Death rates

Some time ago I tried looking up total death rates for different countries to get a mathematical view of Covid’s impact. Curiously, one of the countries that compiles and releases its data first is Sweden.

What I found was so interesting that this post will only consider Covid in passing as it investigates broader trends.

Have a look:

You can see the Covid bump in 2020, likely to be repeated in 2021, but there are many other interesting things going on in this graph.

First, there’s a very obvious downward trend over the decades. You can see how improved nutrition, medicine etc. over the last century led to dramatically lower death rates, especially among infants.

There’s also a bulge over the 1980s. This is no doubt due to the age structure of society at that time as the graph shows crude death rates that are not adjusted for the age of the population.

Do you see those really big spikes? That’s what major pandemics look like. No doubt you can spot the Spanish Flu of a century ago.

Notice how early years have much more irregular death rates due to pandemics (mostly), harsh winters, crop failures and other perils of the pre-modern period. Compare to how death rates smooth over the twentieth century along with economic and technological development.

Most people understand that death rates have gradually declined since the Olden Days but it’s surprising to see that mortality has continued to drop even in the twenty-first century. In Sweden’s case, this decline is such that the Covid blip pushed 2020’s mortality rate up to what would have been normal a decade ago and still well below the average of two decades ago.

As Sweden did not lock down (much) or suffer major economic disruption, this increase in mortality is presumably a ‘pure’ Covid effect. In other countries, the Covid bump may be higher due to these additional causes or lower due to the success of lockdowns.

Unfortunately, I still cannot find comparably up-to-date graphs for other countries to puzzle this out. Chuck us a link if you find one.

Nevertheless, let’s look at stats from the UK that don’t include 2020:

Note that the England/Wales graph is also crude. Compare to the graph below for Australia, which is age-adjusted. If it were not, Australia’s death rate would look more like England’s, with a plateau over the late twentieth-century and perhaps an uptick at the end. This is caused by an aging population, not increased mortality.

Source: https://www.aihw.gov.au/reports/life-expectancy-death/deaths-in-australia/contents/trends-in-deaths

Edit: I found a US graph for 1960-2003 that juxtaposes crude and age-adjusted rates.

In both the England/Wales and Australian graphs, as for Sweden, we see the high and irregular death rates of the age before affluence. Again we observe the dramatic drop in mortality over time, interrupted by the spikes of the Spanish Flu and, in the UK, the Second World War.

Here’s a graph of changing causes of death in Australia, same source:

The biggest fall is in ‘other’ causes. I’m not sure what that could be given that the remaining categories pretty much cover everything. Perhaps death certificates were once more likely to record the cause as ‘old age,’ and this habit was replaced by listing the specific circulatory disease involved by the 1950s. That would explain the rise in the dark blue line.

The consequent fall in circulatory diseases may be related to improved treatment. Probably not lifestyle – we exercise far less than before.

You can see the impact of improved cancer treatment. On the graph you can see a slight fall over the period discussed in the article but it’s more impressive when you consider the parallel aging of the population:

Improvements to the screening and treatment of cancer have reduced deaths in Australia by more than 20 per cent between 1996 and 2015, with 107,000 lives saved, a Cancer Council NSW study reveals.

The study found that there were 20.6 per cent fewer cancer deaths among Australians aged under 75, despite a 2 per cent increase in diagnoses.

Incidentally, graphs of crude death rates for Third World countries would probably resemble those for Western countries except further back in time. Death rates there are rapidly falling from a higher level due mostly to a reduction in extreme poverty, as happened in the West earlier.

Back to the West, we all know that life expectancy rose over the 20th century but tend to forget that, until Covid and fentanyl, that trend continued in most places over the last couple of decades.

There are three points to consider in conclusion:

First, death rates for the developed world are projected to rise gradually over the next century as our populations continue to age. Prediction charts, which I saw but now can’t locate, show increasing twenty-first century deaths almost as a mirror image of the decrease of the twentieth.

Here’s a chart from Japan showing our likely future:

Second, we should not consider the point of life to last as long as possible, nor should the only goal of public policy be to keep death rates as low as possible. That is a huge error we made in 2020.

Long life can be a blessing but it is not the only blessing. Celebrate all that is good in life. If we get a bit longer to enjoy those goods – well, that’s a bonus. It’s not the goal.

Third, perhaps this gives us a clue as to why we’re so terrified of a virus with a fatality rate we previously would have shrugged off (Asian flu, Hong Kong flu etc.)

We’re not used to death.

Almost everybody now lives to a ripe old age, not just compared to the 1800s but even compared to the 1990s. Very recently, an elderly and frail person dying was considered natural, ‘a good innings’, but now we consider it unacceptable.

We don’t only see this attitude in Covid hysteria. We also see it in over-treatment of terminal illnesses. Few know that doctors, wiser about such matters, tend to decline treatment for themselves when they are gravely ill more often than the average person.

Back in the 1990s, we were not bewailing the terrible state of the world even though average death rates were likely higher than for 2020 (age-adjusted or perhaps even in crude terms). In the 1990s, we still accepted death.

The decay of religious belief is not the only reason for our zero-tolerance policy towards death. We have grown so estranged from the event that some are beginning to unconsciously think that death ought to be eliminated in order to achieve a truly just society.