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Discrepancies in Death – Why?

Infographics have long intrigued me. As a longtime academic physician, young physicians’ education was one of my true career joys. I spent many hours developing meaningful presentations detailing risks in anesthesiology and surgery that I hoped was easily recalled in these physicians’ minds.

Now that I am leading a firm focused on helping a variety of individuals with serious (advanced) illness make decisions about care that aligns with their values and goals, discussions of personal risk mitigation often enter into our discussions. Of course, death is a component of what we talk about. Thus, an infographic and analysis at University of California – San Diego by Shen and coworkers earlier this year caught my eye. 

Shen and colleagues posed a series of questions:

1) How do people die
2) How do people think we die?
3) And is there a difference? 

To get at these topics they compared CDC (Center for Disease Control) reported deaths, contrasted those CDC categories with the frequency of Google searches and further contrasted the CDC categories with media coverage of death by the New York Times and The Guardian. The simple version of the story is media coverage and Google search trends do not mirror the frequency with which our U.S. population experiences death. As an aside, Shen and colleagues are imbued with a sense of humor!  Their infographic is below.

One of the first books I authored in the late 1980’s was entitled, Risk and Outcome in Anesthesia, and a central thesis of the book was human beings often fear (worry) about the wrong things when they face high-risk operation.  Shen’s data confirm not much has changed from the 1980’s till 2018.  We seem prone to worry most about the unexpected, out of control risks, not those that cause our mortality.  Morgan in 1993 presented in Scientific American a wonderful summary of how we think about risk; in the manuscript he outlined a risk-axis grid that seems to capture a significant part of the why there is a discrepancy of what kills us and what we fear.

Using insights from Shen coupled with Morgan’s grid, I have taken the liberty of creating a combined risk-axis grid using the discrepancies in death rates contrasted with media coverage and Google search frequency to begin to explain the discrepancies.   In short, we fear what we can’t control and what we are unfamiliar with.