Tag Archives: death

The U.S. #1 in Early Deaths

The Institute of Medicine and the National Research Council released some damaging numbers this month: Americans ranks startlingly low in life expectancy, compared to 16 other similarly developed countries.  This is especially true for younger Americans. Indeed, among people 55 and under, we rank dead last.  Among those 50-80 years old, our life expectancy is 3rd or 2nd to last.

Sabrina Tavernise at the New York Times reports that the “major contributors” to low life expectancy among younger Americans are high rates of death from guns, car accidents, and drug overdoses.  We also have the highest rate of diabetes and the second-highest death rate from lung and heart disease.

Americans had “the lowest probability over all of surviving to the age of 50.”  The numbers for American men were slightly worse than those for women. Overall, life expectancy for men was 17 out of 17; women came in 16th.  Education and poverty made a difference too, as did the more generous social services provided by the other countries in the study.

What isn’t making a difference?  Apparently our incredible rate of health care spending.

Via Citings and Sightings.

Lisa Wade is a professor of sociology at Occidental College and the author of Gender: Ideas, Interactions, Institutions, with Myra Marx Ferree. You can follow her on Twitter and Facebook.

Assault Deaths Within the United States

Cross-posted at Kieran Healy’s blog.

The chart in “America is a Violent Country” has been getting a lot of circulation. Time to follow up with some more data. As several commentators at CT noted, the death rate from assault in the U.S. is not uniform within the country. Unfortunately, state-level and county-level mortality data are not easily available for the time period covered by the previous post — though they do exist, going back to the 1940s. What I have to hand is a decade’s worth of US mortality data courtesy of CDC WONDERcovering 1999 to 2009. I extracted the assault deaths according to the same criteria the OECD uses (for the time period in question, ICD-10 codes X85-Y09 and Y87.1). The estimates are adjusted to the 2000 U.S. population, which isn’t identical to the standard OECD adjustment. But the basic comparability should be OK, for our purposes.

First, it’s well-known that there are strong regional differences in the assault death rate in the U.S. by state and region. Here’s what the patterns look like by state from 1999 to 2009 (click for a larger PNG or PDF):

This figure excludes the District of Columbia, which has a much higher death rate but is also a city. Also missing are a few states with small populations and low absolute numbers of assault deaths — Wyoming, North Dakota, Vermont — such that the CDC can’t generate reliable age-adjusted estimates for them. If you want a “small-multiple” view with each state shown separately from high to low, here you go.

The legend for the figure above arranges the states from high to low, reading top to bottom and left to right. Although it’s clear that geographical region isn’t everything, those tendencies are immediately apparent. Let’s look at them using the official census regions (click for a larger PNG or PDF):

As is well known, the South is more violent than the rest of the country, by some distance. Given the earlier post, the natural thing to do is to put these regional trends into the cross-national comparison and see — for the decade we have, anyway — how these large U.S. regions would fare if they were OECD countries. Again, bear in mind that the age-adjustment is not quite comparable (click for a larger PNG or PDF):

Despite their large differences, all of the U.S. regions have higher average rates of death from assault than any of the 24 OECD countries we looked at previously. The placid Northeast comes relatively close to the upper end of the most violent countries in our OECD group.

Finally, there’s the question of racial and ethic incidence of these deaths within the United States. Here are the decade’s trends broken out by the race of the victim, rather than by state or region (click for a larger PNG or PDF):

The story here is depressing. Blacks die from assault at more than three times the U.S. average, and between ten and twenty times OECD rates. In the 2000s the average rate of death from assault in the U.S. was about 5.7 per 100,000 but for whites it was 3.6 and for blacks it was over 20. Even 3.6 per 100,000 is still well above the OECD-24 average, which – if we exclude the U.S. – was about 1.1 deaths per 100,000 during the 2000s, with a maximum value of 2.9. An average value of 20 is just astronomical. And this is after a long period of decline in the death rate from assault.

—————————

Kieran Healy is a professor of sociology in the Kenan Institute for Ethics at Duke University.  His research is primary concerned with the moral order of a market society. You can follow him on twitter and at his blog.

Public Opinion on Gun Control

Ezra Klein at Wonkblog has put together an impressive collection of statistics on guns and mass shootings, including this data on public opinion on gun control.

To begin, people seem generally less interested in owning guns.  The percent of households with guns has been steadily decreasing for decades:

But, perhaps counter-intuitively, support for gun control has waned:

We might expect a tragedy like this week’s shooting to raise the overall level of support for gun control, but it probably won’t.  Previous shootings have not had much of an impact on opinion:

Still, there is more support for some forms of gun control than others:

For what it’s worth, gun-related deaths are lower in states with stronger gun control.  Economist Richard Florida found ”substantial negative correlations between firearm deaths and states that ban assault weapons (-.45), require trigger locks (-.42), and mandate safe storage requirements for guns (-.48)”:

It’s hard to know, however, whether this is correlation or causation.  Florida did not find correlations between gun deaths and other factors that we might expect to be correlated, including dense populations, high rates of stress, high numbers of immigrants, and mental illness.

Klein thinks that now is the time to talk about the role of gun control in preventing tragedies like the one in Newtown.  He suggests we go ahead and politicize the shooting, since silencing a discussion is just another form of politicization. He writes:

If roads were collapsing all across the United States, killing dozens of drivers, we would surely see that as a moment to talk about what we could do to keep roads from collapsing. If terrorists were detonating bombs in port after port, you can be sure Congress would be working to upgrade the nation’s security measures. If a plague was ripping through communities, public-health officials would be working feverishly to contain it.

Only with gun violence do we respond to repeated tragedies by saying that mourning is acceptable but discussing how to prevent more tragedies is not. “Too soon,” howl supporters of loose gun laws. But as others have observed, talking about how to stop mass shootings in the aftermath of a string of mass shootings isn’t “too soon.” It’s much too late.

I agree that now is a good time to talk about gun control. And, we should do it with as many facts as possible, no matter where they lead us.

Lisa Wade is a professor of sociology at Occidental College and the author of Gender: Ideas, Interactions, Institutions, with Myra Marx Ferree. You can follow her on Twitter and Facebook.

Human Zoos at the Turn of the 20th Century

***TRIGGER WARNING for racism and enslavement***

During a dark period of world history, intellectuals pondered where to draw the line between human and animal.  They arrayed humans hierarchically, from the lightest to the darkest skin.  Believing that Africans were ape-like, they weren’t sure whether to include apes as human, or Africans as apes.

One artifact of this thinking was the “human zoo.”  Kidnapped from their homes at the end of the 19th century and into the next, hundreds of indigenous people were put on display for white Westerners to view.  ”Often they were displayed in villages built in zoos specifically for the show,” according to a Spiegel Online sent in by Katrin, “but they were also made to perform on stage for the amusement of a paying public.”  Many died quickly, being exposed to diseases foreign to them.

This group of captives is from Sri Lanka (called  Ceylon at the time):

This photograph commemorates a show called “Les Indes,” featuring captives from India:

These captives are from Oromo in Ethiopia:

A German named Carl Hagenbeck was among the more famous men involved in human zoos.  He would go on expeditions in foreign countries and bring back both animals and people for European collections.  In his memoirs, he spoke of his involvement with pride, writing: “it was my privilege to be the first in the civilized world to present these shows of different races.”

The zoo in Hamburg still bears his name.

Lisa Wade is a professor of sociology at Occidental College and the author of Gender: Ideas, Interactions, Institutions, with Myra Marx Ferree. You can follow her on Twitter and Facebook.

Assisted-Living Prison Cells? On Aging Prisoners

“Today,” Mother Jones‘s James Ridgeway reports, “roughly 1 in 12 state and federal prison inmates is 55 or older.”  Prisoners sentenced to life without parole will die in prison, so that means they’ll convalesce there too.  In other words, prisons are part nursing home.

Photographer Tim Gruber captured these images of “the golden years” in the Kentucky State Reformatory:

According to a report from the ACLU, the number of elderly prisoners is expected to skyrocket:


Imprisonment is already expensive, but aging patients cost twice what a younger prisoner costs.  Today, we spent $16 billion a year to house elderly prisoners,  Soon we’ll have to start renovating our prisons.

Unless states start releasing them, [former warden Bob] Hood says, we will need to “retrofit every prison in America to put assisted living-units in it, wheelchair accessibility, handicapped toilets, grab bars — the whole nine yards.”

Prisons increasingly feature assisted-living cells and hospice units.

Some argue for “compassionate release.”  After all, elderly prisoners have a very low recidivism rate.  But the ACLU cautions us to remember that release shouldn’t mean abdicating responsibility.  ”For many elderly prisoners,” the director of the ACLU’s National Prison Project explains, “particularly those with serious medical needs, simply pushing them out the prison door will be tantamount to a death sentence.”

Lisa Wade is a professor of sociology at Occidental College and the author of Gender: Ideas, Interactions, Institutions, with Myra Marx Ferree. You can follow her on Twitter and Facebook.

Historical Changes in Causes of Death

The Washington Post has provided an image from the New England Journal of Medicine that illustrates changing causes of death. Comparing the top 10 causes of death in 1900 and 2010 (using data from the Centers for Disease Control and Prevention), we see first that mortality rates have dropped significantly, with deaths from the top 10 causes combined dropping from about 1100/100,000 to about 600/100,000:

And not surprisingly, what we die from has changed, with infectious diseases decreasing and being replaced by so-called lifestyle diseases. Tuberculosis, a scourge in 1900, is no longer a major concern for most people in the U.S. Pneumonia and the flu are still around, but much less deadly than they used to be. On the other hand, heart disease has increased quite a bit, though not nearly as much as cancer.

The NEJM has an interactive graph that lets you look at overall death rates for every decade since 1900, as well as isolate one or more causes. For instance, here’s a graph of mortality rates fro pneumonia and influenza, showing the general decline over time but also the major spike in deaths caused by the 1918 influenza epidemic:

The graphs accompany an article looking at the causes of death described in the pages of NEJM since its founding in 1812; the overview highlights the social context of the medical profession. In 1812, doctors had to consider the implications of a near-miss by a cannonball, teething could apparently kill you, and doctors were concerned with a range of fevers, from bilious to putrid. By 1912, the medical community was explaining disease in terms of microbes, the population had gotten healthier, and an editorial looked forward to a glorious future:

Perhaps in 1993, when all the preventable diseases have been eradicated, when the nature and cure of cancer have been discovered, and when eugenics has superseded evolution in the elimination of the unfit, our successors will look back at these pages with an even greater measure of superiority.

As the article explains, the field of medicine is inextricably connected to larger social processes, which both influence medical practice and can be reinforced by definitions of health and disease:

Disease definitions structure the practice of health care, its reimbursement systems, and our debates about health policies and priorities. These political and economic stakes explain the fierce debates that erupt over the definition of such conditions as chronic fatigue syndrome and Gulf War syndrome. Disease is a deeply social process. Its distribution lays bare society’s structures of wealth and power, and the responses it elicits illuminate strongly held values.

Presidents Who Kill People are Popular

Cross-posted at OrgTheory.

David Henderson and Zachary Gouchenour have a paper on the topic of presidential ratings. The finding is simple. American war casualties, as a fraction of the population, positively correlate with how historians rate U.S. presidents. More death = better presidents. The regression model includes some controls, like economic growth. Here’s the chart:

This is consistent with sociological research on state building, which has traditionally linked wars, bureaucratic growth, and tax collection. See, for example, Charles Tilly’s classic work “Warmaking and Statemaking as Organized Crime.”  My one criticism of the paper is that there is no measure in the regression that controls for “big legislation” (i.e., New Deal). Historians like law passing and it might account for some variation. I have a hunch that is how variation on the right hand side of the figure would be explained.

Henderson and Gouchenour then spin out the policy implication. Greatness rankings by historians may prompt presidents to start more wars. The historians may have more blood on their hands than we care to admit.

Adverts: From Black Power/Grad Skool Rulz

—————————

Fabio Rojas is an Associate Professor of Sociology at Indiana University. He is the author of two books: From Black Power to Black Studies: How a Radical Social Movement Became an Academic Discipline and Grad Skool Rulz: Everything You Need to Know about Academia from Admissions to Tenure.  Rojas’ academic research addresses political sociology, organizational analysis, and computer simulations.

Prisons, Social Class, and One’s Final Resting Place

The New York Times recently ran an  interesting story on prison cemeteries in Texas.  For about $2,000, the state buries about 100 inmates a year. They die of lethal injection, old age, or illness, but they’re all dressed in dark pants, a white shirt, and tie, and are buried with a prayer from the prison chaplain.

When inmates die in custody, their bodies are sometimes unclaimed.  This may be because they have no family at all, or their family members don’t wish to claim the body.   Other times the inmate is cared for by family members who simply can’t afford to bury the person themselves.  So, occasionally the family members will decline to claim the body, but show up on the day of the burial to pay their respects.

Lisa Wade is a professor of sociology at Occidental College and the author of Gender: Ideas, Interactions, Institutions, with Myra Marx Ferree. You can follow her on Twitter and Facebook.