Death comes in many ways. Most hope to quietly die at a ripe old age in their sleep—a life well lived until the end. It’s time.

Statistically, most die differently. Chronic degenerative disease is the most common cause of death.  External causes (falls, traffic accidents, poisonings, violence, drownings, suicides, etc.) claim most other lives.

The reality is most premature deaths are preventable. While the grim reaper has the final say, there are choices we can make throughout our lives to minimise the probability of not seeing our 100^th birthday.

Knowing these choices and which habits to form to prevent premature death is what is called avoidance.

When We Die

Life expectancy is based on an estimate of the average age members of a particular population group will be when they die. In 1800, the global average was 29 years. By 1950, it had increased to 46 years, with wide disparities amongst different parts of the world.

In 2015, life expectancy had increased to 71 years. This was largely due to increased lifespan in developing countries with improvements in sanitation infrastructure and a significant reduction in infant mortality (from Our World in Data).

In the past 60 years, all-gender life expectancy in Canada and the US has increased from 71.1 to 82.8 years and 69.8 to 78.5 years respectively. Australia and New Zealand closely resemble Canada’s Top 10 ranking. The UK and Ireland both rank around the Top 20. The US has continually declined, now sitting in a rather dismal 34th place.

That means more than one half of all deaths in 2017 were people younger than 70. That’s over 28 million people who died too young. Avoidance can help reduce this number in the future.

How We Die

US Top 15 Causes of Death

Today, most die from chronic degenerative disease. Heart disease is #1. Cancer, injuries from accidents, lung disease, and stroke round off the top five.

Look back 100 years and the causes were dramatically different.

From 1915 to 1945, infections were the leading cause of death, period. At virtually every age. For both sexes.

From 1955 to 1995 for males, heart disease took over as the #1 killer.  Motor vehicle deaths were the leading cause of death for men under the age of 30. Cancers, motor vehicle deaths, and heart disease became the most common reasons for women to die.

Jump to 2015 we get a different picture. Death by car accident dramatically decreases. In men, heart disease is prominent, but less so than in the 20^th century. Cancer is now leading in five age groups. And external causes—drug misuse, suicides, and self-harm—kill more men between the ages of 15 and 44 than anything else. For women, it’s cancer across the board, except external causes lead the way in the 15 – 29 age group.

A Century of Death

In the past 100 years, we have seen a near eradication of infectious disease (pre-COVID, of course). A significant reduction in car accident death can be attributed to safer vehicles and highways. Heart disease has been on the decline on a per capita basis—but is still the #1 killer of both sexes.

In analysing the top 50 causes of death today in both Canada and the US, we see the staggering impact of death by chronic degenerative disease. Numbers in Australia, New Zealand, and the UK are remarkably similar:

Chronic Degenerative Disease and Avoidance

As evidenced above, the main causes of death are much different today than 100 years ago. Infectious diseases like tuberculosis and pneumonia, leading killers a century ago, don’t kill us today. Chronic degenerative disease does.

As seen in Table 1, over 86% of the top 50 causes of death today are due to chronic degenerative disease. These are diseases that manifest in the body for years, sometimes decades. Some are the result of genetics and predispositions. But much more often, they are the result of lifestyle choices and the realities of modern society.

In the US, 6 in 10 adults have a chronic disease—4 in 10 adults have two or more. Why the dramatic change in 100 years despite massive investment in medical science?

Chronic disease may not be 100% preventable for anyone—if you live long enough, something is going to get you. But lifestyle choices can determine how soon chronic disease will strike.

Who’ll Live Longer?

Answer a simple question. Two men the same age. One is a life-time smoker, avid beer drinker with a poor diet, 80 lbs (36 kg) overweight, and hasn’t exercised since he was a teenager. The other has maintained his high school weight, exercises regularly, has never smoked, and watches what he eats.

Who is more likely to acquire a chronic disease? A heart condition? Cancer? Diabetes? COPD?

While there are always exceptions, the answer will almost always be the same.

Three Factors Leading to Chronic Disease

Consider the three factors most responsible for the prevalence of chronic disease.

1. Lifestyle Choices

First, the most obvious. Lifestyle choices greatly impact our health, for better or for worse. And all are of our choosing. To paraphrase Shakespeare: “To exercise or not to exercise? To eat well or not eat well? Those are the questions.”

The great thing about most developed countries in the world is the freedom of choice. The bad thing about those same countries is that same freedom of choice.

Be careful what choices you make. Once they become habits, they can shape your life—and in the case of health-related choices—either prematurely end it or prolong it.

Avoidance is choosing not to adopt those habits that lead to chronic disease and making lifestyle choices that will lead to a healthy lifespan.

2. The Environment

Second is our environment. We live in a chemical-filled world. Yes, many chemicals have improved the quality of our lives. But with so many chemicals, most untested for their effects on humans, we are barraged with them daily.

Chemicals are in so much of what we use or consume every day. They are in our foods and our personal care products. In the air we breathe and the water we drink. Household cleaning products and construction materials are filled with toxic chemicals. Often, the air in our own homes is more toxic than the air outdoors in LA on a bad smog day.

The Cumulative Effect and Avoidance

While exposure to most chemicals at any one time is insignificant, the operative word here is accumulation.  The cumulative effect of all these exposures every day for years is what builds up levels of toxicity in our bodies that can result in disease.

An example is endocrine disruptors. Found everywhere—personal care products, plastics, pesticides, canned foods, even ATM receipts—they are thought to be the reason for the concerning fall in sperm counts and decline in egg quality in human reproductive systems.

Avoidance is being vigilant about what we eat, drink, breathe, and expose ourselves to every day. It’s a tough job because toxins have become so prevalent in the world today. But every anti-ager needs to practice this every day.

3. Society Today

The third factor is the radical societal changes over the past 100 years. While science has relegated infectious disease far down the list of causes of death, the massive shift in the way we live today has helped give rise to chronic disease.

Work is much more sedentary than it was even a generation ago. Sitting hunched over a computer screen has replaced  jobs requiring physical labour and movement. Surrounded 24/7 by Wi-Fi, cell phone signals, and other electromagnetic fields (EMFs) has untold effects the human body.

A generation ago, kids played outside every day. They walked to school and played at recess and after school. Today it’s rides from Mom and Xbox.

The Quick Fix and Avoidance

We’ve become obsessed with the quick fix. Fast food instead of home-cooked meals. Six-pack abs in two weeks. Diagnosed with high cholesterol? Don’t change your lifestyle—jump on Lipitor. For the rest of your life.

If we live long enough, most will encounter and die from a chronic degenerative disease. Or several. But too many die from heart attacks, strokes, and cancers too young. Many more suffer and experience poor quality of life in their later years because of chronic conditions. The trappings of the modern world are a significant contributing factor.

It doesn’t have to be this way. Avoidance of premature death by disease comes primarily from knowledge that translates into good lifestyle choices. It’s never too late to start.

Avoidance of Death by External Causes

If death by chronic disease can at least be postponed through lifestyle change, many deaths by external causes can be downright avoided.

While death by each different type of external cause is a small contributor to overall mortality, bundled together, they are the #3 cause of death in the US.

So much of it is senseless and preventable. In most cases, avoidance is simple common sense.

Car Accident

Think of the drunk driver hitting a tree, killed on impact. Or falling off a roof and dying while cleaning out eavestroughs. Or a couple in their 80’s succumbing to a fire from food forgotten on the kitchen stove.

Last month, a couple in their fifties died in an ice fishing shack on the river a mile from our house. An improperly vented heater killed them with carbon monoxide poisoning. Tragic yet so preventable.

The Prevalence of Senseless Death

Examining the 10 Leading Causes of Death by Age Group (US – 2017), it’s astounding the prevalence of senseless death by external causes. Unintentional injury (motor vehicle accidents, falls, poisonings), homicide, and suicide claim too many before their time. A high percentage could be prevented by adopting an avoidance mindset.

To make it to your “golden years”, you must first pass through early and middle adulthood. This is where so many preventable deaths occur. Numbers from the US are most available (see Table 2; World Life Expectancy):

Causes of Death in Early to Middle Years

Avoidance Strategies for Death by External Causes

How can avoidance help with death by external causes?

Be present. Be focused when driving. Most vehicle fatalities are caused by drivers intoxicated, texting, or speeding. Never do this. Ever.

Poisoning is a leading cause of death. Don’t use recreational drugs. Minimise the use of prescription medications, a growing cause of self-inflicted death.

If you have suicidal thoughts, talk to someone. Get help. Don’t suffer alone.

Pay attention to danger in your surroundings. Whether using power tools, working from heights, walking on a snowy sidewalk, or spending a day out on a boat. Wear a helmet when cycling or on an ATV. Recognise danger in parts of a city with which you are unfamiliar. Be safe.

Don’t become a senseless death statistic.

Avoidance and the Anti-Ager

Avoidance of the Grim Reaper

We know the inevitability of death. It comes round for us all.

The expression, ‘Memento mori’, is held in high regard in stoic philosophy.  Literally, it means “Remember you must die”.

That doesn’t mean death is invited for a premature visit.

It’s meant to remind us of the preciousness of life.  Every moment we have on this planet should be lived to the fullest because it could be snatched away from us in a heartbeat.

While we don’t have a fixed departure date, the anti-ager will do everything in his power to minimise the probability of an early demise.

Practising avoidance is one such strategy. An essential one in the pursuit of a long and healthy life.