Circulatory clue
On 26 November, i posted a little quiz on Bluesky, with screenshots of Visidata (Pwanson 2024) showing year intervals during which a certain epidemiological property held for female and male populations (Pettersson 2024). The tables are also available on this site, as tab-delimited files for female and male populations. I asked about the property they show.
The answer is that they show the first and last, or latest, year, and total number of years, with mortality statistics available via WHO (2024a), for which at least 50 percent of deaths among females or males, over all ages, have circulatory disease as underlying cause of death. To avoid fluctuations caused by small populations, in microstates and other territories in the WHO statistics, only years with at least 200 total deaths for each sex have been included.
Circulatory deaths are defined according to the expressions in the Mortintl.jl counfiguration, i.e. mostly the circulatory chapter in the different ICD versions, plus cerebrovascular diseases, which were included in the neurological chapter in ICD-6/7, as they will be again in ICD-11 (WHO 2024b).
The tables show patterns similar to the ones I discussed earlier, e.g. in my posts 27 March 2022 and 19 July 2022. In general, having at least 50 percent deaths ascribed to circulatory disease, has been more common among females, despite females having lower risk for early circulatory death than males in most populations.
The earliest statistics available via WHO (2024a) is from 1950, and at that time, populations in the Anglosphere, such as US, Australia, New Zealand, England and Wales and Scotland, had the property for at least their female populations, and Nordic countries soon followed. However, in most of these countries, the period ended in the 1980s. Sweden was relatively late, with 1991 and 1994 as last years for males and females. The last European non ex-Communist countries having it for at least their female populations were Austria and Germany (partially former East Germany, however) in 2003, and Greece in 2008. Most of the countries with end years later than 2000 are former Eastern Bloc countries in Eastern Europe or Central Asia, and some Middle East and North African countries, such as Syria and Egypt. It should be noted that the availability of statistics via WHO (2024a) is very sparse for many countries, especially in Africa.
These developments could be interpreted partially as a story of rising
and falling mortality from circulatory diseases, due to medical advances
and environmental factors. But, as I have touched on in my earlier
posts, they probably, above all, tell us a story about changing views of
what we accept as causes of death, as discussed by Reid (2024). Rich
countries in the Anglosphere were quick to largely dismiss causes like
old age
during the 20th Century, which led to circulatory diseases,
often referring to arteriosclerosis, dominating age-related mortality
instead (Kohn 1982). But later, these countries, with their ageing
populations, were also quick in perceiving also these practices as too
rough, which has led to increasing shares of deaths attributed to other
causes, such as dementia, and the, for the Western countries, typical
late 20th Century pattern, with a high proportion of circulatory deaths,
nowadays being most common in middle-income countries. The mentioned
changes in ICD-11, where stroke and other cerebrovascular diseases are
separated from heart disease and merged together with dementia, may be
seen in light of these changed perceptions.