The Future Of Dying: Will Infectious Diseases Return?

June 25, 2012

The New England Journal of Medicine has combed through their archives to show how death has changed over the last century. Thanks to treatment of infectious disease, more people are dying of old age (or living long enough to get cancer) than ever before, but with antibiotic resistance and the return of diseases like pertussis (whooping cough), tuberculosis, and super flus (bird, swine…), are the last few decades just a blip on the map?

So What Do Deaths Look Like Then And Now?

More people live long enough these days to die of cancer, but outcomes for cancer patients have been improving in leaps and bounds over the last decade, and that will likely continue for at least another decade. Besides that, heart disease is the number one killer (and America’s obesity is likely to keep that number steady for a while…plus, the efficacy of many treatments are currently being reconsidered).

Most optimistically? Accidental deaths are down. When considering the advent of cars and the severity of car crashes, our ability to treat broken bones and internal injuries has improved dramatically-this is the most hopeful change in the findings!

Fewer Infectious Diseases?

If you only get one vaccine, get the TDAP (Tetanus, Diphtheria, and Pertussis). Whooping cough is mostly responsible for killing infants, and doesn’t make a huge impact on how deaths have changed. Diphtheria, however, does. (And Tetanus? You really, really don’t want it—treatment involves the same type of needle injections as rabies).

Flu, pneumonia, and tuberculosis were the leading cause of death 100 years ago, killing more than heart disease and cancer—combined—do today. Two broad have changed this: the first, obvious one is medicine. Widespread availability of antibiotics wiped tuberculosis from the US, and care (combined with better hygiene) have helped reduce flu and pneumonia deaths.

The second major factor is harder to grasp, but it’s the advent of hospitals/major medical care. The medical system as we experience it today started forming during Reconstruction (post-Civil War era). The medical schools of the time had saturated the country with general practitioners, and began offering specializations.

Combined with local drug stores of the time, there was also a huge campaign to get people to use hospitals (the first people really using them were the very poor—prostitutes and other transients. Doctors still made house calls, and even the poor usually had a healer in the community, even if it was a witch-doctor by today’s standards).

Although there are some not great things about these changes, people with infectious diseases stopped dying in the home, where other family members were likely to catch the same.

Going Forward

Tuberculosis is steadily making a comeback in the US, and mainstream medicine isn’t really prepared. What few antibiotics still work at treating it are often too harsh in and of themselves and not really a great option—especially those most at risk, the very young and very old.

Flu is predicted to make another huge comeback. Scientists have closely been watching things like bird flu and swine flu, both shocking because we’ve grown used to influenza being a survivable disease—but what is feared is such a serious strain moving on a faster scale (it takes a year or two for flu shots to be prepared, and so there’s a bit of a gamble in predicting which strains will hit, and in hoping there’s no new ones).

100 years ago, Tuberculosis killed more than either heart disease or cancer. It’s hard to imagine that happening again, but short of a breakthrough in antibiotics, we may see infectious disease become a major killer again in our lifetimes.

And if that’s the case, how much will our breakthroughs against cancer and other long term disease matter?

What do you think the future of dying looks like? Share your thoughts below!

Comments on this entry are closed.

Previous post:

Next post: