What to Fear

Nice rundown of the statistics.

The single greatest killer of Americans is the so-called “lifestyle disease.” Somewhere between half a million and a million of us get a short ride in a long hearse every year because of smoking, lousy diets, parking our bodies in front of the TV instead of operating them, and downing yet another six pack and / or tequila popper.

According to the US Department of Health and Human Services, between 310,000 and 580,000 of us will commit suicide by cigarette this year. Another 260,000 to 470,000 will go in the ground due to poor diet and sedentary lifestyle. And some 85,000 of us will drink to our own departure.

After the person in the mirror, the next most dangerous individual we’re ever likely to encounter is one in a white coat. Something like 200,000 of us will experience “cessation of life” due to medical errors—botched procedures, mis-prescribed drugs and “nosocomial infections.” (The really nasty ones you get from treatment in a hospital or healthcare service unit.)

The next most dangerous encounter the average American is likely to have is with a co-worker with an infection. Or a doorknob, stair railing or restaurant utensil touched by someone with the crud. “Microbial Agents” (read bugs like flu and pneumonia) will send 75,000 of us to meet the Reaper this year.

If we live through those social encounters, the next greatest danger is “Toxic Agents”—asbestos in our ceiling, lead in our pipes, the stuff we spray on our lawns or pour down our clogged drains. Annual body count from these handy consumer products is around 55,000.

After that, the most dangerous person in our lives is the one behind the wheel. About 42,000 of us will cash our chips in our rides this year. More than half will do so because we didn’t wear a seat belt. (Lest it wrinkle our suit.)

Some 31,000 of us will commit suicide by intention this year. (As opposed to not fastening our seat belts or smoking, by which we didn’t really mean to kill ourselves.)

About 30,000 of us will die due to our sexual behaviors, through which we’ll contract AIDS or Hepatitis C. Another 20,000 of us will pop off due to illicit drug use.

The next scariest person in our lives is someone we know who’s having a really bad day. Over 16,000 Americans will be murdered this year, most often by a relative or friend.

Tags: , , , , ,

Posted on April 7, 2009 at 6:14 AM • 69 Comments

Comments

anon • April 7, 2009 6:30 AM

Got a co-worker in isolation with a MRSA skin infection. The area (TSDC of TSC) is treating it much more seriously than any supposed security threat.

Dido • April 7, 2009 6:45 AM

“Over 16,000 Americans will be murdered this year, most often by a relative or friend.”

Most of those 16 000 are not legally employed, educated, law abiding citizens. The victims’ relation to the shooters tend to be “rivals in crime”.

Anonymous • April 7, 2009 7:13 AM

the next most dangerous individual
we’re ever likely to encounter is one
in a white coat

I wonder about this one. Does this take into account how many of those 200,000 would have died without treatment anyway? Or, also fair, how many of the total population would have died without medical intervention of some kind?

Presumably, the existence of medical care results in a net result of fewer deaths per year (or at least longer life for the vast majority of us), or we could scrap a major portion of human activity altogether.

Kelley Reynolds • April 7, 2009 7:23 AM

The real question that this brings up to me is how can we ‘fix’ the legislative and social priorities to reflect what we ought to be truly afraid of? I see statistics like this quoted often, and many people read and know them, but it rarely seems to make a difference. Is it a simple matter of education? Is it education at the right time (ie, not when we’re 20 or older but 5 and 6), is it something else, or is completely irrational fear something that’s just part of the human condition?

bob • April 7, 2009 7:26 AM

@Dido: stipulated that most people shot are co-criminals, but who said anything about “shooters”? He just said murdered.

It could be anything from poison or a knife through brick and frying pan to a frozen leg of lamb subsequently unknowingly eaten by the police investigating the event (movie plot murder).

wumpus • April 7, 2009 7:31 AM

Now that you’ve been telling us that the only things that make air travel safer are the terrorist (and/or nut) resistant doors and the possibility of an air marshal, what are we to think when we find that increasing the lengths passengers have to walk has significance, and relative to that everything is in the noise?

Calum • April 7, 2009 7:44 AM

@bob: Put down the Roald Dahl and back away slowly.

The best paragraphs in the article are the final ones:

Security itself is an illusion. It is a perception that exists only between our ears. No army, insurance policy, hazmat team, video surveillance or explosive sniffer can protect us from our own immune system, a well-intentioned but clumsy surgeon, failing to look before crossing the street, an asteroid randomly hurtling through space or someone willing to die in order to do others harm.

In this sense, the only things that can truly make us more “secure” are not things. They are the courage to face whatever comes with dignity and intention, and the strong relationships that assure we will face the future together, and find comfort and meaning in doing so.

Imagine, then, what might happen if we simply quit listening to the scaremongers and those who profit from our paranoia. Imagine what the world could look like if we made a conscious choice to live out whatever time we have with courage, compassion, service and joy.

Terrorism is an act of the weak. But so is walking through the airport in our socks.

shadowfirebird • April 7, 2009 7:47 AM

I guess I should give up that job where I drive to an asbestos-ridden hospital and test junk food. I’ve been feeling pretty depressed about it, anyway.

eddie • April 7, 2009 7:48 AM

“Over 16,000 Americans will be murdered this year, most often by a relative or friend.”

Actually, most often by an “acquaintance” rather than by a relative or friend. As Dido says, the way in which they are acquainted is usually as rivals in crime.

If you are not young, unemployed, and engaged in crimes such as theft and drug dealing – or associating with those who are – your risk of being murdered is much lower than average.

Frank • April 7, 2009 7:50 AM

So if we didn’t have any of the things in the article, no one would die?
We’d all live forever! That would be terrible.

Jurjen • April 7, 2009 8:02 AM

No all we have to do is convince the government to spend money in proportion to death probability. That would be fun (and save lots of actual lives).

CGomez • April 7, 2009 8:23 AM

@Kelley Reynolds:

You got it. The people who vote are not well versed in logical, critical thinking and accept appeals to emotion. They vote for people who are masters at appealing to political emotion but know nothing about logic or critical thinking.

End result…?

Nomen Publicus • April 7, 2009 8:26 AM

“The next most dangerous encounter the average American is likely to have is with a co-worker with an infection. Or a doorknob, stair railing or restaurant utensil touched by someone with the crud. “Microbial Agents” (read bugs like flu and pneumonia) will send 75,000 of us to meet the Reaper this year.”

Thus confirming the stupidity of packing all the telephone sanitizers into the B Arc and crashing them on earth – as told by Douglas Adams 🙂

Andrew Gumbrell • April 7, 2009 8:32 AM

Good article.
I realised some time ago that something is going to kill me – I’m just going to make sure it’s not worrying about what it will be.

wow • April 7, 2009 8:43 AM

“Over 16,000 Americans will be murdered this year, most often by a relative or friend.”

Wow… that’s a lot of evil relatives and friends.

Trichinosis USA • April 7, 2009 8:45 AM

@Calum: leave him to his Ronald Dahl, at least it keeps him away from the Richard Marcinko.

Anonymous • April 7, 2009 8:46 AM

It’s interesting that the top killers are directly under our control. We should have fear of ourselves first…

Tangerine Blue • April 7, 2009 9:01 AM

CGomez, you nailed it. Exactly right. Anonymous 8:46, you get it, too.

Generally speaking, we are our own worst enemies. Which is really a very inconvenient idea. It saves us a lot of painful self-analysis if somebody gives us a near-plausible boogeyman to fear instead.

sanders • April 7, 2009 9:14 AM

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Yup, ya gotta keep things in rational perspective.

50 years from now, kids in history classes will be yawning over what panics us today.

counter • April 7, 2009 9:17 AM

If i add up these number about 1,5 million people per year die.
(580,000 +470,000 + 85,000 +200,000 +75,000 +30,000 +42.000 +31.000 +30.0000

Given the fact that in the USA live about 300 million people they will ive an average life of 150 to 200 years. Not bad really.

Joe • April 7, 2009 9:19 AM

One of the big problems here is the underlying assumption that the maximization of average life length is the single most important goal of everyone.

Sometimes, for some people, the trade-off of a shorter better life for a longer worse one is a good trade. The problem is that the length of a person’s life is an easily measured metric, and so it gets fixated upon as the only important one.

Kieran • April 7, 2009 9:25 AM

I realise this may qualify as ironic, but:

What’s a tequila popper? Sounds fun…

Tynk • April 7, 2009 9:28 AM

Just to play devils advocate, but if no one worried about the chance they would be murdered, and thus increased traffic and naivety in locations of a higher then average of people who would commit violent acts on strangers, wouldn’t the number of murders rise? Now I am not talking driving through any particular poor neighborhood, but a bit further, such as not paying attention to your surroundings and those surrounding you when in a foreign country where your death would be much less likely to be cared about.

sanders • April 7, 2009 9:45 AM

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{..assumption that life maximization is most important goal of everyone — Joe}

That assumption (survival) is built into human evolution… where death is the only teacher. Personal rationality can override it.

[“A human lifetime lasts only a tiny fraction of a second on the cosmic calendar… We find that we inhabit an insignificant planet of a hum-drum star lost in an obscure galaxy tucked away in some forgotten corner of a universe where there are far
more galaxies than people.”]

                 -- Carl Sagan

Trichinosis USA • April 7, 2009 9:50 AM

@Kieran:

Tall double sized shot glass or other small glass over which a beer coaster can be laid so as to cap it. Pour in equal quantities of tequila and some clear-ish fizzy soda – 7 Up, ginger ale or seltzer. Add a couple of drops of tabasco or other hot sauce. Cover with the beer coaster and tap or “pop” the full glass on the table to shake it up, then drink the result down in one gulp.

Mike Rankin • April 7, 2009 9:54 AM

The “lifestyle disease” comments are complete nonsense. I bet there isn’t one death in the country from “smoking, lousy diets, parking our bodies in front of the TV instead of operating them, and downing yet another six pack and / or tequila popper.” The Deaths are generally caused by things like lung cancer and heart disease.

I can just see the next episode of CSI:
Robbins: “What was the cause of death?”
Grissom: “They withheld his lima beans.”

And knocking beer? This guy is starting to sound like some liberal elitist spreading fear and terror. Of course we all know that beer has many positive health benefits including reducing chances of stroke and boosting vitamin B6 in the bloodstream. That helps reduce homocysteine which is responsible for arterial plaque.

I’m sure the next step is to fund programs that combat “lifestyle disease”. Oh, and lets make sure we tax people that don’t agree with us and adjust their lifestyle accordingly. Gah!

cress • April 7, 2009 10:18 AM

There is an amazing statistic that I don’t see thrown around that much. There is a 100% chance that we will all die in our lifetime due to mortality. Amazing, absolutely amazing.

Fraud Guy • April 7, 2009 10:21 AM

Old joke:

Did you hear about the 80 year old who didn’t drink, didn’t smoke, ate well and exercised regularly?

He died of nothing yesterday.

liberal elitist • April 7, 2009 10:25 AM

@Mike Rankin

Well, the government is now funding programs to combat ‘terrorism’, although the risks of dying from this is much lower (almost non-existent).

I don’t agree with that, and still I am taxed for it.

Besides, yes, cigarettes (as an example) are a cause of lung cancer, so if a smoker dies of lung cancer, indeed cigarettes killed him/her. Cigarettes => lung cancer => death.

Or would you say if a pedestrian gets hit by a car, but dies on impact with the ground, that he is ‘not killed by a car’?

Guess that makes me an elitist liberal, or whatever.

Clive Robinson • April 7, 2009 10:37 AM

Just a question, in,

“Or a doorknob, stair railing or restaurant utensil touched by someone with the crud.”

What meaning do you put to “crud”?

In the UK it’s meaning is derived from that that we might politly call “natural fertalizer”…

It’s a subject that is a bit close to my small intestin at the moment as I’m recovering from Norovirus, which is realy only transmited from human solid waste to food by somebody not washing their hands properly (or at all)…

KOGI • April 7, 2009 10:40 AM

Compare all these numbers to the total population of the country (roughly 350+ million) and these numbers are nearly insignificant. Even the largest group, “death by cigarette” at 580,000 annually, works out to 0.165% of the population. Move to the smallest group, murder, is at a mere 0.005% of the US population.

Hardly anything to fear.

mcb • April 7, 2009 10:46 AM

@ Kieran

“What’s a tequila popper? Sounds fun…”

While we’re at it, what are “Jello Shots”? They sound like a very festive a lifestyle disease vector.

Someone (in a Terry Gilliam related entertainment if I’m not mistaken) said it well:

“I want to be sick when I die.”

kangaroo • April 7, 2009 11:04 AM

Dido: Most of those 16 000 are not legally employed, educated, law abiding citizens. The victims’ relation to the shooters tend to be “rivals in crime”.

Did you bother to look up the statistics, or are you just pulling it out of your ass to fit your preconceptions. According to the doj (http://www.ojp.usdoj.gov/bjs/homicide/relationship.htm)
50% of those murders are spouses and family members. Some may be co-partners and crimes, but then again some of the friend and acquaintances are not partners in crime.

Supporting that reading, friends are much more likely to shoot each other, while family members are as likely to use alternative such as knives or their bare hands — aka, many of those are irrational crimes, crimes of passion, that are personal in nature.

Additionally, this paper (http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1354924) finds that income inequality is not associated with murder, but is associated with theft.

xd0s • April 7, 2009 11:06 AM

Well if you want to get down to it, the leading cause of death, is birth.

The chain of events is something like this: Birth -> stuff -> death 🙂

The point should be (as has been made in other posts) that taking action using government money should be based on “the greater good” and applied to things we can actually impact by spending money on them.

If you want to save lives then address the controllable problems that kill people, while balancing the “freedom of choice” that allows people to smoke or drink or overeat etc because they want to. Afterall, in the US at least, the Constitution mentions life, liberty, and the pursuit of happiness but not public safety and cost effectiveness though I suppose you could read “provide for the common defense” and “ensure domestic tranquility” could refer to public safety though.

Bottom line: IANAL but the rights of people to kill themselves through otherwise perfectly legal means is more constitutional (in the US) than removing their right to do those things, even if it kills them and we have to pay for it.

Rich Wilson • April 7, 2009 11:21 AM

dido said: Most of those 16 000 are not legally employed, educated, law abiding citizens. The victims’ relation to the shooters tend to be “rivals in crime”.

I once read (and can’t find it online to back this up unfortunately) that the number on factor in one’s risk to getting murdered is being involved in criminal activity.

The second is being a woman who has left a man within the last two years.

RH • April 7, 2009 11:21 AM

@counter:
“Given the fact that in the USA live about 300 million people they will ive[sic] an average life of 150 to 200 years. Not bad really.”

I didn’t look the statistics up myself, but I would not be surprised if “getting old” accounts for the missing 50%ish of death. It would make sense that he overlooks it since that doesn’t really have a killer – besides a genetic predisposition to the cessation of acquisition of contested resources.

Troutwaxer • April 7, 2009 11:41 AM

@ RH,
Don’t forget that there are a zillion causes of death which don’t get noticed unless you know somebody who died from one of them. They kill 100-10,000 people per year, and don’t ever make the top ten. That’s what accounts for the other 50%. Meningitis, for example, kills around 700 people a year. Asthma kills around 4000. Etc.

canadIAN • April 7, 2009 11:55 AM

@xd0s

You missed part.

Life is a sexually transmitted fatal disease. No-one gets out alive.

Leo Petr • April 7, 2009 12:08 PM

@sanders:
Evolution largely stops caring about you once you pass reproductive age, actually.

You still have some evolutionary impact via altruism towards those, such as family members or the human species, who carry similar genes, but your primary contribution to evolution is over once you are past your mid-forties.

Anonymous • April 7, 2009 12:12 PM

“The single greatest killer of Americans is the so-called “lifestyle disease.” Somewhere between half a million and a million of us get a short ride in a long hearse every year because of smoking, lousy diets, parking our bodies in front of the TV instead of operating them, and downing yet another six pack and / or tequila popper.”

Unfortunately, this kind of straight forward sensible talk never gets mentioned on the evening news.

AppSec • April 7, 2009 12:20 PM

@liberal elitist
Actually it’s the impact that killed the pedistrian, not the car.

Just as it isn’t the fall that kills someone, its the impact of stopping suddenly. Which could actually be blamed on gravity — after all, that is what leads to increased velocity over the course of a given distance (up to terminal velocity, of course).

rjh • April 7, 2009 12:37 PM

@kangaroo:

Did you follow the link that you gave? It shows spouse/family/girl/boyfriend totalling 18.8%. Other acquaintance got 32.1% and undetermined got 35%. If you dig into the definition of acquaintance, it includes neighbors and others that they expect would know each other.

I’m not sure how you got 50% for family and close friends.

tracy • April 7, 2009 12:45 PM

More people died from illicit drug use than were murdered, so if they legalize drug use then will they also legalize murder? Obviously the law doesn’t matter, and look how much money is spent solving murders and prosecuting murderers. So, will murder be legalized next? Probably.

Clive Robinson • April 7, 2009 1:57 PM

I have not found it online (yet) but there was a report that indicated that in a US City your chances of death by violence either by your self (suicide) or others (murder) differed significantly on the basis of racial ethnicity.

If I remember correctly in the young adult range it was ten times more likley to be death by suicide if you where WASP and the other way around if you where African American.

I guess the figures need to be looked at more carefully before to many claims are made…

kangaroo • April 7, 2009 2:06 PM

rjh: I don’t see your link — there doesn’t appear to be any other “rjh” postings on this thread.

But according to the doj graph, for say 2000, murders by family (intimate + not intimate) total just under 4000, and murders by acquaintances total just over 4000. Of course, that varies by year: in 1990, family murders were only 50% of acquaintace murder (at the height of the the 80s/90s crime spree, partly fueled by the crack epidemic).

kangaroo • April 7, 2009 2:14 PM

rjh:

Oh, I see, you were referring to the doj graph. The percentages I was talking about was relative: so 18% family plus 32% other acquaintance means that 36% percent of those murders were committed by family members, which is a bit less than half, which is what I eyeballed the graph.

We can’t know what “undetermined” means, so we can’t consider that. And we disregard the “stranger” since that’s irrelevant to the matter at hand. What matters is that a significant percentage of non-stranger murders are probably not crime-related side-effects, but are simply part of the risk of living with other people closely who could lose their marbles at any moment.

!NSA • April 7, 2009 2:37 PM

That’s a nice rundown, but why isn’t Stress on the list? Is it some sort of ghost, b/c it encompasses probaby most in the above list. Robert Sapolsky is onto something big, with his integrated research in particular.

phred14 • April 7, 2009 2:49 PM

Evolution largely stops caring about you once you pass reproductive age, actually.

You do mention the “altruism” side of things, but there has been some evidence to suggest that you dismiss it too casually. The “grandmother hypothesis” suggests that post-reproductive adults were one of those factors that gave the human race a serious leg up in the evolutionary stakes. Less-fit elders were able to watch the kids and put both (presumably more fit) parents out into the hunter-gatherer workforce, thereby increasing the food supply, opening the way to more babies, etc.

Lifestyle Mafia • April 7, 2009 4:02 PM

From the NYT:

But if you are the mayor of New York, no such constraints apply. You can simply announce, as Michael Bloomberg did, that the city is starting a “nationwide initiative” to pressure the food industry and restaurant chains to cut salt intake by half over the next decade. Why bother with consent forms when you can automatically enroll everyone in the experiment?

Public Policy That Makes Test Subjects of Us All

http://www.nytimes.com/2009/04/07/science/07tier.html?8dpc

Anonymous • April 7, 2009 4:10 PM

Going down that list, I find that my lifestyle has me pretty well prepared for most of them (I don’t smoke, I have a healthy diet and exercise regularly — some would say compulsively — I have a modern car with excellent safety features, but take the train whenever I can anyway, etc. etc.)

The ones I am least well prepared for at present are suicide and murder.

clem • April 7, 2009 5:18 PM

@Anonymous
“The ones I am least well prepared for at present are suicide and murder.”

Prozac wants to be your friend. If you take enough of it for the former, it makes you care much less about the latter.

matt • April 7, 2009 6:25 PM

@KOGI: These stats are per year, not per lifetime. Once you do the maths and calculate what percentage of people are killed by these things over their lifetime, rather than this year, it becomes much more interesting.

Filias Cupio • April 7, 2009 8:41 PM

The original article is very brief and unclear on some important issues. E.g. somebody lives a very healthy life, and dies of a heart attack aged 94. Where do they come in these statistics? Possibly they are counted in “lifestyle diseases”, possibly they aren’t counted at all because this are just “premature death” statistics (but the article didn’t tell us.)

A more useful statistic would have been life expectancy loss – if whatever killed you hadn’t, how much longer could you expect to live? (In the case of the 94 year old, the loss is small.) But this gets complicated – was a fat person killed by heart attack or obesity? Do you compare the life expectancy of a same-weight twin who is immune to heart attacks, or a healthy weight twin?

See also “World Death Rate Holding Steady At 100 Percent” http://www.theonion.com/content/node/39236

Matthew • April 7, 2009 10:36 PM

No name-brand threat is a patch on good-old-fashioned “natural causes”, combined with “misadventure”. If they could find a cure for those, then we’d all live a LOT longer.

SpecialK • April 8, 2009 1:56 AM

The total US death rate for about 304 million people is 8.3% annually. The 1.35 million accounted for in this article come to .44%.
I’m curious how many of the balance are old age, as opposed to other ends.

BF Skinner • April 8, 2009 6:24 AM

@Kelley Reynolds @CGomez

But people don’t make decisions as the result of clear thinking and logical reasoning. While pure irrational fear is a bad state our moral decisions tend to be snap judgements that our reasoning later explains to our satisfaction and our friends and acquaintences are more likely to influnence them. (which since they are likely to kill us is probably a selective advantage.)

“It is not enough that I win. All others must lose.” Mother Teresa

Some studies show that people who have completely lost their emotions spend hours trying to arrive at even simple decisionS or that healthy adults will take a bet they know they will lose if it means they can make their opponent lose as well.

“People of good faith and reason…” is, if not a myth only a partial truth. Education of information takes you/us only so far. It must incorporate how the brain has evolved in order to be effective. Needs both blatent emotional manipulation and clear critical reason.

Steve Parker • April 11, 2009 8:17 PM

“About 42,000 of us will cash our chips in our rides this year. More than half will do so because we didn’t wear a seat belt.”

21,000 deaths due to not wearing a seat belt? I don’t have the UK stats to hand, but common experience suggests that virtually everyone in the UK wears a seat belt.

Is there such a difference between the USA and UK in this matter?

Valera • April 14, 2009 11:22 AM

“I don’t have the UK stats to hand, but common experience suggests”

Haha.. that’s cute.

Either way, this bothers me a bit: “We’re statistically far more likely to be killed by a lightning strike than by an action of Al Qaeda, for example.”

Al Qaeda or not, something makes me wonder how much so called terrorist activity we’d witness if we stopped controlling our borders for it and dropped all the intelligence operations (against it.). Maybe the numbers are so low because we’re at least somewhat successful at controlling terrorism on our lands. In Afghanistan or Iraq we’d be more likely to become a victim of terrorism, huh?

Clive Robinson • April 15, 2009 8:49 AM

@ Valera,

“Haha.. that’s cute.”

The reason Steve Parker said,

“I don’t have the UK stats to hand, but common experience suggests”

Is because in the UK not wearing a seat belt is an offence for which both the driver and the passenger could be fined.

There are however exceptions in the law such as taxi drivers etc.

Rich Guida • April 15, 2009 10:22 AM

I am truly wondering when Mr. Schneier’s dismissal of fear-mongering is going to address two sacred cows: those who fear-monger on climate change; and those who fear-monger on the use of nuclear power. He has studiously avoided both topics it appears in all of his criticism of fear-mongering. I do agree with many (although not all) of his concerns that fear-mongering is rampant and that it dulls us to what the real risks are – cigarette smoking, poor diet – etc. But fear-mongering has been going on for eons, many in the environmental community have turned it into an art form, so I am puzzled by why he has turned his sights on them too? They most certainly deserve it arguably more than some of the other targets he has properly hit.

Valera • April 15, 2009 12:06 PM

@ Clive,

That still doesn’t allow us to substitute statistics for common experience. Here, AFAIK, only the driver gets fined, but both, for himself and for the passenger. Either way, there are folks driving without seat belts.

And unless one’s common experience is so common that he sees people many times a day in many different neighborhoods and from many different age groups driving with their seat belt on, and not many without it, IMHO, he shouldn’t claim that “common experience suggests”.

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