Chapter 1. How Death Has Changed in the Last 100 Years

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How Death Has Changed in the Last 100 Years

Reduced infant mortality and disease rates have led to longer lives but not necessarily “good deaths.” In this activity, several graphs show how far we’ve come in 100 years while also prompting reflection on how the circumstances and outcomes of death can be further improved.

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A person’s hand on a tombstone in a cemetery.

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How Death Has Changed in the Last 100 Years

A century ago, the average life span worldwide was less than 40 years (around 50 in the rapidly industrializing United States). Half of the world’s babies died before age 5. Now newborns are expected to live to age 71 (79 in the United States); in many nations, centenarians are the fastest-growing age group.

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Data from MMWR, April 8, 2016.

How Death Has Changed in the Last 100 Years

In the early 1900s, death was usually fast and unstoppable; once the brain, the heart, or any other vital organ failed, the rest of the body quickly followed. Now death can often be postponed through medical technology: Hearts can beat for years after the brain stops functioning, respirators can replace lungs, and dialysis does the work of failing kidneys. For most of our ancestors, death occurred at home, with family nearby. Now most deaths occur in hospitals or other institutions, with the dying surrounded by medical personnel and machines.

Data from National Center for Health Statistics, 2017, p. 116.

How Death Has Changed in the Last 100 Years

People of all ages once usually died of infectious diseases (tuberculosis, typhoid, smallpox), or, for many women and most infants, in childbirth. Now disease deaths before age 50 are rare, and in developed nations most newborns (99 percent) and their mothers (99.99 percent) live.

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Data from Jones, et al., 2012.

How Death Has Changed in the Last 100 Years

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Question 1.1 How Death Has Changed in the Last 100 Years

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Because of the reduction in infant mortality and disease rates, death is much more likely to occur at the end of a long life in the twenty-first century. However, the graphs in this activity indicate that twenty-first century deaths are less likely to be peaceful (death is much more likely to be the result of an accident, of suicide, or of homicide) and quick (medical advancements help sick people live longer with their ailments). Furthermore, the figures showing causes of death and where death occurs indicate that death often happens in unfamiliar surroundings (an emergency room, nursing home, or worse) where there may be no family and friends present, thus increasing the likelihood of pain, confusion, and discomfort. As the text suggests, honest conversation, hospice, and palliative care can help mitigate these harsh realities.

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REFERENCES

MMWR. (2016, April 8). QuickStats: Percentage distribution of deaths, by place of death — United States, 2000–2014. Morbidity and Mortality Weekly Report 65(13), 357. Atlanta, GA: Centers for Disease Control and Prevention. doi: 10.15585/mmwr.6513a6

Jones, David S.; Podolsky, Scott H. & Greene, Jeremy A. (2012). The burden of disease and the changing task of medicine. The New England Journal of Medicine, 366, 2333—2338. doi: 10.1056/NEJMp1113569

National Center for Health Statistics. (2017). Health, United States, 2016: With chartbook on long-term trends in health. Hyattsville, MD: U.S. Department of Health and Human Services.

National Center for Health Statistics. (2011). Health, United States, 2010: With special feature on death and dying. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.

Pew Research Center. (2015, May 12). America’s changing religious landscape: Christians decline sharply as share of population; unaffiliated and other faiths continue to grow. Religion & Public Life. Washington, DC: Pew Research Center.

U.S. Census Bureau. (1907). Statistical Abstract of the United States 1906. Washington, DC: U.S. Department of Commerce.