I have chosen to develop the basic structure of an idea to improve healthcare outcomes and decrease healthcare costs by giving people a personal relationship with death within a predictive and
preventive context. What follows is the outline of a curriculum pilot project to be submitted to a website such as revolution health and used as a public resource. It aims to decrease the incidence of
the major causes of death in the USA. As a self-guided 15-month program of local discussion groups it is divided by cause of death into chapters. Each chapter is introduced by web based basic
information with additional readings and visual media. Groups would convene on a bi-weekly basis for a two-hour potluck dialogue. Additional tasks are suggested to improve health skills or assess
health status. A final project would consist of a personal death narrative based on self-identified risk factors. In a for-credit environment additional requirements might be keeping behavioral
journals of health promotion practices and volunteer activity in healthcare settings such as hospital, hospice or assisted living facilities.
The inspiration behind this project lies in the statistics of healthcare expenditure. In the USA not only do we spend more per capita on healthcare than other developed nations (and in many cases
experience worse outcomes) but 50% of the healthcare dollar is spent by 5% of the population. Generally the members of this group will be dead within two years. This is not to say we should not value
this time in those lives. It is to raise the question of what we buy with this expenditure and whether, through a greater personal understanding of the causes and process, we might make better choices
in our lives and in our deaths. We have an extraordinary ability to intervene to keep people alive (though the impact of those interventions is in itself a significant cause of death) and at the same
time ignore the less ill or the behavioral foundations of illness. In addition the end stage is too often fraught with fear, struggle and technological interventions that bring dubious returns on the
investment of time, energy and money that might be spent on increasing the health of the entire population. The implications of this information are not only personal but political as we are apt in
many cases to direct our resources to the more dramatic threats that present themselves and ignore the day to day realities that have far greater impact.
The Death Risk Tutorial
The following tutorial is designed to reduce your risk of death. Granted, overall your risk of death is 100% and nothing you do will change that, but the information linked to here will help you to
understand and avoid (to the extent possible) the most common causes of death in the USA. Listed are text and visual media that cover the top ten plus a couple of others that will be in the top ten at
some time in YOUR lifespan. Yes, we are talking about you, though you may have some exotic demise planned, the odds say one of the following will play an intimate part in your departure. To complete
the tutorial, review the material (statistical, web, readings and video) and discuss it with your friends and loved ones, or at least those you.d like to keep around. The following will cover not only
the causes of death but also the act itself (based on the idea that it is good to plan ahead) and seek to impart that this is a not only a an inevitable occurrence but a natural one.
Form a group, (social support is good for your health) and together read the texts and see the films, which are divided by cause of death into 14 sections and a fifteenth to share your personal death
narrative based on one of the sections. In other words; after visiting real age and the eons calculator pick a likely cause. What does that look like for you personally? Every other week meet and
dialogue for a couple of hours over a healthy potluck meal. For .extra credit. consider keeping a journal of health promotion practices and volunteer activity in healthcare settings such as hospitals,
hospice or assisted living facilities.
For a basic understanding of your death risk:
http://www.realage.com
https://calculator.eons.com/calculator/disclaimer
For a basic understanding of the causes search for each chapter heading at:
http://en.wikipedia.org
http://medlineplus.gov
http://www.wrongdiagnosis.com
| Death in the United States (2002) | Total % per 100,000 |
| All causes | 2,443,387 | 100.0 | 847.3 |
| 1 Diseases of heart | 696,947 | 28.5241.7 |
| 2 Malignant neoplasms | 557,271 | 22.8 | 193.2 |
| 3 Cerebrovascular diseases | 162,672 | 6.7 | 56.4 |
| 4 Chronic lower respiratory diseases | 124,816 | 5.1 | 43.3 |
| 5 Accidents(unintentional injuries) | 106,742 | 4.4 | 37.0 |
| 6 Diabetes mellitus | 73,249 | 3.0 | 25. |
| 7 Influenza and pneumonia | 73,249 | 3.0 | 25.4 |
| 8 Alzheimer.s disease | 65,681 | 2.7 | 22.8 |
| 9 Nephritis, nephritic syndrome and nephrosis | 58,866 | 2.4 | 20.4 |
| 10 Septicemia | 33,865 | 1.4 | 11.7 |
| All other causes (Residual) | 522,304 | 21.4 | 181.1 |
| | | |
I. Accidents Age 1-4 #1 1,641 33.8%
Calculated Risks: How to Know When Numbers Deceive You
By Gerd Gigerenzer
Trois couleurs: Bleu
Krzysztof Kieslowski
Take a driving lesson
Causes of Accidental Death All Ages
| 1 Total Number of Deaths | 97,900 | 100% |
| 2 Motor Vehicle | 43,354 | 44.3% |
| 3 Unspecified non-transport accidents | 17,437 | 17.8% |
| 4 Falls | 13,322 | 13.6% |
| 5 Poisoning and Noxious Substances | 12,757 | 13.0% |
| 6 Drowning | 3,842 | 3.9% |
| 7 Exposure to Smoke, Fire, Flames | 3,377 | 3.4% |
| 8 Other Land Transport Accidents | 1,492 | 1.5% |
| 9 Complications of Medical Care | 3,059 | 3.1% |
| 10 Accidental Discharge of Firearms | 776 | 0.8% |
II.Genetics Age 1-4 #2 530 10.9%
Genetics Home Reference Handbook
http://ghr.nlm.nih.gov/handbook
A question of Genes: Inherited Risk
PBS
Visit a genetic counselor
All races, both sexes, 1.4 years | Total | % | per 100,000 |
| All causes | 4,858 | 100.0 | 31.2 |
| 1 Accidents (unintentional injuries) | 1,641 | 33.8 | 10.5 |
| 2 Congenital abnormalities | 530 | 10.9 | 3.4 |
| 3 Assault (homicide) | 423 | 8.7 | 2.7 |
| 4 Malignant neoplasms | 402 | 8.3 | 2.6 |
| 5 Diseases of heart | 165 | 3.4 | 1.1 |
| 6 Influenza and pneumonia | 110 | 2.3 | 0.7 |
| 7 Septicemia | 79 | 1.6 | 0.5 |
| 8 Chronic lower respiratory diseases | 65 | 1.3 | 0.4 |
| 9 Certain conditions originating in the perinatal period | 65 | 1.3 | 0.4 |
| 10 Neoplasms | 60 | 1.2 | 0.4 |
| All other causes (Residual) | 1,318 | 27.1 | 8.5 |
III. Infection Age 5-9 #s 7&9 80 2.7%
Good Germs, Bad Germs: Health and Survival in a Bacterial World
Jessica Snyder Sachs
Outbreak
Director: Wolfgang Petersen
Practice washing your hands.
All races, both sexes, 5.9 years | Total | % | per 100,000 |
| All causes | 3,018 | 100.0 | 15.2 |
| 1 Accidents (unintentional injuries) | 1,176 | 39.0 | 5.9 |
| 2 Malignant neoplasms | 537 | 17.8 | 2.7 |
| 3 Congenital abnormalities | 199 | 6.6 | 1.0 |
| 4 Assault (homicide) | 140 | 4.6 | 0.7 |
| 5 Diseases of heart | 92 | 3.0 | 0.5 |
| 6 Neoplasms | 44 | 1.5 | 0.2 |
| 7 Septicemia | 42 | 1.4 | 0.2 |
| 8 Chronic lower respiratory | 41 | 1.4 | 0.2 |
| 9 Influenza and pneumonia | 38 | 1.3 | 0.2 |
| 10 Cerebrovascular diseases | 33 | 1.1 | 0.2 |
| All other causes (Residual) | 676 | 22.4 | 3.4 |
IV. Cancer Age 10-14 #2 535 12.9%
Cancer Made Me a Shallower Person: A Memoir in Comics
By Miriam Engelberg
Bearing Witness: Jocelyn Morton
By Dan Curtis
Get a fecal occult blood test, learn how to do breast or testicular self exams.
All races, both sexes, 10.14 years | Total | % per 100,000 |
| All causes | 4,132 | 100.0 | 19.5 |
| 1 Accidents (unintentional injuries) | 1,542 | 37.3 | 7.3 |
| 2 Malignant neoplasms | 535 | 12.9 | 2.5 |
| 3 Intentional self-harm (suicide) | 260 | 6.3 | 1.2 |
| 4 Congenital abnormalities | 218 | 5.3 | 1.0 |
| 5 Assault (homicide) | 216 | 5.2 | 1.0 |
| 6 Diseases of heart | 163 | 3.9 | 0.8 |
| 7 Chronic lower respiratory diseases | 95 | 2.3 | 0.4 |
| 8 Cerebrovascular diseases | 58 | 1.4 | 0.3 |
| 9 Septicemia | 53 | 1.3 | 0.3 |
| 9 Influenza and pneumonia | 53 | 1.3 | 0.3 |
| All other causes (Residual) | 939 | 22.7 | 4.4 |
V. Suicide Age 15-19 #3 1,513 11%
Night Falls Fast: Understanding Suicide
by Kay Redfield Jamison
The Choice of a Lifetime Returning from the Brink of Suicide.
A New Day film by Nila Bogue
Spend some time with a friend.
All races, both sexes, 15.19 years| Total | % per 100,000 |
| All causes | 13,812 | 100.0 | 67.8 |
| 1 Accidents (unintentional injuries) | 7,137 | 51.7 | 35.0 |
| 2 Assault (homicide) | 1,892 | 13.7 | 9.3 |
| 3 Intentional self-harm (suicide) | 1,513 | 11.0 | 7.4 |
| 4 Malignant neoplasms | 723 | 5.2 | 3.5 |
| 5 Diseases of heart | 405 | 2.9 | 2.0 |
| 6 Congenital abnormalities | 248 | 1.8 | 1.2 |
| 7 Chronic lower respiratory diseases | 93 | 0.7 | 0.5 |
| 8 Influenza and pneumonia | 75 | 0.5 | 0.4 |
| 9 Diabetes mellitus | 55 | 0.4 | 0.3 |
| 10 Cerebrovascular diseases | 53 | 0.4 | 0.3 |
| All other causes (Residual) | 1,618 | 11.7 | 7.9 |
VI. Homicide 20-24 #2 3,327 17.3%
Homicide
by Leonard Beeghley
Tough Guise: Media Images and The Crisis in
Masculinity
Media Education Foundation Distributor
If you have guns, lock them up.
| All races, both sexes, 20.24 years | Total | % per 100,000 |
| All causes | 19,234 | 100.0 | 95.2 |
| 1 Accidents (unintentional injuries) | 8,275 | 43.0 | 40.9 |
| 2 Assault (homicide) | 3,327 | 17.3 | 16.5 |
| 3 Intentional self-harm (suicide) | 2,497 | 13.0 | 12.4 |
| 4 Malignant neoplasms | 1,007 | 5.2 | 5.0 |
| 5 Diseases of heart | 617 | 3.2 | 3.1 |
| 6 Congenital abnormalities | 244 | 1.3 | 1.2 |
| 7 Human immunodeficiency virus (HIV) | 140 | 0.7 | 0.7 |
| 8 Cerebrovascular diseases | 118 | 0.6 | 0.6 |
| 9 Diabetes mellitus | 116 | 0.6 | 0.6 |
| 10 Chronic lower respiratory diseases | 99 | 0.5 | 0.5 |
| All other causes (Residual) | 2,794 | 14.5 | 13.8 |
VII. AIDS 25-34 #6 1,839
Aids in America (2006 Edition)
by Susan Hunter
Common Threads - Stories from the Quilt (1989)
Director: Rob Epstein, Jeffrey Friedman
Know your HIV status and practice safe sex.
| All races, both sexes, 25-34 years | Total | % per 100,000 |
| All causes | 41,355 | 100.0 | 103.6 |
| 1 Accidents (unintentional injuries) | 12,569 | 30.4 | 31.5 |
| 2 Intentional self-harm (suicide) | 5,046 | 12.2 | 12.6 |
| 3 Assault (homicide) | 4,489 | 10.9 | 11.2 |
| 4 Malignant neoplasms | 3,872 | 9.4 | 9.7 |
| 5 Diseases of heart | 3,165 | 7.7 | 7.9 |
| 6 Human immunodeficiency virus (HIV) | 1,839 | 4.4 | 4.6 |
| 7 Diabetes mellitus | 642 | 1.6 | 1.6 |
| 8 Cerebrovascular diseases | 567 | 1.4 | 1.4 |
| 9 Congenital abnormalities | 475 | 1.1 | 1.2 |
| 10 Chronic liver disease and cirrhosis | 374 | 0.9 |
.
| All other causes (Residual) | 8,317 | 20.1 | 20.8 |
VIII. Heart Disease 35-44 #3 13,688 4.4%
Nutrition and Heart Disease: Causation and Prevention
By Ronald Ross Watson, Victor R. Preedy
The Heart Attack Video
http://www.nhlbi.nih.gov/actintime/video.htm
Get your cholesterol and C Reactive Protein checked.
| All races, both sexes, 35-44 years | Total | % per 100,000 |
| All causes | 91,140 | 100.0 | 202.9 |
| 1 Accidents (unintentional injuries) | 16,710 | 18.3 | 37.2 |
| 2 Malignant neoplasms | 16,085 | 17.6 | 35.8 |
| 3 Diseases of heart | 13,688 | 15.0 | 30.5 |
| 4 Intentional self-harm (suicide) | 6,851 | 7.5 | 15.3 |
| 5 Human immunodeficiency virus (HIV) | 5,707 | 6.3 | 12.7 |
| 6 Assault (homicide) | 3,239 | 3.6 | 7.2 |
| 7 Chronic liver disease and cirrhosis | 3,154 | 3.5 | 7.0 |
| 8 Cerebrovascular diseases | 2,425 | 2.7 | 5.4 |
| 9 Diabetes mellitus | 2,164 | 2.4 | 4.8 |
| 10 Chronic Lower Respiratory Disease | 1,008 | 1.1 | 2.2 |
| All other causes (Residual) | 20,109 | 22.1 | 44.8 |
IX. Liver Disease 45-54 #s 4 & 10 9,541 5.6%
The Liver Disorders Sourcebook
by Howard J Worman
Addiction
HBO Films
Get your liver enzymes checked.
| All races, both sexes, 45-54 years | Total | % per 100,000 |
| All causes | 172,385 | 100.0 | 430.1 |
| 1 Malignant neoplasms | 49,637 | 28.8 | 93.7 |
| 2 Diseases of heart | 37,570 | 21.8 | 93.7 |
| 3 Accidents (unintentional injuries) | 14,675 | 8.5 | 36.6 |
| 4 Chronic liver disease and cirrhosis | 7,216 | 4.2 | 18.0 |
| 5 Intentional self-harm (suicide) | 6,308 | 3.7 | 15.7 |
| 6 Cerebrovascular diseases | 6,055 | 3.5 | 15.1 |
| 7 Diabetes mellitus | 5,496 | 3.2 | 13.7 |
| 8 Human immunodeficiency virus (HIV) | 4,474 | 2.6 | 11.2 |
| 9 Chronic Lower Respiratory Disease | 3,475 | 2.0 | 8.7 |
| 10 Viral Hepatitis | 2,331 | 1.4 | 5.8 |
| All other causes (Residual) | 35,148 | 20.4 | 87.7 |
X. Diabetes 55-64 #4 10,022 4%
The China Study: The Most Comprehensive Study of Nutrition Ever Conducted and the Startling Implications for Diet, Weight Loss and Long-term Health
by Thomas M., II Campbell
The Weight of Obesity....a balanced reality
By Mickey Freeman
Know your BMI and get your glycosylated hemoglobin checked.
| All races, both sexes, 55-64 years | Total | % per 100,000 |
| All causes | 253,342 | 100.0 | 952.4 |
| 1 Malignant neoplasms | 93,389 | 36.9 | 351.1 |
| 2 Diseases of heart | 64,234 | 25.4 | 241.5 |
| 3 Chronic Lower Respiratory Disease | 11,280 | 4.5 | 42.4 |
| 4 Diabetes mellitus | 10,022 | 4.0 | 37.7 |
| 5 Cerebrovascular diseases | 9,897 | 3.9 | 37.2 |
| 6 Accidents (unintentional injuries) | 8,345 | 3.3 | 31.4 |
| 7 Chronic liver disease and cirrhosis | 6,097 | 2.4 | 22.9 |
| 8 Intentional self-harm (suicide) | 3,618 | 1.4 | 13.6 |
| 9 Nephritis, nephrotic syndrome and nephrosis | 3,455 | 1.4 | 13.0 |
| 10 Septicemia | 3,360 | 1.3 | 12.6 |
| All other causes (Residual) | 39,643 | 15.6 | 149.0 |
XI. Cerebrovascular Disease 65+ #3 143,293 7.9%
High Blood Pressure for Dummies
by Alan L. Rubin
Elisabeth Kübler-Ross: Facing Death
A Film by Stefan Haupt
Get your blood pressure checked.
| All races, both sexes, 65+ years | Total | % per 100,000 |
| All causes | 1,811,720 | 100.0 | 5,088.8 |
| 1 Diseases of heart | 576,301 | 31.8 | 1,618.7 |
| 2 Malignant neoplasms | 391,001 | 21.6 | 1,098.3 |
| 3 Cerebrovascular diseases | 143,293 | 7.9 | 402.5 |
| 4 Chronic Lower Respiratory Disease | 108,313 | 6.0 | 304.2 |
| 5 Influenza and pneumonia | 58,826 | 3.2 | 165.2 |
| 6 Alzheimer.s disease | 58,289 | 3.2 | 163.7 |
| 7 Diabetes mellitus | 54,715 | 3.0 | 153.7 |
| 8 Nephritis, nephrotic syndrome and nephrosis | 34,316 | 1.9 | 96.4 |
| 9 Accidents (unintentional injuries) | 33,641 | 1.9 |
| 10 Septicemia | 26,670 | 1.5 | 74.9 |
| All other causes (Residual) | 326,355 | 18.0 | 916.7 |
XII. Chronic Lower Respiratory Disease 65-74 #3 29,788 7%
And a Time to Die: How American Hospitals Shape the End of Life
by Sharon R Kaufman
To Live Until I Die
By Jay Shefsky
Stop smoking, actively and passively.
| All races, both sexes, 65-74 years | Total | % per 100,000 |
| All causes | 422,990 | 100.0 | 2,314.7 |
| 1 Malignant neoplasms | 144,757 | 34.2 | 792.1 |
| 2 Diseases of heart | 112,547 | 26.6 | 615.9 |
| 3 Chronic Lower Respiratory Disease | 29,788 | 7.0 | 163.0 |
| 4 Cerebrovascular diseases | 21,992 | 5.2 | 120.3 |
| 5 Diabetes mellitus | 16,709 | 4.0 | 91.4 |
| 6 Accidents (unintentional injuries) | 8,086 | 1.9 | 44.2 |
| 7 Nephritis, nephrotic syndrome and nephrosis | 7,164 | 1.7 | 39.2 |
| 8 Influenza and pneumonia | 6,847 | 1.6 | 37.5 |
| 9 Septicemia | 6,336 | 1.5 | 34.7 |
| 10 Chronic liver disease and cirrhosis | 5,381 | 1.3 | 29.4 |
| All other causes (Residual) | 63,383 | 15.0 | 346.8 |
XIII. Nephrotic Disease 75-84 #8 13,896 2%
Unplugged: Reclaiming Our Right to Die in America
by William Colby
The Vanishing Line
A Film by Maren Monsen
Drink half an ounce of water for every pound of body weight every day.
| All races, both sexes, 75.84 years | Total | % per 100,000 |
| All causes | 707,654 | 100.0 | 5,556.9 |
| 1 Diseases of heart | | 213,581 | 30.2 | 1,677.2 |
| 2 Malignant neoplasms | | 167,062 | 23.6 | 1,311.9 |
| 3 Cerebrovascular diseases | | 54,889 | 7.8 | 431.0 |
| 4 Chronic lower respiratory diseases | | 49,241 | 7.0 | 386.7 |
| 5 Diabetes mellitus | | 23,282 | 3.3 | 182.8 |
| 6 Alzheimer.s disease | | 20,135 | 2.8 | 158.1 |
| 7 Influenza and pneumonia | | 19,984 | 2.8 | 156.9 |
| 8 Nephritis, nephrotic syndrome and nephrosis | | 13,896 | 2.0 | 109.1 |
| 9 Accidents (unintentional injuries) | | 12,904 | 1.8 | 101.3 |
| 10 Septicemia | | 11,010 | 1.6 | 86.5 |
| All other causes (Residual) | 121,670 | 17.2 | 955.4 |
XIV. Alzheimer.s Disease 85+ #4 34,552 5.1%
The Forgetting: Alzheimer's, Portrait of an Epidemic
by David Shenk
Death on Request
A Video by Maarten Nederhorst
Learn something new.
| All races, both sexes, 85 years and over | Total | % per 100,000 |
| All causes | 681,076 | 100.0 | 14,828.3 |
| 1 Diseases of heart | 250,173 | 36.7 | 5,446.8 |
| 2 Malignant neoplasms | 79,182 | 11.6 | 1,723.9 |
| 3 Cerebrovascular diseases | | 66,412 | 9.8 | 1,445.9 |
| 4 Alzheimer.s disease | | 34,552 | 5.1 | 752.3 |
| 5 Influenza and pneumonia | | 31,995 | 4.7 | 696.6 |
| 6 Chronic lower respiratory diseases | | 29,284 | 4.3 | 637.6 |
| 7 Diabetes mellitus | | 14,724 | 2.2 | 320.6 |
| 8 Nephritis, nephrotic syndrome and nephrosis | | 13,256 | 1.9 | 288.6 |
| 9 Accidents (unintentional injuries) | | 12,651 | 1.9 | 275.4 |
| 10 Septicemia | 9,324 | 1.4 | 203.0 All other causes (Residual) | 139,523 | 20.5 | 3,037.7 |
XV. Conclusion 100%
How We Die: Reflections on Life's Final Chapter
by Sherwin B Nuland
The Ballad of Narayama
A Film by Shohei Imamura
Share your personal death narrative.
Visit the online risk assessment tools again to gauge the benefit of your studies.
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