Death in America: When and How We Die

1. Death in America: When and How We Die Chapter 2 Dusana Rybarova 2007 Psyc 456

2. Life Expectancy in the history • Roman Empire – 22 • Middle Ages in Europe – 33 • American Revolution – 36 • 1900 – 47 • Currently – women 79 and men 72 • 39% of women living today and 21% of men can expect to celebrate their 85th birthday • Projections for 2050 – women 85.6, men 79.7

3. Causes of death • The most common causes of death in the US: • Heart disease • Cancer • stroke • The eight leading causes of death in the US defined by years of potential life lost before age 65 • Cancer, heart disease, motor vehicle accidents, suicide, birth defects, homicide, AIDS

4. Dying Trajectories and Stress • Dying trajectories – pattern of dying • Duration of a death • Time between the onset of dying and the actual arrival of death • Shape of a death • The course of the dying process (predictable, expected or unexpected) • Brief trajectory for infants, children, adolescents and young adults • They are much more likely to die by sudden means involving fatal accidents, homicide, suicide, and war • Stress and Life • Long life expectancy is the result of improved life standards but industrialization has consequences for • Global warming; air, water and earth pollution and increased psychological stress

5. Heart Disease • Development of lesions on the coronary arteries is the principal cause of heart disease • Plaques – deposits in arteries • Atherosclerosis – blocking of blood supply to some parts of the heart muscle • Angina pectoris – periodic chest pains caused by an insufficient supply of blood to the heart • Myocardial infarction – blocking off of the heart’s blood supply • Heart disease, hypertension, stroke, atherosclerosis, and other cardiovascular diseases are, as a group, the primary cause of death in the entire world • One in five of us will develop some form of heart disease before our sixtieth birthday

6. Emotions and Afflictions of the Heart • Hypertension • Developing heart disease has been linked to high blood pressure • People who are continually subject to a great deal of stress – and who lack the skills to cope with it – are at significantly greater risk of heart disease • Emotionally driven rises in blood pressure can cause injury to endothelium (the inner lining of the arteries) and as a result plaque begins to form at the site of damage • Type A behavior pattern • Hard-driving, competitive, aggressive, experiencing time-urgency in almost everything they do, fast speaking in loud and explosive style, display clenched fists and aggressive facial expressions • Most harmful pattern of behavior is hostility – results in greater increases in heart rate and blood pressure in response to stressful situations than people with less or no hostility

7. Cancer • General term for more than 100 diseases • Most cancers take 10-40 years to develop thus the risk increases with age • Cancer-prone individuals • An inability to express emotions such as anger, fear, anxiety (cognitive denial and emotional repression) • Inability to cope with stress and tendency to develop feelings of hopelessness and depression • Grieving process and the experience of loneliness may have negative impact on the immune system

8. Alzheimer’s Disease • 10% of people over 65 and nearly half of those 85 or older • The fourth leading cause of death among adults in the USA • Symptoms • Memory loss interfering with daily activities • Forgetting appointments and asking repeatedly the same thing • Forgetting simple words • Poor judgment • Getting lost in familiar places • Patients usually die after having infections, such as pneumonia, or other complications 3 to 20 years after the first signs appear

9. Homicide • Average homicide death – 34 years • USA – highest firearm-related homicide rates of any industrialized nation • 1992 • USA – 13,220 people were murdered by handgun • Australia – 13 • Britain - 33 • After accidents, homicide is the second leading cause of death for Americans in workplace • For young, male African American homicide is the number-one cause of death • The highest rates of homicide are in the 15-24 year-old group • 50% of victims are murdered by a relative, friend, or acquaintance

10. Suicide • Suicide is among the 10 leading causes of death in the Western world • Average suicide death – 43 years • Gender differences • Three times as many women as men attempt to kill themselves • Four times as many men as women actually die by suicide • These differences attributed to differences in serotonin levels and more violent means of dying used by males • The most likely candidates for suicide are elderly, white, alcoholic males and the frequency of suicide increases across life span

11. Accidents • 4th leading cause of death among Americans • Alcohol a factor in a third of fatal crashes involving young people between 18 and 21 • Accidents are the leading cause of premature death in the USA • Number one cause of on-the-job deaths • Every year head injury claims 100,000 lives and leaves 90,000 victims disabled • Head injury often results in radical personality changes and causes marital and family difficulty

12. Natural Disasters • Constitute up to 4% of the total deaths in the world every year (natural and technological) • Need for counseling for paramedics, EMTs, rescue teams, police and firefighters • Critical incident stress debriefing sessions to prevent post-traumatic stress disorder (PTSD)

13. War • Accounts for 110 million deaths in previous century • Disaster syndrome • Shock stage (victim is stunned, dazed, and apathetic) • Suggestible stage (victim tends to be passive, suggestible to directions from rescue workers) • Recovery stage (need to give repeated accounts of the catastrophe, generalized anxiety and later regains psychological equilibrium) • PTSD often experienced by war survivors • Marked by nightmares, continuous stress, flashbacks, psychological numbing, impaired social relationships, possible symptoms of survivor’s guilt • Lifetime prevalence of PTSD in both men and women is 3% • Post-traumatic death syndrome • Pervasive readjustment problem in veterans with and without PTSD • Chronic fears, chronic grief states, pronounced death anxiety, profound attraction to death themes with a paradoxical fear of death and dying in reference to self and others

14. AIDS and communicable diseases • Caused by HIV (human immunodeficiency virus) • Attacking the immune system’s lymphocyte cells • Attacking central nervous system resulting in memory loss, confusion, and uncontrollably jerky movements, learning defects in children • AIDS ranks eight among the leading causes of death in the USA • It is the leading cause of death among Americans between the ages of 25 and 44 • Every day about 6,000 people around the world are infected with HIV • Infectious disease has become the third-leading cause of death in the USA (tuberculosis, E. Coli, drug-resistant pneumonia, hepatitis, hantavirus, and ebola)