Dying differently
By Richard Saltus, Globe Staff
Causes of death
|
1990
|
1999
|
|
1. Pneumonia, flu
|
| Cardiovascular
|
|
2. Tuberculosis
|
| Cancer
|
|
3. Diarrhea, ullcerative colitis
|
| Stroke
|
|
4. Heart disease
|
| Lung disease
|
|
5. Stroke
|
| Accidents
|
|
6. Kidney disease
|
| Pneumonia, flu
|
|
7. Accidents
|
| Diabetes
|
|
8. Cancer
|
| Suicide
|
|
9. Senility
|
| Kidney disease
|
|
10. Diphtheria
|
| Liver disease
|
SOURCE: National Center for Health Statistics
|
|
Death will still be death in the new millennium, an inescapable exit despite everything medical science can do to delay it. We will depart, as Sherwin Nuland wrote in How We Die, because of ''the stoppage of circulation, the inadequate transport of oxygen to the tissues, the failure of organs, the destruction of vital centers.'' These basic failures, he says, are the weapons of every horseman of death.
What's changing is the path to the final flickering out. Continuing a trend that began early in this century, the coming decades will see fewer deaths from infectious disease and more from degenerative diseases like heart disease, cancer, and stroke. We will be living long enough to die more frequently of Alzheimer's disease.
The new millennium, some say, could reveal novel diseases such as unprecedented forms of cancer, mainly because people will be living longer than before. Who knows what might crop up to take the oldest of the old?
It's like peeling an onion: You peel the outer layer, infectious diseases, and you reveal the diseases below it, says Jay Olshansky, a researcher at the University of Chicago's department of medicine.
Improvements in medical care mean that people are living on what Olshansky calls manufactured time - the extra years that medical technology provides by delaying the fatal stage of degenerative disease. With the baby boomers reaching middle age and beyond, the health care system will gear up to keep them as healthy as possible until the end. Not for these high-expectation individuals disability and the gradual decline toward death. The goal is to keep people alive and healthy and functioning, playing golf until they die the next day, in their 80s, says Barry Bloom, dean of the Harvard School of Public Health.
|
