Why do people die? While it may seem a simple question, the answer lies hidden in a vast body of medical research and a complex web of statistics. In the modern world, the causes of death are not just a matter of personal grief, but a reflection of a nation’s healthcare system. Recent data from the World Health Organisation (WHO) and various international research organisations reveals that the causes of death are undergoing a profound transformation in the patterns of human mortality across the globe.
Causes of death can be broadly divided into two categories: 1. ‘Proximate’ or immediate causes, and 2. ‘Non-proximate’ or indirect causes.
Proximate causes are the diseases or conditions that directly lead to death, such as heart disease, cancer or stroke. On the other hand, non-proximate causes are the habits or environmental factors that increase the risk of death. For example, tobacco use is a non-proximate cause that gives rise to proximate causes, such as lung cancer.
According to experts, lifestyle-related deaths are currently the most common in the Western world. High blood pressure, obesity, excessive salt consumption, and a lack of physical exercise are increasing the rate of proximate deaths.
The Global Language of Death: To ensure that the nature of death is standardised across every corner of the globe, the World Health Organisation has been using a coding system called the ‘International Classification of Diseases’ or ICD since 1946. Its 10th version (ICD-10) is currently in use. is in effect, where deaths are divided into 17 main categories and nearly 8,000 sub-categories. This system helps researchers to understand which new diseases (such as HIV or Alzheimer’s) are emerging as new threats to humanity.
The disparity in mortality statistics reveals a stark contrast between developed and developing countries. In developed nations, the leading causes of death are age-related or chronic diseases, such as heart disease and cancer. These account for approximately two-thirds of all deaths.
On the other hand, the picture in developing countries is completely different. There, infectious diseases, parasitic diseases, and complications during childbirth are still major killers. Statistics show that in these countries, around 43 per cent of all deaths are due to infectious diseases and 10 per cent are due to complications during childbirth, such as maternal and child deaths. In developed countries, this rate is only 1 per cent. This demonstrates that the proper distribution of resources and the development of health infrastructure remain major challenges for global health.
In 1971, the researcher Omran proposed the theory of the ‘Epidemiological Transition’. According to him, human society passes through three stages. The first stage is the ‘era of epidemics and famine’, where people primarily die from malnutrition and infectious diseases. The second stage is the ‘era of declining epidemics’, where improvements in sanitation and medicine lead to a reduction in mortality rates. And the current third stage is the era of degenerative diseases, where people primarily die from non-communicable diseases like cancer.
However, in the current era, this theory faces new challenges. On the one hand, diseases such as heart disease are delaying ageing, while on the other, new infectious diseases like COVID or HIV are prompting scientists to rethink. Even antibiotic-resistant bacteria (Superbugs) and bioterrorism could further complicate the causes of future deaths.
There are also limitations in collecting death data. In developing countries, accurate records of most deaths are not kept. Often, the actual cause of death remains unclear due to a lack of doctors or forensic experts. Statistics based on so-called ‘verbal autopsies’ or on descriptions from relatives often fail to provide an accurate picture. Furthermore, in medical science, there is a debate as to which disease should be considered the ‘primary cause’ when a person has multiple illnesses.
The good news is that a study in the United States found that nearly 50 per cent of deaths are preventable. By quitting tobacco, maintaining a balanced diet, getting regular physical activity and moderating alcohol consumption, it is possible to significantly reduce the risk of premature death. Small lifestyle changes can greatly increase our average life expectancy.
Ultimately, the study of causes of death is not merely statistics; it is a new roadmap for living. The proper allocation of health resources and personal awareness can save the world from premature death.
References:
★World Health Organisation (WHO): International Classification of Diseases (ICD-10).
★Allen M. G: Macmillan Encyclopedia of Death and Dying.
★National Center for Health Statistics (NCHS): Annual Cause of Death Reports for the United States.
★Omran, A. R. (1971): The Theory of Epidemiological Transition.
★McGinnis and Foege (1993): Actual Causes of Death in the United States (JAMA).