What do we die of?

Death remains a taboo subject in most societies. It's not that it's socially forbidden to talk about it, but because we don't like it, we avoid it. Religions or certain very specific disciplines deal with the question of death, but it is less common for it to be approached from a secular perspective or to form part of our socialization. It is an inevitable part of life, but we try to deny it, and it is understandable. This does not actually diminish our discomfort or fear, but increases it. For this reason I know that this will not be the most popular post in the series, but I think it is necessary to deal with the subject at least from a statistical point of view. Rather than talking about death itself, however necessary it may be, I think it is important to talk about the data on the causes of death. 

On the one hand, because lately, in that neighbor's yard that is twitter, I have seen that the data on the causes of death in Spain are altered (invented?) to justify certain positions. This finally stalls (if they put it on the Internet, how can it not be true!) and repeated (or twisted) a few times can be assumed as true. But since what we like is to dive into the data, we are going to go a little deeper into the information that the European Statistical Office (Eurostat) offers us for the year 2016. 

First we should specify what we mean by cause of death. This would be the illness or injury that initiated the morbid events (that cause the illness) that led directly to death, or the circumstances of the accident or violence that produced the fatal injury. This definition is derived from the International Classification of Diseases (ICD) of the World Health Organization (WHO). It is true that classifications can vary when the cause of death is multiple or difficult to assess and even due to different notification procedures, but it is very relevant to know the general situation in the European Union (we already talked about why it is important to talk about the EU here). The question of the cause of death is relevant not only because of the space for confusion, but also because, as Eurostat points out, given that there is a general lack of comprehensive European statistics on morbidity, we can use data on causes of death as a tool for assessing EU health systems. But also, and this is fundamental, knowing the data would allow us to develop a health policy that is based on empirical reality (we are talking about something very similar here). For this reason, and although our usual themes in "Aging in Society" are very different, today we are going to talk about the causes of mortality not only among people aged 65 and over, but also to compare it with the reality of children under 65 at EU level. Again, this would serve as a basis for certain health, urban and social policies. 

During 2016 the main cause of death among people under 65 was cancer, while for those over 65 it was circulatory diseases. In a more detailed way and on the total population, we have the following table on the cause of death in the EU, with differences by sex. 

Figure 1- Causes of death - standardised mortality rate, 2016 (per 100 000 inhabitants)

Source: Prepared by the authors on the basis of Eurostat data.

These data that represent the graphs are very different from those that apply to people in old age. For the year in question, 38.7% of deaths among people over 65 in the European Union as a whole were due to circulatory diseases. According to the International Classification of Diseases, two main groups of diseases are related to the circulatory system: ischemic heart disease (also known as coronary heart disease, including stroke) and cerebrovascular disease (stroke). Second, the leading cause of death was cancer (23.8%). Among all cancers, lung cancer was the most common cause of death among the elderly. Finally, we would have deaths from respiratory diseases (8.9%). Respiratory diseases include chronic diseases of the lower respiratory tract or asthma, as well as infectious diseases such as influenza or pneumonia. 

By gender, women have a greater impact of circulatory diseases than men (41.2% as opposed to 35.7%) but somewhat less of cancer (28.4% as opposed to 19.7%) or diseases of the respiratory system (9.9% as opposed to 8.1% of men). 

At territorial level and within the European Union, during 2016 ischemic cardiopathies (or coronary heart disease, which would be when the arteries that supply blood to the heart muscle become obstructed preventing blood flow) caused a higher mortality than cerebrovascular diseases with the exception of Bulgaria, Greece, France, the Netherlands, Slovenia and Portugal. In the rest of the EU, according to Eurostat, there were 534 deaths per 100 000 inhabitants 65+, compared to 376 per 100 000 inhabitants in that age group.