Transcript CH2

Death in America: When and
How We Die
Chapter 2
Dusana Rybarova
2007 Psyc 456
Life Expectancy in the history
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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
Causes of death
• The most common causes of death in the US:
1. Heart disease
2. Cancer
3. stroke
• The eight leading causes of death in the US
defined by years of potential life lost before
age 65
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Cancer, heart disease, motor vehicle accidents,
suicide, birth defects, homicide, AIDS
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
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
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
Cancer
• General term for more than 100 diseases
• Most cancers take 10-40 years to develop thus
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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
Alzheimer’s Disease
• 10% of people over 65 and nearly half of those 85 or
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older
The fourth leading cause of death among adults in the
USA
Symptoms
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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
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
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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
Suicide
• Suicide is among the 10 leading causes of death in the
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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
Accidents
• 4th leading cause of death among Americans
• Alcohol a factor in a third of fatal crashes
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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
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)
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
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, drugresistant pneumonia, hepatitis, hantavirus, and ebola)