No Social Security system was needed. Nursing homes were rare. But as South Korea's hard-charging younger generations joined an exodus from farms to cities in recent decades, or simply found themselves working harder in the hypercompetitive environment that helped drive the nation's economic miracle, their parents were often left behind. Many elderly people now live out their final years poor, in rural areas with the melancholy feel of ghost towns.

How Capitalism Creates The Welfare State

[T]he forces that free market capitalism unleashes are precisely the forces that undermine traditional forms of community and family that once served as a traditional safety net... in South Korea, the shift has been so sudden and so incomplete that you see just how powerfully anti-family capitalism can be... The result is a generation of the elderly committing suicide at historic rates: from 1,161 in 2000 to 4,378 in 2010. The Korean government requires the elderly to ask their families for resources if they can pay for retirement funding – forcing parents to beg children to pay for their living alone – a fate they never anticipated and that violates their sense of dignity. Hence the suicides... We see the consequences far beyond the suicides of elderly Koreans. And in my bleaker moments, I wonder whether humankind will come to see this great capitalist leap forward as a huge error in human history – the moment we undid ourselves and our very environment, reaching untold material wealth as well as building societies in which loneliness, dislocation, displacement and radical insecurity cannot but increase."

Dying Alone Becomes New Normal as Japan Spurns Confucius - "Itoko Uchida, 82, was counting on the nephew she raised to support her in old age. He refused, forcing her to pay for a sponsor to join the 420,000-long queue of Japanese waiting for a nursing home bed."

291 diseases and injuries + 67 risk factors + 1,160 non-fatal complications = 650 million estimates of how we age, sicken, and die

hat — Fri, 14 Dec 2012 11:08:08 -0800

As humans live longer, what ails us isn't necessarily what kills us: five data visualizations of how we age, sicken, and die. Causes of death by age, sex, region, and year. Heat map of leading causes and risks by region. Changes in leading causes and risks between 1990 and 2010. Healthy years lost to disability vs. life expectancy in 1990 and 2010. Uncertainties of causes and risks. From the team for the massive Institute for Health Metrics and Evaluation Global Burden of Diseases, Injuries, and Risk Factors Study 2010. The data visualizations page also includes a large number of static figures from the GBD 2010 study. The GBD 2010 team at the Institute for Health Metrics and Evaluation (IHME), an independent global health research center at the University of Washington, "spent almost 5 years building [the database of causes of death]; we have included almost 800 million deaths from 1950 to 2010, and the data come from different sources," resulting in "the biggest database for cause of death analysis in the world," according to Rafael Lozano at the University of Washington. The GBD 2010 includes:

291 diseases and injuries
67 risk factors
1,160 sequelae (nonfatal health consequences)
Estimates for 21 regions
Estimates for 20 age groups

Takeaway points from the press release (emphasis mine):

Child mortality has dropped by more than 60%, falling "so quickly that it has beaten every published prediction," though diarrhea and other infectious diseases still kill well over a million children under the age of 5 every year.
Deaths among adults aged 15 to 49 increased by 44% between 1970 and 2010, "in part because of increases in violence and the ongoing challenge of HIV/AIDS."
Undernutrition has "successfully been cut by two-thirds," and now physical inactivity and macronutrient overnutrition contribute to a 10%-and-rising fraction of the disease burden.

However,

The trends identified in GBD 2010 occur across regions with one notable exception: sub-Saharan Africa, where infectious diseases, childhood illnesses, and maternal causes of death account for as much as 70% of the burden of disease. By comparison, these conditions account for only one-third of the burden in south Asia and Oceania, and less than 20% in all other regions.

Research findings from the main publication summary (emphasis mine):

In 2010, the three leading risk factors for global disease burden were high blood pressure [...]; followed by tobacco smoking, including secondhand smoke [...]; and alcohol use [...] This reflects a substantial change from 1990 when the leading risk factors were childhood underweight [...]; followed by household air pollution from use of solid fuels [...]; and tobacco smoking, including secondhand smoke [...].
Regional differences are significant. While much of the world is burdened by obesity and high body mass index, underweight is still the leading risk factor in sub‐Saharan Africa. Other prevalent risk factors in the region include household air pollution and nonexclusive and discontinued breastfeeding.
Although child undernutrition has fallen significantly as a risk factor for all ages, it remained the leading risk factor worldwide in 2010 for children under 5, accounting for 12.4% of global DALYs [disability‐adjusted life years], followed by nonexclusive or discontinued breastfeeding at 7.6%.
A number of risks that primarily affect childhood communicable diseases, including unsafe water and sanitation and micronutrient deficiencies, declined in significance in the past 20 years, with unsafe water and sanitation accounting for only 0.9% of global DALYs in 2010.
At the same time, GBD 2010 findings show the importance of household air pollution from solid fuels and ambient particulate matter pollution as major risk factors. One or both rank in the top 10 as causes of disease burden in 13 of the 21 regions. In south Asia, they are the leading cause of burden.

From the Guardian's reporting (more: 1, 2, 3):

Since 1970 the largest gains in life expectancy have taken place in the Maldives (27.3 years for men and 29.4 years for women) and improvements in life expectancy at birth in excess of 20 years were recorded in Bangladesh, Bhutan, Iran, and Peru. But life expectancy fell by one to seven years in Zimbabwe and Lesotho, where populations were severely affected by HIV/Aids, and for men in Ukraine and Belarus, where an alcohol crisis took hold.

If you'd like to read the papers themselves, the full text is currently available for free (but registration required) at The Lancet. In addition to the data visualizations, the IHME provides GBD 2010 publication summaries: Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010

Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Age‐specific and sex‐specific mortality in 187 countries, 1970–2010: a systematic analysis for the Global Burden of Disease Study 2010

Years lived with disability (YLDs) for 1,160 sequelae of 289 diseases and injuries, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Disability‐adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010
Each of the data visualizations again:

Causes of death by age, sex, region, and year
Heat map of leading causes and risks by region
Changes in leading causes and risks between 1990 and 2010
Healthy years lost to disability vs. life expectancy in 1990 and 2010
Uncertainties of causes and risks

The Institute for Health Metrics and Evaluation adds,

The findings are being announced at the Royal Society in London on Dec. 14 and published in The Lancet, the first time the journal has dedicated an entire triple issue to one study.

The Lancet includes The story of GBD 2010: a “super-human” effort:

“Running the programs to map the data to our cause list of 291 causes and correcting the bias can take days, even using a powerful cluster of more than 100 computers. The data that we have to store after the modelling process can take 3 terabytes.” [Rafael] Lozano estimates that the storage needed for the causes of death data was 400 times bigger than that for GBD 1990 [...] Majid Ezzati, chair in global and environmental health at the School of Public Health, Imperial College London, UK, told The Lancet, As researchers, we tend to believe that more ‘data’ are better than less. I still believe so. But more data, but not all the perfect data we could wish for, means that we need to fundamentally think differently about when to stop searching for more and how to use it [...] The study brought out the well-known but far too frequently overlooked issue that people of different scientific traditions—clinicians, basic scientists, epidemiologists, and quantitative scientists—think and speak differently about the same problem. This can of course be a very powerful resource for bringing together different ways of looking at a problem and solving in the most comprehensive and interesting way—a true systems approach. It can also be a challenge, and at times a source of tension.

(Previously on the Institute for Health Metrics and Evaluation: Is there a market for years?)

Trial of the Will

homunculus — Thu, 08 Dec 2011 09:10:12 -0800

Trial of the Will. "Reviewing familiar principles and maxims in the face of mortal illness, Christopher Hitchens has found one of them increasingly ridiculous: 'Whatever doesn’t kill me makes me stronger.' Oh, really? Take the case of the philosopher to whom that line is usually attributed, Friedrich Nietzsche, who lost his mind to what was probably syphilis. Or America’s homegrown philosopher Sidney Hook, who survived a stroke and wished he hadn’t. Or, indeed, the author, viciously weakened by the very medicine that is keeping him alive." [Via]

The pain is killing me

hat_eater — Sun, 27 Nov 2011 11:19:29 -0800

Even a little too much Tylenol over a few days can cause a liver failure. Paracetamol or acetaminophen, active ingredient of such over-the-counter painkillers as Tylenol, Panadol, Anacin-3 and many, many others, is considered safe - and it is, in prescribed doses. But even a single overdose can lead to liver failure despite treatment, and then only a liver transplant can avert a fatal outcome. In light of this, according to the recommendations of the FDA some manufacturers are reducing the dosage, as discussed previously. But now a study (abstract, pdf) published in British Journal of Clinical Pharmacology has found a higher mortality (37%) among patients with so called "staggered overdose" of paracetamol (on average 24 grams over three days) than among those who took one huge dose (28% mortality, on average 27 grams, or 54 Extra Strength Tylenols, 500 mg each). To ingest 24 grams in three days one still has to overdose heavily (16 extra strength pills per day, 10 over the limit), but "staggered overdose" cases are defined as having ingested 4 or more grams (8 or more pills) in the course of three or more days. So, if you feel safe because who's so crazy to take 50 Tylenols, consider an example - you have a really bad back, you pop just two extra strength pills over the limit and the pain goes away, only to return the next morning. If you repeat the pattern for the next two days, you risk liver failure - and for at least one of the patients in the above study such seemingly small overdose proved fatal.

But what about Panadol, Anacin and Efferalgan?

hat_eater — Thu, 04 Aug 2011 11:15:48 -0800

Last week Johnson & Johnson announced that it is lowering the maximum daily dose for single-ingredient Extra Strength Tylenol from 8 to 6 pills per day (from 4,000 to 3,000 mg). The dosage change follows the recommendations posted by the FDA two years ago. The discussion that ensued on Science Based Medicine blog is quite informative. The highlights include the reasons why acetaminophen isn't sold with additives that would prevent liver failure in case of overdose (cost) and what to do if you fail to kill yourself with whisky on the pills and on waking up decide that life isn't that bad after all (go to hospital immediately or you'll eventually succeed). All in all, while pondering both sides of the optimum therapeutic dose, it's worth remembering that even water can be fatal when taken in excess.

Lessons of a $618,616 Death

Joe Beese — Mon, 08 Mar 2010 09:53:06 -0800

Lessons of a $618,616 Death

"I live in hope I can jump before I am pushed."

Artw — Mon, 03 Aug 2009 11:44:40 -0800

Terry Pratchett: I'll die before the endgame

The Saddam Sessions

kliuless — Sun, 27 Jan 2008 22:33:50 -0800

Saddam's Confessions - Given Saddam Hussein's central place in the American Consciousness over the last couple decades and particularly in recent years, I found 60 minutes' interview with FBI interrogator George Piro pretty fascinating.

Warnings

tellurian — Wed, 17 May 2006 19:21:52 -0800

The Australian cigarette health warnings have pretty much filtered down to every retail packet that's bought now. They're pretty gruesome and some smoking acquaintances cover them up with stickers. I thought I'd have a look around and see what other countries warnings were like. None of them were pulling any punches except for Uruguay.

Each member of staff was trained by way of a compulsory three-hour training session.

Lanark — Tue, 20 Dec 2005 11:09:43 -0800

Computerized physician system linked with increase in child mortality In an effort to reduce medical errors and mortality a children's hospital implemented a commercial physician order entry (CPOE) system.
After the system had gone live, analysis over an 18-month period revealed an unexpected increase in mortality from 2.80% to 6.57% (about one extra death per month)
It seems the big mistake was Changing the Systems of Work to suit the computer system, rather than fixing the technology to meet the needs of a specialist work area (intensive care).

If you can help then do something

lisatmh — Thu, 25 Apr 2002 13:01:00 -0800

If you can help then do something Tech columnist Robert X. Cringely's baby, 74-day old Chase, died of SIDS this week. He's trying to get together people with engineering and medical expertise to lead a project to make low-cost monitors to help make SIDS a thing of the past.

Man dies before boarding an airplane?

Kevin Sanders — Mon, 18 Mar 2002 22:12:43 -0800

Man dies before boarding an airplane? Or did he die in midflight? "Authorities disagree on whether Walsh, who had a history of heart- and kidney-related health problems, died midflight or before he boarded the plane." What really gets me is: how could he get on the airplane if he was already dead? Wouldn't the people helping him onto the plane notice?

The dying wish of terminally ill 15-year-old has sparked debate

MegoSteve — Sat, 22 Dec 2001 11:04:54 -0800

The dying wish of terminally ill 15-year-old has sparked debate over whether it was appropriate that it be granted. His wish: to lose his virginity before he died. His friends arranged for a prostitute to grant his wish outside of hospital grounds earlier this month without the knowledge or consent of his parents. He died last week.

Jack Kevorkian's lawyer in trouble.

Potsy — Tue, 17 Apr 2001 08:33:59 -0800

Jack Kevorkian's lawyer in trouble. He made some negative comments about a few appeals court judges. Not while he was in court, but on a radio talk show. Even so, he could potentially lose his license. His partner said, "Since when is it improper to make comments that are critical of government officials?"

quirked — Fri, 06 Apr 2001 09:44:30 -0800

Scientists discover secrets behind aging process raising the possibility that hormonal therapy could add decades to the human life span. While I'm generally environmentally aware and concerned about overpopulation, all I can think is - sign me up!