Question: What is the leading cause of death in the United States?
Answer: Medical Error
I wrote about this in 2013:
This is a great interactive tool from the Institute for Health Metrics and Evaluation (IHME). It gives a clean, visual representation of the change in burden of disease over the last 20 years. Here’s a snapshot of the top 10 causes of death in the US:
1st Comment – Where is “Medical Error” as a cause of death? A new study (A New, Evidence-Based Estimate Of Patient Harms Associated With Hospital Care, Journal of Patient Safety, September 2013) says that between 210,000 and 440,000* patients each year who go to the hospital suffer preventable harm that contributes to their death. Those are just people who go to the hospital. (NPR wrote about this study too: How Many Die From Medical Mistakes In U.S. Hospitals?)
* Dr. Campbell writes, “An analysis of all hospitalized Medicare patients concluded that from 2000 to 2002, “over 575,000 preventable deaths occurred” nationwide.” So, these figures may be the tip of the iceburg.
Here are the top 3 causes of death from the CDC’s list of leading causes of death:
- Heart disease: 611,105
- Cancer: 584,881
- Chronic lower respiratory diseases: 149,205
This study would place medical errors in the third position, perhaps higher if you count undocumented errors. Their authors state:
“This is roughly one-sixth of all deaths that occur in the United States each year. The problem of [preventable adverse events] must emerge from behind the “Wall of Silence” and be addressed for the sake of prolonging the lives of Americans.”
If we add to those 575,000 Medicare deaths another 100,000 deaths from side effects of prescription drugs, taken as directed, (not including deaths because the doctor made a mistake and prescribed the wrong drug, or the pharmacist made a mistake filling the prescription, or the patient accidentally took too much, which inflate the total still more), medical error surpasses heart disease and takes the top position. That is, “physician error, medication error, and adverse events from drugs and surgery” would be the leading cause of death in this country.
The US has the most expensive health care on the planet. Preventable errors related to that care likely account for more deaths than any disease. Why isn’t Medical Error listed on CDC’s website and on other government reports? Dr. Campbell:
“How is it possible that this cause of death not even be listed on a government website as a leading cause of death? Such publicity would be bad for the disease business — and if the US government cares about one thing here, it’s the economic interests of the medical establishment, one of the leading donors to political candidates, parties, and political action committees.”
2nd Comment – Look at that rise in Alzheimer’s Disease. Alzheimer’s is just one form of dementia. And dementia is just one type of mental illness (which include insomnia, depression, ADHD, etc.) Mental disorders have become the greatest health challenge of the 21st century, yet we barely discuss them. As I wrote in 2011, I wish we could get to a place where people spoke as openly about their dementia and depression as they did their heart disease and diabetes.
However you add it up, medical error is one of the top three causes of death in the US, if not the leading cause. Dr. Greger blogged about it this week:
In 2000, Dr. Barbara Starfield, a leader in primary care, placed medical error as the third leading cause of death in the US, after heart disease and cancer. (Is US Health Really the Best in the World?, Journal of the American Medical Association, July 2000)
In a 2009 interview, she said:
“The American public appears to have been hoodwinked into believing that more interventions lead to better health, and most people that I meet are completely unaware that the US does not have the ‘best health in the world’.
Yet, few speak about the deaths from medical error. There’s still silence:
The Silence, Michael Millenson, Health Affairs, 2003
Be very careful when you submit yourself to the medical community. As Dr. Starfield said, more interventions do not necessarily lead to better health.
both my parents died that way
Starfield spoke the absolute truth when she said Americans have been hoodwinked into believing the more tests, the better. That’s not true. It has been one of the most frustrating aspects of my public health career. People will argue with me until they are blue in the face that the more blood tests, mammograms, colonoscopies, x-rays, etc. they get, the sooner they can “take care” of lurking diseases.
Here are some problems with that:
1. Sometimes the tests and therapies cause physical harm (x-rays, internal scopes, going on heart-lung machines and anesthesia during surgery).
2. If the test finds something that isn’t there (false positive), you’ll pay a lot of money and emotion finding out the truth.
3. The therapy may do more harm than good (statins for high cholesterol).
4. If you decide against drugs and surgery and opt for lifestyle (diet, exercise, not smoking), what’s stopping you from doing that now?
In people who are very old, chemotherapy and radiation don’t necessarily extend life, and may hasten it. They surely reduce the quality of those final days, as do the side effects of drugs.
All these drugs and tests and scans and surgeries aren’t helping us live longer or better (but they are big profit-generating businesses!). People in other developed countries pay less for healthcare, have fewer tests, and live longer and healthier lives. The US does not have the best health or healthcare in the world! … But try to tell people that.
I think it’s … people don’t want to grow old. (You can’t blame them for how we treat the old in this country.) They don’t want to face the hair loss, muscle loss, mental function loss – loss of life. Well, loss is hard.
But I think there is something else going on. There is a vanity, a repulsion of anything with the odor, or should I say the stench?, of age. The body-beautiful, selfie, youth culture is driving people to the medical industry in an attempt to defeat aging, to shore them up against the inevitable.
Why not celebrate aging? That happens to be a quality unique to Blue Zones, places known for their longevity.
This is so true. Both my parents died of medical error, medical neglect, etc. And we do not have the best health system globally (and we’re the only country in the world that permits commercial advertising of prescription drugs, but I know you know that).
One recent example of overtesting is the development of 3-D mammography. Not only does it deliver more radiation to the breasts, but its false positive rate is higher. When I went for my mammo, they almost bullied me into the 3-D one, but I refused. Both my internist and gyne had said the 2-D was fine–and the radiation from that is bad enough!
That’s interesting, about the 3-D mammogram, I didn’t know. You would think they could develop a test with less radiation, not more.
You would think so, wouldn’t you? Maybe it’s the medical equivalent to the big-auto, big-truck/SUV phenom (“My machine is bigger, more powerful, than your machine”) And yes, I agree, people don’t want to get old. Had an echocardiogram this week (hadn’t had one for 8 years & doc wanted to check–fortunately not an invasive or radioactive test) and there were several “findings.” But my doc (who, bless his heart, also checked with a cardiologist @ no cost to me) said they’re simply aspects of aging & should not cause any problems. But I felt like I could see my future for the first time, and it involved my heart…. Sigh. Hopefully the walking will be helpful.
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