Postponement of death until symbolically meaningful occasions

Article Abstract:

Epidemiological studies rarely investigate medical aspects of positive events in people's lives, being more occupied with such events as job loss, divorce, or death. However, one study showed that Jewish mortality fell just before Passover and rose by an equal amount right afterward. Non-Jewish groups showed no such fluctuation during the same time. To replicate these results, deaths in another cultural group, the Chinese in the United States, were studied. The Harvest Moon Festival (HMF), a Chinese holiday, met the study's criteria of having great interest for the group studied, but little interest to other groups, which can serve as controls; and the event occurs at different times each year, making it possible to separate results of the holiday from monthly fluctuations in mortality. During the HMF, a ceremonial meal is celebrated and the family gathers. It is a more popular holiday among older people and, in fact, the role of older women is especially important. This allows comparison of mortality for older and younger women. Computerized death records for all Chinese dying in California from 1960 through 1984 were examined. Records for Jews, and for a random sample of two percent of all deaths in California, made up two control groups. Deaths during a 24-week period centered on the holiday were counted and expected mortality was calculated for the period during which the holiday fell. Results for Chinese women 75 years old or more showed a steep drop in the week before the HMF (33 deaths occurred, whereas almost 51 were expected), with a sharp rise after the holiday (instead of an expected 52 deaths, 70 occurred). The similar size of the dip and the peak suggests that the holiday causes a brief postponement of death until it is over. Neither control group showed such a dip or a peak, nor was the effect found for old Chinese men or young Chinese women. This result parallels the finding in previous work among Jews, where Jewish men are the main ceremonial figures during Passover. For Chinese women in the current study, the dip/peak ratio is greatest for those dying of cerebrovascular disease, next largest for heart disease, and next for cancer. The same rankings held for Jewish men in the earlier study. Alternative explanations are discussed, and rejected, in favor of the interpretation that people can delay death briefly until after an important occasion. The results provide a challenge for researchers on several levels, including the importance of taking into account such cultural events when designing short-term studies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Festivals, Chinese Americans

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Learning to deal with death

Article Abstract:

One of the major steps in medical education, and in the practice of medicine, is learning to deal with death. This includes the physician's own feelings as well as those of the patient and patient's family. All too often medical students and residents who become intimately involved with families pass the obligation of informing families and friends that a patient has died to older attending physicians who have had infrequent meetings with the bereaved. As medical students, these young men and women often must face death earlier than their peers. Medicine is inseparably joined to death and the dying. In time, and with experience, death frequently is viewed as a needed friend. Students must proceed to make death easier for the patient and to develop the integrity to communicate honestly and humanely with the family of the deceased.

Medical ethics, Medical education

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An increase in the number of deaths in the United States in the first week of the month: an association with substance abuse and other causes of death

Article Abstract:

More people die in the first week of a month than in the last week of a month. Researchers examined death records from 1973 to 1988, and found that there were about 1% more deaths in the first seven days of the month than in the last seven days of the previous month. There were about 14% more deaths from substance abuse, accidents, suicide, and homicide in the first week compared to the last week, amounting to 4,320 more first-week deaths per year. One factor may be the greater availability of money at the beginning of the month, facilitating drug use and other behaviors.

United States, Causes of, Demographic aspects

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