By Matthew C. Klein / Bloomberg View / April 17, 2014

How Americans Die

The mortality rate fell by about 17 percent from 1968 through 2010, years for which we have detailed data.

Almost all of this improvement can be attributed to improved survival prospects for men.

It looks like progress stopped in the mid-1990s…

…but that’s only because the population has aged a lot since then.

This has a big effect on the overall mortality rate, because old people die sooner than the young.

If you divide the population into separate age cohorts, you can see that improvements in life expectancy have been broad-based and ongoing.

Looking at mortality for each age cohort since 1968, we see that Americans under 25 have made the most progress.

But one line in this chart looks unusual! Look at the mortality rate for people aged 25-44.

What caused the surge in mortality for 25- to 44-year-olds?

AIDS, which at its peak, killed more than 40,000 Americans a year (more than 30,000 of whom were 25 to 44 years old).

(Slowing infection rates and better treatment eventually allowed many of those with the virus to survive into their 50s and 60s)

For a few years, AIDS was the single biggest killer of Americans who should otherwise have been in the prime of their lives.

Although AIDS was one of the biggest killers of people in the 25-44 age cohort — especially black men — it left most other Americans alone.

Another oddity is that Americans aged 45-54 have made surprisingly little progress in mortality since the late-1990s.

This is particularly striking since cancer and heart disease — the two biggest killers for 45- to 54-year-olds — have become much less deadly over the years.

While 45- to 54-year-olds are less likely to die from disease, they have become much more likely to commit suicide or die from drugs.

And, how do suicide and drugs compare to other violent deaths across the population?

Far greater than firearm related deaths, and on the rise.

Cars, generally killing younger people, have decreased in prevalence.

While suicide, by contrast, doesn’t discriminate much by age and has recently become the number one violent cause of death.

In general, though, most Americans are living longer and dying of natural causes. About a third of all deaths are people 85 and older.

The downside to living so long is that it dramatically increases the odds of getting dementia or Alzheimer’s.

That’s why total deaths in the 75+ category has stayed constant despite impressive reductions in the propensity to die of heart disease.

The rise of Alzheimer’s and other forms of dementia has had a big impact on health-care costs because these diseases kill their victims slowly.

About 40 percent of the total increase in Medicare spending since 2011 can be attributed to greater spending on Alzheimer’s treatment.

(We don’t have reliable data on Alzheimer’s spending before that.)

Overall, though, the share of U.S. health-care spending going toward nursing and retirement homes has declined slightly since 2000 and has been flat since 2006.

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GRAPHIC: Jeremy Scott Diamond / Bloomberg Visual Data