How Do Men Die in the Prime of their Lives?

My friends and I are reaching a milestone soon - a quarter century lived. Our own deaths are probably very far from our minds, and for good reason: about 2 percent of male deaths come from the 25-34 category. So while small, it is not insignificant and worth looking at.

According to the CDC in 2004 - the following are the top ten causes of death for males in the United States between the ages of 25-34.

1. Unintentional Injury - 34.8%
2. Suicide - 14.6%
3. Homicide - 13.3%
4. Heart Disease - 7.6%
5. Cancer - 6.2%
6. HIV Disease - 3.2%
7. Diabetes - 1.2 %
8. Stroke - 1.0%
9. Birth Defects - 0.8%
10. Chronic Liver Disease - 0.8%

Unsurprisingly, most of the deaths are not related to traditional disease: accidents (probably mostly automobile), suicide, and murder. This possibly suggests the need for better mental health counseling, which is an area I know very little about - including it's effectiveness and differences between nations.

What surprised me the most in these numbers is the rate of heart disease. Every year a couple of thousand in this young age group are dying of heart disease. I'm interested to know who these people are. Do they have some genetic defect that makes them especially vulnerable? Do they smoke a lot? Are they morbidly obese?

I'll break down the cancer rates in a later post, but younger males should look for cancer in the testis, the blood cancers (lymphoma), and skin cancer (melanoma).

When broadening to include females and between 25-44...

Causes of Death	Number of Deaths	Rate per 100,000
25-44 years All causes	148,904	177.8
1 Accidents and adverse effects	26,554	31.7
. . . Motor vehicle accidents	14,528	17.3
. . . All other accidents and adverse effects	12,026	14.4
2 Human immunodeficiency virus infection	22,795	27.2
3 Malignant neoplasms, including neoplasms of lymphatic and hematopoietic tissues	22,147	26.4
4 Diseases of heart	16,261	19.4
5 Suicide	12,536	15
6 Homicide and legal intervention	9,261	11.1
7 Chronic liver disease and cirrhosis	4,230	5.1
8 Cerebrovascular diseases	3,418	4.1
9 Diabetes mellitus	2,520	3
10 Pneumonia and influenza	1,972	2.4
. . . All other causes (Residual)	27,210	32.5

You can notice the homicide and suicide rates are down, while Cancer and HIV increase. However this data is a bit older (1996), so the HIV mortality rate has gone down in recent years.

A Look Back at my Election Predictions

Predictions:

House: D - 260, R - 175

Senate: D - 58, R- 40

Presidential EV: 368-170 Obama

Popular Vote: 53.6 to 45.1 Obama

Actual:

House: D - 257, R - 178

Senate: D - 57, R - 41 (assuming Franken wins)

Presidential EV: 365-173 Obama

Presidential PV: 52.9 to 45.7 Obama

Not too shabby. I was correct on every state except Montana, which was closer than expected. The pollsters did a pretty good job this year with all the variables they needed to take into account: the new voters, the cell phone effect, bradley effect, and the shy tory factor among others. I thought the cell phone effect would boost Obama up a little more than it did, but I was still within about 1 percentage point. I'm sure if I had confidence intervals (which I should have), the actual results would have been within them.

In the House and Senate races the republicans did a little better than expected. With Bush's favorablity rating hovering in the low 20s, it's pretty impressive how several of his supporters held onto their house seats. It's interesting that many of those who lost were on the moderate side, leaving mostly more conservative republicans left. I think this election as a whole indicates that Change was definitely desired, but the Democrats will need to show real progress in the next 2 and 4 years if they want to keep their command.

If you're interested, check out how the "expert" pundits did on predicting election. It was probably a lot of luck, but I did better than almost all of them.

Women Concentrate on the Wrong Organ (too)

Fear is an interesting concept that I hope to explore more in the future.

In a 2005 study by Women's Health Research, over 1000 women were asked - which disease they feared the most. I was rather surprised they found the fear of Breast Cancer more than doubled Heart Disease. While Breast Cancer caused approximately 3% of the US deaths in 2005, over 22 percent have the most fear for the disease. On the other hand, heart disease accounts for 28.6 percent of diseases and only 9.7 percent consider their top fear!! I know the US society has placed a higher emphasis of breasts over heart, but I can't say I expected this.

Fear Rank																					Disease	Women's Most Feared Diseases										Cause of Death in Women					Difference
1																					Cancer (unspecified)	24.00%										21.60%					2.40%
2																					Breast Cancer	22.10%										3.24%					18.86%
3																					Heart Disease	9.70%										28.60%					-18.90%
4																					HIV/AIDS	9.30%										2%					7.30%
5																					Alzheimer’s Disease	4.60%										3.40%					1.20%
6																					Ovarian Cancer	2.70%										1.30%					1.40%
7																					Lung Cancer	2.40%										5.62%					-3.22%
8																					Diabetes	2.40%										3.10%					-0.70%
9																					Colon Cancer	1.60%										1.94%					-0.34%
10																					Stroke	1.20%										8.00%					-6.80%

So what are the possible explanations for this?

High Incidence?
-While the mortality of breast cancer is low, there is a significant amount of women living and bravely battling the disease. On the other hand, the same can be said about heart disease.

Feeling of Control
-While risk factors such as diet, obesity, and hormones have been established, the cause for breast cancer can still be considered quite a mystery. So most women likely believe that she could develop BC and don't have the power to control it. The risk factors for heart disease - (diet, physical activity, smoking) are a bit more established, so women's feeling of control may be stronger for CHD.

Public Exposure
-Another explanation is that breast cancer has had stronger activists, fundraisers, and lobbyists that push the disease into the mainstream. The general wisdom may be that since Breast Cancer is getting the same or more ad time than Heart Disease - women's risk of death are great for BC.

*Edit*
Age of Disease
Women may believe that they are more likely to get Breast Cancer at a younger age than Heart Disease. According to SEER the median age of dianosis is 61, while the median age of death is 69. For heart disease the average age of a first heart attack is around 70 years old (though the disease can be caught at a much earlier stage).

Women still believe it's a male disease
The stereotypical person with heart disease (at least in my mind) is an overweight, red faced guy in a suit. Women only comprise of about 25 percent of heart studies, and things like this need to change.

Conclusion:
Heart disease kills about 8 times the women than Breast Cancer. The medical community needs to do a better job about expressing this risk. Maybe when people go to their primary doc, they should be asked this "what disease do you fear the most" question. Then the education can begin. Another idea is instead of counseling by doctor, people should have a "medical counclier" who discuss peoples risk of disease and what they can do for prevention. According to the Women's Heart fact sheet only 2 percent of the NIH budget is spent on prevention, and that is just flat out wrong .

2005 data from:
CDC
Women's Health Research
Women's Heart Fact Sheet

The All-Time Greatest College Football Teams: Where are they Headed?

(rankings as of 12/3/08, click on table for larger image)

The teams highlighted blue are likely to advance in the rankings in the future, while the teams in red look like they will fall based on the last ten year win percentage, 2009 recruiting rank, and current BCS rank. Any suggestions on how to make this more scientific?

Teams with a conference championship (Big Twelve, SEC) have a slight advantage. I also give an advantage t0 two teams with nice locations (USC, Texas). Let's not kid ourselves - many good players would rather play in the sun at USC instead of frigid State College. Notice Alabama has the worst win percentage in the last ten year, but seems to be turning it around with a nice year and a quality recruiting class. Nebraska and Tennessee seemed to be failing out of the spotlight lately, and with poor performances on the field and with recruiting it will be tough to regain momentum. Notre Dame has really lost it's luster lately, and it doesn't look like Charlie Weis will be the one to bring them back.

Pretty amazing how these powerhouses just keep going. Five of the top 10 teams are going to be playing the top tier bowls.

Notes:
1. Win percentage statistics generated by stassen.

2. rankings of non-bcs teams from usa today.

3. 2009 recruiting rankings from rivals

Vaccines, Autism, and the Stupid Media

From the Economist:

Why the sudden spike in Measles when we have a vaccine?

"The rise, says the HPA, is due to a fall in vaccination rates. In 1998 91% of two-year-olds were immunised, but by 2004 that had fallen to 80%, far below the 90% rate needed to keep the disease under control....Happily, the dip in vaccination seems to have been temporary. Immunisation rates today are 85% and rising"

Why the drop in Vaccination rate?

Thank you Dr. Wakefield....

"In the UK, the MMR vaccine was the subject of controversy after publication of a 1998 paper by Andrew Wakefield et al. reporting a study of twelve children who had autism spectrum disorders and bowel symptoms, in many cases with onset observed soon after administration of MMR vaccine.[23] During a 1998 press conference, Wakefield suggested that giving children the vaccines in three separate doses would be safer than a single injection. This suggestion was not supported by the paper, and several subsequent peer-reviewed studies have failed to show any association between the vaccine and autism.[24] Administering the vaccines in three separate doses does not reduce the chance of adverse effects, and it increases the opportunity for infection by the two diseases not immunized against first.[24][25] Health experts have criticized media reporting of the MMR-autism controversy for triggering a decline in vaccination rates.[26]
In 2004, after an investigation by The Sunday Times,[27] the interpretation section of the study, which identified a general association in time between the vaccine and autism, was formally retracted by ten of Wakefield's twelve coauthors.[28] The Centers for Disease Control,[29] the Institute of Medicine of the National Academy of Sciences,[30] the UK National Health Service[31] and the Cochrane Library review[9] have all concluded that there is no evidence of a link between the MMR vaccine and autism.
In 2007 Wakefield became the subject of a General Medical Council disciplinary hearing over allegations that his research had received funding related to litigation against MMR-vaccine manufacturers, and had concealed this fact from the editors of The Lancet.[32] It was later revealed that Wakefield received £435,643 [about $780,000] plus expenses for consulting work related to the lawsuit. This funding came from the UK legal aid fund, a fund intended to provide legal services to the poor.[27]"

It's sad what the scientifically illiterate media has done to this issue. I'm also disappointed in the political leaders like Tony Blair who would not reveal if his child was vaccinated or not. You don't mess with diseases like Measles when there is no scientific or epidemiological backup on the subject. Some random doctor speculating does not count...