Birthdays as a source of excess mortality: cause of death composition
Abstract
Problem statement. Previously it was shown that in Russia and in the world, holidays are accompanied by an increase in mortality, mainly at Christmas and New Year’s. But what about diagnoses of the excess mortality due to birthday celebrations?
Material and methods. To assess this, the data of 16.77 million deaths from 01/01/2011 to 12/31/2019 were examined for a possible correlation between birth and death dates. In all cases, the dates of birth and death were given the number of the day of the year. If these numbers coincided, the death case was assigned a value of 0, and if they did not - the number of days of the difference with the birthday before or after this day, from ± 1 to ± 182. This procedure was performed both for mortality in general and for 6 large classes of deaths and 8 types of external causes. Excess deaths on birthdays were estimated using the LOWESS moving average (locally weighted polynomial regression), which described non-holiday mortality, and on holidays its breaks were filled with linear regression, which served as an indicator of “natural” non-holiday mortality on holidays.
Results. A significant increase in birthday mortality was revealed (4.0 thousand per day for 9 years), and the total excess death rate associated with birthdays was 19.7 thousand, or 3.5% of "natural" mortality. The main contribution to excess mortality was made by diseases of the circulatory system (9.1 thousand) and external causes (5.2 thousand), and among external causes, by suicide (1.3 thousand), alcohol poisoning (1.0 thousand) and injuries with undetermined intent (0.8 thousand). Excess deaths on birthdays were proportional to non-holiday deaths, with the exception of alcohol poisoning, which was twice the expected number of deaths. The peculiarity of suicides is that the increase in their number begins two months before the birthday, with a maximum at 35 days, followed by a decrease and a sharp increase on the birthday. Further suicide mortality is cyclical, with peaks at 7 and 15 days after the birthday. Comparison with other holidays showed that birthdays, in terms of excess mortality, occupy an intermediate position between the New Year and other public holidays. The main factor in excess mortality on holidays is the abuse of strong alcoholic beverages.
Conclusion. Birthday celebrations, like public holidays, are accompanied by an increase in mortality. Furthermore, it is easy to assume that the loss is not limited to mortality: there are many more people who fall ill on their birthday than those who die on the occasion.
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References
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